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Subtrochanteric fractures. A retrospective analysis.
J D Lechner1, J P Rao, G Stashak
1Jersey City Medical Center, Department of Orthopaedic Surgery, NJ 07304.
Clinical Orthopaedics and Related Research
|October 1, 1990
Summary
This study on subtrochanteric fractures found that elderly patients often experience complex fractures. Extramedullary fixation devices demonstrated better outcomes than intramedullary systems for treating these challenging orthopedic injuries.
Area of Science:
- Orthopedic Surgery
- Trauma Care
- Biomedical Engineering
Background:
- Subtrochanteric fractures are complex orthopedic injuries, particularly in elderly patients with osteopenic bone.
- These fractures often present with long spiral patterns and butterfly fragments, leading to instability.
Purpose of the Study:
- To compare fracture patterns, fixation devices, and osteosynthesis complications for subtrochanteric fractures.
- To identify optimal fixation devices for treating this challenging orthopedic problem.
Main Methods:
- Retrospective review of 107 patients treated over an eight-year period.
- Fracture classification using the Seinsheimer system.
- Analysis of fixation devices (intramedullary vs. extramedullary) and associated complications.
Main Results:
- Long spiral fractures with butterfly fragments were most frequent in elderly patients.
- Complications included osteosynthesis issues and inherent instability.
- Extramedullary devices yielded better patient outcomes compared to intramedullary systems, despite theoretical biomechanical advantages of the latter.
Conclusions:
- Extramedullary fixation devices are recommended for treating subtrochanteric fractures, especially in elderly patients.
- Careful consideration of fracture patterns and patient bone quality is crucial for successful osteosynthesis.