J Korean Orthop Assoc.  2015 Jun;50(3):192-201. 10.4055/jkoa.2015.50.3.192.

Intertrochanteric Fracture: How to Improve the Surgical Outcomes?

• Oh HK

• KMID: 1851953
• DOI: http://doi.org/10.4055/jkoa.2015.50.3.192

Abstract

The purpose of this review is to summarize the current concepts of the peri-operative management of intertrochanteric fractures to help minimize failures and improve outcomes when treating intertrochanteric fractures.

Keyword

hip fractures; periooperative care; recovery of function

MeSH Terms

Hip Fractures
Recovery of Function

Figure

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  Figure 1 (A) Lateral view showed posterior displacement of the femoral shaft and flexion deformity of the proximal fragment. (B) Indirect reduction was carried out by percutaneous placement of Hormann retractors on each side of the fragments. (C) Fracture reduction should be maintained during insertion of the nail and blade.

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  Figure 2 (A) Fluroscopic image showed comminution of the greater trochanter and medial displacement of the fragment. (B) Lateral retraction of the displaced fragment by two-prong retractor could help to figure out correct entry portal of the guide pin. (C) Holding the fracture of the greater trochanter made it more easier to insert the nail without varus malalignment and displacement of the fracture site.

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  Figure 3 (A) Fluroscopic image showed the reverse oblique intertrochanteric fracture and medial displacement of the femoral shaft. (B) Displaced greater trochanter was reduced by two-prong retractor and reverse oblique fracture was manipulated percutaneous reduction technique. (C) Correct position of the nail and blade was confirmed, while the fracture reuction was maintained during the procedure.

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  Figure 4 (A) Varus impaction of the proximal fragment was noticed in stable fracture pattern. (B) Cortical contact of the medial side was obtained by pusing the proximal fragment with percutaneous pin through lateral wall of the trochanter.

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