Abstract: Background: Subtrochanteric fractures constitute 10-30% of the hip fractures. Various implants were used to fix the fractures. Proximal femoral locking plate (PFLP) allows either direct anatomic reduction or indirect reduction and bridge plating techniques. Due to biomechnical advantage proximal femoral nails (PFN) have found superior to other implants.
Objectives: To compare the Radiological and Functional Outcome of Subtrochanteric Fractures treated with proximal femoral nail (PFN) and Proximal femoral locking plate (PFLP) and to find out the more appropriate implant for the specific fracture pattern.
Methods: 36 patients with Subtrochanteric femur fracture were operated and fixed by proximal femoral nail and proximal femoral locking plate (18 in each group). Follow up done for 24 months. Outcome was assessed by Harris Hip Score (HHS) and radiologically.
Results: The patients treated by proximal femoral nailing required significantly less time for full weight bearing (16.06 weeks) as compared to the patients treated by proximal femoral locking plate (21.41 weeks).Radiological union was significantly delayed in the patients treated by proximal femoral locking plate (mean time 21.41 weeks) as compared to the patients treated by proximal femoral nailing (16.39 weeks). Nailing group had slightly better average HHS (93) than in the plating group (89.44).
Conclusion: PFN have the advantage by taking less operative time, high rate of union, minimal soft tissue damage, less infection rate and early postoperative rehabilitation. In our study we found that both PFN & PFLP can be satisfactorily used in the treatment of Subtrochanteric fractures. There was significantly no major difference between implants with respect to anatomical alignment, limb length discrepancy, postoperative infection and most importantly the final outcome measured by Harris Hip Score.
