title: Short-term follow-up of pertrochanteric fractures treated using the proximal femoral locking plate.
abstract: OBJECTIVE
  The proximal femoral locking compression plate is a fixed angled anatomically contoured stainless steel plate used to treat pertrochanteric fractures of the proximal femur. Recent reports quote a high failure rate associated with this implant. We aimed to identify the common methods of failure and determine the elements of surgical techniques that could be altered to potentially improve outcomes should this implant be used for the treatment of unstable pertrochanteric fractures.
  
  
  METHODS
  Retrospective chart analysis.
  
  
  METHODS
  Three separate centers.
  
  
  METHODS
  Twenty-nine patients with 29 fractures.
  
  
  METHODS
  All patients were treated for pertrochanteric fractures using the proximal femoral locking compression plate.
  
  
  METHODS
  The patient demographics, fracture classification, implant details, and complications.
  
  
  RESULTS
  Twelve of 29 fractures (41.4%) suffered a complication associated with the implant, and 83% of these occurred in elderly women. Complications included bending, backing-out, fracture, or cut-out of the proximal screws and plate fracture. Common technical errors included the following: (1) leaving the plate proud proximally, (2) malposition of the proximal screws within the femoral neck/head, (3) inappropriate use of the hook plate, (4) creating too ridged a construct when used as a bridging plate.
  
  
  CONCLUSIONS
  Our experience with the use of this implant suggests an unacceptably high failure rate (41.4%). A knowledge of the common pitfalls encountered when using this device is critical in an effort to reduce failure rates. Based on our data, we would urge caution when considering this device for unstable pertrochanteric fractures, especially in the elderly female.
  
  
  METHODS
  Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Trauma and Orthopaedics, University Hospital North Staffs, Staffordshire, England, United Kingdom.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Johnson
authors.forename: Jonathan
authors.initials: J
authors.lastname: Stevenson
authors.forename: Ramsey
authors.initials: R
authors.lastname: Chamma
authors.forename: Amit
authors.initials: A
authors.lastname: Patel
authors.forename: Shin-Jae
authors.initials: SJ
authors.lastname: Rhee
authors.forename: Caroline
authors.initials: C
authors.lastname: Lever
authors.forename: Ian
authors.initials: I
authors.lastname: Starks
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Roberts
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012189:Retrospective Studies; D055815:Young Adult