9 | SOME COMMENTS ABOUT SURGICAL TREATMENT
Most
femoral trochanteric fractures are treated surgically, if there is no
contraindication due to the patient’s health status.
In terms of surgical methods, until now, the bone fixation is still
considered the mainstream, in which mainly the sliding hip compression
screw (DHS) and the intramedullary hip screw nail, while the hip
replacement is indicated in special cases are related to the patient’s
overall condition as well as the functional status of the hip.
- Sliding hip screw is indicated when the fracture line is stable,
according to AO classification as type A1 and A2.1, A2.2, and when the
lateral wall of the femoral shaft is intact and has thickness bigger
than 2cm.
- Intramedullary hip screw is widely indicated, including both stable
and unstable fractures
- Hip replacement is indicated when the hip joint has been pre-existing
and symptomatic arthritis, or when the fracture is severe comminuted
not able to do bone fixation.