Treatment of Subtrochanteric Nonunion with a Blade Plate / 대한정형외과학회잡지

ABSTRACT

PURPOSE: Although nonunion is a relatively common complication in the management of subtrochanteric fractures, there are few studies regarding the treatment of nonunion. The purpose of this study was to evaluate clinical and radiological results for the treatment of subtrochanteric nonunions with a blade plate. MATERIALS AND METHODS: We retrospectively analyzed 16 cases of subtrochanteric nonunions that were treated with a blade plate between April 1997 and June 2008 and were followed for at least one year after the index operation. There were 8 males and 8 females with an average age of 58 years (range, 42-77 years). Outcome variables included the time to union, postoperative complications, Harris hip score, and the functional rating scale of Sanders. The average follow-up period was 26 months (range, 12-63 months). RESULTS: Union was achieved in 15 (94%) of 16 subtrochanteric nonunions after an average of 7 months (range, 4-11 months). One patient who did not reach union after the index operation underwent repeated surgery with a longer blade plate and bone graft, but this patient was eventually treated with total hip arthroplasty because of persistent nonunion and breakage of the blade plate. Two patients developed complications. One patient had bursitis around the greater trochanter and the other developed avascular necrosis of the femoral head. Of these, the patient with avascular necrosis of the femoral head was treated with total hip arthroplasty because of persistent hip pain 2 years after the index operation. At latest follow-up, the mean Harris hip score was 88 points (range, 36-100 points) and the functional rating scale of Sanders was good or excellent in 14 (88%) of 16 patients. CONCLUSION: The treatment of subtrochanteric nonunions with a blade plate is associated with a very high union rate and good clinical results.