Biological plate osteosynthesis of comminuted subtrochanteric fractures: a clinical study.

BACKGROUND

Comminuted subtrochantric fractures represent a challenge for trauma surgeons. Achieving appropriate reduction and stable fixation can be difficult, some techniques being associated with technical difficulties and complications. The aim of this study is the assessment of biologic fixation in comminuted subtrochantric fractures.

METHOD: Twenty six men with comminuted subtrochanteric femoral fractures treated by bridging dynamic hip screw were prospectively studied. Patients were assessed clinically for pain, hip and knee range of motion, angular and rotational deformities and leg-length discrepancy. Union was assessed radiographically.

RESULTS

Seinheimer classification: 8 fractures were type III, 11 patients type IV and seven patients type V. Fixation was performed with dynamic hip screw (DHS). Union occurred in all cases. None of the patients had clinical pain or dysfunction.

DISCUSSION: We highly recommend submuscular plating in the treatment of comminuted subtrochantric fractures especially in the third world.