Locking compression plate fixation of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity: a retrospective study

Abstract

Background To investigate the clinical efficacy of locking compression plate fixation for the treatment of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity. Methods A retrospective analysis was conducted on 37 patients with femoral intertrochanteric fractures combined with preexisting proximal femoral deformity between January 2013 and July 2019. The patients included 24 males and 13 females aged from 23 to 69 years old, with an average age of 47.5 years. The preexisting proximal femoral deformities resulted from poliomyelitis sequela, proximal femoral fibrous dysplasia, malunion and implant failure combined with coxa vara after intramedullary nailing fixation. There were 6 cases of 31-A2.1, 6 cases of 31-A2.2, 20 cases of 31-A3.1, and 5 cases of 31-A3.2, determined based on the AO classification of intertrochanteric fractures. All fractures were managed through open reduction and locking plate fixation. The hip disability and osteoarthritis outcome score (HOOS) was used to assess hip function before injury and at the last postoperative follow-up. The short form 36 (SF-36) Health Survey Questionnaire was used to assess quality of life. Results Thirty-seven patients were followed up for 12 to 27 months (average, 20.7 months). All patients achieved bone healing within 5.1 months on average (range, 3 to 6 months). Postoperative complications included deep vein thrombosis in three patients, bedsores in one and delayed union in one patient. No other complications, such as surgical site infection, fat embolism, nonunion and re-fracture, were presented. There was no significant difference in the HOOS scores and the SF-36 Health Questionnaire outcomes at pre-injury and at the last postoperative follow-up (p > 0.05). Conclusions It is difficult to perform intramedullary fixation of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity, while locking compression plate fixation is a simple and effective method of treatment.

Clinical efficacy of internal fixation with locking compression plates in the treatment of patients with extremity fractures and the effect on the recovery of limb function

“…Their differences lie in the fact that LCP internal fixation is a minimally invasive procedure in which an incision is made proximally and distally to create a subcutaneous tissue tunnel for placement of a compression plate, thereby reducing surgical trauma, protecting the patient’s periosteum and surrounding soft tissues, and minimizing damage to the blood flow to the fracture site. [ 19 , 20 ] In addition, the plate has a locking threaded hole, which provides a more stable angle between the plate and the locking screw, and enables a stronger bond between the bone structure, the plate and the locking screw, effectively avoiding postoperative displacement. [ 21 , 22 ] Because of its rapid healing, patients will benefit from early functional limb training, which will improve their quality of life.…”

Observation of the clinical efficacy of percutaneous reduction by leverage combined with intramedullary nail internal fixation in the treatment of irreducible femoral intertrochanteric fracture: a retrospective single-arm cohort study

“…For patients with poor physical conditions, blind pursuit of anatomic reduction is not desirable. Repeated continuous reduction and prolonged surgery and anesthesia may lead to a significant increase in postoperative hidden blood loss in patients, which in turn leads to an increased risk of complications in patients (23)(24)(25). Therefore, priority should be given to the alignment of the fracture rather than complete reduction for frail elderly patients.…”