Abstract
OBJECTIVE: To study the outcome of subtrochanteric hip fractures treated with proximal lateral femur locking plate. METHOD: We retrospectively reviewed the clinical results of 48 cases of femoral subtrochanteric fractures treated with proximal lateral femur locking plates from January 2008 to May 2010. The progress of fracture healing, as well as the occurrence of complications, was recorded. The function of the hip joint was evaluated by the Harris social index and the Parker and Palmer mobility score one year after the operation. RESULT: 45 patients were followed up until fracture union or a revision surgery. Among the 45 patients, 43 patients obtained fracture union without further intervention. Thirty-eight fractures healed with no loss of position at 1-year follow-up. There were no cases of hip screw cutting through the femoral head. The mean score of the Harris social index was 86.5±9.8 (73~95). The mean Parker and Palmer mobility score was 7.4±2.1 (3~9). CONCLUSION: The proximal lateral femur locking plate is the kind of stable and effective internal fixation for treating subtrochanteric hip fractures which has the advantage of stable fixation especially for the lateral femoral wall fracture. Level of Evidence IV, Case Series.
Highlights
The peritrochanteric fracture is one of the most serious causes of mortality and morbidity in the elderly
The difficulty involved in the treatment of this fracture is partly due to the fact that this injury pattern is anatomically different from other proximal femoral peritrochanteric fractures and to the difficult features of femoral shaft fractures
We retrospectively reviewed the clinical results of proximal lateral femur locking plates used in 48 cases of subtrochanteric fractures
Summary
The peritrochanteric fracture is one of the most serious causes of mortality and morbidity in the elderly. Surgical intervention is advocated in the majority of these patients to reduce the complications associated with long-term immobilization.[4] The aim of the surgery is to achieve initial stability and early mobilization of the patients to avoid complications, such as deep vein thrombosis, thrombophlebitis, pulmonary embolism, urinary and lung infection and ulcers.[5,6] The difficulty involved in the treatment of this fracture is partly due to the fact that this injury pattern is anatomically different from other proximal femoral peritrochanteric fractures and to the difficult features of femoral shaft fractures As a result, it must be treated with specially designed implants that can sustain significant muscular forces for prolonged periods of healing. The main treatment choices of femoral subtrochanteric fractures can be divided into two groups, the cepholomeduallary hip nails and the lateral plate-screw systems.[6,7,8,9,10] The use of intramedullary nail fixation in peritrochanteric fractures has been increasing, but some problems exist when
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