AO Reconstruction Plate as Buttressing for Greater Trochanter in Hemiarthroplasty Procedure

Luthfi Hidayat, Aditya Fuad Robby Triangga, Rahadyan Magetsari



The trend of intertrochanter fractures has gradually increased leading to a high frequency of difficulties and damage as the result of the increased age and risk factors. Accordingly, the aim of stable fixation in these fractures is designed with appropriate surgical procedures and patient care. The contribution of a stable fixation is due to several considerations including fracture shape and assurance, bone quality, comminution pattern, implant choice, and surgical technique. This study aimed to assess the functional outcomes of the patients with an intertrochanteric fracture who underwent hemiarthroplasty with AO recon as buttressing.


This was a case series study conducted in Gadjah Mada University Academic Hospital in Yogyakarta from July 2017 to August 2018. Patients with Evans unstable intertrochanteric femoral fractures who underwent simultaneous bipolar hemiarthroplasty and fixation with AO reconstruction plate and SS wire as buttressing were evaluated. Pre and postoperative radiographs, postoperative Visual Analog Scale (VAS) score, walking ability using Harris Hip Score (HHS), and Lower Extremity Functional Score (LEFS) were the outcome parameters.


A total of 6 patients, 4 of whom were male with an average age of 81 years old were included in this study. All the mechanisms of injury were low-energy trauma. The mean VAS score was decreased, from 7 pre-operatively to 1.5 post-operatively at final follow-up (p-value < 0.05). The patients had a mean HHS of 82.5 and a LEFS mean of 56.7.


Buttress plate fixation using an AO reconstruction plate for trochanteric fracture following bipolar hemiarthroplasty resulted in a good functional outcome. 


Hemiarthroplasty; AO reconstruction plate; Intertrochanteric fracture; Functional outcome

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Lee J-M, Cho Y, Kim J, Kim D-W. Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note. Hip Pelvis. 2017;29(1):44. doi:10.5371/hp.2017.29.1.44

Kim GM, Nam KW, Seo KB, Lim C, Kim J, Park YG. Wiring technique for lesser trochanter fixation in proximal IM nailing of unstable intertrochanteric fractures: A modified candy-package wiring technique. Injury. 2017;48(2):406-413. doi:10.1016/j.injury.2016.11.016

Lee YK, Ha YC, Chang BK, Kim KC, Kim T young, Koo KH. Cementless Bipolar Hemiarthroplasty Using a Hydroxyapatite-Coated Long Stem for Osteoporotic Unstable Intertrochanteric Fractures. J Arthroplasty. 2011;26(4):626-632. doi:10.1016/j.arth.2010.05.010

Luo X, He S, Zeng D, Lin L, Li Q. Proximal femoral nail antirotation versus hemiarthroplasty in the treatment of senile intertrochanteric fractures: Case report. Int J Surg Case Rep. 2017;38:37-42. doi:10.1016/j.ijscr.2017.04.027

Lim YW, Chang YJ, Kwon SY, Kim YS. A simple method using a PACS to minimize leg length discrepancy in primary THA. A method to minimize leg length discrepancy. J Arthroplasty. 2013;28(10):1791-1795. doi:10.1016/j.arth.2013.02.022

Chan KC, Gill GS. Cemented hemiarthroplasties for elderly patients with intertrochanteric fractures. Clin Orthop Relat Res. 2000;(371):206-215. doi:10.1097/00003086-200002000-00025

Qi X, Zhang Y, Pan J, Ma L, Wang L, Wang J. Effect of Bone Cement Implantation on Haemodynamics in Elderly Patients and Preventive Measure in Cemented Hemiarthroplasty. Biomed Res Int. 2015;2015. doi:10.1155/2015/568019

Amstutz H, Mai L, Schmidt I. Results of interlocking wire trochanteric reattachment and technique refinements to prevent complications following total hip arthroplasty. Clin Orthop Relat Res. 1984;(183):82-89.

Barrack RL, Butler RA. Current status of trochanteric reattachment in complex total hip arthroplasty. Clin Orthop Relat Res. 2005;(441):237-242. doi:10.1097/01.blo.0000191274.42410.40

Boardman K, Bocco F, Charnley J. An evaluation of a method of trochanteric fixation using three wires in the Charnley low friction arthroplasty. Clin Orthop Relat Res. 1978;(132):31-38.

Aktselis I, Kokoroghiannis C, Fragkomichalos E, et al. Prospective randomised controlled trial of an intramedullary nail versus a sliding hip screw for intertrochanteric fractures of the femur. Int Orthop. 2014;38(1):155-161. doi:10.1007/s00264-013-2196-7

Babst R, Renner N, Biedermann M, et al. Clinical results using the trochanter stabilizing plate (TSP): the modular extension of the dynamic hip screw (DHS) for internal fixation of selected unstable intertrochanteric fractures. J Orthop Trauma. 1998;12(6):392-399. doi:10.1097/00005131-199808000-00005

Madsen J, Naess L, Aune A, Alho A, Ekeland A, Strømsøe K. Dynamic hip screw with trochanteric stabilizing plate in the treatment of unstable proximal femoral fractures: a comparative study with the Gamma nail and compression hip screw. J Orthop Trauma. 1998;12(4):241-248. doi:10.1097/00005131-199805000-00005

Rodop O, Kiral A, Kaplan H, Akmaz I. Primary bipolar hemiprosthesis for unstable intertrochanteric fractures. Int Orthop. 2002;26(4):233-237. doi:10.1007/s00264-002-0358-0



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