Abstract
Between January 1996 and December 1998, we treated 76 cases of trochanteric femoral fracture. The patients included 16 males and 60 females, with a mean age of 82 years. 22 cases with stable fracture were treated using a compression hip screw (CHS), and the other 54 cases with unstable fracture were treated using an intramedullary hip screw (IMHS). As post operative complications, osteomyelitis occurred in 2 cases after IMHS. They were delayed infections, occurring approximately at 5 months and at 15 months after IMHS. For treatment, we performed removal of the implant, curettage of the focus, closed continuous irrigation, followed by general infusion of antibiotics. In one case, the organism was Methicillin-resistant Staphylococcus aureus (MRSA), and in another case, the organism was Acinetobacter calcoaceticus in laboratory cultures. The case with MRSA additionally underwent local irrigation and hyperbaric oxygenation (HBO) therapy because the wound was dehiscent and a marrow cavity in the femur was exposed. A split-thickness skin graft was performed after filling up the dead space with granulation tissue. 2 cases were successfully treated.
