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OBJETIVO: Estudar o desfecho de fraturas subtrocantéricas de quadril tratadas com placa de bloqueio lateral da parte proximal do fêmur. MÉTODO: Revisamos retrospectivamente os resultados clínicos de 48 casos de fraturas subtrocantéricas tratadas com placas de bloqueio lateral da parte proximal do fêmur de janeiro de 2008 a maio de 2010. Registrou-se o progresso da consolidação da fratura, assim como a ocorrência de complicações. A função da articulação do quadril foi avaliada pelo índice social de Harris e o escore de mobilidade de Parker-Palmer, um ano após a cirurgia. RESULTADO: Quarenta e cinco pacientes foram acompanhados até a união da fratura ou a revisão da cirurgia. Entre os 45 pacientes, 43 atingiram a união da fratura sem outra intervenção. Trinta e oito fraturas consolidaram sem perda da posição no acompanhamento de um ano. Não houve casos de perfuração da cabeça do fêmur pelo parafuso. O escore médio do índice social de Harris foi 86,5 ± 9,8 (73 ~95). A média do escore de mobilidade de Parker e Palmer foi 7,4 ± 2,1 (3~ 9). CONCLUSÃO: A placa de bloqueio lateral da parte proximal do fêmur é o tipo de fixação interna estável e efetiva para tratar as fraturas subtrocantéricas de quadril e tem a vantagem de fixação estável, em especial em fratura da parede lateral do fêmur. Nível de evidência IV, Série de Casos. OBJECTIVE: To study the outcome of subtrochanteric hip fractures treated by using a proximal lateral femur locking plate. METHOD: We retrospectively reviewed the clinical results of 48 cases of femoral subtrochanteric fractures treated with proximal lateral femur locking plates from Jan 2008 to May 2010. The progress of fracture healing, as well as the occurrence of complications, was recorded. The function of the hip joint was evaluated by Harris social index and the Parker and Palmer mobility score at 1 year after the operation. RESULT: 45 patients were followed up until fracture union or a revision surgery. Among the 45 patients, 43 patients obtained fracture union without further intervention. 38 fractures healed with no loss of position at the 1-year follow-up. There were no cases of hip screw cutting through the femoral head. The mean score of Harris social index was 86.5±9.8 (73~95). The mean Parker and Palmer mobility score was 7.4±2.1 (3~9). CONCLUSION: The proximal lateral femur locking plate is the kind of stable and effective internal fixation of treating subtrochanteric hip fractures which has the advantage of stable fixation especially for the lateral femoral wall fracture. Level of Evidence IV, Case Series.

OBJECTIVE:To evaluate the differences in spinal stability and stabilizing potential of instrumentation after cervical corpectomy and spondylectomy. METHODS: Seven human cadaveric specimens were tested: 1) intact; 2) after grafted C5 corpectomy and anterior C4-C6 plate; 3) after adding posterior C4-C6 screws/rods; 4) after extending posteriorly to C3-C7; 5) after grafted C5 spondylectomy, anterior C4-C6 plate, and posterior C4-C6 screws/rods; and 6) after extending posteriorly to C3-C7. Pure moments induced flexion, extension, lateral bending, and axial rotation; angular motion was recorded optically. RESULTS: After corpectomy, anterior plating alone reduced the angular range of motion to a mean of 30% of normal, whereas added posterior short- or long-segment hardware reduced range of motion significantly more (P < 0.003), to less than 5% of normal. Constructs with posterior rods spanning C3-C7 were stiffer than constructs with posterior rods spanning C4-C6 during flexion, extension, and lateral bending (P < 0.05), but not during axial rotation (P > 0.07). Combined anterior and C4-C6 posterior fixation exhibited greater stiffness after corpectomy than after spondylectomy during lateral bending (P = 0.019) and axial rotation (P = 0.001). Combined anterior and C3-C7 posterior fixation exhibited greater stiffness after corpectomy than after spondylectomy during extension (P = 0.030) and axial rotation (P = 0.0001). CONCLUSION: Circumferential fixation provides more stability than anterior instrumentation alone after cervical corpectomy. After corpectomy or spondylectomy, long circumferential instrumentation provides better stability than short circumferential fixation except during axial rotation. Circumferential fixation more effectively prevents axial rotation after corpectomy than after spondylectomy. Synthes Spine