A comparative study of proximal trochanteric contoured plate vs proximal femoral nail for unstable inter-trochanteric fracture of femur

Abstract

Background: Unstable inter-trochanteric fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. This study was done to compare the proximal femoral nail and proximal femoral locking plate for the management of unstable inter-trochanteric fractures and their postoperative complications. Material and methods: This was a prospective study of 40 patients with unstable inter-trochanteric fractures of femur who were treated with PFN (20 cases) and PFLP (20 cases). The fractures were classified according to Boyds and Griffin classification. All patients were assessed functionally by Harris Hip Score. Results: Average duration of union was 14.75±3.52 weeks (range 14 to 16 weeks) in PFN cases and 17.70±2.00weeks (range 14 to 21 weeks) in PFLP cases, union was achieved in 100% cases except one case of PFN which goes to non union due to Z effect. Various complications were seen in both cases. As per Harris Hip score, excellent results were noted in 75%PFN and 40%PFLP cases, good in 15%PFN and 25%PFLP cases and fair in 5% PFN and 35% PFLP cases and poor in 5%PFN and 0%PFLP cases. Conclusion: Harris hip score comparison of study suggests that functional results were better in PFN than PFLP. Less Blood loss, less operative time, early weight bearing were other favouring factors in PFN. Though blood loss and operative time was more, rigidity of fixation was better in unstable fractures in PFLP group. We conclude that PFN is the better implant for unstable intertrochanteric fractures with lesser operative time and lesser blood loss. While PFLP can be a good alternative for unstable intertrochanteric fractures with better results with slightly longer operative time and more blood loss when compared with PFN.