title: Perioperative lateral trochanteric wall fractures: sliding hip screw versus percutaneous compression plate for intertrochanteric hip fractures.
abstract: OBJECTIVE
  This study was performed to determine the incidence of perioperative lateral wall fractures with a standard sliding hip screw (SHS) versus a percutaneous compression plate (PCCP) using identical meticulous closed reduction techniques in both groups.
  
  
  METHODS
  Retrospective analysis of a prospective trauma registry.
  
  
  METHODS
  Urban Level I trauma center.
  
  
  METHODS
  Over a 7-year period, 337 patients with intertrochanteric hip fractures were treated with either a SHS or a PCCP at our institution. The PCCP group (Group 1) consisted of 200 patients, of which 141 (71%) had adequate images to be included in the study. The SHS group (Group 2) consisted of 137 patients, of which 100 (73%) had adequate images to be included in the study.
  
  
  METHODS
  Closed reduction and plate application with either a standard sliding hip screw or a percutaneous compression plate for an Orthopaedic Trauma Association 31A1 or 31A2 intertrochanteric hip fracture.
  
  
  METHODS
  : Radiographic evidence of lateral trochanteric wall fracture as measured by intraoperative and perioperative radiographs.
  
  
  RESULTS
  There was an overall lateral wall fracture incidence of 20% in the SHS group versus 1.4% in the PCCP group (P < 0.01). For the unstable 31A2 fracture types, there was a lateral wall fracture incidence of 29.8% in the SHS group versus 1.9% in the PCCP group (P < 0.01).
  
  
  CONCLUSIONS
  Overall, the PCCP group had a significantly decreased incidence of lateral trochanteric wall fracture compared with the SHS group. This difference became greater when just unstable intertrochanteric fractures were analyzed. An anatomic reduction, combined with a device (PCCP) that uses small-diameter defects in the lateral trochanteric wall, essentially eliminates perioperative lateral trochanteric wall fractures.
authors.affiliation: Orlando Regional Medical Center, Orlando, FL, USA. joshua.langford@me.com
authors.forename: Joshua
authors.initials: J
authors.lastname: Langford
authors.forename: Gita
authors.initials: G
authors.lastname: Pillai
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Ugliailoro
authors.forename: Edward
authors.initials: E
authors.lastname: Yang
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates / Q000706:statistics & numerical data*; D001863:Bone Screws / Q000706:statistics & numerical data*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000706:statistics & numerical data; D006620:Hip Fractures / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D017211:Treatment Failure; D016896:Treatment Outcome