Stable Fixation of Intertrochanteric Fractures

Abstract

The combined roles of three different positions of reduction and three different fixation devices in stabilization of a standard four-fragment intertrochanteric fracture were studied to determine which combination would best support the load of weight-bearing. Experimental four-part fractures were produced in forty-one pairs of embalmed adult femora. These fractures were stabilized using an anatomical reduction position, the Dimon-Hughston position of medial displacement, and the Wayne County General Hospital position of slight lateral and upward displacement of the femoral shaft fragment, combined with Jewett nail, telescoping screw, and Holt nail implants in all combinations. The stabilized specimens were loaded to failure and examined for the maximum load supported and for resistance to continued deformation under load. The implant device was found to play the major role in fixation stability. The three positions of reduction exerted only a minor influence on the maximum load supported.