Volume 15 | Issue 2 | Apr-Jun 2020 | Page 1-7 | Yashwant J Mahale 1, Shankar A Tengale1
Authers: Yashwant J Mahale [1], Shankar A Tengale [1]
[1] Department of Orthopaedics, Grant Medical College and Sir J.J. Group of Hospitals, Byculla, Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Shaswat Mishra
Department of Orthopaedics, Grant Medical College and Sir J.J. Group of Hospitals, Byculla, Mumbai, Maharashtra, India.
E-mail: shaswatmishra1994@gmail.com
Abstract
Background: Intertrochanteric (IT) fractures are most common injuries affecting elderly population. In India more than 2,00,000 IT fractures occur every year. In stable intertrochanteric fractures, Dynamic Hip Screw (DHS) always remains a GOLD STANDARD implant but same results are not reproducible with unstable IT fractures. Standard Trochanteric Stabilizing Plate (TSP) can be used with DHS to minimize postoperative complications in unstable IT fracture femur, however standard TSP does not provide support to posterior or medial fragment in unstable IT fracture specially in AO type 31A2.3 or 31A2.2. Therefore we modified the standard TSP to maintain reduction & provide stability in these unstable IT fractures. The aim of this study is to evaluate the functional & radiological outcome of unstable IT fracture femur in AO type 31A2.3 & 31A2.2 treated by DHS with Modified TSP.
Material & Methods: This is a prospective study done at tertiary care centre from December 2016 to November 2018. Total 50 patients with unstable IT fractures having comminution (AO 31A2.3) or vertical split(AO 312.2) fracture of greater trochanter in coronal plane were treated by internal fixation by DHS with Modified TSP. Patients were followed up at 6 weeks, 3 months, 6 months & 1 year for radiological and functional assessment.
Result: Out of 50 patients 41 had domestic fall while 9 were injured in RTA. At 1 year follow up, all patients showed union. One patient had shortening of 1 cm & was managed by shoe raise. One patient had superficial infection which was treated successfully by higher oral antibiotics. One patient had 5 mm outward migration of DHS screw at 3 months follow up. All patients were assessed by Harris Hip Score at one year follow up.
Conclusion: DHS with Modified TSP fixation in unstable intertrochanteric fracture of femur specially in AO type 31A2.3 or 31A2.2 helps in achieving anatomical reduction, imparts stability, provides an effective technique and has excellent functional and radiological outcomes with minimal complications.
Keywords: Unstable IT fracture, DHS, Modified TSP, Functional Outcome..
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| How to Cite this article: Pawar E D, Sonawane D V, Chikodi A, Mishra S, Bansal S, Khemkar S. Functional outcome in patients operated with High Tibial Osteotomy (HTO) medial open wedge osteotomy with HTO fixator in a prospective study. Journal of Trauma and Orthopaedic Surgery. April – Jun 2020;15(2):1-7. |