Effect of lesser trochanter posteromedial wall defect on the stability of femoral intertrochanteric fracture using 3D simulation.

J Orthop Surg Res

Department of Orthopaedics, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, No. 2800, Gongwei Road, Shanghai, 201399, China.

Published: July 2020

Background: This study investigated the effects of posteromedial fracture fragments on the postoperative stability of intertrochanteric fractures of the femur by analyzing the quantity and range of fragments in CT 3D reconstruction.

Materials And Methods: Patients diagnosed with femoral lesser trochanter fractures were collected from September 2015 to February 2018. CT 3D reconstruction was applied to evaluate the quantity and extension of posteromedial fragments and the presence of isolated medial fragments. The stability of postoperative fracture was evaluated by comparing the changes of "neck-shaft angle" and "telescoping" from 1 week to 1 year after operation.

Results: A total of 143 patients were finally confirmed, in which 63 patients contained isolated fragments on the medial side, and the average number of fragments in the posteromedial side was 1.93 ± 0.34, which accounted for an average of about 86.11% ± 8.20% in the whole posteromedial wall. When the number of posteromedial fragments was > 2 and the range of posteromedial fragments was > 75%, then the changes in the neck-shaft angle and "telescoping" showed statistical significance (12.27 ± 4.18 mm and 10.13 ± 6.17°, respectively), and when there were isolated medial isolated fragments, then the change in the neck-shaft angle was 10.66 ± 4.27°, showing statistical significance.

Conclusions: These findings revealed a certain correlation between the quantity and the range of posteromedial fragments and the postoperative "shortening" and "collapse" of femoral intertrochanteric fractures.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333289PMC
http://dx.doi.org/10.1186/s13018-020-01763-xDOI Listing

Publication Analysis

Top Keywords

posteromedial fragments
16
fragments
10
lesser trochanter
8
posteromedial
8
posteromedial wall
8
femoral intertrochanteric
8
fragments postoperative
8
intertrochanteric fractures
8
quantity range
8
isolated medial
8

Similar Publications

Background: Bicondylar tibial plateau fractures are often associated with significant soft tissue compromise making operative treatment challenging. Dual plating through a two-incision approach following temporary external fixation has been shown to improve complication rates although deep infection rates remain high.The objective was to evaluate early outcomes following a novel technique of percutaneous application of the medial plate superficial to the pes anserinus tendons.

View Article and Find Full Text PDF

Purpose: Varus posteromedial rotatory instability (VPMRI) involves anteromedial coronoid fracture (AMCF), lateral ulnar collateral ligament (LUCL), and medial collateral ligament (MCL) injury. There is no general consensus regarding the surgical treatment, but most surgeons recommend internal fixation of the coronoid along with primary ligament repair. This methodology involves postoperative immobilization to allow ligament healing, occasionally associated with stiffness.

View Article and Find Full Text PDF

Objective: To summarize the characteristics of posterior coronal banana-shaped fragments and its research progress in treatment of intertrochanteric femoral fracture with cephalomedullary nail, provide valuable reference for clinical practice.

Methods: Relevant domestic and foreign literature was extensively reviewed to summarize the history, anatomical structure of posterior coronal banana-shaped fragments, and the need for reduction and fixation, the influence on the stability of cephalomedullary nail, and the remedies.

Results: The posterior coronal banana-shaped fragments refers to the second level fracture line of the intertrochanteric femoral fracture, involving four anatomical structures, namely, the posterior part of the greater trochanter, the intertrochanteric crest, the lesser trochanter, and the posteromedial cortex.

View Article and Find Full Text PDF

A 30-year-old male sustained a road traffic accident and presented to our trauma centre with injuries to his pelvis and right knee. Radiology showed closed fractures of the right posterior wall and posterior column of the acetabulum and PCL bony avulsion with posteromedial tibial plateau osteochondral fracture, without any distal neurovascular deficit. He was managed with surgical intervention for both injuries.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigated the serum calcium and vitamin D levels in elderly patients with intertrochanteric (IT) fractures, focusing on their relationship to the severity of stable versus unstable fractures.
  • Out of 286 patients analyzed, those with unstable IT fractures showed significantly lower vitamin D levels compared to those with stable fractures, while the difference in calcium levels was not significant.
  • The findings suggest that higher vitamin D levels might help prevent severe IT fractures, indicating the potential benefit of vitamin D supplementation in this patient population.
View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!