Hip Pelvis.  2012 Dec;24(4):316-321. 10.5371/hp.2012.24.4.316.

Fixation of Greater Trochanteric Fracture Using Double Strands and Double Loops with Figure of 8 Wiring in Non-cement Total Hip Arthroplasty for Unstable Intertrochanteric Fracture

• Nam HJ
• Sun DH
• Jang SW

• KMID: 1425048
• DOI: http://doi.org/10.5371/hp.2012.24.4.316

Abstract

PURPOSE
Non-cement total hip arthroplasty for unstable intertrochanteric fracture in elderly patients is regarded as another surgical technique preventing complications such as non-union, long term limitation of weight bearing, pressure sore, pulmonary thromboembolism after open reduction or closed reduction with intramedullary nailing, or plate fixation. We would like to announce the short-term results of primary non-cement total hip arthroplasty with double strands and double loops figure of 8 wiring for unstable intertrochanteric fracture in elderly patients.
MATERIALS AND METHODS
All of the 20 patients admitted to the hospital between April 2010 and February 2012 who underwent non-cement total hip arthroplasty with double strands and double loops figure of 8 wiring for unstable intertrochanteric fractures were evaluated. The mean age was 71.1(57-86), there were nine males, and 11 females, with an average follow up period of six months. The post-operative state was evaluated by Harris hip score.
RESULTS
The mean operation time was 95 min, and the average blood loss was 800 cc. Mean Harris hip score at the last available follow-up was 92.7, and, among the patients, 15 had all functions of daily life without limitation of walking distance, one had hip dislocation, one had breakage of strands. Pressure sore, deep vein thrombosis, and pulmonary thromboembolism were absent. Radiography at the last available follow-up showed no loosening of the femoral stem in any of the patients, and 13 patients had osteogenesis around the fracture site, and there was no osteolysis.
CONCLUSION
Primary non-cement total hip arthroplasty with double strands and double loops figure of 8 wiring in elderly patients with unstable intertrochanteric fractures showed satisfactory results. These results are expected to be useful for further studies with a long-term follow-up and in development of a reduction method.

Keyword

Hip; Intertrochanteric fracture; Double strands; Non-ciment total hip arthroplasty

MeSH Terms

Aged
Arthroplasty
Female
Femur
Follow-Up Studies
Fracture Fixation, Intramedullary
Hip
Hip Dislocation
Hip Fractures
Humans
Male
Osteogenesis
Pressure Ulcer
Pulmonary Embolism
Venous Thrombosis
Walking
Weight-Bearing

Figure

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  Fig. 1 Unstable comminuted intertrochanteric fracture of Lt. hip in simple hip X-rays.

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  Fig. 2 Unstable comminuted intertrochanteric fracture of Lt. hip in hip CT scans.

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  Fig. 3 Double strands and double loops figure of 8 fixation with 1.0 mm wires for unstable intertrochanteric fracture fragments.

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  Fig. 4 Double strands and double loops figure of 8 wiring fixation.

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  Fig. 5 Preoperative and postoperative radiographs illustrate the case of a 65-year-old man with unstable intertrochanteric fracture. He underwent total hip arthroplasty using double strands and double loops figure of 8 fixation.

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