A comparison of proximal femoral locking compression plates with dynamic hip screws in extracapsular femoral fractures

Zhong, Bao‐Liang; Zhang, Y.; Zhang, C.; Luo, Congfeng

doi:10.1016/j.otsr.2014.06.012

Cited by 24 publications

(23 citation statements)

References 21 publications

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“…The study was initiated to compare DHS and PFNA for differences in outcomes, based on the hypothesis that DHS would have more complications and worse outcome than PFNA in the treatment of stable IFFs (type AO/OTA 31.A1). Many authors comparing DHS devices with PFNA devices in stable IFF pointed out no obvious differences among the results of treatments with either DHS or PFNA implant [2, 12, 13]. However, to our knowledge, no comparison was performed in terms of post-operative femoral fractures after implant removal, postoperative HHS, and reoperation rate during post-operative follow-up assessment of a minimum 4 years in literature.…”

Section: Discussionmentioning

confidence: 89%

Proximal femoral nails anti-rotation versus dynamic hip screws for treatment of stable intertrochanteric femur fractures: an outcome analyses with a minimum 4 years of follow-up

Zhang

Zhu

et al. 2016

BMC Musculoskelet Disord

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BackgroundDynamic hip screws (DHSs) and proximal femoral nails anti-rotation (PFNAs) are well-documented implants for stable intertrochanteric femur fractures(IFFs); however, there is no consensus regarding which type of implant is the better option for stable IFFs. This study aimed to compare DHSs with PFNAs in the management of stable intertrochanteric fractures.MethodsA retrospective study was performed in our institution. Between June, 2005 and November, 2015, 267 patients (267 hips) with stable IFFs (AO/OTA Type 3.1A1) were treated with a DHS or a PFNA. Inclusion and exclusion criteria were designed to focus on isolated stable IFFs in ambulatory patients. Follow-up was undertaken at 1, 3, 12, 15, 18, 21, 24, 36, 48 postoperative months, and at final follow-up. Radiograph outcomes were obtained at all visits. The primary outcome measure was re-operation rate. The secondary outcome was patient function, evaluated using Harris hip score (HHS). Tertiary outcomes included: intra- and post-operative orthopaedic complications.ResultsTwo hundred twenty two patients (110 in the PFNA group and 112 in the DHS group) were evaluated with a mean follow-up period of 53 months (range, 48–60 months). There was an increased risk of reoperation after DHS in one-year follow-up: 0 % and 5.4 % for PFNA and DHS, respectively (P = 0.029). The difference persisted with time: 6.4 % and 13.4 % at last follow-up (P < 0.05). There are statistical differences in postoperative HHS at 12, 15, 18, 21, 24, 36, 48 months postoperatively and at final follow-up. No statistical differences in medical complications was observed between the two groups. The orthopaedic complications were more in the DHS group (n = 42) compared with the PFNA group (n = 18) (P <0.05).ConclusionCompared with PFNA device, DHS device might not be the preferred implant for stable intertrochanteric femur fractures.

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Section: Discussionmentioning

confidence: 89%

Proximal femoral nails anti-rotation versus dynamic hip screws for treatment of stable intertrochanteric femur fractures: an outcome analyses with a minimum 4 years of follow-up

Zhang

Zhu

et al. 2016

BMC Musculoskelet Disord

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“…6 PFLCP merges locking screw technology with conventional plating, and this technique offers optimal fixation of comminuted and highly unstable fractures associated with greater shearing and pull-out forces. 10 The dynamic hip screw (DHS) has gained wide use within the twenty years and has become a standard device for current comparison of treatment outcomes. 11 Accordingly, DHS is the standard fixation procedure for extracapsular femoral fracture and yields good results in patients with stable intertrochanteric fractures.…”

Section: Introductionmentioning

confidence: 99%

“…11 Accordingly, DHS is the standard fixation procedure for extracapsular femoral fracture and yields good results in patients with stable intertrochanteric fractures. 10,12 The proximal femoral nail has technical advantages compared with other devices. 13 The proximal femoral nail antirotation (PFNA) system was introduced into clinical practice in 2003 by the Association for Osteosynthesis.…”

Section: Introductionmentioning

confidence: 99%

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

Huang

Chen

Zhang

et al. 2017

American Journal of Therapeutics

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In this study, a randomized trial was conducted to compare the clinical effectiveness of proximal femoral locking compression plate (PFLCP), dynamic hip screw (DHS), and proximal femoral nail antirotation (PFNA) for unstable intertrochanteric femoral fracture treatment. Ninety patients diagnosed with unstable intertrochanteric femoral fracture were enrolled in this study at the department of orthopedics at Linyi Second People's Hospital between May 2010 and May 2012. Fractures were classified according to Tronzo-Evans classification, and the patients were randomly divided into 3 groups, PFLCP, DHS, and PFNA, with 30 patients in each group. The length of incision, operative time, intraoperative blood loss, postoperative drainage, postoperative weight-bearing ambulation time, and duration of fracture union were significantly lower in patients who underwent PFNA and PFLCP compared to patients treated with DHS. Furthermore, when the same clinical parameters were used for comparison, the PFNA group showed markedly lower values compared with the PFLCP group. The total incidence of postoperative complications was significantly different among the PFNA, PFLCP, and DHS groups, with the PFNA group exhibiting markedly lower complication rates compared with PFLCP and DHS groups. However, PFLCP and DHS groups did not show significant differences in the incidence of postoperative complications. Notably, the Harris hip score of PFNA group was markedly higher than the DHS group. In conclusion, our results provide convincing evidence that PFNA may be the most effective internal fixation treatment of unstable intertrochanteric femoral fracture.

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“…It was found to have less complications than DHS in unstale intertrochanteric fractures. 2 Incidences of hardware failures are less with PFLCP. 3 Failures seems related to two factors the type of internal fixation used and stability of fracture.…”

Section: Introductionmentioning

confidence: 99%

Role of proximal femur locking plate in management of complex proximal femoral end fractures

Mann¹,

Sahni²,

Kumar³

et al. 2020

IJOS

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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.

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A comparison of proximal femoral locking compression plates with dynamic hip screws in extracapsular femoral fractures

Abstract: Case control study, level III.

Cited by 24 publications

References 21 publications

Proximal femoral nails anti-rotation versus dynamic hip screws for treatment of stable intertrochanteric femur fractures: an outcome analyses with a minimum 4 years of follow-up

Proximal femoral nails anti-rotation versus dynamic hip screws for treatment of stable intertrochanteric femur fractures: an outcome analyses with a minimum 4 years of follow-up

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

Role of proximal femur locking plate in management of complex proximal femoral end fractures

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