BACKGROUND: Surgical treatment of comminuted subtrochanteric fractures may be associated with high incidences of non-union and implant failure. Biological fixation may solve this problem by encouraging rapid callus formation which buttresses the medial cortex. METHODS: In all, 33 patients with comminuted subtrochanteric femur fractures underwent indirect reduction and biological internal fixation. The mean age of the group was 39.12 (19-64) years. RESULTS: Patients were followed up for a mean of 24.6 (12-66) months. Union was achieved within a mean of 15.10 (13-22) weeks, with no cases of delayed union or non-union but with limb-length discrepancy, mean 1.22 (1-2) cm, in nine cases. According to the Traumatic Hip Rating Scale, functional results were excellent in 23 and good in 10 cases. CONCLUSIONS: Indirect reduction and biological internal fixation yield acceptable results in comminuted fractures. These good results can be attributed to early weight-bearing with rapid solid callus formation and early union, which are particularly advantageous in comminuted subtrochanteric fractures, avoiding the implant failure which is not uncommon in these fractures.
BACKGROUND: Surgical treatment of comminuted subtrochanteric fractures may be associated with high incidences of non-union and implant failure. Biological fixation may solve this problem by encouraging rapid callus formation which buttresses the medial cortex. METHODS: In all, 33 patients with comminuted subtrochanteric femur fractures underwent indirect reduction and biological internal fixation. The mean age of the group was 39.12 (19-64) years. RESULTS:Patients were followed up for a mean of 24.6 (12-66) months. Union was achieved within a mean of 15.10 (13-22) weeks, with no cases of delayed union or non-union but with limb-length discrepancy, mean 1.22 (1-2) cm, in nine cases. According to the Traumatic Hip Rating Scale, functional results were excellent in 23 and good in 10 cases. CONCLUSIONS: Indirect reduction and biological internal fixation yield acceptable results in comminuted fractures. These good results can be attributed to early weight-bearing with rapid solid callus formation and early union, which are particularly advantageous in comminuted subtrochanteric fractures, avoiding the implant failure which is not uncommon in these fractures.
Authors: Dietmar Krappinger; Bernhard Wolf; Dietmar Dammerer; Martin Thaler; Peter Schwendinger; Richard A Lindtner Journal: Arch Orthop Trauma Surg Date: 2019-02-07 Impact factor: 3.067