Palanikumar, C (2013) Internal fixation of unstable intertrochanteric fractures with sliding hip screw and proximal locking compression plate: A short term prospective and comparative study. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: Hip fractures are the second most common cause for hospitalisation elderly patients. Several epidemiological studies have shown that the incidence of proximal femoral fractures are increasing which is not unexpected because General life expectancy and associated osteopenia of population increased significantly during the past few decades .This number is expected to double by year 2050.The cause of Injury is simple fall in elderly individuals and high energy trauma in case of younger individuals. Now the two broad categories1 of internal fixation devices are used for fixation of inter trochanteric fractures. 1. Extramedullary (SHS, DCS, Angled blade plate), 2.Intra medullary (Cephalo-medullary nails). But the preferred type device in unstable intertrochanteric fracture is controversial. So still there is a series of evaluation in search of a perfectimplant. Role of SHS in unstable intertrochanteric fracture is having complication rate as high as 4-20% such as screw cut out and varus collapse of the proximal fragment. AIM: To prospectively compare the functional outcome of unstable intertrochanteric fractures treated with Sliding Hip Screw and PFLCP. MATERIALS AND METHODS: This study was conducted at Rajiv Gandhi Government General Hospital and Madras Medical College on 40 patients with unstable intertrochanteric fractures from June 2010 to October 2012 and they were treated respectively by PFLCP (n=20) and SHS (n=20). Inclusion Criteria - • Age more than 18 years, • Both genders, • Unstable intertrochanteric fracturesof Boyd and Griffin type II, III, IV. Exclusion criteria: • Open fractures (Grade II, III), • Pathological fractures, • Inability to walk prior to injury, • Patients with associated fractures of lower limb, • Patient unfit for surgery, • Un co- operative patient for post-operative rehabilitation. RESULTS: This study was conducted at Madras Medical College and Rajiv Gandhi Govt.General Hospital on 40 unstable intertrochanteric fractures from May 2010 to October 2012 .In our study all the patients were evaluated clinically using Harris - Hip Score at various follow-up period. Based on the Harris Hip Score the results were graded as excellent, good, fair, and poor as follows: Excellent : > 90 points, Good : 80-89 points, Fair : 70-79 points, Poor : < 70 points. CONCLUSION: Results of our study were comparable with already published reports of treatment of unstable intertrochanteric fractures with proximal femoral locking compression plate. From our study fractures treated with PFLCP hadbetter outcome than SHS. In ourstudy despite randomisation the PFLCP group had significantly younger individuals, which may have biased the outcome. Though results were encouraging the experience was short. More clinical trials are needed to analyse the validity of PFLCP fixation in the treatment of unstable intertrochanteric fractures.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Internal fixation ; unstable intertrochanteric fractures ; sliding hip screw ; proximal locking compression plate ; short term prospective and comparative study. |
| Subjects: | MEDICAL > Orthopaedics |
| Depositing User: | Subramani R |
| Date Deposited: | 16 Sep 2017 08:22 |
| Last Modified: | 16 Sep 2017 08:22 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3141 |
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