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Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
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2022, Number 3

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Acta Ortop Mex 2022; 36 (3)

No infected union of subtrochanteric fracture of femur, treated with autograft and plate

Gil-Ferrer J, Portilla-Maya D, Mejía-Corzo M, González-Fang Y
Full text How to cite this article 10.35366/109695

DOI

DOI: 10.35366/109695
URL: https://dx.doi.org/10.35366/109695

Language: Spanish
References: 8
Page: 185-189
PDF size: 254.06 Kb.


Key words:

femur, subtrochanteric fracture, infection, vascularization, fibula, osteosynthesis.

ABSTRACT

Hip fractures are considered a public health problem in the world. Among hip fractures we find subtrochanteric fractures that are defined as proximal femur fractures located in the trochanteric region within 5 cm below the lesser trochanter; and they have an approximate incidence of 15 to 20 per 100,000 people. The objective of this case is to report the success of the reconstruction of an infected subtrochanteric fracture, with a non-vascularized fibular segment and a distal femur condylar support plate. Clinical case: 41-year-old male patient suffering from a right subtrochanteric fracture as a result of a traffic accident that required the use of osteosynthesis material. With subsequent rupture of the cephalomedullary nail in its proximal third, non-union of the fracture and infections at the fracture site. He was treated with multiple surgical lavages, antibiotic therapy, and an unconventional orthopedic and surgical procedure, such as the use of a distal femur condylar support plate and an endomedullary bone graft with a 10-cm segment of non-vascularized fibula. Patient with satisfactory and favorable evolution.


REFERENCES

  1. Mattisson L, Bojan A, Enocson A. Epidemiology, treatment and mortality of trochanteric and subtrochanteric hip fractures: data from the Swedish fracture register. BMC Musculoskelet Disord. 2018; 19(1): 369.

  2. Freigang V, Gschrei F, Bhayana H, Schmitz P, Weber J, Kerschbaum M, et al. Risk factor analysis for delayed union after subtrochanteric femur fracture: quality of reduction and valgization are the key to success. BMC Musculoskelet Disord. 2019; 20(1): 391.

  3. Apóstol-González S, Herrera J. Fracturas subtrocantéricas de fémur tratadas con enclavado endomedular bloqueado. Acta Ortop Mex. 2009; 23(3): 130-6.

  4. Garrison I, Domingue G, Honeycutt MW. Subtrochanteric femur fractures: current review of management. EFORT Open Rev. 2021; 6(2): 145-51.

  5. Saarenpaa I, Heikkinen T, Jalovaara P. Treatment of subtrochanteric fractures. A comparison of the Gamma nail and the dynamic hip screw: short-term outcome in 58 patients. Int Orthop. 2007; 31(1): 65-70.

  6. Kim KK, Won Y, Smith DH, Lee GS, Lee HY. Clinical results of complex subtrochanteric femoral fractures with long cephalomedullary hip nail. Hip Pelvis. 2017; 29(2): 113-9.

  7. Allis OH. Fracture in the upper third of the femur exclusive of the neck. Med New. 1891; 59: 585-90.

  8. Ochoa CR, Mancilla JA. Fracturas subtrocantéricas de fémur tratadas con placa LCP 4.5 para fémur. Acta Med. 2013; 11(2): 83-88.




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Acta Ortop Mex. 2022 May-Jun;36