Better reduction is achieved when using cerclage wires for fragility subtrochanteric fractures. These fractures had a negative effect on quality of life and social function, but better outcomes were observed in the cerclage group.

Despite advances in the management of subtrochanteric fractures, in particular with the use of cephalomedullary nails, outcomes remain worse than other fractures of the proximal femur. Because an anatomic reduction is needed to offer the best results, several methods of reduction, using clamps and wires have been described. Reduction of fractures in elderly patients is especially complicated because of poor bone quality, comorbidities, and unfavorable fracture patterns. We describe a new technique of reduction and cerclage wiring through a mini-open approach for isolated subtrochanteric, as well as intertrochanteric fractures with extension into the subtrochanteric area, and report our results in a series of patients.

Se realizó un estudio histomorfométrico comparativo del porcentaje de osteointegración (B.I.C.: bone implant contact) entre implantes dentales comerciales, con distintas superficies (titanio liso, plasma spray de titanio, hidroxiapatita y SBM), e implantes experimentales (aleación MA-956 y superficie de rutilo), desarrollados en el Centro Nacional de Investigaciónes Metalúrgicas (CSIC). Los implantes se colocaron de forma intramedular en el extremo distal de los fémures de 36 conejos de la cepa Nueva Zelanda. Los animales fueron sacrificados a las 10 y 20 semanas. El B.I.C., cociente entre el perímetro total del implante y el perímetro en contacto directo con el tejido óseo, se valoró para cada muestra. El estudio estadístico se realizó mediante el análisis de la varianza multifactorial. Los resultados no mostraron diferencias significativas entre los distintos grupos estudiados, ni con respecto al tipo de implante utilizado (p=0,16), ni con respecto al tiempo (p=0,90). Podemos concluir que los implantes experimentales empleados se han comportado de manera semejante, a lo largo del tiempo estudiado, a los implantes comerciales utilizados en la clínica de forma habitual. An histomorphometric comparative study of BIC (bone implant contact) between trading dental implants with several surfaces (smooth, titanium plasma spray, hydroxiapatita and SBM) and experimental implants (MA-956 alloy and rutile surface) developed by National Center for Metallurgical Research (CSIC), was realized. The implants were located intramedullarly in the distal femur in 36 New Zeland rabbits. The animals were sacrificed at 10 and 20 weeks. B.I.C., quotient between total perimeter of implant and contact bone-implant zones, was assessed for each sample. The statistical study was performed by multifactorial variance analysis. The results showed no significant differences between the studied groups, in relation to the type of implant (p=0.16) and the time (p=0.90). The data lead us to conclude that experimental implants and conventional implants had similar behaviour patterns through the studied period.

Se realiza un estudio comparativo entre densidad mineral ósea (DMO) en hueso fresco y formolizado, como paso previo para comparar, en posteriores trabajos, la DMO en hueso formolizado con la osteointegración obtenida mediante estudios histológicos. Se utilizó un densitómetro Norland XR-26 y como animales de experimentación, conejos Nueva Zelanda, a los que se les colocaron implantes intramedulares de distintos tipos en sus fémures, se utilizó también un grupo control sin implante. Los animales fueron sacrificados a los 2,5 meses y a los 5 meses. Se midió la densidad mineral ósea (DMO) alrededor del implante. A continuación se fijó el fémur para su estudio histológico, utilizando formol tamponado a pH 7, y se volvió a medir la DMO. En el grupo control sin implante se midió el mismo área que en los grupos con implantes. Resultados: No se encontraron diferencias significativas entre las dos mediciones de DMO. Se encontró una menor DMO en el grupo sin implante frente a todos los grupos con implantes. Conclusiones: La medición de la DMO en hueso fresco, o formolizado es un valor útil para su correlación con la osteointegración. La variaciones de la DMO tras la presencia del implante no son comparables con el grupo control sin implante. The purpose of this study is to compare bone mineral density (BMD) of fresh bone and formaldehyde bone, in order to do, posteriorly, comparative studies between formaldehyde bone and osseointegration obtained by means of histological studies. Norland XR-26 Densitometer was used. Several intramedullary implants were located in the femur of New Zeeland rabbits. There was a control group without implants. Rabbits were sacrificied after 2´5 and 5 months post surgery. BMD was measured around the implant. Femur was prepared for histological study in tampon formaldehyde at pH 7 and BMD was measured once more. Similar areas in control group and implanted groups were measured. Results showed no statistical significant differences between measurements of BMD. BMD was smaller in control group in comparison with all implant groups. Conclusions: Measurements of BMD in fresh or formaldehyde bone are a useful value to correlate with BIC. Variations of BMD after implant are nor comparable with the control group.