Date: Wed, 31 Jul 2002 00:30:43 -0400

Subject: Hip screws

Does anyone on the list know of any references regarding the placement of cannulated hip screws above/below the lesser trochanter as it relates to the risk of subsequent subtroch fracture? i know placement should be above the lesser trochanter but i have been unable to find evidence to support this. thank you.

Max Talbot, PGY-4 U of Montreal, Canada

Date: Wed, 31 Jul 2002 06:50:08 -0400

From: Benedetti Gary E LtCol 74 MDOS/SGOSO

Reported 20% incidence of fracture if screws are placed too low, below the lesser trochanter, or  with un-filled drill holes there too. I have not looked at it in a long time but I believe the reference on this topic is: Karr, Clin Ortho Rel Res 1985.

Gary E. Benedetti, LtCol, USAF, MC, FS
Orthopaedic Trauma Surgery

Date: Wed, 31 Jul 2002 15:22:36 -0700

From: Gary L. Zohman, MD