title: Bridge-plating osteosynthesis of 20 comminuted subtrochanteric fractures with dynamic hip screw.
abstract: BACKGROUND
  A prospective clinical trial was conducted to evaluate the conjunctive use of an extramedullary device and the bridge-plating technique in the treatment of comminuted subtrochanteric fractures with major extension into the femoral shaft.
  
  
  METHODS
  A Winquist criteria was used to classify 3 fracture patterns. The type 3 fractures were excluded from this study because of great extent of the fracture zone for which the bridge-plating technique is not indicated. There were 14 men and 6 women, with a mean age of 49 (range, 17-76) years. A dynamic hip screw (DHS) with a long side plate was chosen as the fixation device because of the small learning curve.
  
  
  RESULTS
  The fractures united at a mean of 7.6 (range, 3-15) months postoperatively. Mobility was scored at 9 points in 18 patients and 6 points in 2 patients (Mobility score of Parker & Palmer). Pain was absent in 14, mild in 3, and moderate in 3 patients. Two limbs were shortened by 1 and 1.5 cm, respectively.
  
  
  CONCLUSIONS
  Our results indicate that DHS fixation using the bridge-plating technique leads to union of all comminuted Winquist types 1 and 2 fractures without major complications, and it is a valuable alternative to new intramedullary devices. This procedure offers the significant advantage of being less technically demanding.
authors.affiliation: Division of Trauma & Emergency, Department of Orthopedic Surgery, Chung Gung Memorial Hospital, Taipei, Taiwan, ROC. leebone@cgmh.org.tw
authors.forename: Po-Cheng
authors.initials: PC
authors.lastname: Lee
authors.forename: Shang-won
authors.initials: SW
authors.lastname: Yu
authors.forename: Pang-Hsin
authors.initials: PH
authors.lastname: Hsieh
authors.forename: Juin-Yih
authors.initials: JY
authors.lastname: Su
authors.forename: Yeung-Jen
authors.initials: YJ
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D018460:Fractures, Comminuted / Q000601:surgery*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies