Treatment of early cut-out of a lag screw using a trochanter supporting plate: 11 consecutive patients with unstable intertrochanteric fractures.

INTRODUCTION

Superior cut-out of a lag screw remains a serious complication in the treatment of intertrochanteric fractures. It is related to the stability of fracture reduction. We describe the application of a trochanter supporting plate (TSP) to restore the fracture stability after early cut-out of a lag screw in unstable intertrochanteric fractures.

MATERIALS AND METHODS

A total of 11 consecutive patients with superior cut-out of the lag screw of a dynamic hip screw (DHS) or a gamma nail in an unstable intertrochanteric fracture occurring within 6 months after surgery were included in the present study. They underwent repeat surgery for placement of a DHS and a laterally mounted TSP of our design. All patients were monitored for at least 6 months (median 15 months; range 6-28 months).

RESULTS

There was no repeated cut-out of a lag screw, and 10 patients (91%) achieved bony union within 5 months. At the last follow-up, all patients could walk with or without aids.

CONCLUSION

It reveals that a TSP, as an adjuvant to a lag screw placed inferiorly, is an easy and safe solution for the treatment of early cut-out of a lag screw in unstable intertrochanteric fractures.