TITLE:
Trochanteric Buttress Plate Combined with Proximal Femoral Nail for Unstable Intertrochanteric Fractures. [Innovative Technique]
AUTHORS:
Shashikant Basavraj Ganjale, Wasudeo M. Gadegone, Pradeep Kothadia
KEYWORDS:
Trochanteric Buttress Plate, Lateral Wall Comminution of Greater Trochanter, Unstable Trochanteric Fracture, Screw Migration, Cut Out of Screw
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.8 No.6,
June
21,
2018
ABSTRACT: Introduction: Proximal femoral nail is a better choice of implant for the treatment of
an unstable trochanteric fracture, however it is associated with screw migration and cutout because of greater
trochanteric comminution and coronal split. This study is to evaluate the results of Trochanteric Buttress Plate
(TBP) combined with PFN in an unstable IT fractures for buttressing lateral
wall and reinforcing fixation. Materials and Methods: We carried out a
consecutive study of 32 patients of Unstable intertrochanteric fracture femur
with lateral wall comminution. It was studied at Ashwini Sahakari Rugnalaya and
Sanshodhan Kendra Solapur India and Government medical college Chandrapur India
from April-2015 to December-2017 using innovative Trochanteric buttress plate
along with PFN. Eighteen male and fourteen female in the age group of 55 to 80
years were included in the study. There
were 26 cases of A3 and six cases of A2 were fixed by PFN combined with trochanteric buttress plate to augment the comminuted lateral
wall. Results: The bone healing is observed in all the cases in the mean
period of 12.6 weeks. Four patients developed complications, including lateral migration of neck screws (n = 2),
superficial infection (n = 2). Patients were followed up for a mean
of 10.6 months. At the end of follow-up the Salvati and Wilson hip function was
36 (out of 40) in 87.5% of patients [twenty
eight patients]. The clinical, radiological
and functional outcomes were found to be satisfactory. Conclusion: The
stabilization of lateral trochanteric wall with trochanteric buttress plate
restores anatomy, increases the stability of
construct and prevents inherent complication of screw migration and cutout.