Biologic plating versus intramedullary nailing for comminuted subtrochanteric fractures in young adults: a prospective, randomized study of 66 cases

The Journal of Trauma
Po-Cheng LeeChi-Chuan Wu

Abstract

Published reports about treatment of comminuted subtrochanteric fractures in young patients are few. This study compared the effectiveness of biologic plating and intramedullary nailing in the treatment of such fractures. A prospective, randomized, and nonblinded study was conducted. Closed reduction and fracture osteosynthesis were performed with either a dynamic condylar screw (DCS) or a Russell-Taylor reconstruction nail (RTRN) in all 66 patients. The average age of the patients was 36.1 years. The average follow-up period was 28.1 months. All but two patients had uneventful bone union and the average time to union was 15.1 weeks. One implant failure in the RTRN group and one delayed union in the DCS group required additional surgery to achieve bone union. Shorter fluoroscopic time, reduced blood loss, and fewer patients requiring blood transfusion were found in the DCS group, though the DCS group had a higher hip pain score 2 years postoperatively. Otherwise, the surgical results and functional outcomes were comparable between groups. With the enhanced fixation properties demonstrated in the present study, the DCS proved to be a feasible fixation device for comminuted subtrochanteric fractures in young patients. Our results...Continue Reading

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Citations

Dec 2, 2014·The Orthopedic Clinics of North America·Siddharth B JoglekarArmen Martirosian
Dec 1, 2012·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Nirav H AminDouglas L Cerynik
Jun 12, 2012·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·P R J V C BoopalanVinoo M Cherian
Nov 28, 2008·Injury·V S NikolaouP V Giannoudis
Apr 15, 2015·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Ahmet ImerciMurat Yeşil
Apr 4, 2015·International Journal of Surgery Case Reports·Kyung-Jae LeeMin-Ji Kim
Dec 24, 2017·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·K J DonnellyJ D Acton
Sep 9, 2010·The Cochrane Database of Systematic Reviews·Martyn J Parker, Helen Hg Handoll
Mar 15, 2011·Journal of Orthopaedic Trauma·Philipp N StreubelMichael J Gardner
Aug 5, 2009·The Journal of Bone and Joint Surgery. American Volume·Alan AfsariGeorge J Haidukewych
Jun 29, 2012·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Saeed Reza MehrpourReza Sorbi
Dec 24, 2018·BMC Musculoskeletal Disorders·Sebastian LotzienJan Gessmann

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