Unstable intertrochanteric fracture of the femur. A prospective randomised study comparing anatomical reduction and medial displacement osteotomy.
We conducted a prospective randomised trial to compare the results of anatomical reduction and medial displacement osteotomy in 127 consecutive patients with unstable intertrochanteric fractures, of whom 109 completed the study. After an average follow-up of 11 months, we found no significant differences in walking ability, social status or failure of fixation in the two groups. Postoperative complication rates and the early mortality rate were not significantly different, but operating time and blood loss were significantly higher in the osteotomy group. With the use of modern sliding hip screws, medial displacement osteotomy is rarely indicated for unstable intertrochanteric fractures.
University of Montreal, Canada.
A L
AL
Desjardins
A
A
Roy
G
G
Paiement
N
N
Newman
F
F
Pedlow
D
D
Desloges
R E
RE
Turcotte
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D006620:Hip Fractures / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period; D007593:Joint Instability / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D013997:Time Factors; D017211:Treatment Failure; D016138:Walking