Medial Displacement Osteotomy for Unstable Intertrochanteric Fractures

Abstract

Fifty-five unstable intertrochanteric fractures were treated with a sliding compression screw apparatus. Thirty-seven cases were treated by anatomic nailing and 18 cases were treated by primary medial displacement osteotomy (MDO) by the method of Dimon and Hughston. The mean age of these patients was 82.5 years. Women out-numbered men seven to one. The times to healing for fractures treated with MDO and anatomic nailing were the same. There were no nonunions. The rate of major complications was similar for both groups; however, trochanteric bursitis was more apparent in the anatomically nailed group. Eighty-nine percent of the fractures treated with anatomic nailing collapsed into a medially displaced position. Ninety-seven percent of anatomically nailed fractures in which the sliding compression screw was appropriately placed healed without complications. Satisfactory stability and healing occurred in both MDO and anatomic nailing groups. There was no demonstrated advantage of MDO over anatomic nailing using a sliding compression screw.