Trochanteric Femoral Fractures Treated with McLaughlin Osteosynthesis

Jensen, J. Steen; Michaelsen, M

doi:10.3109/17453677508989266

Cited by 148 publications

(80 citation statements)

References 10 publications

(1 reference statement)

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“…The treatment of stable trochanteric fractures of type 1 or type 2 according to the classification of Jensen and Michaelsen (J-M) 1 is uncontroversial and good results can be expected with various implants. 2 Most authors favour the sliding hip screw (SHS) and recent studies on this method have shown rates of failure below 2%.…”

mentioning

confidence: 99%

The standard Gamma nail or the Medoff sliding plate for unstable trochanteric and subtrochanteric fractures

Miedel

Ponzer

Törnkvist

et al. 2005

The Journal of Bone and Joint Surgery. British volume

122

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We studied 217 patients with an unstable trochanteric or subtrochanteric fracture who had been randomly allocated to treatment by either internal fixation with a standard Gamma nail (SGN) or a Medoff sliding plate (MSP, biaxial dynamisation mode). Their mean age was 84 years (65 to 99) and they were reviewed at four and 12 months after surgery. Assessments of outcome included general complications, technical failures, revision surgery, activities of daily living (ADL), hip function (Charnley score) and the health-related quality of life (HRQOL, EQ-5D).The rate of technical failure in patients with unstable trochanteric fractures was 6.5% (6/ 93) (including intra-operative femoral fractures) in the SGN group and 5.2% (5/96) in the MSP group. In patients with subtrochanteric fractures, there were no failures in the SGN group (n = 16) and two in the MSP group (n = 12). In the SGN group, there were intraoperative femoral fractures in 2.8% (3/109) and no post-operative fractures. There was a reduced need for revision surgery in the SGN group compared with the MSP group (8.3%; 9/108; p = 0.072). The SGN group also showed a lower incidence of severe general complications (p < 0.05) and a trend towards a lower incidence of wound infections (p = 0.05). There were no differences between the groups regarding the outcome of ADL, hip function or the HRQOL. The reduction in the HRQOL (EQ-5D index score) was significant in both groups compared with that before the fracture (p < 0.005).Our findings indicate that the SGN showed good results in both trochanteric and subtrochanteric fractures. The limited number of intra-operative femoral fractures did not influence the outcome or the need for revision surgery. Moreover, the SGN group had a reduced number of serious general complications and wound infections compared with the MSP group. The MSP in the biaxial dynamisation mode had a low rate of failure in trochanteric fractures but an unacceptably high rate when used in the biaxial dynamisation mode in subtrochanteric fractures.The negative influence of an unstable trochanteric or subtrochanteric fracture on the quality of life was significant regardless of the surgical method.The treatment of stable trochanteric fractures of type 1 or type 2 according to the classification of Jensen and Michaelsen (J-M) 1 is uncontroversial and good results can be expected with various implants. 2 Most authors favour the sliding hip screw (SHS) and recent studies on this method have shown rates of failure below 2%. 3,4 In the case of unstable trochanteric fractures (J-M type 3 to 5) 1 and subtrochanteric fractures, 5 the treatment is more controversial and the rate of failure for the SHS in these fractures is considerably higher, ranging from 4% to 15%. 3,4,[6][7][8][9] The Medoff sliding plate (MSP) evolved from the SHS and gives axial compression along both the femoral neck (optional) and the femoral shaft. It has produced remarkably good results in prospective trials in both unstable trochanteric and subtrochanteric fractures with a rate of fa...

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mentioning

confidence: 99%

The standard Gamma nail or the Medoff sliding plate for unstable trochanteric and subtrochanteric fractures

Miedel

Ponzer

Törnkvist

et al. 2005

The Journal of Bone and Joint Surgery. British volume

122

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“…It was necessary to re-operate on two patients (3 per cent). The percentage of re-operations in another series was 5.9 per cent (Jensen & Michaelsen 1975). …”

Section: Discussionmentioning

confidence: 97%

“…The McLaughlin nail-plate is one of the most frequently used methods although technical complications are often encountered (Foster 1958, Jensen & Michaelsen 1975. A more recent method, Ender nailing, has been reported to reduce the number of complications (Ender & Simon-Weidner 1970, Kuderna et al 1976, Hult & Nilsson 1978, Raugstad et al 1979, Pankovich & Tarabishy 1980.…”

mentioning

confidence: 99%

Trochanteric and Subtrochanteric Fractures:The Operative Results in a Prospective and Comparative Study of Ender Nailing and McLaughlin Osteosynthesis

Høgh¹,

Lucht²

1981

Acta Orthopaedica Scandinavica

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“…Unstable trochanteric femoral fractures have been variously defined as fractures that have lost posterolateral or medial support 1 , fractures with comminuted posterior walls in the greater trochanter 7 , fractures with large lesser trochanter fragments 7 , or fractures with medial fragments and large posterior fragments 8 . Yamazaki et al 9 assessed trochanteric femoral fractures in 37 patients using CT imaging and reported that rotational deformity is more likely to occur after surgery if the greater and lesser trochanters are displaced from the proximal and distal fragments and there is a posterior wall fragment.…”

Section: Limitations Of Sfns For Trochanteric Femoral Fracturesmentioning

confidence: 99%

Radiographic Analysis of Preoperative and Postoperative 3DCT Images of Trochanteric Femoral Fractures

Ito

Obara

Atsumi

2014

Showa Univ J Med Sci

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: The present study compared a 3-dimensional computed tomography 3DCT classi cation Nakano classi cation with conventional x-ray classi cations Jensen classi cation and AO classi cation in 44 patients with trochanteric femoral fractures, and evaluated the patterns of fracture lines using 3DCT images. The concordance rate between the Jensen and 3DCT classification, and between the AO and 3DCT classification was 65.9 and 75.0 , respectively. 3DCT scans enabled the creation of detailed images of fracture lines. The anterior fracture line was found to run along the intertrochanteric crest in 90.9 of patients, while the location of the posterior fracture line was in the same approximate position in all patients, including those with comminuted fractures 34.1 . Posterior destruction along lateral fracture lines was present in 63.6 of patients. Furthermore, the preoperative and postoperative CT images of 33 patients with fractures treated via insertion of short femoral nails demonstrated that there was dif culty reducing greater trochanteric fractures. This included reducing fracture sites separated by nail insertion 42.4and greater trochanteric fracture sites displaced after surgery 54.5 , suggesting that the use of short femoral nails is limited.

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Trochanteric Femoral Fractures Treated with McLaughlin Osteosynthesis

Cited by 148 publications

References 10 publications

The standard Gamma nail or the Medoff sliding plate for unstable trochanteric and subtrochanteric fractures

The standard Gamma nail or the Medoff sliding plate for unstable trochanteric and subtrochanteric fractures

Trochanteric and Subtrochanteric Fractures:The Operative Results in a Prospective and Comparative Study of Ender Nailing and McLaughlin Osteosynthesis

Radiographic Analysis of Preoperative and Postoperative 3DCT Images of Trochanteric Femoral Fractures

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