Results of Revision Intramedullary Nailing with and Without Auxillary Plate in Aseptic Trochanteric and Subtrochanteric Nonunion

Overview

Journal Eur J Trauma Emerg Surg

Specialties Critical Care
Emergency Medicine

Date 2021 Apr 16

PMID 33861371

Citations 3

Authors

Christina Dietze

Andreas Brand

Jan Friederichs

Fabian Stuby

Dorien Schneidmueller

Christian von Ruden

Affiliations

Soon will be listed here.

Abstract

Purpose: Aim of this study was to investigate whether limited open auxiliary angle stable plate fixation has an effect on functional and radiologic outcomes one year after revision intramedullary nailing in aseptic trochanteric and subtrochanteric fracture nonunion.

Methods: In a retrospective analysis, surgically revised aseptic trochanteric and subtrochanteric nonunion was evaluated in a total of 190 consecutive patients ranging from 18 to 94 years between 12/2005 and 10/2018.

Results: One year after revision intramedullary nailing, nonunion healing was assessed in 129 out of 136 patients (95%) in group 1 without auxiliary plate fixation and in 51 out of 54 patients (94%) in group 2 with auxiliary plating (p = 0.23). In group 1, range of motion (ROM) was unrestricted in 88 patients and still restricted in 48 patients. In group 2, ROM was free in 34 patients and restricted in 20 patients (p = 0.25). The mean Lower Extremity Functional Scale (LEFS) was 56 points in group 1 and 55 points in group 2 (p = 0.55).

Conclusion: This study did not demonstrate significant differences in functional and radiologic outcomes following revision intramedullary nailing of aseptic trochanteric and subtrochanteric fracture nonunion. Limited open auxiliary plate fixation might be a reasonable option especially in cases of relevant varus axis deviation and comminuted or atypical fracture configurations, regardless of patients' age. Retrospectively registered with the German Clinical Trials Register (01/25/2021; ID: DRKS00024112).

Citing Articles

Functional and Radiological Results Following Revision Blade Plating and Cephalomedullary Nailing in Aseptic Trochanteric and Subtrochanteric Nonunion.

Rehme-Rohrl J, Brand A, Dolt A, Grunewald D, Hoffmann R, Stuby F J Clin Med. 2024; 13(12).

PMID: 38930120 PMC: 11205226. DOI: 10.3390/jcm13123591.

[Nonunions after intertrochanteric and subtrochanteric femoral fractures].

Reumann M, Hillrichs H, Menger M, Herath S, Rollmann M, Stuby F Unfallchirurgie (Heidelb). 2024; 127(5):356-363.

PMID: 38224360 DOI: 10.1007/s00113-023-01402-0.

The role of an augmentative plating in the management of femoral subtrochanteric nonunion.

Kim J, Oh C, Park K, Oh J, Yoon Y, Hong W Arch Orthop Trauma Surg. 2023; 143(8):4915-4923.

PMID: 36624207 DOI: 10.1007/s00402-023-04767-4.

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