Accurate reduction of medial arch fracture fragments in intertrochanteric fractures: A novel technical note

Xiaodong Li; Chen Zhao; Guantong Sun; Pengcheng Liu; Jian Tang; Fei Yang; Xiaoqing Wang

doi:10.3389/fsurg.2023.1140250

Accurate reduction of medial arch fracture fragments in intertrochanteric fractures: A novel technical note

Front Surg. 2023 Feb 27:10:1140250. doi: 10.3389/fsurg.2023.1140250. eCollection 2023.

Authors

Xiaodong Li^{1

2}, Chen Zhao^{1

2}, Guantong Sun^{1

2}, Pengcheng Liu^{1

2}, Jian Tang^{1

2}, Fei Yang^{1

2}, Xiaoqing Wang^{1

2}

Affiliations

¹ Department of Orthopedics, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
² Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Abstract

Intramedullary fixation is currently used to stabilize intertrochanteric fractures. Surgical reduction of the medial arch cortex is crucial to achieve stabilization of the internal fixation system, however, it is challenging to perform. To ensure anatomical reduction, we developed a novel surgical technique to assist in achieving accurate and convenient reduction. In this technique, right-angle forceps were used to pry and reset medial arch cortex fragments via a mini-helical blade incision. Noteworthily, all patients who underwent this technique achieved anatomical reduction with reduced operation times and bleeding. Our article illustrates intraoperative reduction techniques and summarizes tips and tricks that may be beneficial and educative for orthopedists.

Keywords: Intertrochanteric fractures; enhanced recovery after surgery (ERAS); medial arch; reduction techniques; right angle forceps.

Grants and funding

This work was supported by National Natural Science Foundation of China (grant No. 81871791) and Shanghai Ninth People's Hospital Cross Research Fund of Medical Engineering (grant No. JYJC201915).