Treatment of Intertrochanteric Fractures Using the Compression Hip Nail

Abstract

PurposeTo investigate the clinical and radiologic outcomes following treatment of intertrochanteric fractures using the Compression Hip Nail® (CHN), which has a sliding lag screw.Materials and MethodsTwenty-eight cases of intertrochanteric fractures treated with CHN from November 2012 to October 2013 and followed-up for >6 months were included. The patient population consisted of 11 men and 17 women with a mean age of 75.2 years at the time of surgery. For the initial 11 cases, 10 mm sliding lag screws were used; the remaining 17 cases used 20 mm sliding lag screws. Clinical variables including operation time, amount of transfusion, weight-bearing start time, postoperative physical activity, and complications were investigated. The average sliding of lag screws and the average union were investigated radiologically at 3 and 6 months after surgery.ResultsIn an analysis of 23 cases (exclusion of 3 cases of lag screw cutout and 2 cases of nonunion), 11 (48%) recovered their pre-injury activity level. In an analysis of 25 cases (exclusion of 3 cases of cutout), 17 (68%) and 23 (92%) showed radiological union at postoperative months 3 and 6, respectively. Seven complications were noted. Cutout of the lag screw and the lateral protrusion of barrels were significantly greater in the group with 10 mm sliding lag screws as compared to the group using 20 mm sliding lag screws.ConclusionThe use of CHN for the treatment of intertrochanteric fracture yielded poor results. However, results from patients in the 20 mm sliding lag screw group were better than for the 10 mm sliding lag screw group. Therefore, use of the 20 mm sliding lag screw is advisable.

Local Postoperative Complications after Surgery for Intertrochanteric Fractures Using Cephalomedullary Nails

“…Choo et al 14) reported favorable outcomes of a controlled telescoping system for lateral hip pain relief in their study using Compression Hip Nail. Yi et al 17) reported a higher complication rate of Compression Hip Nail in cases using 10 mm sliding lag screw. However, long-term observational studies are insufficient to comprehensively assess cut-out and other postoperative complications after surgery using Compression Hip Nail.…”

Midterm Outcomes of Intramedullary Fixation of Intertrochanteric Femoral Fractures Using Compression Hip Nails: Radiologic and Clinical Results

“…In addition, a lag screw capable of sliding about 10–20 mm can promote the compressive healing of fracture sites. 15) Since the lateral part is diagonal, it can reduce the stimulation of lateral structures such as the iliotibial ligament. 15) In addition, no patient had lateral stimulation in the current study ( Fig.…”

“… 15) Since the lateral part is diagonal, it can reduce the stimulation of lateral structures such as the iliotibial ligament. 15) In addition, no patient had lateral stimulation in the current study ( Fig. 5 ).…”