Abstract
Intertrochanteric fractures are quite common in the elderly age group due to the osteoporotic nature of the bone. Unstable fracture patterns are challenging to treat and would require an implant which would address the requirements. This study was performed to evaluate the functional outcome following management of these fractures with PFLP (Proximal femoral locking plate). Thirty patients with unstable intertrochanteric fractures who presented between January 2012 to January 2015 were managed by ORIF (Open reduction and internal fixation) with PFLP and were followed up for three years. Functional assessment was performed using the Harris hip score. There was a female preponderance seen in our study with the left side being more commonly affected. The most common mode of injury was slip and fall, and Boyd and Griffin type 3 was the most common fracture type seen. The mean Harris hip score was 83.6(82-95). We were able to achieve a 100% union rate in our series with minimal complications. ORIF with PFLP is a good treatment option in the management of unstable intertrochanteric fractures and gives good rates of union and functional outcomes.
Full text article
References
Crist, B. D., Khalafi, A., Hazelwood, S. J., Lee, M. A. 2009. A Biomechanical Comparison of Locked Plate Fixation With Percutaneous Insertion Capability Versus the Angled Blade Plate in a Subtrochanteric Fracture Gap Model. Journal of Orthopaedic Trauma, 23(9):622–627.
Glassner, P. J., Tejwani, N. C. 2011. Failure of Proximal Femoral Locking Compression Plate: A Case Series. Journal of Orthopaedic Trauma, 25(2):76– 83.
Hasenboehler, E. A., Agudelo, J. F., Morgan, S. J., Smith, W. R., Hak, D. J., Stahel, P. F. 2007. Treatment of Complex Proximal Femoral Fractures With the Proximal Femur Locking Compression Plate. Orthopedics, 30(8):618–623.
Jensen, J. S. 1980. Classification of trochanteric fractures. Acta Orthopaedica Scandinavica, 51(1- 6):803–810.
Kumar, N., Kataria, H., Yadav, C., Gadagoli, B. S., Raj, R. 2014. Evaluation of proximal femoral locking plate in unstable extracapsular proximal femoral fractures: Surgical technique & mid term follow up results. Journal of Clinical Orthopaedics and Trauma, 5(3):137–145.
Lorich, D. G., Geller, D. S., Nielson, J. H. 2004. Osteoporotic Pertrochanteric Hip Fractures. The Journal of Bone & Joint Surgery, 86(2):398–410.
Nieves, J. W., Bilezikian, J. P., Lane, J. M., Einhorn, T. A., Wang, Y., Steinbuch, M., Cosman, F. 2010. Fragility fractures of the hip and femur: incidence and patient characteristics. Osteoporosis International, 21(3):399–408.
Schipper, I. B., Marti, R. K., van der Werken, C. 2004. Unstable trochanteric femoral fractures: extramedullary or intramedullary fixation. Injury, 35(2):142–151.
Seinsheimer, F. 1978. Subtrochanteric fractures of the femur. The Journal of Bone & Joint Surgery, 60(3):300–306.
Shah, M. D., Kapoor, C. S., Soni, R. J., Patwa, J. J., Golwala, P. P. 2017. Evaluation of outcome of proximal femur locking compression plate (PFLCP) in unstable proximal femur fractures. Journal of Clinical Orthopaedics and Trauma, 8(4):308–312.
Streubel, P. N., Moustoukas, M. J., Obremskey, W. T. 2013. Mechanical Failure After Locking Plate Fixation of Unstable Intertrochanteric Femur Fractures. Journal of Orthopaedic Trauma, 27(1):22– 28.
Werner-Tutschku, W., Lajtai, G., Schmiedhuber, G., Lang, T., Pirkl, C., Orthner, E. 2002. Intra-and perioperative complications in the stabilization of per and subtrochanteric femoral fractures by means of PFN. Der Unfallchirurg, (10):881–886.
Wieser, K., Babst, R. 2010. Fixation failure of the LCP proximal femoral plate 4.5/5.0 in patients with missing posteromedial support in unstable per-, inter-, and subtrochanteric fractures of the proximal femur. Archives of orthopaedic and trauma surgery, 130(10):1281–1287.
Zha, G. C., Chen, Z. L., Qi, X. B., Sun, J. Y. 1299. Treatment of pertrochanteric fractures with a proximal femur locking compression plate. Injury, 42(11):1294–1299.
Authors
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.