Proximal Femoral Locking Plate (PFLP ) A Salvage Option in Nonunion of Proximal Femoral Fractures
Keywords:
Proximal femoral locking compression plate, proximal femoral fracture OsteosysthesisAbstract
Nonunion of intertrochanteric fractures is uncommon because there is excellent blood supply and good cancellous bone in the intertrochanteric region of the femur. When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN) or surface implants like Dynamic Condylar Screw (DCS) are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the proximal femoral locking compression plate (PFLP) in one case undergoing revision surgery. We aimed to evaluate the efficacy of this implant in salvage situations. Patient with primary proximal femoral fracture (reverse oblique type) was treated with DHS and plate and subsequently went into non union because of implant failure. Fracture united satisfactorily after fixation with PFLP and bone grafting, without any complications.
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References
Mathews V, Cabanela ME. Femoral neck nonunion treatment. Clin Orthop Relat Res. 2004;419:57–64.[PubMed]
Angelini M, McKee MD, Waddell JP, Haidukewych G, Schemitsch EH. Salvage of failed hip fracture fixation. J Orthop Trauma. 2009;23:471–8. [PubMed]
Baumgartner MR, Solberg BD. Awareness of tipapex distance reduces failure of fixation of trochanteric fractures of the hip. J Bone Joint Surg Br. 1997;79:969–71. [PubMed]
Kyle RF, Gustilo RB, Premer RF. Analysis of 622 intertrochanteric hip fractures. J Bone Joint Surg Am. 1979;61:216–21. [PubMed]
Baker HR. Ununited intertrochanteric fractures of the femur. Clin Orthop Relat Res. 1960;18:209–20.
Boyd HB, Lipinski SW. Nonunion of trochanteric and subtrochanteric f ra c t u re s . S u r g Gy n e c o l O b s t e t . 1957;104:463–70. [PubMed]
Haidukewych GJ, Israel TA, Berry DJ. Reverse obliquity of fractures of the intertrochanteric region of the femur. J Bone Joint Surg Am. 2001;83:643–50. [PubMed]
Mariani EM, Rand JA. Nonunion of intertrochanteric fractures of the femur following open reduction and internal fixation: Results of second attempts to gain union. Clin Orthop Relat Res. 1987;218:81–9. [PubMed]
Sarathy MP, Madhavan P, Ravichandran KM. Nonunion of intertrochanteric fractures of the femur. J Bone Joint Surg Br. 1994; 77:90–2. [PubMed]
Wu CC, Shih CH, Chen WJ, Tai CL. Treatment of cutout of a lag screw of a dynamic hip screw in an intertrochanteric fracture. Arch Orthop Trauma Surg. 1998; 117:193–6. [PubMed]
Weber BG, Cech O. Pseudoarthrosis. Bern: Huber; 1976. pp. 181–4.
Bartonícek J, Skála-Rosenbaum J, Dousa P. Valgus intertrochanteric osteotomy for malunion and nonunion of trochanteric fractures. J Orthop Trauma. 2003; 17:606–12. [PubMed]
Fracture and dislocation compendium. Orthopaedic Trauma Association Committee for Coding and Classification. J Orthop Trauma. 1996;10(Suppl 1):1–154. [PubMed]
Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: Treatment by mold arthroplasty: An endresult study using a new method of result evaluation. J Bone Joint Surg Am. 1969; 51:737–55. [PubMed]
Haidukewych GJ, Berry DJ. Salvage of failed internal fixation of intertrochanteric hip fractures. Clin Orthop Relat Res. 2003; 412:184–8. [PubMed]
Altner PC. Reasons for failure in treatmen of intertrochanteric fractures. Orthop Rev. 1982; 11:117.
