The Surgical Treatment Of Reverse Oblique Intertrochanteric Fractures

Objective To compare the effective in the treatment of reverse oblique intertrochanteric fractures with varier internal fixations.Methods To review retrospectively a series of 42 patients treated with internal fixations for reverse oblique intertrochanteric fractures between January 1999 and January 2004 in our hospital. The nine patients were treated with the sliding hip screw (SHS), five cases with the trochanter stabilizing plate in addition to the dynamic hip screw (DHS+ TSP), seventeen cases with the dynamic condylar screw (DCS),and 11 cases with the intramedullary fixation (IMF ). The clinical results including the complications, fracture healing and the hip function were evaluated. Restate Forty-one patients were followed for 35.8 months (range: 14 to 73 months). Forty patients had good healed after the operation. The average healing time were 4.1 months in SHS, 4.5 months in DHS+ TSP, 3.9 months in DCS, and 3.7 months in IMF. There were twenty-one early post-operative complications (including seven complications in SHS, five in DHS+TSP, five in DCS, and four in IMF) and eleven late post-operative complications in the groups. Of them, failure of internal fixation were happened in seven patients (three in SHS, one in DHS+ TSP, two in DCS, and one in IMF). The post- operative function of hip were 79.6 in SHS, 83.3 in DHS+ TSP, 86.1 in DCS, and 85.4 in IMF according to Harris score (average 83.6 ). Conclusion The intramedullary fixation for treatment of reverse oblique intertrochanteric fractures should be applied firstly because their significant stability. Considering less complex procedure and easier handling, DCS and DHS+ TSP are alternative methods for treatment of the fractures.