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Original Article
The Treatment of Subtrochanteric Fracture with Cephallomedually Nail: Minimal Incision and Lowman Clamp Assisted Reduction
Jang Seok Choi, M.D., Do Hyun Moon, M.D., Young Tae Noh, M.D.
Journal of the Korean Fracture Society 2011;24(4):301-306.
DOI: https://doi.org/10.12671/jkfs.2011.24.4.301
Published online: October 30, 2011

Department of Orthopedic Surgery, Gachon University Gil Hospital, Incheon, Korea.

Address reprint requests to: Do Hyun Moon, M.D. Department of Orthopaedic Surgery, Gachon University Gil Hospital, 1198, Guwol-dong, Namdong-gu, Incheon 405-760, Korea. Tel: 82-32-460-3384, Fax: 82-32-468-5437, dhmoon@gilhospital.com
• Received: December 29, 2010   • Revised: January 7, 2011   • Accepted: September 5, 2011

Copyright © 2011 The Korean Fracture Society

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  • Purpose
    To evaluate the radiographic results of patients with subtrochanteric femoral fracture using minimal incision and cephalomedullary nail technique.
  • Materials and Methods
    This study was performed on 54 patients, 54 cases of hip, recruited among patients who underwent minimal incision and Cephalomedullary nail from September 2005 to August 2008 and were available for 1-year or longer follow up. The gender ratio was 37 males and 17 females, and the mean age at the time of surgery was 57.4 years (range; 16~81 years). According to injury mechanism, traffic accident was 29 cases, fall down form high height was 18 cases, slip down was 7 cases. In classification by Seinsheimer, type II was 23 cases (m/c), type III was 18 cases, type IV was 13 cases. Average follow up period was 14 months (12~18). Radiographic evaluation was performed for time taking union, mal-union and complication.
  • Results
    53 of the 54 cases united. 39 of 54 reductions were anatomic. 19 fractures had a monir varus deformity of proximal fragment (between 2° and 5°). There was no varus deformity of more than 5°. 1 case that had been treated with PFN had nail breakage without trauma. There were no other complications.
  • Conclusion
    Surgical treatment of subtrochanteric fractures with minimal incision and Cephalomedullary nail technique can reslut in excellent reduction without complications including inflammation & malunion. Careful attention to detail for using Lowman clamp is demanding to decrease soft tissue injury.
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Fig. 1
Surgical technique.
(A) Temporary fixation by using Lowman clamp.
(B) Nail insertion & screw fixation through previous proximal incision site.
jkfs-24-301-g001.jpg
Fig. 2
Result after surgical treatment using PFN.
(A) Pre-operative X-ray shows Seinsheimer type IV subtrochanteric fracture.
(B) Radiograph at 6-months after surgery shows solid bony union.
jkfs-24-301-g002.jpg
Fig. 3
(A) Radiograph at 3-months after surgery shows breakage of metal implant.
(B) Reoperation using a blade plate at 6-months after interlocking intramedullary nailing.
jkfs-24-301-g003.jpg

Figure & Data

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    Citations

    Citations to this article as recorded by  
    • The Treatment of Subtrochanteric Fractures with Proximal Femoral Nail Antirotation
      Chi Hyoung Pak, Sang Hong Lee, Sang Ho Ha, Gwang Chul Lee, Kyoung Chul Song
      Journal of the Korean Fracture Society.2013; 26(4): 284.     CrossRef
    • Fixation of the Femoral Subtrochanteric Fracture with Minimally Invasive Reduction Techniques
      Chul-Hyun Park, Chul-Wung Ha, Sang-Jin Park, Min-Su Ko, Oog-Jin Shon
      Journal of the Korean Fracture Society.2013; 26(2): 112.     CrossRef

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      The Treatment of Subtrochanteric Fracture with Cephallomedually Nail: Minimal Incision and Lowman Clamp Assisted Reduction
      J Korean Fract Soc. 2011;24(4):301-306.   Published online October 31, 2011
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    The Treatment of Subtrochanteric Fracture with Cephallomedually Nail: Minimal Incision and Lowman Clamp Assisted Reduction
    Image Image Image
    Fig. 1 Surgical technique. (A) Temporary fixation by using Lowman clamp. (B) Nail insertion & screw fixation through previous proximal incision site.
    Fig. 2 Result after surgical treatment using PFN. (A) Pre-operative X-ray shows Seinsheimer type IV subtrochanteric fracture. (B) Radiograph at 6-months after surgery shows solid bony union.
    Fig. 3 (A) Radiograph at 3-months after surgery shows breakage of metal implant. (B) Reoperation using a blade plate at 6-months after interlocking intramedullary nailing.
    The Treatment of Subtrochanteric Fracture with Cephallomedually Nail: Minimal Incision and Lowman Clamp Assisted Reduction

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