Journal of Musculoskeletal Trauma

Original Articles

The Treatment of Unstable Intertrochanteric Fractures with Dynamic Hip Screw and Trochanter Stabilizing Plate: Sang Won Park, Soon Hyuck Lee, Dae Hee Lee, Jong Won Chung, Gi Won Choi; J Korean Fract Soc 2005;18(4):359-363. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.359

PURPOSE
To analyze the effect of treatment of unstable intertrochanteric fractures with dynamic hip screw and additional trochanter stabilizing plate.
MATERIALS AND METHODS
Among twenty three cases of unstable intertrochanteric fractures treated with DHS and additional TSP between January 2002 to December 2004, seventeen cases over sixty years old were reviewed with minimal follow up of one year. We analyzed the type of fracture by AO classification, the age of patient, sex, the cause of trauma in seventeen cases. We evaluated the lag screw slippage, the change of neck-shaft angle and lateral displacement of greater trochanter, the period of union by comparison of last follow up radiographs with immediate postoperative radiographs. The fixation failure is defined that displacement of lag screw tip is more than 3 mm or cut out of the screw from the femoral head.
RESULTS
The period of union was average 12.8 weeks. The lag screw slippage was average 8.22 mm. The change of neck-shaft angle was average 2.66 degree. No lateralization of greater trochanter was noted in twelve cases, but five cases showed average 0.8 mm (range: 0.5~1 mm) of lateral displacement of greater trochanter. There was not fixation failure.
CONCLUSION
In unstable intertrochanteric fracture, the addition of a TSP to the dynamic hip screw can decrease a change of neck shaft angle, a lag screw slippage, and prevent lateral displacement of greater trochanter.

Citations

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Analysis of the Causes for Failed Compression Hip Screws in Femoral Intertrochanteric Fracture and Hip Reconstruction Operation
Ui Seoung Yoon, Jin Soo Kim, Jae Sung Seo, Jong Pil Yoon, Seung Yub Baek
Journal of the Korean Fracture Society.2010; 23(3): 270. CrossRef

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The Compression Hip Screw with Trochanter Stabilizing Plate for Internal Fixation of Unstable Intertrochanteric Fractures: Jin Ho Cho; J Korean Fract Soc 2005;18(3):221-226. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.221

Abstract PDF: PURPOSE
To evaluate trochanter stabilizing plate and compression hip screw can prevent excessive impaction and cutting-out in unstable intertrochanteric fractures.
MATERIALS AND METHODS
One hundred twenty-one patients with intertrochanteric fractures were treated between December 1999 and March 2002. Of the patients, twenty-four patients were treated with an additional TSP on the CHS. Nineteen patients were followed for more than six months. The fractures were classified according to the AO classification. Impactions of compression lag screw were measured immediate postoperatively and postoperatively three months later on simple radiographs. Functional results were followed Salvati-Wilson assessment score at postoperative six months later.
RESULTS
The group consisted of seven men and twelve women, and the mean age was 73 years. Two were classified as A2.2, six A2.3, one A3.2, and ten A3.3 fractures. Mean impaction was 5.4 mm (range 1.8 to 11.4 mm). Functional results were excellent in 32% and good in 53%. Eighteen patients had healed after operation. One complication required a bipolar hemiarthroplasty due to cutting-out of lag screw.
CONCLUSION
In three-part and four-part intertrochanteric fractures with lateral cortex breakage or vertical fracture in greater trochanter, the addition of TSP to CHS can prevent abductor muscle weakness due to fracture impaction, limb shortening and additional lateral cortical fracture. It also helps early weight bearing and bone healing.

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Treatment of Unstable Intertrochanteric Fractures in Elderly Patients: Comparison between DHS and Additional TSP: Sang Won Park, Jong Ryoon Baek, In Seok Moon; J Korean Soc Fract 2003;16(1):9-14. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.9

Abstract PDF

PURPOSE
The purpose of this study was to compare the results by only Dynamic HIP Screw(DHS) with those by DHS and additional Trochanter Stabilizing Plate(TSP) in the operative treatments of unstable intertrochanteric fractures.
MATERIALS AND METHODS
From January 1998 to December 2000, twenty-five cases of unstable intertrochanteric fractures in the patient over 70 years old were reviewed with minimal follow up of one year. Ten cases(group I) were treated with DHS and additional TSP. Fifteen cases(group II) were treated with only DHS. The cases were analyzed according to the type of fracture by AO classification, the cause of trauma, the age of patient. We evaluated the sliding of lag screw, the change of neck-shaft angle and lateral displacement of greater trochanter by comparison of last follow up radiographs with immediate postoperative radiographs.
RESULTS
The degree of sliding of lag screws was average 8.57 mm in group I and average 14.75 mm in group II(P=0.04). The change of neck-shaft angle was average 3.81 degree in group I and average 3.93 degree in group II(P>0.05). There was a significant difference between group I(0 case) and group II(14 cases) in lateral displacements of greater trochanter. In group II, the degree of lateral displacement of greater trochanter was average 6.41 mm.
CONCLUSION
We consider that additional TSP is more effective method for reducing excessive sliding of lag screw and lateral displacement of greater trochanter than only using dynamic hip screw in the treatment of unstable intertrochanteric fracture.

Citations

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A Comparison of Clinical Results between Compression Hip Screw and Proximal Femoral Nail as the Treatment of AO/OTA 31-A2.2 Intertrochanteric Femoral Fractures
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, In Hwa Back, Kyeong Soo Eom
Journal of the Korean Orthopaedic Association.2016; 51(6): 493. 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

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