title: Extramedullary fixation of trochanteric hip fracture.
abstract: Extramedullary fixation with a sliding hip screw remains the treatment of choice for the majority of trochanteric hip fractures. Attention to surgical detail is far more important that the actual choice of implant. The fracture must be reduced to an anatomical or slight valgus position using the fracture table. Surgical exposure need not be excessive as most fractures can be reduced by closed means. The position of the lag screw is critical to achieve a central to inferior position on the anterior-posterior radiograph and a central position on the lateral view. A four-hole plate should suffice for most fractures. After surgery, weight bearing as able should be allowed. For fractures fixed correctly, wound or fracture healing complication should be rare, occurring in <5 % of cases.
authors.affiliation: Department of Orthopaedics, Peterborough City Hospital, Bretton Gate, Peterborough, PE3 9GZ, England, UK. Martyn.Parker@pbh-tr.nhs.uk.
authors.forename: M J
authors.initials: MJ
authors.lastname: Parker
keywords: Extramedullary fixation; Hip fracture; Sliding hip screw
references.citation: J Bone Joint Surg Br. 1996 May;78(3):387-90
references.pmid: 8636171
references.citation: Cochrane Database Syst Rev. 2010 Sep 08;(9):CD000093
references.pmid: 20824825
references.citation: J Bone Joint Surg Am. 1991 Sep;73(8):1192-9
references.pmid: 1890120
references.citation: J Bone Joint Surg Br. 2012 Mar;94(3):391-7
references.pmid: 22371549
references.citation: J Bone Joint Surg Am. 2011 May 18;93(10):942-7
references.pmid: 21593370
references.citation: Injury. 1993 May;24(5):313-6
references.pmid: 8349340
references.citation: J Orthop Trauma. 2000 Sep-Oct;14 (7):490-5
references.pmid: 11083611
references.citation: Cochrane Database Syst Rev. 2013 Feb 28;(2):CD000339
references.pmid: 23450528
references.citation: Acta Orthop Scand. 1996 Aug;67(4):329-32
references.pmid: 8792733
references.citation: J Bone Joint Surg Br. 1997 Nov;79(6):969-71
references.pmid: 9393914
references.citation: Cochrane Database Syst Rev. 2006 Jul 19;(3):CD000168
references.pmid: 16855952