The Role of Lateral Buttress in Treatment of Jensen type 4 Intertrochanteric Fractures of the Femur using Dynamic Compression Hip Screw in the Elderly.
10.4055/jkoa.2005.40.7.935
- Author:
Yong Sik KIM
1
;
Soon Yong KWON
;
Suk Ku HAN
;
Woo Hyuk CHOI
;
Nam Yong CHOI
Author Information
1. Department of Orthopaedic Surgery, St. Paul's Hospital, The Catholic University of Korea, Seoul, Korea. hnsukku@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Femur;
Intertrochanteric fracture;
Jensen type 4;
Dynamic compression screw;
Lateral buttress;
Proximal-medial fragmentary angle
- MeSH:
Aged*;
Femur*;
Follow-Up Studies;
Fracture Healing;
Head;
Hip Fractures*;
Hip*;
Humans;
Incidence;
Retrospective Studies
- From:The Journal of the Korean Orthopaedic Association
2005;40(7):935-941
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To investigate the effect of lateral buttress on the fracture healing of Jensen type 4 intertrochanteric fracture of the femur treated by dynamic compression hip screw (DCS) in elderly patients, retrospectively. MATERIALS AND METHODS: From March 1999 to February 2003, 54 patients, older than 65 years, of Jensen type 4 intertrochanteric fractures of the femur treated by DCS were included. The relationship between the structual integrity of lateral buttress measured by proximal-medial fragment angle (PMFA) and postoperative neck-shaft angle, penetrating length of lag screw, the sliding length and incidence of fixation loss were evaluated. RESULTS: Among 38 patients of group II (PMFA above 50 degree), 6 cases (15.8%) including 4 cases of cutting out of lag screw from femoral head, 1 case of nonunion and 1 case of excessive extrusion of lag screw failed radiologically. But there was no fixation loss case in 16 cases of group I (PMFA 50 and below 50). The neck-shaft angle in last follow-up was 138.1 degree in group I and 132.1 in group II. The sliding length of lag screw was 7.0 mm in group I and 12. 5 mm in group II (p<0.05). CONCLUSION: Preoperative evaluation of intactness of lateral buttress measured by proximal-medial fragmentary angle is an useful method in treatment of Jensen type 4 intertrochanteric fractures treated by DCS in elderly patients.
