J Korean Hip Soc.  2009 Sep;21(3):257-262. 10.5371/jkhs.2009.21.3.257.

Modified Double Tension Band Wiring for Reattaching the Greater Trochanter When Performing Hemiarthroplasty for Intertrochanteric Fracture in Elderly Patients

• Kim WY
• Shin ES
• Moon CY

• KMID: 1465831
• DOI: http://doi.org/10.5371/jkhs.2009.21.3.257

Abstract

PURPOSE
We wanted to evaluate the clinical and radiological results after performing arthroplasty for an intertrochanteric fracture in patients 70 years of age or older, and we used a new fixation technique of the greater trochanter. MATERIAL AND METHODS: From January, 2004 to August 2007, we treated 21 cases (M/F: 3/18) of intertrochanteric fracture with hemiarthroplasty with modified double tension band wiring. All the cases were above type 2 (AO/OTA A1.3) according to the Jensen modification of the Evans classification, and all the patients were elderly. The fractures were evaluated for the fracture pattern by using simple radiography and 3D computed tomography. We analyzed the clinical and radiological results at a minimum of 12 months (range: 12~36 months).
RESULTS
We performed hemiarthroplasty with modified double tension band wiring. Two cases (9.5%) among the 21 cases developed loss of reduction due to an additional injury and one of them underwent reoperation using a greater trochanter reattachment device (GTRD). The greater trochanters were well maintained without displacement and excellent union was seen at the fracture site of 19 cases.
CONCLUSION
The modified double tension band wiring technique, along with several other fixation methods, should be considered to easily obtain rigid fixation in an unstable intertrochanteric fracture.

Keyword

Intertrochanteric fracture; Hemiarthroplasty; Modified double tension band wiring

MeSH Terms

Aged
Arthroplasty
Displacement (Psychology)
Femur
Hemiarthroplasty
Humans
Reoperation