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J Korean Soc Fract. 2003 Apr;16(2):128-135. Korean. Original Article.
Kim JO , Roh KJ , Yun YH , Koh YD , Yoo JD , Jung JM , Bang HC , Jung JH .
Department of Orthopaedic Surgery, School of Medicine, Ewha Woman's University, Seoul, Korea.

PURPOSE: To evaluate the relationship between fracture stability and functional results, and analyze the correlation between stability factors and the outcome in intertrochanteric fractures of the elderly. MATERIALS AND METHODS: Of the 231 patients, 84 patients with age above 60 were able to follow up for minimum 6 months. We measured the sliding length of the lag screw, varus degree, position of lag screw, reduction status and medialization of distal fragment radiologically. The functional outcome of the treatment was evaluated with the Clawson's result classification and we evaluated the correlation between the radiological results of measurement and the functional recovery depending on the Evans fracture classification. RESULTS: There were good results in 40 cases out of 51 stable fractures, and in 10 cases out of 33 unstable fractures (p<0.001). In case of sliding of lag screw more than 10 mm, good results were obtained in 4 cases, and poor in 21. And in case of sliding less than 10 mm, good results were obtained in 46, and poor in 13 (p<0.001). But there was no relationship between other radiologic factors and clinical results. In unstable type, there were 12 cases with lag screw sliding more than 10 mm and 10 cases with less than 10 mm. In comminuted type, there were 11 cases with lag screw sliding more than 10 mm and 2 cases with less than 10 mm (p<0.001). CONCLUSION: The sliding of lag screw more than 10 mm may result in poor outcome. As in comminuted unstable pattern, sliding of lag screw might be excessive, the use of compression hip screw alone is not a good treatment option.

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