Journal of Musculoskeletal Trauma

Original Article

Treatment of subtrochanteric fracture - Comparison of treatment efficacy according to internal fixation device -: Taek Rim Yoon, Sung Man Rowe, Eun Kyoo Song, Jong Yoon Seol, Sang Gyoo Shin; J Korean Soc Fract 2001;14(2):189-199. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.189

PURPOSE
The purpose of this study was to compare the clinical results of subtrochanteric fractures which were treated with compression hip screw, intramedullary nailing and Rowe plate.
MATERIALS AND METHODS
From 1991 to 1999, 84 cases of subtrochanteric fractures were treated in Chonnam national university hospital. Among them, 25 cases were treated with compression hip screw, 18 cases with interlocking IM nailing and 32 cases with Rowe plate. Excluding pathologic fracture, there were 24 cases(group A), 16 cases(group B) and 30 cases(group C) of subtrochanteric fractures which were followed over 1 year. Mean follow up period was 18, 21, 24 months each. We compared the fracture pattern, operation time, operation method, additional fixation, bone union and complications among the groups.
RESULTS
We devided subtrochanteric fracture into below class II and above class III based on Seinsheimer classification. The overall clinical results were 1 case below class II, 22 above III in group A, 12 below II, 6 above II in group B, and 4 below II, 26 above III in group C. The average operation time was 153 minutes in group A, 166 in group B, and 150 in group C. Additional wiring was performed in 15 cases in group A, 1 in group B and 6 in group C. Interfragmentary screw fixation was performed only in group A(12 cases). Bone graft was performed in 6 cases in group A, 6 cases in group B and 11 cases in group C. The complications were as follows; delayed union 1 case in group A, 2 cases in group B and 6 cases in group C.; Nonunion only 1 case in group B; varus deformity 4 cases in group B and 2 cases in group C; metal failure 1 case in group B and 1 case in group C.
CONCLUSIONS
In treatment of subtrochanteric fractures, compression hip screw was applied to more communited fractures than intramedullary nail, but with additional fixation safe union and excellent clinical outcomes obtained. For intramedullary nailing, great care should be taken not to produce varus malalignment. In plate fixation, we should keep in mind the possibility of metal failure and varus malalignment. Weight bearing should be delayed.

Citations

Citations to this article as recorded by

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European Journal of Orthopaedic Surgery & Traumatology.2025;[Epub] CrossRef
Factors Affecting Time to Bony Union of Femoral Subtrochanteric Fractures Treated with Intramedullary Devices
Jung-Yoon Choi, Yerl-Bo Sung, Jin-Hee Yoo, Sung-Jae Chung
Hip & Pelvis.2014; 26(2): 107. CrossRef
Efficacy of Percutaneous Cerclage Wiring in Intramedullary Nailing of Subtrochanteric Femur Fracture - Technical Note -
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Journal of the Korean Fracture Society.2013; 26(3): 212. CrossRef
The Treatment of Subtrochanteric Fracture with Cephallomedually Nail -Minimal Incision and Lowman Clamp Assisted Reduction-
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Journal of the Korean Fracture Society.2011; 24(4): 301. CrossRef

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