Treatment of Intertrochanteric Fractures Using the Compression Hip Nail
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Purpose: To investigate the clinical and radiologic outcomes following treatment of intertrochanteric fracturesusing the Compression Hip Nail (CHN), which has a sliding lag screw. Materials and Methods: Twenty-eight cases of intertrochanteric fractures treated with CHN from November2012 to October 2013 and followed-up for >6 months were included. The patient population consisted of 11 menand 17 women with a mean age of 75.2 years at the time of surgery. For the initial 11 cases, 10 mm sliding lagscrews were used; the remaining 17 cases used 20 mm sliding lag screws. Clinical variables including operationtime, amount of transfusion, weight-bearing start time, postoperative physical activity, and complications wereinvestigated. The average sliding of lag screws and the average union were investigated radiologically at 3 and 6months after surgery. Results: In an analysis of 23 cases (exclusion of 3 cases of lag screw cutout and 2 cases of nonunion), 11 (48%)recovered their pre-injury activity level. In an analysis of 25 cases (exclusion of 3 cases of cutout), 17 (68%) and23 (92%) showed radiological union at postoperative months 3 and 6, respectively. Seven complications werenoted. Cutout of the lag screw and the lateral protrusion of barrels were significantly greater in the group with 10mm sliding lag screws as compared to the group using 20 mm sliding lag screws. Conclusion: The use of CHN for the treatment of intertrochanteric fracture yielded poor results. However,results from patients in the 20 mm sliding lag screw group were better than for the 10 mm sliding lag screwgroup. Therefore, use of the 20 mm sliding lag screw is advisable.
Abstract
Purpose: To investigate the clinical and radiologic outcomes following treatment of intertrochanteric fracturesusing the Compression Hip Nail (CHN), which has a sliding lag screw. Materials and Methods: Twenty-eight cases of intertrochanteric fractures treated with CHN from November2012 to October 2013 and followed-up for >6 months were included. The patient population consisted of 11 menand 17 women with a mean age of 75.2 years at the time of surgery. For the initial 11 cases, 10 mm sliding lagscrews were used; the remaining 17 cases used 20 mm sliding lag screws. Clinical variables including operationtime, amount of transfusion, weight-bearing start time, postoperative physical activity, and complications wereinvestigated. The average sliding of lag screws and the average union were investigated radiologically at 3 and 6months after surgery. Results: In an analysis of 23 cases (exclusion of 3 cases of lag screw cutout and 2 cases of nonunion), 11 (48%)recovered their pre-injury activity level. In an analysis of 25 cases (exclusion of 3 cases of cutout), 17 (68%) and23 (92%) showed radiological union at postoperative months 3 and 6, respectively. Seven complications werenoted. Cutout of the lag screw and the lateral protrusion of barrels were significantly greater in the group with 10mm sliding lag screws as compared to the group using 20 mm sliding lag screws. Conclusion: The use of CHN for the treatment of intertrochanteric fracture yielded poor results. However,results from patients in the 20 mm sliding lag screw group were better than for the 10 mm sliding lag screwgroup. Therefore, use of the 20 mm sliding lag screw is advisable.
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