Techniques in Orthopaedics

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Techniques in Orthopaedics:
June 2008 - Volume 23 - Issue 2 - pp 97-105
doi: 10.1097/BTO.0b013e31817bf2f9
Articles

Indirect Reduction and Submuscular Plating of Subtrochanteric Femur Fracture

Ostrum, Robert F. MD

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Abstract

Summary: The fact that proximal femoral shaft fractures require operative treatment is not controversial. However, treatment options are varied and often based on surgeon preference rather than orthopaedic science. The point should be made that the functional outcome, not which plate or nail is used, should be the bottom line. Fracture surgery should be technique driven not implant driven. Restoration of limb alignment with prevention of deformity is the primary goal for the treatment of proximal femur fractures. More recent advances in plate fixation with an emphasis on biology and limited soft tissue stripping have led to better union rates and excellent alignment. Submuscular plate application through limited skin incisions has led to good clinical results without injuring the abductor muscles. Although intramedullary nailing may be more prevalent, plating still has a place in the treatment of subtrochanteric femur fractures. Yogi Berra once said, Don't make the wrong mistake. Unfortunately, this is easier said than done. Complications are part of surgery and unavoidable. The purpose of this article is to highlight some of the areas of potential problems and pitfalls along with strategies to prevent their occurrence in the plating of proximal femoral shaft fractures.

© 2008 Lippincott Williams & Wilkins, Inc.

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