Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Hip
Abstract number: 23529
INNOVATIVE DEVICE FOR PLACEMENT OF DEROTATION SCREW IN
TROCHANTERIC FRACTURES
SHALIN MAHESHWARI 1 , RATNA JOHARI 2 , KISHOR MAHESHWARI 3
1 Dr. D. Y. Patil Medical College, jamnagar (INDIA), 2 Johari nursing home, mumbai
(INDIA), 3 maheshwari Orthopaedic hospital, jamnagar (INDIA)
Trochanteric fractures comprise of 50% of all fractures of proximal femur and is most
commonly seen in the age group of 65-75 yrs. They present with a variety of
presentations like basicervical #, # with subtrochanteric extension, reverse obliquity
and most often severe comminution owing to osteoporosis in this age group. Due to
the unstable fracture pattern often the surgeon is in dilemma with the choice of
implant. Most implants like trochanteric stabilization plate, 95 degree blade plate,
DHS plating with encirclage wire are time consuming and require technical expertise
to achieve desired result. In this scenario we found DHS plating with a derotation
screw to be effective & simple technique. Some technical problems like parallel
placement of two screws in a tight compartment required excess time & radiation. To
counter this problem we devised a Zig that enables parallel screw placement with
multitude of options with no requirement of Radiographic confirmation. We have a
Series of 85 patients with Peritrochanteric fractures treated with this technique with
mean follow up of 2 years. We have excellent results with this technique as it
decreases operative time, radiation and morbity in such unstable fractures. No
complications like revision of screw placement, guide wire breakage were
encountered. Postoperatively all patients achieved union of the fracture and none
required revision.
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