Subtrochanteric Fractures: Open Versus Closed Reduction

Abstract

33 consecutive patients with a displaced subtrochanteric fracture treated with an intramedullary nail were reviewed. 18 underwent open, 15 underwent closed reduction. Time of operation and measured blood loss were reviewed. Type of fracture, postoperative quality of the reduction and long-term results were evaluated radiographically. No statistically significant difference between open and closed reduction in postoperative results, long-term results and measured blood loss was found. In all, the time of operation appeared longer in the group of open reduction. But there was no statistically significant difference of operation time by comparing the fracture types separately. Our hypothesis that open reduction provides better alignment and better results than closed manipulation and nailing was not shown.

Key words

Internal fixation - hip fracture - postoperative results - long-term results - blood loss - time of operation

References

• 1 Grosse A. Personal communication. 1989
• 2 Kempf I, Grosse A, Beck G. Closed locked intramedullary nailing.  J Bone Joint Surg [Am]. 1985;  67 709-720
• 3 Küntscher G. Die Marknagelung von Knochenbrüchen.  Langenbecks Arch Klin Chir. 1940;  200 443
• 4 Müller M E, Nazarian S, Koch P, Schatzker J. The Comprehensive Classification of Fractures of Long Bones. Springer-Verlag, Berlin, Heidelberg, New York 1995
• 5 Schatzker J, Waddell J P. Subtrochanteric fractures of the femur.  Orthop Clin North Am. 1980;  11 539-554
• 6 Zickel R E. Zickel II Subtrochanteric Fracture Appliance. Howmedica, Surgical Techniques. Pfizer Hospital Products Group Inc. 1984 and 1985