J Korean Fract Soc.  2010 Jan;23(1):13-19. 10.12671/jkfs.2010.23.1.13.

Unstable Intertrochanteric Femoral Fracture Treated with Mini-incision Reduction Technique and Intramedullary Nail

• Shon OJ
• Kim DS

• KMID: 1461567
• DOI: http://doi.org/10.12671/jkfs.2010.23.1.13

Abstract

PURPOSE
To evaluate the efficacy of mini-incision reduction technique in unstable intertrochanteric femoral fracture treated with intramedullary nail.
MATERIALS AND METHODS
From January, 2005 to December, 2007, we selected 26 patients of unstable intertrochanteric femoral fracture which underwent anatomic reduction by mini-incision reduction technique using various instruments, and treated with intramedullary nail. We evaluated the radiological results with the union time, change of femoral neck-shaft angle and distance of lag screw sliding by follow-up radiography, and the clinical results with the mobility score of Parker and Palmer, Salvati and Wilson hip function scoring system and Jensen index.
RESULTS
The mean union time was 18.9 weeks. The mean changes of femoral neck-shaft angle was 4.1 degree. The mean distance of lag screw sliding was 4.4 mm. Decrease of mobility score of Parker and Palmer, Salvati and Wilson hip function score was showed, and social function score of Jensen maintained 54% compared with preoperative score.
CONCLUSION
Mini-incision reduction technique using various instruments showed satisfactory clinical and radiological results, and we believe that it is a recommendable method in unstable intertrochanteric femoral fracture which manual reduction is difficult.

Keyword

Unstable intertrochanteric femoral fracture; Mini-incision reduction; Intramedullary nail

MeSH Terms

Femoral Fractures
Follow-Up Studies
Hip
Humans
Nails

Figure

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  Fig. 1 (A) Lateral view of intertrochanteric femoral fracture shows the overlap of the head and neck fragment from the shaft. (B) Hohmann retractor is inserted through an accessory anterolateral mini-incision at the level of femoral neck. (C) Fluoroscopic view shows correction of the malreduction using Hohmann retractor.

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  Fig. 2 (A) Lateral view of intertrochanteric femoral fracture shows anteriorly displaced head and neck fragment. (B) Bone hook with mini-incision is used to improve reduction by resisting flexion of the proximal fragment. (C) Bone hook is placed around the femoral neck.

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  Fig. 3 (A) 74 year old male had unstable femoral intertrochanteric fracture by slip down. (B) Treated with a intramedullary nail. (C) One-year follow-up radiograph shows complete union without deformity. (D) Accessory mini-incision (★).

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