The Effect of an Attachable Lateral Support Plate on the Stability of Intertrochanteric Fracture Fixation with a Sliding Hip Screw

Abstract

Background  

Use of a sliding hip screw (SHS) alone for some unstable intertrochanteric femur fractures can allow excessive medial shaft displacement during impaction. This study eval-uated the effect of an attachable lateral support plate on these fractures after loading.

Methods  

Unstable, three-part intertrochanteric fractures were created in 10 matched pairs of embalmed femurs that were instrumented with 135-degree SHSs with or without an attachable lateral support plate. Under physiologic loading, inferior and lateral head displacements and lag screw sliding distances were measured.

Results  

After 10,000 cycles at 750 N, all measurements for femurs with the lateral support plate were significantly less than for the femurs with the SHS alone: mean lateral difference was 1.7 mm (34%) (p < 0.05), mean inferior difference was 3.0 mm (38%) (p < 0.05), and mean lag screw sliding difference was 4.5 mm (58%) (p < 0.05).

Conclusion  

The addition of an attachable lateral support plate to an SHS significantly decreased displacement of the femoral head after cyclic loading.