Varus Malunion as an Outcome of Pertrochanteric Fracture Fixation
Background: Despite the high incidence of pertrochanteric fractures in African countries, there are insufficient data on radiographic outcomes of fixation. Previous studies focused on cut-out as an outcome measure. Varus malunion may be a significant outcome measure as it results in biomechanical al...
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Surgical Society of Kenya
2025-04-01
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| Series: | The Annals of African Surgery |
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| Online Access: | https://www.annalsofafricansurgery.com/pertrochanteric-fracture-fixation |
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| author | Wanjiku Njongo Vincent Muoki Mutiso John Kabia King’ori |
| author_facet | Wanjiku Njongo Vincent Muoki Mutiso John Kabia King’ori |
| author_sort | Wanjiku Njongo |
| collection | DOAJ |
| description | Background: Despite the high incidence of pertrochanteric fractures in African countries, there are insufficient data on radiographic outcomes of fixation. Previous studies focused on cut-out as an outcome measure. Varus malunion may be a significant outcome measure as it results in biomechanical alterations at the hip. Objective: This study aimed to identify varus malunion as an outcome of pertrochanteric fracture fixation in our population. Study design: This was a cross-sectional, prospective, observational study. Materials and methods: Fifty-nine patients were operated on at three facilities over a 1-year period. Post-operative neck–shaft angle (NSA) and tip–apex distance (TAD) were measured. After 12 weeks, radiographs were assessed for varus malunion and cut-out. Results: The mean post-operative NSA was 3° of varus and the mean TAD was 36 mm. After 12 weeks, there was an average varus collapse of 6°. Predictors of varus collapse were increased TAD (p = 0.002) and decreased post-operative NSA (p < 0.001). The cut-out rate was 4.9%. Conclusion: Pertrochanteric fractures show varus collapse after fixation. Reduction in valgus may allow the fracture to collapse into a near-anatomical position, avoiding malunion. The position of the implant within the femoral head plays an active role in preventing varus malunion. |
| format | Article |
| id | doaj-art-c59eb6b111a44731b23f1ccdca27fe06 |
| institution | OA Journals |
| issn | 1999-9674 2523-0816 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Surgical Society of Kenya |
| record_format | Article |
| series | The Annals of African Surgery |
| spelling | doaj-art-c59eb6b111a44731b23f1ccdca27fe062025-08-20T02:32:39ZengSurgical Society of KenyaThe Annals of African Surgery1999-96742523-08162025-04-012225560http://dx.doi.org/10.4314/aas.v22i2.4Varus Malunion as an Outcome of Pertrochanteric Fracture FixationWanjiku Njongo0https://orcid.org/0000-0002-2956-4948Vincent Muoki Mutiso1https://orcid.org/0000-0001-8946-9048John Kabia King’ori2https://orcid.org/0009-0008-1929-6290Jomo Kenyatta University of Agriculture and Technology, Department of Surgery, Juja, KenyaUniversity of Nairobi, Department of Surgery, Nairobi, KenyaUniversity of Nairobi, Department of Surgery, Nairobi, KenyaBackground: Despite the high incidence of pertrochanteric fractures in African countries, there are insufficient data on radiographic outcomes of fixation. Previous studies focused on cut-out as an outcome measure. Varus malunion may be a significant outcome measure as it results in biomechanical alterations at the hip. Objective: This study aimed to identify varus malunion as an outcome of pertrochanteric fracture fixation in our population. Study design: This was a cross-sectional, prospective, observational study. Materials and methods: Fifty-nine patients were operated on at three facilities over a 1-year period. Post-operative neck–shaft angle (NSA) and tip–apex distance (TAD) were measured. After 12 weeks, radiographs were assessed for varus malunion and cut-out. Results: The mean post-operative NSA was 3° of varus and the mean TAD was 36 mm. After 12 weeks, there was an average varus collapse of 6°. Predictors of varus collapse were increased TAD (p = 0.002) and decreased post-operative NSA (p < 0.001). The cut-out rate was 4.9%. Conclusion: Pertrochanteric fractures show varus collapse after fixation. Reduction in valgus may allow the fracture to collapse into a near-anatomical position, avoiding malunion. The position of the implant within the femoral head plays an active role in preventing varus malunion.https://www.annalsofafricansurgery.com/pertrochanteric-fracture-fixationpertrochantericintertrochanterichip fracturescut-outvarus |
| spellingShingle | Wanjiku Njongo Vincent Muoki Mutiso John Kabia King’ori Varus Malunion as an Outcome of Pertrochanteric Fracture Fixation The Annals of African Surgery pertrochanteric intertrochanteric hip fractures cut-out varus |
| title | Varus Malunion as an Outcome of Pertrochanteric Fracture Fixation |
| title_full | Varus Malunion as an Outcome of Pertrochanteric Fracture Fixation |
| title_fullStr | Varus Malunion as an Outcome of Pertrochanteric Fracture Fixation |
| title_full_unstemmed | Varus Malunion as an Outcome of Pertrochanteric Fracture Fixation |
| title_short | Varus Malunion as an Outcome of Pertrochanteric Fracture Fixation |
| title_sort | varus malunion as an outcome of pertrochanteric fracture fixation |
| topic | pertrochanteric intertrochanteric hip fractures cut-out varus |
| url | https://www.annalsofafricansurgery.com/pertrochanteric-fracture-fixation |
| work_keys_str_mv | AT wanjikunjongo varusmalunionasanoutcomeofpertrochantericfracturefixation AT vincentmuokimutiso varusmalunionasanoutcomeofpertrochantericfracturefixation AT johnkabiakingori varusmalunionasanoutcomeofpertrochantericfracturefixation |