Title: A Study of Functional Outcome of Patients with Extra Capsular Femoral (Pertrochanteric) Fractures Managed by Proximal Femoral Locking
Authors: Dr Shakkir. U.K, Dr Muhammed Sageer. A, Dr Sabarisree M
Background: Proximal femoral fractures are challenging injuries which are usually seen in elderly population due to low energy trauma like domestic falls, along with osteoporosis .In younger patients these fractures occurs with high energy trauma like road traffic accidents and fall from height .Despite vast improvement in implant designs, surgical techniques and patient care these fractures are associated with high incidence of implant failure, refracture and varus collapse.
Objectives: assessment of functional outcome of patients with extracapsular proximal femoral (pertrochanteric) fractures managed by proximal femoral locking plate. Potential complications are also evaluated.
Materials and Methods: This is a prospective study which was carried out from October 2016 to october 2017 in government medical college Thiruvanathapuram. In this study period 60 cases of pertrochanteric fractures which are managed by PF-LCP were carried out. The functional outcome were measured using harris hip scoring system.
Results: most of the patients were between age group of 60 to 80. Average age was 66. Males predominated in our study (60%), with male to female ratio of 3:2.
Most common mode of injury was domestic fall accounts for 86.7%.Right sided fractures were common -63.3%.Most of the fractures were intertrochanteric fractures accounts for 70% ,as compared to subtrochanteric fractures which is 30%. Most of the pertrochanteric fractures were unstable. Functional outcome measured by harris hip scoring system, after one year, 41.7 % of patients had excellent and 31.7% had good outcome. 10% had fair and 11.7% patients had poor outcome.5% became a failure. Complications like non union ,infection and varus collapse were seen in 6 patients out of 60. Medialisation of femur was there in 3 patients.Secondary surgeries were done for 5 patients.
Conclusion: In the present study of PF-LCP, performed for extracapsular fracture neck of femur in 60 patients, at government medical college, Thiruvananthapuram. PF-LCP represents a feasible and good alternative for the treatment of unstable inter and subtrochanteric fractures. PF-LCP permits stable fixation of unstable fractures and early functional rehabilitation. Although it is not free of complications our study has has shown very good results. Future biomechanical studies and clinical trials are required to evaluate the validity of the PF-LCP for the treatment of pertrochanteric fractures.
Keywords: Intertrochanteric fractures, sutrochanteric fractures, pertrochanteric fractures, proximal femoral locking plate (PF-LCP), harris hip score.