The outcome of unstable proximal femoral fracture treated with reverse LISS plates

详细信息    查看全文

• 作者：Shih-Jie Lin^a ; Kuo-Chin Huang^a ; ^b ; Po-Yao Chuang^a ; Chien-Yin Lee^a ; Tsan-Wen Huang^a ; ^b ; ^{b8601081@cgmh.org.tw" class="auth_mail" title="E-mail the corresponding author} ; Mel S. Lee^b ; ^c ; ^{bone@doctor.com" class="auth_mail" title="E-mail the corresponding author} ; Robert Wen-Wei Hsu^a ; ^b
• 关键词：Reverse LISS ; Proximal femur ; Pertrochanteric ; Unstable fracture ; Locking plate
• 刊名：Injury
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：47
• 期：10
• 页码：2161-2168
• 全文大小：1972 K

文摘

The Russel-Taylor type 2B fractures compromised the trochanteric region and medial buttress of proximal femur. This fracture pattern limits the choice of implants and raises the risk of adverse outcomes. We aimed to (i) determine the outcome of Russel-Taylor type 2B fractures treated using reverse less invasive stabilization system plates (LISS-DF) and to (ii) learn what factors affected outcomes after osteosynthesis with reverse LISS plates.

Design

A retrospective study

Setting

The study was conducted at a Level III trauma center in Taiwan.

Methods

Twenty-five consecutive patients presenting with a Russel-Taylor type 2B fracture were enrolled. All cases were treated with reverse LISS plates. A Modified Radiographic Union Scale for Femur (RUSF), Radiographic parameters, functional scores, and complications were assessed.

Results

Union occurred in 21 cases at an average of 18.8 weeks. The average immediate postoperative neck-shaft angle was 130° (range: 122–135°) compared with 139° (range: 135–141°, p = 0.05) on the contralateral side. Two cases had complications of proximal screws cutting out and two cases had broken implants. Finally, all 4 cases required repeated surgeries (16%). Malunion occurred in 4 patients and early mechanical failure (proximal screws cut out) occurred in 2. There was a significant difference in the purchase index of the proximal screws between cases with redisplacement and those without (26.4 mm and 98.6 mm, p = 0.01).

Conclusions

The use of reverse LISS plate appeared to be an alternative procedure for the specific pattern in the present study. We recommend using this reverse locking plate to treat unstable proximal femoral fractures with meticulous techniques of placing plates. Adequate purchase of the proximal locking screws might decrease the risks of complications.