title: Treatment of intertrochanteric fractures of the femur with L-trapezoid compression plate and its mechanical principles.
abstract: OBJECTIVE: To improve the results of the treatment of unstable types of intertrochanteric fractures of the femur (ITFF) by internal fixation. METHODS: A L-trapezoid compression plate system (L-TCP) was designed and compared to the AO/ASIF angle plates of 95 and 130 (L-AP) with mechanical tests. An Evans Type III model was made, the simulation electrical test with loading on single and both legs were done. The results demonstrated that the stability of the L-TCP fixation was significantly greater, and the stress concentration at the upper screw hole was relevantly smaller than that of L-AP. From June 1986 to June 1998, 82 patients of ITFF were treated with L-TCP fixation. The average age was 67.4 years old (26-91). Seventy-four of those fractures were unstable. Fifty-eight patients were treated with open reduction, and 24 cases were treated by closed reduction and limited open (only lateral aspect of upper femur was exposed) fixation with L-TCP under X-ray monitoring. RESULTS: Sixty-six patients were followed up for 6-69 months. Complications, including 3 wound infection, 1 non-union, 3 coxa varus and 2 implant breakage (9 complications of 7 cases), all occurred in the open reduction group. No complication was found in the closed reduction group. CONCLUSIONS: In the treatment of ITFF, the results of closed reduction and limited open fixation with L-TCP is significantly better than that of open reduction and fully exposed fixation.
authors.affiliation: Department of Orthopaedics, First Teaching Hospital, Norman Bethune University o f Medical Sciences, Changchun 130021, China.
authors.forename: Xinxiang
authors.initials: X
authors.lastname: Xu
authors.forename: Xiaonan
authors.initials: X
authors.lastname: Zhang
authors.forename: Jianguo
authors.initials: J
authors.lastname: Liu
authors.forename: Daming
authors.initials: D
authors.lastname: Qin
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang