Journal of Musculoskeletal Trauma

Comparative Study of Intertrochanteric Fracture Treated with the Proximal Femoral Nail Anti-Rotation and the Third Generation of Gamma Nail: Jae Cheon Sim, Tae Ho Kim, Ki Do Hong, Sung Sik Ha, Jong Seong Lee; J Korean Fract Soc 2013;26(1):37-43. Published online January 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.1.37

PURPOSE
To compare the result between the third generation gamma nail (gamma 3 nail) and proximal femoral nail anti-rotation (PFNA) in the treatment of unstable intertrochanteric fractures.
MATERIALS AND METHODS
Between March 2009 and June 2011, 47 consecutive patients with unstable intertrochanteric femoral fractures were treated with gamma 3 nail or PFNA. We reviewed 24 cases of gamma 3 nail and 23 cases of PFNA. Retrospectively, we evaluated the mean operation time, amount of bleeding, average union period, reduction status, change of neck shaft angle, Tip-apex distance, Cleveland index, sliding of lag screw and complication on set of telephone interview and outpatient. We also evaluated the postoperative capability of function and mobility, using 'Modified Koval index'.
RESULTS
There were no significant differences between the groups, which were treated with gamma 3 nail and PFNA. In addition, they did not show statistical difference. We experienced 2 cases of complication (gamma 3 nail 1 case, PFNA 1 case), which were cut-out of the femoral head.
CONCLUSION
The gamma 3 nail and PFNA were seen with good results in the treatment of unstable intertrochanteric fracture.

Citations

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Comparative analysis of operation time and intraoperative fluoroscopy time in intramedullary and extramedullary fixation of trochanteric fractures
Milan Mitkovic, Sasa Milenkovic, Ivan Micic, Predrag Stojiljkovic, Igor Kostic, Milorad Mitkovic
Vojnosanitetski pregled.2022; 79(2): 177. CrossRef
Does the Helical Blade Lead to Higher Rates of Fixation Failure as Compared to Lag Screw in the Cephalomedullary Nailing Treatment of Hip Fractures? A Systematic Review and Meta-Analysis
Chul-Ho Kim, Han Soul Kim, Yong-Chan Kim, Dou Hyun Moon
Journal of Orthopaedic Trauma.2021; 35(8): 401. CrossRef
The Curative Effect Comparison Between Prolonged Third Generation of Gamma Nail and Prolonged Dynamic Hip Screw Internal Fixation in Treating Femoral Intertrochanteric Fracture and the Effect on Infection
Wenye He, Wei Zhang
Cell Biochemistry and Biophysics.2015; 71(2): 695. CrossRef
Accuracy of the Lesser Trochanter for Guiding Lag Screw Insertion in Hip Fracture Management
Jianlin Xiao, Zhongli Gao, Yanguo Qin, Xuezhou Li, Ao Wang, Lanyu Zhu, Jincheng Wang
Orthopedics.2014;[Epub] CrossRef

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Helical Blade versus Lag Screw for Treatment of Intertrochanteric Fracture: Kwang Jun Oh, Sung Tae Lee, Suk Ha Lee, Jin Ho Hwang, Min Suk Kang; J Korean Fract Soc 2010;23(1):6-12. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.6

Abstract PDF

PURPOSE
To evaluate the radiographic and functional outcomes between who had unstable intertrochanteric fracture, treated with the ITST (lag screw design) and the PFNA (helical blade design).
MATERIALS AND METHODS
We selected each 17 and 13 patients of unstable intertrochanteric fracture which were treated with ITST or PFNA from April 2005 to December 2008. We evaluated the radiographic results by follow-up radiography and the clinical outcomes with the mobility score of Parker and Palmer, Social function scoring system.
RESULTS
The mean sliding distance of cervical screw with ITST nails was not shown significant differences than with using PFNA nails. The other factors were not statistically different. Decrease of mobility score of Parker and Palmer, Social function score were similar. 2 cases of cutting out was noted with ITST nails and 1 case of cutting out was noted with PFNA nails.
CONCLUSION
Unlike the existed biomechanical reposts, there are no differences that are clinical and radiological results in treatment of unstable intertrochanteric fracture using the ITST nails and PFNA nails.

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Does the Helical Blade Lead to Higher Rates of Fixation Failure as Compared to Lag Screw in the Cephalomedullary Nailing Treatment of Hip Fractures? A Systematic Review and Meta-Analysis
Chul-Ho Kim, Han Soul Kim, Yong-Chan Kim, Dou Hyun Moon
Journal of Orthopaedic Trauma.2021; 35(8): 401. CrossRef
Comparative Study of Intertrochanteric Fracture Treated with the Proximal Femoral Nail Anti-Rotation and the Third Generation of Gamma Nail
Jae-Cheon Sim, Tae-Ho Kim, Ki-Do Hong, Sung-Sik Ha, Jong-Seong Lee
Journal of the Korean Fracture Society.2013; 26(1): 37. CrossRef
Treatment of Intertrochanteric Fractures Using Targon Proximal Femoral Nails
Il Ho Park, Jong Kyoung Won, Kye Young Han
Hip & Pelvis.2012; 24(2): 117. CrossRef

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Posterior Hip Dislocation with Ipsilateral Fractures of the Femoral Head and Intertrochanter: A Case Report: Jai Hyung Park, Hyung Soo Kim, Soo Tae Chung, eong Hyun Yoo, Joo Hak Kim, Seung Do Cha, Tae Woo Lee; J Korean Fract Soc 2010;23(1):113-117. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.113

Abstract PDF

High-energy injury, as traffic accident or fall down, can cause fracture of femur head and posterior dislocation of hip joint which is accompanied with ipsilateral acetabulum fracture or femur neck fracture. But the case that femur head fracture and posterior dislocation of the hip joint coincide with ipsilateral intertrochanteric fracture of proximal femur is so uncommon that reports of the case is very rare. We hereby are to report the experienced and treated-cases of femur head fracture and posterior dislocation of the hip joint that is accompanied with ipsilateral intertrochanteric fracture.

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Decoding the behaviour of extracapsular proximal femur fracture- dislocation - A systematic review of a rare fracture pattern
Keyur B. Desai
Journal of Clinical Orthopaedics and Trauma.2021; 18: 157. CrossRef

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Comparison Study of Intertrochanteric Fractures Treated with Intertrochanteric/subtrochanteric Fixation with a Standard vs a Mini-incision: Se Dong Kim, Oog Jin Sohn, Jae Ho Cho; J Korean Fract Soc 2008;21(1):1-7. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.1

Abstract PDF

PURPOSE
To evaluate the radiographic, clinical results between who had intertrochnateric fracture, treated with ITST with a standard or a mini-incision.
MATERIALS AND METHODS
We selected each 20 patients of intertrochanteric fracture which were treated with ITST with a standard incision or a mini-incision from June 2004 to July 2006. We compared of mean operative time, transfusion doses and postoperative VAS score between two groups. We evaluated the radiographic results by follow-up radiography and the clinical results with the mobility score of Parker and Palmer and Salvati and Wilson hip function scoring system.
RESULTS
Mean operative time, transfusion doses and postoperative VAS score were significantly less in the mini-incision there were 87.8 min., 2.0 pints and 4.2 for the standard group versus 40.3 min., 1.1 pints and 3.3 for the mini group. The radiographic results were not significantly different. Decrease of mobility score of Parker and Palmer and Salvati and Wilson hip function scoring system were similar.
CONCLUSION
Mini-incision significantly reduces operative time, transfusion doses and postoperative pain for fixation intertrochanteric fracture treated with ITST.

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Treatment of the Intertrochanteric Femoral Fracture with Proximal Femoral Nail: Nailing Using the Provisional K-wire Fixation
Gu-Hee Jung
Journal of the Korean Fracture Society.2011; 24(3): 223. CrossRef

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A Comparative Study of Trochanteric Fractures Treated with the Intertrochanteric/subtrochanteric Fixation or the Proximal Femoral Nail: Oog Jin Sohn, Sae Dong Kim, In Whan Kim, Seong Joon Byun; J Korean Fract Soc 2006;19(3):303-308. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.303

Abstract

PURPOSE
To evaluate the radiographic, clinical results and the complications between who had intertrochanteric fracture, treated with the ITST or the PFN.
MATERIALS AND METHODS
We selected each 30 patients of intertrochanteric fracture which were treated with ITST or PFN from July 2002 to November 2005. We evaluated the radiographic results by follow-up radiography and the clinical results with the mobility score of Parker and Palmer, Salvati and Wilson hip function scoring system and Jensen index.
RESULTS
The mean distance of lag screw sliding was 4.1 mm at the ITST group and 6.6 mm at the PFN group. Decrease of mobility score of Parker and Palmer, Salvati and Wilson hip function score were similar. Patients complaint pain over lateral thigh area in 5 cases (ITST group) and 8 cases (PFN group).
CONCLUSION
The ITST nail and PFN were seen good results in treatment of stable and unstable intertrochanteric fracture.

Citations

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Treatment of Unstable Pertrochanteric Fractures with a Long Intramedullary Nail
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, Dae Jung Huh
Hip & Pelvis.2013; 25(1): 51. CrossRef
Minimally Invasive Plate Osteosynthesis of Subtrochanteric Femoral Fractures
Chang-Wug Oh
Journal of the Korean Fracture Society.2009; 22(2): 123. CrossRef
The Comparison between ITST™ (Intertrochanteric/Subtrochanteric) & DHS (Dynamic Hip Screw) in Unstable Femur Intertrochanteric Fracture
Ho-Seung Jeon, Byung-Mun Park, Kyung-Sub Song, Hyung-Gyu Kim, Jong-Ju Yun
Journal of the Korean Fracture Society.2009; 22(3): 131. CrossRef
Comparison Study of Intertrochanteric Fractures Treated with Intertrochanteric/subtrochanteric Fixation with a Standard vs a Mini-incision
Se Dong Kim, Oog Jin Sohn, Jae Ho Cho
Journal of the Korean Fracture Society.2008; 21(1): 1. CrossRef
Treatment of Senile Osteoporotic Intertrochanteric Fracture using Proximal Femoral Nail
Dong-Hui Kim, Sang-Hong Lee, Young-Lae Moon, Jun-Young Lee, Kun-Sang Song
Journal of the Korean Fracture Society.2007; 20(3): 215. CrossRef

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Treatment of Failed Internal Fixation of Intertrochanteric Fractures of Femur: Hyung Gyu Kim, Byeong Mun Park, Kyeong Seop Song, Chang Hun Sung, Jong Min Kim, Jae Hyung Cho, Nam Heun Kim; J Korean Fract Soc 2005;18(2):120-125. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.120

Abstract PDF: PURPOSE
To compare the result of failed internal fixation of intertrochanteric fractures treated with arthroplasty and 95degrees angled blade plate.
MATERIALS AND METHODS
From June 2000 to may 2003, there were 12 cases with failed internal fixation of intertrochanteric fractures among 185 cases treated with dynamic hip screw and followed up for more than 1 year. The 4 cases were treated with bipolar hemiarthroplasty, 1 case with total hip arthroplasty, and other 7 cases were treated with 95degrees angled blade plate with allograft, evaluated clinically the operation times, blood loss, walking ability and complication.
RESULTS
In the 7 cases, which treated with 95degrees angled blade plate, the average operation time was 109 minutes, the average blood loss was 431 ml. The result of keeping abreast of 1 year, no aid ambulation was 4 cases, the cane ambulation was 2 cases, the walker ambulation was 1 case, and there was no pain in 3 cases, mild pain in 4 cases, and no moderate pain. In the 5 cases, which treated with arthroplasty, the average operation time was 157 minutes, the average blood loss was 618 ml. During 1 year, no aid ambulation was 3 cases, the cane ambulation was 1 case, the walker ambulation was 1 case, and no pain in 2 cases, mild pain in 1 case, moderate pain in 1 case.
CONCLUSION
Both 95degrees angled blade plate and arthroplasty can be useful for failed internal fixation of intertrochanteric fractures, and the choice of implant must be determined with caution, considering the surgical conditions of patient, as well as benefits of each devices

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The Angulation as to the Location of the Lag Screw of Compression Hip Screw in the Intertrochanteric Fracture of the Hip: Sang Won Park, Kwang Jun Oh, Seung Yong Wang; J Korean Soc Fract 2002;15(1):15-20. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.15

Abstract PDF: PURPOSE
The purpose of this study was to evaluate the change of the angulation deformity according to apposition of medial cortex and sliding mechanism as to the location of the lag screw in the intertrochanteric fracture of the Korean femur which neck-shaft angle is relatively small .
MATERIALS AND METHODS
We selected the patients those angulation of femur neck-shaft was within 5 degree in comparison with normal side, and displacement of fracture fragment was within 4mm on the immediate post-operative radiograph. According to Evans classification, all patients were type I fracture. We classified the patients in two groups -stable medial cortex apposition(Group I) was 13 cases, and unstable no apposition(Group II) was 16 cases.
RESULTS
In the Group I, the varus-valgus angulation was average 3.3 degrees when lag screw was positioned at the middle of the femur neck, average 3.6 degrees when lag screw was positioned at the inferior to the femur neck. In the Group II, the varus-valgus angulation was average 6.1 degrees when lag screw was middle of the femur neck, average 1.5 degrees when lag screw was inferior to the femur neck.
CONCLUSION
There is no difference in angulation deformity when the lag screw is inferior or middle of femur neck if medial cortex is contacted, but the angulation deformity is less when the lag screw is inferior to femur neck if medial cortex is not contacted, in intertrochanteric fracture.

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Treatment of Intertrochanteric Fractures of Femur in Elderly Patients over 65 Years Old: Young Sun Koh, Chang Moo Yu, Suk Ha Lee, Sung Jong Lee, Taik Sun Kim, Jae lk Shim; J Korean Soc Fract 1995;8(1):46-53. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.46

Abstract PDF: The incidence of intertrochanteric fracture of femur is increasing because of increasing number of old-aged people. The goal in the treatment of an elderly patient with an intertrochanteric fracture is to restore the patient to his prefracture activity as soon as possible. The purpose of this report is to review of the difficulty of treating the intertrochanteric fracture of femur in elderly patients. The authors treated 213 cases of intertrochanteric fracture from Jan,1980 to Dec.1993. We analyzed the clinical result of 73 cases intertrochanteric fracture with minimum 1 year follow up retrospectively. The results were as follows. 1. The degrees of osteoporosis by Singh index were 27 cases in Grade III, 22 Cases in Grade II,14 cases in grade IV,5 cases in Grade I and 5 cases in Grade V. 2. By Tronzo classification of fracture, the most common type was 38 cases in type III, 17 cases in type II and 8 casesintype V. 3. The operation method were compression hip screw(38 cases), Jewett nail (12 cases), Ender nail(17 cases), multiple pinning (5 cases), and primary kerniarthoplasty(3 cases). 4. Average bony union time was 13.2 weeks in compression hip screw group, 14.5 weeks in Jewett nail group,14.7 weeks in Ender nail group and 15.4 weeks in multiple pinning group.

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Treatment of Tibial Shaft Fractures by Intramedullary Nailing: Sung Kon Kim, Sung Woo Suh, Hyung Suk Kim; J Korean Soc Fract 1994;7(2):438-443. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.438

Abstract PDF: The incidence of the intertrochanteric fracture of the femur is increasing due to increased geriatric population. The primary goal in the treatment of an order patients with an intertrochanteric fracture is to obtain anatomical reduction and rigid fixation for the rapid mobilization, decreased mortality and restoration of function. Many devices were developed for this purpose, especially of compression hip screw had gained considerable acceptance. A retrospective study of clinical results of the 50 cases intertrochanteric fracture from March 1990 to January 1993 was performed. The result were as follows; 1. Average age is 58 years and sex distribution is 31 cases of male, 19 cases of female. 2. Common cause of injury are slip down and traffic accident. Affected side is Rt 32 cases and Lt 18 cases. 3. According to the classification (of Boyd-Graffin), there are 14 case of Type I, 31 cases of Type II 2 cases of type III,3 cases of Type IV. 4. Among 50 cases, complication is encountered in 8 cases angular deformity (4 cases), limitation of motion(3 cases), infection(1 case). 5. After treatment of intertrochanteric fracture ; Neck-shaft angle of non-displaced fracture and comminuted fracture was an average 2 degree varus angular deformity. Vertical displacement of non-displaced fracture was an average 4.5mm and comminuted fracture was 5.0 mm. Medial displacement of non-displaced fracture was an average 3.5mm and comminuted fracture was 4.5mm. 6. Satifactory results could be obtained by open reduction and internal fixation with compression hip screw.

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