Lateral hip fracture salvage with 95º blade plate (AO/ASIF)

Abstract

Backround Contemporary techniques of reduction and internal fixation, make most femoral neck and intertrochanteric hip fractures heal without problems. Most of these fractures are treated with closed reduction and internal fixation with excellent results. Treatment failure of hip fractures usually lead to pain and disability. Treatment alternatives in these cases can be limited to two options excepting the conservative non operative treatment in critical patients: a new fixation system or an arthroplasty. The valgus osteotomy aims to transform the shear forces in the area of nonunion into compressive forces, thereby stimulating fracture healing.Methods 14 patients with intertrochanteric hip fractures nonunion were retrospectively reviewed between January 2010 and February 2014. All patients underwent revision surgery in order to achieve a valgus position of the proximal fragment, using a 95º blade plate (AO / ASIF). The objective of this study was to evaluate the clinical and radiographic results of intertrochanteric hip fracture nonunion treated with this method.Results Fracture healing was achieved in all 14 patients. Average healing time ranged from three to six months. The Harris Score averaged 82,65. Hardware removal was not performed after fracture   healing.Conclusion We believe that the 95° blade plate is still a very good option in cases of proximal femur nonunion, provided that you perform a correct preoperative planning and assessment, good surgical technique and a proper postoperative care.