Treatment of intertrochanteric fracture of the femur using sliding screw plate fixation.

Sliding screw plate fixation of intertrochanteric fractures of the femur is not always a simple operation with universally excellent results. There is a need to recognize potential pitfalls of this technique by careful analysis of a large number of cases. A retrospective study of 295 intertrochanteric fractures of the femur over a nine-year period was conducted. All fractures were fixed with a sliding screw sideplate device. Mechanical fracture complications occurred in 9% of 142 stable fractures and 19% of 37 unstable fractures. Medial displacement fixation reduction lowered the complication rate of unstable fractures to 10% of 19 cases. A roentgenographic study of 179 hips identified a technical error rate of 22.9% using described criteria. Including 39 deaths, 30 fracture complications, and 45 general complications, the serious complication rate was 38.6%. The sliding screw sideplate device can provide satisfactory fixation, but success is dependent on many other factors, including reduction, operative technique and postoperative care.