Proximal femur locking plate fixation for the treatment of unstable femoral intertrochanteric fractures in elderly patients

Abstract

Objective To explore the efficacy of proximal femur locking plate(PFLP) for the treatment of unstable femoral intertrochanteric fractures in elderly patients. Methods Data of 120 cases of patients with unstable femoral intertrochanteric fractures who were treated by PFLP were retrospectively analyzed. There were 56 males and 64 were females, aging from 62 to 78 year-old (average, 69.4 year-old). 85 cases were left hip, and 35 cases right hip. According to AO fracture classification, there were 12 cases of A2.2, 23 A2.3, 34 A3.1, 29 A3.2, and 22 A3.3. According to Evans intertrochanteric fractures classification: there were 93 cases of type III, 19 type IV, and 8 type V. Operation time, length of hospital stay, fracture healing time, postoperative complications and hip joint Harris scores were recorded. Results All patients were followed up for 8-14 months (average, 12.4 months). Their operating time were 51-80 min (average, 63.1 min); X-ray exposure were 8-15 times (average, 11.6 times); intraoperative blood loss were 70-120 ml (average, 92.7 ml); postoperative drainage volume were 50-100 ml (average, 61.7 ml), and length of hospital stay were 7-14 d (average, 10.2 days). The healing time ranged from 12 to 32 weeks (20.4 weeks average). 14 cases had delayed union, and healing time was 8-10 months. In addition, 4 cases had deep vein thrombosis (after thrombolysis therapy the vein was recanalized); 2 had internal fixation broken, who were then treated with PFNA II, and bone healed after 6 months; 5 had hip varus, who were then treated via hip replacement, and no hip prosthesis fracture were found. No other complications occurred in the remaining patients. At the latest follow-up, according to Harris hip score: there were 38 cases with excellent results, 71 good, 9 fair, and 2 poor, and the rate of excellent and good was 90.8% (109/120). Conclusion PFLP for the treatment of unstable femoral intertrochanteric fractures has advantages of less invasion, less complication, reliable fixation and high fracture healing rate, thus it is suitable for unstable intertrochanteric fractures in elderly patients. Key words: Aged; Hip; Fractures, bone; Fracture fixation, internal