Proximal femoral fractures account for about 10 to 34% of all hip fractures with bimodal age distribution and different mechanisms of injury. Older patients sustain low velocity trauma while in younger patients these fractures are from high energy trauma. Early surgical intervention is recommended for most of these patients to reduce the complications associated with prolonged immobilization. The locking compression plate is used for angular-stable plating for the treatment of complex comminuted and osteoporotic fractures. This type of internal stabilization may be the choice for subtrochanteric or transverse intertrochanteric fractures.
Objective: The study aimed to report the outcome of management of unstable proximal femoral fractures which was managed using proximal femoral locked compression plate in our setting.
Method: A retrospective study of all conservative patients managed at two centres in Nigeria. The Jos University Teaching Hospital, Jos, Plateau State and the Barau Dikko Teaching Hospital, Kaduna State University Teaching Hospital Kaduna. A structured Proforma was used to retrieve information from the hospital records and operation notes of patients that where fixed with PF-LCP.
Results: A total of 25 fractures in 25 patients where studied, 17 males and 8 females with a male female ratio of 2:1. The patient age ranged between 20 to 88 years. Road traffic accident was the commonest etiologic agent account for 73.9% of the cases and the remaining 26.1% was due to domestic falls at home. 43.8% of the patients presented 12 weeks after the injury, 25.0% of them between 4 to 12 weeks of injury and 31.2% presented within 4 weeks of the injury. The fractures were intertrochanteric in 16.0% of the patients and sub trochanteric in 84.0%. The average duration of union as evidenced by bridging callus in at least 3 cortices radiologically was 15.4weeks. 23 of the patients went on to unite without any complication one had implant failure (screw breakage) due to premature full bearing for which additional surgeries where done while another had an implant infection.
Conclusion: Proximal locked compression plating for proximal femoral fractures is a useful alternative based on its anatomic design for proximal femoral fractures in which could be due to osteoporosis especially in elderly patients.