Application of anatomical reduction and fixation of lesser trochanter through posterior-lateral approach in treating intertrochanteric fractures in the elderly / 中华老年医学杂志

ABSTRACT

Objective To observe the feasibility and clinical curative effect of anatomical reduction and fixation of lesser trochanter through posterior-lateral approach for the treatment of comminuted femoral intertrochanteric fractures in elderly patients.Methods A total of 19 cases with comminuted femoral intertrochanteric fracture,aged 60 to 84 years were enrolled in this study.According to Evans-Jensen classification,13 cases had type Ⅱ B and 6 cases had type Ⅲ femoral fracture.Through the posterior-lateral approach,the lesser trochanter was fully exposed,reduced and fixed by screw.The proximal and distal femur were well fixed with dynamic hip screw(DHS)or proximal femoral locking plate(PFLP).The lesser trochanter reduction was observed by intraoperative vision and postoperative X-ray.The function evaluation after hip surgery was performed by using Sanders hip function score.Results All 19 patients obtained the anatomic reattachment in the lesser trochanter.All patients were followed up for an average of 18 months.After treatment,the Sanders hip function score were excellent in 7 patients (36.8 ％),fine in 12 cases (63.2 ％).And curative efficacy was good in all cases(100％).There was no significant difference in the curative effect between patients with different classification and gender.Conclusions Through the posterior-lateral approach,the surrounding structures of the lesser trochanter can be fully exposed,and the lesser trochanter can be anatomically repositioned.The posterior-lateral approach to anatomical reduction and fixation of lesser trochanter is an effective and feasible method for the treatment of comminuted intertrochanteric fracture in the elderly.