Intramedullary Interlocking Nailing Versus Fixed Angle Blade Plating for Subtrochanteric Femoral Fractures

Abstract

Background: subtrochanteric Fractures of proximal third of the femur are a major cause of morbidity and mortality in patients with lower extremity injuries. Most fractures are sustained in young adults during high velocity injuries. Patients and Methods: Twenty four patients with subtrochanteric fracture were treated in Al– Karkh Hospital .Baghdad between October 2017 to September 2018. Twelve patients had been treated with open reduction and internal fixation using a fixed angle blade plate were matched to twelve  patients treated with standard IM nailing, with regard to gender, age decade, and the Russell-Taylor classification of the fracture. Results: Four  patients treated with ORIF versus only one patients treated with IM nailing had a revision surgery. Furthermore, we found significant difference with regard to time to union, non-union, implant  failure or fracture between ORIF and IM nailing. Our results suggest that the rate of revision surgery is higher with ORIF using fixed angle blade plate for subtrochanteric femoral fractures. Conclusions: With the respect of two choices of implants for the fixation of subtrochanteric fracture of the femur, Internal fixation using a fixed angle blade plate for subtrochanteric femoral fractures has higher implant failure and revision rate, compared to closed intramedullary nailing

Keywords

subtrochanteric fractures, closed standard Intramedullary interlocking nailing, ORIF,  fixed angle blade plating