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HOME > J Musculoskelet Trauma > Volume 20(4); 2007 > Article
Original Article
Comparison between Results of Internal Fixation and Hemiarthroplasty in Unstable Intertrochanter Fracture of Osteoporotic Bone
Haw Jae Jung, M.D., Jae Yeol Choi, M.D., Hun Kyu Shin, M.D., Eugene Kim, M.D., Se-Jin Park, M.D., Yong Taek Lee, M.D., Gwang-Sin Kim, M.D., Jong-Min Kim, M.D.
Journal of the Korean Fracture Society 2007;20(4):291-296.
DOI: https://doi.org/10.12671/jkfs.2007.20.4.291
Published online: June 14, 2016

Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

*Department of Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Address reprint requests to: Jong-Min Kim, M.D. Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, 108, Pyung-dong, Jongro-gu, Seoul 100-634, Korea. Tel: 82-2-2001-2168, Fax: 82-2-2001-2176, kim@samsung.com

Copyright © The Korean Fracture Society. All rights reserved

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  • Purpose
    To perform comparative analysis between the results of internal fixation and hemiarthroplasty in unstable intertrochanteric fracture of osteoporotic bone.
  • Materials and Methods
    From February 2003 to February 2006, 36 patients treated surgically for unstable intertrochanteric fractures were evaluated. The patient's age was older than 70 year old; the T-score of preoperative bone mineral density (BMD) was lower than -3.0; they were followed up for more than 1 year. The patient were divided into two groups. One group was treated with dynamic hip screw or proximal femoral nail (Group A, 23 cases), and the other group was treated with bipolar hemiarthroplasty (Group B, 13 cases). The two groups were compared in terms of hip joint function using Clawson classification and radiologically.
  • Results
    Nonunion and fixation failure happened in 6 cases (26%) of gruop A. However, all patients in group B showed stable maintenance of implant. Recovery of hip joint function was found in 13 cases (43%) of group A, whereas 12 cases (93%) of group B recovered.
  • Conclusion
    Nonunion and failure of fixation happened more frequently in internal fixation than bipolar hemiarthroplasty, and the postoperative hip joint function was better in bipolar hemiarthroplasty than internal fixation. Therefore, bipolar hemiarthroplasty might be better operative treatment for unstable intertrochanteric fracture of osteoporotic bone.
  • Key words: Unstable intertrochanteric fracture, Osteoporosis, Internal fixation, Hemiarthroplasty
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Fig. 1

Evans classification of intertrochanteric fracture.

jkfs-20-291-g001.jpg
Fig. 2

(A) Preoperative radiograph of a 78-year-old female showing unstable intertrochanteric fracture according to Evans classification. (B) Postoperative after 6 month showing lag screw loosening and incarceration of proximal fragement into intramedullary cavity of the distal fragment. (C) After conversion to bipolar hemiarthroplasty.

jkfs-20-291-g002.jpg
Fig. 3

(A) Preoperative radiograph of a 72-year-old male showing unstable intertrochanteric fracture according to Evans classification. (B) Postoperative radiograph after 13 months showing good maintenance of implant.

jkfs-20-291-g003.jpg
Table 1

Clawson classification

jkfs-20-291-i001.jpg
Table 2

Data of premorbid and postop hip joint function of group A and B

jkfs-20-291-i002.jpg

Figure & Data

REFERENCES

    Citations

    Citations to this article as recorded by  
    • The Stability Score of the Intramedullary Nailed Intertrochanteric Fractures: Stability of Nailed Fracture and Postoperative Patient Mobilization
      Sung-Rak Lee, Seong-Tae Kim, Min Geun Yoon, Myung-Sang Moon, Jee-Hyun Heo
      Clinics in Orthopedic Surgery.2013; 5(1): 10.     CrossRef
    • Analysis of the Factors Involved in Failed Fixation in Elderly Intertrochanteric Femoral Fracture
      Joon Soon Kang, Ryuh Sup Kim, Bom Soo Kim, Young Tae Kim, Seung Hyun Hong
      Journal of the Korean Fracture Society.2012; 25(4): 263.     CrossRef
    • Results of Osteoporotic Treatment Drug after Periarticular Fracture of Hip
      Soo Jae Yim, Young Koo Lee, Cheong Kwan Kim, Hyun Seok Song, Hee Kyung Kang
      Journal of the Korean Fracture Society.2010; 23(2): 167.     CrossRef

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      Comparison between Results of Internal Fixation and Hemiarthroplasty in Unstable Intertrochanter Fracture of Osteoporotic Bone
      J Korean Fract Soc. 2007;20(4):291-296.   Published online October 31, 2007
      DOI: https://doi.org/10.12671/jkfs.2007.20.4.291
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    Comparison between Results of Internal Fixation and Hemiarthroplasty in Unstable Intertrochanter Fracture of Osteoporotic Bone
    Image Image Image
    Fig. 1 Evans classification of intertrochanteric fracture.
    Fig. 2 (A) Preoperative radiograph of a 78-year-old female showing unstable intertrochanteric fracture according to Evans classification. (B) Postoperative after 6 month showing lag screw loosening and incarceration of proximal fragement into intramedullary cavity of the distal fragment. (C) After conversion to bipolar hemiarthroplasty.
    Fig. 3 (A) Preoperative radiograph of a 72-year-old male showing unstable intertrochanteric fracture according to Evans classification. (B) Postoperative radiograph after 13 months showing good maintenance of implant.

    Fig. 1

    Fig. 2

    Fig. 3

    Comparison between Results of Internal Fixation and Hemiarthroplasty in Unstable Intertrochanter Fracture of Osteoporotic Bone

    Clawson classification

    Data of premorbid and postop hip joint function of group A and B
    Table 1 Clawson classification

    Table 2 Data of premorbid and postop hip joint function of group A and B

    Table 1

    Table 2

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