Criteres predictifs d'une effraction articulaire meconnue apres osteosynthese d'une fracture du col du femur

ABSTRACT

On the basis of a retrospective study comprising 91 cases of femoral neck fracture treated by DHS, unrecognized screw articular penetration was observed in 9 cases [9,9%]. The coxa valga [Garden 1] fractures are the most interested by this complication [7 cases out of 9]. With a practical purpose and to avoid remarking each time complex measurements again we found that the distance "d" separating the end of the implant from subchondral bone calculated on antero posterior and lateral views and so the angle measured on the lateral view were two criteria significantly predictive of this technical error with respectively P 0,005 and P 0,0005.Thus during the surgical procedure taking these two measurements after the installation of the pin guide would allow attention on the risk incurred. In case of doubt, we have changed the way of this pin before resorting to drilling and tapping