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Abstract
The purpose of this study was to compare the clinical effectiveness of minimally invasive clamp-assisted reduction and open reduction with wire cerclage and intramedullary nails for unstable subtrochanteric fractures. Between January 2016 and October 2019, 68 patients who had unstable subtrochanteric fractures experienced intramedullary nail surgery in this retrospective study. There were 41 cases in the minimally invasive clamp or closed reduction group (group A) and 27 cases in the open reduction with wire cerclage group (group B). There were 3 cases of complications in group A and 2 cases of complications in group B. Remarkable distinction was observed between the two groups in the operation time (p < 0.05), quality of reduction (p < 0.05), and union time (p < 0.05). For the successful surgical treatment of unstable femoral subtrochanteric fractures, an anatomical reduction is crucial. Reduction and wire cerclage are cut to give medial support for the anatomical reduction, which has a positive effect on fracture healing.
Highlights
About 5% to 20% of proximal femoral fractures are femoral subtrochanteric fractures [1]. e area expanding 5 cm from the distal end of the lower edge of the lesser trochanter is the subtrochanteric area [2]. e disease is mainly manifested as a bimodal distribution
E specific contributions of this paper include: (1) this study showed that the vital point to the successful treatment of unstable femoral subtrochanteric fractures was the anatomical reduction, and the use of cerclage wires may improve the fracture reduction effect, which is the first study that compares the clinical efficacy of minimally invasive clamp-assisted reduction and open reduction with wire cerclage for unstable subtrochanteric fractures
Group A was treated with minimally invasive clamp-assisted reduction, and group B was treated with open reduction with wire cerclage
Summary
About 5% to 20% of proximal femoral fractures are femoral subtrochanteric fractures [1]. e area expanding 5 cm from the distal end of the lower edge of the lesser trochanter is the subtrochanteric area [2]. e disease is mainly manifested as a bimodal distribution. About 5% to 20% of proximal femoral fractures are femoral subtrochanteric fractures [1]. E area expanding 5 cm from the distal end of the lower edge of the lesser trochanter is the subtrochanteric area [2]. Low-energy traumas, such as falls, cause subtrochanteric fractures [3]. Because of concentrated stress and variables in this fractured area, after a fracture, the proximal end of the fracture exhibits flexion, abduction, and external rotation displacement caused by traction from the gluteus muscle, iliopsoas muscle, and the external rotator muscle group [4]. Intramedullary central fixation is mechanically and biologically advantageous, and it is the preferred choice for the treatment of subtrochanteric fractures [5, 6]
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