Biological fixation of comminuted subtrochanteric fractures with proximal femur locking compression plate

Abstract

Introduction: Subtrochanteric fractures are challengeable fractures that are associated with high incidence of complications and various intramedullary and extramedullary implants, are available for their fixation.(1) Traditional extramedullary implants are associated with higher rate of implant failure and varus collapse while the intramedullary nails are biomechanically better but technically demanding and are associated with higher re-operation rates.(2)-(3) This study was done to evaluate the outcome following biological (indirect) fixation of comminuted subtrochanteric fractures with proximal femur locking plate (PF-LCP). Methods: Thirty patients with comminuted subtrochanteric fractures were operated upon with PF-LCP (Synthes) by using an indirect reduction technique. Russell Taylor types A and B fractures were included in the study. 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 implantrelated complications. The Harris Hip Score was used to document hip function at final follow-up. Results: The mean operating time was 90.5 min and total blood loss averaged 241.4 ml. Union was achieved in all cases with an average time of 15.87weeks. Complications included two cases of delayed union and two cases of infection.