Original Article

J Korean Hip Soc 2007; 19(1): 58-63

Published online March 1, 2007

© The Korean Hip Society

대전자 부위의 골절을 동반한 불안정 대퇴 전자간 골절 치료에 있어 전자부 안정화 금속판의 유용성을 높이는 방법 - 강선 및 나사를 이용한 대전자부 고정 -

김주학∙박재형∙김형수∙정수태∙유정현∙차승도∙박상준∙조주원

관동대학교 의과대학 명지병원 정형외과학교실

Methods to Increase the Effectiveness of Trochanteric Stabilizing Plate for Unstable Femoral Intertrochanteric Fractures with Gtreater Trochanteric Fracture - Fixation of Greater Trochanter with Wire and Screw -

Joo-Hak Kim, M.D., Jai-Hyung Park, M.D., Hyung-Soo Kim, M.D., Soo-Tai Chung, M.D., Jeong-Hyun Yoo, M.D., Seung-Do Cha, M.D., Sang-Joon Park, M.D., Joo-Won Joh, M.D.

Department of Orthopaedic Surgery, Kwandong University, College of Medicine

Correspondence to : 박재형
경기도 고양시 덕양구 화정동 697-24 관동대학교 의과대학 명지병원 정형외과학교실
Tel: 82-31-810-5520
Fax: 82-31-810-6537
E-mail: wonnypia@hanmail.net

* 본 논문의 요지는 2006년 제 50차 대한정형외과학회 추계학술대회에서 발표되었음.

Abstract

Purpose: The clinical outcome is favorable for the treatment of unstable femoral intertrochanteric fractures using both dynamic hip screw (DHS) and trochanter stabilizing plate (TSP) in elderly patients. However, there are sometimes complications related to excessive sliding. Therefore, the aim of this study was to evaluate the value of additional fixation of greater trochanter using wires and screw in the unstable femoral intertrochanteric fractures with a greater trochanter fracture.
Materials and Methods: From March 2004 through December 2005, thirty-seven patients, who were more than sixty-five years of age and were diagnosed with osteoporosis, were treated with DHS and TSP in unstable femoral intertrochanteric fractures with a follow-up of more than 6 months (mean duration, 13.5 months). The patients were divided into two groups. One group (group A: 20 patients) was treated with DHS and TSP only, whereas the other (group B: 17 patients) was treated with DHS and TSP augmented by a wire and screw. The average age was 80.9 (range 68 to 89) and 83.2 years (range 72 to 91) in groups A and B, respectively. All the patients in both groups were assessed radiographically immediately after surgery and at the last follow-up. The level of sliding of the lag screw and displacement of the greater trochanter were evaluated statistically.
Results: Bony union was achieved in all cases except for two cases in group A. At the last follow-up, the average of lag screw sliding in groups A and B was 8.96±5.98mm and 4.80±3.68, respectively, showing a statistical difference (P value<0.05). The average greater trochnateric displacement in groups A and B was 2.06±2.86mm and 0.99±1.41mm, respectively, showing no statistical significance (P value > 0.05).
Conclusion: Unstable femoral intertrochanteric fractures can be treated successfully using a hip screw and TSP alone. However, the addition of wires and screws in the greater trochanter can prevent excessive sliding that occurs after displacing the greater trochanteric fragments out of the plate in the presence of a greater trochanteric fracture line or severe bone defect in the lateral aspect.

Keywords Unstable femoral intertrochanteric fracture, Fracture of greater trochanter, DHS, TSP

Article

Original Article

J Korean Hip Soc 2007; 19(1): 58-63

Published online March 1, 2007 https://doi.org/10.5371/jkhs.2007.19.1.58

Copyright © The Korean Hip Society.

대전자 부위의 골절을 동반한 불안정 대퇴 전자간 골절 치료에 있어 전자부 안정화 금속판의 유용성을 높이는 방법 - 강선 및 나사를 이용한 대전자부 고정 -

김주학∙박재형∙김형수∙정수태∙유정현∙차승도∙박상준∙조주원

관동대학교 의과대학 명지병원 정형외과학교실

Methods to Increase the Effectiveness of Trochanteric Stabilizing Plate for Unstable Femoral Intertrochanteric Fractures with Gtreater Trochanteric Fracture - Fixation of Greater Trochanter with Wire and Screw -

Joo-Hak Kim, M.D., Jai-Hyung Park, M.D., Hyung-Soo Kim, M.D., Soo-Tai Chung, M.D., Jeong-Hyun Yoo, M.D., Seung-Do Cha, M.D., Sang-Joon Park, M.D., Joo-Won Joh, M.D.

Department of Orthopaedic Surgery, Kwandong University, College of Medicine

Correspondence to:박재형
경기도 고양시 덕양구 화정동 697-24 관동대학교 의과대학 명지병원 정형외과학교실
Tel: 82-31-810-5520
Fax: 82-31-810-6537
E-mail: wonnypia@hanmail.net

* 본 논문의 요지는 2006년 제 50차 대한정형외과학회 추계학술대회에서 발표되었음.

Abstract

Purpose: The clinical outcome is favorable for the treatment of unstable femoral intertrochanteric fractures using both dynamic hip screw (DHS) and trochanter stabilizing plate (TSP) in elderly patients. However, there are sometimes complications related to excessive sliding. Therefore, the aim of this study was to evaluate the value of additional fixation of greater trochanter using wires and screw in the unstable femoral intertrochanteric fractures with a greater trochanter fracture.
Materials and Methods: From March 2004 through December 2005, thirty-seven patients, who were more than sixty-five years of age and were diagnosed with osteoporosis, were treated with DHS and TSP in unstable femoral intertrochanteric fractures with a follow-up of more than 6 months (mean duration, 13.5 months). The patients were divided into two groups. One group (group A: 20 patients) was treated with DHS and TSP only, whereas the other (group B: 17 patients) was treated with DHS and TSP augmented by a wire and screw. The average age was 80.9 (range 68 to 89) and 83.2 years (range 72 to 91) in groups A and B, respectively. All the patients in both groups were assessed radiographically immediately after surgery and at the last follow-up. The level of sliding of the lag screw and displacement of the greater trochanter were evaluated statistically.
Results: Bony union was achieved in all cases except for two cases in group A. At the last follow-up, the average of lag screw sliding in groups A and B was 8.96±5.98mm and 4.80±3.68, respectively, showing a statistical difference (P value<0.05). The average greater trochnateric displacement in groups A and B was 2.06±2.86mm and 0.99±1.41mm, respectively, showing no statistical significance (P value > 0.05).
Conclusion: Unstable femoral intertrochanteric fractures can be treated successfully using a hip screw and TSP alone. However, the addition of wires and screws in the greater trochanter can prevent excessive sliding that occurs after displacing the greater trochanteric fragments out of the plate in the presence of a greater trochanteric fracture line or severe bone defect in the lateral aspect.

Keywords: Unstable femoral intertrochanteric fracture, Fracture of greater trochanter, DHS, TSP

H&P
Vol.36 No.1 Mar 01, 2024, pp. 1~75

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