Subtrochanteric Fracture after Cannulated Cancellous Screw Fixation of Osteoporosis-Induced Femoral Subcapital Fractures: A Report of Three Cases

DOI 9 References
  • Yamashita Akihisa
    Department of Orthopaedic Surgery, Shimonoseki City Hospital, Yamaguchi, Japan
  • Shirasawa Kenzo
    Department of Orthopaedic Surgery, Shimonoseki City Hospital, Yamaguchi, Japan
  • Kido Hidehiko
    Department of Orthopaedic Surgery, Shimonoseki City Hospital, Yamaguchi, Japan
  • Irie Manabu
    Department of Orthopaedic Surgery, Shimonoseki City Hospital, Yamaguchi, Japan
  • Ogata Junya
    Department of Orthopaedic Surgery, Shimonoseki City Hospital, Yamaguchi, Japan
  • Mitsuyasu Hiroaki
    Department of Orthopaedic Surgery, Shimonoseki City Hospital, Yamaguchi, Japan

Bibliographic Information

Other Title
  • 高齢者大腿骨骨頭下骨折に対するＣＣＳ骨接合術後に転子下骨折を来した症例の検討

Search this article

Abstract

Osteoporosis-induced femoral neck fracture is a major traumatic disorder in elderly patients. This fracture is often treated surgically. Although many implants have been developed, we use cannulated cancellous screw (CCS) for femoral subcapital fracture fixation as it offers advantages such as rotational stability, compression of fracture site, and technical convenience. Complications of surgical treatment for femoral subcapital fracture, such as non-union of fracture and post-traumatic femoral head necrosis, have been reported. Subtrochanteric fracture after CCS osteosynthesis is rarely seen. We have experienced three cases of subtrochanteric fracture after CCS operation. The common denominator in all three patients seemed to be entry point in the lateral cortex below the level of the lesser trochanter, the highest screw angle of insertion, without washer engagement. It is therefore important to pay attention to the screw inserted site, screw angle, and screw location during the CCS operation. Furthermore, we have also identified the following guidelines for our CCS operation of femoral subcapital fractures: 1) lowest angle of screw insertion, 2) insertion above inferior edge of lesser trochanter, 3) three-point fixation, 4) parallel insertion of all screws, 5) apex distal triangle pattern if three screws are inserted, and 6) use of washer.

Journal

References(9)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top