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Case Reports
. 2020 Feb 22:26:100293.
doi: 10.1016/j.tcr.2020.100293. eCollection 2020 Apr.

Management of infected non-union of subtrochanteric fracture: Two cases

Tomohiro Saito  1 , Tomohiro Matsumura  1 , Mitsuharu Nakashima  1 , Katsushi Takeshita  1
Affiliations
Case Reports

Management of infected non-union of subtrochanteric fracture: Two cases

Tomohiro Saito et al. Trauma Case Rep. .

Erratum in

Abstract

Infected non-union of subtrochanteric fractures is challenging to treat. We experienced two cases and had good clinical results. Treatment strategy comprised debridement without hesitation after considering later limb lengthening; insertion of the proximal lateral bone edge spike into the distal bone marrow cavity until achieving medial-side bony contact and holding good alignment to compensate for the medial-side bone loss, according to the modified Dimon method; and internal fixation with an angled plate in the decubitus position. The angle of the angled plate should be directed toward the abundant cancellous bone using preoperative computed tomography. Residual limb shortening after ORIF was improved by limb lengthening.

Keywords: Fracture non-union; Infected non-union; Modified Dimon method; Subtrochanteric fracture.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Radiographs in Case 1. [a] Anteroposterior (AP) radiograph of the left subtrochanteric fracture. [b] AP radiograph after surgery. [c] AP radiographs after debridement. [d] AP radiograph after definitive surgery. [e] AP and lateral radiographs demonstrating fracture union 2 years after the definitive surgery. [f] AP and lateral radiographs of the proximal femur obtained at the final follow-up.
Fig. 2
Fig. 2
Radiographs in Case 2. [a] Anteroposterior (AP) and lateral radiographs before debridement, 2 years after the initial surgery. [b] AP radiograph after removal of the implant. [c] AP radiograph after the definitive surgery. [d] AP and lateral radiographs obtained 6 months after the definitive surgery demonstrating fracture union. [e] AP and lateral radiographs of the proximal femur obtained at the final follow-up.
Fig. 3
Fig. 3
Illustration of modified Dimon method. The proximal lateral bone edge spike was inserted into the distal bone marrow cavity until achievement of medial-side bony contact. The arrow indicates the medial bony contact.
See this image and copyright information in PMC

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