Management of unstable pertrochanteric fractures with proximal femoral locking compression plates and affect of neck-shaft angle on functional outcomes

Kovalak, Emrah; Ermutlu, Cenk; Atay, Tolga; başal, özgür

doi:10.1016/j.jcot.2017.07.006

Cited by 9 publications

(10 citation statements)

References 26 publications

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“…In our study, we report the radiological and functional outcomes of unstable peritrochanteric fractures fixed with the use of PF-LCP. The mean age group of our study population was 65 years, in contrast to the higher age group reported in the literature [8,11]. There was a slight female predominance (1:1.7) in contrast to the recent Indian literature [8].…”

Section: Discussioncontrasting

confidence: 67%

“…The majority of the patients (67%; n=20) had an acceptable reduction; a good reduction was followed in 27% (n=8) of patients and a poor reduction in 6% (n=2) of patients. On the contrary, Kovalak et al [11] reported an 80% good reduction in their case series. The mean neck-shaft angle post radiological union in our case series was 126.1 degrees, whereas Shah et al [8] and Kovalak et al [11] reported post-reduction a neck-shaft angle of 125.9˚ and 129.5˚, respectively.…”

Section: Discussionmentioning

confidence: 85%

“…On the contrary, Kovalak et al [11] reported an 80% good reduction in their case series. The mean neck-shaft angle post radiological union in our case series was 126.1 degrees, whereas Shah et al [8] and Kovalak et al [11] reported post-reduction a neck-shaft angle of 125.9˚ and 129.5˚, respectively. Two of our patients had coxa vara.…”

Section: Discussionmentioning

confidence: 85%

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Functional and Radiological Outcomes of Unstable Proximal Femur Fractures Fixed With Anatomical Proximal Locking Compression Plate

Krishna¹,

Venkatesan²,

Singh³

2022

Cureus

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IntroductionPeritrochanteric 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 methodsA 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. ResultsThirty 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. ConclusionsThe 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.

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Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 85%

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Functional and Radiological Outcomes of Unstable Proximal Femur Fractures Fixed With Anatomical Proximal Locking Compression Plate

Krishna¹,

Venkatesan²,

Singh³

2022

Cureus

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“…The swollen top of the plate plays a crucial role in gathering comminuted fractures, reinforcing the structure of the lateral wall at the same time. The PFLP was specifically designed for fractures in the proximal femoral region to increase early mobilization of patients by placing more screws into the proximal femur at different angles 27 , which is theoretically superior to the intramedullary nail. The PFLP used in this study was designed for fractures in the proximal femur and recommended by its producer for the treatment of unstable intertrochanteric femoral fractures.…”

Section: Discussionmentioning

confidence: 99%

Controlled study on Gamma nail and proximal femoral locking plate for unstable intertrochanteric femoral fractures with broken lateral wall

Han¹,

Liu

Hu³

et al. 2018

Sci Rep

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The gamma nail and proximal femoral locking plate (PFLP) are both used for fractures. A controlled study was performed to determine the optimal implant. To assess and analyze the clinical effects of gamma nails and PFLPs for patients with unstable intertrochanteric femoral fractures, specifically with broken lateral walls. Thirty-six patients with unstable intertrochanteric femoral fractures and broken lateral walls were treated with gamma nails or PFLPs and retrospectively studied. The clinical data were compared. Duration of surgery and early full weight-bearing time were significantly longer in the PFLP group compared to the gamma nail group (P < 0.05). However, intraoperative fluoroscopy frequency and total blood loss in the PFLP group were significantly less than those in the gamma nail group (P < 0.05). No significant differences were found in hospitalized days, Parker Palmer mobility scores, Harris hip scores, and complications between the two groups. No difference in hip-functional recovery was found between the gamma nail group and the PFLP group, indicating that both the gamma nail and PFLP were effective for unstable intertrochanteric femoral fractures with a broken lateral wall. However, early weight bearing on the fractures was not encouraged in patients treated with PFLP.

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“…Author Average Bone union time (wks) Biao Zhong [20] 16 wks Hodel S [21] 16 wks Kovalak E [22] 22 wks Shah MD [23] 20 wks Present Study 20 wks…”

Section: Bone Union Timementioning

confidence: 97%

Management of osteoporotic extracapsular fractures of the proximal femur with proximal femur locking plate: A prospective study

Sujai¹,

Tm²,

Latheef³

et al. 2018

Int. J. Orthop. Sci.

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Introduction: Proximal femur fractures are a cause for significant morbidity & mortality in the elderly. These fractures need to be fixed surgically so as to help rehabilitate the patient at the earliest. Extra capsular fractures (Intertrochanteric fractures & Sub trochanteric fractures) when occur in osteoporotic bone are usually comminuted in nature. Choice of implant is of prime importance as the risk of implant failure is very high in such patients. This study was undertaken to see the functional outcome in management of osteoporotic proximal femoral bone fractures treated by open reduction & internal fixation with Proximal Femoral Locking Plate. Materials & Methods: In this prospective study conducted at MVJMC&RH, 40 elderly patients with Extra capsular fractures of the proximal femur (IT & ST) were treated with surgical fixation using PFLP from October 2014 to march 2017.Results: In the present study of 40 cases with an average age of patient is 65years with Male to Female ratio of 42.5%: 57.5%; 26 Intertrochanteric fractures & 14 Sub trochanteric fractures the outcome was found to be 25% (10) excellent, 32.5% (13) good, 32.5%(13) fair, 10% (4) poor result with Harris hip scoring system. 4 complications include 1 infection; 2 delayed union & 1 case of purely implant related complication like plate bending due to early mobilization & weight bearing. Conclusion:In view of the results obtained from our study which are comparable with the results obtained from similar studies; despite few unfavourable results and complications, Proximal FLP is a good option for treatment of proximal femur fractures with severe comminution and osteoporosis.

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Management of unstable pertrochanteric fractures with proximal femoral locking compression plates and affect of neck-shaft angle on functional outcomes

Cited by 9 publications

References 26 publications

Functional and Radiological Outcomes of Unstable Proximal Femur Fractures Fixed With Anatomical Proximal Locking Compression Plate

Functional and Radiological Outcomes of Unstable Proximal Femur Fractures Fixed With Anatomical Proximal Locking Compression Plate

Controlled study on Gamma nail and proximal femoral locking plate for unstable intertrochanteric femoral fractures with broken lateral wall

Management of osteoporotic extracapsular fractures of the proximal femur with proximal femur locking plate: A prospective study

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