Trochanteric femoral fractures treated with McLaughlin osteosynthesis.

Of 317 patients with trochanteric femoral fractures, 305 were treated with McLaughlin osteosynthesis. The mortality rate was 14.5 per cent. The postoperative complication rate (35.6 per cent) was dominated by cardiopulmonary (10.6 per cent) and thromboembolic (10.6 per cent) events. Wound infection was found in 3.8 per cent and osteitis in 0.9 per cent. In all, 106 patients had stable fractures according to the Evans classification. Of these, four had to be re-operated due to penetration or a loose bolt. Two hundred and eleven patients (66.6 per cent) had unstable fractures. Follow-up of 169 patients showed two-thirds to have healed in unchanged position. Only 14.8 per cent of the 169 patients had significant fracture complications, particularly varus dislocation of more than 20 degrees (nine patients) and penetration of the nail (eight patients). A total of 10 patients (5.9 per cent) had to be re-operated because of varus dislocation, broken plate or development of pseudarthrosis after removal of the osteosynthesis material. McLaughlin osteosynthesis is concluded to be a suitable method for the treatment of trochanteric femoral fractures--also of the unstable type.