J Korean Hip Soc.  2009 Sep;21(3):245-251. 10.5371/jkhs.2009.21.3.245.

Fixaton of Lesser Trochanteric Fragments on an Unstable Intertrochanteric Fracture of the Femur

• Kang JS
• Moon KH
• Kim RS
• Bae JH
• Lee BC

• KMID: 1465829
• DOI: http://doi.org/10.5371/jkhs.2009.21.3.245

Abstract

PURPOSE
We evaluated the effect of cable fixation of the lesser trochanter for treating unstable intertrochanter fractures.
MATERIALS AND METHODS
In this retrospective study, we assessed the availability of cable fixation of the lesser trochanter and the cause of complications in a series of 47 unstable intertrochanteric femoral fractures that were seen between February 2001 to May 2008 at our hospital. The fractures were classified using the Evans-Jensen classification system. The lesser trochanters were fixed in 21 cases. The correlations between the lag screw position, comminution of the fracture site and the radiological results were studied. Nonunion was diagnosed if patients experienced pain and the radiographs revealed a persistent, radiolucent defect at the fracture site 6 months after fracture fixation.
RESULTS
Union was observed in 43 cases (91.5%). The average union time was 3.75 months. Nonunion was observed in 4 cases (8.5%) 1 in group l and 3 in group ll. The average sliding distance of the lag screw was 8.76 mm. In groups l and ll, the distance was 4.92 mm and 12.45 mm, respectively. Excessive sliding, which was defined as more than 15mm, developed in 9 cases, and 7 of these 9 cases were in group ll. The average neck-shaft angle change was 1.28degrees and 5.81degrees, respectively.
CONCLUSION
Additional cable fixation of the lesser trochanter for treating intertrochanter fractures, including large posteromedial fragments, is recommended for preventing the excessive sliding of lag screws and varus deformity.

Keyword

Femur; Unstable intertrochanteric fracture; Fixation of lesser trochanter

MeSH Terms

Congenital Abnormalities
Femoral Fractures
Femur
Humans
Retrospective Studies