J Korean Fract Soc.  2010 Jul;23(3):270-275. 10.12671/jkfs.2010.23.3.270.

Analysis of the Causes for Failed Compression Hip Screws in Femoral Intertrochanteric Fracture and Hip Reconstruction Operation

• Yoon US
• Kim JS
• Seo JS
• Yoon JP
• Baek SY

• KMID: 1712341
• DOI: http://doi.org/10.12671/jkfs.2010.23.3.270

Abstract

PURPOSE
To analyze the causes of fixation failure of compression hip screw and evaluate outcomes of hip arthroplasty for reconstruction.
MATERIALS AND METHODS
We reviewed 108 femoral intertrochanteric fractures that underwent compression hip screw between January 1997 and December 2007. Failure group (group I) contained 28 cases who had hip arthroplasty for failed compression hip screw and the control group (group II) contained 80 cases who had successive compression hip screw. We analyzed the causes of failure of compression hip screw and evaluated the results of hip arthroplasty for reconstruction.
RESULTS
In group I, 21 cases (75%) were unstable fractures. Group II, 14 cases (17%) were unstable fractures. Tip-apex distance was 26.5 (18~35) mm in group I and 18.6 (8~22) mm in group II. Lateral wall fracture of greater trochanteric area was combined in 24 cases (85.7%) in group I and 9 cases (11.3%) in group II. Harris Hip Score improved from 33.5 (22~43) points to 84.2 (75~93) points after salvage hip arthroplasty.
CONCLUSION
We considered the causes of failed compression hip screw to be fracture instability, increased tip-apex distance and presence of lateral wall fracture of greater trochanter. Hip arthroplasty was found to be a useful method for failed compression hip screw.

Keyword

Femur; Intertrochanteric fracture; Compression hip screw

MeSH Terms

Arthroplasty
Femur
Hip
Hip Fractures

Figure

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  Fig. 1 A 87-year-old female with left hip pain, (A) Preoperative radiograph showing a unstable intertrochanteric fracture with lateral wall fracture. (B) The fracture was fixed by using compression hip screw. (C) Postoperative 3 months follow-up. The lag screw slid excessively and nearly protruded a femoral head. The acetabular surface was preserved. (D) Postoperative 18months follow-up. Radiograph showing well fixed components after bipolar hemiarthroplasty.

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