Locking compression plate fixation of femoral intertrochante
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A Study was conducted to investigate the clinical efficacy of locking compression plate fixation for the treatment of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity.

A retrospective analysis was conducted on 37 patients with femoral intertrochanteric fractures combined with preexisting proximal femoral deformity. The patients included 24 males and 13 females aged from 23 to 69 years old, with an average age of 47.5 years.

The preexisting proximal femoral deformities resulted from poliomyelitis sequela, proximal femoral fibrous dysplasia, malunion and implant failure combined with coxa vara after intramedullary nailing fixation. There were 6 cases of 31-A2.1, 6 cases of 31-A2.2, 20 cases of 31-A3.1, and 5 cases of 31-A3.2, determined based on the AO classification of intertrochanteric fractures. All fractures were managed through open reduction and locking plate fixation.

The hip disability and osteoarthritis outcome score (HOOS) was used to assess hip function before injury and at the last postoperative follow-up. The short form 36 (SF-36) Health Survey Questionnaire was used to assess quality of life.

Results:
--37 patients were followed up for 12 to 27 months (average, 20.7 months). All patients achieved bone healing within 5.1 months on average (range, 3 to 6 months).

--Postoperative complications included deep vein thrombosis in three patients, bedsores in one and delayed union in one patient.

--No other complications, such as surgical site infection, fat embolism, nonunion and re-fracture, were presented.

--There was no significant difference in the HOOS scores and the SF-36 Health Questionnaire outcomes at pre-injury and at the last postoperative follow-up.

In conclusion, intramedullary fixation of femoral intertrochanteric fractures in patients with proximal femoral deformity is difficult, while locking compression plate fixation is an easy and efficient treatment option.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02430-5
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