VIDEO: Recognize signs of instability in intertrochanteric and subtrochanteric fractures
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KOLOA, Hawaii — At Orthopedics Today Hawaii, Frank A. Liporace, MD, spoke about intertrochanteric and subtrochanteric fractures.
“The biggest thing with the intertrochanteric and subtrochanteric fractures is to get it right the first time. What I mean by that is to recognize signs of instability, whether it be lateral wall comminution, a poor thickness of the lateral wall or a pattern of reverse obliquity of subtrochanteric extension,” he said.
He said one can then appropriately treat the fracture with any of those signs of instability, use an intramedullary device — either screw or blade plus/minus an anti-rotation screw and distal interlocking.
“When instability goes unrecognized, and either the wrong implant is used or not appropriately placed with an appropriate reduction, which we shouldn’t be afraid to do an open reduction in these cases, that is when we lead to failure,” Liporace said.