Subtrochanteric Fractures of the Femur Results of Treatment by Interlocking Nailing

Wiss, Donald A.; Brien, W W

doi:10.1097/00003086-199210000-00032

Cited by 87 publications

(57 citation statements)

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“…We could not identify any complications that preclude the use of this technique. The rates of nonunion and infection were comparable to that reported in the existing literature [2,3,4,10,11,13]. We had no significant hardware failures or femoral neck fractures; however, since none of the nails were removed and only three proximal screws required removal, we do not know the long-term outcomes of patients with screws removed from the femoral neck.…”

Section: Discussionsupporting

confidence: 79%

Femoral nailing with transverse locking screws through the femoral neck

Ziran

Wasan

Chapman

2001

International Orthopaedics (SICOT)

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We treated 55 patients with subtrochanteric or comminuted femoral fractures with a transverse locking femoral nail (Alta, Howmedica). This nail was positioned more cephalad than usual so that at least one fixation screw was located in the femoral neck or head. Fortyseven fractures (20 subtrochanteric and 27 diaphyseal) were available for follow-up averaging 12 months (3-35). The time to radiographic healing averaged 7 months (3-21). There was one delayed union, one nonunion, two superficial infections, one broken proximal screw, one compartment syndrome of the thigh, and one peroneal nerve palsy. There were no femoral neck fractures, avascular changes of the femoral head, or gluteal irritation at the most recent follow up. The described technique appears safe and effective, is technically easy, and avoids intra-articular screws.Résumé Nous avons traité 55 patients présentant une fracture fémorale sous-trochanterienne ou comminutive avec un clou à verrouillage transversal (Alta, Howmedica) qui a été placé de façon plus céphalique qu'habituellement afin qu'au moins une des vis de la fixation ait été localisée dans le col ou dans la tête. 47 fractures, 20 soustrochanteriennes et 27 diaphysaires, étaient disponibles avec un suivi moyen de12 mois (3-35). Le temps de consolidation radiographique était de 7.0 mois (3-21). Il y avait un cas de retard de consolidation, une non-consolidation, deux infections superficielles, une vis proximale cassé, un syndrome de compartiment de la cuisse, et un paralysie du sciatique poplité externe. Il n'y avait pas de fractures du col fémoral, ni de trouble vasculaire de la tête fémorale, ni de tendinite du fessier au plus récent examen. La technique décrite ne paraît pas dangereuse, efficace, techniquement facile, et évite le risque de vis intra-articulaires.

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Section: Discussionsupporting

confidence: 79%

Femoral nailing with transverse locking screws through the femoral neck

Ziran

Wasan

Chapman

2001

International Orthopaedics (SICOT)

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“…[7, 27, 28, 37, 53, 64, 72, 73, 91, 102-104 [, 124, 132-136, 138, 139, 141, 147, 197]. Generally, surgical management of proximal femur fractures is considered standard treatment [7,23,43,55,62,100,135,[138][139][140]202]. There is no evidence from randomized studies regarding the timing of fracture management; and observational studies have reached various conclusions [22,45,70,140,194].…”

Section: Explanationmentioning

confidence: 99%

Level 3 guideline on the treatment of patients with severe/multiple injuries

Bouillon¹,

Pieper²,

Flohé³

et al. 2018

Eur J Trauma Emerg Surg

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“…1). 1 Fractures in this area may extend proximally into the trochanteric area or neck and distally into the shaft. Reverse trochanteric or transverse trochanteric fractures, although involving the proximal trochanteric area, present many of the same challenges as subtrochanteric fractures.…”

Section: Introductionmentioning

confidence: 99%