Steinmenn pins used to assist reduction in treatment of unstable intertrochanteric fractures with proximal femoral nail antirotation

Abstract

Objective To evaluate application of Steinmenn pins to assist reduction in the treatment of unstable intertrochanteric fractures with proximal femoral nail antirotation(PFNA). Methods From February 2010 to June 2013, 38 unstable intertrochanteric fractures were treated by us. There were 23 men and 15 women, aged from 32 to 69 years. By Evans-Jensen classification, 18 cases were type Ⅲ, 13 type Ⅳ and 7 type V. They were divided into 2 groups (n=19). Group A received reduction on a traction bed assisted by Steinmenn pins plus PFNA fixation while group B received reduction only on a traction bed plus PFNA fixation. The 2 groups were compared in terms of fracture reduction, operation time, intro-operative blood loss, fracture healing time, and Harris scores one year postoperation. Results According to the evaluation system modified by Baumgaetner et al., the postoperative quality of fracture reduction was fine in 15 cases and fair in 4 in group A while it was fine in 9 cases, fair in 8 and poor in 2 in group B, showing a significant difference between the 2 groups (P 0.05). No cases of refracture, delayed union, nonunion, or avascular necrosis of the femoral head were reported. Conclusion In the treatment of unstable intertrochanteric fractures, compared with reduction only on a traction bed plus PFNA fixation, application of Steinmenn pins to assist reduction on a traction bed plus PFNA fixation may lead to better curative efficacy due to its limited invasion, simplicity and beneficial assistance in reduction. Key words: Hip fractures; Fracture fixation, intramedullary; Bone nails; Reduction; Steinmenn pins