3 - 2 - 3 - MANAGEMENT OF FAILED SUBTROCHANTERIC FRACTURES WITH A PROXIMAL FEMORAL NAIL BY A REVERSE SUPRACONDYLAR LOCKING PLATE

Abstract: 

Objective: To show the advantages of distal femoral anatomical locking plates for salvaging failed subtrochanteric femoral fractures.  Material & Methods: 11 patients (9 males, 2 females) with subtrochanteric fractures with nonunion following implantation with a PFN (10 patients) or an interlocking nail (1 patient) were managed by removal of the implant, open reduction, freshening of bony ends, and internal fixation by a reverse supracondylar locking plate along with autogenous corticocancellous bone grafting. All patients were followed up clinically and radiologically. Functional outcomes were assessed in terms of the Harris Hip score.  Results: All patients showed union at an average of 23.2 weeks after revision surgery. The Harris Hip score at the most recent follow-up was 84.6. Functional outcomes were excellent in 18.1%, good in 45.4%, fair in 27.2%, and poor in 9% of patients. Conclusion: A reverse supracondylar locking plate can be used as a viable option for failed primary osteosynthesis in subtrochanteric fractures and is associated with good functional outcome.