Clinico-radiological results of unstable trochanteric fractures treated with custom-made trochanteric stabilisation plate and dynamic hip screw (DHS)

Abstract

Aim: To evaluate the clinico-radiological results of implantation of Custom-made Trochanteric stabilisation plate (TSP) along with Dynamic Hip Screw (DHS) in unstable trochanteric fractures and assess whether it prevents complications such as excessive collapse and femoral medialization.Materials and Methods: 58 consecutive patients with unstable intertrochanteric fractures (AO CLASSIFICATION) were treated with an additional custom-made TSP superimposed on the regular DHS at our institution between JAN 2012 TO DEC 2015.9 patients did not turn up for regular follow-up. Thus, 49 patients were followed-up for a period of 6 months. Patients were assessed clinically using Harris His Score and Salvati-Wilson score at each follow-up. Results: Excessive collapse and medialization of femur were successfully prevented in 49 patients. Clinico-radiological consolidation of fracture was observed at an average of 15.23 weeks in all the cases. The average sliding distance was 7.3 mm.38 patients had a Harris Hips Score (HHS) of above 90 at the final follow up and the rest had a HHS of above 80. Functional results were excellent in 88 percent of patients and good in the rest 12 percent according to Salvati- Wilson score. Conclusion: In unstable intertrochanteric fractures with lateral wall comminution, the use of our custom-made TSP along with DHS helps in achieving a stable fixation and prevents complications such as excessive collapse and femoral medialization. Custom-made TSP is easily available and is a cost-effective alternative for anatomical TSP.