How effective are osteotomies for unstable intertrochanteric fractures?

M F Gargan, R Gundle, A H Simpson

Research output: Contribution to journalArticlepeer-review

Abstract

Osteotomy has been used in the treatment of unstable intertrochanteric hip fractures in an attempt to increase the stability of the fracture fragments. We have assessed this stability in a randomised prospective trial on 100 consecutive patients, all having fixation by an AO dynamic hip screw, comparing anatomical reduction with two types of osteotomy. The groups were similar in terms of age, gender, mental test score, and fracture configuration. There were more failures of fixation in the osteotomy groups, and the operations took longer. We found no clear benefit from osteotomy and therefore recommend anatomical reduction and fixation by a sliding hip screw in most cases. Rarely, a fracture configuration which does not allow load-sharing between the fracture fragments and the device may benefit from an osteotomy or the use of an alternative implant.

Original languageEnglish
Pages (from-to)789-92
Number of pages4
JournalJournal of Bone and Joint Surgery, British Volume
Volume76
Issue number5
Publication statusPublished - Sep 1994

Keywords

  • Aged
  • Aged, 80 and over
  • Bone Plates
  • Bone Screws
  • Female
  • Fracture Fixation, Intramedullary
  • Hip Fractures
  • Humans
  • Male
  • Middle Aged
  • Osteotomy
  • Postoperative Complications
  • Prospective Studies
  • Range of Motion, Articular
  • Treatment Outcome

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