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Fixation of basicervical and related fractures

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Abstract

We prospectively studied 42 patients in order to identify a group of proximal femoral fractures having liability for axial and rotational instability, and to present results of their fixation using the dynamic hip screw (DHS) with derotation screw (DRS). At 12 months postoperatively, patients were functionally evaluated and the radiological outcome was analysed. All fractures united within an average period of 11.5 weeks. The mean sliding distance was 5.5 mm and mean shortening of the limbs was 2 mm. According to the criteria of Kyle et al. (J Bone Joint Surg [Am] 61-A:216–221), 39 patients obtained excellent results, two good and one fair. We conclude that the AO types B2.1, A1.1, A2.1, A2.2 and A2.3 have a common instability denominator and therefore should be treated alike. The sliding component of the DHS allows solid fixation of the two major fragments in two planes and the DRS in the third plane.

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References

  1. Bartucci EJ, Gonzalez MH, Cooperman DR et al (1985) The effect of adjunctive methylmethacrylate on failures of fixation and function in patients with intertrochanteric fractures and osteoporosis. J Bone Joint Surg (Am) 67-A:1094–1107

    Google Scholar 

  2. Baumgaertner MB, Solberg BD (1997) Awareness of tip-apex distance reduces failure of fixation of trochanteric fractures of the hips. J Bone Joint Surg [Br] 79-B:969–971

    Article  Google Scholar 

  3. Blair B, Koval KJ, Kummer F, Zuckerman JD (1994) Basicervical fractures of the proximal femur. A biomechanical study of 3 internal fixation techniques. Clin Orthop Relat Res 306:256–263

    PubMed  Google Scholar 

  4. Brooker A, Bowerman J, Robinson R, Riley LH Jr (1973) Ectopic ossification following total hip replacement: incidence and a method of classification. J Bone Joint Surg. [Am] 55-A:1629–1632

    Google Scholar 

  5. Clark DW, Ribbans WJ (1990) Treatment of unstable intertrochanteric fractures of the femur: a prospective trial comparing anatomical reduction and valgus osteotomy. Injury 21:84–88

    Article  CAS  PubMed  Google Scholar 

  6. DeLee JC (1996) Fractures and dislocations of the hip. In: Rockwood and Green's fracture in adults, 4th ed. Lippincott-Raven, Philadelphia

  7. Deneka DA, Simonian PT, Stankewich CJ et al (1997) Biomechanical comparison of internal fixation techniques for the treatment of unstable basicervical femoral neck fractures. J Orthop Trauma 11:337–343

    Article  CAS  PubMed  Google Scholar 

  8. Giannoudis PV, Schneider E (2006) Principles of fixation of osteoporotic fractures. J Bone Joint Surg [Br] 88-B:1272–1278

    Google Scholar 

  9. Gill JM, Johnson GR, Sher JL, Kornjaca NA (1989) Biomechanical aspects of the repair of intertrochanteric fractures. J Biomed Eng 11:235–239

    Article  CAS  PubMed  Google Scholar 

  10. Gurusamy K, Parker MJ, Rowlands TK (2005) The complications of displaced intracapsular fractures of the hip: The effect of screw positioning and angulation on fracture healing. J Bone Joint Surg [Br] 87-B:632–634

    Google Scholar 

  11. Jensen JS (1980) Classification of trochanteric fractures. Acta Orthop Scand 51:803–810

    Article  CAS  PubMed  Google Scholar 

  12. Kyle RF (1994) Fractures of the proximal part of the femur. J Bone Joint Surg Am 76:924–950

    Google Scholar 

  13. Kyle RF, Gustilo RB, Premer RF (1979) Analysis of six hundred and twenty-two intertrochanteric hip fractures. J Bone Joint Surg [Am] 61-A:216–221

    Google Scholar 

  14. Ly TV, Swiontkowski MF (2008) Management of femoral neck fracture in young adult. IJO 42:3–12

    Google Scholar 

  15. Madsen JE, Naess L, Aune AK, Ahlo A, Ekeland A, Strmse K (1998) Dynamic hip screw with trochanteric stabilizing plate in the treatment of unstable proximal femoral fractures: A comparative study with the gamma nail and compression hip screw. J Orthop Trauma 12(4):241–248

    Article  CAS  PubMed  Google Scholar 

  16. Mattsson P, Alberts A et al (2005) Resorbable cement for the augmentation of internally fixed unstable trochanteric fractures. J Bone Joint Surg [Br] 87-B:1203–1209

    Google Scholar 

  17. Miedel R, Ponzer S, Tornkvist H et al (2005) The standard gamma nail or the Medoff sliding plate for unstable trochanteric and subtrochanteric fractures. A randomised, controlled trial. J Bone Joint Surg [Br] 87-B:68–75

    Google Scholar 

  18. Müller ME, Allgöwer M, Schneider R, et al (eds) (1992) Proximal femur. In: Manual of internal fixation: techniques recommended by the AO-ASIF Group, 3rd edn. Springer, Berlin

  19. Ort PJ, LaMont J (1984) Treatment of femoral neck fractures with a sliding compression screw and two Knowles pins. Clin. Orthop 190:158–162

    PubMed  Google Scholar 

  20. Pajarinen J, Lindahl J, Michelsson O et al (2005) Pertrochanteric femoral fractures treated with a dynamic hip screw or a proximal femoral nail. A randomized study comparing post-operative rehabilitation. J Bone Joint Surg [Br] 87-B:76–81

    Google Scholar 

  21. Pervez H, Parker MJ, Pryor GA et al (2002) Classification of trochanteric fracture of the proximal femur: a study of the reliability of current systems. Injury 33:713–715

    Article  PubMed  Google Scholar 

  22. Saarenpaa I, Partanen J, Jalovaara P (2002) Basicervical fracture—a rare type of hip fracture. Arch Orthop Trauma Surg 122:69–72

    Article  CAS  PubMed  Google Scholar 

  23. Smith FB (1959) Effects of rotary and valgus malpositions of blood supply to the femoral head. J Bone Joint Surg 41A:800–815

    Google Scholar 

  24. Su BW, Heyworth BE, Protopsaltis TS et al (2006) Basicervical versus intertrochanteric fractures: an analysis of radiographic and functional outcomes. Orthopedics 29:919–925

    PubMed  Google Scholar 

  25. Swiontkowski MF (1994) Intracapsular fractures of the hip. J Bone Joint Surg Am 76:129–138

    CAS  PubMed  Google Scholar 

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Correspondence to Elsayed Ibraheem Elsayed Massoud.

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Massoud, E.I.E. Fixation of basicervical and related fractures. International Orthopaedics (SICOT) 34, 577–582 (2010). https://doi.org/10.1007/s00264-009-0814-1

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  • DOI: https://doi.org/10.1007/s00264-009-0814-1

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