Use of an Angled Blade Plate for 31A3 Intertrochanteric Fractures
| Autor: | Kaushik Bhowmick, Viju Daniel Varghese, Boopalan Ramasamy, Thilak S. Jepegnanam, Reka Karuppusami |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Reoperation Difficult problem medicine.medical_specialty Radiography Bone Screws Bone Nails Fracture Fixation Internal Young Adult 03 medical and health sciences 0302 clinical medicine medicine Humans Surgical Wound Infection Orthopedics and Sports Medicine 030212 general & internal medicine Aged Retrospective Studies Fixation (histology) Aged 80 and over Fracture Healing 030222 orthopedics Hip Fractures business.industry Significant difference Implant failure Level iv General Medicine Middle Aged Rating score Surgery Treatment Outcome Feasibility Studies Female Blade plate business Bone Plates Follow-Up Studies |
| Zdroj: | Journal of Bone and Joint Surgery. 103:2006-2013 |
| ISSN: | 1535-1386 0021-9355 |
| DOI: | 10.2106/jbjs.19.01265 |
| Popis: | Background A subgroup of pertrochanteric fractures-namely, the AO/OTA 31A3 fracture-continues to be a difficult problem to treat, even with cephalomedullary nails. We present the results for 26 patients with a 31A3 fracture treated with the angled blade plate. Methods The records of 26 consecutive patients with a 31A3 fracture that was treated operatively with the angled blade plate device between 2007 and 2012 at our center were reviewed, and the patients were contacted for follow-up. The functional outcome (traumatic hip rating score) and radiographic outcome (the neck-shaft angle at the time of fixation and final follow-up) were obtained for 20 of the 26 patients at a minimum follow-up of 1 year. Results All 26 patients had primary surgery. At final review, 2 patients had died and 4 had been lost to follow-up. Of the 4 patients lost to follow-up, 2 had revision of the fixation with the angled blade plate. Of the 20 patients with follow-up, 1 had malreduction and implant failure but eventually had healing after revision of the fixation with the angled blade plate. The mean traumatic hip rating score at the time of follow-up was 50.0 with 4, 14, and 2 patients having excellent, good, and failed outcomes, respectively. The mean neck-shaft angle at the time of final union was 126.16°, which was an average of 4° less than that on the unaffected side. However, this did not correlate with functional outcome. There was no significant difference between the immediate postoperative and final neck-shaft angles. Conclusions This study demonstrated that blade plate fixation for 31A3 fractures is associated with low rates of failure (15%), revision surgery (15%), and infection (15%), which are comparable with the results of nail fixation (range, 5% to 12%) and superior to those of sliding hip screw fixation. This large series demonstrates that the angled blade plate can be utilized for these complex fractures and should be part of the armamentarium for these injuries. Level of evidence Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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