A retrospective analysis of surgically-treated complex proximal femur fractures with proximal femoral locking compression plate (original) (raw)
Related papers
Surgical outcome of proximal femoral fractures using proximal femoral - locking compression plate
2015
Introduction: Proximal femoral fractures are complex fractures following devastating injuries in young and elderly population. Despite marked improvement in implant design, surgical technique and patient care these fractures are associated with high incidence of implant failure, refracture and varus collapse. Intramedullary nails are technically demanding and associated with high re-operation rates. The study was done to evaluate the outcome of proximal femoral fractures treated with proximal femur locking compression plate (PF-LCP). Methods: This study is conducted at Al Ameen Medical College and Hospital, Bijapur during the period Jan 2012 to March 2014.Pertrochanteric fractures especially unstable intertrochanteric & subtrochanteric fractures were included. Technical difficulties with the implant and operating time were quantified. Union of fracture site and implant related complications were followed up clinically and radiological. The Harris Hip Score was used to evaluate the f...
International Journal of Research in Orthopaedics, 2018
Background: Pertrochanteric fractures consume major part of orthopaedic injuries with high morbidity and cost factors. They affect almost all age groups. The treatment options vary a lot depending on the type of fracture and age. Despite marked improvement in implant design, surgical technique and patient care; pertrochanteric fractures continue to consume a substantial proportion of our health care resources.Methods: This prospective study consists of 20 adult patients of pertrochanteric fractures of femur, who were treated with internal fixation using PFLP. All patients were followed up at an interval of 4 to 6 weeks till fracture union and then once in 3 months till 1 year.Results: Anatomical results are noted as good or poor depending upon shortening, varus deformity, hip movements and knee movements and functional result as excellent, good, fair and poor depending upon the hip pain, ambulatory status, ability to squat, and sit cross leg. In the study 2 patients had shortening o...
Proximal femoral locking plate: A good alternate in comminuted proximal femoral fractures
International Journal of Orthopaedics Sciences, 2017
Introduction: Intertrochanteric and sub trochanteric fractures account for 50% of all fractures of the proximal femur. Surgical treatment is the preferred method in these fractures to reduce the complications of prolonged immobilization. Recently proximal femoral locking compression plate (PF-LCP) has been applied in the treatment of proximal femur fractures. Materials and methods: This is a prospective type of study of 12 cases of comminuted inter trochanteric and sub trochanteric fractures of femur treated surgically with proximal femoral locking compression plate (PF-LCP). All the cases were operated electivley on regular operation theatre days. Results: In age distribution, 6 (50%) patients were between 50-75years. The range of age was between 20-75 years, with mean age of 43.8years. In sex distribution, there were 8 (66%) males and 4(34%) females. Left lower limb was involved in 9 (75%) cases and right lower limb in 3 (25%) cases. In mode of injury, 8 cases (66%) were due to slip and fall and 4 cases (34%) were due to road traffic accident. Kickstand screw was used in 9(75%) cases and not used due to narrow femoral neck in 3(25%) cases. Proximal screw was back out two patients (16%). Varus collapse occurred in one patient (8%). Delayed union in two patients (16%). Conclusion: The PF-LCP is appropriate for complex and unstable proximal femoral fractures with poor bone quality.
Proximal femoral locking compression plate for proximal femoral fractures
Journal of orthopaedic surgery (Hong Kong), 2014
To review short-term outcomes of proximal femoral locking compression plate (PF-LCP) fixation for proximal femoral fractures in terms of postoperative complications and failure rates. Medical records of 21 men and 5 women aged 22 to 85 (mean, 49.7) years who underwent internal fixation with the PF-LCP for proximal femoral fractures were reviewed. Younger patients (mean age, 38.7 years) were more commonly involved in high-energy trauma with multiple musculoskeletal injuries, whereas older patients (mean age, 67.7 years) were more commonly involved in low-energy trauma. Fractures were classified into: multi-fragmentary pertrochanteric fractures (n=13), transtrochanteric fractures (n=6), and subtrochanteric/proximal diaphyseal fractures (n=7). Patients were followed up for a mean of 14.7 months. Seven patients developed complications including loosening of locking screws (n=4), delayed union (n=2), and infection (n=1); 4 of them required additional surgeries. The PF-LCP is appropriate ...
Cureus
Introduction Peritrochanteric fractures are the most frequent fractures of the proximal femur that accounts for nearly half of all proximal femur fractures. They are a major cause of disability in the elderly. The aim is to study the functional and radiological outcome of unstable proximal femur fractures fixed with proximal femur locking compression plate (PF-LCP) and its complications. Unstable proximal femur fracture patients operated with proximal femur locking compression plate were followed up functionally by Harris Hip Score and radiologically by neck-shaft angle measure. Materials and methods A retrospective analysis of 30 patients with unstable peritrochanteric fractures treated with PF-LCP in the first-level trauma center was conducted between 2015 and 2019. Stable peritrochanteric, pediatric and open fractures, and polytrauma were excluded. As a mid-term follow-up, functional and radiological outcomes were assessed at six weeks, three months, six months, and 12 months. Data was analyzed using a chi-square test, and results were compared with available western literature. Results Thirty patients with unstable peritrochanteric fractures operated between 2015 and 2019, complying with our inclusion criteria, were analyzed. All patients were operated by the same surgeon and were available for a mid-term follow-up (12 months). Mean radiological union time was 12.5+/-2 weeks, with 24 patients achieving union between 10-15 weeks, three patients had union little more than 15 weeks. Two patients had non-union and required re-surgery. Functional results were assessed in the 30 patients available for followup using Harris Hip Score. Excellent results were seen in 17, good in seven, fair in three, and poor in three patients. Conclusions The choice of implant used to manage unstable peritrochanteric fractures has always been a debatable subject in our orthopedic fraternity. In our study, we used the anatomic, fixed-angle plates in peritrochanteric fractures and obtained significant functional and radiological outcomes over a midterm follow-up. We recommend PF-LCP as a good, stable alternative in the treatment of peritrochanteric femoral fractures. We consider that fracture pattern and extent in the proximal femur have a definite influence in determining the implant of choice. It provides good-to-excellent bone healing with reduced complications and better biomechanical stability.
Journal of Evidence Based Medicine and Healthcare, 2015
Fractures of proximal femur and hip are relatively common injuries in elderly individuals. The incidence of peritrochanteric and intertrochanteric fracture is also increasing among young population, who sustain high energy trauma Rigid Internal fixation and early mobilization has been the standard method of treatment. A combination of orthopaedic surgery and early postoperative physiotherapy and ambulation is the best approach. The overall goal in the treatment of hip fractures is to return the patient to pre-morbid level of function. AIMS & OBJECTIVE: To analyse the anatomical and functional outcome of the treatment with LCP-Proximal femur. METHODOLOGY: The present study consists of 12 adult patients of peritrochanteric factures of femur satisfying the inclusion criteria, treated with Proximal Femoral Locking Compression Plate at S. V. R. R. Govt. General Hospital, Tirupati during the period of nov 2013 to Oct 2015. INCLUSION CRITERIA: Age >18years, comminuted trochanteric and sub trochanteric fractures, Signed written informed consent. EXCLUSION CRITERIA: Inter trochanteric fractures involving piriformis fossa, Compound fractures. Pathological fractures. Any displacement of a femoral neck fracture. Associated malignancy. RESULTS: Average age incidence in the present study was 62.7 years., Predominantly males (75%) were affected., Most cases occurred after a fall 10 (50%) cases which was statistically significant, Right side involvement was more common., Average post-operative stay was 13.5 days., Out of the 12 cases, evaluated using Salvati-Wilson scoring: 3 cases (25%) had good, 8 cases (66.67%) fair, 1 case (8.33%) had poor score, Average weight bearing time was14.5 weeks, Average union rate was 19.45 weeks.
Journal of Clinical Orthopaedics and Trauma, 2016
Pertrochanteric fractures are described as fractures occurring in the region extending from extracapsular basilar neck region and passing through or below the greater trochanter along the lesser trochanter. 1 These are the most frequent factures of the proximal femur and account for approximately 50% of all fractures in this region. Pertrochanteric fractures occur majorly in elderly patients with osteoporosis and are a result of low-energy trauma and cause severe disability in such patients. 2 Hagino et al. reported that individuals above 50 years of age have a lifetime risk of hip fractures and the incidence is 5.6% for men and 20% for women. 3 The incidence of per-trochanteric fractures is also increasing among younger population majorly due to high energy trauma with the increase in road traffic accidents (Figs. 1-3). Complications secondary to these injuries produce significant morbidity and include infection, non-union, malunion, decubitus ulcers, fat emboli, deep venous thrombosis, pulmonary embolus, pneumonia, myocardial infarction, stroke, and death. Pertrochanteric fractures have always been known for their complexity and variety. The treatment has evolved and changed over a period of time, from conservative to operative, from extramedullary to intramedullary devices, from open reductions and fixations to newer minimally invasive techniques. It is well evident that new fixation devices are sought to improve the outcome of these injuries. No implant is universally fit for these
Role of proximal femur locking plate in management of complex proximal femoral end fractures
Indian Journal of Orthopaedics Surgery, 2018
Introduction: To study the role of proximal trochanteric contoured plate in management of complex proximal femur end fractures. Materials and Methods: A total of 30 cases 11 male and 19 female patients aged 19 to 90 years [Mean age 42] were included. Time duration of surgery, total amount of blood loss, hospital stay, mobilization and weight bearing, radiological assessment of union, complications and Harris Hip score were assessed at the end of 6 months Results: Mean duration of surgery was 72.18 mins, average blood loss was 283.75ml, average hospital stay was 13.75 days. Mean time for radiological union was 16.8 wks and Harris hip score was 84.6. Abductor lurch occurred in 4 cases. Conclusion: Proximal Femoral Locking Compression Plate (PFLCP) provides stable fixation for fractures of proximal end of femur especially for lateral wall fracture because it provides stable fixation of lateral fragments and prevents lateral migration of proximal fragments.
International Journal of Research in Orthopaedics, 2017
Trochanteric fractures are common in the elderly people. The frequency of these fractures has increased primarily due to the increasing life span and more sedentary life style brought on by urbanization. Trochanteric fractures occur in the younger population due to high velocity trauma, whereas in the elderly population it is most often due to trivial trauma. 1 Dynamic hip screws (DHS) have been considered as the standard fixation for extra-capsular femoral fracture and yielded good results in the patients with stable intertrochanteric fractures. 2,3 However, its value for ABSTRACT Background: Intertrochanteric fractures occur in people with poor bone quality, about half of the intertrochanteric fractures are comminuted and unstable. The purpose of the present study was to compare the outcome of surgical treatment of proximal femoral fracture by dynamic hip screw (DHS), proximal femoral nail (PFN) and proximal femoral locking compression plate (PFLCP). Methods: This prospective comparative observational study had included cases presented with intertrochanteric fractures of femur attended orthopedic OPD and emergency department were treated with dynamic hip screw (DHS), proximal femoral nailing (PFN) or proximal femoral locking compression plate. Post-operative x-rays were done to assess reduction and progress of union (non-union/mal-union), any post-operative complications e.g. operative wound infection, implant failure etc. Results: In our study, we found that PFNs prove to be more useful in difficult fractures with a subtrochanteric extension or reversed obliquity. The rotational stability was higher when proximal femoral nail is used in these fractures. The incidence of wound infection was found to be lower with intramedullary implants which resulted in early ambulation of the patients. Conclusions: In our study, we found that proximal femoral nails prove to be more useful in difficult fractures with a sub-trochanteric extension or reversed obliquity. The rotational stability was higher when PFN is used in these fractures. The incidence of wound infection was found to be lower with intramedullary implants which resulted in early ambulation of the patients. Non-union of trochanteric fracture although is a rare entity.