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. 2001 Jul 26;25(6):360–362. doi: 10.1007/s002640100287

Failure of intertrochanteric fracture fixation with a dynamic hip screw in relation to pre-operative fracture stability and osteoporosis

Weon-Yoo Kim 1, Chang-Hwan Han 1, Jin-Il Park 1, Jin-Young Kim 1
PMCID: PMC3620783  PMID: 11820441

Abstract.

We have reviewed 178 intertrochanteric fractures treated by dynamic hip screw (DHS) fixation between March 1995 and December 1999 and followed for a minimum of 1 year. We used Singh's classification of the trabecular bone structure in the proximal femur as a measure of osteoporosis and also classified the fractures according to three different systems (Boyd-Griffin, Evans, AO). The postoperative radiographs were examined for loss of reduction, i.e. varus angulation >100, perforation of the femoral head, more than 20-mm extrusion of a lag screw or metal failure. We found 49 cases which showed radiographic failures. Two were stable fractures and 47 unstable fractures (Evans' classification). Unstable fractures with osteoporosis had a failure rate of more than 50%. In such cases DHS should not be the first choice for treatment.

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