Percutaneous Compression Plating of Intertrochanteric Hip Fractures

OBJECTIVE: To present the principles of a surgical technique for percutaneous compression plating of intertrochanteric hip fractures and to report the clinical results of treatment using this method. DESIGN: Retrospective. SETTING: University hospital. PATIENTS: Ninety-eight intertrochanteric hip fractures in ninety-seven patients with a minimum follow-up of twelve months. MAIN OUTCOME MEASURES: Radiographic and clinical evidence of functional outcome and complications including fracture collapse and implant failure. RESULTS: Mean perioperative blood loss was 92.4 milliliters (range 14 to 245 milliliters), and the mean postoperative hospital stay was 8.7 days (range 4 to 20 days). Complications included two minor wound hematomas and one soft tissue infection. Radiographically, one fracture with a varus deformity of 8 degrees and two fractures had minor screw pullout that did not affect the final results. No collapses, screw cutouts, or head penetrations were seen. Three patients required reoperation: one for avascular necrosis after a fracture at the base of the neck and two, after fracture healing, for trochanteric bursitis requiring plate removal. All surviving patients (80 of 98; 82 percent) had uneventful fracture healing with union achieved by six months in all patients. CONCLUSIONS: Use of the percutaneous compression plating for intertrochanteric hip fractures resulted in reduced complications, event-free fracture healing, and improved rehabilitation.