PURPOSE This study evaluates the effectiveness of the condylar blade plate for internal fixation of unstable trochanteric fractures of the femur. MATERIALS AND METHODS Twenty six unstable trochanteric fractures of the femur (AO classification, 9 type A2 and 17 type A3) were treated by condylar blade plate fixation. Osteoporosis was found in 14 cases. Fractures were operated on the average 7th day after trauma and cancellous bone graft was performed in 3 fractures with severe comminution. Results were evaluated by operating time, time of fracture healing, complications, and function of the hip and walking ability at the final follow-up assessment. RESULTS Operating time was 123 minutes on average. All fractures were united in an average of 14.0 weeks. Complications at the fracture site were a heterotopic ossification and a refracture. Motion of the hip was limited moderately in a case with heterotopic ossification and mildly in 5 cases. Two patients used a cane and 2 patients revealed a mild limp. CONCLUSION Although the condylar blade plate is technically difficult to apply, it provides stable fixation to obtain good results with less complications for unstable trochanteric fractures of the femur, especially even in the presence of osteoporosis.
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Helical Blade Locking Sleeve Disassembly Following Failed Femur Intertrochanter Fracture - A Case Report - Soon Ho Huh, Hong-Man Cho, Ji-Yeon Park Journal of the Korean Fracture Society.2021; 34(3): 112. CrossRef
Excessive Sliding of the Helical Blade and the Femoral Neck Fracture after Insertion of Proximal Femoral Nail Anti-Rotation for Type A2 Intertrochanteric Fractures - A Case Report - Bong-Ju Park, Hong-Man Cho, Ju-Han Kim, Woo-Jin Sin Journal of the Korean Fracture Society.2013; 26(2): 151. CrossRef
A Case Report of Unique Complications of PFNA Penetration of the Blade into the Hip Joint Se-Ang Jang, Young-Ho Cho, Young-Soo Byun, Hun-Sik Cho, Sung Choi, Hyun-Seong Yoo Hip & Pelvis.2011; 23(4): 318. CrossRef
PURPOSE This study was performed to analyze the significant factors that may affect failure of fixation in trochanteric fractures of the femur treated with the compression hip screw. MATERIALS AND METHODS From May 1995 to July 2000, the authors analyzed 97 cases of trochanteric fracture of the femur treated with the compression hip screw and followed more than one year. We classified the fracture type by Jensen 's method. We used Singh index for the degree of osteoporosis. In the post-operative radiograph, we checked neck-shaft angle, state of reduction, position of the lag screw within the femoral head, tip-apex distance, and sliding distance of the lag screw. The relationship between these factors and failure of fixation was statistically analyzed. RESULTS There were 17 cases (17.5%) of failure of fixation ; 15 cases (15.4%) of excessive sliding of the lag screw, 1 case (1%) of cutting out of the lag screw, and 1 case (1%) of valgus malunion. There were significant relationships between failure of fixation and old age over 80, unstable fracture, telescoping reduction, anterior or medial displacement of the distal fragment, and anterior placement of the lag screw within the femoral head. CONCLUSION Accurate reduction and avoidance of the placement of the lag screw in the anterior part of the femoral head were important factors to prevent failure of fixation in trochanteric fractures of the femur treated with the compression hip screw.
Physeal fractures in children are the most common in the distal radius. In the distal radius Salter-Harris type II physeal fractures occur predominantly, while type IV physeal fractures are quite rare. For type IV physeal fractures, open reduction and internal fixation are usually indicated to align both the physis and the articular surface. Growth arrest can be developed by premature physeal closure depending on multiple factors, particularly the severity of trauma. We treated a type IV physeal fracture of the distal radius with open reduction and internal fixation in an 11-year-old boy, but growth arrest with gross deformity and painful motion limitation of the wrist occurred. The deformity in external appearance was nearly corrected and symptoms were improved by surgical shortening of the ulna 3 years after injury, and the final result was satisfactory.