Comparison of Compression Hip Screw, Captured Hip Screw and Gamma-Locking Nail in Intertrochanteric Fracture of Femur

Chung, Eu Seup; Choi, Kyung Seo; Kim, Min Ki; Lee, Jong Bong

Abstract

It is well known that most of the intertrochanteric fractures of femur occur in elderly patients with osteoporosis and poor general conditions. So, there are many problems in the treatment of intertrochanteric fractures of femur due to osteoporosis and unstable patterns of fracture and poor general conditions in clderly patients. Various devices have been developed and the results of treatment have been improved, but the morbidity and the mortality still remain high. The authors analysed 33 cases of compression hip screw(group 1), 19 cases of captured hip screw(group 2), and 13 cases of Camma-locking nail(group 3) amomg 65 cases of intectrochanteric fracture of femul operated at Presbyterian Medical Center from Jan.1990 to Aug.1994. We compared the intraoperative and postoperative complications amomg the three devices, and obtained the following results; 1. The incidences of fixation failure were not sigmificant among the three groups. 2. The lag screw penetration of femoral head and angulation were higher in Gamma-locking nail group(23%) among the three groups. 3. Most of anterior displacement of distal fragment and severe impaction of fracture site were occured in unstable fracture and higher in captured hip screw group(16%), and none in Camma locking nail group. 4. In Gamma-locking nail group, severe impaction at fractuie site was not found but the lag screw penetration of femoral head and angulation were higher. In the other two groups, the results were reverse.