2007 OITE Question 86

Question

Figures 27a and 27b show the radiographs of a 65-year-old man who fell. When used for this fracture, what type of implant is most commonly associated with nonunion, displacement, and hardware failure?

1- 95° blade plate

2- Intramedullary hip screw

3- Dynamic hip screw

4- Dynamic condylar screw

5- Cephalomedullary nail

Figures

Answer (click for answer)

The correct answer is 3- Dynamic hip screw

Radiographs show a reverse obliquity multifragmentary pertrochanteric (33.A3.3 OTA) femur fracture. Dynamic (sliding) hip screws fail 56 % of the time with this fracture because a normal obliquity fracture causes compression across the device, in a reverse obliquity fracture, the reverse occurs, resulting in fatique failure of the implant

Reference:

Attachments:

OITE 2007 figure 27b.jpg (image/jpeg)




OITE 2007 figure 27a.jpg (image/jpeg)