gms | German Medical Science

Objectives: To investigate the clinical efficacy of locking compression plate fixation in the treatment of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity.

Methods: A retrospective analysis was conducted by enrolling 37 patients with femoral intertrochanteric fractures combining the preexisting proximal femoral deformity from January 2013 to July 2020. There were 24 males and 13 females aged 23 to 69 with an average of 47.5. The preexisting proximal femoral deformity resulted from poliomyelitis sequela, proximal femoral fibrous dysplasia, malunion and implants failure combined with coxa vara after intramedullary nailing fixation. There were 6 cases of 31-A2.1, 6 cases of 31-A2.2, 20 cases of 31-A3.1 and 5 cases of 31-A3.2 according to the AO classification of intertrochanteric fracture. All fractures were managed by open reduction and locking plate fixation. The hip disability and osteoarthritis outcome score (HOOS) was used to assess the hip function before injury and at the last postoperative follow-up. The short form 36(SF-36) Health Survey Questionnaire was used to assess the quality of life.

Results: 37 patients were followed up for 12 to 27 months (average 20.7 months). All patients achieved bone healing in 5.1 months by average (ranging from 3 to 6 months). Postoperative complications included deep vein thrombosis in three patients, bedsores in one and delayed union in one patient. No other complications such as surgical site infection, fat embolism, nonunion and re-fracture were presented. There was no significant difference in the HOOS scores and the SF-36 Health Questionnaire between pre-injury and the last postoperative follow-up group (p>0.05).

Conclusions: It is difficult to perform intramedullary fixation for femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity while locking compression plate fixation is a simple and effective treatment.