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

World J Clin Cases. 2023 Sep 6;11(25):5863-5869. doi: 10.12998/wjcc.v11.i25.5863.

Abstract

Background: Closed reduction and internal fixation with intramedullary nails has been widely accepted for treating intertrochanteric fractures.

Aim: To focus on how to avoid displacement of the lesser trochanter in unstable intertrochanteric fractures.

Methods: We developed a lesser trochanteric reduction fixator for treating intertrochanteric fractures through fixing the lesser trochanter by combining the loop plate through the fixator after reduction by the reducer. Five patients with intertrochanteric fractures treated with the newly developed lesser trochanteric reduction fixator and loop plate combined with intramedullary nails, and 20 patients with intertrochanteric fractures treated with simple intramedullary nails were selected from December 2020 to March 2021.

Results: The postoperative Harris hip score was significantly higher in patients treated with the lesser trochanteric reduction fixator than in patients treated without the lesser trochanteric reduction fixator, which indicated that this 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.

Conclusion: 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 of the main fracture end should be performed and the lesser trochanter should be reduced and fixed at the same time.

Keywords: Intertrochanteric fractures; Lesser trochanteric; Loop plate; Reduction fixator; Unstable fractures.