Biomechanical Comparison of Proximal Locking Plates and Blade Plates for the Treatment of Comminuted Subtrochanteric Femoral Fractures

• DOI: 10.1097/bot.0b013e3181b04835
• Publication Date: 2010-01-27T06:36:26Z
• Authors: John C P Floyd; Robert V O'Toole; Alec Stall; Daren P Forward; Marjan Nabili; Daniel Shillingburg; Adam Hsieh; Jason W Nascone
• Keywords: Greater trochanter; Breakage; Trochanter

Objectives: The 95° angled blade plate is an accepted standard for plating subtrochanteric femoral fractures but can be technically demanding and often requires extensive soft tissue exposure. Proximal locking plates (PFLPs) have been developed pertrochanteric are potentially easier to apply with less dissection. Clinical experience has raised concerns regarding the strength of PFLP. purpose our study was compare relative stability two designs PFLP under loads simulating first 3 months progressive weight bearing after fracture fixation. Methods: A comminuted model created a 2-cm gap below lesser trochanter in 15 synthetic femora. Fracture fixation three (95° [blade plate], original version [O-PFLP], newest [N-PFLP]), all manufactured by Synthes, Inc., Paoli, PA, tested cyclic loading reproduce during force number cycles reach 5 mm displacement head or failure implant were compared each implant. Results: N-PFLPs significantly stiffer than O-PFLPs (P = 0.01) had trend toward withstanding more before 0.06). All five demonstrated catastrophic fatigue completion protocol. One failed complete protocol 0.04). Conclusions: In studied, shown biomechanical properties that at least equivalent those plate. failures mirrored clinical experience. Use N-PFLP might viable alternative method currently treated plates.