Abstract
BackgroundFractures of the intertrochanteric hip are common and the treatment of unstable fractures generally requires an operative approach. In elderly patients, osteoporosis makes internal fixation problematic and frequently contributes to failed fixation and poor clinical results. We have attempted to apply the Less Invasive Stabilization System (LISS) in reverse position for the repair of intertrochanteric hip fractures in elderly patients with osteoporotic bones. A retrospective review is presented of the cases of 28 elderly patients with stable and unstable fractures of the intertrochanteric hip treated using the reverse LISS.MethodsWe treated 28 elderly patients with a mean age of 82.3 years. According to the Evens classification, there were 2 Type I fractures, 2 Type II fractures, 3 Type III fractures, 13 Type IV fractures, 6 Type V fractures and 2 Type R fractures. All fractures were treated using the reverse LISS. Radiographic and clinical evidence of functional outcome and complications were evaluated.ResultsMean perioperative blood loss was 92.4 milliliters (range 35 to 245 milliliters), and the mean postoperative hospital stay was 8.7 days (range 3 to 14 days).Complications included one minor wound hematoma. Radiographically, no collapses, screw cutouts, or head penetrations were seen. All surviving patients (28 of 28; 100 percent) had uneventful fracture healing with union achieved by six months in all patients.ConclusionsUse of the Reverse LISS plating for intertrochanteric hip fractures resulted in event-free fracture healing.
Highlights
Fractures of the intertrochanteric hip are common and the treatment of unstable fractures generally requires an operative approach
The present study evaluates the treatment of intertrochanteric hip fractures with the reverse Less Invasive Stabilization System (LISS) plating system
Uneventful fracture healing and union was achieved by six months (Figures 2, 3, 4 and 5)
Summary
Fractures of the intertrochanteric hip are common and the treatment of unstable fractures generally requires an operative approach. We have attempted to apply the Less Invasive Stabilization System (LISS) in reverse position for the repair of intertrochanteric hip fractures in elderly patients with osteoporotic bones. 50% of hip fractures are intertrochanteric fractures, a large percentage of which are unstable [1,2]. Treatment goals for this patient population include early rehabilitation, restoration of the anatomic alignment of the proximal part of the femur, and maintenance of the fracture reduction [3]. The minimally invasive surgical techniques have led to a widespread use of many new implants [5,6]it has been shown that they can reduce operative
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