Pantrochanteric Fracture: Incidence of the Complication in Patients with Trochanteric Fracture Treated with Dynamic Hip Screw in a Hospital of Southern Brazil^[*]

Abstract

Objective

The aim of the present study was to investigate the incidence of pantrochanteric fractures in cases of trochanteric fractures treated with dynamic hip screw in our service.

Methods

A sample of 54 patients with trochanteric fractures treated with dynamic hip screws was included in this retrospective study. Preoperative radiographs were evaluated for fracture classification using the Arbeitsgemeinschaft für Osteosynthesefragen (Association for the Study of Internal Fixation, in German)/Orthopedic Trauma Association (AO/OTA) system for the identification of radiographic osteoporosis and for the measurement of the lateral femoral wall thickness. In the immediate postoperative images, the presence of pantrochanteric fracture was evaluated.

Results

The final sample presented an incidence of 16.7% of pantrochanteric fractures. The thickness of the lateral wall was significantly lower in the group with the complication (p < 0.001). Although fractures classified as 31-A2 were more numerous in the group with pantrochanteric fracture, the difference was not statistically significant (p = 0.456).

Conclusion

The percentage of pantrochanteric fractures in this service is in accordance with previous studies. There was an association between lateral femoral wall thickness and the occurrence of iatrogenic fracture of the lateral cortex. There was no significant difference between fracture classification and pantrochanteric fracture, possibly due to sample size.

Keywords

proximal femur fracture - trochanteric fracture - DHS - pantrochanteric fracture - lateral wall thickness

^* Work developed at Hospital Universitário de Canoas, RS, Brazil.

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