Lee Wei Ting, Murphy Diarmuid, Kagda Fareed H Y, Thambiah Joseph
Department of Orthopaedic Surgery, National University Hospital, Singapore.
J Orthop Surg (Hong Kong). 2014 Dec;22(3):287-93. doi: 10.1177/230949901402200304.
To review short-term outcomes of proximal femoral locking compression plate (PF-LCP) fixation for proximal femoral fractures in terms of postoperative complications and failure rates.
Medical records of 21 men and 5 women aged 22 to 85 (mean, 49.7) years who underwent internal fixation with the PF-LCP for proximal femoral fractures were reviewed. Younger patients (mean age, 38.7 years) were more commonly involved in high-energy trauma with multiple musculoskeletal injuries, whereas older patients (mean age, 67.7 years) were more commonly involved in low-energy trauma. Fractures were classified into: multi-fragmentary pertrochanteric fractures (n=13), transtrochanteric fractures (n=6), and subtrochanteric/proximal diaphyseal fractures (n=7).
Patients were followed up for a mean of 14.7 months. Seven patients developed complications including loosening of locking screws (n=4), delayed union (n=2), and infection (n=1); 4 of them required additional surgeries.
The PF-LCP is appropriate for complex proximal femoral fractures with poor bone quality, revision surgeries, and multi-fragmentary subtrochanteric/proximal diaphyseal fractures. For intertrochanteric fractures, the sliding hip screw system should be used to avoid failure.
从术后并发症和失败率方面回顾股骨近端锁定加压钢板（PF-LCP）固定治疗股骨近端骨折的短期疗效。
回顾了21例男性和5例女性患者的病历，这些患者年龄在22至85岁（平均49.7岁）之间，因股骨近端骨折接受了PF-LCP内固定治疗。年轻患者（平均年龄38.7岁）更常因高能量创伤合并多处肌肉骨骼损伤，而老年患者（平均年龄67.7岁）更常因低能量创伤。骨折分类为：多片段转子间骨折（n = 13）、经转子骨折（n = 6）和转子下/近端骨干骨折（n = 7）。
患者平均随访14.7个月。7例患者出现并发症，包括锁定螺钉松动（n = 4）、骨不连（n = 2）和感染（n = 1）；其中4例需要再次手术。
PF-LCP适用于骨质质量差的复杂股骨近端骨折、翻修手术以及多片段转子下/近端骨干骨折。对于转子间骨折，应使用滑动髋螺钉系统以避免失败。
