The role of biological fixation with bridge plating for comminuted subtrochanteric fractures of the femur.
BACKGROUND
The surgical outcomes of comminuted subtrochanteric fractures result in high incidence of nonunion and malunion due to high energy trauma. Biological fixation offers decrease in these complications while preserving soft tissue vascularity. The aim of this study was to evaluate the results of patients treated with bridge plating for comminuted subtrochanteric femoral fractures retrospectively.


METHODS
Ten patients with comminuted subtrochanteric femoral fractures between 1996 and 2002 were included into this study. All patients were male and mean age was 46+/-15.2 years (range: 29-76 years). Six patients had C-3-1 and four patients had C-3-2 type fractures according to AO/OTA classification. Bridge plating under fluoroscopy control, according to biological fixation principles was carried out on all patients. Pain, walking capacity, functionality, motion, daily activities, radiological assessment for Sander's criteria and shaft-neck angles of both fractured and the other sides were recorded for statistical analysis, at the last follow-up.


RESULTS
Mean follow-up period was 62+/-20.9 months (range: 37-104 months). Partial and full weight-bearing were recommended at an average period of 3.3+/-1.1 (range: 1.5-4.5 months) and 4.8+/-1 months (range: 3-6 months) respectively (range: 3-6 months). There were eight excellent (80%), one good (10%) and one poor (10%) results according to Sanders' criteria. There was no statistically significant difference between the healthy and fractured sides with respect to femoral shaft-neck angles.


CONCLUSIONS
We have concluded that biological fixation applied with bridge plating offered an alternative method in the treatment of comminuted subtrochanteric femoral fractures.
Kayali
Cemil
C
Department of Orthopedics and Traumatology, Tepecik Training and Research Hospital, Izmir, Turkey. cemilkayali@yahoo.com
Ağuş
Haluk
H
Zincircioğlu
Gürhan
G
D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome