A retrospective analysis of surgically-treated complex proximal femur fractures with proximal femoral locking compression plate

Syed Ibrahim, Jimmy Joseph Meleppuram, Syed Ibrahim, Jimmy Joseph Meleppuram

Abstract

Objective: Analyze the outcomes of proximal femoral locking compression plate (PF-LCP) in these complex fractures.

Methods: This study retrospectively analyzed 21 proximal femoral fractures treated with PF-LCP from June 2013 to February 2015. There were 15 females (71%) and six males (29%) with an average age of 61.4 years (range: 34-80 years). The peritrochanteric fractures constituted by intertrochanteric and subtrochanteric fractures were classified by the Boyd and Griffin classification and Seinshemier's classification, respectively. Among them, 16 cases (76%) were of intertrochanteric and five cases (24%) were of subtrochanteric fracture pattern. The functional outcome was assessed by Harris Hip Score and the Parker Palmer mobility score one year post-surgery.

Results: Among 21 patients, 19 patients obtained fracture union without further intervention; two patients required additional bone grafting. No cases of the hip screw cutting the femoral head were noted. There was no post-operative mortality in this study. The average Harris Hip Score was 84.5 (range: 83-94). The assessment by Parker and Palmar mobility score was 7.5 (range: 4-9).

Conclusion: The PF-LCP is a good, stable alternative in the treatment of peritrochanteric femoral fractures. It provides good-to-excellent bone healing with reduced complications.

Keywords: Bone plates; Femoral fractures; Fracture fixation; Internal.

Figures

Fig. 1
Fig. 1
Proximal femur locking compression plate with screws set.
Fig. 2
Fig. 2
(a, b) Pre-operative X-rays of 60 years female with left complex proximal femoral fracture; (c, d) immediate post-op X-rays after PF-LCP fixation; (e, f) X-rays showing united fracture at one year follow-up; (g, h) clinical picture showing excellent functional outcome as well as the Parker and Palmar mobility score of 5.7 for the patient.
Fig. 3
Fig. 3
(a, b) Pre-operative X-rays of 36 year male with right complex proximal femoral fracture; (c, d) 3 month post-op X-rays after PF-LCP fixation showing delayed union and required additional bone grafting; (e, f) X-rays showing good fracture union at end of one year; (g, h) clinical picture showing fair functional outcome and Parker–Palmar mobility score of 7.7 for the patient.

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