Sarmiento osteotomy with plate and screw fixation for comminuted/unstable inter-trochanteric fracture femur

Abstract

Comminuted inter-trochanteric fractures are unstable and treated with conventional anatomic reduction and internal Fixation stability may not be restored due to significant cortical defect present postero-medially. Several surgical methods of treatment for comminuted and unstable inter-trochanteric fracture is described. In this study we performed oblique valgus osteotomy (Augusto Sarmiento) technique in fixing unstable comminuted inter-trochanteric fractures using a short Smith Petersen (SP Nail) and Mclaughlin plate system has been used to achieve union.Materials and Methods: A prospective study was carried out on 20 hips of 20 patients are treated with oblique valgus osteotomy (Augusto Sarmiento) technique and fixed with short Smith Petersen Nail and Mclaughlin Plate was used, the patients were evaluated at a mean of 10 months to 62 months average (26 months) for union, leg equalisation, clinical outcomes.Results: Mean time of union was 12.5 +_ (range 10 – 22 weeks). NO intra-operative instability of the osteotomy site was encountered.Conclusions: Comminuted unstable inter -trochanteric fracture treated by valgus osteotomy (Sarmiento technique) and medial displacement of the distal fragment with accurate approximation of the medial cortex of the two major fragments greatly enhances the efficiency of fixation.