J Korean Fract Soc.  2007 Apr;20(2):129-134. 10.12671/jkfs.2007.20.2.129.

Trochanteric Management for Unstable Intertrochanteric Femoral Fracture in the Elderly Patients

• Kho DH
• Shin JY
• Kim KH
• Lee JH
• Kim DH

• KMID: 2295569
• DOI: http://doi.org/10.12671/jkfs.2007.20.2.129

Abstract

PURPOSE
To evaluate the results after fixation with figure of eight and cerclage wiring for comminuted trochanteric fracture. Because comminution of the femoral trochanteric fracture in elderly patients is severer in the operating field than x-ray findings, so the fixation is more difficult.
MATERIALS AND METHODS
Between March 1998 and March 2004, the clinical records on twenty-eight patients more than 70 years old who underwent the bipolar hemiarthroplaty using calcar replacement type of femoral stem and followed more than 24 months were reviewed. Figure of eight and cerclage wiring was used for the comminuted trochanteric fracture of the femoral intertrochanteric fracture. The mean age was 80.4 (70~103) years. 19 cases were female, 9 cases were male. Mean follow-up period was 58 (24~92) months. We evaluated the results by modified Harris hip score, walking ability, activity of daily living, radiologic findings and union of the fracture.
RESULTS
The mean duration of bony union was 12 weeks. The mean postoperative modified Harris hip score was 82.3. Preoperative walking ability was recovered in 23 cases (82%). Also basic activity of daily living was recovered in 22 cases (79%). Nonunion of trochanter was found in only one case by radiologic evaluation but clinical correlation was not significant.
CONCLUSION
We consider fixation with figure of eight and cerclage wiring for unstable intertrochanteric fracture of femur in the elderly patient is more appropriate in terms of convenience of fixation, duration of union, early ambulation and cost effectiveness.

Keyword

Comminuted trochanteric fracture; Figure of eight and cerclage wiring; Bipolar hemiarthroplasty

MeSH Terms

Aged*
Cost-Benefit Analysis
Early Ambulation
Female
Femoral Fractures*
Femur*
Follow-Up Studies
Hip
Humans
Male
Walking

Figure

• 

  Fig. 1 (A, B) Both hip anteroposterior and left hip lateral radiography of 81 year-old female patient shows Evans unstable femoral intertrochanteric fracture. (C, D) After 28 months follow up, bony union has been achieved and the stem is tightly fitted after bipolar hemiarthroplasty with figure of eight and cerclage wiring.

• 

  Fig. 2 (A, B) Both hip anteroposterior and right hip lateral radiography of 75 year-old female patient shows Evans unstable femoral intertrochanteric fracture. (C, D) After 28 months follow up, bony union has been achieved and the stem is tightly fitted after bipolar hemiarthroplasty with cerclage wiring and Dall-Miles cable.

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