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

Abstract

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.

Comparison of locking plate and cephalomedullary nailing in unstable proximal femur fractures

“…To achieve a successful treatment, the clinical, anatomical and biomechanical characteristics of the region must be well known [3,6]. Although these fractures are seen in all age groups, they are mostly seen in elders with low energy injuries (falling) and in young people with high energy injuries (traffic accident or falling from a high level) [2]. In our study, the number of high energy trauma was 14, and low energy trauma was 22.…”

“…Unstable proximal femur fractures are difficult entities even for experienced surgeons [2]. To achieve a successful treatment, the clinical, anatomical and biomechanical characteristics of the region must be well known [3,6].…”

“…The mean age was 60, but the age interval was 19-90. In the surgical method of implant selection in unstable proximal femur fractures, many treatment methods were suggested in the past, and there were still discussions about that [2][3][4][7][8][9][10]. In one of them that is 95 degree wedged condylar plates, fusion rate had been found 92-100 %, malunion was 13-24%, the late union was 6-19%, nonunion was 3-12%, and implant failure was 6-24% [9].…”

“…Even if it is seen in all age groups, it is mostly seen in elderly patients (low energy trauma like falling) and young people (high energy trauma like falling from a high level and traffic accident) [2]. Recently, CMN has been the standard treatment due to fewer complication rates than hip nails in unstable proximal femur fractures [3].…”

Comparison of proximal femur locking compression plate and proximal femur nail in treatment of complex proximal femoral fractures

“…The result concurred with studies. In 2013 Mirbolook, Babak Siavashi, Adel et al [13] concluded that the results of pertrochanteric fracture fixation by intramedullary or locking plate were similar and had the same outcome. Neither treatment has statistically significant difference in complications, onset of complications incidence, and time of full-weight bearing.…”