Classification and Treatment of Unstable Intertrochanteric Fracture according to the Existence of Posterior Fragment: Preliminary Report

Wang, Lih; Shon, Sung Keun; Lee, Kyu Yeol; Kim, Chul Hong; Lee, Myung Jin; Lee, Chul Won; Kim, Sung Soo

doi:10.12671/jkfs.2008.21.2.110

Cited by 2 publications

(1 citation statement)

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“…In the present cases, the presence of a fractured posterior part of the greater trochanter, which did not extend to the trochanteric ridge, was always observed. Wang et al 21) noted that the recognition of the posterior wall fragment of the greater trochanter area was an important predictive factor in the treatment of unstable intertrochanteric fractures. However, since the posterior part of the greater trochanter is not the major site for insertion of the hip abductors, the fixation of its posterior fragment not involving the trochanteric ridge area did not play an important role in fracture stability in this series.…”

Section: Discussionmentioning

confidence: 99%

Additional Fixations for Sliding Hip Screws in Treating Unstable Pertrochanteric Femoral Fractures (AO Type 31-A2): Short-Term Clinical Results

et al. 2011

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BackgroundTo evaluate the utility of additional fixation methods and to suggest a method of reduction in the treatment of unstable pertrochanteric femur fractures with a sliding hip screw (SHS).MethodsA retrospective study was performed on thirty patients with unstable pertrochanteric femur fractures, who were operated on with a SHS between September 2004 and September 2009 and were followed up for at least 6 months. The additional fixation devices were as follows; antirotation screw (21 cases), fixation of displaced fractures of the posteromedial bone fragment (cerclage wiring, 21 cases and screw, 2 cases) and trochanter stabilizing plate (27 cases). Clinically, the Palmer's mobility score and Jensen's social function group were used. Radiologically, alignment and displacement were observed. The tip-apex distance (TAD) and sliding of the lag screw were measured, and the position of the lag screw within the femoral head was also examined.ResultsThe mean age at the time of surgery was 76 years (range, 56 to 89 years) and the average follow-up period was 25 months (range, 6 to 48 months). At the last follow-up, the average mobility and social function score was 6.2 (± 3.5) and 2.3 (± 1.5). Postoperatively, the alignment and displacement indices were adequate in almost all the cases. The mean amount of lag screw sliding and the mean TAD was 5.1 mm (range, 2 to 16 mm) and 6 mm (range, 3 to 11 mm) respectively. The lag screws were located in the center-center zone in 21 cases. The average period to union was 18.7 weeks without any cases of nonunion or malunion. Mechanical failure was noted in one case with breakage of the lag screw and clinical failure was noted in another case with persistent hip pain related to excessive sliding (16 mm).ConclusionsWith additional fixations, the unstable pertrochanteric femur fractures could be well stabilized by SHS until bone union.

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Section: Discussionmentioning

confidence: 99%