Skip to main content

Advertisement

Log in

Keyhole Sliding Hip Screw Fixation for Stable Intertrochanteric Hip Fractures: A Novel Technique

  • Surgical Technique
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Intertrochanteric hip fractures are common orthopaedic injuries and the incidence is growing with increasing life expectancy. Several randomized controlled studies have shown the advantages of intramedullary devices over hip screw fixation in unstable intertrochanteric fractures. However, the proven advantage of the intramedullary device in stable intertrochanteric fractures, OTA (Orthopaedic Trauma Association) classification 31-A1 and some 31-A2 fractures are in less blood loss compared with standard hip screw fixation. In the current technical note, we describe a novel minimally invasive technique of hip screw fixation that use a keyhole size incision to fix stable intertrochanteric fractures using sliding hip screw. The less invasive nature and potentially reduced blood loss makes this technique an attractive option for stabilizing stable intertrochanteric hip fractures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Sharma A, Sethi A, Sharma S (2017) Treatment of stable intertrochanteric fractures of the femur with proximal femoral nail versus dynamic hip screw: a comparative study. Rev Bras Ortop 53(4):477–481. https://doi.org/10.1016/j.rboe.2017.07.008

    Article  PubMed  PubMed Central  Google Scholar 

  2. Zuckerman, J. D. (Ed.). (1990). Comprehensive care of orthopaedic injuries in the elderly. Urban & Schwarzenberg.

    Google Scholar 

  3. Evans, E. M. (1949). The treatment of trochanteric fractures of the femur. Journal of Bone and Joint Surgery. American Volume, 31B(2), 190–203.

    Article  CAS  Google Scholar 

  4. Boyd, H. B., & Griffin, L. L. (1949). Classification and treatment of trochanteric fractures. Archives of Surgery, 58(6), 853–866.

    Article  CAS  Google Scholar 

  5. Kyle, R. F., Gustilo, R. B., & Premer, R. F. (1979). Analysis of six hundred and twenty-two intertrochanteric hip fractures. Journal of Bone and Joint Surgery. American Volume, 61(2), 216–221.

    Article  CAS  Google Scholar 

  6. Gotfried, Y. (2004). The lateral trochanteric wall: A key element in the reconstruction of unstable pertrochanteric hip fractures. Clinical Orthopaedics and Related Research, 425, 82–86.

    Article  Google Scholar 

  7. Marsh, J. L., Slongo, T. F., Agel, J., et al. (2007). Fracture and dislocation classification compendium—2007: Orthopaedic Trauma Association classification, database and outcomes committee. Journal of Orthopaedic Trauma, 21(10), S1-133.

    Article  CAS  Google Scholar 

  8. Schipper, I. B., Marti, R. K., & van der Werken, C. (2004). Unstable trochanteric femoral fractures: Extramedullary or intramedullary fixation. Review of literature. Injury, 35(2), 142–151.

    Article  CAS  Google Scholar 

  9. Ziran, B. H., Heckman, D. S., Olarte, C. M., Chou, K., & Baranick, J. (2009). Intramedullary hip screw versus standard compression hip screw: Early postoperative rehabilitation comparisons. Orthopedics, 32(2), 83.

    PubMed  Google Scholar 

  10. Barton, T. M., Gleeson, R., Topliss, C., Greenwood, R., Harries, W. J., & Chesser, T. J. (2010). A comparison of the long gamma nail with the sliding hip screw for the treatment of AO/OTA 31–A2 fractures of the proximal part of the femur: A prospective randomized trial. Journal of Bone and Joint Surgery. American Volume, 92(4), 792–798.

    Article  Google Scholar 

  11. Utrilla, A. L., Reig, J. S., Munoz, F. M., & Tufanisco, C. B. (2005). Trochanteric gamma nail and compression hip screw for trochanteric fractures: A randomized, prospective, comparative study in 210 elderly patients with a new design of the gamma nail. Journal of Orthopaedic Trauma, 19(4), 229–233.

    Article  Google Scholar 

  12. Pajarinen, J., Lindahl, J., Michelsson, O., Savolainen, V., & Hirvensalo, E. (2005). Pertrochanteric femoral fractures treated with a dynamic hip screw or a proximal femoral nail. A randomised study comparing post-operative rehabilitation. Journal of Bone and Joint Surgery. British Volume, 87(1), 76–81.

    Article  CAS  Google Scholar 

  13. Parker, M. J., & Handoll, H. H. (2008). Gamma and other cephalocondylic intramedullary nails versus extramedullary implants for extracapsular hip fractures in adults. The Cochrane Database of Systematic Reviews, 3, CD000093.

    Google Scholar 

  14. Shah, N. H., Walton, N. P., Sudhahar, T. A., & Donell, S. T. (2004). Screening time for extra-capsular proximal femoral fracture fixation; the difference between extra-medullary and intra-medullary implant usage. Injury, 35(10), 1010–1014.

    Article  CAS  Google Scholar 

  15. Lee, Y. S., Huang, H. L., Lo, T. Y., & Huang, C. R. (2007). Dynamic hip screw in the treatment of intertrochanteric fractures: A comparison of two fixation methods. International Orthopaedics, 31(5), 683–688.

    Article  Google Scholar 

  16. Wong, T. C., Chiu, Y., Tsang, W. L., Leung, W. Y., & Yeung, S. H. (2009). A double-blind, prospective, randomised, controlled clinical trial of minimally invasive dynamic hip screw fixation of intertrochanteric fractures. Injury, 40(4), 422–427.

    Article  Google Scholar 

  17. Kosygan, K. P., Mohan, R., & Newman, R. J. (2002). The Gotfried percutaneous compression plate compared with the conventional classic hip screw for the fixation of intertrochanteric fractures of the hip. Journal of Bone and Joint Surgery. British Volume, 84(1), 19–22.

    Article  CAS  Google Scholar 

  18. Leung, W. Y., & Tsang, W. L. (2008). Conventional muscle-reflection approach versus mini-incision muscle-splitting approach in dynamic hip screw fixation. Journal of Orthopaedic Surgery (Hong Kong), 16(2), 156–161.

    Article  CAS  Google Scholar 

  19. Peyser, A., Weil, Y. A., Brocke, L., et al. (2007). A prospective, randomised study comparing the percutaneous compression plate and the compression hip screw for the treatment of intertrochanteric fractures of the hip. Journal of Bone and Joint Surgery. British Volume, 89(9), 1210–1217.

    Article  CAS  Google Scholar 

  20. DiPaola, M., Rozbruch, S. R., & Helfet, D. L. (2004). Minimal incision technique using a two-hole plate for fixation of stable intertrochanteric hip fractures. Orthopedics, 27(3), 270–274.

    Article  Google Scholar 

  21. Alobaid, A., Harvey, E. J., Elder, G. M., Lander, P., Guy, P., & Reindl, R. (2004). Minimally invasive dynamic hip screw: Prospective randomized trial of two techniques of insertion of a standard dynamic fixation device. Journal of Orthopaedic Trauma, 18(4), 207–212.

    Article  CAS  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to B. Shivashankar.

Ethics declarations

Conflict of Interest

None of the authors have any conflicts to declare.

Ethical Standard Statement

This article does not contain any studies with human or animal subjects performed by any of the authors.

Informed Consent

For this type of study informed consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shivashankar, B., Shah, S., Kumar, G. et al. Keyhole Sliding Hip Screw Fixation for Stable Intertrochanteric Hip Fractures: A Novel Technique. JOIO 56, 1101–1107 (2022). https://doi.org/10.1007/s43465-022-00624-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s43465-022-00624-5

Keywords

Navigation