A simple minimally invasive technique providing anterior and medial reduction in intertrochanteric femur fractures: A case-control study.

ABSTRACT

BACKGROUND: The aim of the study was to compare the clinical and radiological results of the Verbrugge minimally invasive technique used in AO/OTA 31-A2.2/A2.3 intertrochanteric fracture types with those of the closed reduction technique performed on a traction table. METHODS: A retrospective evaluation was made of 671 patients treated in our clinic for intertrochanteric fracture between 2017 and 2020. The patients included in the study were those aged >70 years, applied with intramedullary nailing for an AO/OTA 31-A2.2/A2.3 fracture type, with >1 year of follow-up. Patients were excluded if they did not meet these criteria, if they had a pathological fracture, an open fracture, or a history of hip surgery. A total of 177 patients were accepted for analysis in the study. The patients were separated into two groups as those where reduction was provided with the Verbrugge minimal invasive technique Verbrugge reduction group (VRG) and those with closed reduction applied on a traction table Conventional reduction group (CRG). The reduction quality was evaluated radiologically with the modified Chang method and the varus reduction rates were compared. The clinical results of the groups were compared in respect of time to full weight-bearing mobilization, complication rates, and Harris Hip Scores (HHS). RESULTS: Varus malreduction was seen less often in the VRG compared to the CRG, the reduction quality was more successful, the patients could be mobilized earlier and the HHSs were better. No significant difference was determined in terms of operating time and complications. CONCLUSION: The Verbrugge method can be used in all AO/OTA 31-A2.2/A2.3 intertrochanteric fractures where closed reduction applied on a traction table is not sufficient. This method can be considered to be an effective technique that increases the quality of the fracture reduction, provides protection throughout the operation, and has similar complication rates to those of the conventional reduction method.