Evaluation of proximal femoral plate in peritrochanteric fractures

Abstract

Background Peritrochanteric fracture is one of the leading causes of mortality and morbidity of the elderly, in whom the fracture can occur from just a simple fall. In younger individuals, it occurs owing to severe trauma such as motor car accident or fall from a height. These type can occur in any age but got a higher incidence in the fifth and seventh decade of life. Multiple intramedullary and surface fixation implants have been designed to fix such a fracture, such as the dynamic hip screw, the anatomic proximal femoral plate, and the proximal femoral nail, but there is no single design that got the best results in all types of proximal femoral fracture. Aim To evaluate the outcomes of using proximal femoral plate in peritrochanteric fractures. Patients and methods A prospective study was conducted on 20 patients with proximal femoral fracture fixed by proximal femoral plate presented to the Cairo University Hospital from August 2014 to June 2016. The study included 14 male and six females. Their age ranged from 29 to 71 years old (mean 57 years old). The mode of trauma was three patients (15%) with motor car accident, three patients (15%) with motor bike accidents, 12 patients (60%) with fall on the ground, and two patients (10%) with fall from height. According to orthopeadic trauma association (OTA) classification, eight patients (40%) had 31-A2.1 pattern, six patients (30%) had 31-A2.2 pattern, and 2 patients (10%) had 31-A2 pattern. Results Radiological outcome was anatomical in eight patients (40%), satisfactory in nine patients (45%), and poor in three patients (15%). The follow-up was from 7 to 20 months (average 11 months). Fracture healing time ranged from 7 to 29 week (average 14 weeks). The modified Harris hip score was used to evaluate patients at 3 and 6 months postoperatively, which ranged from 60 to 74 (mean was 66.5±3.5) at 3 months and 68 to 93 (84.4±9.5) at 6 months. Conclusion Proximal femoral plate is an easy, safe, and dependable alternative for fixation proximal femoral fracture, giving satisfactory results comparable to other surface and intramedullary fixation devices, when applied in the accurate recommended position.