Original Article

J Korean Hip Soc 2007; 19(1): 51-57

Published online March 1, 2007

© The Korean Hip Society

고도의 불안정성 대퇴골 전자부 골절에 대한 치료

성열보∙안종국∙염재광∙정형진∙신용운∙이상림∙성기혁

인제대학교 의과대학 상계백병원 정형외과학교실

Treatment of Highly Unstable Trochanteric Fractures

Yerl-Bo Sung, M.D., Jong-Kuk Ahn, M.D., Jae-Kwang Yum, M.D., Hyung-Jin Chung, M.D., Yong-Woon Shin, M.D., Sang-Lim Lee, M.D., Ki-Hyuk Sung, M.D.

Department of Orthopaedic Surgery, Sang-Gye Paik Hospital, College of Medicine, Inje University, Seoul, Korea

Correspondence to : 안종국
서울특별시 노원구 상계 7동 761-1 인제대학교 의과대학 상계백병원 정형외과학교실
Tel: 82-2-950-1032
Fax: 82-2-934-6342
E-mail: jkahn@sanggyepaik.ac.kr

* 본 논문의 요지는 2006년도 대한정형외과학회 추계학술대회에서 발표되었음.
* 본 논문은 2005년도 인제대학교 학술연구조성비 보조에 의한 것임 (This work was supported by the 2005 Inje University Research Grant.).

Abstract

Purpose: This study analyzed the treatment results of highly unstable trochanteric fractures and made treatment guidelines.
Materials and Methods: Among three hundred six cases of trochanteric fractures from October 2001 to February 2006, the patients were divided into group 1(highly unstable trochanteric fracture, 69 cases) and group 2(age and gender-matched control group, 70 cases). The two groups were compared clinically and radiologically. A highly unstable trochanteric was defined as a fracture with a neck-shaft angle < 100° and anterior angulation. The mean follow-up duration in groups 1 and 2 was 13.2 and 15.5 months, respectively. The mean neck-shaft angle in groups 1 and 2 was 92.1° and 118.9°, respectively. The mean anterior angulation in groups 1 and 2 was 23.0° and 4.6°.
Results: In group 1, 39 cases were treated with a dynamic hip screw (DHS), 22 cases were treated with a proximal femoral nail (PFN), and 8 cases(11.6%) were treated with primary bipolar hemiarthroplasty. The average amount of sliding of the lag screw in groups 1 and 2 was 10.5 mm and 3.7 mm, respectively (p<0.05). The average change in the neck-shaft angle in groups 1 and 2 was 7.0° 1 and 2.1°, respectively (p<0.05). There were 7 complications in group 1, including 5 cutting-out, 1 back-out and 1 Z-effect, and 2 cases of cutting-out in group 2.
Conclusion: A highly unstable trochanteric fracture has a high risk of the need for additional surgery. Therefore, considerable care should be taken to treat it with a consideration of the possible need for arthroplasty.

Keywords Trochanteric fracture, Highly unstable, Neck-shaft angle, Anterior angulation

Article

Original Article

J Korean Hip Soc 2007; 19(1): 51-57

Published online March 1, 2007 https://doi.org/10.5371/jkhs.2007.19.1.51

Copyright © The Korean Hip Society.

고도의 불안정성 대퇴골 전자부 골절에 대한 치료

성열보∙안종국∙염재광∙정형진∙신용운∙이상림∙성기혁

인제대학교 의과대학 상계백병원 정형외과학교실

Treatment of Highly Unstable Trochanteric Fractures

Yerl-Bo Sung, M.D., Jong-Kuk Ahn, M.D., Jae-Kwang Yum, M.D., Hyung-Jin Chung, M.D., Yong-Woon Shin, M.D., Sang-Lim Lee, M.D., Ki-Hyuk Sung, M.D.

Department of Orthopaedic Surgery, Sang-Gye Paik Hospital, College of Medicine, Inje University, Seoul, Korea

Correspondence to:안종국
서울특별시 노원구 상계 7동 761-1 인제대학교 의과대학 상계백병원 정형외과학교실
Tel: 82-2-950-1032
Fax: 82-2-934-6342
E-mail: jkahn@sanggyepaik.ac.kr

* 본 논문의 요지는 2006년도 대한정형외과학회 추계학술대회에서 발표되었음.
* 본 논문은 2005년도 인제대학교 학술연구조성비 보조에 의한 것임 (This work was supported by the 2005 Inje University Research Grant.).

Abstract

Purpose: This study analyzed the treatment results of highly unstable trochanteric fractures and made treatment guidelines.
Materials and Methods: Among three hundred six cases of trochanteric fractures from October 2001 to February 2006, the patients were divided into group 1(highly unstable trochanteric fracture, 69 cases) and group 2(age and gender-matched control group, 70 cases). The two groups were compared clinically and radiologically. A highly unstable trochanteric was defined as a fracture with a neck-shaft angle < 100° and anterior angulation. The mean follow-up duration in groups 1 and 2 was 13.2 and 15.5 months, respectively. The mean neck-shaft angle in groups 1 and 2 was 92.1° and 118.9°, respectively. The mean anterior angulation in groups 1 and 2 was 23.0° and 4.6°.
Results: In group 1, 39 cases were treated with a dynamic hip screw (DHS), 22 cases were treated with a proximal femoral nail (PFN), and 8 cases(11.6%) were treated with primary bipolar hemiarthroplasty. The average amount of sliding of the lag screw in groups 1 and 2 was 10.5 mm and 3.7 mm, respectively (p<0.05). The average change in the neck-shaft angle in groups 1 and 2 was 7.0° 1 and 2.1°, respectively (p<0.05). There were 7 complications in group 1, including 5 cutting-out, 1 back-out and 1 Z-effect, and 2 cases of cutting-out in group 2.
Conclusion: A highly unstable trochanteric fracture has a high risk of the need for additional surgery. Therefore, considerable care should be taken to treat it with a consideration of the possible need for arthroplasty.

Keywords: Trochanteric fracture, Highly unstable, Neck-shaft angle, Anterior angulation

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