Application of lesser trochanteric reduction fixator in the treatment of unstable intertrochanteric fractures

ARTICLE HIGHLIGHTS

Research background

We invented a new device for better treatment of femoral intertrochanteric fractures. During the treatment of intertrochanteric fractures, we fully realize the significance of trochanteric reduction and fixation, namely, reconstruction of structures under pressure.

Research motivation

As long as the general condition of patients is suitable and they are willing to undergo surgery, fixation should be carried out at the main fracture end and the lesser trochanter should be reduced and fixed at the same time. Some foreign scholars have proposed another method for performing nail fixation through a medial incision. However, as a medial incision causes larger trauma, we advocate that the lateral intramedullary nail incision shall be appropriately lengthened and the soft tissue shall be properly stripped from the anterior and posterior aspects of the greater trochanter, followed by placement of the newly developed lesser trochanteric reduction fixator.

Research objectives

We aimed to focus on how to avoid displacement of the lesser trochanter in unstable intertrochanteric fractures.

Research methods

IBM SPSS 26 was used for data analyses. An independent samples t-test was used for comparison of means between groups. A P value of < 0.05 was considered statistically significant.

Research results

The postoperative Harris hip score in patients who were treated with the lesser trochanteric reduction fixator was significantly higher than that in patients who were treated without the lesser trochanteric reduction fixator (P < 0.05), which indicated that the lesser trochanteric reduction fixator had a positive impact on rehabilitation of the hip joint after surgery and could significantly improve the quality of life of patients. In addition, the proximal incision in patients who were treated with the lesser trochanteric reduction fixator was larger than that in patients who were treated without the lesser trochanteric reduction fixator (P < 0.05).

Research conclusions

We fully realize the significance of trochanteric reduction and fixation, namely, reconstruction of structures under pressure, in the treatment of intertrochanteric fractures. As long as the general condition of patients is favorable and they are willing to undergo surgery, fixation should be carried out at the main fracture end and the lesser trochanter should be reduced and fixed at the same time. Some foreign scholars have proposed another method for performing nail fixation through a medial incision. However, as a medial incision causes greater trauma, we advocate that the lateral intramedullary nail incision should be appropriately lengthened and the soft tissue should be properly stripped from the anterior and posterior aspects of the greater trochanter, followed by placement of the newly developed lesser trochanteric reduction fixator.

Research perspectives

This newly developed lesser trochanteric reduction fixator has some advantages: (1) After reliable reduction and fixation, this fixator can be introduced into the loop plate through the customized holes, and the loop plate can pass through the muscle space of the lesser trochanter, which can achieve reduction and fixation of the lesser trochanter; and (2) This fixator can improve the quality of reduction of the lesser trochanter, and the loop plate can achieve elastic fixation. There is no risk of nail breakage caused by nail fixation.