Complications following proximal femoral locking compression plating in unstable proximal femur fractures: medium-term follow-up

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Abstract
Purpose To assess the outcome in patients treated with proximal femoral locking compression plate (PF-LCP 4.5/5.0, Synthes©) for unstable inter- and subtrochanteric femoral fractures. Methods A retrospective analysis of 16 patients with proximal femur fractures (AO: 31A2: n = 5/32.3%; 31-A3: n = 10/62.5%; 32B1: n = 1/6.3%) treated with a PF-LCP at a Level 1 trauma centre between 2011 and 2015 was conducted. Results Sixteen patients were available for follow-up with a mean follow-up time of 14 months (range 4–29). Primary outcome included fracture healing, post-operative complications and post-operative ambulatory status. Male to female ratio was 1:1. Mean age was 61 ± 17 years. Union was achieved in a mean of 13.5 ± 3 weeks (range 12–20 weeks). Five patients (31.3%) had implant-associated complications like non-union, malrotation, late implant-associated infection, distal screw fractures and post-traumatic impingement of the hip. Consequently, four patients (25%) had to undergo revision surgery. There was no reported case of secondary varus collapse or cut-out. Conclusions Complications occurred in 31.3% (n = 5) in medium-term follow-up after PF-LCP in proximal unstable inter- and subtrochanteric femur fractures. These findings are supported by results of other groups. However, further studies to evaluate risk factors associated with failure of this implant are required.

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