Kyung-Jae Lee; Byung-Woo Min; Ki-Cheor Bae; Dong-Hu Kim; Kyoung-Lag Lee

doi:10.12671/jkfs.2013.26.2.105

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Original Article
Salvage Re-Fixation for the Failed Fixation of Pertrochanteric Fracture: Kyung-Jae Lee, M.D., Byung-Woo Min, M.D., Ki-Cheor Bae, M.D., Dong-Hu Kim, M.D., Kyoung-Lag Lee, M.D.; Journal of the Korean Fracture Society 2013;26(2):105-111.
DOI: https://doi.org/10.12671/jkfs.2013.26.2.105
Published online: April 22, 2013

Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.

Address reprint requests to: Byung-Woo Min, M.D. Department of Orthopedic Surgery, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 700-712, Korea. Tel: 82-53-250-7267, Fax: 82-53-250-7205, min@dsmc.or.kr

• Received: October 12, 2012 • Revised: November 24, 2012 • Accepted: November 24, 2012

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Abstract
REFERENCES

Abstract

Purpose
The purpose of this study is to evaluate the clinical and radiological result in patients who got salvage re-fixation for the failed fixation of pertrochanteric fracture retrospectively.
Materials and Methods
Between 1992 and 2009, 21 patients who could be followed-up for more than 1 year after salvage re-fixation for the failed fixation of pertrochanteric fracture were enrolled in this study. There were 16 men and 5 women. The mean age was 53 years (19-84 years) at the index surgery and the mean follow-up was 6.4 years. We evaluated the clinical and radiographic results and postoperative complications.
Results
Walking ability and pain were improved in all cases and the mean leg length discrepancy was improved from 2.5 cm (0-10 cm) preoperatively to 1 cm (0-4 cm) at the latest follow-up. Nineteen patients (90.5%) out of 21 patients achieved bony union at the final evaluation and the mean union time was 4 months (3-7 months). There were 2 cases of non-union who had not received bone graft as a complication.
Conclusion
The clinical and radiological results of the salvage re-fixation for the failed fixation of pertrchanteric fracture were satisfactory in our study. Secure component fixation for the mechanical stability and proper bone graft for the improvement of bone biology are mandatory to improve the result.
Key words: Femur, Trochanter, Fracture, Re-fixation, Bone graft

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Fig. 1

A diagram shows author's treatment algorism for the failed fixation of pertrochanteric fracture. DHS: Dynamic hip screw, IM: Intramudullary.

Fig. 2

A 64-years-old male with left hip pain.

(A) Preoperative radiograph shows the non-union of pertrochanteric fracture with broken angle blade plate.

(B) Immediate postoperative radiograph shows dynamic hip screw fixation due to the inferior head defect. During the re-fixation, bone graft was added due to the bone defect on the non-union site.

(C) Radiograph after one year shows solid fracture union.

Fig. 3

A 69-years-old male with left hip pain.

(A) Preoperative radiograph shows infected non-union of fracture site with large bone defect.

(B) After infection control, 90 degree angle blade plate was used due to the superior head defect. During the re-fixation, bone graft was done.

(C) One year after the operation, the fracture site was well united.

Table 1

Aspects of Primary Fixation Failure

Table 2

Change of Walking Ability

Figure & Data

REFERENCES

Citations

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Salvage treatment of failed internal fixation of intertrochanteric fractures: What factors determine the failure of treatment?
Byung-Woo Min, Kyung-Jae Lee, Jong-Keon Oh, Chul-Hyun Cho, Jae-Woo Cho, Beom-Soo Kim
Injury.2020; 51(2): 367. CrossRef

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Salvage Re-Fixation for the Failed Fixation of Pertrochanteric Fracture

J Korean Fract Soc. 2013;26(2):105-111. Published online April 30, 2013

DOI: https://doi.org/10.12671/jkfs.2013.26.2.105

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Figure

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Salvage Re-Fixation for the Failed Fixation of Pertrochanteric Fracture

Fig. 1 A diagram shows author's treatment algorism for the failed fixation of pertrochanteric fracture. DHS: Dynamic hip screw, IM: Intramudullary.

Fig. 2 A 64-years-old male with left hip pain. (A) Preoperative radiograph shows the non-union of pertrochanteric fracture with broken angle blade plate. (B) Immediate postoperative radiograph shows dynamic hip screw fixation due to the inferior head defect. During the re-fixation, bone graft was added due to the bone defect on the non-union site. (C) Radiograph after one year shows solid fracture union.

Fig. 3 A 69-years-old male with left hip pain. (A) Preoperative radiograph shows infected non-union of fracture site with large bone defect. (B) After infection control, 90 degree angle blade plate was used due to the superior head defect. During the re-fixation, bone graft was done. (C) One year after the operation, the fracture site was well united.

Fig. 1

Fig. 2

Fig. 3

Salvage Re-Fixation for the Failed Fixation of Pertrochanteric Fracture

Table 1

Aspects of Primary Fixation Failure

Table 2

Change of Walking Ability

Table 1 Aspects of Primary Fixation Failure

Table 2 Change of Walking Ability