BIAXIAL DYNAMIZATION IN UNSTABLE INTERTROCHANTERIC FRACTURES - GOOD EXPERIENCE WITH A SIMPLIFIED MEDOFF SLIDING PLATE IN 94 PATIENTS

In a prospective study, 94 consecutive patients with unstable intertro chanteric fractures were treated by 16 surgeons, using a modified 4-ho le Medoff sliding plate and followed clinically and radiographically f or 1 year. Weight bearing after surgery was allowed as tolerated. This new device is smaller and uses a simpler technique of insertion than the original 6-hole Medoff sliding plate. The modification of the plat e makes biaxial sliding along both the shaft and the neck of the femur obligatory. All fractures united and no postoperative lag screw penet ration occurred. The use of a shorter side-plate with 4 cortical bone screws was sufficient for fixation and no plate loosening or breakage was observed. On the basis of this experience, biaxial dynamization se ems to facilitate fracture impaction and stability, and the simplified 4-hole Medoff sliding plate appears to be a suitable method for the t reatment of unstable intertrochanteric fractures.