Lesser Trochanter Migration following Intramedullary Fixation of an Intertrochanteric Femur Fracture

Montoli, C.; Pasquali, Cecilia; Paiusco, Elia; Pellecchia, Vincenzo; Vulcano, Ettore

doi:10.1155/2016/9348032

Cited by 2 publications

(2 citation statements)

References 4 publications

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“…Intertrochanteric fractures commonly occur in older adults, and more than 50% of the cases are associated with a complete fracture of the LT [ 23 ]. Several studies demonstrated that the LT, as a major part of posteromedial construction, plays a significant role in the stability of unstable osteoporotic intertrochanteric fractures [ 10 – 13 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of the union of lesser trochanter fragments after intramedullary fixation of trochanteric femoral fractures: an X-ray based study

You

Wang

et al. 2022

BMC Musculoskelet Disord

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Background Displacement of the lesser trochanter (LT) is not uncommon after managing intertrochanteric femoral fractures and the influence of nonunion of the LT-fragment on clinical outcomes remains controversial. This study aimed to investigate the relationship between the displacement distance and union of the LT-fragment and evaluate the influence of LT-fragment nonunion on hip function and complications. Methods This retrospective study included patients with intertrochanteric fractures and displaced LT treated with intramedullary fixation at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from June 2015 to July 2017. The patients were grouped as union and nonunion of the LT-fragment at 1 year. The LT-fragment displacement distance of LT was measured by the anterior–posterior radiographs. Results Thirty-one and 22 patients showed union and nonunion at 1 year, respectively. The nonunion group had a higher postoperative complication rate than the union group (59% vs. 29%, P = 0.047), especially mechanical complications (45% vs. 6%, P = 0.001). There was no significant difference in hip function between the two groups (P > 0.05). The receiver operating characteristic (ROC) curve revealed an area under the curve of 0.933 of displacement ratio. Patients with a displacement ratio > 0.35 were more likely to have nonunion of the LT-fragment. Conclusions The displacement ratio might be a reliable predictor of LT-fragment union. The incidence of postoperative complications might increase with LT-fragment nonunion.

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Section: Discussionmentioning

confidence: 99%

The impact of the union of lesser trochanter fragments after intramedullary fixation of trochanteric femoral fractures: an X-ray based study

You

Wang

et al. 2022

BMC Musculoskelet Disord

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“…With a high LT detachment ratio of over 50% in trochanteric fractures (3,18), many reports tried to demonstrate whether it was worth the effort to reduce and fix the displaced LT. However, they couldn't reach a consensus.…”

Section: Introductionmentioning

confidence: 99%

When to Reduce and Fix Displaced Lesser Trochanter in Treatment of Trochanteric Fracture: A Systematic Review

Dong

Mao

et al. 2022

Front. Surg.

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PurposeTo systematically evaluate the benefits of reducing and fixing displaced lesser trochanter (LT) of trochanteric fractures and when this procedure is worth the effect.MethodsFrom database establishment through March 2021, four online databases (PubMed, Cochrane, Embase, and Web of Science) were searched for relevant literature that investigated reduction and fixation for displaced LT of trochanteric fractures. The papers were then screened by two reviewers independently and in duplicate according to prior inclusion and exclusion criteria. Demographic data as well as data on fracture types, surgical protocols, and surgical outcomes were recorded, analyzed, and interpreted.ResultsTotal 10 clinical studies with 928 patients were included, in which 48 cases had intact LT and 880 cases involved the displaced LT, of which 196 (22.27%) cases underwent reduction and fixation for LT while the rest of 684 (77.73%) cases not. In these studies, complications were evaluated as a more applicable predictive parameter for operation than postoperative hip function.ConclusionIt was beneficial to reduce and fix the displaced LT when one of the conditions below occurred: displacement distance of LT ≥2 cm, quantity of comminuted LT fragments ≥2, and range of LT fragments in medial wall ≥75%; the fracture line of LT fragments reaching or exceeding the midline of the posterior wall.

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Lesser Trochanter Migration following Intramedullary Fixation of an Intertrochanteric Femur Fracture

Cited by 2 publications

References 4 publications

The impact of the union of lesser trochanter fragments after intramedullary fixation of trochanteric femoral fractures: an X-ray based study

The impact of the union of lesser trochanter fragments after intramedullary fixation of trochanteric femoral fractures: an X-ray based study

When to Reduce and Fix Displaced Lesser Trochanter in Treatment of Trochanteric Fracture: A Systematic Review

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