Study of femur unstable peritrochanteric fractures treated with blocked cephalodiaphyseal shaft: a minimally invasive technique

• Autor(es):

  Moraes, Mauricio de (Faculdade de Medicina do ABC, Hospital Bandeirantes de São Paulo. Centro de Traumatologia e Ortopedia);

  Rodrigues, Rubens (Hospital Bandeirantes de São Paulo. Centro de Traumatologia e Ortopedia);

  Milani, Carlo (Faculdade de Medicina do ABC, Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Ortopedia e Traumatologia);

  Fujiki, Edison Noboru (Faculdade de Medicina do ABC);

  Ono, Nelson Keiske (Faculdade de Medicina do ABC);

  Costa, Paulo H. N. da.

• Fonte:

  Acta Ortopédica Brasileira; volume 13, número 3, páginas 153-155. 2005.

• Assuntos:

  Femur;

  Fracture fixation system;

  Peritrochanteric fractures;

  Surgery;

  Adult;

  Elderly.

• Resumo:

  Sixty five patients with unstable peritrochanteric fractures were surgically treated with blocked intramedullary cephalodiaphyseal fixation (minimally invasive system). Closed reduction in traction table was performed with radioscopy. Assisted partial load was encouraged after the second postoperative day. In all examined patients, healing was achieved within 12 to 18 weeks (average 14.5 weeks). Complications were seen in six cases (9.2%) with vicious union, four cases (6.1%) with shortening of the limb (<1cm), three cases (4.6%) with compression screw migration to acetabulum, and one case (1.5%) with intraoperative fracture of the lateral femur cortical. Five patients (7.6%) presented with distal deep venous thrombosis (DVT) with no clinical repercussion. No superficial or deep infection was seen up to the last review. In the three cases of proximal migration of the compression screw, system was removed without intercurrences. We concluded that the methodology employed here is efficient, safe, with low morbidity potential. It is a fast technique, presenting little complications, promoting an early rehabilitation for the patient.

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