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Can an Inferior Calcar Stabilising Antirotation Screw Improve Stability in Unstable A2 Inter Trochanteric Fractures
Zaid Mohammed Al-Ani1,2, Santosh Bindumadhavan1,2, Khalid Sharif
1Department of Trauma & Orthopedics, Hinchinbrooke Hospital, Huntingdon, United Kingdom.
Objective:
To determine the effect of a calcar stabilising anti rotation screw on reducing the complication rate in intertrochanteric hip fractures.
Study Design:
An observational study.
Place And Duration Of Study:
Hinchingbrooke Hospital, Northwest Anglia Foundation Trust, Huntingdon, UK, from July 2019 to December 2020.
Methodology:
All A2 Intertrochanteric fractures according to the AO31 classification fixed with dynamic hip screw (DHS) were included. Exclusion criteria were A1 and A3 fractures, pathological, and per-prosthetic fractures. Fifty-four patients were divided into two groups. Group one (21) patients were managed with a DHS and a calcar stabilising screw. Group two (33) were managed with a dynamic hip screw (DHS) only. Both groups had a 12 months follow-up. Study variables were age, gender, ASA and preoperative mobility status, and tip-apex distance; while outcome measures were mechanical failures including cut-out needing revisions and medialisation associated with pain.
Results:
No patients in the group one suffered mechanical failure compared to 27% in group two.
Conclusion:
A calcar stabilising screw reduces the failure rate of A2 unstable intertrochanteric fractures when used in conjunction with the DHS.
Key Words:
Intertrochanteric fractures, Hip fracture, A2 unstable fracture, Dynamic hip screw, Calcar stabilising screw, Mechanical failure.
