Duk-Hwan Kho; Ju-Yong Shin; Ki-Hwan Kim; Jun-Hyuck Lee; Dong-Heon Kim

doi:10.12671/jkfs.2007.20.2.129

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Original Article
Trochanteric Management for Unstable Intertrochanteric Femoral Fracture in the Elderly Patients: Duk-Hwan Kho, M.D., Ju-Yong Shin, M.D., Ki-Hwan Kim, M.D., Jun-Hyuck Lee, M.D., Dong-Heon Kim, M.D.; Journal of the Korean Fracture Society 2007;20(2):129-134.
DOI: https://doi.org/10.12671/jkfs.2007.20.2.129
Published online: June 14, 2016

Department of Orthopedic Surgery, College of Medicine, Konkuk University, Chungju, Korea.

Address reprint requests to: Dong-Heon Kim, M.D. Department of Orthopedic Surgery, Konkuk University Hospital, College of Medicine, Konkuk University, 620-5, Gyohyeon-dong, Chungju 380-704, Korea. Tel: 82-43-840-8251, Fax: 82-43-844-7300, kdkim@kku.ac.kr

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Abstract
REFERENCES

Abstract

Purpose
To evaluate the results after fixation with figure of eight and cerclage wiring for comminuted trochanteric fracture. Because comminution of the femoral trochanteric fracture in elderly patients is severer in the operating field than x-ray findings, so the fixation is more difficult.
Materials and Methods
Between March 1998 and March 2004, the clinical records on twenty-eight patients more than 70 years old who underwent the bipolar hemiarthroplaty using calcar replacement type of femoral stem and followed more than 24 months were reviewed. Figure of eight and cerclage wiring was used for the comminuted trochanteric fracture of the femoral intertrochanteric fracture. The mean age was 80.4 (70~103) years. 19 cases were female, 9 cases were male. Mean follow-up period was 58 (24~92) months. We evaluated the results by modified Harris hip score, walking ability, activity of daily living, radiologic findings and union of the fracture.
Results
The mean duration of bony union was 12 weeks. The mean postoperative modified Harris hip score was 82.3. Preoperative walking ability was recovered in 23 cases (82%). Also basic activity of daily living was recovered in 22 cases (79%). Nonunion of trochanter was found in only one case by radiologic evaluation but clinical correlation was not significant.
Conclusion
We consider fixation with figure of eight and cerclage wiring for unstable intertrochanteric fracture of femur in the elderly patient is more appropriate in terms of convenience of fixation, duration of union, early ambulation and cost effectiveness.
Key words: Comminuted trochanteric fracture, Figure of eight and cerclage wiring, Bipolar hemiarthroplasty

REFERENCES

1. Chan KC, Gill GS. Cemented hemiarthroplasties for elderly patients with intertrochanteric fractures. Clin Orthop Relat Res, 2000;371:206-215.Article
2. Chilvers M, Vejvoda H, Trammell R, Allan DG. Trochanteric fixation in total hip arthroplasty using the S-ROM bolt and washer. J Arthroplasty, 2002;17:740-746.Article
3. Chin KR, Brick GW. Reattachment of the migrated ununited greater trochanter after revision hip arthroplasty: the abductor slide technique. A review of four cases. J Bone Joint Surg Am, 2000;82:401-408.
4. Grimsrud C, Monzon RJ, Richman J, Ries MD. Cemented hip arthroplasty with a novel cerclage cable technique for unstable intertrochanteric hip fractures. J Arthroplasty, 2005;20:337-343.
5. Evans EM. The treatment of trochanteric fractures of the femur. J Bone Joint Surg Br, 1949;31:190-203.
6. Haentjens P, Casteleyn PP, Opdecam P. Primary bipolar arthroplasty or total hip arthroplasty for the treatment of unstable intertrochanteric and subtrochanteric fractures in elderly patients. Acta Orthop Belg, 1994;60:Suppl 1. 124-128.
7. Hamadouche M, Zniber B, Dumaine V, Kerboull M, Courpied JP. Reattachment of the ununited greater trochanter following total hip arthroplasty: the use of a trochanteric claw plate. J Bone Joint Surg Am, 2003;85:1330-1337.
8. Kim KW, Ahn SH. Elderly trochanteric fractures - principles of treatment -. J Korean Soc Fract, 1994;7:227-234.
9. Kitamura S, Hasegawa Y, Suzuki S, et al. Functional outcome after hip fracture in Japan. Clin Orthop Relat Res, 1998;348:29-36.
10. Koval KJ, Zuckerman JD. Functional recovery after fracture of the hip. J Bone Joint Surg Am, 1994;76:751-758.
11. Lestrange NR. Bipolar arthroplasty for 496 hip fractures. Clin Orthop Relat Res, 1990;251:7-19.
12. Koval KJ, Skovron ML, Aharonoff GB, Meadows SE, Zuckerman JD. Ambulatory ability after hip fracture. A prospective study in geriatric patients. Clin Orthop Relat Res, 1995;310:150-159.
13. Rodop O, Kiral A, Kaplan H, Akmaz I. Primary bipolar hemiprosthesis for unstable intertrochanteric fractures. Int Orthop, 2002;26:233-237.
14. Singh M, Nagrazh AR, Maini PS. Changes in trabecular pattern of the upper end of the femur as an index of osteoporosis. J Bone Joint Surg Am, 1970;52:457-467.
15. Squires B, Bannister G. Displaced intracapsular neck of femur fractures in mobile independent patients: total hip replacement or hemiarthroplasty. Injury, 1999;30:345-348.
16. Vahl AC, Dunki Jacobs PB, Patka P, Haarman HJ. Hemiarthroplasty in elderly, debilitated patients with an unstable femoral fracture in the trochanteric region. Acta Orthop Belg, 1994;60:274-279.
17. Wang JW, Chen LK, Chen CE. Surgical treatment of fractures of the greater trochanter associated with osteolytic lesions. J Bone Joint Surg Am, 2005;87:2724-2728.
18. Yoon ES, Min HJ, Suh JS, et al. Comparison of clinical results between bipolar hemiarthroplasty and compression hip screw on unstable intertrochanteric fractures of the femur in elderly patients. J Korean Fract Soc, 2004;17:214-220.
19. Zain Elabdien BS, Olerud S, Karlstrom G. Ender nailing of pertrochanteric fractures. Results at follow-up evaluation after one year. Clin Orthop Relat Res, 1984;191:53-63.

Fig. 1

(A, B) Both hip anteroposterior and left hip lateral radiography of 81 year-old female patient shows Evans unstable femoral intertrochanteric fracture.

(C, D) After 28 months follow up, bony union has been achieved and the stem is tightly fitted after bipolar hemiarthroplasty with figure of eight and cerclage wiring.

Fig. 2

(A, B) Both hip anteroposterior and right hip lateral radiography of 75 year-old female patient shows Evans unstable femoral intertrochanteric fracture.

(C, D) After 28 months follow up, bony union has been achieved and the stem is tightly fitted after bipolar hemiarthroplasty with cerclage wiring and Dall-Miles cable.

Table 1

Age and sex distribution

Table 2

Mechanism of injury

Table 3

Modified Harris hip score. The score is multiplied by 1.1 to give an assessment out of 100

Table 4

Recovery of walking ability

Figure & Data

REFERENCES

Citations

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Outcomes of dynamic hip screw augmented with trochanteric wiring for treatment of unstable type A2 intertrochanteric femur fractures
Chetan Puram, Chetan Pradhan, Atul Patil, Vivek Sodhai, Parag Sancheti, Ashok Shyam
Injury.2017; 48: S72. CrossRef
Fixation of Greater Trochanter Using an AO Trochanteric Reattachment Device (AO TRD) in Arthroplasty for Intertrochanteric Femur Fracture of Elderly Patients
Weon-Yoo Kim, Young-Yul Kim, Jae-Jung Jeong, Do-Joon Kang
Hip & Pelvis.2013; 25(4): 274. CrossRef
Bipolar Hemiarthroplasty Using the Greater Trochanter Reattachment Device (GTRD) for Comminuted Intertrochanteric Femur Fracture in Elderly Patients
Jin-Wan Kim, Young-Chul Ko, Chul-Young Jung, Il-Soo Eun, Hyeon-Soo Choi, Ok-Gul Kim, Young-June Kim
Journal of the Korean Fracture Society.2009; 22(4): 232. CrossRef

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Trochanteric Management for Unstable Intertrochanteric Femoral Fracture in the Elderly Patients

J Korean Fract Soc. 2007;20(2):129-134. Published online April 30, 2007

DOI: https://doi.org/10.12671/jkfs.2007.20.2.129

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Trochanteric Management for Unstable Intertrochanteric Femoral Fracture in the Elderly Patients

Fig. 1 (A, B) Both hip anteroposterior and left hip lateral radiography of 81 year-old female patient shows Evans unstable femoral intertrochanteric fracture. (C, D) After 28 months follow up, bony union has been achieved and the stem is tightly fitted after bipolar hemiarthroplasty with figure of eight and cerclage wiring.

Fig. 2 (A, B) Both hip anteroposterior and right hip lateral radiography of 75 year-old female patient shows Evans unstable femoral intertrochanteric fracture. (C, D) After 28 months follow up, bony union has been achieved and the stem is tightly fitted after bipolar hemiarthroplasty with cerclage wiring and Dall-Miles cable.

Fig. 1

Fig. 2

Trochanteric Management for Unstable Intertrochanteric Femoral Fracture in the Elderly Patients

Table 1

Age and sex distribution

Table 2

Mechanism of injury

Table 3

Modified Harris hip score. The score is multiplied by 1.1 to give an assessment out of 100

Table 4

Recovery of walking ability

Table 1 Age and sex distribution

Table 2 Mechanism of injury

Table 3 Modified Harris hip score. The score is multiplied by 1.1 to give an assessment out of 100