Fixation of Subtrochanteric Fracture of the Femur: Our Experience
Introduction: Subtrochanteric fracture of the femur is a variant of the peritrochanteric fracture of the femur. It extends upto 5 cm below the lesser trochanter. The incidence is relatively much lower (3.9% of all the proximal femoral fractures). It is common in the older population with low ene...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2012-02-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/1826/18%20-%203422.(A).pdf |
| Summary: | Introduction: Subtrochanteric fracture of the femur is a variant
of the peritrochanteric fracture of the femur. It extends upto 5 cm
below the lesser trochanter. The incidence is relatively much lower
(3.9% of all the proximal femoral fractures). It is common in the
older population with low energy trauma along with osteoporosis
and in younger patients with high energy trauma. This is also the
commonest site for a pathological fracture. Pathophysiological
and biomechanical studies have shown that the subtrochanteric
region is the most stressed area which concentrates stress on
the implant and this is difficult to treat due to complications.
With the improved knowledge and understanding of the fracture
pattern, specific treatment options with successful results of
improved quality may be obtained.
Material and Methods: A total of 12 cases of subtrochanteric
fracture of the femur which were admitted in the Orthopaedic
Dept, Manipal Teaching Hospital, Pokhara, Nepal, from Jan, 2010
to July, 2011, were selected in our study. The classification of the
fracture was done by using the Russell and Taylor’s classification
for simplicity and it is the one which is currently mostly used for
clinical use. Various implants like locking plate, proximal femoral
nail (PFN), dynamic hip screw (DHS) and K-nail were used for
fracture fixation. Clinical and radiographic analyses were done
at a follow up of 3 weeks, 6 weeks, 3 months, 6 months and 1
year.
Results: Out of 12 cases, 9 were males and 3 were female.s K-nail
fixation was done in one case of pathological fracture. Three
locking plates, 4 DHS and 4 PFN were done. All the fractures
united with good to excellent results, with few complications like
mild restriction of the hip range of motion, mild varus deformity
and a shortening of 2 cm.
Conclusion: With the various choices of implants for the fixation
of subtrochanteric fracture of the femur, PFN, in our opinion,
gave the best fixation with excellent results. We recommend
PFN as a reliable cephalomedullary implant for the fixation of
subtrochanteric fracture of the femur. |
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| ISSN: | 2249-782X 0973-709X |