Title: Outcome of Peritrochanteric Fractures with Proximal Femur Locking Compression Plate

Authors: Dr Jaspal Singh MS, Dr Basant Rai MS, Dr Manpreet Singh, Dr H.S Sohal MS

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i1.148

Abstract

Background: Fractures of the proximal femur, including fractures affecting the peritrochanteric region, have become a public health problem. Owing to aging of the population, we have to operate on even more elderly patients who sometimes present with significant co-morbidities. Although conventional implants have given good results in stable peritrochanteric fractures, proximal femur locking compression plate (PFLCP) which has been recently introduced is better suited for comminuted, unstable peritrochanteric fractures and osteoporotic bones. In PF-LCP, bone-implant construct so formed is mechanically stable and fixation failure due to screw loosening in osteoporotic bone can be reduced.

Materials & Methods: This prospective study was conducted from July 2015 to October 2017 and was approved by local ethical committee. Twenty-five consecutive patients of either sex with age more than 60 years (range, 60-84) having peritrochanteric fractures were operated upon with PFLCP. A.O classification was followed in the study and Singh’s index for osteoporosis was calculated. Operating time, blood loss and any technical difficulty with the implant were recorded. Patients were followed clinically and radiologically for union at fracture site and implant-related complications. The Harris Hip Score was used to document hip functions at final follow-up.

Observations: Amongst the 25 patients, the average operation time in our study was 66.60±10.57 minutes. The average radiological union was 3.40±0.63 months (13.6 weeks). Average time for full weight bearing was 13.12±1.90 weeks. There were two cases of wound infection, one case of coxa vara and one case of a proximal screw back-out. There was no case of plate lift or screw breakage. There was no case of non-union.

Conclusion: The PFLCP can be a feasible alternative to the treatment of peritrochanteric fractures. Treatment with PFLCP can provide good-to-excellent healing in osteoporotic bones having comminuted and unstable peritrochanteric fractures, with a limited occurrence of complications.

Keywords: Peritrochanteric fractures, Osteoporosis, Internal fixation, PF-LCP.

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Corresponding Author

Dr Manpreet Singh

Address – 328 Akash Avenue, FGC road,

Amritsar, Punjab-143001. INDIA

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