The Impact of Medial Cortical Reduction on the Outcomes of Fixation in Unstable Intertrochanteric Fractures

Intertrochanteric fractures, especially unstable fractures, are common among the elderly and present significant challenges in terms of fracture healing and post-operative recovery. The medial cortex of the femur plays a crucial role in maintaining fracture stability and promoting healing. This study explores the impact of medial cortical reduction on the outcomes of fixation in unstable intertrochanteric fractures.

To assess the effect of medial cortical reduction on fracture healing, functional recovery, and implant failure in patients with unstable intertrochanteric fractures.

A prospective observational study was conducted on 50 patients with unstable intertrochanteric fractures. Patients were categorized into three groups based on the quality of medial cortical reduction achieved: positive, neutral, or negative. Functional recovery was evaluated using the walking ability score (WAS) at 4, 6, and 12 weeks post-surgery.

Patients with positive medial cortical reduction showed significantly higher WAS scores at all follow-up points, indicating better functional recovery. The complication rate was 10%, with implant failure observed in 4% of cases. The positive reduction group had the best outcomes in terms of healing and functional recovery.

Positive medial cortical reduction is associated with superior functional recovery, reduced implant failure, and better overall outcomes in unstable intertrochanteric fractures. Achieving optimal medial cortical reduction should be prioritized during surgical fixation for these fractures.