Modified proximal locking plates in the treatment of comminuted femoral intertrochanteric fracturers
YANG Yun-gang
YANG Lei-gang
YANG Tian-xu
YANG Yu-xuan
YANG Xiu-ming
XUE Huan-xiang
YUAN Hong
Abstract：Objective To compare the effects of modified proximal locking plates and proximal femoral nail antirotation ( PFNA ) for the treatment of comminuted femoral intertrochanteric fracturers. Methods From January 2008 to June 2016, 118 patients with comminuted femoral intertrochanteric fracturers were treated with modified proximal locking plates or PFNA. All patients were divided into Group A ( PFNA ) and Group B ( modified proximal locking plates ). There were 51 males and 67 females, with an average age of 73 years ( range: 61 - 88 years ). According to the Evans fracture classification: 54 patients were of type III, 43 patients were of type IV, 21 patients were of type V. The data were collected for statistical analysis on the following aspects: operation time, blood loss, clinical fracture healing time, postoperative complications, Harris and Parker hip scores. Results All cases were followed up for 6 - 24 months ( average: 13.27 ± 5.42 months ). There were no significant differences between the 2 groups in operation time, average perioperative blood loss, hospital stay, fracture healing time, time to postoperative hip mobilization ( P > 0.05 ). The intraoperative fluoroscopy frequency in Group A ( 5.63 ± 2.1 times ) was significantly higher than that of the Group B ( 2.21 ± 1.1 times ) ( P < 0.05 ). The average loading time after the operation in Group A ( 18.1 ± 4.2 days ) was significantly earlier than that of the Group B ( 35.4 ± 7.2 days ) ( P < 0.05 ). Group A: limb shortening occurred in 3 cases, fracture nonunion and fixation failure occurred in 2 cases; Group B: no coxa vara, limb shortening, fracture nonunion or fixation failure occurred; significant differences existed ( P < 0.05 ). Excellent and good rate based on the Harris, Parker evaluation system: 70.5% in Group A; 94.3% in Group B; significant differences existed ( P < 0.05 ). Conclusions Fixation with modified proximal locking plates is a reliable method achieving proximal cortex fixation on both sides. It resists rotation force, tensile stress, shear force, pull-out force with less bone loss, less complications, lower intraoperative fluoroscopy frequency, higher fracture healing rate. It is beneficial to the recovery with broader indications, which is meanwhile safe and effective.
Keywords：Femoral fracturesHip fracturesFracture fixationinternal
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 179-183 )