抄録
Internal fixation by use of cannulated cancellous screw is a common orthopaedic procedure. Between January 2002 and September 2003, we treated three cases of subtrochanteric fracture following cannulated cancellous hip screw fixation for femoral neck fracture. The patients were women between 78 and 80-years-old. All three fractures occurred within 6 weeks of surgery. One fracture occurred at the site of the distal screws,one occurred after falling,the other occurred spontaneously while walking. Re-osteosynthesis was required in two cases using an intramedullary hip nail system after all screws were removed. Although the cause of these subtrochanteric fractures is unclear, several factors are thought to be operative. Two of three our patients who sustained subtrochenteric fracture while walking showed severe osteoporosis. Because bone density has been found to correlate with fracture stability, we assessed the degree of bone mineral density (BMD). In most of such cases with osteoporosis, we believe the degree of osteoporosis should be taken into consideration, when selecting among alternative methods of treatment.
