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불안정 대퇴 전자간 골절에서 소전자부 골편의 고정 효과
강준순 ( Joon Soon Kang ),문경호 ( Kyung Ho Moon ),김려섭 ( Ryu Seop Kim ),배주한 ( Joo Han Bae ),이병철 ( Byung Cheol Lee ) 대한고관절학회 2009 Hip and Pelvis Vol.21 No.3
Purpose: We evaluated the effect of cable fixation of the lesser trochanter for treating unstable intertrochanter fractures. Materials and Methods: In this retrospective study, we assessed the availability of cable fixation of the lesser trochanter and the cause of complications in a series of 47 unstable intertrochanteric femoral fractures that were seen between February 2001 to May 2008 at our hospital. The fractures were classified using the Evans-Jensen classification system. The lesser trochanters were fixed in 21 cases. The correlations between the lag screw position, comminution of the fracture site and the radiological results were studied. Nonunion was diagnosed if patients experienced pain and the radiographs revealed a persistent, radiolucent defect at the fracture site 6 months after fracture fixation. Results: Union was observed in 43 cases (91.5%). The average union time was 3.75 months. Nonunion was observed in 4 cases (8.5%) 1 in group l and 3 in group ll. The average sliding distance of the lag screw was 8.76 mm. In groups l and ll, the distance was 4.92 mm and 12.45 mm, respectively. Excessive sliding, which was defined as more than 15mm, developed in 9 cases, and 7 of these 9 cases were in group ll. The average neck-shaft angle change was 1.28° and 5.81°, respectively. Conclusion: Additional cable fixation of the lesser trochanter for treating intertrochanter fractures, including large posteromedial fragments, is recommended for preventing the excessive sliding of lag screws and varus deformity.
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