Muhammad Kamran Shafi.
Results of Non Anatomical Fixation of Unstable Pertrochanteric Fracture Femur.
Annals Punjab Med Coll Jan ;3(2):132-4.

Objective: To evaluate the results of union in unstable pertrochanteric fracture of femur in nonanatomical reduction and fixation. Methodology: A descriptive study conducted at Department of Orthopaedic surgery Bahawal Victoria Hospital Bahawalpur. In the present study, we had 30 patients with unstable intertrochanteric fractures of either sex. Patients were treated by nonanatomic reduction, either by Dimon Houghsten or Sarmiento osteotomy depending upon fracture geometry, and fixed by dynamic hip screw. Results: Out of thirty patients, 21(70%) were male and 9 (30%) were female. The average age of male patients was 74.9 years and that of female was 61.2 years. We included patients with Jensen’s type IV fractures having osteoporotic grade of four to six according to Singh’s index. Patients were followed up for minimum period of 20 weeks and evaluated for radiological union and functional outcome using Sikorski and Barrington’s pain and mobility scale. Out of thirty patients, only 25 completed the follow up. Four patients had limb length discrepancy. 88% of the patients had excellent to good functional outcome. Conclusion: Anatomical reduction must be tried in all cases. However, to avoid the complications of implant failure and loss of reduction with varus union in unstable fractures, non anatomical reduction should be considered.

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