Original Article

J Korean Hip Soc 2009; 21(2): 180-188

Published online June 1, 2009

© The Korean Hip Society

Effect of a Trochanter-stabilizing Plate in Unstable Intertrochanteric Fractures - A Clinical and Biomechanical Study -

Tae Ho Kim, MD, Jong Oh Kim, MD, Jeong Ho Seo, MD

Department of Orthopedic Surgery, Mokdong Hospital, Ewha Woman’s University, School of Medicine, Seoul, Korea

Correspondence to : Jong Oh Kim, MD
Department of Orthopedic Surgery, Mokdong Hospital, Ewha Woman’s University School of Medicine, Korea, 911-1, Mok-dong, Yangcheon-gu, Seoul 158-710, Korea
TEL: +82-2-2650-5276 FAX: +82-2-2642-0349
E-mail: ewhamdos@korea.com

• 본 논문의 요지는 2008년도 대한고관절학회 춘계학술대회에서 발표되었음.

Received: January 15, 2009; Revised: March 23, 2009; Accepted: May 22, 2009

Abstract

Purpose: To evaluate the effectiveness of a trochanter-stabilizing plate (TSP) for the treatment of unstable intertrochanteric fractures.
Materials and Methods: In the clinical aspect of the study, 48 patients who were treated surgically for unstable intertrochanteric fractures were evaluated. One group of patients was treated with CHS [spell out with 1st use] only (group 1, n=23) and the other group was treated with CHS and TSP (group 2, n=25). In the biomechanical aspect of the study, an AO type A2.2 intertrochanteric fracture was reproduced in 10 proximal femur models. Five models were reduced and fixed using CHS only (group 1) and 5 models were fixed using CHS with TSP (group 2). A load of 750 N (300 cycles) was applied using Instron.
Results: In the clinical aspect of the study, the extent of lag screw sliding, greater trochanter lateralization, and neck-shaft angle varus change was less in group 2 than in group 1. In the biomechanical aspect of the study, the extent of lag screw sliding was less in group 2 than in group 1, but the neck-shaft angle varus change was greater in group 2 than in group 1.
Conclusion: The use of TSP is effective for the buttress effect on the proximal fragment. It decreases the excessive sliding of the lag screw, lateral displacement of the greater trochanter, and neck-shaft angle varus change. Therefore, TSP may be a useful treatment for unstable intertrochanteric fractures.

Keywords Femur, Intertrochanteric fracture, Compression hip screw, Trochanter stabilizing plate

Article

Original Article

J Korean Hip Soc 2009; 21(2): 180-188

Published online June 1, 2009 https://doi.org/10.5371/jkhs.2009.21.2.180

Copyright © The Korean Hip Society.

Effect of a Trochanter-stabilizing Plate in Unstable Intertrochanteric Fractures - A Clinical and Biomechanical Study -

Tae Ho Kim, MD, Jong Oh Kim, MD, Jeong Ho Seo, MD

Department of Orthopedic Surgery, Mokdong Hospital, Ewha Woman’s University, School of Medicine, Seoul, Korea

Correspondence to:Jong Oh Kim, MD
Department of Orthopedic Surgery, Mokdong Hospital, Ewha Woman’s University School of Medicine, Korea, 911-1, Mok-dong, Yangcheon-gu, Seoul 158-710, Korea
TEL: +82-2-2650-5276 FAX: +82-2-2642-0349
E-mail: ewhamdos@korea.com

• 본 논문의 요지는 2008년도 대한고관절학회 춘계학술대회에서 발표되었음.

Received: January 15, 2009; Revised: March 23, 2009; Accepted: May 22, 2009

Abstract

Purpose: To evaluate the effectiveness of a trochanter-stabilizing plate (TSP) for the treatment of unstable intertrochanteric fractures.
Materials and Methods: In the clinical aspect of the study, 48 patients who were treated surgically for unstable intertrochanteric fractures were evaluated. One group of patients was treated with CHS [spell out with 1st use] only (group 1, n=23) and the other group was treated with CHS and TSP (group 2, n=25). In the biomechanical aspect of the study, an AO type A2.2 intertrochanteric fracture was reproduced in 10 proximal femur models. Five models were reduced and fixed using CHS only (group 1) and 5 models were fixed using CHS with TSP (group 2). A load of 750 N (300 cycles) was applied using Instron.
Results: In the clinical aspect of the study, the extent of lag screw sliding, greater trochanter lateralization, and neck-shaft angle varus change was less in group 2 than in group 1. In the biomechanical aspect of the study, the extent of lag screw sliding was less in group 2 than in group 1, but the neck-shaft angle varus change was greater in group 2 than in group 1.
Conclusion: The use of TSP is effective for the buttress effect on the proximal fragment. It decreases the excessive sliding of the lag screw, lateral displacement of the greater trochanter, and neck-shaft angle varus change. Therefore, TSP may be a useful treatment for unstable intertrochanteric fractures.

Keywords: Femur, Intertrochanteric fracture, Compression hip screw, Trochanter stabilizing plate

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

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