The effect of nonanatomic positive medial cortical support on the reduction stability of unstable pertrochanteric proximal femur fractures: A cohort study.

Older adults with osteoporosis often face challenges from pertrochanteric hip fractures, leading to suboptimal functional outcomes despite high union rates. For that reason, we conducted this study to evaluate the outcomes of these fractures, focusing on the impact of positive and negative medial cortical support on postoperative stability and recovery. Key factors influencing treatment success include bone quality, fracture configuration, and the effectiveness of fixation methods, with emerging criteria like the Chang reduction quality criteria offering improved assessment of stability. A retrospective analysis of 154 patients aged 60 and older with pertrochanteric fractures was conducted to evaluate the impact of fracture reduction quality on clinical outcomes. The study focused on pre-injury conditions, surgical techniques, postoperative recovery, and complications, highlighting the importance of effective management in this population. The study analyzed 154 patients with pertrochanteric fractures, categorizing them by medial cortex position, revealing significant differences in femoral neck-shaft angle loss and time to full weight-bearing among groups. Patients with positive medial cortical support experienced the least loss and achieved full weight-bearing faster than those with negative support. This study evaluates the clinical significance of the Chang reduction quality criteria in pertrochanteric fractures, highlighting its impact on neck-shaft angle changes and time to full weight-bearing among patients with varying medial cortical support. Results indicate that better reduction quality correlates with improved surgical outcomes and faster recovery, emphasizing the importance of achieving optimal fracture alignment. The Chang reduction quality criteria is a reliable and comprehensive tool for evaluating the quality of fracture reduction. Restoring normal hip biomechanics and allowing early mobilization are key to achieving a reduction with positive or neutral medial cortical support. This helps keep complications to a minimum and speeds up the patient's recovery.