Complications following proximal femoral locking compression plating in unstable proximal femur fractures: medium-term follow-up

被引:8
作者
Hodel S. [1 ]
Beeres F.J.P. [1 ]
Babst R. [1 ]
Link B.-C. [1 ]
机构
[1] Department of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, Luzern 16
关键词
Intertrochanteric fracture; Pertrochanteric fracture; Plate osteosynthesis; Subtrochanteric fracture;
D O I
10.1007/s00590-017-1981-1
中图分类号
学科分类号
摘要
Purpose: To assess the outcome in patients treated with proximal femoral locking compression plate (PF-LCP 4.5/5.0, Synthes©) for unstable inter- and subtrochanteric femoral fractures. Methods: A retrospective analysis of 16 patients with proximal femur fractures (AO: 31A2: n = 5/32.3%; 31-A3: n = 10/62.5%; 32B1: n = 1/6.3%) treated with a PF-LCP at a Level 1 trauma centre between 2011 and 2015 was conducted. Results: Sixteen patients were available for follow-up with a mean follow-up time of 14 months (range 4–29). Primary outcome included fracture healing, post-operative complications and post-operative ambulatory status. Male to female ratio was 1:1. Mean age was 61 ± 17 years. Union was achieved in a mean of 13.5 ± 3 weeks (range 12–20 weeks). Five patients (31.3%) had implant-associated complications like non-union, malrotation, late implant-associated infection, distal screw fractures and post-traumatic impingement of the hip. Consequently, four patients (25%) had to undergo revision surgery. There was no reported case of secondary varus collapse or cut-out. Conclusions: Complications occurred in 31.3% (n = 5) in medium-term follow-up after PF-LCP in proximal unstable inter- and subtrochanteric femur fractures. These findings are supported by results of other groups. However, further studies to evaluate risk factors associated with failure of this implant are required. © 2017, Springer-Verlag France.
引用
收藏
页码:1117 / 1124
页数:7
相关论文
共 33 条
[1]  
Koval K.J., Zuckermann J.D., Lower extremity fractures and dislocations, Handbook of fractures, pp. 329-338, (2006)
[2]  
Wirtz C., Abbassi F., Evangelopoulos D.S., Kohl S., Siebenrock K.A., Kruger A., High failure rate of trochanteric fracture osteosynthesis with proximal femoral locking compression plate, Injury, 44, pp. 751-756, (2013)
[3]  
Knobe M., Munker R., Sellei R.M., Schmidt-Rohlfing B., Erli H.J., Strobl C.S., Et al., Unstable pertrochanteric femur fractures. Failure rate, lag screw sliding and outcome with extra- and intramedullary devices (PCCP, DHS and PFN), Z Orthop Unfallchirurgie, 147, pp. 306-313, (2009)
[4]  
Rahme D.M., Harris I.A., Intramedullary nailing versus fixed angle blade plating for subtrochanteric femoral fractures: a prospective randomised controlled trial, J Orthop Surg (Hong Kong), 15, pp. 278-281, (2007)
[5]  
Suckel A.A., Dietz K., Wuelker N., Helwig P., Evaluation of complications of three different types of proximal extra-articular femur fractures: differences in complications, age, sex and surviving rates, Int Orthop, 31, pp. 689-695, (2007)
[6]  
Sadowski C., Lubbeke A., Saudan M., Riand N., Stern R., Hoffmeyer P., Treatment of reverse oblique and transverse intertrochanteric fractures with use of an intramedullary nail or a 95 degrees screw-plate: a prospective, randomized study, J Bone Joint Surg Am, 84, pp. 372-381, (2002)
[7]  
Brunner A., Jockel J.A., Babst R., The PFNA proximal femur nail in treatment of unstable proximal femur fractures-3 cases of postoperative perforation of the helical blade into the hip joint, J Orthop Trauma, 22, pp. 731-736, (2008)
[8]  
Madsen J.E., Naess L., Aune A.K., Et al., Dynamic hip screw with trochanteric stabilizing plate in the treatment of unstable proximal femoral fractures: a comparative study with the Gamma nail and compression hip screw, J Orthop Trauma, 12, pp. 241-248, (1998)
[9]  
Synthes© Incorporation or its affiliates4.5 mm LCP Proximal Femur Plates, (2010)
[10]  
Wieser K., Babst R., Fixation failure of the LCP proximal femoral plate 4.5/5.0 in patients with missing posteromedial support in unstable per-, inter-, and subtrochanteric fractures of the proximal femur, Arch Orthop Trauma Surg, 130, pp. 1281-1287, (2010)