Classification and Treatment of Unstable Intertrochanteric Fracture according to the Existence of Posterior Fragment : Preliminary Report.
10.12671/jkfs.2008.21.2.110
- Author:
Lih WANG
1
;
Sung Keun SHON
;
Kyu Yeol LEE
;
Chul Hong KIM
;
Myung Jin LEE
;
Chul Won LEE
;
Sung Soo KIM
Author Information
1. Department of Orthopaedic Surgery, College of Medicine, Dong-A University, Busan, Korea. sskim2@dau.ac.kr
- Publication Type:Original Article
- Keywords:
Intertrochanteric fracture;
3D computed tomography;
Proximal femoral nail;
Gamma nail
- MeSH:
Follow-Up Studies;
Hip Fractures;
Nails;
Neck;
Reoperation;
Retrospective Studies
- From:Journal of the Korean Fracture Society
2008;21(2):110-116
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To predict the feature and stability of intertrochanteric fractures with posterior fragment using preoperative 3D computed tomography and to investigate the importance of the posterior fragment in treatment of unstable intertrochanteric fracture. MATERIALS AND METHODS: 15 cases of unstable fractures with posterior fragment which were treated with nail only between October 2006 to August 2007 were classified into 2 groups: study group (5 cases with cannulated screw fixation of posterior fragment) and control group (10 cases without cannulated screw fixation). The average difference of neck-shaft angle, neck screw sliding distance and the complications in the two groups were compared retrospectively after a follow up of at least 3 months. RESULTS: The average difference of neck-shaft angle in study and control group was 3.8 and 7.5 degree (p>0.05), respectively. The average difference of neck screw sliding distance was 1.6 and 6.6 mm (p<0.05), respectively. Complication which required reoperation was not noted in study group and complications of 3 cases about neck screw lateral protrusion, proximal migration and Z-effect phenomenon were noted in control group. CONCLUSION: The recognition and fixation of the posterior wall was found to be an important predictive factor in unstable intertrochanteric fracture treatment.
