Objective: To observe and report the clinical results of the treatment of intertrochanteric hip fractures treated with a 135-degree hip screw with a two-hole side plate.
Design: Prospective consecutive.
Setting: Community private practice.
Patients: A consecutive series of seventy primarily older patients with intertrochanteric hip fractures treated in a community hospital setting.
Intervention: Surgical treatment with a 135-degree sliding hip screw and a two-hole side plate.
Main Outcome Measurements: Healing rate and time, operative blood loss and time, incidence of hardware failure, and complications including loss of side plate fixation and amount of collapse.
Results: Sixty-nine patients, with seventy intertrochanteric hip fractures, underwent surgical treatment with a 135-degree sliding hip screw and a two-hole side plate. There were twenty-one (30 percent) A1.1, sixteen (23 percent) A1.2, twenty-one (30 percent) A2.1, and twelve (17 percent) A2.2 fractures in twenty-three (33 percent) men and forty-six (67 percent) women. Average age was seventy-nine years. The average estimated blood loss was seventy-seven cubic centimeters (range 10 to 300 cubic centimeters), and the average surgical time was thirty-one minutes (range 8 to 90 minutes). The average time to union was fifteen weeks (range 8 to 17 weeks). There were three failures: two from screw cut-out and one from screw plate dissociation. No cases failed due to loss of fixation of the two-hole side plate. Collapse was minimum in fifty-five patients (79 percent), moderate in twelve patients (17 percent), and severe in two patients (3 percent).
Conclusions: Use of the 135-degree sliding hip screw with a two-hole side plate produces satisfactory healing and results in relatively low blood loss and short surgical times without the loss of side plate fixation.
Bayfront Medical Center, St. Petersburg, Florida, U.S.A.
Accepted September 4, 1998.
Address correspondence and reprint requests to Dr. Brett R. Bolhofner, All Florida Orthopaedic Associates, 4600 4th Street North, St. Petersburg, FL 33703, U.S.A.
No financial support of this project has occurred. The authors have received nothing of value.
The devices that are the subject of this manuscript are FDA-approved.