Technique and early results of percutaneous reduction of sagittally unstable intertrochateric fractures

Background: This paper introduces a percutaneous reduction technique using one or two Steinman pin(s) to reduce sagittallyunstable intertrochanteric fractures.Methods: A fracture was defined as a sagittally unstable intertrochanteric fracture when posterior sagging of a distal fragmentand flexion of the proximal fragment worsens after usual maneuvers for a closed reduction. Of 119 intertrochanteric fracturestreated from June 2007 to December 2008, twenty-one hips showed sagittal instability. The sagittal displacement was reducedusing a Steinmann pin as a joystick, and stabilized with a nail device. Nineteen hips were followed up for more than one year. Theclinical and radiological results were reviewed in 19 hips and compared with those of the remaining cases.Results: The demographics were similar in both groups. The mean anesthetic time did not differ. Although the pre-injury and finalactivity levels were significantly lower in the study group, the degree of recovery was the same. No clinical complications relatedto this technique were encountered. Radiologically, the reduction was good in all hips in both groups. Union was obtained in allcases without any time differences.Conclusions: This less invasive reduction technique is simple and safe to use for this type of difficult fracture.