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O3461 ALGORYTHM OF SURGICAL MANAGEMENT OF TROCHANTERIC FRACTURES



Abstract

Aims: The aim of our study was to assess results of treatment of trochanteric fractures using a speciþc algorythm Methods: From January 2000 to March 2002, 215 patients affected by fractures of trochanteric region were treated. 130 were female and 85 male, the average age was 72,5 (5–96). Author used an algorythm based on the analysis of stability of the bone-device system considering three groups: GROUP 1: stable fractures (A1 and A2.1 according to AO classiþcation) in which dynamic hip screw was employed, GROUP 2: unstable fractures (A2.2, A2.3, A3.1) in which dynamic hip screw and trochanteric stabilizing plate were employed, GROUP 3:unstable fractures (A3.2 and A3.3) in which intramedullary nailing was performed. Results: The average healing time was 6 weeks for GROUP 1 and GROUP 2 and 7,2 weeks for GROUP 3. According to the HHS at 12 months the average score for GROUP 1 was 83,1, with 72% of excellent results, 20% good, 4% fair and 4% poor; for GROUP 2 the average score was 79,7 with 56% of excellent results, 25% good, 10% fair and 9% poor; for GROUP 3 the average score was 77,2 with 40% of excellent results, 29% good, 18% fair and 13% poor. In GROUP 2 we observed 2 cases of limb shortening more then 2 cm and 9 cases of pain due to trochanteric plate. In 2 cases of cut-out of the lag screw cemented endoprosthesis was required. In GROUP 3 we observed 5 cases of limb shortening more then 2 cm and 4 cases of persistent trochanteric pain. Conclusions: Following this algorythm a low rate of complication were observed specially in GROUP 2.

Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.