Reverse distal femoral locking plate for the management of unstable peritrochanteric femoral fracture

Abstract

Background: Dynamic Hip screw(DHS) is gold standard for fixation of stable intertrochanteric fractures and for unstable fractures proximal femoral nail (PFN) is preferred implant however PFN is technically demanding and has frequent complications. We have evaluated the efficacy of reverse supracondylar locking plate for the management of unstable peritrochanteric fractures.Methods and material: 23 patients with unstable peritrochanteric fracture were recruited in our study as per AO classification. All the patients, after getting informed consent, were treated surgically by reverse supracondylar locking plate. Functional outcome was evaluated in terms of Harris Hip Score. Results: After a minimum follow-up of 29 months, all patients have shown fracture healing and union at mean of 12.4 weeks. The Harris Hip score at most recent follow up was 84.1. Outcomes were excellent in 14.2%, good in 61.9%, fair in 9.5%while poor in 14.2%. Conclusion: By virtue of our results we can recommend that reverse supracondylar locking plate can be used as an alternative, viable and easily available implant that can be used effectively for unstable peritrochanteric fractures.