Review Question - QID 3035

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Intertrochanteric Fractures QID: 3035 (OBQ09.222)

QID 3035 (Type "3035" in App Search)

A patient with an intertrochanteric hip fracture undergoes reduction and dynamic hip screw application. The post-operative radiographs demonstrate that the lag screw is superior in the femoral head with a tip-apex distance of 40 millimeters. This patient is at increased risk of what complication?

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lag screw cutout

96%

1760/1841

osteonecrosis

21/1841

osteoarthritis

14/1841

peri-prosthetic fracture

18/1841

lag screw breakage

22/1841

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Baumgaertner et al in their classic study in 1995 determined that the position of the lag screw in the femoral head influenced the risk of cutout of a dynamic hip screw construct in treatment of intertrochanteric fractures. They had no cutouts if the tip-apex distance on the combined AP and lateral radiographs was less than 25 millimeters. Subsequent studies demonstrated a decreased cutout rate once people were aware of the tip-apex distance importance.