Treatment of Seinsheimer type Ⅲ subtrochanteric femoral fractures with prolonged Gamma3 nails and titanium wire fixation in the aged patients / 中华创伤骨科杂志

ABSTRACT

Objective To investigate the treatment of subtrochanteric femoral fractures of Sein-sheimer type Ⅲ with prolonged Gamma3 nails and titanium wire fixation in the aged patients. Methods From October 2014 to December 2015, 23 old patients with subtrochanteric femoral fracture were treated with prolonged Gamma3 nails and titanium wire fixation. They were 7 men and 16 women, aged from 62 to 78 years ( 69. 3 years on average ) . By Seinsheimer classification, 14 cases were type ⅢA and 9 type ⅢB. The time from injury to surgery averaged 3. 4 days ( from 2 to 6 days ) . Their operation time, intraoperative bleeding, hospital stay, fracture union time and hip function at the final follow-up were documented. Results Their operation time averaged 1. 3 hours ( from 1. 0 to 1. 6 hours ) , intraoperative bleeding 161 mL ( from 115 to 215 mL ) , and hospital stay 10. 7 days ( from 9 to 12 days ) . They obtained follow-ups from 5 to 12 months ( 9. 3 months on average ) . All the fractures achieved bony union after an average of 15. 4 weeks ( from 12 to 20 weeks ) . The function of the affected hip assessed at the final follow-up according to the Harris scoring was excellent in 15 cases, good in 5 and fair in 3, resulting in an excellent to good rate of 87. 0％. Their follow-ups revealed no deep venous thrombosis of lower limb, fat embolism, coxa vara, refracture, cut-in of the femoral head by the lag screw, or implant breakage. Conclusions In the treatment of senile subtrochanteric femoral fractures of Seinsheimer type Ⅲ, prolonged Gamma3 nails and titanium wire fixation exhibits advan-tages of limited operative trauma, rigid fixation, a high rate of union and limited complications. Additionally, this treatment can increase the accuracy of inserting distal locking nails, shorten operation time and improve functional recovery.