Treatment of Unstable Trochantric Fractures using Proximal Femoral Locked Plate

Background: Unstable trochanteric fractures remain a major clinical challenge, particularly in elderly and osteoporotic patients. The proximal femoral locked compression plate (PFLCP) has been proposed as an alternative, offering angular stability and enhanced fixation in unstable fracture patterns. This study aimed to evaluate the clinical and radiological outcomes of unstable trochanteric fractures treated with PFLCP. Methods: This prospective cohort study was conducted at the Orthopedic Surgery Department, Zagazig University Hospitals. A total of 48 skeletally mature patients with closed unstable trochanteric fractures were treated with PFLCP. Patients were followed clinically and radiologically for at least six months. Functional outcomes were assessed using the Harris Hip Score (HHS) and Foster grading system. Results: The mean age of patients was 58.97 years, with a male predominance (68.7%). The mean operative time was 98.75±8.9 minutes, and bone grafting was required in 39.6% of cases. Radiological union was achieved in 87.5% of patients, with a mean union time of 8.47±1.34 weeks. Complications occurred in 14.6% of cases, including implant failure (4.2%), superficial infection (4.2%), and limb-length discrepancy (6.3%). The mean preoperative HHS was 39.47±4.8, which improved significantly to 87.69±5.74 postoperatively (p≤0.001). According to the Foster grading system, 41.7% of patients achieved excellent results, 39.6% good, 6.2% fair, and 12.5% poor outcomes. Conclusion: PFLCP provides stable fixation and satisfactory functional recovery in unstable trochanteric fractures, with an acceptable complication rate. It represents a reliable alternative to DHS and IMN, particularly in elderly and osteoporotic patients.