A Prospective Randomized Study for Comparison of Modified Proximal Femoral Plate with Dynamic Hip Screw System
Aim: To conduct a prospective randomized study comparing the functional and radiological outcomes of dynamic hip screw (DHS) and modified proximal femoral locking compression plate (PFLCP) in Asian population with intertrochanteric fractures. Materials and methods: The modified PFLCP design has been...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Jaypee Brothers Medical Publisher
2024-06-01
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| Series: | Journal of Orthopedics and Joint Surgery |
| Subjects: | |
| Online Access: | https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1169 |
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| Summary: | Aim: To conduct a prospective randomized study comparing the functional and radiological outcomes of dynamic hip screw (DHS) and modified proximal femoral locking compression plate (PFLCP) in Asian population with intertrochanteric fractures.
Materials and methods: The modified PFLCP design has been created by the authors. The modification to the standard PFLCP design involves increasing the screw density for the trochanteric area, along with the provision of locking as well as compression screw slots. It is an angular stable construct with the ability to achieve compression across the fracture site. We included 112 patients (1:1 parallel design, <i>n</i> = 56) with intertrochanteric fractures. Randomization was done using the lottery method. The mean age was 65.66 years (range, 28–90) and 64.07 years (range, 31–90) in the DHS group and PFLCP group, respectively. The mean duration of surgery, intraoperative blood loss, and functional outcome at 6 months using the Harris hip score (HHS) were compared.
Results: In the DHS group and PFLCP group, the mean time to union was 18.3 and 17.2 weeks, respectively. Significant shortening at final follow-up occurred in 15.68 and 12% of patients (<i>p</i> = 0.59). Postoperative discharge from the surgical site occurred in 5.88 and 4% of patients. Implant failure occurred in 3.92 and 8% of patients (<i>p</i> = 0.43). Varus collapse occurred in 33.33 and 14% of patients (<i>p</i> = 0.022), respectively. The mean HHS was 82.6 and 86.3 in the DHS and PFLCP groups, respectively (<i>p</i> = 0.19).
Conclusion: The modified PFLCP is capable of providing equally effective radiological and functional outcomes. The modified PFLCP can be used as an alternative to the DHS in intertrochanteric fractures in severely osteoporotic patients. |
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| ISSN: | 2582-7863 |