Is the reconstruction of medial support important for revision following failed treatment of femoral trochanteric fractures? A retrospective comparative study

Abstract

Background: Hip-preserving revision in patients with failed treatment of femoral trochanteric fracture is still a major challenge. Whether the medial support reconstruction could benefit the patients and improve the success rate of hip-preserving revision is still controversial. Hence, the purpose of this study was to evaluate the clinical significance and prognosis of medial support reconstruction during the hip-preserving revision of failed femoral trochanteric fracture treatment.Methods: Patients with failed femoral trochanteric fractures treatments addressed by hip-preserving revision at our hospital from January 2014 to December 2020 were analyzed retrospectively. 31 patients were included and divided into a medial support group (n=16) and a non-medial support group (n=15). The Oxford Hip Score (OHS) was the primary measurement. In addition, the differences in quality of life, fracture healing, surgical trauma, and complications were also evaluated.Results: The OHS (42.06 ± 4.12 vs. 30.93 ± 11.56, M ± SD), the mental component score of the 12-item Short-Form Survey (SF-12) (54.48 ± 5.38 vs. 47.90 ± 3.47, M ± SD), the fracture healing rate (100%, 16/16 vs. 66.67%, 10/15), and the fracture healing time [4 (3,5) vs. 6 (3.75,6) months, M (Q1, Q3)] were significantly better and the incidence of complications [0(0/16) vs. 40%(6/15)] was significantly lower in the medial support group than the non-medial support group (p<0.05). No significant differences in the physical component score of the SF-12, surgical trauma and reduction in collodiaphyseal angle of affected femur were observed between groups.Conclusions: The reconstruction of medial support seems important for revision following failed treatment of femoral trochanteric fractures. Due to the medial augmentation and improvement of the mechanical stability for proximal femur, the patients might benefit from functional and fracture healing prognosis.