PARADIGM SHIFT IN OPERATING UNSTABLE INTERTROCHANTERIC FRACTURE: ANATOMICAL LOCKING PLATE
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Keywords
Functional outcome,, proximal femoral locking plate, unstable intertrochanteric fracture
Abstract
Abstract
Background: Intertrochanteric fracture is a common orthopedic injury sustained in the elderly population because of osteoporosis and trivial fall. Life-threatening systemic complications occur mainly due to immobility. Materials and Methods: We included 62 patients (40 males and 22 females) of unstable intertrochanteric fracture (AO 31 A2 and A3) attending Department of Orthopedics. They were all subjected to surgical treatment with proximal femoral locking plate (PFLP). Patients were followed up at 3rd, 6th, and 12th month for outcome variables, i.e., functional (Harris hip score, Palmer and Parker mobility score) and radiological outcomes (neck shaft angle, loss of reduction, union, and implant-related complications). Statistical analysis was done using Friedman’s test after calculating the data in terms of mean and median using SPSS 20 software. Results: Mean age of our patients was 64 years; 40 were males and 22 females. Fifty patients sustained fracture due to trivial fall and 12 due to road traffic accidents. Thirty-five out of 62 patients had medical comorbidities. Twenty-six patients needed open reduction of fracture and 36 were close reduced. Twenty-two patients had severe comminution (AO A3 III type). Mean degree of loss of reduction was 5° in 6th month and 4° in 12th month. Union was achieved in 48 out of 50 patients at 12th month. Most of the patients achieved fair-to-good functional outcome scores at 12th month of follow-up. We noticed difficulties in fracture reduction as well as complications related to implant. Conclusion: PFLP is an effective implant in comminuted intertrochanteric fractures with broken lateral wall. Complications can be minimized by following the principles of locking plate meticulously.
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