The Hansson Twin Hook is adequate for fixation of trochanteric fractures: 2 fixation failures in a series of 157 prospectively followed patients.
OBJECTIVE
The Hansson Twin Hook (HTH) is an alternative to the lag screw in the treatment of trochanteric fractures. In osteoporotic bone, mechanical tests have indicated that the HTH has better fixation properties than the lag screw. We evaluated the fixation stability of the HTH in a large series of elderly patients with trochanteric fractures. Many surgeons were involved in assessment of whether the device was user-friendly.


METHODS
In a prospective bicentric study, 55 surgeons used the HTH and a standard plate in 157 consecutive patients with trochanteric fractures, 83% of which were unstable. The mean age of the patients was 83 (43-98) years. They were followed regularly clinically and radiographically for at least 4 months, with a radiographic file search at 2 years.


RESULTS
Technical errors occurred intraoperatively in 7 cases. The reduction of the fracture was inaccurate in these patients; thus, the HTH had not been placed centrally in the femoral head. One of these errors was immediately and easily corrected without interference with the standard plate, and caused no further problems. 2 of the remaining 6 intraoperative errors developed into failures of fixation during the 2-year period.


CONCLUSIONS
The HTH gives adequate fixation in the bone of elderly patients with trochanteric fractures and has a low failure rate. It is also easy to use.
Department of Orthopedics, Helsingborg Hospital, Helsingborg, Sweden.
Peter
P
Olséen
Brynjolfur
B
Jonsson
Leif
L
Ceder
Jack
J
Besjakov
Ola
O
Olsson
Ingemar
I
Sernbo
Karl
K
Lunsjö
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006620:Hip Fractures / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications; D011446:Prospective Studies; D016896:Treatment Outcome