title: The stability score of the intramedullary nailed intertrochanteric fractures: stability of nailed fracture and postoperative patient mobilization.
abstract: BACKGROUND
  Intertrochanteric fractures of the femur are the most common type of fracture, and are an increasing occurrence due to the aging of the population. The objectives of our study are to predict the fate of intertrochanteric fractures treated with intramedullary hip nails by assessing the postoperative fracture stability utilizing the newly developed scoring system, and to help rehabilitate these patients.
  
  
  METHODS
  Eighty-two patients with intertrochanteric fractures that were treated with intramedullary hip nails between December, 2004 and January, 2011 were subjected to this study. The patients who could be followed for a minimum of one year postoperatively were enrolled. The immediate postoperative conditions were determined by radiograms: reduction status (3 parameters/4 points: contact accuracy of posteromedial cortex, severity of angulation, and distraction), fixation status (3 parameters/3 points: tip-apex distance, location of tip of the lag screw, entry point of the intramedullary nail), and fracture type (1 parameter/1 point: stable or unstable type by the Kyle's classification). Postoperative reduction loss and fixation failure were checked by radiograms taken at a minimum 3 months postoperative.
  
  
  RESULTS
  Reduction loss and fixation failure were observed in 14 consecutive patients (17%). The fixation failure rate was 100% (2 patients) in score 1, 60% (3 out of the 5 patients) in score 2, 39% (3 out of the 8 patients) in score 3, and 50% (4 out of the 8 patients) in score 4 groups. There were fixation failures only in 1 out of 13 patients with score 5, and in 1 out of 18 patients with score 6. There was no fixation failure in 17 patients with score 7 and 11 patients with score 8.
  
  
  CONCLUSIONS
  Maintenance of the fracture reduction by the stable fixation in the patient scores over 5 could be predicted by the postoperative radiograms.
authors: Department of Orthopaedic Surgery and Traumatology, Cheju Halla General Hospital, Jeju, Korea.
authors: Sung-Rak
authors: SR
authors: Lee
authors: Seong-Tae
authors: ST
authors: Kim
authors: Min Geun
authors: MG
authors: Yoon
authors: Myung-Sang
authors: MS
authors: Moon
authors: Jee-Hyun
authors: JH
authors: Heo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D004434:Early Ambulation; D005260:Female; D005269:Femur / Q000601:surgery; D005594:Fracture Fixation, Intramedullary; D006305:Health Status Indicators; D006620:Hip Fractures / Q000145:classification / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Fixation stability score; Fracture; Intertrochanteric; Intramedullary hip nail