Belastbarkeit und Verformung instabiler pertrochanterer Osteotomien nach 145°-Winkelplattenosteosynthese und Endernagelung

Abstract

In 24 femora an unstable intertrochanteric osteotomy was performed. In twelve an endernail osteosynthesis and in the other twelve a 145 degree-plate osteosynthesis was performed. Eight femora were tested as control. The loading capacity was 500 N higher in the endernail group. In four cases after 145 degrees-plate osteosynthesis but only in one case after endernailing the osteosynthesis becomes unstable under an alternating load of 2000 N. In femora with pronounced osteoporosis the maximal loading capacity is higher in the endernail osteosynthesis group. The loading capacity increase with the CCD-angle. The deformation after alternating load of 500 N is significantly lower in the 145 degree-plate osteosynthesis group. At higher alternating load the deformation of the 145 degree-plate osteosynthesis exceeds that of the endernail osteosynthesis.

Treatment of intertrochanteric fracture with the Gamma AP locking nail or by a compression hip screw - a randomised prospective trial

“…This approach gives satisfactory results in the majority of stable fractures but not in those in which the posteromedial fragment has not been reduced anatomically. There is then impaction with shortening of the neck of the femur and the leg with reduction of the lever-age of the hip abductors [5,6,9]. The Gamma locking nail is an intramedullary device which was introduced after the success of closed intramedullary nailing of fractures of the femoral.…”