J Korean Fract Soc.  2013 Apr;26(2):112-117. 10.12671/jkfs.2013.26.2.112.

Fixation of the Femoral Subtrochanteric Fracture with Minimally Invasive Reduction Techniques

• Park CH
• Ha CW
• Park SJ
• Ko MS
• Shon OJ

• KMID: 1496165
• DOI: http://doi.org/10.12671/jkfs.2013.26.2.112

Abstract

PURPOSE
To evaluate the results of using minimally invasive reduction techniques in patients with femoral subtrochanteric fracture.
MATERIALS AND METHODS
We retrospectively analyzed 40 patients (41 cases) with subtrochanteric fracture who underwent using minimally invasive reduction techniques. The mean age was 61.4 years (15-89 years), and the mean follow-up period was 32.7 months (12-66 months). Clinical results were assessed using the Parker-Palmer mobility score and the Salvati-Wilson hip functional score. Radiographic results were evaluated using bone union time and femur neck-shaft angle.
RESULTS
No significant difference was observed in the pre- and postoperative Parker-Palmer mobility score. Salvati-Wilson hip functional score showed more than good grade in 37 cases (90%) at the last follow-up. Union was achieved in all 41 cases at an average of 22.5 weeks (18-30 weeks). The mean femoral neck-shaft angle immediately postoperatively was 128.8 degrees (120-140 degrees), and the mean difference versus contralateral sides was 2.5 degrees varus (-6-13 degrees).
CONCLUSION
Fixation of femoral subtrochanteric fracture using minimally invasive reduction techniques showed excellent clinical and radiographic results and low complication rate.

Keyword

Femur; Subtrochanteric fracture; Minimal invasive reduction; Minimal invasive osteosynthesis

MeSH Terms

Femur
Follow-Up Studies
Hip
Humans
Retrospective Studies

Figure

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  Fig. 1 Reduction technique. (A, B) Reduction was performed with a Hohmann retractor and a long tonsil in the proximal thigh. (C) Reduction was maintained with a bone hook.

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  Fig. 2 (A, B, C) Fractures of the oblique pattern were temporally reduced by a collinear clamp and fixed with a cerclage wiring.

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  Fig. 3 (A) A bone hook was maintained in place until the lag screws were inserted at the proper position of the femoral head. (B) A locking compressing plate-distal femur (LCP-DF) was inserted through the proximal submuscular tunnel and fixed with locking screws.

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