Abstract
Background:
Comminuted intertrochanteric fractures in middle-aged patients present complex treatment challenges due to unstable fracture patterns and the necessity for early functional recovery. Proximal femoral locking plates (PFLPs) offer angular stability and anatomical fixation in such scenarios, yet limited prospective data exists evaluating their effectiveness in this age group.
Objective:
To evaluate the early clinical and radiological outcomes of proximal femoral locking plates in the management of comminuted intertrochanteric fractures in middle-aged patients.
Methods:
This prospective observational case series was conducted from June 2023 to December 2024 at a tertiary care trauma center in LUMHS, Jamshoro, Pakistan. Twenty patients aged 35–55 years with AO/OTA type 31-A2 and A3 comminuted intertrochanteric fractures were enrolled. All patients underwent open reduction and internal fixation using proximal femoral locking plates. Functional outcomes were assessed using the Harris Hip Score (HHS), and radiological union was evaluated through serial radiographs. Patients were followed until union or complication-related intervention.
Results:
The mean age was 45.6 years, with 12 males and 8 females. Fracture union was observed between 4 and 5 months (mean 4.5 months). According to HHS, 40% had excellent, 30% good, 20% fair, and 10% poor functional outcomes. Complications included three superficial infections managed conservatively and one deep infection with implant failure requiring plate removal and Ilizarov fixation. Seventeen patients completed all follow-ups.
Conclusion:
PFLPs demonstrated satisfactory early union and functional outcomes in comminuted intertrochanteric fractures among middle-aged patients, supporting their use as a reliable fixation method in complex proximal femoral fractures.
Keywords:
Bone Plates, Femoral Fractures, Fracture Fixation Internal, Hip Fractures, Intertrochanteric Fractures, Middle Aged, Orthopedic Procedures.