Is rigid fixation of the greater trochanter necessary for arthroplasty of intertrochanteric fractures?

INTRODUCTION

Stable fixation of the greater trochanter fracture fragments is necessary in arthroplasty of intertrochanteric hip fractures, as nonunion of the greater trochanter fracture comminution may result in impaired function or dysfunction of the abductor lever arm.

HYPOTHESIS

The ethibond suture technique is an efficient method for fixation of the greater trochanter fracture fragments.

MATERIALS AND METHODS

A total of 47 cases were studied. The mean age of the patients was 80.6 years, and the minimum follow-up was 6 months. Radiologic evaluation was done by examination of greater trochanter healing and measurement of migration of the greater trochanter fragment. Functional evaluation was done by comparison of pre-injury and postoperative ambulation status.

RESULTS

The mean migration of the greater trochanter fragment with ethibond sutures was 5.98mm. Union was achieved in 76.6%, and the nonunion rate was 23.4%. 86.9% of patients had no difference in ambulation or had a difference of only 1 level by the Koval score after treatment compared to their pre-injury status.

DISCUSSION

The ethibond suture technique provides good fixation of the greater trochanter fragments in arthroplasty of intertrochanteric hip fractures.

LEVEL OF EVIDENCE

IV, Case series.