Role of intermediate sealed prostheses in the treatment of fractures of the trochanter major in the elderly. Apropos of a continuous series of 110 prosthesis
Saragaglia, D.; Carpentier, E.; Gordeeff, A.; Faure, C.; Butel, J.
Journal de Chirurgie 122(4): 255-260
1985
ISSN/ISBN: 0021-7697 PMID: 3997992 Document Number: 247239
Between January 1980 and July 1983, 265 fracture of the trochanteric region in elderly patients were treated in Prof. J. Butel's department. Prior to 1980, 75% of the cases were treated with Ender's pin. However, the high failure rate of this procedure (especially in the case of complex fractures) led the authors to select the indications for this operation much more carefully. In the present series of 265 cases, there were: 110 intermediate sealed prostheses, 136 Ender's pin 19 direct osteosyntheses. At the present time (and for the last 2 years) the indications are distributed in the following way: 50% intermediate sealed prostheses, about 40% Ender's pin and 5 to 10 direct osteosyntheses. The ideal indication for intermediate sealed prosthesis is a unstable fracture of the greater trochanter (complex trochanteric fractures, fractures with a large 3rd fragment separating the lesser trochanter, trochantero-diaphyseal fractures) in autonomous elderly patients over the age of 75. This operation allows immediate weight-bearing and the operative mortality is barely more than with other techniques (21%) with very satisfactory results (more than 80 of good and very good results).