INTERNAL FIXATION WITH HANSSON TWIN HOOK FOR TROCHANTERIC FRACTURES

Authors

  • O. ALEXA “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • D. POPESCU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • B. PUHA “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • A. FILIP “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • B. VELICEASA “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Keywords:

TWIN HOOK, TROCHANTERIC FRACTURES, ROTATIONAL STABILITY

Abstract

Hansson Twin Hook was recently developed as an alternative to the classical Dynamic Hip Screw. In the present study we aimed at presenting our results obtained by using the HTH in the treatment of trochanteric fractures. Materials and methods: Over a 2-year interval, 55 patients with trochanteric fractures were treated by reduction and internal fixation using HTH system. According to the AO fracture classification, we recorded 21 cases of 31.A1 fractures and 34 cases of 31.A2 fractures. Results: Clinical assessment at 3 months postoperatively using Merle D'Aubignier scale showed very good results in 41 (82%) patients, good in 7 (14%) patients and poor in 2 (4%) patients (two patients presented fixation failure). In these 2 patients, surgical reintervention was performed -implant removal and its replacement with a Dynamic Condylar Screw with good results at 3 months follow-up. Conclusions: Osteosynthesis with Hansson Twin Hook is a good choice in trochanteric fractures. Since it is a new developed implant, more studies are necessary for clinical validation of its value.

Author Biographies

  • O. ALEXA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    1. Department of Surgery (II)
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi
    2. Department of Orthopedics and Traumatology

  • D. POPESCU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    1. Department of Surgery (II)
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi
    2. Department of Orthopedics and Traumatology

  • B. PUHA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    1. Department of Surgery (II)
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi
    2. Department of Orthopedics and Traumatology

  • A. FILIP, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    “Sf. Spiridon” County Clinical Emergency Hospital Iasi
    Department of Orthopedics and Traumatology

  • B. VELICEASA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    1. Department of Surgery (II)
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi
    2. Department of Orthopedics and Traumatology

References

1. Bonnaire F, Weber A, Bösl O et al. “Cutting out” in pertrochanteric fractures-problem of osteoporosis? Unfallchirurg 2007; 110(5): 425-432.
2. Bhandari M, Devereaux PJ, Swiontkowski MF et al. Internal fixation compared with arthroplasty for displaced fractures of the femoral neck. A meta-analysis. J Bone Joint Surg Am 2003; 85(A9): 1673-1681.
3. Saarenpää I, Heikkinen T, Ristiniemi J, et al. Functional comparison of the dynamic hip screw and the Gamma locking nail in trochanteric hip fractures: a matched-pair study of 268 patients. Int Orthop 2009; 33(1): 255-260.
4. Olsson O. Alternative techniques in trochanteric hip fracture surgery.Clinical and biomechanical studies on the Medoff sliding plate and the Twin hook. Acta Orthop Scand Suppl 2000; 295: 1-31.
5. Olsson O, Ceder L, Lunsjö K, Hauggaard A. Extracapsular hip fractures: fixation with a twin hook or a lag screw? Int Orthop 2000; 24(5): 249-255.
6. Olsson O, Tanner KE, Ceder L, Ryd L. A biomechanical study on fixation stability with twin hook or lag screw in artificial cancellous bone. Int Orthop 2002; 26(6): 349-355.
7. Alexa O, Cozma T, Cionca D, Puha B. Hansson Twin Hook - a new implant technique in trochanteric fractures. Rev Med Chir Soc Med Nat Iasi 2006; 110(1): 161-166.
8. Baumgaertner MR, Curtin SL, Lindskog DM, Keggi JM. The value of the tip-apex distance in pre-dicting failure of fixation of peritrochanteric fractures of the hip. J Bone Joint Surg Am 1995; 77(7): 1058-1064.
9. Hagino T, Ochiai S, Wako M et al. Twin hook fixation for proximal femoral fractures. J Orthop Surg (Hong Kong) 2008; 16(2): 162-164.
10. Olséen P, Jonsson B, Ceder L et al. The Hansson Twin Hook is adequate for fixation of trochanteric fractures: 2 fixation failures in a series of 157 prospectively followed patients. Acta Orthop 2008; 79(5): 602-608.
11. Roerdink WH, Aalsma AM, Nijenbanning G, van Walsum AD. The dynamic locking blade plate, a new implant for intracapsular hip fractures: biomechanical comparison with the sliding hip screw and Twin Hook. Injury 2009; 40(3): 283-287.

Additional Files

Published

2017-12-22