2010年4月16日 星期五

Intertrochanteric Fractures: 10 Tips to Improve Results

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Haidukewych GJ: Intertrochanteric Fractures: Ten Tips to Improve Results. The Journal of Bone and Joint Surgery (American). 2009;91:712-719.

Tip 1: Use the Tip-to-Apex Distance.
Tip 2: "No Lateral Wall, No Hip Screw"
  • Lateral wall指的是reverse oblique及transtrochanteric fractures
Tip 3: Know the Unstable Intertrochanteric Fracture Patterns, and Nail Them.
Tip 4: Beware of the Anterior Bow of the Femoral Shaft.
Tip 5: When Using a Trochanteric Entry Nail, Start Slightly Medial to the Exact Tip of the Greater Trochanter.
Tip 6: Do Not Ream an Unreduced Fracture.
Tip 7: Be Cautious About the Nail Insertion Trajectory, and Do Not Use a Hammer to Seat the Nail.
Tip 8: Avoid Varus Angulation fo the Proximal Fragment - Use the Relationship Between the Tip of the Trochanter and the Center of the Femoral Head.
Tip 9: When Nailing, Lock the Nail Distally if the Fracture Is Axially or Rotationally Unstable.
Tip 10: Avoid Fracture Distraction When Nailing.