J Korean Fract Soc.  2015 Jan;28(1):17-22. 10.12671/jkfs.2015.28.1.17.

Steinmann Pin Assisted Reduction of Subtrochanteric Femoral Fracture

• Lim SW
• Shon OJ

• KMID: 1774092
• DOI: http://doi.org/10.12671/jkfs.2015.28.1.17

Abstract

PURPOSE
Nail insertion is the treatment of choice for subtrochanteric femoral fracture, but displacement of proximal bone fragment makes it difficult to find an ideal entry point. Therefore, in this study we aimed to determine the usefulness of treatment of subtrochanteric femoral fracture using Steinmann pin assisted reduction, internal fixation, and insertion of intramedullary nails.
MATERIALS AND METHODS
We evaluated 33 patients who were followed-up more than a year with a displaced subtrochanteric femoral fracture treated with closed reduction and intramedullary nail fixation between January 2008 and March 2013. In addition, we studied postoperative bone union time, postoperative reduction status, change of the femur neck shaft angle, evaluation of hip joint function, return to daily life, and complications.
RESULTS
All fractures with Steinmann pin assisted reduction were united but they included three cases of delayed union. In Fogagnolo classification, all cases were up to acceptable states and the varus change of femur neck shaft angle was 0.94degrees+/-3.1degrees; no significant difference in Harris hip score was observed between preoperative and last follow-up (p>0.05).
CONCLUSION
There were satisfactory results in bone union and reduction state with Steinmann pin assisted reduction. Therefore, Steinmann pin assisted reduction is a useful surgical technique for subtrochanteric femoral fracture.

Keyword

Subtrochanteric femoral fracture; Fracture reduction techniques; Steinmann pin

MeSH Terms

Classification
Femoral Fractures*
Femur Neck
Follow-Up Studies
Hip
Hip Joint
Humans

Figure

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  Fig. 1 (A) Typical external rotation, abduction, and flexion deformity of the proximal fragment in subtrochanteric fracture. (B-D) Reduction is carried out by Steinmann pin and induction of a guide wire and gradual reaming is performed. (E) Nail insertion and proximal fixation. (F-G) Distal fixation.

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  Fig. 2 Serves as a blocking screw to prevent nail from proceeding anteriorly.

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