Evaluation of proximal femoral locking plate in unstable extracapsular proximal femoral fractures: Surgical technique & mid term follow up results

Abstract

Background: Stable trochanteric femur fractures can be treated successfully with conventional implants such as sliding hip screw, cephalomedullary nails, angular blade plates. However comminuted and unstable inter or subtrochanteric fractures with or without osteoporosis are challenging & prone to complications. The PF-LCP is a new implant that allows angular stability by creating fixed angle block for treatment of complex, comminuted proximal femoral fractures.

Method: We reviewed 30 patients with unstable inter or subtrochanteric fractures, which were stabilized with PF-LCP. Mean age of patient was 65 years, and average operative time was 80 min. Patients were followed up for a period of 3 years (June 2010-June 2013). Patients were examined regularly at 3 weekly interval for signs of union (radiological & clinical), varus collapse (neck-shaft angle), limb shortening, and hardware failure.

Result: All patients showed signs of union at an average of 9 weeks (8-10 weeks), with minimum varus collapse (<10°), & no limb shortening and hardware failure. Results were analysed using IOWA (Larson) hip scoring. Average IOWA hip score was 77.5.

Conclusion: PF-LCP represents a feasible alternative for treatment of unstable inter- or subtrochanteric fractures.

Keywords: Angular stability; Osteoporosis; PF-LCP; Proximal femur; Unstable.

Figures

Fig. 1

Showing PF-LCP applied over bone model.

Fig. 2

Showing PF-LCP applied over bone model.

Fig. 3

Showing reverse LISS applied over bone model; proximal portion is not sitting properly.

Fig. 4

Showing reverse LISS applied over bone model; proximal portion is not sitting properly.

Fig. 5

Showing unstable extracapsular proximal femoral fractures (Case no. 21).

Fig. 6

Showing unstable extracapsular proximal femoral fractures (Case no. 21).

Fig. 7

Showing immediate post op X-ray of the case (Case no. 21).

Fig. 8

Showing immediate post op X-ray of the case (Case no. 21).

Fig. 9

Showing 3 month post operative X-ray of the case (Case no. 21).

Fig. 10

Showing 3 month post operative X-ray of the case (Case no. 21).

Fig. 11

Showing unstable proximal femoral fracture (Case no. 3).

Fig. 12

Showing immediate post op X-ray of the case (Case no. 3).

Fig. 13

Showing immediate post op X-ray of the case (Case no. 3).

Fig. 14

Showing united fracture – 3 month follow up (Case no. 3).

Fig. 15

Showing unstable proximal femoral fractures (Case no. 14).

Fig. 16

Showing fracture stabilized with PF-LCP (Case no. 14).

Fig. 17

Showing union at fracture site with PF-LCP at 6 month follow up (Case no. 14).