Intertrochanteric fracture fixation with Dynamic Hip Screw: Is tip-apex distance measurement useful for predicting fixation failure?
The International Medical Journal Malaysia
;
(2): 31-34, 2016.
Article
in English
| WPRIM
| ID: wpr-627180
ABSTRACT
Introduction:
Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to guide the optimal placement of lag screw and to predict subsequent risk of screw cut-out. In this study, the value of TAD was evaluated to verify its usefulness.Methods:
This is a retrospective study of 33 consecutive patients with intertrochanteric fracture treated with DHS. Demographic data of the patients were traced from their case notes. Post-operative radiographs were reviewed by focusing on measurement of TAD on anteroposterior and lateral radiographs. Radiographs at one year follow-up were reviewed to depict any fixation-related failure or complication.Results:
Fifty two percent of patients did not achieved the recommended TAD of ≤ 25mm. The mean post-operative TAD was 25.9mm and elderly patients were likely to achieve TAD of ≤ 25mm. The overall complication rate of 6% was attributed to screw cut-out in two cases. The unstable left-sided fracture was identified to be a potential risk for screw cut-out or migration.Conclusion:
TAD is a valuable measurement to guide optimal placement of lag screw during DHS fixation of intertrochanteric fracture.
Full text:
Available
Index:
WPRIM (Western Pacific)
Type of study:
Observational study
/
Prognostic study
Language:
English
Journal:
The International Medical Journal Malaysia
Year:
2016
Type:
Article
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