Abstract: Background: Intertrochanteric fractures with lateral wall involvement pose a challenge in terms of fracture stability and treatment outcomes. The use of a trochanteric buttress plate (TBP) in conjunction with a proximal femoral nail (PFN) has been proposed to address this issue. This study aims to evaluate the functional outcomes of using a TBP with PFN for unstable intertrochanteric fractures with broken lateral walls.
Methods: A prospective study was conducted in 30 patients with unstable intertrochanteric fractures and lateral wall fractures. The patients underwent surgery using PFN augmented with TBP. Surgical details, including duration, blood loss, and radiation exposure, were recorded. Fracture union and functional outcomes were assessed using radiological evaluation and the Harris hip score, respectively. Complications were also monitored.
Results: The mean age of the patients was 56±7.8 years, with 14 female and 16 male patients. Road traffic accidents were the most common cause of injury (14 cases). The mean duration of surgery was 95.5±12.8 minutes, with an intra-operative blood loss of 229±3.6 ml. Fracture union was achieved in all cases, with an average duration of 13.4 weeks. The mean Harris hip score was 94.1±7.5, indicating excellent to good outcomes in the majority of patients. Complications were minimal, with only one case of impingement observed.
Conclusion: The combination of TBP with PFN for the treatment of unstable intertrochanteric fractures with broken lateral walls showed favorable outcomes. The technique provided improved fracture stability, enhanced reduction, and facilitated early healing and weight bearing. The low incidence of complications highlights the effectiveness of this combined approach. Further studies with larger sample sizes and longer follow-up periods are needed to validate these findings and compare the technique with other treatment methods.
