The role of a trochanteric buttress plate in intertrochanteric fractures with lateral wall fractures: A longitudinal cohort
Keywords:
Trochanteric instability, lateral wall fixationAbstract
Objectives: To study the outcome of lateral wall buttressing along with Proximal Femoral Nail fixation in lateral wall Intertrochanteric fractures and comparing with Proximal femoral Nail fixation only. Method: This study is a longitudinal cohort analysis comprised of 30 consecutive patients of all ages and either gender, with intertrochanteric fracture with fracture lateral wall, Orthopaedic trauma classification (OTA) classification type 31-A3, admitted at Government medical college Ratlam, MP, India, from the period of January 2019 to April 2020. The minimum followup considered was 12 weeks. Functional outcome was measured by Harris Hip score, intraoperative parameters for comparison include blood loss, duration of surgery and radiological exposures. Possible complications of operative fixation of such intertrochanteric fractures were also analyzed in both the groups. All the comparative parameters were compared with student’s T-test. Material: Operative fixation of the subject fracture by Proximal femoral nailing only, odd number of patients (Group A) and Proximal femoral nailing with a Trochanteric buttress plate, even number of patients (Group B). Results: Functional outcome by Harris hip score (HHS) came out to be significantly improved in subjects with augmentation with the trochanteric buttress plate (group B), 80% (12 of 15) with HHS 90 to 100 as compared to 60% (09 of 15) with HHS 90 to 100 in proximal femoral nailing only patients(group A). Also, there was statistically significant increased blood loss, duration of surgery, and the number of radiological exposures in the group B, skewed by the probable deterrent factor as the learning curve of the intervention. Conclusions: The study yields the lateral wall reconstruction as an important factor for the stability of intertrochanteric fractures. Combining a trochanteric stabilization plate with proximal femoral nailing appears to be a useful method to achieve stabilization, which needs to be further assessed by biomechanical stress studies.
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Copyright (c) 2021 Nitin Kiradiya, Pradeep Dubey, Vijendra Damor, Harshwardhan Dawar
This work is licensed under a Creative Commons Attribution 4.0 International License.