[Nonunions after intertrochanteric and subtrochanteric femoral fractures]. / Pseudarthrosen nach per- und subtrochantären Femurfrakturen.
Unfallchirurgie (Heidelb)
; 127(5): 356-363, 2024 May.
Article
in De
| MEDLINE
| ID: mdl-38224360
ABSTRACT
INTRODUCTION:
The overall frequency of proximal femoral fractures means that we are repeatedly confronted with failed healing and implant failure, despite a relatively low nonunion rate especially in intertrochanteric fractures (<â¯5%). The aim of this paper is to present our approach to treating these nonunions of the proximal femur and discuss the treatment results. MATERIAL ANDMETHODS:
Between 2009 and 2023, patients with nonunion of the proximal femur were retrospectively identified and analyzed. Age, gender, time to revision, the Weber-Cech classification of pseudarthrosis and radiographic imaging before and after revision were analyzed.RESULTS:
A total of 66 patients were analyzed. The mean age was 58 years (range 25-88 years). The overall healing rate was 88% with a mean consolidation time of 8 months (range 2-29 months). The main osteosynthesis procedures were plate osteosynthesis (nâ¯= 45, of which 44 were blade plates), and nail replacement (nâ¯= 12). Other procedures included augmentative plate osteosyntheses (nâ¯= 4), isolated cancellous bone graft (nâ¯= 2), nail dynamization (nâ¯= 2), and the use of a dynamic hip screw (nâ¯= 1).DISCUSSION:
The analysis of our treatment data as well as the current literature, revealed a trend towards intramedullary revision procedures. Implants that can be used to correct the CCD angle, such as the blade plate, remain a predictable option to achieve correction, especially in nonunions with an increased degree of varus. Particularly in the subtrochanteric region, fractures can also be treated in a targeted manner by a combination of mechanical and biological methods with a reamed nail change to a larger caliber implant.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Fracture Fixation, Internal
/
Fractures, Ununited
/
Hip Fractures
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
De
Journal:
Die Unfallchirurgie (Heidelberg. Online)
/
Unfallchirurgie (Heidelb)
Year:
2024
Type:
Article