Hodel Sandro, Beeres Frank J P, Babst Reto, Link Björn-Christian
Department of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland.
Eur J Orthop Surg Traumatol. 2017 Dec;27(8):1117-1124. doi: 10.1007/s00590-017-1981-1. Epub 2017 May 25.
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.
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.
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.
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.
评估采用股骨近端锁定加压钢板（PF-LCP 4.5/5.0，辛迪思公司）治疗不稳定型股骨转子间及转子下骨折患者的治疗结果。
对2011年至2015年期间在某一级创伤中心接受PF-LCP治疗的16例股骨近端骨折患者（AO分型：31A2型：n = 5/32.3%；31-A3型：n = 10/62.5%；32B1型：n = 1/6.3%）进行回顾性分析。
16例患者均获得随访，平均随访时间为14个月（4 - 29个月）。主要观察指标包括骨折愈合情况、术后并发症及术后活动状态。男女比例为1:1。平均年龄为61±17岁。骨折平均在13.5±3周（12 - 20周）愈合。5例患者（31.3%）出现与植入物相关的并发症，如骨不连、畸形旋转、晚期植入物相关感染、远端螺钉骨折及创伤后髋关节撞击。因此，4例患者（25%）不得不接受翻修手术。未报告继发性内翻塌陷或内固定物穿出的病例。
在不稳定型股骨转子间及转子下骨折患者中，采用PF-LCP治疗的中期随访结果显示，并发症发生率为31.3%（n = 5）。其他研究组的结果也支持这些发现。然而，需要进一步研究以评估与该植入物失败相关的危险因素。
