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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| Format: | Article |
| Language: | English |
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Jaypee Brothers Medical Publisher
2024-06-01
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| Series: | Journal of Orthopedics and Joint Surgery |
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| Online Access: | https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1169 |
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| author | Jitendra Wadhwani Ramchander Siwach Himanshu Bansal Roop Singh Pradeep Kamboj Hemant More |
| author_facet | Jitendra Wadhwani Ramchander Siwach Himanshu Bansal Roop Singh Pradeep Kamboj Hemant More |
| author_sort | Jitendra Wadhwani |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-42f5e9cad8b04e8bb6480b69a0cbc22c |
| institution | Kabale University |
| issn | 2582-7863 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Jaypee Brothers Medical Publisher |
| record_format | Article |
| series | Journal of Orthopedics and Joint Surgery |
| spelling | doaj-art-42f5e9cad8b04e8bb6480b69a0cbc22c2025-02-07T11:18:35ZengJaypee Brothers Medical PublisherJournal of Orthopedics and Joint Surgery2582-78632024-06-016213614110.5005/jojs-10079-116910A Prospective Randomized Study for Comparison of Modified Proximal Femoral Plate with Dynamic Hip Screw SystemJitendra Wadhwani0https://orcid.org/0000-0002-3656-3281Ramchander Siwach1https://orcid.org/0009-0008-7162-3877Himanshu Bansal2https://orcid.org/0000-0002-4441-4737Roop Singh3https://orcid.org/0000-0002-5996-5099Pradeep Kamboj4https://orcid.org/0000-0002-6526-9823Hemant More5https://orcid.org/0000-0001-9704-1148Jitendra Wadhwani, Department of Orthopedics, Pt BD Sharma, PGIMS, Rohtak, Haryana, India, Phone: +919812337494Department of Orthopedics, Pt BD Sharma, PGIMS, Rohtak, Haryana, IndiaDepartment of Orthopedics, Pt BD Sharma, PGIMS, Rohtak, Haryana, IndiaDepartment of Orthopedics, Pt BD Sharma, PGIMS, Rohtak, Haryana, IndiaDepartment of Orthopedics, Pt BD Sharma, PGIMS, Rohtak, Haryana, IndiaDepartment of Orthopedics, Pt BD Sharma, PGIMS, Rohtak, Haryana, IndiaAim: 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.https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1169dynamic hip screwharris hip scoreintertrochanteric fracturesmodified proximal femoral locking compression plateproximal femoral locking compression plate. |
| spellingShingle | Jitendra Wadhwani Ramchander Siwach Himanshu Bansal Roop Singh Pradeep Kamboj Hemant More A Prospective Randomized Study for Comparison of Modified Proximal Femoral Plate with Dynamic Hip Screw System Journal of Orthopedics and Joint Surgery dynamic hip screw harris hip score intertrochanteric fractures modified proximal femoral locking compression plate proximal femoral locking compression plate. |
| title | A Prospective Randomized Study for Comparison of Modified Proximal Femoral Plate with Dynamic Hip Screw System |
| title_full | A Prospective Randomized Study for Comparison of Modified Proximal Femoral Plate with Dynamic Hip Screw System |
| title_fullStr | A Prospective Randomized Study for Comparison of Modified Proximal Femoral Plate with Dynamic Hip Screw System |
| title_full_unstemmed | A Prospective Randomized Study for Comparison of Modified Proximal Femoral Plate with Dynamic Hip Screw System |
| title_short | A Prospective Randomized Study for Comparison of Modified Proximal Femoral Plate with Dynamic Hip Screw System |
| title_sort | prospective randomized study for comparison of modified proximal femoral plate with dynamic hip screw system |
| topic | dynamic hip screw harris hip score intertrochanteric fractures modified proximal femoral locking compression plate proximal femoral locking compression plate. |
| url | https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1169 |
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