ABSTRACT
PURPOSE: The aim of this study was to investigate the utility of percutaneous wiring in the reduction of reverse oblique trochanteric fractures (AO classification 31-A3.3) by analyzing the treatment results with or without the use of percutaneous wiring. MATERIALS AND METHODS: Thirty-five cases from January 2008 to August 2014 that could be followed-up for at least one year were selected among patients with unstable trochanteric fractures who underwent either internal fixation or open reduction. Seventeen patients underwent surgery with percutaneous wire fixation but another 18 patients underwent surgery without it. All patients received a closed reduction and internal fixation with an intramedullary nail. The factors evaluated were as follows: the length of operation, loss of blood, length of in-hospital stay, lower limb function scale, return to preinjury daily life, change in femur neck shaft angle, postoperative gap of the fracture site, time taken for bone attachment, quality of post-operative reduction, and complications. RESULTS: No significant difference in the mean operative time, loss of blood, length of in hospital stay, lower limb function scale, return to pre-injury daily life, change in femur neck shaft angle, postoperative gap of the fracture site, and quality of postoperative reduction was observed between the two groups. A significant difference was noted in the time taken for bone attachment (p=0.032). Bone attachment took 13.3 weeks (9–17 weeks) on average when fixed with percutaneous wiring and no patient was found to have any complications. When treated without percutaneous wiring, however, bone attachment took 17.8 weeks (12.5–28.0 weeks) on average and three cases resulted in delayed union. CONCLUSION: Percutaneous wiring is a recommended treatment option for patients with an unstable trochanteric fracture.
Subject(s)
Humans , Classification , Femur Neck , Femur , Fractures, Comminuted , Hip Fractures , Length of Stay , Lower Extremity , Operative TimeABSTRACT
The subtrochanteric fractures of femur have high rates of delayed union or nonunion due to less-dense cancellous bone, insufficient cortical blood flow and high stress concentration. Anatomical reduction and rigid internal fixation are important in this region; however, an open reduction might damage the biological environment at the fracture site as well as increase the risk of nonunion. We present our experience with nine cases of subtrochanteric femur fractures surgically fixated with intramedullary nailing after percutaneous cerclage wiring through minimal incision.
Subject(s)
Femur , Fracture Fixation, Intramedullary , Hip FracturesABSTRACT
PURPOSE: To report the method of anatomical reduction and its maintenance by percutaneous wiring reduction in minimally invasive plate osteosynthesis for distal tibial fractures. MATERIALS AND METHODS: 17 cases that were diagnosed oblique, spiral or transverse fracture of distal tibia from August 2007 to February 2010 and were able to anatomically reduce by the method of percutanous wiring reduction in minimally invasive plate osteosynthesis were included in this study. Mean age was 50, and mean follow up period was 18 months. We investigated the period until bone union was achieved, degree of angulation angle, and complications. For postoperative evaluation, Olerud and Molander ankle score and VAS pain score in daily living were checked. RESULTS: The mean varus/valgus angulation after bone union on AP radiograph was 0.9 degrees and the mean anterior/posterior angulation on lateral radiograph was 2.0 degrees The mean Olerud and Molander ankle score was 89.4, and mean pain score due to walk adjacent to metal plate was 0 points. CONCLUSION: By the method of percutaneous wiring reduction in distal tibial fracture, anatomical reduction is easily acquired, and only by wire itself, reduction could be maintained, so that without additional manual reduction, plate could be easily fixed.