Minimally invasive plate osteosynthesis of subtrochanteric femur fractures with a locking plate: a prospective series of 20 fractures.
BACKGROUND
Intramedullary nailing is a mainstay in the treatment of subtrochanteric femoral fractures. But nailing is often unsuitable for difficult fracture patterns with comminution or when the medullary canal is narrow. The purpose of this study was to clarify the efficacy of minimally invasive plate osteosynthesis (MIPO) with locking compression plate in the treatment of subtrochanteric fractures.


METHODS
Twenty patients with subtrochanteric fractures (mean age 49.6 years) were prospectively treated using the MIPO technique using a locking plate. Indications of procedure were fractures with the greater trochanter or medial comminution, and multiple injured patients with a narrow femoral canal. According to the AO/OTA classification, there were three of type A, eight of type B, and nine of type C.


RESULTS
All healed without bone graft, at an average of 20.1 weeks (range 16-32). With the exception of two patients with minor internal rotation deformity and one patient with 1 cm of shortening, most achieved acceptable alignment. All patients were able to walk with no or only a slight limp, and median Merle d'Aubigne score was 17.3 (15-18). Four patients complained of a slight pain in the trochanteric area due to plate prominence. The MIPO technique with a locking plate provides an alternative method for fixing subtrochanteric femur fractures, when IM nailing is inappropriate. This technique provides stable fixation, with a high union rate and a minimal complication rate.
Oh
Chang-Wug
CW
Department of Orthopedic Surgery, Kyungpook National University Hospital, 50, 2-Ga, Samdok, Chunggu, Daegu, 700-721, Korea. cwoh@knu.ac.kr
Kim
Jung-Jae
JJ
Byun
Young-Soo
YS
Oh
Jong-Keon
JK
Kim
Joon-Woo
JW
Kim
Shin-Yoon
SY
Park
Byung-Chul
BC
Lee
Hyun-Joo
HJ
D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D018460:Fractures, Comminuted; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011859:Radiography; D055815:Young Adult