TREATMENT OF CUTOUT OF A LAG SCREW OF A DYNAMIC HIP SCREW IN AN INTERTROCHANTERIC FRACTURE

Sixteen consecutive patients with cutout of a lag screw of a dynamic h ip screw fixation in an intertrochanteric fracture were treated with r einsertion of a lag screw, bone cement supplementation in the neck-tro chanter, and subtrochanteric valgus osteotomy, Postoperatively, patien ts were permitted to ambulate with protected weight-bearing. Fourteen patients were followed-up for at least 1 year (median 2 years; range 1 -3 years), and all had a solid union. The union period took a median o f 5 months, with a range of 3-7 months. Usually, union of an intertroc hanteric fracture was faster than that of subtrochanteric osteotomy (P < 0.01). There were no complications of wound infection, loss of redu ction, cutout of a lag screw, or osteonecrosis of the femoral head. Fr om clinical and theoretical considerations, we conclude that despite c utout of a lag screw of a dynamic hip screw fixation being difficult t o treat, out technique still can provide an excellent outcome. Therefo re, we strongly recommend its wide use.