Analysis of cause of collapse and Non-union After Internal Fixation of Intertrochanteric Fracture

Suh, Seung Woo; Hur, Chang Ryong; Park, Jung Ho; Hong, Jun Seok; Moon, Woo Nam

Abstract

Sixty-five Intertrochanteric hip fractures were analyzed radiologically to study the factors affecting postoperati ye stability. Fractures were evaluated by measuring shortening and angulation, collapse of telescoping device when utilized, and migration of the fixation device within the femoral head. Fractures were classified according to their stability preoperatively and the reduction of lessor trochanteric fracture fragment postoperatively. The failure rate and postoperative stability were then compared on terms of severity of osteoporosis, type of fracture, existence of reduction of lestor trochanter fragment.
Results
indicated that the severity of osteoporosis was not related to the group of fracture, which determines stability of fracture. Regarding the rate of bone union, anatomically reduced groups showed similar rates of bone union(73.8% in average) and degree of sliding of lag screw (4.13mm in average) regardless of fixation of lesser trochanter fragment. On the other hand, malreduced group which failed to obtain anatomical reduction had 26.1% of bone union rates and 10.95mm of sliding of lag screw representing importance of anatomical reduction rather than fixation of lesser trochanteric fracture. In conclusion, there was no correlationthip between severity of oLteoporosis and type of fracture. And it is suggested that unstabae intertrochanteric fractures accompanied by large lesser trochanteric fracture fragment can be provided stability avoiding major complications such as loosening of implant or collapse of fracture fragment if it is fixed with anatomical reduction of fracture even without the fixation of lesser trochanteric fragment.