Clinical study of fixation of unstable inter-trochanteric femoral fractures with 95⁰ angle blade plate

Abstract

Background: Inter-Trochanteric hip fractures account for approximately half of the hip fractures in the elderly. By definition, these are extra-capsular fractures occurring between greater and lesser trochanters of the proximal femur, occasionally extending into sub-trochanteric region. These fractures present in bimodal age distribution. In older females these osteoporotic low energy fractures, while in young patients, usually males are affected with high energy injuries. Intertrochanteric fractures unite with conservative management also, but not without high rate of complications. Therefore, Stable reduction and rigid internal fixation is the treatment of choice for these fractures. In the present study, attempt has been made to evaluate the results of surgical management of unstable inter-trochanteric fractures with a 95 degrees angle blade plate. Materials and Methods: This study is a hospital based prospective study centered in Department of Orthopaedics at R.L Jalappa Hospital and Research Centre, Kolar, from October 2012 to October 2014 in which 30 patients with Unstable inter-trochanteric fractures are treated with open reduction and internal fixation with 95 degrees angle blade plate. Results: Patients were regularly followed-up post-operatively. Thirty cases were available for follow up. Excellent results were seen in 21 patients, good results in 7 patients, fair results in 2 patients and poor results in none. Conclusion: This study has shown that the 95 degrees angle blade plate fixation is a reliable and effective treatment of trochanteric fractures. This plate can be used for both stable and unstable intertrochanteric fractures. The final result is dependent on various other factors such as the type of fractures, lateral wall comminution and stability of the medial wall post reduction. The operative technique and final implant position also influenced the results. Over-all results also were dependent on co-morbidities of the patients. The ideal position of the implant is to keep the tip of the blade in the lower half of the femoral head and the blade should pass below the superior cortex of the neck. The 95 degrees angle blade plate is found to be a stable and acceptable implant for the fixation of intertrochanteric fractures.