Treatment of unstable intertrochanteric fractures with Sarmiento valgus osteotomy and acrylic cement augmentation

Abstract

Seventy unstable intertrochanteric fractures (Kyle III) were treated by Sarmiento valgus osteotomy, fixation with a sliding hip-screw and plate, and augmentation of the posteromedial upper femoral defect with acrylic cement. Immediate full weight bearing walking was started after the operation. Forty-two patients were followed up for more than 1 year (average 21.4 months). Excellent or good results were obtained in 71.4 per cent. However, there was mechanical failure in which the hip screw cut out of the femoral head superolaterally in 8.6 per cent. Comparison was made between the results of the present technique and our previously reported technique which consisted of Dimon-Hughston medial displacement osteotomy, fixation with sliding hip screw and acrylic cement augmentation to the upper posteromedial femoral defect. It was found that the result of the latter technique is slightly better, probably because of the more rigid reduction.