Author(s): Mondeep Gayan, Pranjal Tahbildar, Nayanmoni Dutta, Zaheer Parveez Islam
BACKGROUND There is no consensus about the best option of internal fixation for unstable intertrochanteric fractures of femur. This study aimed to evaluate the treatment effects of contra-lateral reverse distal femoral locking compression plates in unstable femoral intertrochanteric fractures as a viable alternative to intramedullary devices. MATERIALS AND METHODS A total of 30 cases with unstable femoral intertrochanteric fractures were treated with contra-lateral reverse distal femoral locking compression plates. The period from injury to operation was 3-10 days. RESULTS The intra-operative blood loss was 160.5 ± 80 ml and the operation time was 55 ± 20 mins. The fractures united within 12-24 weeks (average 16.4 weeks). According to the Modified Harris Hip Score, the results were excellent in 15, good in 12, fair in 2 and poor in 1 case. Excellent and good rate of clinical results were 90%. 2 cases developed trochanteric bursitis due to irritation by hardware. 1 case had plate collapse who was offered surgical option but sought no treatment for malunion. None of the cases had any implant failure, non-union and any surgical site infection. CONCLUSION Contra-lateral reverse distal femoral locking compression plate is an effective way for treating unstable femoral intertrochanteric fractures. However, early weight bearing should be avoided and judicious use of bone grafting wherever it is needed is recommended to achieve early union.