Extra Medullary Fixation in Unstable Proximal Femoral Fractures by PF-LCP

Area of Science:

• Orthopedic surgery
• Traumatology
• Biomedical engineering

Background:

• Extra-medullary fixation of proximal femur fractures presents challenges.
• Traditional methods like the Dynamic Hip Screw (DHS) can lead to complications such as iatrogenic fractures.
• The Proximal Femur Locking Compression Plate (PFLCP) offers a potential solution with improved biomechanical properties.

Purpose of the Study:

• To evaluate the clinical outcomes of unstable proximal femur fractures treated with the PFLCP.
• To assess the efficacy of PFLCP in maintaining fracture stability and preserving bone biology.
• To compare the PFLCP technique with existing fixation methods.

Main Methods:

• A prospective study included 64 patients with unstable intertrochanteric and subtrochanteric femur fractures (Seinsheimer types II-V).
• Fractures were treated using a Minimally Invasive Plate Osteosynthesis (MIPO) technique with PFLCP.
• Outcomes were assessed by evaluating loss of reduction, infection, implant failure, fracture healing (Reborne Score), and functional recovery (Parker Mobility Score - PMS).

Main Results:

• Out of 64 patients, 24 achieved pre-injury PMS, while 39 experienced a decline of 1-3 points.
• One patient required revision surgery.
• Excellent or good results were observed in 87.5% of patients, with no reported cases of non-union or plate breakage.

Conclusions:

• PFLCP provides angular and torsional stability, crucial for resisting deforming forces in proximal femur fractures.
• The MIPO technique with PFLCP minimizes soft-tissue stripping, preserves periosteal blood supply, and enhances fracture healing.
• This approach reduces complications such as delayed healing, nonunion, infection, and implant failure, leading to favorable functional outcomes.