Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure?

Goh, Kian Liang and Zakaria@Mohamad, Zamzuri and Sharifudin, Mohd Ariff and Mohamed Amin, Mohamed Azril (2016) Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure? International Medical Journal Malaysia, 15 (1). pp. 31-34. ISSN 1823-4631

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Abstract

Introduction: Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to guide the optimal placement of lag screw and to predict subsequent risk of screw cut-out. In this study, the value of TAD was evaluated to verify its usefulness. Methods: This is a retrospective study of 33 consecutive patients with intertrochanteric fracture treated with DHS. Demographic data of the patients were traced from their case notes. Post-operative radiographs were reviewed by focusing on measurement of TAD on anteroposterior and lateral radiographs. Radiographs at one year follow-up were reviewed to depict any fixation-related failure or complication. Results: Fifty two percent of patients did not achieved the recommended TAD of ≤ 25mm. The mean post-operative TAD was 25.9mm and elderly patients were likely to achieve TAD of ≤ 25mm. The overall complication rate of 6% was attributed to screw cut-out in two cases. The unstable left-sided fracture was identified to be a potential risk for screw cut-out or migration. Conclusion: TAD is a valuab

Item Type:	Article (Journal)
Additional Information:	5929/50898
Uncontrolled Keywords:	Intertrochanteric fracture, dynamic hip screw, tip-apex distance, screw cut-out
Subjects:	R Medicine > RD Surgery > RD701 Orthopedics
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Department of Orthopaedics, Traumatology & Rehabilitation
Depositing User:	Dr Kian Liang Goh
Date Deposited:	23 Jun 2016 08:58
Last Modified:	28 Jul 2016 09:52
URI:	http://irep.iium.edu.my/id/eprint/50898

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