Fixation of the Greater Trochanter in Arthroplasty for Unstable Intertrochnateric Fracture

Choi, Dong-Hyeok; Heo, Ju-Yeong; Jang, Young-Jae; Chung, Young-Yool

doi:10.12671/jkfs.2014.27.1.58

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…However, studies on the classification of greater trochanter (GT) fractures and fixation methods according to the type of GT fracture have been rarely performed. Here, we report a difference in the stability of the greater trochanteric fragment depending on the GT fracture types in our previous study13). For this reason, we hypothesized that bone fragments could be successfully fixed by choosing an appropriate fixation method according to fragment stability, and secondary surgery could be avoided by minimizing the risk of irritation in plate fixation.…”

Section: Introductionmentioning

confidence: 81%

“…We reported that the GT fracture fragments vary in shape and can be classified as different types in bipolar hemiarthroplasty used for intertrochanteric fractures of the femur13). Although a previous study identified a difference in radiographic outcomes according to the type of fractures, the study was limited because fixation methods were not selected based on the fracture type.…”

Section: Discussionmentioning

confidence: 99%

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Selecting Arthroplasty Fixation Approach Based on Greater Trochanter Fracture Type in Unstable Intertrochanteric Fractures

et al. 2019

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Purpose To evaluate the success rate of fixation approaches for greater trochanter (GT) fracture types in those with unstable intertrochnateric fractures. Materials and Methods Forty-four patients who underwent arthroplasty for unstable intertrochanteric fractures between January 2015 and November 2017 and followed-up more than six months were included in this study. The fractures of GT were classified into one of four types (i.e., A, B, C, and D) and fixed using either figure-8 wiring or cerclage wiring according to fracture type. Fractures were type A (n=7), type B (n=20), type C (n=6), and type D (n=11). Type A and B, which are fractures located above the inferior border of GT were fixed using figure-8 wiring and/or adding cerclage wiring. On the other hand, all type C and D fractures, which were located below the inferior border, were fixed using cerclage wiring. Fixation failure was defined as breakage of wire and progressive migration of GT fragment greater than 5 mm on follow-up radiographs. Results The most common GT fracture types were B and D, both of which are longitudinal fractures. The success rates of fixation were 85.7% (6 out of 7 cases) for the treatment of type A, 90.0% (18 out of 20 cases) for the treatment of type B, and 100% for the treatment of types C (6 out of 6 cases) and D (11 out of 11 cases). Conclusion We note high success rates following fixation methods were selected based on the GT fracture type.

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Section: Introductionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Selecting Arthroplasty Fixation Approach Based on Greater Trochanter Fracture Type in Unstable Intertrochanteric Fractures

et al. 2019

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“…Compared with other systems of fixation, the wiring technology provides low resistance to fatigue and breaking strength 20) . In addition, because there were differences in the pattern of fractures of trochanteric fragments and stability, a single system/configuration for holding the fragments was inadequate to support a favorable outcome 21) . A successful approach must include application of adequate compression at the fracture sites.…”

Section: Discussionmentioning

confidence: 99%

Primary Arthroplasty for Unstable and Failed Intertrochanteric Fractures: Role of Multi-Planar Trochanteric Wiring Technique

et al. 2023

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Purpose The primary objective of the current study is to demonstrate the trochanteric wiring technique. A secondary objective is to evaluate the clinico-radiological outcomes of use of the wiring technique during primary arthroplasty for treatment of unstable and failed intertrochanteric fractures. Materials and Methods A prospective study including follow-up of 127 patients with unstable and failed intertrochanteric fractures who underwent primary hip arthroplasty using novel multi-planar trochanteric wiring was conducted. The average follow-up period was 17.8±4.7 months. Clinical assessment was performed using the Harris hip score (HHS). Radiographic evaluation was performed for assessment of union of the trochanter and any mechanical failure. P <0.05 was considered statistically significant. Results At the latest follow-up, the mean HHS showed significant improvement from 79.9±1.8 (at three months) to 91.6±5.1 ( P <0.05). In addition, no significant difference in the HHS was observed between male and female patients ( P =0.29) and between fresh and failed intertrochanteric fractures ( P =0.08). Union was achieved in all cases of fractured trochanter, except one. Wire breakage was observed in three patients. There were five cases of limb length discrepancy, three cases of lurch, and three cases of wire-related bursitis. There were no cases of dislocation or infection. Radiographs showed stable prosthesis in situ with no evidence of subsidence. Conclusion Use of the proposed wiring technique was helpful in restoring the abductor level arm and multi-planar stability, which enabled better rehabilitation and resulted in excellent clinical and radiological outcomes with minimal risk of mechanical failure.

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Is rigid fixation of the greater trochanter necessary for arthroplasty of intertrochanteric fractures?

Lee¹,

Lee²,

Noh³

et al. 2019

Orthopaedics & Traumatology: Surgery & Research

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Fixation of the Greater Trochanter in Arthroplasty for Unstable Intertrochnateric Fracture

Cited by 4 publications

References 27 publications

Selecting Arthroplasty Fixation Approach Based on Greater Trochanter Fracture Type in Unstable Intertrochanteric Fractures

Selecting Arthroplasty Fixation Approach Based on Greater Trochanter Fracture Type in Unstable Intertrochanteric Fractures

Primary Arthroplasty for Unstable and Failed Intertrochanteric Fractures: Role of Multi-Planar Trochanteric Wiring Technique

Is rigid fixation of the greater trochanter necessary for arthroplasty of intertrochanteric fractures?

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