Assessment of lateral femoral wall thickness as a measure to predict postoperative lateral femoral wall fractures in intertrochanteric fractures treated with Dynamic Hip Screw
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 10
Abstract
Background: Intertrochanteric fracture is defined as the fracture in which the main plane of bony separation passes the tip of the greater trochanter obliquely downwards and inwards to or through the lesser trochanter. Interchanteric fractures occur in the area just distal to the capsule of the hip joint, and above the area of isthmus of the medullary canal. Dynamic Hip Screw is the gold standard in the management of intertrochanteric fractures. Aim: To investigate the reliability of lateral femoral will thickness as a measure to predict postoperative lateral femoral will fractures in AO31A1 and AO31A2 intertrochanteric fractures treated with Dynamic Hip Screw. Methods: A retrospective study was conducted. Data was collected for a period of 2 years. Intertrochanteric fractures AO31A1 and AO31A2 who were treated with dynamic Hip screw were included in the study. Results: Thirty, intertrochanteric fractures of AO31A1 and AO31A2 type were enrolled. The mean age group is 64.3 years among which mostly were males (53%). Most of the patients (60%) had fractures on the left side of which (86%) sustained injury due to trivial fall. Out of 30 cases 12 cases (40%) were AO31A1type and 18 cases (60%) were AO31A2 type. The mean thickness was 27.9mm in AO31A1 group and 21.4mm in AO31A2 group. AO31A1 (40%) and AO31A2 (43%) achieved normal radiological union within 6 months postoperatively without any lateral femoral wall fractures in the postoperative period. The lateral femoral wall thickness is significantly thin in AO31A2 group with lateral femoral wall fractures (P<0.008) when compared with those without lateral femoral wall fractures (AO31A1 and AO31A2). Conclusion: Preoperative assessment of lateral femoral wall thickness is a useful measure to predict postoperative lateral femoral wall fractures in intertrochanteric fractures treated with DHS. From this study, it is recommended that a preoperative lateral femoral wall thickness of less than 22.1 mm is the critical value below which the lateral femoral wall fracture can occur when fixed with DHS alone.
Authors and Affiliations
Dr. Kurapathi Rajesh MS Ortho, Dr Irigi Kameshwar Ms. Ortho, Dr I. Ramulu, Dr. Yadaiah Damera, Dr. Neetika Ashwani
Keywords
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- EP ID EP401672
- DOI 10.9790/0853-1710054756.
- Views 36
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