Name of the Procedure:

Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture with plate/screw type implant, with or without cerclage

Summary

This surgical procedure involves repairing a fracture in the upper part of the femur (thigh bone) using a combination of metal plates and screws. Cerclage, a type of wiring technique, may also be used to stabilize the bone fragments. This helps the bone heal correctly.

Purpose

This procedure addresses fractures in the upper thigh bone around the hip area. The goal is to stabilize the fracture, promote proper bone healing, restore mobility, and reduce pain.

Indications

• Patients with intertrochanteric, peritrochanteric, or subtrochanteric femoral fractures.
• Severe pain or inability to bear weight on the affected leg.
• Fractures that are not suitable for non-surgical treatment methods.

Preparation

• Patients may need to fast for several hours before the surgery.
• Adjustment or temporary discontinuation of certain medications, as instructed by the healthcare provider.
• Preoperative assessments including blood tests, imaging studies (X-rays, MRI, or CT scans), and anesthesia evaluation.

Procedure Description

1. The patient is positioned on the surgical table and administered anesthesia.
2. An incision is made over the fractured area of the femur.
3. The broken bone fragments are repositioned (reduction) to their normal alignment.
4. Metal plates and screws are applied to hold the bone fragments together.
5. If necessary, cerclage wires are wrapped around the bone to provide additional stability.
6. The incision is closed with sutures or staples, and a dressing is applied.

Duration

The procedure typically takes between 2 to 3 hours, depending on the complexity of the fracture.

Setting

The surgery is performed in a hospital operating room.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technologists

Risks and Complications

• Infection
• Bleeding
• Blood clots
• Nerve or blood vessel injury
• Hardware failure or displacement
• Delayed bone healing or nonunion

Benefits

• Stabilizes the fracture, leading to proper healing.
• Reduces pain and restores function.
• Enables quicker return to mobility.

Recovery

• Hospital stay for a few days post-surgery.
• Pain management with prescribed medications.
• Physical therapy to regain strength and mobility.
• Follow-up appointments to monitor healing.
• Full recovery may take several weeks to months, with some activity restrictions during the healing period.

Alternatives

• Non-surgical treatments like casting or traction (less effective for severe fractures).
• Minimally invasive procedures, though not suitable for all types of fractures.
• Each alternative has its own risks and benefits which should be discussed with the healthcare provider.

Patient Experience

• During the procedure, the patient will be under anesthesia and should not feel pain.
• Postoperatively, there may be some pain and discomfort at the incision site, which can be managed with pain medications.
• Physical therapy may cause some discomfort initially but is essential for recovery.