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Reduction techniques for difficult subtrochanteric fractures

  • Technical Note • HIP - FRACTURES
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Subtrochanteric fractures can result from high-energy trauma in young patients or from a fall or minor trauma in the elderly. Intramedullary nails are currently the most commonly used implants for the stabilization of these fractures. However, the anesthetic procedure for the patients, the surgical reduction and osteosynthesis for the fractures are challenging. The anesthetic management of orthopedic trauma patients should be based upon various parameters that must be evaluated before the implementation of any anesthetic technique. Surgery- and patient-related characteristics and possible comorbidities must be considered during the pre-anesthetic evaluation. Adequate fracture reduction and proper nail entry point are critical. Understanding of the deforming forces acting on various fracture patterns and knowledge of surgical reduction techniques are essential in obtaining successful outcomes. This article discusses the intraoperative reduction techniques for subtrochanteric fractures in adults and summarizes tips and tricks that the readers may find useful and educative.

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Authors and Affiliations

  1. Department of Orthopaedics, University of Patras, School of Medicine, Rio-Patras, Greece

    Zinon T. Kokkalis, Dimitris I. Ntourantonis & Elias Panagiotopoulos

  2. Second Department of Anesthesiology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

    Dimitrios Giannoulis, Eleftheria Souliotis & Theodosis Saranteas

  3. First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 41 Ventouri Street, Holargos, 15562, Athens, Greece

    Andreas F. Mavrogenis, Vasilios G. Igoumenou, Thekla Antoniadou, Renos Karamanis, Panayiotis D. Megaloikonomos, Georgios N. Panagopoulos & Panayiotis J. Papagelopoulos

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  1. Zinon T. Kokkalis
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  2. Andreas F. Mavrogenis
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  3. Dimitris I. Ntourantonis
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  4. Vasilios G. Igoumenou
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  9. Dimitrios Giannoulis
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  13. Elias Panagiotopoulos
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Correspondence to Andreas F. Mavrogenis.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Kokkalis, Z.T., Mavrogenis, A.F., Ntourantonis, D.I. et al. Reduction techniques for difficult subtrochanteric fractures. Eur J Orthop Surg Traumatol 29, 197–204 (2019). https://doi.org/10.1007/s00590-018-2239-2

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  • DOI: https://doi.org/10.1007/s00590-018-2239-2

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