PMC8505106_01
X-ray of case 1: ((a) subtrochanteric fracture; (b) missed fixation of DCP; (c) atrophic nonunion with fracture of the DHS system; (d) locked plate osteosynthesis).
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fig1
The diagnosis of subtrochanteric fracture classified 32C3 according to AO/OTA (Figure 1(a)) is made and a dynamic compressive plate osteosynthesis performed in a clinic. The patient is referred to us 2 weeks postoperatively for posttraumatic plate removal (Figure 1(b)). The evolution after six (6) postoperative months is marked by atrophic pseudarthrosis and a rupture of the plate in the 8th month (Figure 1(c)). The management consisted of a cure of nonunion, a spongy graft, and the internal fixation by a locking plate for proximal femur (Figure 1(d)).
PMC8505106_02
X-rays of patient 2. (a) DHS osteosynthesis of neck fracture. (b) Neck pseudarthrosis with phenomenon. (c) Cut out phenomenon with cephalic osteonecrosis. (d) Right hemiarthroplasty.
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fig2
The clinical and paraclinical examination made it possible to make the diagnosis of transcervical fracture of the femoral neck classified 31B2.3 according to AO/OTA (Figure 2(a)). The course is marked by pain in the hip, pseudarthrosis of the fracture site, and necrosis of the femoral head and a gradual migration of the DHS system objectified in the 4th (Figure 2(b)) and 6th month (Figure 2(c)) postoperatively. The management consisted of a hip hemiarthroplasty (Figure 2(d)).
PMC8505106_03
X-rays of patient 3. (a) Osteosynthesis y DHS. (b) Subtrochanteric malunion with pseudarthrosis of femur neck. (c) Cut out phenomenon. (d) Hemiarthroplasty.
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fig3
AO/OTA (Figure 3(a)). A 7-hole DHS was installed. The evolution is marked by a vicious callus in the subtrochanteric region in the 4th postoperative month and pseudarthrosis of the femoral neck (Figure 3(b)). In the 6th postoperative month, osteonecrosis of the femoral head and dynamic screw migration is observed (Figure 3(c)).
PMC8505106_04
X-rays of patient 4. (a) Pertrochanteric fracture type 31A1.3 AO/OTA. (b) Osteosynthesis by DHS.
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fig4
The fracture was stabilized using the DHS system (Figure 4(b)) after 3 days.
PMC8505106_05
X-rays of patient 4. (a) Pertrochanteric fracture type 31A1.3 AO/OTA. (b) Osteosynthesis by DHS.
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fig4
The fracture was stabilized using the DHS system (Figure 4(b)) after 3 days.
X-rays of patient 5. (a) Pertrochanteric fracture of the left hip class 31A1.2 according to AO/OTA. (b) Osteosynthesis by DHS.
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fig5
At presentation, he was hemodynamically stable, and radiographs confirmed a minimally displaced pertrochanteric fracture of the left hip class 31A1.2 according to AO/OTA (Figure 5).