Fixation of the Femoral Subtrochanteric Fracture with Minimally Invasive Reduction Techniques

Chul-Hyun Park; Chul-Wung Ha; Sang-Jin Park; Min-Su Ko; Oog-Jin Shon

doi:10.12671/jkfs.2013.26.2.112

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Park, Ha, Park, Ko, and Shon: Fixation of the Femoral Subtrochanteric Fracture with Minimally Invasive Reduction Techniques

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2013; 26(2): 112-117.

Published online: 22 April 2013

DOI: https://doi.org/10.12671/jkfs.2013.26.2.112

Fixation of the Femoral Subtrochanteric Fracture with Minimally Invasive Reduction Techniques

Chul-Hyun Park, M.D., Chul-Wung Ha, M.D., Sang-Jin Park, M.D.^*, Min-Su Ko, M.D.^†, Oog-Jin Shon, M.D.

Department of Orthopedic Surgery, Yeungnam University College of Medicine, Daegu, Korea.

^*Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu, Korea.

^†Department of Orthopedic Surgery, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Address reprint requests to: Oog-Jin Shon, M.D. Department of Orthopedic Surgery, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 705-717, Korea. Tel: 82-53-620-3640, Fax: 82-53-628-4240, ossoj@med.yu.ac.kr

Received 4 October 2012 Revised 4 November 2012 Accepted 1 January 2013

(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.

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.

Keywords: Femur, Subtrochanteric fracture, Minimal invasive reduction, Minimal invasive osteosynthesis

Figures and Tables

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.

Fig. 2

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

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.

Table 1

Demographic Data

Values are presented as number (range) or number. ITST: Intertrochanteric/subtrochanteric, PFNA: Proximal femur nail antirotation, LCP-DF: Locking compressing plate-distal femur, TA: Traffic accident.

Table 2

Radiologic Results Data

Values are presented as number (range). F/U: Follow-up.

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