Treatment of unstable intertrochanteric fracture with augmentation technique injected with PMMA through lateral holes of dynamical hip screw / 中华创伤杂志

ABSTRACT

Objective To observe curative effects of augmentation fixation technique injected with PMMA through lateral holes of dynamical hip screw (DHS) in treatment of unstable intertrochanteric fracture of senile osteoporotic patients. Methods From January 2006 to December 2007,15 senile osteoporotic inpatients with unstable femoral intertrochanteric fracture were treated with augmentation technique injected with PMMA to the femoral head through central channel and lateral holes of DHS. Clinical data about function of hip joint and complications early after operation were observed. All patients were followed up till fractures were healed, when the hip joint function was evaluated according to Harris standarch. Results Surgical trauma indices such as operation time and bleeding volume of augmentation technique were the same as those of merely DHS fixation. All the patients could safely do hip flexion and extension exercises in the bed and completely sit up by bedside 2-3 days after operation. Six patients could do walking exercise with aid one week after operation, with no complications relating to staying in bed or to PMMA during per-operation period. All fractures were healed 3-6 months after operation, without complications like fixation loosening, cut or destruction of femoral head during postoperative follow-up period. Six months after operation, 14 patients recovered viability to normal. According to Harris standards, the results were excellent in four patients, good in 10 and fair in one, with average Harris score of 83 points. Conclusions The augmentation fixation technique injected with PMMA through lateral holes of DHS has advantages of better DHS anchoring ability in femoral heads, less surgical trauma, reliable fixation and early functional exercise and is suitable for senile osteoporotic patients with unstable intertrochanteric fractures.