The Treatment of Trochanteric Fracture Using Jewett Nail / 대한정형외과학회잡지

ABSTRACT

The prime objective in treating the trochanteric fracture is to achieve bony stability at the fracture site by internal fixation as it provide satisfactory reduction and fixation of the fractures allowing early mobilization of the patient thus avoiding general and local complication following this sort of trauma. The operative management of trochanteric fracture using Jewett nail was performed in eighty-three patients who were admitted at the department of orthopedic surgery, Kyungpook National University Hospital from 1978 to 1985. Of eighty-three patients, only fifty-five patients were able to be analysed completely. The results were as followed: 1. Of the83 cases of the trochanteric fracture, 56 cases were in man, 27 cases were in female, with peak age at 7th decade. 2. The most common cause of fracture was traffic accident in 34 cases, fall down in 26 cases and slip down in 23 cases. 3. According to the classification of the intertrochanteric fracture by Tronzo, most common type was type III in 30 cases, and in the subtrochanteric fracture by Fielding classification, type I in 6 cases, type II in 9 cases and type III in 6 cases. 4. Of the 83 cases of the trochanteric fractures, reduction with medialization was done in 13 cases. 5. The average time until weight bearing was 7.1 weeks in intertrochanteric fracture and 10.8 weeks in subtrochanteric fracture. 6. The average bony union time was 16.8 weeks in intertrochanteric fracture, and 20.2 weeks in subtrochanteric fracture. 7. Of the 32 cases of unstable intertrochanteric fracture, late varus deformity was noticed with 6.0° in cases of anatomical reduction, 4.5° in cases of medialization and leg shorteing was 1.0cm in cases of anatomic reduction, 1.4cm in cases of medialization. 8. Complication was encountered in 14 cases. Limping in 9 cases, surgical wound infection in 2 cases, nail penetration into hip joint in 2 cases and refracture in 1 case. 9. By evaluation of overall, result was good in 34 cases, moderate in 18 cases and poor in 3 cases.