OBJECTIVETo retrospectively study medium term follow-up outcomes of the femoral intertrochanteric with lateral femoral wall fractures using anatomic locking plate fixation.

METHODSFrom June 2010 to January 2013, 18 cases of the unstable femoral intertrochanteric with lateral femoral wall fractures were treated with the anatomic locking plate, included 8 males and 10 females with an average age of 75.5 years ranging from 19 to 83 years old. There were 8 cases of traffic accident injuries, 6 cases of falls injuries, and 4 cases of falling from high place. The time from injury to operation was ranged from 1 to 14 days with an average of 4.5 days. The operation time, intraoperative blood loss and the length of hospitalization were recorded and analyzed. The fracture union was assessed by follow-up radiographs and hip functional recovery by PPMS and Harris hip scoring.

RESULTSAll patients were followed up from 36 to 68 months with a mean of(44.8±8.8) months. The mean operative time was (61.02±38.28) min;the mean blood loss was (226.00±162.52) ml;the mean length of hospitalization was (10.8±9.2) days. During the follow-up period, no infection, deep veintllrombosis, screwed cut-out and implant failure occurred in all patients. Coxa vara with shortening deformity was noted in 2 cases. Bone union was found in all the cases. The bone healing time was ranged from 4 to 10 months with an average of 6.2 months. The mean PPMS score at the final follow-up was 7.22±2.36. The Harris score was 79.46±11.02, 5 cases were classified as excellent, 9 as good and 2 as fair.

CONCLUSIONSProximal femoral anatomic locking plate can be used in treating intertrochanteric fractures with compromised lateral wall, which has a satisfied medium term follow-up outcomes, especially for complex fractures patterns in which intramedullary nailing may be difficult, and should not emphasis on premature loading.