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Oh: Intertrochanteric Fracture: How to Improve the Surgical Outcomes?

Symposium

Proximal Femur Fractures

Journal of the Korean Orthopaedic Association 2015; 50(3): 192-201.

Published online: 30 June 2015

DOI: https://doi.org/10.4055/jkoa.2015.50.3.192

Intertrochanteric Fracture: How to Improve the Surgical Outcomes?

Hyoung-Keun Oh, M.D.

Department of Orthopaedic Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

Correspondence to: Hyoung-Keun Oh, M.D. Department of Orthopaedic Surgery, Ilsan Paik Hospital, Inje University College of Medicine, 170 Juhwa-ro, Ilsanseo-gu, Goyang 411-706, Korea. TEL: +82-31-910-7301, FAX: +82-31-910-7967, osd11@paik.ac.kr

Received 3 June 2015 Accepted 8 June 2015

Copyright © 2015 by The Korean Orthopaedic Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: hip fractures, periooperative care, recovery of function

Figures and Tables

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.

jkoa-50-192-g001

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.

jkoa-50-192-g003

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.

jkoa-50-192-g004

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

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