Mid-term results after treatment of intertrochanteric femoral fractures with percutaneous compression plate (PCCP)

Shen, Jie; Luo, Fei; Sun, Dong; Huang, Qiang; Xu, Jianzhong; Dong, Shiwu; Xie, Zhiyong

doi:10.1016/j.injury.2014.04.033

Cited by 8 publications

(6 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With the increase in the aging population, trochanteric fractures including pertrochanteric, intertrochanteric, and subtrochanteric fractures also have a rising trend, and most of these fractures need surgical treatment [ 1 – 4 ]. For stable fracture types, either extramedullary or intramedullary implants such as the dynamic hip screw (DHS), the dynamic condylar screw (DCS), and proximal femoral nail anti-rotation (PFNA) are considered to be successful devices [ 1 , 5 ]. According to published studies, however, the most effective implant for the treatment of unstable trochanteric fractures is still being debated [ 6 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

High failure rate of proximal femoral locking plates in fixation of trochanteric fractures

Yan

Zhu

et al. 2018

J Orthop Surg Res

View full text Add to dashboard Cite

BackgroundThe aim of this study was to report our previous results of treatments for trochanteric fractures with proximal femoral locking plates (PFLP) and to analyze the underlying mechanisms and possible risk factors associated with the high failure rate of this technique.MethodsFrom January 2010 to October 2014, 273 consecutive patients with trochanteric femoral fractures were identified, and 95 patients (with 97 fractures) ultimately met the inclusion criteria. Clinical records regarding demographic features and intraoperative data including total incision length, operation time, blood loss, and failures detected in radiographs were documented and assessed. The collected data were analyzed with SPSS 19.0 software.ResultsThe stable group (AO/OTA 31 A1 and A2.1) had less blood loss than the unstable group (AO/OTA 31 A2.2, A2.3, and A3). The ultimate failure rate was 36% in 97 fractures. The obvious complications in this study included nonunion in 7 (7.2%) fractures, implant breakage in 4 (4.1%) fractures, varus deformity in 34 (35%) fractures, and loosening of the proximal femoral screw in 21 (21.6%) fractures. Six patients received reoperations. The total failure rate in the stable group was 17% and was 50% in the unstable group. In patients greater than 60 years old in the unstable group, the failure rate was 60.5%.ConclusionsHigh failure rates of PFLP were observed in patients with trochanteric fracture, especially in patients who were greater than 60 years old with unstable fracture types. PFLP was not an appropriate treatment for trochanteric fractures.

show abstract

Section: Introductionmentioning

confidence: 99%

High failure rate of proximal femoral locking plates in fixation of trochanteric fractures

Yan

Zhu

et al. 2018

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…With the rapid increase in the elderly population, the morbidity of intertrochanteric femoral fractures (IFFs) is also displaying a rising trend [ 1 – 3 ]. And IFFs account for approximately half the hip fractures in elderly patients [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

A retrospective analysis of the InterTan nail and proximal femoral nail anti-rotation-Asia in the treatment of unstable intertrochanteric femur fractures in the elderly

Zhang

Zhu

et al. 2016

J Orthop Surg Res

View full text Add to dashboard Cite

BackgroundThe purpose of this study was to compare the clinical outcomes of elderly patients undergoing surgery for treatment of unstable trochanteric fractures receiving either proximal femoral nails anti-rotation-Asia (PFNA-IIs) or InterTan nails (ITs).MethodsBetween January 1, 2012, and June 31, 2015, 168 elderly patients with unstable intertrochanteric femur fractures enrolled in this study. The only intervention was ITs or PFNA-IIs of the unstable trochanteric femur fractures. Follow-up was at 1, 3, 6, and 12 months postoperatively and yearly thereafter. Intraoperative variables and postoperative complications were compared between the two groups.ResultsEight patients died, six were too infirmed for follow-up, and seven were lost during follow-up, leaving 147 patients meeting the criteria were evaluated at a mean follow-up of 20 months (range 16–26 months). Significant differences were observed between the two groups regarding local complications (IT, n = 10 vs. PFNA-II, n = 20), varus collapse of the head/neck or femoral shaft fractures at the tip of the nail (IT, n = 1 vs. PFNA-II, n = 8), femoral neck shortening (IT, 4.4 ± 1.1 mm vs. PFNA-II, 7.4 ± 2.4 mm), fracture healing time (IT, 14.7 ± 2.1 weeks vs. PFNA-II, 15.7 ± 2.4 weeks), femoral shaft fractures (IT, n = 0 vs. PFNA-II, n = 4), rotational loss of reduction (IT, n = 0 vs. PFNA-II, n = 9), lateral cortex fractures of the proximal femur or lateral greater trochanter fractures (IT, n = 8 vs. PFNA-II, n = 1), operative time (IT, 71.9 ± 6.8 min vs. PFNA-II, 52.3 ± 4.0 min), intraoperative blood loss (IT, 190.6 ± 6.0 mL vs. PFNA-II, 180.9 ± 10.8 mL), fluoroscopy time (IT, 5.0 ± 0.48 min vs. PFNA-II, 2.8 ± 0.33 min), hospital stay (IT, 9.65 ± 0.95 days vs. PFNA-II, 8.58 ± 0.93 days), cut-out (IT, n = 0 vs. PFNA-II, n = 6), and tip-apex distance (IT, 26.7 ± 0.91 mm vs. PFNA-II, 23.2 ± 1.22 mm). No significant differences existed for the other observation indexes (p > 0.05).ConclusionsThe IT nail may have more advantage for patients with unstable intertrochanteric fractures of the femur. However, for those complicated with lateral greater trochanter fractures, lateral cortex fractures of the proximal femurs, or unfit for surgery, the PFNA-II nail could be a good option. In addition, a large-sample, multicenter observational study is required for evaluation of its long-term efficacy, and optimal management strategies for specific unstable fracture patterns, different sorts of bone quality, and different levels of patient demand.

show abstract

“…They concluded that proximal femoral locking plates decreased the chances of limb shortening and medialisation of the shaft [38]. A recent study by Shen J et al concluded that these plates are an effective and safe method in the treatment of all types of intertrochanteric femoral fractures, but good fracture reduction and ideal positioning of the neck screw are prerequisites for the success of the device [39].…”

Section: Newer Proximal Femoral Locking Platesmentioning

confidence: 99%

Management Options and Treatment Algorithm in Intertrochanteric fractures

Dhamangaonkar¹

2015

View full text Add to dashboard Cite

Background: Intertrochanteric (IT) fractures are one of the most common lower limb fractures. There are many varied treatment options to treat the same. Also, our basic understanding of IT fractures is improving leading to evolution of newer concepts which in turn is leading to designing of newer implants. In this sea of newer treatment options, are all newer implants merely market driven? The new- age orthopaedic surgeon needs to be made aware of the newer concepts of IT fractures, implant designs and also a comprehensive literature support of the various treatment options available like concept of unstable IT farcture, the dynamic hip screw (DHS) system, Medoff’s plate, DHS with a trochanteric stabilization plate, 95 degree Dynamic Condylar Screw, first to third generations of gamma nails, proximal femoral nails (PFN), expandable PFN, InterTAN with integrated interlocking screws, proximal femoral locking plates and use of bipolar hemiarthroplasty. This article also aims to present a practical treatment algorithm for the treatment of IT fractures, but this may not be generalizable to all orthopaedic surgeons. Keywords: Intertrochanteric; unstable; DHS; PFN; Gamma; hemiarthroplasty.

show abstract

Mid-term results after treatment of intertrochanteric femoral fractures with percutaneous compression plate (PCCP)

Cited by 8 publications

References 63 publications

High failure rate of proximal femoral locking plates in fixation of trochanteric fractures

High failure rate of proximal femoral locking plates in fixation of trochanteric fractures

A retrospective analysis of the InterTan nail and proximal femoral nail anti-rotation-Asia in the treatment of unstable intertrochanteric femur fractures in the elderly

Management Options and Treatment Algorithm in Intertrochanteric fractures

Contact Info

Product

Resources

About