[Clinical characteristics and treatment of AO/OTA A2.3 intertrochanteric fractures with posterior coronal plane fractures]

Objective: To explore the characteristics, the operative techniques and effect of AO/OTA A2.3 intertrochanteric fractures with posterior coronal fractures.

Methods: From January 2011 to January 2014, 33 patients suffered from AO/OTA A2.3 intertrochanteric fractures with posterior coronal fractures were treated with proximal femoral anti rotation nail, included 15 males and 18 females, with an average age of (73.1±8.2) years old ranged from 61 to 92 years old. According to AO/OTA classification, all cases were type A2.3 fracture. All cases were closed fractures and treated with limited open reduction and internal fixation. The postoperative hip function was evaluated by Harris score.

Results: One case was died at 19 days after operation, 32 cases were followed up from 9 to 24 months with an average of (16.3±5.1) months. Bone union time was from 6 to 9 months with an average of (7.2±1.5) months according to X rays. At the final followed up, Harris scores were 76 to 95 points with an average of (85.3±5.6) points;13 cases were classified as excellent, 16 as good, and 3 as fair.

Conclusions: AO/OTA A2.3 intertrochanteric fracture with posterior coronal fractures is a special type and unstable, it's difficult to reset. It needs to be fixed with proximal femoral anti rotation nail by limited open reduction. It is necessary that postoperative rehabilitation should be chosen individually.