Treatment of Intertrochanteric Fracture of the Femur Using a Dyna Locking Trochanteric (DLT) Nail

Yong-Sik Kim; Jae-Woong Yoon; Suk-Ku Han

doi:10.5371/jkhs.2010.22.3.216

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Kim, Yoon, and Han: Treatment of Intertrochanteric Fracture of the Femur Using a Dyna Locking Trochanteric (DLT) Nail

Original Article

The Journal of the Korean Hip Society

The Journal of the Korean Hip Society 2010; 22(3): 216-221.

Published online: 30 September 2010

DOI: https://doi.org/10.5371/jkhs.2010.22.3.216

Treatment of Intertrochanteric Fracture of the Femur Using a Dyna Locking Trochanteric (DLT) Nail

Yong-Sik Kim, MD^*, Jae-Woong Yoon, MD, Suk-Ku Han, MD

Department of Orthopaedic Surgery, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

^*Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Address reprint request to Suk-Ku Han, MD. Department of Orthopaedic Surgery, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, 620-56 Jeonnong 2-dong, Dongdaemun-gu, Seoul 130-709, Korea. TEL: +82-2-961-4503, FAX: +82-2-965-1456, hnsukku@catholic.ac.kr

Received 13 April 2010 Revised 28 September 2010 Accepted 30 September 2010

Abstract

Purpose

We analyzed the clinical and radiological results after treatment of intertrochanteric fracture of the femur using a Dyna locking trochanteric (DLT) nail.

Materials and Methods

From March 2008 to February 2009, 36 patients (10 males and 26 females) who had at least 6 months follow-up among 43 patients were included in our study. The average age of the patients was 76.4 years (range: 65~90 years) and the average follow-up period was 13.4 months (range: 9~21 months). We evaluated the radiological results such as the neck-shaft angle and the sliding length of the lag screw at last follow-up and the clinical results such as intraoperative complications, the operation time, the postoperative blood loss and the incidence of fixation failure.

Results

The average neck-shaft angle at last follow-up was 131.1 degrees and the average sliding length of lag screw was 3.6 mm. Two cases (5.6%) of femoral shaft fracture during the insertion of a lag screw or nail happened and one case of stress fracture of the femoral neck occurred. Two cases of fixation failure developed due to deep infection or varus angulation.

Conclusion

Fixation using a DLT nail can be a good option for the treatment of intertrochanteric fractures of the femur.

Keywords: Femur, Intertrochanteric fracture, Dyna locking trochanteric nail

Figures and Tables

Fig. 1

78 year-old female injured her right hip fracture by fall. (A) Initial radiograph showed comminuted intertrochanteric fracture with loss of lateral buttress (A3.3 AO/OTA). (B) The operation was performed with DLT nail fixation. (C) At 6 months after operation, the fracture was united.

Fig. 2

74 year-old male injured left intertrochanteric fracture (A1.1 AO/OTA). (A) Initial film showed a minimally displaced intertrochanteric fracture. (B) The fracture was fixed with DLT nail. (C) The radiograph at postoperative 6 months showed a sclerotic line at head-neck junction and healed state of intertrochanteric fracture. (D) Bone scans showed increased isotope uptake in left medial femoral neck and trochanter. (E) After removal of nail, a subcapital stress fracture was observed by computed tomography. (F) A bipolar hemiarthroplasty was performed at postoperative 7 months.

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