The outcome in early Cases of Treatment of Subtrochanteric Fractures with Proximal Femur locking Compression Plate

Abstract

The objective of this study was to evaluate the outcome in early treatment of subtrochanteric fractures with proximal femur locking compression plate (PF-LCP).The patients included in this study were those with subtrochanteric fractures (AO type 32A-C) treated with PF-LCP (Synthes) between Jan 2009 and Jun 2011. The patient characteristics and details of clinical conditions were obtained from records. Clinical and radiographic follow-ups were done at one, two, four and 6 months intervals, and at one year. The primary outcome studied included fracture union and functional ambulatory status. Twenty-six patients were included in the study, 19 of whom were male with a mean age of 42.4 years. Fourteen patients (53.9%) had sustained AO type 32B fractures, the majority in motor vehicle accidents. Twenty-two fractures (84.6%) achieved union, while sixpatients (23.1%) had complications such as broken plate, varus collapse, and broken screw. Four patients (15.4%) underwent a second operation. At the end of the follow-ups, 25 patients (96.2%) were community ambulators. We conclude that PF-LCP is an effective alternative treatment for subtrochanteric fractures when properly performed.

Comparison of the Clinical Effectiveness of PFNA, PFLCP, and DHS in Treatment of Unstable Intertrochanteric Femoral Fracture

“…It is one of the most prevalent fractures seen in elderly women with osteoporosis. 1,2 Most clinicians are in agreement that conservative treatment of unstable intertrochanteric femoral fracture leads to severe complications and sequelae. Therefore, aggressive surgical intervention is recommended in patients with these fractures, along with the use of a variety of implants.…”

“…Therefore, aggressive surgical intervention is recommended in patients with these fractures, along with the use of a variety of implants. [2][3][4] Poor bone quality, loss of fixation, excessive collapse, and lag screw cut out are frequent complications encountered in treatment of these fractures. 5 The subtrochanteric area of the femur is defined as the region between the lesser trochanter and the junction of the proximal and the middle third of the femur.…”

A prospective study for the treatment of femur bone fracture following femur plate fixation with a screws to achieve initial stability and early mobilization

“…Implant related complications, non-union is the major cause reported after surgery but in our study, no case of non-union, mal union or delayed union was observed. 5,6,[9][10][11][14][15][16] Non implant related clinical complications, infection has the highest rate of occurrences, because surgical sites were usually more prone to infection which can either be a deep infection or superficial infection. 4,10,11,14,15 In our study neither of the patients were affected with either of the types of infection, proper sterilization of implants was done before surgery as well as patients were on very high vigilance during the period of hospitalization with the sterilized environment conditions.…”

“…4,13 10-34% femur bone fracture has subtrochanteric type of fractures and the Distal end of the femur bone has a 6% chance of fracture apart from this proximal femur fracture have a 50% chance. [5][6][7] Furthermore, the type of stable fracture and unstable fracture affects mobility until the complete bony union is achieved. 8 Some other methods of bone fracture healing were also there but in that cases the reoperation rate is reported higher in percentage like of dynamic hip screw (DHS) and intramedullary nails is reported to be 8.2% and 3-12.7% respectively Hence, plates are designed to apply in minimally invasive fashion to preserve local biology and avoid problems with fracture healing and infection.…”

Clinical analysis using proximal femoral locking plate in the management of complex, comminuted pertrochanteric femoral fractures in adults: a prospective study

“…15 Gunadham et al reported 23% failure rate in a comparative analysis of 26 patients with subtrochanteric fractures including 2 broken plates, 1 broken screw, 1 non-union and 2 varus collapse. 16 Glassner et al reported a case series including 10 patients with implant failure in 7 cases (70%) with 2 plate and 2 screw breakages and loss of fixation from varus collapse and implant cut-out in 3 cases. 17 Our short series did not have any case of varus collapse.…”