J Korean Fract Soc.  2010 Jan;23(1):6-12. 10.12671/jkfs.2010.23.1.6.

Helical Blade versus Lag Screw for Treatment of Intertrochanteric Fracture

• Oh KJ
• Lee ST
• Lee SH
• Hwang JH
• Kang MS

• KMID: 1461566
• DOI: http://doi.org/10.12671/jkfs.2010.23.1.6

Abstract

PURPOSE
To evaluate the radiographic and functional outcomes between who had unstable intertrochanteric fracture, treated with the ITST (lag screw design) and the PFNA (helical blade design).
MATERIALS AND METHODS
We selected each 17 and 13 patients of unstable intertrochanteric fracture which were treated with ITST or PFNA from April 2005 to December 2008. We evaluated the radiographic results by follow-up radiography and the clinical outcomes with the mobility score of Parker and Palmer, Social function scoring system.
RESULTS
The mean sliding distance of cervical screw with ITST nails was not shown significant differences than with using PFNA nails. The other factors were not statistically different. Decrease of mobility score of Parker and Palmer, Social function score were similar. 2 cases of cutting out was noted with ITST nails and 1 case of cutting out was noted with PFNA nails.
CONCLUSION
Unlike the existed biomechanical reposts, there are no differences that are clinical and radiological results in treatment of unstable intertrochanteric fracture using the ITST nails and PFNA nails.

Keyword

Femur intertrochanteric fracture; Proximal femoral nail A; Intertrochanteric/subtrochanteric fixation

MeSH Terms

Follow-Up Studies
Humans
Nails

Figure

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  Fig. 1 The ITST (Zimmer) with lag screw. 2 cm of threaded lag screw length, 130° of neck-shaft angle, 5° of medial-lateral angle.

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  Fig. 2 The PFNA/II (Synthes) with a helical blade. 3 cm of helical blade length, 125° or 130° of neck-shaft angle, 6° of medial-lateral angle (PFNA)/5° of medial-lateral angle (PFNAII).

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  Fig. 3 (A) 66 years old male had unstable hip fracture by slip down. (B) Treated with ITST. (C) Cutting out by varus deformity. (D) Total hip replacement arthroplasty was done.

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  Fig. 4 (A) 76 years old female had unstable hip fracture by slip down. (B) Treated with ITST. (C) Cutting out. (D) Bipolar hemiarthroplasty was done.

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  Fig. 5 (A) 58 years old male had unstable hip fracture by slip down. (B) Treated with PFNA-II. (C) Cutting out by medial migration of helical blade. (D) Treated with angled blate plate.

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