Operative Treatment of Intertrochanteric Fractures of the Femur in Elderly Patiene

Park, Sang Won; Hahn, Seung Beom

Abstract

There are many problems in the treatment of the intertrochanteric fractures due to oslteoporosis and unstable pattern of fractures in elderly patients and determined by quality of the bone, geometry of the fragments, reduction of the fragments, type of the implant and its placements. The authors analysed the 52 patients of the intertrochanteric fracture over 60 years old age who were operatively treated with compression hip screws and followed more than 1 year at Department of Orthopaedic Surgery, Korea University Hospital from Mar. 1986 to Dec.1992 in order to evaluate the results and prognostic factors. The results obtained were as follows: 1. According to Tronzo classification, the most common type was 3 in 27 cases(52%). 2. Among the fifty two cases, the patients having osteoporosis below grade 3 of Singh index was 30 cases(58%). In osteoporotic group(Singh index 1-3), unstable type fracture were more common(70%). 3. The most common pattern of reduction was anatomical reduction in 23 cases(66%), and medialization(9 cases), varus reduction(6 cases), valses refection(3 cases) in order of frequency. 4. The sliding length of lag screw was 7.8mm in average, 16.5mm in complicated cases, and 4.1 mm in uncomplicated cases. 5. The complications were developed in 13 cases(257o), and progressive varus deformity was most common in 9 cases. The complication rate had statiscally significant correlation with type of fracture, osteoporosis, pattern of reduction and sliding length of the lag screw. 6. The prognostic factors of the intertrochanteric fractures of the femur in elderly patients were fracture type, pattern of the reduction, position of the lag screws.