Skip Navigation
Skip to contents

J Musculoskelet Trauma : Journal of Musculoskeletal Trauma

OPEN ACCESS

Articles

Page Path
HOME > J Musculoskelet Trauma > Volume 23(1); 2010 > Article
Original Article
Helical Blade versus Lag Screw for Treatment of Intertrochanteric Fracture
Kwang-Jun Oh, M.D., Sung-Tae Lee, M.D., Suk-Ha Lee, M.D., Jin-Ho Hwang, M.D., Min-Suk Kang, M.D.
Journal of the Korean Fracture Society 2010;23(1):6-12.
DOI: https://doi.org/10.12671/jkfs.2010.23.1.6
Published online: January 31, 2010

Department of Orthopedic Surgery, Konkuk University Medical School, Seoul, Korea.

Address reprint requests to: Jin-Ho Hwang, M.D. Department of Orthopedic Surgery, Konkuk University Medical School, 4-12, Hwayang-dong, Gwangjin-gu, Seoul 143-914, Korea. Tel: 82-2-2030-7495, Fax: 82-2-2030-7369, osjinho@naver.com
• Received: July 28, 2009   • Revised: September 3, 2009   • Accepted: December 15, 2009

Copyright © 2010 The Korean Fracture Society

  • 97 Views
  • 0 Download
  • 3 Crossref
prev next
  • Purpose
    To evaluate the radiographic and functional outcomes between who had unstable intertrochanteric fracture, treated with the ITST (lag screw design) and the PFNA (helical blade design).
  • Materials and Methods
    We selected each 17 and 13 patients of unstable intertrochanteric fracture which were treated with ITST or PFNA from April 2005 to December 2008. We evaluated the radiographic results by follow-up radiography and the clinical outcomes with the mobility score of Parker and Palmer, Social function scoring system.
  • Results
    The mean sliding distance of cervical screw with ITST nails was not shown significant differences than with using PFNA nails. The other factors were not statistically different. Decrease of mobility score of Parker and Palmer, Social function score were similar. 2 cases of cutting out was noted with ITST nails and 1 case of cutting out was noted with PFNA nails.
  • Conclusion
    Unlike the existed biomechanical reposts, there are no differences that are clinical and radiological results in treatment of unstable intertrochanteric fracture using the ITST nails and PFNA nails.
  • 1. Brunner A, Jöckel JA, Babst R. The PFNA proximal femur nail in treatment of unstable proximal femur fractures--3 cases of postoperative perforation of the helical blade into the hip joint. J Orthop Trauma, 2008;22:731-736.Article
  • 2. Fogagnolo F, Kfuri M Jr, Paccola CA. Intramedullary fixation of pertrochanteric hip fractures with the short AO-ASIF proximal femoral nail. Arch Orthop Trauma Surg, 2004;124:31-37.ArticlePDF
  • 3. Harrington P, Nihal A, Singhania AK, Howell FR. Intramedullary hip screw versus sliding hip screw for unstable intertrochanteric femoral fractures in the elderly. Injury, 2002;33:23-28.
  • 4. Herrera A, Domingo J, Martinez A. Results of osteosynthesis with the ITST nail in fractures of the trochanteric region of the femur. Int Orthop, 2008;32:767-772.ArticlePDF
  • 5. Hornby R, Evans JG, Vardon V. Operative or conservative treatment for trochanteric fractures of the femur. A randomised epidemiological trial in elderly patients. J Bone Joint Surg Br, 1989;71:619-623.ArticlePDF
  • 6. Jensen JS. Determining factors for the mortality following hip fractures. Injury, 1984;15:411-414.Article
  • 7. Kyle RF, Cabanela ME, Russell TA, et al. Fractures of the proximal part of the femur. Instr Course Lect, 1995;44:227-253.
  • 8. Laros GS, Moore JF. Complications of fixation in intertrochanteric fractures. Clin Orthop Relat Res, 1974;110-119.
  • 9. Lenich A, Fierlbeck J, Al-Munajjed A, et al. First clinical and biomechanical results of the Trochanteric Fixation Nail (TFN). Technol Health Care, 2006;14:403-409.Article
  • 10. Madsen JE, Naess L, Aune AK, Alho A, Ekeland A, Strømsøe K. Dynamic hip screw with trochanteric stabilizing plate in the treatment of unstable proximal femoral fractures: a comparative study with the gamma nail and compression hip screw. J Orthop Trauma, 1998;12:241-248.
  • 11. Oh JK, Hwang JH. Osteoporotic pertrochanteric fracture: IM nailing. J Korean Fract Soc, 2009;22:56-65.
  • 12. Park JH, Park JW, Wang JH, Lee JW, Lee JI, Kim JG. Treatment of intertrochanteric fracture: comparison of ptoximal femoral nail and proximal femoral nail A. J Korean Fract Soc, 2008;21:103-109.
  • 13. Parker MJ, Palmer CR. A new mobility score for predicting mortality after hip fracture. J Bone Joint Surg Br, 1993;75:797-798.
  • 14. Sadowski C, Lübbeke A, Saudan M, Riand N, Stern R, Hoffmeyer P. Treatment of reverse oblique and transverse intertrochanteric fractures with use of an intramedullary nail or a 95 degrees screw-plate: a prospective, randomized study. J Bone Joint Surg Am, 2002;84:372-381.
  • 15. Saudan M, Lübbeke A, Sadowski C, Riand N, Stern R, Hoffmeyer P. Pertrochanteric fractures: is there an advantage to an intramedullary nail?: a randomized, prospective study of 206 patients comparing the dynamic hip screw and proximal femoral nail. J Orthop Trauma, 2002;16:386-393.
  • 16. Sommers MB, Roth C, Hall H, et al. A laboratory model to evaluate cutout resistance of implants for pertrochanteric fracture fixation. J Orthop Trauma, 2004;18:361-368.
  • 17. Strauss E, Frank J, Lee J, Kummer FJ, Tejwani N. Helical blade versus sliding hip screw for treatment of unstable intertrochanteric hip fractures: a biomechanical evaluation. Injury, 2006;37:984-989.
  • 18. Weil YA, Gardner MJ, Mikhail G, Pierson G, Helfet DL, Lorich DG. Medial migration of intramedullary hip fixation devices: a biomechanical analysis. Arch Orthop Trauma Surg, 2008;128:227-234.
Fig. 1
The ITST (Zimmer) with lag screw. 2 cm of threaded lag screw length, 130° of neck-shaft angle, 5° of medial-lateral angle.
jkfs-23-6-g001.jpg
Fig. 2
The PFNA/II (Synthes) with a helical blade. 3 cm of helical blade length, 125° or 130° of neck-shaft angle, 6° of medial-lateral angle (PFNA)/5° of medial-lateral angle (PFNAII).
jkfs-23-6-g002.jpg
Fig. 3
(A) 66 years old male had unstable hip fracture by slip down. (B) Treated with ITST. (C) Cutting out by varus deformity. (D) Total hip replacement arthroplasty was done.
jkfs-23-6-g003.jpg
Fig. 4
(A) 76 years old female had unstable hip fracture by slip down. (B) Treated with ITST. (C) Cutting out. (D) Bipolar hemiarthroplasty was done.
jkfs-23-6-g004.jpg
Fig. 5
(A) 58 years old male had unstable hip fracture by slip down. (B) Treated with PFNA-II. (C) Cutting out by medial migration of helical blade. (D) Treated with angled blate plate.
jkfs-23-6-g005.jpg
Table 1
AO/OTA classification
jkfs-23-6-i001.jpg
Table 2
Classification of reduction
jkfs-23-6-i002.jpg
Table 3
Immediately postoperative reduction status
jkfs-23-6-i003.jpg
Table 4
Comparison of radiologic results between lag screw group and helical blade group
jkfs-23-6-i004.jpg
Table 5
Comparison of clinical outcomes between lag screw group and helical blade group
jkfs-23-6-i005.jpg

Figure & Data

REFERENCES

    Citations

    Citations to this article as recorded by  
    • Does the Helical Blade Lead to Higher Rates of Fixation Failure as Compared to Lag Screw in the Cephalomedullary Nailing Treatment of Hip Fractures? A Systematic Review and Meta-Analysis
      Chul-Ho Kim, Han Soul Kim, Yong-Chan Kim, Dou Hyun Moon
      Journal of Orthopaedic Trauma.2021; 35(8): 401.     CrossRef
    • Comparative Study of Intertrochanteric Fracture Treated with the Proximal Femoral Nail Anti-Rotation and the Third Generation of Gamma Nail
      Jae-Cheon Sim, Tae-Ho Kim, Ki-Do Hong, Sung-Sik Ha, Jong-Seong Lee
      Journal of the Korean Fracture Society.2013; 26(1): 37.     CrossRef
    • Treatment of Intertrochanteric Fractures Using Targon Proximal Femoral Nails
      Il Ho Park, Jong Kyoung Won, Kye Young Han
      Hip & Pelvis.2012; 24(2): 117.     CrossRef

    • Cite
      CITE
      export Copy Download
      Close
      Download Citation
      Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

      Format:
      • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
      • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
      Include:
      • Citation for the content below
      Helical Blade versus Lag Screw for Treatment of Intertrochanteric Fracture
      J Korean Fract Soc. 2010;23(1):6-12.   Published online January 31, 2010
      Close
    • XML DownloadXML Download
    Figure
    • 0
    • 1
    • 2
    • 3
    • 4
    We recommend
    Helical Blade versus Lag Screw for Treatment of Intertrochanteric Fracture
    Image Image Image Image Image
    Fig. 1 The ITST (Zimmer) with lag screw. 2 cm of threaded lag screw length, 130° of neck-shaft angle, 5° of medial-lateral angle.
    Fig. 2 The PFNA/II (Synthes) with a helical blade. 3 cm of helical blade length, 125° or 130° of neck-shaft angle, 6° of medial-lateral angle (PFNA)/5° of medial-lateral angle (PFNAII).
    Fig. 3 (A) 66 years old male had unstable hip fracture by slip down. (B) Treated with ITST. (C) Cutting out by varus deformity. (D) Total hip replacement arthroplasty was done.
    Fig. 4 (A) 76 years old female had unstable hip fracture by slip down. (B) Treated with ITST. (C) Cutting out. (D) Bipolar hemiarthroplasty was done.
    Fig. 5 (A) 58 years old male had unstable hip fracture by slip down. (B) Treated with PFNA-II. (C) Cutting out by medial migration of helical blade. (D) Treated with angled blate plate.
    Helical Blade versus Lag Screw for Treatment of Intertrochanteric Fracture

    AO/OTA classification

    Classification of reduction

    Immediately postoperative reduction status

    Comparison of radiologic results between lag screw group and helical blade group

    Comparison of clinical outcomes between lag screw group and helical blade group

    Table 1 AO/OTA classification

    Table 2 Classification of reduction

    Table 3 Immediately postoperative reduction status

    Table 4 Comparison of radiologic results between lag screw group and helical blade group

    Table 5 Comparison of clinical outcomes between lag screw group and helical blade group


    J Musculoskelet Trauma : Journal of Musculoskeletal Trauma
    Close layer
    TOP