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Surgical Treatment of Femoral Unstable Intertrochanteric Fractures in Elderly Patients: Comparative Study between Compressive Hip Screws and Additional Trochanteric Stabilizing Plates
Kap Jung Kim, Dae Suk Yang, Sang Ki Lee, Won Sik Choy, Kyoung Wan Bae
J Korean Fract Soc 2011;24(4):295-300.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.295
AbstractAbstract PDF
PURPOSE
To evaluate the radiologic results between compressive hip screw and compressive hip screw with additional trochanteric stabilizing plate in patients with femoral unstable intertrochanteric fractures in patients with more 65 years old.
MATERIALS AND METHODS
From 2006 to May 2009, 121 cases were included. Group I (compressive hip screw only) was 54 cases and group II (compressive hip screw with trochanteric stabilizing plate) was 67 cases. We checked the lag screw sliding, lateral translation of greater trochanter, changes of neck-shaft angle and complications through periodic follow up of radiographs.
RESULTS
Mean lag screw sliding was 7.6 mm in group I and 3.9 mm in group II (p=0.001). Mean lateral translation of greater trochanter was 3.86 mm in group I and 0.59 mm in group II (p=0.01). Mean changes of neck-shaft angle was nearly the same, 3.57degrees in group I and 3.66degrees in group II. Complications were 15 cases in group I and 10 cases in group II.
CONCLUSION
Compressive hip screw with additional trochanteric stabilizing plate was effective surgical option in patients with femoral unstable intertrochanteric fractures in patients with more than 65 years old. It decreased lag screw sliding, lateral translation of greater trochanter and complication rates.

Citations

Citations to this article as recorded by  
  • The Role of Beta-Tricalcium Phosphate Graft in the Dynamic Hip Screw Fixation of Unstable Intertrochanter Fracture
    Chul-Ho Kim, Ji Wan Kim, Eic Ju Lim, Jae Suk Chang
    Journal of the Korean Fracture Society.2016; 29(4): 250.     CrossRef
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The Results of Surgical Treatment of Intertrochanteric Fractures in the Elderly Patients Aged over 65 years : Comparative Study between Compression Hip Screw and Ender Nail Fixationt
Byeong Yeon Seong, Chang Min Lee, Dong Sung Park
J Korean Soc Fract 1999;12(4):802-811.   Published online October 31, 1999
DOI: https://doi.org/10.12671/jksf.1999.12.4.802
AbstractAbstract PDF
OBJECTIVES
: To analyse the comparative results of surgical treatment with compressive hip screw or Ender nail for intertrochanteric fracture in aged over 65 years. MATERIALS & METHODS : From June 1990 to December 1997, 39 of 55 patients who were operated with compression hip screw or Ender nailing and followed up for more than 1 year. A retrospective survey was completed for 39 intertrochanteric fractures which were operated with compressive hip screw(22 patients, Group 1) or Ender nail(17 patients, Group 2). There was an average follow up of 48 months, with a range of 12 to 84 months. Radiographic measurements were performed in aspects of osteoporosis and fracture classification. Clinical evaluation of follow up was measured as Clawsons evaluation according to the fracture claffification and types of fixation. 23 of 39 cases(59%) were unstable and 26 of 39 cases(66.6%) showed below grade III in osteoporosis. Age, cause of fracture, fracture classification, accompanying diseases and Singhs index were identical to both group.
RESULTS
The mean radiologic bone union period was 16.4 weeks. The rate of complication was 7 cases(31.8%) in group I and 8 cases(47.0%) in group II. The rate of mortality was 3 cases(13.6%) in group I and 3 cases(17.6%) in group II. Satisfactory rate was 20 of 22cases(90.9%) in group I and 14 of 17 cases(82.3%) in group II.
CONCLUSION
: We suppose that compressive hip screw fixation for the elderly over 65 years who had intertrochanteric fracture and medical problem, produced good results as comparing to Ender nail fixation. The clinical satisfactory rate were superior in the compressive hip screw group comparing to Ender nail group. Cement fixation for eldly could help to fixate more in compression hip screw.
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