- See:
-
Sliding Screw Insertion Technique:
-
Sliding Screw Fixation in Subtroch Frx:
- Discussion:
- treatment of
unstable intertrochanteric frxs w/ sliding screw device w/o obtaining necessary
bony stability, risks hardware failure;
- if device impinges, it will act as a
fixed angle nail plate and will result in either cutting out or
penetration of the head as the unstable frx settles into a position of bone stability;
- because sliding hip screw allows controlled collapse at frx site, unstable frxs which are anatomically
reduced can be expected to impact spontaneously to stable & often medially displaced position;
- as slinding device shortens w/ settling of unstable frx, the lever arm acting on the nail on the nail
plate junction shortens w/ settling of the unstable frx, thereby reducing force on the implant;
- unstable frx treated w/ sliding device may undergo shortening and medial displacement, but frx tend to go onto union;
- the following example is self explanatory as to why sliding screws should be used w/ caution
in treating subtrochanteric fractures;
-
trochanteric stabilization plate:
- the trochanteric stabilization plate is designed to fit onto a DHS (dynamic hip screw) and has an
superior extension of the plate which provides lateral support for the trochanter prevents excessive
medial displacement of the shaft fragment;
- in the study by Madsen et al. 1998, there was 6 %;
Dynamic hip screw with trochanteric stabilizing plate in the treatment of unstable proximal femoral fractures: A comparitive study with Gamma Nail and Compression hip screw.
JE Madsen et al.
J. Orthop. Trauma. Vol 12. No 4. p 241-248. 1998.
Integrity of the Lateral Femoral Wall in Intertrochanteric Hip Fractures: An Important Predictor of a Reoperation.
