Locking plate fixation of intertrochanteric fractures in patients with deformed proximal femur / 中华创伤骨科杂志

ABSTRACT

Objective To explore the clinical outcomes of locking plate fixation of intertrochanteric fractures in patients with deformed proximal femur.Methods A retrospective review was made of the 25 patients with intertrochanteric fracture and deformed proximal femur who had been treated from January 2009 to July 2015.They were 17 men and 8 women,from 22 to 76 years of age (mean,45.2 years).The proximal femoral deformities were postpoliomyelitis syndrome in 6 cases,fibrous dysplasia in 4,malunion in 13,and hip varus caused by implant breakage following intramedullary nailing in 2.By AO classification,there were 4 cases of type 31-A2.1,3 ones of type 31-A2.2,16 ones of type 31-A3.1,and 2 ones of type 31-A3.2.All the patients were treated by open reduction plus locking plate fixation.At the final follow-up,function of the affected hip was evaluated by the Hip Disability and Osteoarthritis Outcome Score (HOOS),and quality of life of the patients was evaluated using the SF-36 health survey questionnaire.Results The 25 patients were effectively followed up for 12 to 24 months (mean,17.4 months).No infection,pneumonia,fat embolism,or deep venous thrombosis of lower limb was observed.The fractures healed without nonunion or refracture after a mean time of 5.9 months (range,from 3 to 6 months) in the 25 patients.By the HOOS evaluation at the final follow-ups,the 25 patients scored,on average,83.7± 15.6 in pain,55.6± 14.1 in symptoms,53.6 ± 9.5 in daily living function,52.7 ± 8.9 in sports and recreational activities and 62.4 ± 12.3 in quality of life;by SF-36 evaluation,they had a mean total score of 71.2 ± 13.8.Both the HOOS and SF-36 scores were not significantly different from the pre-injury values (P ＞ 0.05).Conclusion Locking plate fixation is a simple and effective way for the intertrochanteric fractures complicated with deformed proximal femur because intramedullary nailing is difficult or infeasible.