Treatment of unstable peritrochanteric femoral fractures using a 95 degrees angled blade plate.

Abstract

OBJECTIVE: To clarify the efficacy of a 95-degree angled blade plate fixation in the treatment of unstable peritrochanteric fractures of the femur.

DESIGN: Retrospective, clinical study.

SETTING: University hospital.

PATIENTS: Thirty-nine consecutive patients with peritrochanteric femoral fractures were followed for a minimum of 12 months. There were 29 subtrochanteric fractures and 10 intertrochanteric fractures (reverse obliquity pattern) for which the compression hip screw could not be used because of comminution of the trochanteric area and fracture extension to the lateral cortex. The mean age of the patient population at the time of operation was 54 (range, 17-71) years.

INTERVENTION: Open reduction and internal fixation of the pertrochanteric fractures using a 95 degrees angled blade plate.

MAIN OUTCOME MEASUREMENTS: Time to fracture union, operation time, and complications.

RESULTS: Duration of clinical follow-up averaged 26 (range, 12-36) months. The average time to osseous union for those fractures that healed primarily was 19 (range, 13-28) weeks. Two of 39 fractures united with 10 degrees varus deformity, but no corrective surgery was warranted. Limb length discrepancy more than 1.5 cm did not occur. Implant failure before solid bony union occurred in 1 case with a severely comminuted subtrochanteric fracture. Postoperative infection or osteonecrosis of the femoral head did not occur any time throughout the follow-up period.

CONCLUSION: A 95 angled blade plate can be a useful alternative fixation device for the treatment of unstable peritrochanteric femoral fractures.