title: Redisplacement after reduction with intramedullary nails in surgery of intertrochanteric fracture: cause analysis and preventive measures.
abstract: OBJECTIVE
  During the implantation of intramedullary nail in surgery of intertrochanteric fracture, the fact that the originally satisfactory reduction may incur redisplacement remains a major concern. In this article, we will analyze the reasons of redisplacement and describe some methods that can improve the quality of reduction.
  
  
  METHODS
  From January 2012 to October 2014, 67 patients with intertrochanteric fracture were treated using Gamma3 or PFNA system. All the surgical procedures were monitored by fluoroscopy on the AP and lateral views, and the X-ray films were used to evaluate all cases.
  
  
  RESULTS
  Redisplacement occurred in ten cases intraoperatively. According to the fracture type, re-occurring deformities appeared in 31-A2 and 31-A3 commonly, 6 and 3 cases. We found the redisplacement emerged usually in operative procedure and some manipulations should be taken to obtain an anatomic reduction.
  
  
  CONCLUSIONS
  When reduction is achieved in the surgery of intertrochanteric fracture, surgeons tend to overlook the occurrence of redisplacement, or not to treat it that has emerged timely. Internal fixation in nonanatomic reduction may increase the likelihood of fixation failure postoperatively. For the importance of accurate reduction of the fracture, once redisplacement occurs during the surgery, some methods or tricks are applicable to it to restore the anatomic reduction.
authors: Department of Orthopaedics, Chuiyangliu Hospital of Beijing, Beijing, 100022, China, youngdenver@sohu.com.
authors: Zhiyang
authors: Z
authors: Xu
authors: Mei
authors: M
authors: Zhang
authors: Jian
authors: J
authors: Yin
authors: Longxi
authors: L
authors: Ren
authors: Yanjun
authors: Y
authors: Zeng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005471:Fluoroscopy; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*