Journal List > J Korean Soc Fract > v.5(1) > 1078032

Cho, Kwak, Cho, and Son: Trochanteric fractures of the femur pitfalls of the treatment withdynamic hip screw in elderly patients

Abstract

Among the many deyices available for the internal fixation of the trochanteric fractures of the femur, the sliding-screw plate method has gained considerable acceptance. However the procedure is demanding to be more delicate and skillfull, and its problems are not infrequent especially in the elderly patients with unstable fractures.
A retrospective study of roentgenograms and charts was made of the trochanteric fractures in the elderly treated with the Dynamic Hip Screw ; to investigate the relationships between the type of fracture, the type of reduction, the presence of osteoporosis, the implant position, and technical complications and re-operations.
The results were as follows
1. Technical complications occurred in 7 unstable cases(17.9%).
2. Complication rates were 14.3% in cases of medial reduction ; 21.5%, anatomical reduction ; and 50.O%, lateral reduction.
3. More unstable fractures and technical complications were noted in cases with osteoporosis.
4. Technical complications were more frequent in cases of the lag screw tip inserted into the superior portion of the femoral head.
5. Unstable fractures(mean ; 9.1mm) collapsed more than stable cases (mean ; 3.6mm).
6. The change ef nerk-shaft angle was most noticeable in unstable fractures with anatomic reduction.

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