Abstract
PurposeAim of this study was to investigate whether limited open auxiliary angle stable plate fixation has an effect on functional and radiologic outcomes one year after revision intramedullary nailing in aseptic trochanteric and subtrochanteric fracture nonunion.MethodsIn a retrospective analysis, surgically revised aseptic trochanteric and subtrochanteric nonunion was evaluated in a total of 190 consecutive patients ranging from 18 to 94 years between 12/2005 and 10/2018.ResultsOne year after revision intramedullary nailing, nonunion healing was assessed in 129 out of 136 patients (95%) in group 1 without auxiliary plate fixation and in 51 out of 54 patients (94%) in group 2 with auxiliary plating (p = 0.23). In group 1, range of motion (ROM) was unrestricted in 88 patients and still restricted in 48 patients. In group 2, ROM was free in 34 patients and restricted in 20 patients (p = 0.25). The mean Lower Extremity Functional Scale (LEFS) was 56 points in group 1 and 55 points in group 2 (p = 0.55).ConclusionThis study did not demonstrate significant differences in functional and radiologic outcomes following revision intramedullary nailing of aseptic trochanteric and subtrochanteric fracture nonunion. Limited open auxiliary plate fixation might be a reasonable option especially in cases of relevant varus axis deviation and comminuted or atypical fracture configurations, regardless of patients’ age.Retrospectively registered with the German Clinical Trials Register (01/25/2021; ID: DRKS00024112).
Highlights
The development of aseptic nonunion following trochanteric and subtrochanteric femoral fractures remains a major challenge for the treating surgeon
The current study intended to prove this procedure for the concept of revision intramedullary nailing in aseptic trochanteric and subtrochanteric fracture nonunion in a large number of patients
The aim was to investigate whether auxiliary limited open angle stable plate fixation has an effect on functional and radiologic results one year after revision intramedullary nail replacement
Summary
The development of aseptic nonunion following trochanteric and subtrochanteric femoral fractures remains a major challenge for the treating surgeon. Intramedullary exchange nail with additional augmentation plate fixation is a well-known approach for diaphyseal femoral nonunion [8,9,10]. Several studies including own biomechanical investigations in trochanteric and subtrochanteric fractures treated by cephalomedullary nailing confirmed that interfragmentary rotational and shear forces are significantly lower with the use of an auxiliary plate and that the stability of the entire construct is significantly higher than in the control group [14, 15]. The current study intended to prove this procedure for the concept of revision intramedullary nailing in aseptic trochanteric and subtrochanteric fracture nonunion in a large number of patients. The aim was to investigate whether auxiliary limited open angle stable plate fixation has an effect on functional and radiologic results one year after revision intramedullary nail replacement
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
