title: Contralateral reversed distal femoral locking plate for fixation of subtrochanteric femoral fractures.
abstract: OBJECTIVE
  Subtrochanteric fractures of the femur are being managed successfully with various intramedullary and extramedulary implants with reasonable success. However, these implants require precise placement under image intensifier guidance, which exposes the surgeon to substantial amount of radiation. It also restricts the management of these fractures at peripheral centers where facility of image intensifiers is not available. Keeping this in mind we designed this study to identify if contralateral reversed distal femoral locking plate can be used successfully without the use of image intensifier.
  
  
  METHODS
  Twenty-four consecutive patients (18 men and 6 women) with a mean age of 28 years (range 19-47 years) suffering subtrochanteric fractures of the femur underwent open reduction and internal fixation with reversed contralateral distal femoral locking plate. The outcome was assessed at the mean follow-up period of 3.2 years (range 2-4.6 years) using the Harris hip score.
  
  
  RESULTS
  Twenty-one fractures united with the primary procedure, with a mean time of consolidation being 11 weeks (range, 9-16 weeks). One patient developed superficial suture line infection, which resolved with oral antibiotics. Another patient had a fall 3 weeks after surgery and broke the plate. Repeat surgery with reversed distal femoral locking compression plate was performed along with bone grafting and the fracture united. Two cases had nonunion, which went in for union after bone grafting. The mean Harris hip score at the time of final follow-up was 90.63 (range 82-97).
  
  
  CONCLUSIONS
  The reversed contralateral distal femoral plate is a biomechanically sound implant, which when used for fixation of the subtrochanteric fractures with minimal soft tissue stripping shows results comparable to those achieved by using other extramedullary implants as well as intramedullary devices. The added advantage of this implant is its usability in the absence of an image intensifier.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Pt BD Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India.
authors.forename: Paritosh
authors.initials: P
authors.lastname: Gogna
authors.forename: Reetadyuti
authors.initials: R
authors.lastname: Mukhopadhyay
authors.forename: Amanpreet
authors.initials: A
authors.lastname: Singh
authors.forename: Ashish
authors.initials: A
authors.lastname: Devgan
authors.forename: Sahil
authors.initials: S
authors.lastname: Arora
authors.forename: Amit
authors.initials: A
authors.lastname: Batra
authors.forename: Sushil Kumar
authors.initials: SK
authors.lastname: Yadav
mesh_terms: D000328:Adult; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged