Minimally Invasive Plate Osteosynthesis of Subtrochanteric Femoral Fractures

Chang-Wug Oh

doi:10.12671/jkfs.2009.22.2.123

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Oh: Minimally Invasive Plate Osteosynthesis of Subtrochanteric Femoral Fractures

Review Article

Journal of the Korean Fracture Society 2009; 22(2): 123-129.

Published online: 30 April 2009

DOI: https://doi.org/10.12671/jkfs.2009.22.2.123

Minimally Invasive Plate Osteosynthesis of Subtrochanteric Femoral Fractures

Chang-Wug Oh, M.D.

Department of Orthopedic Surgery, School of Medicine, Kyungpook National University, Deagu, Korea.

Address reprint requests to: Chang-Wug Oh, M.D. Department of Orthopedic Surgery, School of Medicine, Kyungpook National University, 101, Dongin-dong 2-ga, Jung-gu, Deagu 700-422, Korea. Tel: 82-53-420-5630, Fax: 82-53-422-6605, cwoh@knu.ac.kr

(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/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Figures and Tables

Fig. 1

(A) A 54 year-old man had a comminuted subtrochanteric femur.

(B) The surgical darping was done for both legs to have a better evaluation of postoperative alignment.

(C) After the insertion of a flexible nail from the distal segment, a preliminary reduction was achieved.

(D, E) Then, half-pins were fixed on the anterior aspect of proximal and distal segments, with assembling with an external

fixator. A LCP-DF was inserted through the proximal submuscular tunnel.

(F, G, H) A butterfly fragment was fixed with a lag screw by the help of collinear clamp.

(I, J) Satisfactory alignment was achieved postoperatively and a bridging callus was seen at 6 months postoperatively.

Fig. 2

(A) A 34 year-old woman with a comminuted subtrochanteric femur.

(B) Initially, the proximal segment was internally rotated with the help of half-pin.

(C) This makes a better idea to have a preliminary reduction. The flexible nail technique was used.

(D) A locking plate was inserted through the proximal submuscular tunnel (arrow).

(E, F, G) A fine tuning of remained displacement was done by pulling the distal segment with a half-pin (arrows).

(H, I) Postoperatively, satisfactory alignment was achieved without touching the middle fragment.

(J) A successful union with a good bridging callus at 8 months postoperatively.

Fig. 3

(A) A 40 year-old man with a spiral fracture of subtrochanteric femur.

(B) The patient had multiple rib fractures with lung contusion, which made the choice of plating rather than nailing. Colinear

clamp made a successful reduction, (C, D) followed by the percutaneous lag screws.

(E) After insertion of a locking plate through the submuscular tunnel, (F, G) screws were fixed percutaneouosly.

(H) Postoperatively, good alignment was achieved.

(I, J, K, L) Union occurred at 6 months postoperatively, with a good functional outcome.

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