Objective: To explore the effect of Mimics assisted virtual reduction and personalized additional fixation with proximal femoral nail anti rotation in the treatment of unstable intertrochanteric fracture of lateral wall.
Methods: From January 2015 to June 2018, 11 cases of intertrochanteric fracture with unstable lateral wall injury were analyzed retrospectively, including 3 males and 8 females, aged 64 to 81 years old. There were 3 cases of A3.1, 6 cases of A3.2 and 2 cases of A3.3 according to AO classification. All patients underwent CT scanning, according to the CT scanning data, three-dimensional reconstruction of fracture was performed by Mimics soft. Virtual reduction was performed first, and PFNA was implanted after satisfactory reduction. According to the relationship between the fracture characteristics of the lateral wall and the position of the lag screw tail in the lateral wall, 4 cases were treated with PFNA and titanium cable or steel wire, and 7 cases were treated with PFNA and reconstruction locking plate.The quality of reduction and healing were evaluated by follow up, and Harris score of hip joint was performed in the last reexamination.
Results: All patients were followed up for 12 to 18 months. No postoperative infection of incision and loosening of internal fixation occurred. The time of fracture healing was 12 to 20 weeks. At the final follow up, Harris score of hip joint was excellent in 6 cases, good in 3 cases and fair in 2 cases.
Conclusion: The treatment of intertrochanteric fracture of femur with Mimics assisted virtual reduction and PFNA is helpful to preoperative planning and improve the surgical effect.
Keywords: Femoral fractures; Fracture fixation, intramedullary; Hip frcatures; Mimics soft.