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

Détails

ID Serval
serval:BIB_DB8226F3DBB7
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Sub- or intertrochanteric fracture following screw fixation of an intracapsular proximal femoral fracture: true complication or technical error?
Périodique
Swiss Surgery
Auteur(s)
Pelet S., Leyvraz P.F., Garofalo R., Borens O., Mouhsine E.
ISSN
0007-1323
1023-9332
Statut éditorial
Publié
Date de publication
2003
Volume
9
Numéro
2
Pages
82-86
Langue
anglais
Résumé
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.
Mots-clé
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
Création de la notice
24/01/2008 16:17
Dernière modification de la notice
20/08/2019 17:00
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