RESUMO
OBJECTIVE: To analysis the reasons of fixation failure for intertrochanteric fractures, so as to select correct operation indications and fixation methods. METHODS: Retrospective analysis the clinical data of 13 patients with failed internal fixation of intertrochanteric fractures from September 1997 to September 2008, and the failure reasons were summarized. There were 7 males and 6 females,ranging in age from 58 to 93 years,averaged 71 years. Two patients were treated with intramedullary fixation, 4 patients with anatomical proximal femoral plate, 3 patients with DHS fixation, 2 patients with hollow compression screws, and 2 patients with external fixation. According to Evans types: 1 patient was type II, 7 patients were type III, and 5 patients were type IV. RESULTS: Eight patients with unstable fractures and malreduction had no grafted bone. Six patients had bad position of neck screws in the femur neck. Postoperative collodiaphyseal angle: 3 patients were under 90 degree, 7 patients 90 to 110 degree, and 3 patients 110 to 130 degree. Five patients had internal fixed screw exited, 6 patients had neck screws cutting to superior lateral, 3 patients had early weight bearing, and 10 patients were osteoporosis occurred after operation from 6 weeks to 11 months, averaged 4.5 months. CONCLUSION: The fixation failure of intertrochanteric fractures was concerned with fractures types, reduction, fixation methods, osteoporosis and the time of weight bearing.
