فهرست نشریات علمی دسترسی آزاد ایران

Background and Objectives: Intertrochanteric fractures are prevalent in the elderly, contributing significantly to morbidity and healthcare costs. Proximal femoral locking plates (PF-LPs) are used for fixation, particularly in osteoporotic bone, but their outcomes remain debated. This study evaluates the clinical outcomes and complications of PF-LP fixation in elderly patients, emphasizing the role of posteromedial cortex reduction.    Methods: This retrospective study included patients over 60 years with intertrochanteric fractures treated with PF-LP between April 2021 and March 2024. Patients with polytrauma, end-stage disease, or incomplete follow-up were excluded. Analyzed variables included demographics, AO/OTA classification, reduction quality, posteromedial cortex status, and postoperative complications. Treatment failure was defined as the need for revision surgery due to complications like infection, nonunion, varus collapse, implant failure, or screw cut-out.    Results: A total of 197 patients (mean age: 74.3 ± 9.2 years) were analyzed. Treatment failure occurred in 48 patients (24.4%), with higher rates in females, those with type 31A2 fractures, and osteoporotic patients. Negative posteromedial cortex alignment was strongly associated with mechanical failure. Varus collapse and screw cut-out were the most common complications.    Conclusion: PF-LP fixation in elderly intertrochanteric fractures has a significant failure rate, especially in osteoporotic bone with poor posteromedial support. Achieving proper reduction with positive cortical alignment is critical. Surgeons should consider optimized reduction techniques or alternative fixation methods in high-risk cases. Future studies should include control groups using devices like dynamic hip screws or intramedullary nails to compare efficacy.