Skip Navigation
Skip to contents

J Musculoskelet Trauma : Journal of Musculoskeletal Trauma

OPEN ACCESS

Articles

Page Path
HOME > J Musculoskelet Trauma > Volume 28(1); 2015 > Article
Original Article
Steinmann Pin Assisted Reduction of Subtrochanteric Femoral Fracture
Seung Wan Lim, M.D., Oog-Jin Shon, M.D.
Journal of the Korean Fracture Society 2015;28(1):17-22.
DOI: https://doi.org/10.12671/jkfs.2015.28.1.17
Published online: January 20, 2015

Department of Orthopedic Surgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea.

Address reprint requests to: Oog-Jin Shon, M.D. Department of Orthopedic Surgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 705-703, Korea. Tel: 82-53-620-3640, Fax: 82-53-628-4020, wooyasw@gmail.com
• Received: August 25, 2014   • Revised: September 15, 2014   • Accepted: September 26, 2014

Copyright © 2015 The Korean Fracture Society. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • 132 Views
  • 4 Download
  • 1 Crossref
prev next
  • Purpose
    Nail insertion is the treatment of choice for subtrochanteric femoral fracture, but displacement of proximal bone fragment makes it difficult to find an ideal entry point. Therefore, in this study we aimed to determine the usefulness of treatment of subtrochanteric femoral fracture using Steinmann pin assisted reduction, internal fixation, and insertion of intramedullary nails.
  • Materials and Methods
    We evaluated 33 patients who were followed-up more than a year with a displaced subtrochanteric femoral fracture treated with closed reduction and intramedullary nail fixation between January 2008 and March 2013. In addition, we studied postoperative bone union time, postoperative reduction status, change of the femur neck shaft angle, evaluation of hip joint function, return to daily life, and complications.
  • Results
    All fractures with Steinmann pin assisted reduction were united but they included three cases of delayed union. In Fogagnolo classification, all cases were up to acceptable states and the varus change of femur neck shaft angle was 0.94°±3.1°; no significant difference in Harris hip score was observed between preoperative and last follow-up (p>0.05).
  • Conclusion
    There were satisfactory results in bone union and reduction state with Steinmann pin assisted reduction. Therefore, Steinmann pin assisted reduction is a useful surgical technique for subtrochanteric femoral fracture.
  • 1. Nikolaou VS, Papathanasopoulos A, Giannoudis PV. What's new in the management of proximal femoral fractures? Injury, 2008;39:1309-1318.Article
  • 2. Perren SM. Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br, 2002;84:1093-1110.Article
  • 3. Tornetta P 3rd, Ritz G, Kantor A. Femoral torsion after interlocked nailing of unstable femoral fractures. J Trauma, 1995;38:213-219.Article
  • 4. Winquist RA, Hansen ST Jr, Clawson DK. Closed intramedullary nailing of femoral fractures. A report of five hundred and twenty cases. J Bone Joint Surg Am, 1984;66:529-539.Article
  • 5. Russell TA, Mir HR, Stoneback J, Cohen J, Downs B. Avoidance of malreduction of proximal femoral shaft fractures with the use of a minimally invasive nail insertion technique (MINIT). J Orthop Trauma, 2008;22:391-398.Article
  • 6. de Vries JS, Kloen P, Borens O, Marti RK, Helfet DL. Treatment of subtrochanteric nonunions. Injury, 2006;37:203-211.Article
  • 7. Gugenheim JJ, Probe RA, Brinker MR. The effects of femoral shaft malrotation on lower extremity anatomy. J Orthop Trauma, 2004;18:658-664.Article
  • 8. Parker MJ, Dutta BK, Sivaji C, Pryor GA. Subtrochanteric fractures of the femur. Injury, 1997;28:91-95.Article
  • 9. Siebenrock KA, Müller U, Ganz R. Indirect reduction with a condylar blade plate for osteosynthesis of subtrochanteric femoral fractures. Injury, 1998;29:Suppl 3. C7-C15.Article
  • 10. Sims SH. Subtrochanteric femur fractures. Orthop Clin North Am, 2002;33:113-126. viii.
  • 11. Vanderschot P, Vanderspeeten K, Verheyen L, Broos P. A review on 161 subtrochanteric fractures: risk factors influencing outcome: age, fracture pattern and fracture level. Unfallchirurg, 1995;98:265-271.
  • 12. Nungu KS, Olerud C, Rehnberg L. Treatment of subtrochanteric fractures with the AO dynamic condylar screw. Injury, 1993;24:90-92.Article
  • 13. Rohilla R, Singh R, Magu NK, Siwach RC, Sangwan SS. Mini-incision dynamic condylar screw fixation for comminuted subtrochanteric hip fractures. J Orthop Surg (Hong Kong), 2008;16:150-155.
  • 14. Kinast C, Bolhofner BR, Mast JW, Ganz R. Subtrochanteric fractures of the femur. Results of treatment with the 95 degrees condylar blade-plate. Clin Orthop Relat Res, 1989;(238):122-130.
  • 15. Kyle RF, Cabanela ME, Russell TA, et al. Fractures of the proximal part of the femur. Instr Course Lect, 1995;44:227-253.Article
  • 16. Asher MA, Tippett JW, Rockwood CA, Zilber S. Compression fixation of subtrochanteric fractures. Clin Orthop Relat Res, 1976;(117):202-208.Article
  • 17. Trafton PG. Subtrochanteric-intertrochanteric femoral fractures. Orthop Clin North Am, 1987;18:59-71.
  • 18. Krettek C, Miclau T, Schandelmaier P, Stephan C, Möhlmann U, Tscherne H. The mechanical effect of blocking screws (Poller screws) in stabilizing tibia fractures with short proximal or distal fragments after insertion of small-diameter intramedullary nails. J Orthop Trauma, 1999;13:550-553.Article
  • 19. Krettek C, Stephan C, Schandelmaier P, Richter M, Pape HC, Miclau T. The use of Poller screws as blocking screws in stabilising tibial fractures treated with small diameter intramedullary nails. J Bone Joint Surg Br, 1999;81:963-968.Article
  • 20. Stedtfeld HW, Mittlmeier T, Landgraf P, Ewert A. The logic and clinical applications of blocking screws. J Bone Joint Surg Am, 2004;86:Suppl 2. 17-25.Article
  • 21. Seyhan M, Unay K, Sener N. Comparison of reduction methods in intramedullary nailing of subtrochanteric femoral fractures. Acta Orthop Traumatol Turc, 2012;46:113-119.
  • 22. Park J, Yang KH. Correction of malalignment in proximal femoral nailing--Reduction technique of displaced proximal fragment. Injury, 2010;41:634-638.Article
Fig. 1
(A) Typical external rotation, abduction, and flexion deformity of the proximal fragment in subtrochanteric fracture. (B-D) Reduction is carried out by Steinmann pin and induction of a guide wire and gradual reaming is performed. (E) Nail insertion and proximal fixation. (F-G) Distal fixation.
jkfs-28-17-g001.jpg
Fig. 2
Serves as a blocking screw to prevent nail from proceeding anteriorly.
jkfs-28-17-g002.jpg
Table 1
Clinical Results
jkfs-28-17-i001.jpg

Values are presented as median (range).

Table 2
Comparison of Reduction Techniques
jkfs-28-17-i002.jpg

Figure & Data

REFERENCES

    Citations

    Citations to this article as recorded by  
    • Percutaneous acetabular anchoring pin-assisted cephalomedullary nailing for subtrochanteric and unstable intertrochanteric fractures
      Keong-Hwan Kim, Youngsik Yoon, Eic Ju Lim
      Injury.2020; 51(3): 769.     CrossRef

    • Cite
      CITE
      export Copy Download
      Close
      Download Citation
      Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

      Format:
      • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
      • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
      Include:
      • Citation for the content below
      Steinmann Pin Assisted Reduction of Subtrochanteric Femoral Fracture
      J Korean Fract Soc. 2015;28(1):17-22.   Published online January 31, 2015
      Close
    • XML DownloadXML Download
    Figure
    • 0
    • 1
    We recommend
    Steinmann Pin Assisted Reduction of Subtrochanteric Femoral Fracture
    Image Image
    Fig. 1 (A) Typical external rotation, abduction, and flexion deformity of the proximal fragment in subtrochanteric fracture. (B-D) Reduction is carried out by Steinmann pin and induction of a guide wire and gradual reaming is performed. (E) Nail insertion and proximal fixation. (F-G) Distal fixation.
    Fig. 2 Serves as a blocking screw to prevent nail from proceeding anteriorly.
    Steinmann Pin Assisted Reduction of Subtrochanteric Femoral Fracture

    Clinical Results

    Values are presented as median (range).

    Comparison of Reduction Techniques

    Table 1 Clinical Results

    Values are presented as median (range).

    Table 2 Comparison of Reduction Techniques


    J Musculoskelet Trauma : Journal of Musculoskeletal Trauma
    Close layer
    TOP