Clinical Characteristics And Treatment Of AO/OTA A2.3 Intertrochanteric Fractures In Paitients With Coronal Shear Fractures In The Rear

ObjectiveTo explore the characteristics,the operative techniques and effect of AO/OTA A2.3 Intertrochanteric fractures with coronal shear fractures in the rear.MethodsFrom January 2011 to January 2014,33 patients were treated with proximal femoral nail anti-rotation,who suffered AO/OTA A2.3 Intertrochanteric fractures with coronal shear fractures in the rear. The group included 15 males and 18 females.The range of their age was from 61 to 92 years old,with an average age of (73.1±8.2) years According to AO/OTA classification,all were type A2.3 fracture.All of the cases were closed fracture,treated with limited open reduction and internal fixation.The postoperative hip function was evaluated using Harris score.Results1 case was died at 19 days after operation.32 cases were followed up for (16.3±5.1) months (range,9-24months). Bone union was observed with the average time of(7.2±1.5)months(range,6-9months).At final follow up,Harris evaluation were 76-95 points, average (85.3±5.6)points.l3cases were classified as excellent,16 as good, and 3 as fair. The overall rate of excellent or good result was 90.6%(29/32).ConclusionAO/OTA A2.3 intertrochanteric fracture is irreducible variant and unstable with coronal shear fractures in the rear.It can be fixed with proximal femoral nail antirotation by limited open reduction. It is necessary that postoperative rehabilitation should be chosen individually.