Original Article

J Korean Hip Soc 2007; 19(3): 190-196

Published online September 1, 2007

© The Korean Hip Society

고령의 대퇴골 전자간 골절 치료에서 압박고 나사의 과도한 활강

주석규∙오형근∙김영철∙이동봉

인제대학교 의과대학 일산백병원 정형외과학교실

Excessive Sliding of Compression Hip Screw For the Treatment of Intertrochanteric Fracture in Elderly

Suk-Kyu Choo, M.D., Hyoung-Keun Oh, M.D., Young-Chul Kim, M.D., Dong-Bong Lee, M.D.

Department of Orthopedic Surgery, Inje University, Ilsan Paik Hospital, Koyang, Korea

Correspondence to : 오형근
경기도 고양시 일산서구 대화동 2240번지 인제대학교 의과대학 일산백병원 정형외과학교실
TEL: 82-31-910-7968
FAX: 82-31-910-7967
E-mail: medicos21@naver.com

* 본 연구는 2005년 인제 학술연구기금으로 연구함.

Abstract

Purpose: To analyze the cause of excessive sliding of a compression hip screw for the treatment of an intertrochanteric fracture in elderly patients.
Materials and Methods: 109 intertrochanteric fractures stabilized with a compression hip screw from January 2000 to December 2006 were analyzed. The lag screws that had slid for more than 15 mm were defined as excessive. The length and incidence of compression hip screw sliding, which were compared with the fracture type (AO classification), tip-apex distance (TAD), position of the lag screw in the femoral head, use of trochanteric stabilizing plate and displacement of lesser trochanter were analyzed.
Results: Fourteen out of 109 cases (13%) had slid more than 15 mm. In the AO classification, 3 out of 47 (6.4%) A1 fractures, 10 out of 59 (17%) A2 fractures, and 1 out of 3(33%) A3 fractures slid excessively. In patients with a displaced lesser trochanter fragment more than 10 mm, there were 9 cases (9/10) that slid excessively. Most of the lag screws (84 out of 109) were placed in zone 5, and 9(11%) of them had slid excessively. Five were placed in zone 2 and 4 (80%) had slid excessively. Five of the 18 with a tip-apex distance of 25 mm or more had slid excessively.
Conclusion: In A2 fractures, the size and displacement of the lesser trochanter fragment appears to be an important factor for excessive sliding. In addition, the position of the lag screw and TAD (Tip-Apex Distance) are factors for excessive sliding.

Keywords Intertrochanteric fracture, Excessive sliding, Compression hip screw

Article

Original Article

J Korean Hip Soc 2007; 19(3): 190-196

Published online September 1, 2007 https://doi.org/10.5371/jkhs.2007.19.3.190

Copyright © The Korean Hip Society.

고령의 대퇴골 전자간 골절 치료에서 압박고 나사의 과도한 활강

주석규∙오형근∙김영철∙이동봉

인제대학교 의과대학 일산백병원 정형외과학교실

Excessive Sliding of Compression Hip Screw For the Treatment of Intertrochanteric Fracture in Elderly

Suk-Kyu Choo, M.D., Hyoung-Keun Oh, M.D., Young-Chul Kim, M.D., Dong-Bong Lee, M.D.

Department of Orthopedic Surgery, Inje University, Ilsan Paik Hospital, Koyang, Korea

Correspondence to:오형근
경기도 고양시 일산서구 대화동 2240번지 인제대학교 의과대학 일산백병원 정형외과학교실
TEL: 82-31-910-7968
FAX: 82-31-910-7967
E-mail: medicos21@naver.com

* 본 연구는 2005년 인제 학술연구기금으로 연구함.

Abstract

Purpose: To analyze the cause of excessive sliding of a compression hip screw for the treatment of an intertrochanteric fracture in elderly patients.
Materials and Methods: 109 intertrochanteric fractures stabilized with a compression hip screw from January 2000 to December 2006 were analyzed. The lag screws that had slid for more than 15 mm were defined as excessive. The length and incidence of compression hip screw sliding, which were compared with the fracture type (AO classification), tip-apex distance (TAD), position of the lag screw in the femoral head, use of trochanteric stabilizing plate and displacement of lesser trochanter were analyzed.
Results: Fourteen out of 109 cases (13%) had slid more than 15 mm. In the AO classification, 3 out of 47 (6.4%) A1 fractures, 10 out of 59 (17%) A2 fractures, and 1 out of 3(33%) A3 fractures slid excessively. In patients with a displaced lesser trochanter fragment more than 10 mm, there were 9 cases (9/10) that slid excessively. Most of the lag screws (84 out of 109) were placed in zone 5, and 9(11%) of them had slid excessively. Five were placed in zone 2 and 4 (80%) had slid excessively. Five of the 18 with a tip-apex distance of 25 mm or more had slid excessively.
Conclusion: In A2 fractures, the size and displacement of the lesser trochanter fragment appears to be an important factor for excessive sliding. In addition, the position of the lag screw and TAD (Tip-Apex Distance) are factors for excessive sliding.

Keywords: Intertrochanteric fracture, Excessive sliding, Compression hip screw

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