Should Pertrochanteric and Subtrochanteric Fractures Be Treated with a Short or Long Intramedullary Nail?

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Bjarke Viberg ◽  
Lasse Eriksen ◽  
Katia D. Højsager ◽  
Frederik D. Højsager ◽  
Jens Lauritsen ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Subtrochanteric Fractures

scholarly journals Pitfalls and Remedial Technique of Intramedullary Nail for Subtrochanteric Femur Fractures: A Case Series

2021 ◽  
Author(s):  
Botao Chen ◽  
Xiaohong Fan
Keyword(s):  
Internal Fixation ◽  
Intramedullary Nailing ◽  
Intramedullary Nail ◽  
Locking Plate ◽  
Case Series ◽  
Trochanteric Fracture ◽  
Subtrochanteric Fracture ◽  
Chinese Patients ◽  
Good Reduction ◽  
Subtrochanteric Fractures

Abstract Background: Intraoperative technical complications are occasionally encountered while implanting intramedullary nails for subtrochanteric fractures. Surgeons must pay attention to the pitfalls and remedial technique of this operation.Methods: We report on three cases in which intraoperative difficulties occurred during the implantation of an intramedullary nail among Han Chinese patients from mainland China. In Case 1, during an operation on a 57-year-old man, a seinsheimer type V in a right subtrochanteric fracture was not fully realized, and the dislocation of intertrochanteric fracture was aggravated after reduction of the subtrochanteric fracture. The intramedullary nail fixation was completed with the aid of an additional anterolateral plate. Case 2 involved a transverse subtrochanteric fracture. The surgeon neglected the coronal dislocation when considering good sagittal reduction. Although an auxiliary reduction device was used during the operation, there was unacceptable coronal dislocation after the intramedullary nail was inserted. A temporary anterolateral locking plate fixation was used to complete the intramedullary nail fixation. Case 3 involved an old trochanteric fracture combined with a new subtrochanteric fracture in an 81-year-old woman. After reducing the subtrochanteric fractures, the intramedullary nail fixation was successfully completed by releasing the poorly healed intertrochanteric fractures and fixing the anterior lateral plate.Results: With the development of techniques, reliable results can be obtained with fewer complications. Of the various internal fixation methods, we favor using a trochanteric start intramedullary nail.Conclusions: The treatment of subtrochanteric fractures presents challenges. Good reduction and reliable temporary fixation are key to completing the intramedullary nailing. If percutaneous joysticks, finger reduction tools, blocking screws, clamps, and Schanz pins cannot be used for effective auxiliary reduction or temporary reliable fixation, reduction after intramedullary nailing will not be satisfactory. The temporary addition of a reconstruction locking plate can achieve good reduction and temporary stability, and an extra reconstruction locking plate should be retained when the temporary fixation device is removed to reduce the risk of internal fixation failure during fracture healing.

scholarly journals Comparison of third generation long Gamma nail and femur intramedullary nail for the treatment of femoral subtrochanteric fractures

2021 ◽  
Vol 5 (3) ◽  
pp. 249-254
Author(s):  
Şahin ÇEPNİ ◽  
Enejd VEİZİ ◽  
Ali ŞAHİN ◽  
Ahmet FIRAT ◽  
Özay SUBAŞI ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Gamma Nail ◽  
Third Generation ◽  
Subtrochanteric Fractures

Subtrochanteric Fractures of the Femur Treated by Intramedullary Nail Fixation

1972 ◽  
Vol 65 (2) ◽  
pp. 147-153
Author(s):  
PHILIP M. ARONOFF ◽  
PAUL M. DAVIS ◽  
JACK K. WICKSTROM
Keyword(s):  
Intramedullary Nail ◽  
Subtrochanteric Fractures ◽  
Fractures Of The Femur

scholarly journals Cementless total hip arthroplasty for failed treatment of subtrochanteric fracture

2020 ◽  
Author(s):  
Sheng-Yu Jin ◽  
Jing-Yao Jin ◽  
Woo-Jong Kim ◽  
Taek-Rim Yoon ◽  
Kyung-Soon Park
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Intramedullary Nail ◽  
Subtrochanteric Fracture ◽  
Subtrochanteric Fractures ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
The Mean

Abstract Background Failed treatment of subtrochanteric fractures commonly leads to pain, limping, and poor function. Cementless total hip arthroplasty (THA) could be an option as a salvage procedure in such cases. This study was to evaluate the clinical and radiological results and complications of this treatment in our hospital. Method Eighteen cementless THAs for failed treatment of subtrochanteric fractures were performed at our institution between January 2001 to December 2017. There were eleven males and seven females, and the average age was 74 years (range 57.0-89.0). Eight patients were previously operated with an intramedullary nail, six patients were treated with a dynamic hip screw, two patients were treated with an angled blade plate, one patient was treated with a proximal femur locking plate, and one patient was treated with a dynamic compression plate. Results The mean follow-up was 5.2 years (range 2.2-10.8). The mean duration of the operation was 98.0 minutes (standard deviation [SD],15.4; range 70-135). The mean total blood loss was 992.2 mL (SD,171.2; range 640-1260 mL), and the amount of transfusion was 2.2 units (SD, 0.8, range 1-4). The mean Harris hip score (HHS) was 38.2 (SD, 9.3; range, 24-56) preoperatively and 85.4 (SD, 4.9; range, 79-92) at the last follow-up. Compared to the patients treated with plate-screws, those treated with an intramedullary nail had significantly shorter surgical duration, fewer blood transfusions, and less intraoperative blood loss. Kaplan-Meier survivorship with an endpoint of revision was 94.4% (95% confidence interval 72.7-99.9) at five years. Conclusion Cementless THA is one of the acceptable procedures for failed treatment of the subtrochanteric fracture with fewer complications.

Selection of intramedullary nail system for femoral subtrochanteric fractures

2017 ◽  
Vol 2017 (0) ◽  
pp. J0250102
Author(s):  
Keisuke SASAGAWA ◽  
Masafumi ODA ◽  
Toshiaki HARA ◽  
Naofumi SHIOTA
Keyword(s):  
Intramedullary Nail ◽  
Subtrochanteric Fractures ◽  
Selection Of
Sign in / Sign up

Export Citation Format

Share Document