scholarly journals Surgical management of pertrochanteric fractures with proximal lateral femur locking compression plate

Author(s):  
Biju R. ◽  
Kumar Babu B.L.S. ◽  
Sarat Chandra M.

<p><strong>Background:</strong> Pertrochanteric femoral fractures are of intense interest globally. Pertrochanteric fracture is a one of the most serious cause of mortality and morbidity in elderly people. The number of such admissions is on a raise because of increasing life span, sedentary habits and increased road traffic accidents. Pertrochanteric region is a high stress area. Hence delayed union, implant failures, varus collapse and non-union are common complications. Choice of implant was also a tough decision for surgeons in this area. Hence this study was intended to evaluate the functional outcome of proximal femur fractures treated with proximal femur locking compression plate (PFLCP) in terms of union of fracture, patient compliance and complications.</p><p><strong>Methods:</strong> This prospective study was conducted at the department of orthopaedics, Narayana Medical College and Hospital, Nellore from December 2014 to June 2016. The complete data was collected from all the patients by taking history of illness and by doing detailed clinical examination and relevant investigations. Finally after the diagnosis, the patients were selected for the study depending on the inclusion and exclusion criteria. Postoperatively all the cases were followed for the minimum period of 6 months to maximum period of 1 year.</p><p><strong>Results: </strong>In this study 22 patients were involved. There were 14 males and 8 females, with a mean age of 46 years. 19 cases were admitted due to slip and fall and with slight predominance of right side. Mean duration of hospital stay was 20 days and mean time of full weight bearing is 10 weeks. Out of 22 cases 2 cases lost follow up before first follow up time of 6 weeks. Out of 20, remaining cases 8 were type 3 and 12 were type 4. Functional results were graded by Harris hip scoring system. Good to excellent results were seen in 87% cases of type 3 fractures and 83% cases in type 4 fractures.</p><strong>Conclusions: </strong>Treatment with a PFLCP can provide good-to-excellent healing for proximal femur fractures, with a limited occurrence of complications especially for severe comminuted fracture and osteoporosis.

2017 ◽  
Vol 8 (4) ◽  
pp. 308-312
Author(s):  
Malkesh D. Shah ◽  
Chirag S. Kapoor ◽  
Rishit J. Soni ◽  
Jagdish J. Patwa ◽  
Paresh P. Golwala

2021 ◽  
Vol 12 (3) ◽  
pp. 81-87
Author(s):  
Sujay K Mahadik ◽  
Sasha Martyres ◽  
Mrutyunjay S Gaonkar ◽  
Anish W Isapure ◽  
Shrikant B Deshpande

Background: Distal femur fractures are generally due to high velocity trauma particularly form road traffic accidents and fall from height. The treatment of distal femur fractures has evolved from conservative to operative to fixation of both lateral and medial columns of femur. Aims and Objective:  The aim of this study was to evaluate the functional outcome of operated cases of comminuted fracture of lower end of femur fixed with locking compression plate laterally and augmented with titanium elastic nail system medially. Materials and Methods: The present study was a prospective study carried out in Bharati Vidyapeeth Medical College and Hospital, Sangli after approval from institutional ethical committee. In this study, 20 patients with communited fracture of lower end of femur were included on the basis of a predefined inclusion and exclusion criteria. Detailed history was taken and clinical examination was done in all cases. After preanesthetic evaluation and relevant investigations patients were treated by reduction (close or open) and fixation was done by locking compression plate laterally and augmented with titanium elastic nail system medially. Patients were followed up at 6, 10 and 14 weeks for functional outcome by Neer’s scoring system and degree of flexion at knee joint. Results: Out of 20 studied cases there were 16 (80%) males and 4 (20%) were females with a M:F ratio of 4:1. The mean age of male patients was found to be 42.81+/-14.79 whereas mean age of female patients was 40.5 +/- 14.36. The mean age of male and female patients was found to be comparable with no statistically significant difference (P=0.78). Most of the patient were diagnosed with the fracture of AO TYPE C3 (7 cases), followed by AO TYPE C1 (4 cases). Full weight bearing was achieved in 8 (40%) patients within 18 weeks whereas remaining 12 (60%) patients required more than 20 weeks for full weight bearing. 14 (70%) patients had excellent outcome whereas, Good, Fair and poor outcomes were seen in 4 (20%), 1 (5%) and 1 (5%) patient. On one-way ANOVA analysis, showed that the flexion was significantly higher in 12 weeks as that of the 6 weeks (P =<0.0001). Further the flexion was significantly higher in 24 weeks as that of the 6 and 12 weeks (P =<0.0001). Conclusion: Our study found that locking compression plating laterally augmented with titanium elastic nail system medially for comminuted distal femoral fractures is a good fixation system and provides good angular stability.


2018 ◽  
Vol 2 (3) ◽  
pp. 260-265
Author(s):  
Shambhu Sah ◽  
Navin Kumar Karn ◽  
Bikash KC ◽  
Roshan Yadav ◽  
Sailj Jung Dangi ◽  
...  

Introduction: Distal femoral fractures comprise 4-6% of all femur fractures. The management of distal femur fractures are challenging because of significant morbidity and complication rate even with advanced surgical techniques and implants. Open reduction and internal fixation (ORIF) with pre-contoured distal femoral locking compression plate (DF-LCP) is one of the most acceptable surgical procedures these days.Objectiv: Evaluation of functional outcomes of distal femur fractures managed surgically using DF-LCP at Koshi Zonal Hospital.Methodology: In this cross sectional study 21 patients having closed distal femur fractures with or without intra-articular extension to femoral condyle fixed with DF-LCP at Koshi Zonal Hospital, Nepal from March 2016 to March 2017 were included. Patients with open fracture, severe comminuted fracture, and neurovascular impairment were excluded. These patients were followed-up for up to one year and we recorded the knee range of motion, full weight bearing time fracture union time, and complications. We used Neers' functional scoring system to evaluate the final outcomes and data was analysed using Microsoft Excel Programe.Results: Out of the 21 patients of distal femur fractures, 16 were diametaphyseal distal femur fractures and five were supracondylar fractures with intra-articular extension. Mean age recorded was 45 (range 19-75) years, hospital stay mean duration 12 (range 10-19) days and duration of surgery 85 (range 60-150) minutes, full weight bearing walking time mean 16 (range 12-22) weeks, radiological union time mean 20 (range 17-29) weeks and Neers' score was excellent in 66.66%, satisfactory in 23.80%, unsatisfactory in 4.76%, and poor in 4.76%.None of our patients had complications like; loss of fixation, implant failure or post-operative neurovascular injury.Conclusion: Distal Femoral Locking Plate is one of the best implant to be used as fixation method for both extra-articular and intraarticular distal femur fracture.Birat Journal of Health SciencesVol.2/No.3/Issue 4/Sep- Dec 2017, Page: 260-265  


2020 ◽  
Vol 6 (2) ◽  
pp. 69-72
Author(s):  
Sandeep Krishna Avulapati ◽  
◽  
Avinash Bajjuri ◽  
Sunil Boddu ◽  
Anudeep Peddineni ◽  
...  

Author(s):  
Mahendra K. Aseri ◽  
Vijaypal Singh ◽  
Pradeep Kr. Sharma

<p class="abstract"><strong>Background:</strong> Tibial plateau fractures are common intra-articular fractures, representing 1.2% of all fractures. These fractures are common in two age groups: as higher-energy fractures in younger patients and lower-energy fractures in elderly patients secondary to osteopenia. In the younger population, these injuries are associated with an increased incidence of complications like nonunion, infection, restriction of motion, and post-traumatic arthritis. The study aimed for final outcome of proximal tibial fracture using locking compression plate by minimally invasive percutaneous plate osteosynthesis (MIPPO).</p><p class="abstract"><strong>Methods:</strong> 30 cases of proximal tibial fractures were treated by using locking compression plate and studied from December 2015 to November 2017 in Department of Orthopaedics, Dr. S.N. Medical College associated group of Hospitals, Jodhpur.<strong></strong></p><p class="abstract"><strong>Results:</strong> All the selected 30 cases were followed up for 6 months. The average time for union of fracture was 21 weeks ranging from 18-24 weeks. Full weight bearing was not allowed until 12 weeks or complete fracture union. Partial immobilization was kept for 6 weeks in long knee brace. An average flexion was achieved upto0-114<sup>0</sup>. We observed 4 cases of postoperative complications that included 2 infections, one knee stiffness and one varus deformity.</p><p class="abstract"><strong>Conclusions:</strong> Surgical management of proximal tibia fractures with only lateral plating by MIPPO gave excellent reduction, rigid fixation to restore articular congruity and provides early motion to achieve optimal knee function and reducing post-traumatic osteoarthritis.</p>


2022 ◽  
Vol 8 (1) ◽  
pp. 253-260
Author(s):  
Manpreet Singh

Background: Fractures of the proximal femur, including fractures affecting the pertrochanteric region, have become a public health problem. Owing to aging of the population, we have to operate on even more elderly patients who sometimes present with significant co-morbidities. Although conventional implants have given good results in stable peritrochanteric fractures, proximal femur locking compression plate (PFLCP) which has been recently introduced is better suited for comminuted, unstable pertrochanteric fractures and osteoporotic bones. In PF-LCP, bone-implantconstruct so formed is mechanically stable and fixation failure due to screw loosening in osteoporotic bone can be reduced. Materials &Methods: This prospective study was conducted in our institute and was approved by local ethical committee. Twenty-five consecutive patients of either sex with age more than 60 years (range, 60-84) having pertrochanteric fractures were operated upon with PFLCP. A.O classification was followed in the study and Singh’s index for osteoporosis was calculated. Operating time, blood loss and any technical difficulty with the implant were recorded. Patients were followed clinically and radiologically for union at fracture site and implant-related complications for a period of 24 months. The Harris Hip Score was used to document hip functions at final follow-up. Observations: Amongst the 25 patients, the average operation time in our study was 66.60±10.57 minutes. The average radiological union was 3.40±0.63 months (13.6 weeks). Average time for full weight bearing was 13.12±1.90 weeks. There were two cases of wound infection, one case of coxa vara and one case of a proximal screw back-out. There was no case of plate lift or screw breakage. There was no case of non-union. Conclusion: The PFLCP can be a feasible alternative to the treatment of peritrochanteric fractures. Treatment with PFLCP can provide good-to-excellent healing in osteoporotic bones having comminuted and unstable peritrochanteric fractures, with a limited occurrence of complications.


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