KEYWORDS: Intertrochanteric Fracture, PFLCP, DHS Outcome.
ABSTRACT: INTRODUCTION: There have been many case series advocating the potential benefits of PFLCP for fixation of intertrochanteric fractures. But these studies are lacking in terms of guidelines regarding the type of fractures in which PFLCP has an upper hand over the gold standard implant that is the DHS. Moreover there have been very few control studies comparing these two implants. Therefore, we performed a case control study to assess: (1) If PFLCP offers better functional results and fewer complications than dynamic hip screws (DHS)? (2) Which kind of extracapsular femoral fractures would benefit from PFLCP fixation? PATIENTS AND METHODS: A total of 60 patients with intertrochanteric femoral fractures were recruited. Thirty patients underwent PFLCP fixation, and thirty patients underwent DHS fixation. Patient information, type of fracture, functional level (as assessed by Harris hip score), bone union, and implant complications were compared for the two treatment groups. RESULTS: The Mean duration for union in PFLCP group was 17 Weeks (12-24 weeks). The Mean duration for union in DHS group was 16 Weeks (12-28 weeks). Although there were better functional results (Harris Hip Score) in PFLCP group when compared to DHS group the difference was not statistically significant (P value= 0.06) in our study. The complications like fracture of the lateral cortex, shortening >2cm, rotational deformity, varus mal-union screw cut off phenomenon, plate lift off were more in DHS group when compared to PFLCP. CONCLUSION: We conclude that there was no major difference between DHS and PFLCP for stable intertrochanteric fractures and PFLCP is a better alternative in fixing osteoporotic and unstable intertrochanteric fractures. Further large case control studies are needed in this regard.
