Deting Xue1, Jiawei Yu2, Qiang Zheng3, Gang Feng4, Weixu Li5, Zhijun Pan6, Jian Wang7, Hang Li8. 1. Department of Orthopaedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China. Electronic address: xuedeting@163.com. 2. Department of Orthopaedics, Zhuji People's Hospital of Zhejiang Province, Shaoxing, 311800, Zhejiang, China. Electronic address: yujiawei1990@163.com. 3. Department of Orthopaedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China. Electronic address: zhengqiang1967@homtmail.com. 4. Department of Orthopaedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China. Electronic address: fenggang123@163.com. 5. Department of Orthopaedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China. Electronic address: liwenxu234@126.com. 6. Department of Orthopaedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China. Electronic address: panzhijun001@163.com. 7. Department of Orthopaedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China. Electronic address: wangjian1@hotmail.com. 8. Department of Orthopaedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China. Electronic address: lihanghz001@163.com.
Abstract
BACKGROUND: Intertrochanteric femoral fractures are common, but the nonunion of intertrochanteric fractures is not. The purpose of this study was to divide intertrochanteric fracture nonunion into different types and give corresponding treatment strategies. METHODS: We retrospectively evaluated 23 patients with intertrochanteric fracture nonunion. The patients were divided into five groups and each group was treated with a different strategy. All patients had staged clinical and radiographic follow-ups and the mean follow-up was 16.0±4.6months. RESULTS: Except for the patients treated with total hip arthroplasty, all patients achieved fracture union. The mean union time was 4.7±1.2months. The Harris hip function score differed significantly from preoperative (28.9±6.8) to postoperative (83.8±6.3; p<0.05). For the three patients who were classified as type III, the femoral neck shaft angle was corrected to a significant degree, from 97.3±6.4 to 127.3±2.5 (p<0.05). For the four patients who were classified as type V, the mean time from debridement to re-internal fixation was 3.7±1.5months. CONCLUSIONS: There are several factors associated with the failure of intertrochanteric fracture treatments. We need to analyze the causes of fracture treatment failure carefully. Based on our five classifications and corresponding treatment strategies, the radiographic and functional treatment outcomes were satisfactory. Future larger comparative studies are needed to confirm our results.
BACKGROUND: Intertrochanteric femoral fractures are common, but the nonunion of intertrochanteric fractures is not. The purpose of this study was to divide intertrochanteric fracture nonunion into different types and give corresponding treatment strategies. METHODS: We retrospectively evaluated 23 patients with intertrochanteric fracture nonunion. The patients were divided into five groups and each group was treated with a different strategy. All patients had staged clinical and radiographic follow-ups and the mean follow-up was 16.0±4.6months. RESULTS: Except for the patients treated with total hip arthroplasty, all patients achieved fracture union. The mean union time was 4.7±1.2months. The Harris hip function score differed significantly from preoperative (28.9±6.8) to postoperative (83.8±6.3; p<0.05). For the three patients who were classified as type III, the femoral neck shaft angle was corrected to a significant degree, from 97.3±6.4 to 127.3±2.5 (p<0.05). For the four patients who were classified as type V, the mean time from debridement to re-internal fixation was 3.7±1.5months. CONCLUSIONS: There are several factors associated with the failure of intertrochanteric fracture treatments. We need to analyze the causes of fracture treatment failure carefully. Based on our five classifications and corresponding treatment strategies, the radiographic and functional treatment outcomes were satisfactory. Future larger comparative studies are needed to confirm our results.