Reliability and Outcome Predictors of Proximal Femoral Locking Compression Plate Osteosynthesis at a Nigerian North-Eastern Tertiary Hospital

Abstract

Shaphat Shuaibu Ibrahim, Abubakar Musa, Olaoluwa Moses Shodipo, Emuan Timothy and abd Aremu Ab-dulra haman

Background The choice of proximal femur locking compression plate (PFLCP) for fixation of proximal femur fractures has evolved over the years with occasional poor outcome especially with complex intertrochanteric fractures.

Objective To evaluate the reliability of PFLCP with regards to radiologic union and to determine predictors of poor outcome.

Materials and methods Single center retrospective cross sectional study at a Nigerian tertiary hospital, where data of patients who have attained skeletal maturity with intertrochanteric (IT) and subtrochanteric fractures who had PFLCP fixation between1st October 2019 and 30th September 2021 was analyzed. Poor outcome defined as mechanical failure, non-union and varus collapse were statistically analyzed (P value 0.05) against possible predictive variables.

Results A total of 28 patients, with mean age of 51.75±18.7 years, age range of 20-95 years, mean body mass index (BMI) of 27.23±0.8kg/m2 and M: F of 1.8:1 were studied. Unstable IT fracture was the most common fracture seen in 12 patients (42.8%), followed by stable IT fracture (35.7%) and subtrochanteric fracture (21.4%). Radiologic union was achieved in 20 patients (71.4%) and poor outcome of mechanical failure/non-union, varus collapse seen in 3(10.7%) and 5(17.8%) patients respectively. There was a statistically significant association between obesity and mechanical failure (P value 0.001) and also a significant association between unstable IT and varus collapse (P value 0.011).

Conclusion An excellent outcome was achieved with PFLCP fixation, however obesity and unstable IT fractures were predictors of poor outcome.

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