Abstract

PESCIALLO, César Á; PEREZ ALAMINO, Leonel; GARABANO, Germán  and  DEL SEL, Hernán. Errores de osteosíntesis en fracturas laterales de cadera tratadas con placa/tornillo deslizante. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2019, vol.84, n.4, pp.328-336. ISSN 1852-7434.

Objectives: The use of dynamic hip screws (DHS) for intertrochanteric fractures has proven to be an effective, but infalible, fixation method. The purpose of this study was to evaluate the reason behind fixation failure in patients with this type of hip fracture treated with a DHS. Materials and Methods: 177 patients were treated in our center for intertrochanteric hip fractures. A DHS was placed in 151 of them. Our analysis included quality of reduction after surgery, tip-apex distance, femoral head lag screw position, and possible complications. Results: The series included 143 patients. The average follow-up was 18 months (range 12-48). The failure rate was 8.4% (n = 12): 7 (4.8%) cases were due to intrapelvic migration of the lag screw ("cut-out") and 2 (1.4%) were due to medial perforation ("cut-through"), while 2 (1.4%) cases presented with pseudarthrosis and 1 (0.70%) with varus deformity after reduction. The revision rate was 7.7% (n = 11). Lag screws placed in a superior/posterior position had the highest failure rate (100% migration rate) (n = 4) (p <0.001, statistically significant difference). Conclusions: Superior/posterior positioning of the lag screw may increase the possibility of migration and, consequently, the failure rate of the DHS system.

Keywords : Fracture; Hip; Plate; Dynamic screw; Faillure.

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