Journal of Musculoskeletal Trauma

Excessive Sliding of the Helical Blade and the Femoral Neck Fracture after Insertion of Proximal Femoral Nail Anti-Rotation for Type A2 Intertrochanteric Fractures - A Case Report -: Bong Ju Park, Hong Man Cho, Ju Han Kim, Woo Jin Sin; J Korean Fract Soc 2013;26(2):151-155. Published online April 30, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.2.151

Proximal femoral nail anti-rotation (PFNA) with a lag screw that is shaped like a spiral blade shape is an orthopedic implant to fix trochanteric fractures of the proximal femur. In addition the reason of the biomechanical advantages, PFNA widely been used recently. We report an 83-year-old man with excessive sliding of the helical blade and a femoral neck fracture after AO/OTA type A2 intertrochanteric fracture, which was fixed with a PFNA.

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Helical Blade Locking Sleeve Disassembly Following Failed Femur Intertrochanter Fracture - A Case Report -
Soon Ho Huh, Hong-Man Cho, Ji-Yeon Park
Journal of the Korean Fracture Society.2021; 34(3): 112. CrossRef
Retrospective Comparative Study of the Intraoperative Fracture Gap Compression in the Treatment of Intertrochanteric Fracture Using Proximal Femoral Nail Antirotation
Se Jin Kim, Hong Man Cho, Jiyeon Park, Ki Yong An, Young Woo Chung, Woojin Shin
Journal of the Korean Fracture Society.2020; 33(4): 179. CrossRef
Failure of a Rotation Control Gamma 3 Lag Screw Used to Treat a Trochanteric Fracture
Kyungho Choi, Yongtae Kim, Shicheng Zhou, Jihyo Hwang
Hip & Pelvis.2018; 30(2): 129. CrossRef
Femoral neck fractures after internal fixation of trochanteric fractures with implants in situ in adults: A systematic review
Antonio Barquet, Peter V. Giannoudis, Andrés Gelink
Injury.2018; 49(12): 2121. CrossRef

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New Wiring Method for Lesser Trochanter Fixation in Unstable Intertrochanteric Fractures: Technical Note: Joong Myung Lee, Jeong Hee Lee, Churl Woo Lee, Hyun Min Kim; J Korean Fract Soc 2005;18(2):209-212. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.209

Abstract PDF

In unstable femoral trochanteric fracture, we usually used transversing K-wires through the lesser trochanter to achieve an anatomical reduction, and using sliding hip screws. However, in patients with comminuted lesser trochanter or osteoporosis, an intrusion of the wire into the lesser trochanter and/or iatrogenic intertrochanteric fractures were often resulted. Those who were not familiar with a technique of puncturing two holes through the lesser trochanter might have had to face some difficulties. In order to overcome aforementioned drawbacks, the authors had quite satisfactory results by employing the method of passing each of two wires above and below the iliopsoas muscle, and they were twisted posteriorly and then anteriorly; and finally they were pulled together posteriorly. Through this technique, both firm fixation of the lesser trochanter and more stable bony union were obtained.

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The lesser trochanter “Sling fixation technique” in proximal intramedullary nailing of unstable intertrochanteric fractures: A polymer-based cerclage wiring
Marco Villano, Matteo Innocenti, Roberto Civinini, Christian Carulli, Alessandro Civinini, Zyad Ayman Taha, Andrea Cozzi Lepri
Journal of Orthopaedics.2022; 34: 94. CrossRef
Unstable Intertrochanteric Fracture: Do We Know Everything? A Review
Balaji Zacharia, Harshitha Hayavadana Udupa
SN Comprehensive Clinical Medicine.2022;[Epub] CrossRef
When to Reduce and Fix Displaced Lesser Trochanter in Treatment of Trochanteric Fracture: A Systematic Review
Ao-Lei Yang, Wei Mao, Jun-Guo Wu, Yi-Qun He, Hao-Fei Ni, Hai-Long Li, You-Hai Dong
Frontiers in Surgery.2022;[Epub] CrossRef
Medial wall fragment involving large posterior cortex in pertrochanteric femur fractures: a notable preoperative risk factor for implant failure
Pengfei Li, Yang Lv, Fang Zhou, Yun Tian, Hongquan Ji, Zhishan Zhang, Yan Guo, Zhongwei Yang, Guojin Hou
Injury.2020; 51(3): 683. CrossRef
In response
David J. Ciufo, John P. Ketz
Journal of Orthopaedic Trauma.2018; 32(9): e382. CrossRef
Three-Dimensional Computed Tomography Reduced Fixation Failure of Intramedullary Nailing for Unstable Type of Intertrochanteric Fracture
Wei-Yu Li, Kai-Cheng Lin
Journal of Orthopaedic Trauma.2018; 32(9): e381. CrossRef
Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note
Joong-Myung Lee, Yongsuk Cho, Junhyun Kim, Dong-Won Kim
Hip & Pelvis.2017; 29(1): 44. CrossRef
Wiring technique for lesser trochanter fixation in proximal IM nailing of unstable intertrochanteric fractures: A modified candy-package wiring technique
Gyeong Min Kim, Kwang Woo Nam, Kyu-Bum Seo, Chaemoon Lim, Jiyun Kim, Yong-Geun Park
Injury.2017; 48(2): 406. CrossRef
Bipolar Hemiarthroplasty with Cementless Femoral Stem for Unstable Intertrochanteric Fractures
Joong-Myung Lee, Hee-Tae Nam, Sang-Hun Lee
Journal of the Korean Orthopaedic Association.2012; 47(2): 79. CrossRef

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Sliding after Internal Fixation of Stable Intertrochanteric Fracture of the Femur: Woo Suk Lee, Whan Young Chung, Woo Sik Kim, Yong Chan Kim, Taek Soo Jeon, Sung Kwun Jo, In Tak Bae, Young Su Lim; J Korean Fract Soc 2005;18(2):110-114. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.110

Abstract PDF

PURPOSE
To evaluate the risk factors of sliding after internal fixation with sliding compression hip screw in stable intertrochanteric fracture of the femur.
MATERIALS AND METHODS
From March 2000 to April 2003, 61 stable intertrochanteric fractures (Kyle-Gustilo type II) were treated operatively with sliding compression hip screws. The patients were 40 females and 21 males with an average age of 74 (range, 54~99). We measured vertical and horizontal shortening in regard to age, sex, bone mineral density, neck-shaft angle, cancellous bone defect, and the existence of lessor trochanter fracture on postoperative 6 months.
RESULTS
The average vertical shortening was 4.1 mm (0~22 mm) and the average horizontal shortening was 7.3 mm (0~30 mm). Age, sex, bone density and neck-shaft angle were not significantly related with vertical and horizontal shortening (p>0.05). Vertical shortening was significantly greater in the group with cancellous bone defect and in the group without lesser trochanter fracture (p<0.05).
CONCLUSION
Proper management for fracture site and fixation was needed to make it stable because the stable intertrochanteric fracture with cancellous bone defect and intact lesser trochanter could be induced into unexpected sliding.

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Benefits of a Demineralized Bone Matrix in Osteoporotic Intertrochanteric Femoral Fracture Patients
Se Jin Kim, Hong-Man Cho, Myung Cheol Jung
Journal of the Korean Fracture Society.2022; 35(4): 151. CrossRef

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A comparison of fixation with Ender nail and sliding screw plate in intertrochanteric fractures of elderly patients: Joo Hyoun Song, Yong Koo Kang, Han Yong Lee, Hae Seok Koh, Kee Won Rhyu, Kwang Won Lee; J Korean Soc Fract 1999;12(2):203-211. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.203

Abstract PDF: In order to investigate the correlation between morbidity of the elderly patients and method of fixation, we analyzed 39 elderly patients had undergone internal fixation with Ender nail or sliding screw plate for the intertrochanteric fractures of the femur from January 1992 through December 1995. Among the 39 patients, 20 patients and 20 fractures were treated with Ender nail. Mean follow-up period was 26 months and average in age was 76.2 years Remaining 19 patients, 19 fractures were treated with sliding screw plate Mean follow-up period was 25 months and average in age was 75.4 years. The results obtained were as follows : 1. In the cases where Ender nails were used, the average operation time took in the average of 45 minutes and whereby, in the cases where sliding screw plates were used, took in the average of 110 minutes. 2. During the operation time, the amount of hemorrhage in the cases of Ender nail was about 100ml and the sliding screw plate resulted in about 350 ml. And the average amount of transfusion was 0.9 pints in cases of Ender nail and 2.3 pints in cases of sliding screw plate. 3. Among 20 patients fixed with Ender nail, only 2 patients had to be cared at ICU, but 9 of 19 patients had to be cared at ICU in the cases of sliding screw plates. 4. In the cases of Ender nail, the radiologic bony union time was about 13.4 weeks and they could walk with supports with in a week. But, in the cases of sliding screw plate the radiologic bony union time was about 16.2 weeks and they could walk with orthrosis at 28.4 days postoperatively. 5. Most patients treated with Ender nail were suffered from the problem at knee and protrusion of Ender nail into the hip joint, backing out of nail through the entry, coxa valga deformity were major complications after the operation. In the cases of sliding screw plates, loosening of sliding screw with coxa vara deformity, wound infection and delayed union were major complications. 6. Despite of many complications, if the indication is chosen well, the fixation with Ender nail will result in a benefical treatment method in the elderly patients for its advantages in general condition of the patients.

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Comparision of Ender Nailing with Sliding Screw Plate Fixation in Intertrochanteric Fracture: Dong Heon Kim, Young Roon Kim, Kyeong Soon Kim; J Korean Soc Fract 1994;7(2):545-552. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.545

Abstract PDF: A sliding screw plate is the most commonly used device for the fixation of intertrochanteric hip fractures, providing secure fxation and controlled impaction but several complications, such as penentration of lag screw, back out of lag screw, wide skin incision and relatively long operation time, have been reported. An intramedullary device has been introduced as an alternative method. Ender nailng for intertrochanteric fracture of femur has many advantages such as minimal operative trauma and blood loss, short operation time, low incidence of infection, good stability of fracture and early ambulation. The authors have treated 45 cases of intertrochateric fracture from March 1988 to July 1994 with sliding screw plate(25 cases) or Ender nailing(20 cases). The results are as follows : 1. The ratio between men and women was 1 : 1.5 and the average age was 69 years old. 2. The most common causes were slip down injury followed by traffic accident and fall down injury. 3. Follow-up period was 16 to 34 monthes(average 23 monthes). 4. The most common type of fractures was Tronzo type III. 5. The average bony union time was about 14.2 weeks in sliding screw plate group and 15.1 weeks in Ender nailing group. 6. The most common complications were progressive varus deformity in SSP group and pain & limited ROM of knee joint in Ender nailing group. 7. The outcome was satisfactory in both group.

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