The Role of Beta-Tricalcium Phosphate Graft in the Dynamic Hip Screw Fixation of Unstable Intertrochanter Fracture

ABSTRACT

PURPOSE: The purpose of this study was to introduce our method of stabilizing unstable intertrochanteric fractures by using the dynamic hip screw (DHS) with a beta-tricalcium phosphate (β-TCP) graft and to compare the outcomes of this procedure with those of the conventional DHS without β-TCP. MATERIALS AND METHODS: Patients who underwent surgery by using DHS between March 2002 and January 2016 were retrospectively reviewed for analysis of the outcomes. The inclusion criteria were 1) age of 60 years and older; 2) low-energy fracture resulting from a fall from no greater than the standing height; 3) multifragmentary pertrochanteric fracture (AO classification 31-A2.2, 2.3); and 4) follow-up of over 3 months. We compared 29 patients (29 hips) who underwent surgery, using DHS without β-TCP, with 29 age-sex matched patients (29 hips) who underwent surgery using DHS with grafted β-TCP granules to empty the trochanter area after reaming. We investigated the fracture union rate, union time, and length of lag screw sliding. RESULTS: Bone union was achieved in all cases. The mean union time was 7.0 weeks in the β-TCP group and 8 .8 weeks in the non-β-TCP group. The length of lag screw sliding was 3.6 mm in the β-TCP group and 5 .5 mm in the non-β-TCP group. There were no implant failure cases in both groups. CONCLUSION: The β-TCP graft for reinforcement DHS acquired satisfactory clinical outcomes for treating unstable intertrochanteric fractures.