Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

Introduction:intertrochanteric femur fractures are one of the most devastating injuries. Most of the fractures in the elderly results from trivial fall while in the younger age group it is mainly due to high energy trauma. Fixing unstable intertrochanteric fractures properly is clinically challenging. Various implants both intramedullary and extramedullary are available for their fixation. Purpose: to compare the results of proximal femoral nails (PFN) and proximal femoral locking compression plates (PFLP) in management of unstable intertrochanteric fractures and to evaluate the clinical results and complications. Patients and methods: 30 patients above 50 years will be conducted with unstable intertrochanteric fractures .Patients will be divided into two groups:Group (1)Including 15 cases undergoing managed with proximal femoral nail. Group (2)Including 15 cases undergoing managed with Proximal femoral locking compression plates. Results:Intraoperative blood loss, incision length and operative time were statistically significant less in the PFN group than in the PFLCP group. No significant difference was found between the groups in terms of radiologic exposure time and hospital length of stay. Time to full union was statistically significant lower in the PFN group than in the PFLCP group. Of the 15 PFLCP patients, 14 achieve union eventfully; all 15 PFN patients achieved union. Two PFN patients and three PFLCP patients developed a superficial infection. There was 1 nonunion in the PFLCP group but none in the PFN group. There was no significant difference between the groups in terms of functional outcome (HHS) at final follow-up. Conclusion:both PFN and PFLCP have good functional outcomes and acceptable complication rates.PFN is superior in shorter incisions and intraoperative bleeding , hospital length of stay, shorter time to full weight-bearing and time to union

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