title: Proximal femoral locking plate versus dynamic hip screw for unstable intertrochanteric femoral fractures.
abstract: OBJECTIVE
  To compare the outcome in patients who underwent surgery for unstable intertrochanteric femoral fractures using the proximal femoral locking plate versus the dynamic hip screw (DHS).
  
  
  METHODS
  15 men and 5 women aged 32 to 78 (mean, 55) years were randomised to the proximal femoral locking plate group, whereas 14 men and 6 women aged 38 to 75 (mean, 59) years were randomised to the conventional 135-degree DHS group. The time to union, medialisation of the shaft, neck-shaft angle, limb shortening, varus collapse, and functional outcome (using the Hospital for Special Surgery Hip Rating System) were assessed.
  
  
  RESULTS
  Respectively in the locking plate and DHS groups, the mean times to union were 14.6 and 16.5 weeks (p=0.067) and the mean limb shortenings were 0.3 and 1.4 cm (p<0.001). Medialisation of the shaft occurred in 0 and 15 patients (p<0.0001); varus collapse occurred in 2 and 5 patients (p=0.408); the functional hip score was good-to-excellent in 18 and 11 patients (p=0.031); deep wound infection occurred in 3 and 2 patients; and implant cut-out occurred in one patient each group.
  
  
  CONCLUSIONS
  A non-collapsing locking plate achieved bone union in unstable intertrochanteric fractures with lower risks of limb shortening and medialisation of the shaft.
authors.affiliation: Department of Orthopaedics, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Sion, Mumbai, 400022, Maharashtra, India.
authors.forename: Anoop C
authors.initials: AC
authors.lastname: Dhamangaonkar
authors.forename: Deepak
authors.initials: D
authors.lastname: Joshi
authors.forename: Arvind B
authors.initials: AB
authors.lastname: Goregaonkar
authors.forename: Akhil A
authors.initials: AA
authors.lastname: Tawari
mesh_terms: D000328:Adult; D000368:Aged; D001858:Bone Nails; D001860:Bone Plates; D005260:Female; D005264:Femoral Fractures / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006620:Hip Fractures / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D016896:Treatment Outcome
keywords: bone plates; bone screws; hip fractures