To compare the clinicoradiological outcome of various operative techniques and fixation devices in treatment of subtrochanteric fractures

Dr. Nirnay Pandey, D. Chaurasia
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Abstract

Background: There are various operative techniques and fixation devices in treatment of subtrochanteric fractures. The objective of treatment is restoration of optimal functions in the shortest possible time by the safest and most dependable method of treatment. Aim: To compare the clinicoradiological outcome of various operative techniques and fixation devices in treatment of subtrochanteric fractures and its variants. To compare the efficacy of various operative techniques in management of subtrochanteric fractures and its variants. To assess efficiency of various fixation devices in different (A-O) types of subtrochanteric fractrues and to compare our results with those available in literature. Methods: This prospective study was conducted in department of orthopedic surgery, in a span of two years. 38 Cases of subtrochanteric fractures and two types of extensions of subtrochanteric fractures admitted in orthopedics wards and treated by various operative methods were included in the study. Results: Malunion was seen in 3 cases and infection in 2 cases. Excellent and good results were seen in most of the cases fixed with intramedullary devices 35% & 39% respectively) and these using closed techniques (38% & 43% respectively). Majority of excellent result (52%) were seen in cases fixed with Proximal Femoral Nail. Most of the cases fixed using Dynamic Condylar Screw and Dynamic Hip Screw had fair to good results. Conclusion: Successful management of a case of subtrochanteric fracture is an exercise in balancing mechanical and biological consideration in maximize the likelihood of rapid healing and full restoration of function with minimal risk of complications at the least cost to the patient and society
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比较不同手术方法和固定装置治疗粗隆下骨折的临床放射学效果
背景:治疗粗隆下骨折有多种手术技术和固定装置。治疗的目的是用最安全可靠的治疗方法,在最短的时间内恢复最佳功能。目的:比较不同手术方法和固定装置治疗转子下骨折及其变型的临床放射学效果。比较不同手术方法治疗转子下骨折及其变型的疗效。评估不同固定装置在不同(A-O)型转子下骨折中的疗效,并将我们的结果与文献中已有的结果进行比较。方法:本前瞻性研究在骨科进行,为期两年。选取骨科病房收治的38例股骨粗隆下骨折及两种类型的股骨粗隆下延伸骨折,采用不同的手术方式治疗。结果:畸形愈合3例,感染2例。采用髓内装置固定的病例(分别为35%和39%)和采用封闭技术固定的病例(分别为38%和43%)均取得了良好的效果。股骨近端髓内钉固定的病例中,绝大多数(52%)取得了良好的效果。大多数病例采用动态髁螺钉和动态髋螺钉固定均有良好的效果。结论:股骨粗隆下骨折的成功治疗是一种平衡机械和生物学考虑的练习,最大限度地提高快速愈合和功能完全恢复的可能性,以最小的并发症风险,对患者和社会造成最小的损失
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