title: Treatment of cutout of a lag screw of a dynamic hip screw in an intertrochanteric fracture.
abstract: Sixteen consecutive patients with cutout of a lag screw of a dynamic hip screw fixation in an intertrochanteric fracture were treated with reinsertion of a lag screw, bone cement supplementation in the neck-trochanter, and subtrochanteric valgus osteotomy. Postoperatively, patients were permitted to ambulate with protected weight-bearing. Fourteen patients were followed-up for at least 1 year (median 2 years; range 1-3 years), and all had a solid union. The union period took a median of 5 months, with a range of 3-7 months. Usually, union of an intertrochanteric fracture was faster than that of subtrochanteric osteotomy (P < 0.01). There were no complications of wound infection, loss of reduction, cutout of a lag screw, or osteonecrosis of the femoral head. From clinical and theoretical considerations, we conclude that despite cutout of a lag screw of a dynamic hip screw fixation being difficult to treat, out technique still can provide an excellent outcome. Therefore, we strongly recommend its wide use.
authors.affiliation: Department of Orthopedics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: C C
authors.initials: CC
authors.lastname: Wu
authors.forename: C H
authors.initials: CH
authors.lastname: Shih
authors.forename: W J
authors.initials: WJ
authors.lastname: Chen
authors.forename: C L
authors.initials: CL
authors.lastname: Tai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing / Q000502:physiology; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012086:Reoperation; D016896:Treatment Outcome