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The Neccessity of Additional Supporting Fixation for the Unstable Intertrochanteric Fractures of the Femur in the Elderly
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Hyoun Oh Cho, Kyoung Duck Kwak, Soo Min Sohn, Cheol Ho Kang, Seung Il Whang, Sang Min An, Do Young Lee
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J Korean Soc Fract 2001;14(1):23-29. Published online January 31, 2001
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DOI: https://doi.org/10.12671/jksf.2001.14.1.23
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 Abstract
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- PURPOSE
This study was designed to assess the necessity of additional supporting fixation to the traditional internal fixation for unstable intertrochanteric fractures of femur.
MATERIALS AND METHODS
Seventy two cases of unstable intertrochanteric fractures (modified Boyd-Anderson type III, IV) in the elderly were reviewed, which were internally fixed with Dynamic Hip Screw. 48 cases were treated with Dynamic Hip Screw only(Group I) and 24 cases with Dynamic Hip Screw and additional trochanteric supporting plate(Group II). In 13 cases with weak femoral cortx, we added wiring to the side plate. We measured neck-shaft angle, degrees of displacement of greater trochanteric fragment, slippage of hip screw on plain radiographs.
RESULTS
Varus change in neck-shaft angle, displacement of greater trochanteric fragment and slippage of hip screw revealed 7.3°, 5.4 mm, and 10.7 mm respectively in group I, while 2.1°, 0.1 mm and 3.8 mm respectively in group II. There were no pullout of cortical screws.
CONCLUSION
Internal fixation with additional trochanteric supporting plate to the conventional Dynamic Hip Screw was effective in unstable intertrochanteric fractures of the femur in the elderly. Added wiring to the side plate was also helpful in weak femoral cortex.
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Augmentative Plate Fixation for Femoral Nonunion after Intramedullary Nailing
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Hyoun Oh Cho, Kyoung Duck Kwak, Jong Jin Kim, Soo Min Sohn, Cheol Ho Kang, Hong Ju Lee
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J Korean Soc Fract 2000;13(4):825-831. Published online October 31, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.4.825
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Abstract
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- The purpose of this study is to evaluate the efficacy of augmentative plate fixation for the femoral nonunion after intramedullary nailing. We reviewed eleven femoral nonunion after intramedullary nailing, which were treated with augmentative plate internal fixation. All cases were initially managed with interlocking intramedullary nailing. Five were hypervascular and six were avascular. Leaving the intramedullay nail in situ, an augmentative plate fixation was applied to the fracture site to counter the rotational instability. A simultaneous bone grafting was performed in six avascular nonunion to repair the bony defect. The union time was 8.2 months in average( 7.8 months in hypervascular and 8.5 months in avascular). In conclusion, augmentative plating leaving the intramedullary nail in situ is an useful alternative for the treatment of femoral nonunion after intramedullary nailing. The technique is simple and does not require any special instruments. It facilitates an early weight bearing and gives a quick recovery from nonunion.
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Citations
Citations to this article as recorded by  - The Comparison of LC-DCP versus LCP Fixation in the Plate Augmentation for the Nonunion of Femur Shaft Fractures after Intramedullary Nail Fixation
Se Dong Kim, Oog Jin Sohn, Byung Hoon Kwack
Journal of the Korean Fracture Society.2008; 21(2): 117. CrossRef
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