Comparison of the Radiologic Outcomes following the Kinds of Implants in Treating Unstable Osteoporotic Intertrochanteric Fracture

Abstract

Objectives: To determine whether kinds of implants would influence on the radiologic outcomes in the treatment of unstable osteoporotic intertrochanteric fractures.

Materials and Methods: In this retrospective study, radiologic outcomes of 151 patients with unstable osteoporotic intertrochanteric fractures undergoing surgical treatments were compared based on the types of fixation implants as follows : PFNA (53 cases, group Ⅰ), gamma nail 3(31 cases, group Ⅱ), CHS with TSP (43 cases, group Ⅲ), and helical blade type LCP-DHS with TSP (24 cases, group Ⅳ). On the follow-up radiographs after operations, we assessed differences of bone union durations, neck-shaft ankle changes, lag screw or helical blade slippages, and varus alpha angle changes among the study groups.

Results: All the radiologic outcomes evaluated in this study were not significantly different among the study groups. The average bone union durations of the group Ⅰ, Ⅱ, Ⅲ and Ⅳ were 17.7, 18.0, 18.2, and 17.8 weeks, respectively (P=0.429). The average variation of neck-shaft angle of the group Ⅰ, Ⅱ, Ⅲ and Ⅳ were 3.6o, 3.1o, 3.7o and 2.9o, respectively (P=0.273). The average lag screw or blade slippage of the group Ⅰ, Ⅱ, Ⅲ and Ⅳ were 5.1 mm, 3.3 mm, 3.6 mm and 2.7 mm, respectively (P=0.154). The average variation of varus alpha of the group Ⅰ, Ⅱ, Ⅲ and Ⅳ were 5.3o, 4.7o, 4.1o and 4.6º, respectively (P=0.894).

Conclusions: This study indicates that four typical types of fixation implants for treating unstable osteoporotic intertrochanteric fractures would not lead to differences in postoperative radiological outcomes.