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The debrunner-cech valgus osteotomy in osteoporotic four-part intertrochanteric fractures

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Summary

The main problems encountered in the management of comminuted four-part intertrochanteric fractures in the elderly are instability, severe osteoporosis and the need for early mobilization. Thirty-one patients, average age 75 years, with such fractures were operated on using a sliding blade-plate and the Debrunner-Cech valgus osteotomy. The follow-up was from 1–5 years with an average of 3.2 years. All patients were got out of bed on the first postoperative day and walked with help on the second day. The fractures united in 29 patients. The one exception occurred when the blade cut out of the neck; the operation was repeated with a good result. Two further patients died in the postoperative period. We conclude that this method is the best treatment for osteoporotic four-part intertrochanteric fractures.

Résumé

Les principaux problèmes, dans le traitement des fractures per-trochantériennes comminutives du sujet âgé, sont l'instabilité, l'ostéoporose et la nécessité d'un lever précoce. Trente et un sujets, âgés en moyenne de 75 ans et porteurs de telles fractures, ont été opérés par ostéotomie de valgisation selon Debrunner-Cech et synthèsés par lameplaque à compression. Le recul est compris entre 1 et 5 ans, avec une moyenne de 3,2 ans. Tous les opérés ont été levés le lendemain de l'intervention et ont commencé à marcher, avec aides, dès le deuxième jour. Vingt-neuf patients ont consolidé avec une seule complication: la lame ayant traversé le col. L'opération a été reprise avec un bon résultat. Deux autres malades sont morts durant la période post-opératoire. Les auteurs concluent que cette méthode constitue le meilleur traitement des fractures per-trochantériennes comminutives.

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Authors and Affiliations

  1. Orthopaedic Section, Jordan University Hospital, P.O. Box 13112, Amman, Jordan

    A. O. Shannak, H. D. Malkawi & S. T. Hadidi

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  1. A. O. Shannak
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  2. H. D. Malkawi
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  3. S. T. Hadidi
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Shannak, A.O., Malkawi, H.D. & Hadidi, S.T. The debrunner-cech valgus osteotomy in osteoporotic four-part intertrochanteric fractures. International Orthopaedics 12, 143–147 (1988). https://doi.org/10.1007/BF00266980

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