Sub- or intertrochanteric fracture following screw fixation of an intracapsular proximal femoral fracture: true complication or technical error?

Details

Serval ID
serval:BIB_DB8226F3DBB7
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Sub- or intertrochanteric fracture following screw fixation of an intracapsular proximal femoral fracture: true complication or technical error?
Journal
Swiss Surgery
Author(s)
Pelet S., Leyvraz P.F., Garofalo R., Borens O., Mouhsine E.
ISSN
0007-1323
1023-9332
Publication state
Published
Issued date
2003
Volume
9
Number
2
Pages
82-86
Language
english
Abstract
PURPOSE: To review, retrospectively, the possible causes of sub- or intertrochanteric fractures after screw fixation of intracapsular fractures of the proximal femur. METHODS: Eighty-four patients with an intracapsular fracture of proximal femur were operated between 1995 and 1998 by using three cannulated 6.25 mm screws. The screws were inserted in a triangular configuration, one screw in the upper part of the femoral neck and two screws in the inferior part. Between 1999 and 2001, we use two screws proximally and one screw distally. RESULTS: In the first series, two patients died within one week after operation. Sixty-four fractures healed without problems. Four patients developed an atrophic non-union; avascular necrosis of the femoral head was found in 11 patients. Three patients (3.6%) suffered a sub- and/or intertrochanteric fracture after a mean postoperative time of 30 days, in one case without obvious trauma. In all three cases surgical revision was necessary. Between 1999 and 2001 we did not observe any fracture after screwing. CONCLUSION: Two screws in the inferior part of the femoral neck create a stress riser in the subtrochanteric region, potentially inducing a fracture in the weakened bone. For internal fixation for proximal intracapsular femoral fracture only one screw must be inserted in the inferior part of neck.
Keywords
Adult, Aged, Aged, 80 and over, Biomechanics, Bone Screws, Female, Femur Neck/radiography, Femur Neck/surgery, Fracture Fixation, Internal/methods, Hip Fractures/radiography, Hip Fractures/surgery, Humans, Joint Capsule/injuries, Joint Capsule/radiography, Male, Middle Aged, Postoperative Complications/etiology, Postoperative Complications/radiography, Recurrence, Reoperation/methods, Retrospective Studies, Risk Factors, Treatment Outcome
Pubmed
Create date
24/01/2008 15:17
Last modification date
20/08/2019 16:00
Usage data