A Comparative Study Between Proximal Femur Locking Compression Plate and Dynamic Hip Screw Fixation in Management of Pertrochanteric Fracture

Background: Pertrochanteric (intertrochanteric) fractures are common injuries in older adults and are associated with substantial morbidity. Dynamic hip screw (DHS) remains a widely accepted extramedullary implant for many trochanteric fracture patterns, while proximal femur locking compression plate (PFLCP) has been proposed as an alternative, particularly in osteoporotic bone and selected unstable patterns.

Objectives: To compare perioperative parameters, radiological union, complications, and functional outcomes between PFLCP and DHS fixation in pertrochanteric fractures.

Materials and Methods: A prospective comparative study was conducted from January–September 2025. Forty adults with pertrochanteric fractures were treated with either PFLCP (n=20) or DHS (n=20). Fractures were classified using AO/OTA trochanteric fracture types. Standardized postoperative rehabilitation protocols were followed. Primary outcomes included time to union and functional outcome (Harris Hip Score). Secondary outcomes included operative time, blood loss, hospital stay, and complications (implant failure, varus collapse, infection, nonunion, reoperation). Statistical analysis used independent t-test/Mann-Whitney U for continuous variables and Chi-square/Fisher’s exact test for categorical variables; p<0.05 was considered significant.

Results (example format—replace with your actual data): Baseline demographics and fracture types were comparable between groups. Mean operative time was higher in the PFLCP group (90.4±11.8 min) compared with DHS (71.6±9.7 min; p<0.001). Mean blood loss was also higher with PFLCP (225±58 mL vs 172±46 mL; p=0.004). Mean time to radiological union was similar (PFLCP 13.2±2.1 weeks vs DHS 14.0±2.4 weeks; p=0.24). At 24 weeks, mean Harris Hip Score was comparable (84.1±7.8 vs 82.0±8.6; p=0.41). Complication rates were not statistically different (PFLCP 15% vs DHS 25%; p=0.69), though DHS showed more varus collapse/collapse-related shortening.

Conclusion: Both PFLCP and DHS produced comparable union and functional outcomes at short-term follow-up. DHS was associated with shorter operative time and lower blood loss, whereas PFLCP showed a trend toward better maintenance of alignment in selected unstable/osteoporotic cases. Implant selection should be individualized based on fracture morphology, lateral wall integrity, and bone quality