Treatment of Peritrochanteric Femur Fractures With Proximal Femur Locked Plating.

OBJECTIVES

To report on our results using a proximal femoral locking plate for the treatment of peritrochanteric femur fractures.

DESIGN

Retrospective study.

SETTING

Level I Academic Medical Center.

PATIENTS: Sixty-eight patients with 68 fractures.

INTERVENTION: Demographics, fracture morphology, preoperative imaging, rationale against nailing, and outcomes were collected.

MAIN OUTCOME MEASUREMENTS: Outcomes were grouped into no complication, minor complication, or major complication. Minor complications included healed fractures with implant failure or change in alignment from immediate postoperative radiographs, which did not require intervention or elective implant removal. Major complications included any case that required revision for nonunion or implant failure.

RESULTS

Nine patients were lost to follow-up. Of the 59 fractures, 16 had complications (27%): 9 minor and 7 major. Active tobacco use (P = 0.020) and fractures with an associated intracapsular femoral neck component (P = 0.006) correlated with complications.

CONCLUSIONS

Proximal femoral locking plates continue to be associated with a high complication rate. However, based on our experience, proximal femoral locking plates may be considered in highly selected cases when absolutely no other implant is deemed appropriate, based on the degree of comminution and the complexity of the fracture pattern. Patients must be informed about the possibility of revision surgery based on the inherent limitations of these devices.

LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.