Journal of Musculoskeletal Trauma

Original Articles

Trochanteric Management for Unstable Intertrochanteric Femoral Fracture in the Elderly Patients: Duk Hwan Kho, Ju Yong Shin, Ki Hwan Kim, Jun Hyuck Lee, Dong Heon Kim; J Korean Fract Soc 2007;20(2):129-134. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.129

PURPOSE
To evaluate the results after fixation with figure of eight and cerclage wiring for comminuted trochanteric fracture. Because comminution of the femoral trochanteric fracture in elderly patients is severer in the operating field than x-ray findings, so the fixation is more difficult.
MATERIALS AND METHODS
Between March 1998 and March 2004, the clinical records on twenty-eight patients more than 70 years old who underwent the bipolar hemiarthroplaty using calcar replacement type of femoral stem and followed more than 24 months were reviewed. Figure of eight and cerclage wiring was used for the comminuted trochanteric fracture of the femoral intertrochanteric fracture. The mean age was 80.4 (70~103) years. 19 cases were female, 9 cases were male. Mean follow-up period was 58 (24~92) months. We evaluated the results by modified Harris hip score, walking ability, activity of daily living, radiologic findings and union of the fracture.
RESULTS
The mean duration of bony union was 12 weeks. The mean postoperative modified Harris hip score was 82.3. Preoperative walking ability was recovered in 23 cases (82%). Also basic activity of daily living was recovered in 22 cases (79%). Nonunion of trochanter was found in only one case by radiologic evaluation but clinical correlation was not significant.
CONCLUSION
We consider fixation with figure of eight and cerclage wiring for unstable intertrochanteric fracture of femur in the elderly patient is more appropriate in terms of convenience of fixation, duration of union, early ambulation and cost effectiveness.

Citations

Citations to this article as recorded by

Outcomes of dynamic hip screw augmented with trochanteric wiring for treatment of unstable type A2 intertrochanteric femur fractures
Chetan Puram, Chetan Pradhan, Atul Patil, Vivek Sodhai, Parag Sancheti, Ashok Shyam
Injury.2017; 48: S72. CrossRef
Fixation of Greater Trochanter Using an AO Trochanteric Reattachment Device (AO TRD) in Arthroplasty for Intertrochanteric Femur Fracture of Elderly Patients
Weon-Yoo Kim, Young-Yul Kim, Jae-Jung Jeong, Do-Joon Kang
Hip & Pelvis.2013; 25(4): 274. CrossRef
Bipolar Hemiarthroplasty Using the Greater Trochanter Reattachment Device (GTRD) for Comminuted Intertrochanteric Femur Fracture in Elderly Patients
Jin-Wan Kim, Young-Chul Ko, Chul-Young Jung, Il-Soo Eun, Hyeon-Soo Choi, Ok-Gul Kim, Young-June Kim
Journal of the Korean Fracture Society.2009; 22(4): 232. CrossRef

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Treatment of Comminuted Trochanteric Fracture with Dynamic Hip Screw and Trochanteric Stabilizing Plate: Seungki Baek, Youngjoon Choi, Chunghwan Kim, Yoojin Kim, Jaekwang Hwang, Hyungsun Ahn, Hyuntae Ahn, Kyungjun Park, Jaiwoo Cho; J Korean Soc Fract 2002;15(2):278-285. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.278

Abstract PDF

PURPOSE
The purpose of this study is to evaluate the results of treatment of comminuted femoral trochanteric fracture using dynamic hip screw(DHS) with trochanteric stabilizing plate(TSP) and DHS only.
MATERIALS AND METHODS
we analysed retrospectively 32 cases that has fracture extends over two or more levels of medial cortex(A2 of AO classification) and fracture extends through lateral cortex of femur(A3 of AO classicification) of femoral trochanteric fractures between 1997 and 2000. On simple AP radiograph of the DHS with TSP(n=16) and DHS only group(n=16), we reviewed bony union, slippage of lag screw, lateral displacement of greater trochanter.
RESULT
Bony union was observed in all cases. When bony union is done in follow up radiograph, Mean slippage of lag screw is 14.5mm in DHS only group, 12.6mm in DHS with TSP group and mean lateral displacement of greater trochanter is 9.8mm in DHS only group, 1.2mm in DHS with TSP group.
CONCLUSION
Use of DHS with TSP in comminuted femoral trochanteric fracture is lesser slippage of lag screw and lateral displacement of greater trochanter than DHS only used, and that is better method to maintain fracture reduction and internal fixation in treatment of comminuted femoral trochanteric fractures than DHS only.

Citations

Citations to this article as recorded by

Results of Use of Compression Hip Screw with Trochanter Stabilizing Plate for Reverse Oblique Intertrochanteric Fracture
Byung-Woo Min, Kyung-Jae Lee, Gyo-Wook Kim, Ki-Cheor Bae, Si-Wook Lee, Du-Han Kim
Journal of the Korean Fracture Society.2014; 27(2): 120. CrossRef
A Comparison of Intramedullary and Extramedullary Fixations for the Treatment of Reverse Oblique or Transverse Intertrochanteric Femoral Fractures
Yerl-Bo Sung, Jung-Yun Choi, Eui-Yub Jung
Hip & Pelvis.2012; 24(2): 109. CrossRef

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