Wiring technique for lesser trochanter fixation in proximal IM nailing of unstable intertrochanteric fractures: A modified candy-package wiring technique

Kim, Gyeong Min; Nam, Kwang Woo; Seo, Kyu-Bum; Lim, Choon Woo; Kim, Jiyun; Park, Yong Bum

doi:10.1016/j.injury.2016.11.016

Cited by 27 publications

(18 citation statements)

References 23 publications

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“…Some researchers believe that fixation of the lesser trochanter is unnecessary, while others recommend fixation to provide posteromedial support. Some surgical procedures have been proposed for the reduction of the lesser trochanter, such as nailing or cable bundling [16]. We divided the lesser trochanter fragments into three types: maintaining a continuation with the greater trochanter (19 cases, 32.20%), separated but intact lesser trochanter fragments (25 cases, 42.37%), and comminution of the lesser trochanter to >3 pieces (15 cases, 25.42%).…”

Section: 2mentioning

confidence: 99%

[Retracted] Three‐Dimensional Mapping of Medial Wall in Unstable Pertrochanteric Fractures

Zhang

Sun

Liao

et al. 2020

BioMed Research International

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Objective. Unstable pertrochanteric fractures are usually treated with internal fixation, and the integrity of the anteromedial cortex is an important factor for stability and healing. In this study, we described and analyzed the three-dimensional mapping technology and morphological characteristics of pertrochanteric fractures. Methods. Fifty-nine pertrochanteric fractures (OTA/AO 2007 types 31A2) were retrospectively reviewed. Computed tomographic (CT) images for all fractures were superimposed on a standard template. Medial wall integrity was analyzed, and three-dimensional fracture maps were created. Results. Pertrochanteric fractures always have a posterior defect in the medial cortex. The mean width of the defect, in our study, was 21.5 mm (SD: 6.1 mm, range: 10–40 mm), 56.3% (SD: 13.7%, range: 27.5-100%). Bone segments that contact by the anteromedial cortex were 16.5 mm (SD: 5.3 mm, range: 0-29 mm). Conclusion. The integrity of the anteromedial cortex should be considered during internal fixation of femoral trochanteric fractures. These morphological characteristics could be used to form postoperative cortical contact and improve stability of the fixation. Three-dimensional mapping technology can help establish a typical fracture model, thereby improving doctors’ understanding of fracture characteristics.

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Section: 2mentioning

confidence: 99%

[Retracted] Three‐Dimensional Mapping of Medial Wall in Unstable Pertrochanteric Fractures

Zhang

Sun

Liao

et al. 2020

BioMed Research International

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“…Therefore, our surgical procedure may be a safe method for proximal femoral fractures. Kim et al introduced the modified candy package technique using steel wires to hold the displaced lesser trochanter fragment [ 13 ]. Although they showed good clinical results without complications, we are concerned regarding damage to blood vessels around the femur because of steel wire migration.…”

Section: Discussionmentioning

confidence: 99%

“…Although it is preferable to fix it in its original position, most orthopedic surgeons do not fix the lesser trochanter fragment because the procedure is difficult. In contrast, Kim et al reported a surgical method called the modified candy package technique to hold the lesser trochanter using twisted steel wires [ 13 ]. Although their study obtained good clinical results, we believe that the operative technique is a little complicated and are worried regarding the complications of using metallic materials.…”

Section: Introductionmentioning

confidence: 99%

Banding with lesser trochanter fragment using nonabsorbable tape in trochanteric femoral fractures

Usami

Takada

Nishida

et al. 2021

SICOT-J

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Introduction: Trochanteric femoral fracture is one of the most common fractures in the elderly. Trochanteric femoral fracture with involvement of the lesser trochanter is considered unstable and recognized as having a poor prognosis. However, fixation of lesser trochanter fragment is scarce because of technical difficulties. In this study, we reported the simple surgical procedure and the effect of using nonabsorbable tape in lesser trochanter fixation. Methods: From January 2014 to December 2017, 114 patients treated with proximal intramedullary nailing for trochanteric fractures with the lesser trochanter fragment were reviewed. Among patients enrolled in this study, 73 were followed up until radiographic bone union, of which 26 were treated with lesser trochanter fragment banding (group B) and 47 without banding (group N). Radiographs and/or computed tomography images were used to evaluate bone union of the lesser trochanter fragment at three months postoperatively. Results: The bone union of the lesser trochanter fragment was achieved in 24 cases (92%) in group B and 30 cases (64%) in group N. Compared with group N, group B showed a significantly increased number of mild and moderate deformities but decreased number of severe deformity and nonunion (P < 0.001). Postoperative complications were not observed in both groups. Conclusions: From the viewpoint of increasing lesser trochanteric bone union ratio, fixation of the lesser trochanter fragment using nonabsorbable tape in the treatment of trochanteric fractures could be an effective procedure.

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“…[10] The appearance of intramedullary nail provides the basis for closed reduction or minimally invasive open reduction. [11][12]In the process of implantation, the minimally invasive is often needed, and the concept of minimally invasive reduction should run through the whole operation process [13]. Although design and technology on implant have been developments, a better nail does not compensate for de cient surgical techniques.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary Nailing of Intertrochanteric Fractures - Minimal Invasive Techniques for Reduction

Duan

Tong

Zhang

et al. 2021

Preprint

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Background: An intramedullary nail has become the implant of choice for intertrochanteric fractures. This paper introduced some minimal invasive techniques were used to improve quality of intertrochanteric fracture reduction. Methods: Of 119 intertrochanteric fractures treated from January 2014 to October 2019. All patients who received internal fixation on traction bed, and who could not achieve satisfactory closed reduction through the process of "external rotation, abduction, traction, adduction and internal rotation". Reductions were classified as good, acceptable, or poor. We had acceptable reduction in 83 cases and poor reduction in 37 cases though closed reduction. The displacement was reduced using some minimal invasive techniques. Results: After performing the relative techniques in these cases, no case had a poor result. 112(94.9%) cases were in a good reduction. Anatomical reduction should always be achieved in intertrochanteric fractures. Conclusion: The minimal invasive techniques could help the surgeon achieve satisfactory reduction in intertrochanteric fractures. This work had the potential to improve the cognition of reduction of intertrochanteric fractures for surgeons, especially beginners and juniors.

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Wiring technique for lesser trochanter fixation in proximal IM nailing of unstable intertrochanteric fractures: A modified candy-package wiring technique

Cited by 27 publications

References 23 publications

[Retracted] Three‐Dimensional Mapping of Medial Wall in Unstable Pertrochanteric Fractures

[Retracted] Three‐Dimensional Mapping of Medial Wall in Unstable Pertrochanteric Fractures

Banding with lesser trochanter fragment using nonabsorbable tape in trochanteric femoral fractures

Intramedullary Nailing of Intertrochanteric Fractures - Minimal Invasive Techniques for Reduction

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