RESUMEN
BACKGROUND: Surgical treatment of comminuted subtrochanteric fractures may be associated with high incidences of non-union and implant failure. Biological fixation may solve this problem by encouraging rapid callus formation which buttresses the medial cortex. METHODS: In all, 33 patients with comminuted subtrochanteric femur fractures underwent indirect reduction and biological internal fixation. The mean age of the group was 39.12 (19-64) years. RESULTS: Patients were followed up for a mean of 24.6 (12-66) months. Union was achieved within a mean of 15.10 (13-22) weeks, with no cases of delayed union or non-union but with limb-length discrepancy, mean 1.22 (1-2) cm, in nine cases. According to the Traumatic Hip Rating Scale, functional results were excellent in 23 and good in 10 cases. CONCLUSIONS: Indirect reduction and biological internal fixation yield acceptable results in comminuted fractures. These good results can be attributed to early weight-bearing with rapid solid callus formation and early union, which are particularly advantageous in comminuted subtrochanteric fractures, avoiding the implant failure which is not uncommon in these fractures.
Asunto(s)
Fijación Interna de Fracturas/métodos , Fracturas Conminutas/cirugía , Fracturas de Cadera/cirugía , Adulto , Placas Óseas , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Rango del Movimiento Articular/fisiología , Recuperación de la Función/fisiología , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
We treated 22 children with a supracondylar fracture of the humerus and an ipsilateral fracture of the forearm by closed reduction and percutaneous fixation. There were four Gartland type-II and 18 Gartland type-III supracondylar fractures of the humerus. There were fractures of both bones of the forearm in 16 and of the radius in six. Both the supracondylar and the distal forearm fractures were treated by closed reduction and percutaneous fixation. The mean follow-up time was 38.6 months. At the latest follow-up there were 21 excellent or good results and one fair result. There were no cases of delayed union, nonunion or malunion. Five nerve injuries were diagnosed on admission and all recovered spontaneously within eight weeks. No patient developed a compartment syndrome.