TREATMENT OF UNSTABLE INTERTROCHANTERIC FRACTURES OF THE FEMUR - A PROSPECTIVE TRIAL COMPARING ANATOMICAL REDUCTION AND VALGUS OSTEOTOMY

被引:17
作者
CLARK, DW
RIBBANS, WJ
机构
[1] Wexham Park Hospital, Slough
[2] Central Middlesex Hospital, London
来源
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 1990年 / 21卷 / 02期
关键词
D O I
10.1016/0020-1383(90)90060-8
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
A series of 100 consecutive patients with unstable intertrochanteric fractures were treated by compression hip screw fixation; 55 patients had an anatomical reduction (Group 1) and 45 patients a Sarmiento osteotomy and valgus reduction (Group 2). Group 1 spent an average of 10 days less in hospital than Group 2 (21 days compared with 31 days) (P < 0.02). They also had a greater chance of returning to their pre-injury accommodation and of achieving their pre-injury walking capability. Radiological failure of fracture fixation, with varus angulation of the femoral head by cutting out of the screw, was seen seven times in Group 1 but only once in Group 2. Anatomical reduction provides better clinical results than valgus osteotomy in the patient with an unstable intertrochanteric fracture stabilized by a compression hip screw. The capacity for failure of fracture fixation is greater, however, in the former. Valgus osteotomy provides a simple means of securing a stable reduction of the fracture which cannot be satisfactorily reduced by closed means. © 1990.
引用
收藏
页码:84 / 88
页数:5
相关论文
共 10 条
[1]  
Chang, Zuckerman, Kumer, Et al., Biomechanical evaluation of anatomic reduction versus medial displacement osteotomy in unstable intertrochanteric fractures., Clin Orthop Relat Res, 225, (1987)
[2]  
Dimon, Hughston, Unstable intertrochanteric fractures of the hip, J. Bone Joint Surg., 49 A, (1967)
[3]  
Evans, The treatment of intertrochanteric fractures of the femur, J. Bone Joint Surg., 31 B, (1949)
[4]  
Harrington, Johnston, The management of comminuted unstable intertrochanteric fractures, J. Bone joint Surg., 55 A, (1973)
[5]  
Heyse-Moore, MacEachern, Jameson Evans, Treatment of intertrochanteric fractures of the femur — A comparison of the Richards screw-plate with the Jewett nail-plate, J. Bone Joint Surg., 65 B, (1983)
[6]  
Steen, Tondevold, Mossing, Unstable trochanteric fractures treated with the sliding screw-plate system — A biomechanical study of unstable trochanteric fractures, Acta Orthop. Scand., 49, (1978)
[7]  
Office of Population Censuses and Surveys. (OPCS), Hospital In-patient Enquiry, (1987)
[8]  
Pun, Chow, Chan, Et al., Treatment of unstable inter-trochanteric fractures with Sarmiento Valgus osteotomy and acrylic cement augmentation, Injury, 18, (1987)
[9]  
Rao, Banzon, Weiss, Et al., Treatment of unstable intertrochanteric fractures with anatomic reduction and compression hip screw fixation, Clin. Orthop., 175, (1983)
[10]  
Sarmiento, Williams, The unstable intertrochanteric fracture: Treatment with a valgus osteotomy and I-beam nail-plate, J. Bone Joint Surg., 52 A, (1970)