Failure of Proximal Femoral Locking Compression Plate: A Case Series

Glassner, Philip J.; Tejwani, Nirmal C.

doi:10.1097/bot.0b013e3181e31ccc

Cited by 98 publications

(89 citation statements)

References 6 publications

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“…Glassner in his study stated that five of the seven cases treated with locking plate developed complications and device failure after 12.7 days, in average [10]. Our study is also partly consistent with Glassner's results; as 44 % of the patients experienced complications during the first 10 days.…”

Section: Discussionsupporting

confidence: 91%

“…It is attributed to the stiffness of this tool that prevents any fracture site micromotion, placing the mechanical burden on the implant, which can result in failure at the bonescrew interface or fatigue failure of the implant itself [9]. In Glassner's study, seven treatment failures with the locking plate were due to nonunion, implant fracture, and loss of fixation [10]. Generally, different causes for this issue are intended.…”

Section: Discussionmentioning

confidence: 99%

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Subtrochanteric Fractures: Comparison of Proximal Femur Locking Plate and Intramedullary Locking Nail Fixation Outcome

et al. 2013

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Fixation of subtrochanteric fracture, even for experienced surgeons, is a challenge. This fracture is most difficult to treat, and the incidence of complications in this type of fracture is higher. This study compared surgical results of two methods, proximal femur locking compression plate and intramedullary locking nail. This is an analytic study, performed on all patients with subtrochanteric fracture who were referred to the hospital during 3 years. They were treated with proximal femur locking plate or intramedullary locking nail. The postoperative complications were evaluated and recorded. Finally, the data were analyzed by SPSS software. Complications were studied in both groups. Neither treatment has statistically significant difference in complications, onset of complications incidence, and time of full-weight bearing. Although the Harris Hip Score among patients improved in both methods of treatment, there is no significant difference between the two groups. The results of subtrochanteric fracture fixation by intramedullary or locking plate were similar and had the same outcome.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Subtrochanteric Fractures: Comparison of Proximal Femur Locking Plate and Intramedullary Locking Nail Fixation Outcome

et al. 2013

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“…In contrast to this the PFLCP act as angular stable devices and provide rigid fixation. But they are associated with a higher number of varus collapse and implant failure [13,14]. To overcome this problem the reverse-DFLCP of the contralateral side has been advocated by some authors, as it provides an added number of screw options for proximal femoral fracture fragment, resulting in a more stable construct [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

“…Due to higher failure rates of proximal femoral locking compression plate [13,14], some authors advocated the use of reverse distal femoral locking compression plate (reverse-DFLCP) of the contralateral side for intertrochanteric fractures, as it provided an added number of screw options for proximal femoral fracture fragments, thus resulting in a more stable construct with higher pull out resistance [15][16][17]. Clinical studies have also showed good results of reverse-DFLCP when compared to intramedullary devices [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Proximal femoral nails compared with reverse distal femoral locking plates in intertrochanteric fractures with a compromised lateral wall; a randomised controlled trial

Haq

Manhas

Pankaj

et al. 2014

International Orthopaedics (SICOT)

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Purpose There is no consensus about the best option of internal fixation for unstable intertrochanteric fractures. The aim of the present study was to compare proximal femoral nail (PFN) with contralateral reverse distal femoral locking compression plate (reverse-DFLCP) in the management of unstable intertrochanteric fractures with compromised lateral wall. Method In a randomized controlled study, from November 2011 to October 2012, 40 patients with unstable intertrochanteric fractures with compromised lateral wall (AO 31A 2.2 to 3.3) had osteosynthesis by PFN (n=20) or reverse-DFLCP (n=20). Intraoperative variables compared were duration of surgery, blood loss during surgery, fluoroscopy time and surgeons perception of the surgery. Patients were followed up clinically for a minimum of one year. Functional outcome was assessed by Parker Palmer mobility score (PPMS), Harris hip score (HHS), and Short Form-12. Failure was defined as any condition which would necessitate revision surgery with change of implant. Results Duration of surgery (p=0.022), blood loss during surgery (p=0.008) and fluoroscopy time (p=0.0001) were significantly less in the PFN group than in the reverse-DFLCP group. No significant difference was found in type of reduction, difficulty in reduction and surgeon's perception of surgery. The PFN group had better functional outcome than the reverse-DFLCP group. HHS for the PFN group was 81.53±13.21 and for the reverse-DFLCP group it was 68.43±14.36 (p=0.018). SF-12 physical (p=0.002) and mental component (p=0.007) scores in the PFN group was significantly better than in the reverse-DFLCP group. There was one failure in the PFN group as compared to six in the reverse-DFLCP group (p=0.036). Conclusion Due to favourable intra-operative variables, better functional outcome and lower failure rates, we conclude that PFN is a better implant than reverse-DFLCP for intertrochanteric fractures with compromised lateral wall.

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“…Concluded that seven failures in their cases may be partially the result of patient factors as well as technical factors; however, there appears to be a high rate of failure even when surgery is performed by experienced and fellowship-trained traumatologists. 25 In 2011 Zhongguo Gu Shang et al in comparative study of intertrochanteric fractures treated with proximal femur locking compress plate in elderly patients and compared the clinical outcomes of dynamic hip screw (DHS), intramedullary fixation (IF) and proximal femur locking plate (PF-LCP) in the treatment of 165 old patients with intertrochanteric fractures were treated respectively by DHS, IF, PF-LCP. There were58 DHS, 65 IF and 42 PF-LCP cases in study.…”

mentioning

confidence: 99%

Study of proximal femoral locking compression plate in extra capsular fracture neck of femur

Ravi

Saheb

2015

Int J Res Med Sci

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Background:The hip joint transmits weight several times that of the body weight particularly during running, functioning as both a highly mobile and very stable joint. In weight bearing the pressure forces are transmitted to the head and neck of the femur at an angle of 1650 to 1700, regardless of the position of pelvis. The planes of force coincide with strongly developed trabeculae. The reacting force normally runs perpendicular to the cartilaginous epiphyseal plate. The mechanism of bone failure in a structure will fail if it suffers an overload situation. An overload situation will occur if the system is unable to absorb the energy that is applied to it. In the hip joint area this overload situation can occur as a result of number of independent but often interrelated factors. The present work is conducted to study the; profiles of patients with extra capsular fracture neck of femur, efficiency and outcome of fractures treated with Proximal Femoral Locking Compression Plate (PFLCP), intra -operative & post-operative complication following management of extra capsular fracture neck of femur with Proximal Femoral Locking Compression Plate. Methods: This is a prospective study of 21 cases of extra capsular fracture neck of femur admitted to Victoria and Bowring and Lady Curzon Hospitals, Bangalore, treated with PFLCP. Results: In our study of 21 cases, cases 13 cases were intertrochanteric fracture and remaining 8 were subtrochanteric fracture with the mean age was 51.47 years. Minimum age was 19 years and maximum age was 85 years. 14 patients (67%) were males and 7 patients (33%) were females, 13 IX patients (62%) had right-sided fracture and 8 patients (38%) had left-sided fracture. with right side being more common side affected. The average duration of stay in the hospital was 25.31 days. The average follow up was 18 months [11 to 23 months]. Out of 21 patients in our study 16 patients (76%) are able to sit cross-legged and can squat on ground without any problem. The functional results were graded according to Harris Hip Scoring, In our study, 10 patients (48%)had excellent results, 8 patients (38%)had good results, 2 patients (10%)had poor result, and 1 failed case (5%) as she is an elderly female of 85 years with limited activity both preoperatively due to physiological age and general weakness. Conclusions: In conclusion the potentiality of the Proximal Femoral Locking Compression Plate (PF-LCP) in varied indications, shows its versatility. Although not free of complications our study has demonstrated excellent results. The procedure offers, faster mobilization, rapid return to activities of daily living, improves the quality of life and gave a long term solution in patients with extracapsular fracture neck of femur. Larger studies with longer follow up will further validate the procedure.

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Failure of Proximal Femoral Locking Compression Plate: A Case Series

Cited by 98 publications

References 6 publications

Subtrochanteric Fractures: Comparison of Proximal Femur Locking Plate and Intramedullary Locking Nail Fixation Outcome

Subtrochanteric Fractures: Comparison of Proximal Femur Locking Plate and Intramedullary Locking Nail Fixation Outcome

Proximal femoral nails compared with reverse distal femoral locking plates in intertrochanteric fractures with a compromised lateral wall; a randomised controlled trial

Study of proximal femoral locking compression plate in extra capsular fracture neck of femur

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