Objective: To observe and report the clinical results of the treatment of intertrochanteric hip fractures treated with a 135-degree hip screw with a two-hole side plate.
Design: Prospective consecutive.
Setting: Community private practice.
Patients: A consecutive series of seventy primarily older patients with intertrochanteric hip fractures treated in a community hospital setting.
Intervention: Surgical treatment with a 135-degree sliding hip screw and a two-hole side plate.
Main outcome measurements: Healing rate and time, operative blood loss and time, incidence of hardware failure, and complications including loss of side plate fixation and amount of collapse.
Results: Sixty-nine patients, with seventy intertrochanteric hip fractures, underwent surgical treatment with a 135-degree sliding hip screw and a two-hole side plate. There were twenty-one (30 percent) A1.1, sixteen (23 percent) A1.2, twenty-one (30 percent) A2.1, and twelve (17 percent) A2.2 fractures in twenty-three (33 percent) men and forty-six (67 percent) women. Average age was seventy-nine years. The average estimated blood loss was seventy-seven cubic centimeters (range 10 to 300 cubic centimeters), and the average surgical time was thirty-one minutes (range 8 to 90 minutes). The average time to union was fifteen weeks (range 8 to 17 weeks). There were three failures: two from screw cut-out and one from screw plate dissociation. No cases failed due to loss of fixation of the two-hole side plate. Collapse was minimum in fifty-five patients (79 percent), moderate in twelve patients (17 percent), and severe in two patients (3 percent).
Conclusions: Use of the 135-degree sliding hip screw with a two-hole side plate produces satisfactory healing and results in relatively low blood loss and short surgical times without the loss of side plate fixation.