Two Proximal Interlocking Screws vs. One

Posted by on Jul 8, 2013 | Comments Off on Two Proximal Interlocking Screws vs. One

Fractures in the proximal femur if treated by antegrade approach should be stabilized by two interlocking screws in the proximal fragment.

Reason the gluteus medius and minimus cause the proximal fragment to abduct. The piriformis, gemellus  superior and inferior cause the proximal fragment to externally rotate. The psoas, which may be detached  by a fracture through the lesser trochanter, is a flexor and external rotator of the hip. The distal fragment is adducted by the adductor muscle group. These forces must be neutralized by the fixation. This is best accomplished by two proximal interlocking screws rather than one.

Reduction is different than other fractures because both proximal and distal fragments must be manipulated for reduction rather than reducing the distal shaft to the proximal shaft.

Experienced SIGN surgeons use two proximal interlocking screws. New SIGN surgeons must learn by experience.

That is a value of followup x-rays and reports.

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