The Journal of Bone and Joint Surgery, Vol 63, Issue 5 773-779, Copyright © 1981 by Journal of Bone and Joint Surgery, Inc
Closed treatment of subtrochanteric fractures of the femur in a modified cast-brace
JC DeLee, TO Clanton and CA Rockwood
We studied a series of fifteen consecutive subtrochanteric fractures
treated in a long quadrilateral cast-brace with a pelvic band. Patients
with severely comminuted fractures in which stability cannot be obtained by
internal fixation, as well as those with open fractures, are considered
candidates for such treatment. Treatment with preliminary traction followed
by a ambulatory cast-brace with a pelvic band resulted in a shorter period
of treatment, an excellent range of motion of the hip and knee, and no
non-unions in the fifteen comminuted or open fractures. Shortening,
angulation, and rotational deformity were not significant complications. It
must be emphasized that this treatment regimen requires exacting attention
to detail by the treating physician. The amount of time needed from the
physician in this form of treatment is considerably greater than that after
open reduction and internal fixation.