To evaluate the late radiographic and functional complications occurring after treatment of reverse oblique trochanteric fractures with the proximal femoral nail. This is a retrospective study which was conducted between October 2004 and October 2009. 55 patients with a reverse oblique trochanteric fracture were treated with the Gamma 3 nail. According to the AO classification, there were 36 type AIII-1, 8 AIII-2, 11 AIII-3 fractures. Closed reduction was achieved in all patients. The long gamma 3 nail was used in 34 fractures. The mean follow up was 18 months (range 9 to 32 months). The patients were evaluated clinically (Harris hip score) and radiographically.PURPOSE
PATIENTS
We treated 24 patients with high-energy fractures of the tibial plateau by the Ilizarov fixator and transfixion wires. Eleven fractures were open, and 20 patients had complex injuries. Twelve were treated by ligamentotaxis and percutaneous fixation, seven by limited open reduction and five by extensive open reduction. All were followed for at least 24 months. All the fractures united, with an average time to healing of 14.4 weeks. Thirteen patients achieved full extension and 13 more than 110° of flexion. Twenty-two knees were stable. Fifteen patients walked normally and the rest with only a slight limp. All but two knees had an articular step-off of less than 4 mm and all had normal axial alignment except two. There were no cases of postoperative skin infection, osteomyelitis or septic arthritis. Ilizarov circular fixation is an ideal method of treatment for these fractures when extensive dissection and internal fixation are contraindicated due to trauma to the soft tissue, deficiency of bone stock, and bony comminution.
