Percutaneous Compression Plating of Intertrochanteric Hip Fractures

OBJECTIVE:To present the principles of a surgical technique for percutaneous compression plating of intertrochanteric hip fractures and to report the clinical results of treatment using this method. DESIGN:Retrospective. SETTING:University hospital. PATIENTS:Ninety-eight intertrochanteric hip fractures in ninety-seven patients with a minimum follow-up of twelve months. MAIN OUTCOME MEASURES:Radiographic and clinical evidence of functional outcome and complications including fracture collapse and implant failure. RESULTS:Mean perioperative blood loss was 92.4 milliliters (range 14 to 245 milliliters), and the mean postoperative hospital stay was 8.7 days (range 4 to 20 days). Complications included two minor wound hematomas and one soft tissue infection. Radiographically, one fracture with a varus deformity of 8 degrees and two fractures had minor screw pullout that did not affect the final results. No collapses, screw cutouts, or head penetrations were seen. Three patients required reoperationone for avascular necrosis after a fracture at the base of the neck and two, after fracture healing, for trochanteric bursitis requiring plate removal. All surviving patients (80 of 98; 82 percent) had uneventful fracture healing with union achieved by six months in all patients. CONCLUSIONS:Use of the percutaneous compression plating for intertrochanteric hip fractures resulted in reduced complications, event-free fracture healing, and improved rehabilitation.