Does the wedge wing in the neck screw prevent cut-out failure in OTA/AO 31-A2 trochanteric fractures in elderly patients?

Published online: Mar 27 2014

Cuneyd GUNAY, Hakan ATALAR, Murat ALTAY, Osman Yuksel YAVUZ, Ahmet Ozgur YILDIRIM, Ozdamar Fuad OKEN

From Ankara Numune Training and Research Hospital, Ankara, Turkey


The purpose of this retrospective study was to evaluate the effects of Dyna Locking Trochanteric (DLT) nail (U & I Corporation 529-1, Yonghyun-dong, Uijungbu Kyunggi-Do, Korea 480-050) in 31-A1 and 31-A2 intertrochanteric femur fractures. Eighty-seven patients (63 female and 24 male, mean age 77 years) were treated. The mean duration of follow-up was 16.6 ± 3.1 months (range, 12-24 months). There were 36 cases of 31-A1 and 51 cases of 31-A2 fractures. The duration of surgery, fluoroscopy screening time, the blood loss, the hospital stay, the tip-apex distance were significantly less in the 31-A1 fracture group compared with the 31-A2 fracture group (p < 0.001). Cut-out was observed in 13 patients (14.9%) above 80 years old with 31-A2 fractures. Especially in elderly patients with unstable 31-A2 fractures, the wedge wing on the neck screw does not work properly. Therefore further biomechanical investigations and also prospective clinical studies with larger series are needed to improve the device.