Treatment of Unstable Intertrochanteric Fractures of the Femur Using an Anti-Hypersliding Compression Hip Screw and TSP

Myung-Rae Cho; Sang-Hwa Lee; Dae-Won Cho; Sang-Bong Ko

doi:10.5371/jkhs.2012.24.1.37

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Cho, Lee, Cho, and Ko: Treatment of Unstable Intertrochanteric Fractures of the Femur Using an Anti-Hypersliding Compression Hip Screw and TSP

Original Article

The Journal of the Korean Hip Society

The Journal of the Korean Hip Society 2012; 24(1): 37-44.

Published online: 31 March 2012

DOI: https://doi.org/10.5371/jkhs.2012.24.1.37

Treatment of Unstable Intertrochanteric Fractures of the Femur Using an Anti-Hypersliding Compression Hip Screw and TSP

Myung-Rae Cho, MD, Sang-Hwa Lee, MD, Dae-Won Cho, MD, Sang-Bong Ko, MD

Department of Orthopaedic Surgery, Catholic University of Daegu School of Medicine, Daegu, Korea.

Address reprint request to Myung-Rae Cho, MD. Department of Orthopaedic Surgery, Catholic University of Daegu School of Medicine, Daemyung 1 dong, Nam-gu, Daegu 705-718, Korea. TEL: +82-53-650-4270, FAX: +82-53-626-4272, cmr0426@cu.ac.kr

Received 2 May 2011 Revised 16 March 2012 Accepted 16 March 2012

Abstract

Purpose

This study evaluated the result of fixation of unstable intertrochanteric fractures using an anti-hypersliding compressive hip screw and a trochanter stabilizing plate.

Materials and Methods

One hundred patients with unstable intertrochanteric fractures who were given an anti-hypersliding compressive hip screw (Group A) or conventional compressive hip screw (Group B) were analyzed. The mean follow-up period was 23.5 months. Radiographic evaluation included the changes of neck-shaft angle, lateral displacement of proximal fragment, distal migration of the lag screw, fixation failure, and union time using plain radiographs taken at postoperative and last follow-up time.

Results

Lateral displacement of the proximal fragment averaged 1.62 mm in Group A and 3.97 mm in Group B, which was statistically significant (p<0.05). The neck-shaft angle was increased in Group B, but has no significance. The average of the Harris hip score and walking ability after surgery is higher in Group A than B, but there was no significant difference. The complication rate was significantly lower in Group A. But union time showed no difference in each group.

Conclusion

Anti-hypersliding compression hip screw with a TSP, which reduces sliding of the lag screw and extreme change of the moment arm, is a another good option for the treatment of intertrochanteric femoral fractures against an increase of the failure rate from the hypersliding of the lag screw.

Keywords: Femur, Intertrochanteric fracture, Anti-hypersliding compression hip screw

Figures and Tables

Fig. 1

Anti-hypersliding compression hip screw.

Fig. 2

Measurement of the TAD.

Fig. 3

Radiographic evaluation according to Doppelt's method of radiologic evaluation17). (A) Immediate postoperative radiographs. (B) Subsequent radiograph. Correction factor=B/b, the extent of sliding=A-a×B/b, the extent of lateral displacement=c-C×B/b.

Fig. 4

Antero-posterior X-ray of pelvis. (A) Immediate postoperative X-ray shows good reduction. (B) X-ray taken 2 years after operation demonstrates complete union of the fracture site.

Table 1

Comparative Data between Group A and Group B

Table 2

Evaluation of Walking Ability according to Ceder et al.19)(p=0.09)

Table 3

Complications after Surgery in Group A and B.

Table 4

Complications after Surgery in between Group A and B between with TSP.

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