Acta Medica Okayama 71巻 4号
2017-08 発行

Analysis of the Postoperative Displacement of Trochanteric Fractures on Lateral View Radiographs

Furui, Atsuo Department of Orthopaedic Surgery, Fujita Health University, Banbuntane Houtokukai Hospital
Terada, Nobuki Department of Orthopaedic Surgery, Fujita Health University, Banbuntane Houtokukai Hospital
Publication Date
2017-08
Abstract
Achieving sufficient support of the anterior cortex of the femoral neck is a fundamental goal of the reduction of trochanteric fractures. However, anterior-cortex support is often lost after the fracture reduction. Our aim was to analyze factors contributing to the postoperative displacement of an acceptably reduced trochanteric fracture. The cases of 40 patients with a post-reduction Ikuta subtype N fracture alignment were reviewed. All fractures were fixed with 135° free-sliding plates. On postoperative day 14, patients were classified into two groups: those with retention of the Ikuta subtype N alignment, and those with progression to Ikuta subtype P alignment. The clinical and radiological factors were evaluated between the groups. In addition, to define one of the factors, i.e., the postoperative rotational displacement between the proximal and distal fragments, the relationship between radiographic findings and computed tomography image measurements was assessed in 15 of the 40 patients. Angulation at the fracture site on lateral view radiographs was defined as postoperative rotational displacement, and unstable trochanteric fractures and postoperative rotational displacement were identified as significant risk factors for the postoperative displacement. Therefore, cautious and careful follow-up is warranted for patients with unstable trochanteric fractures or fractures having rotational displacement.
Document Type
Original Article
Keywords
trochanteric fracture
sliding hip screw
subtype
rotational displacement
iliofemoral ligament
Link to PubMed
Thumnail 71_4_269.pdf 2.69 MB