No abstract available.
Hip

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Hip

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Hip

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Hip*

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Hip*

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Hip*

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Arthroplasty* ; Hip Fractures* ; Hip*

PURPOSE: To investigate the characteristics of the sliding pattern of the proximal fragment (head and neck) in unstable intertrochanteric fractures, which were fixed with a dynamic hip screw (DHS) with anterior to posterior or posterior to anterior insertion angle in the axial view. MATERIALS AND METHODS: AO type A2.1 intertrochanteric fracture was reproduced in 10 proximal femur model (Synbone, Malans, Switzerland). Five fractured models were reduced and fixed using DHS with anterior to posterior insertion angle (group 1) and five models were fixed with posterior to anterior angle (group 2). Load of 500 N (30 cycles) was applied to the fracture fragment-plate complex using Instron 6022. Data on the distance of sliding and the angle of rotation of the proximal fragment were collected and analyzed. RESULTS: No significant difference was noted statistically in the distance of sliding between the two groups (p=0.92). However, the mean angle of rotation was 13.4degrees and 8.0degrees in group 1 and 2, respectively and the difference was statistically significant (p=0.012). Anterior cortical fracture of distal fragment was noted in 3 cases of group 1. There was no fracture of the anterior cortex in group 2. CONCLUSION: In unstable intertrochanteric fracture, the insertion angle of the lag screw in axial view does seem to play a role in the fate of bone-plate complex. Early eccentric contact of both fragments caused rotation of the proximal fragment in all cases and anterior cortical fracture of the distal fragment in 3 cases of group 1.
Femur ; Hip ; Hip Fractures*

We experienced 3 cases of incomplete intertrochanteric fracture that were detected by multiplanar reconstruction computerized tomography (MPR CT). On the plain radiographs, two cases had only greater trochanteric fracture and the other case had a localized intertrochanteric fracture. There were linear hot uptakes in the intertrochanteric area in all cases on the bone scintigrams. On MPR CT, cortical breakage was found only in the anterior cortex, and the medial, lateral and posterior cortices were intact in all cases. Two cases were treated surgically with using compression hip screws and the other case was managed conservatively because of the patient's poor general condition. The findings of MPR CT were definitely different from those MRI findings of the previously reported incomplete intertrochanteric fractures.
Femur ; Hip ; Hip Fractures

Unstable femoral intertrochanteric fractures are characterized by comminution of the posteromedial cortex, resulting in a fragment of variable size containing the lesser trochanter. Need for fixation of the fracture fragment of lesser trochanter remained controversial. We assessed the superior and medial migration of the fracture fragment of lesser trochanter, bone union, change of hip flexor power, limitation of motion and clinical results in a 29 unstable femoral intertrochanteric fractures which had been internally fixed with gamma interlocking nail (14 cases), compression hip screw (10 cases) and anatomical bent plate (5 cases). The fracture fragment of lesser trochanter was fixed with long trans-fixation screw in the cases of the anatomical bent plate. Superior migration of the fracture fragment of lesser trochanter is statistically different between Gamma interlocking nail and the other operations (P<0.05). Medial migration, bone union, change of hip flexor power, LOM and clinical results are not statistically different in the each operations (P>0.05). Although the stability could be provided by trans-fixation of the fracture fragment of lesser trochanter because the fragment acts as a buttress, clinical results was not influenced whether the fixation of the fracture fragment of lesser trochanter was done or not. We conclude that additional trans-fixation screw doesn t need if major fracture site was firmly fixed through any operation.
Femur* ; Hip ; Hip Fractures*