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Treatment of the Intertrochanteric Fractures of the Femur in Elderly Patients: Comparision of Wayne-County Reduction and Anatomical Reduction
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Nam Yong Choi, Kee Ho Nah, Hyun Seok Song, Sang Il Seo, Jung Keun Choi, Suk Ku Han
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J Korean Fract Soc 2004;17(4):301-307. Published online October 31, 2004
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DOI: https://doi.org/10.12671/jkfs.2004.17.4.301
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 Abstract
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- PURPOSE
To compare the radiological and clinical results of Wayne-County reduction with anatomical reduction in treatment of the intertrochanteric fractures of the femur in elderly patients.
MATERIALS AND METHODS
Among one hundred-three of intertrochanteric fractures treated with 135- degree angled compression hip scresw, eighty three cases treated by Wayne-County reduction (Group 1, 42 cases) and anatomical reduction (Group 2, 41 cases) with at least 1 year follow-up were reviewed. The average pateint ages were 72.4 (65~92) in group 1, 71.6 (65~89) in group 2, respectively. 33 cases (75.2%) in group 1 and 31 cases (77.5%) displayed unstable fractures by Jensen classification. The radiological observation was included neck-shaft angle, penetrating length of lag screw into head, sliding length of lag screw and time of bony union. The clinical results were evaluated by Koval criteria, Kyle's functional evaluation, leg length inequality and complications.
RESULTS
There were no significant changes between group 1 and group 2 in stable fractures in the radiological and clinical results. In unstable fractures, the neck-shaft angle averaged 132.2 degree in group 1 and 129.4 degree in group 2 in the final follow-up films. The penetrating length of lag screw into head were 2.2 mm in group 1 and 3.1 mm in group 2 (p<005). But there were little differences in the sliding length of lag screw, the time of bony union and complication rates between groups. In post- operative evaluation of walking abilility by Koval, 31 patients (73.8%) in group 1 and 28 (68.3%) recovered the activity level before injury by the postoperative 1 year follow-up. Leg length discrepancy at final follow-up was 4.1+/-6 mm shortening in group 1 and 6.5+/-8 mm in group 2, respectively.
CONCLUSION
Both Wayne-County reduction and anatomical reduction had a favorable results after treatment of stable intertrochanteric fractures of the femur, but Wayne-County reduction may be a better method in treatment of unstable fractures, especially in elderly patients, in which it is difficult to obtain anatomical reduction.
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Citations
Citations to this article as recorded by  - High Fixation Failure Rate of Cephalomedullary Nail Fixation in Patients with Low-Energy Basicervical Femoral Fractures: Do We Need Extramedullary Reduction?
Chang-Jin Yon, Ki-Cheor Bae, Young-Hun Kim, Kyung-Jae Lee
Medicina.2025; 61(1): 112. CrossRef - New Approach in the Treatment of Intertrochanteric Fracture Using a Cephalomedullary Nail
Junyoung Kim, Kihong Choi, Kyu Hyun Yang
Journal of the Korean Orthopaedic Association.2020; 55(3): 193. CrossRef - The Effect of Valgus Reduction on the Position of the Blade of the Proximal Femoral Nail Antirotation in Intertrochanteric Hip Fractures
Eui Yub Jung, In Taek Oh, Sang Yeup Shim, Byung Ho Yoon, Yerl Bo Sung
Clinics in Orthopedic Surgery.2019; 11(1): 36. CrossRef - Effectiveness of the Valgus Reduction Technique in Treatment of Intertrochanteric Fractures Using Proximal Femoral Nail Antirotation
Ji-Kang Park, Hyun-Chul Shon, Yong-Min Kim, Eui-Sung Choi, Dong-Soo Kim, Kyoung-Jin Park, Byung-Ki Cho, Jung-Kwon Cha, Sang-Woo Kang
Journal of the Korean Orthopaedic Association.2013; 48(6): 441. CrossRef
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