Condylar blade plate in subtrochanteric femur fractures: a robust implant forgotten way too early

Abstract

Background: Subtrochanteric femur fractures comprise 10-34% of hip fractures. While cephalomedullary (CM) nails have largely replaced fixed-angle devices like the condylar blade plate (CBP), CBP's superior angular and rotational stability warrant reassessment. This study evaluated functional and radiological outcomes of subtrochanteric fractures treated with CBP.

Methods: This prospective observational study at MIOT International Hospitals, Chennai, included 36 patients (31 males, 5 females; mean age 51.47 years) treated with CBP fixation from June 2015 to December 2016. Patients with acute unilateral subtrochanteric fractures aged >17 years were followed for two years or until union. Outcomes were assessed using the Lower Extremity Functional Scale (LEFS), clinical examination (range of motion, pain, deformity), and radiographic monitoring. Statistical analysis employed Chi-square and ANOVA tests (p<0.05).

Results: Mean radiographic union occurred at 15.61 weeks. Functional outcomes were excellent in 36.1% (n=13), very good in 13.9% (n=5), good in 27.8% (n=10), moderate in 16.7% (n=6), and poor in 5.6% (n=2). No patients exhibited varus malalignment or implant failure. The reoperation rate was 5.55%. CBP demonstrated effective anatomical reduction, strong stability, limb length restoration, and bone stock preservation.

Conclusions: CBP remains a viable fixation method for subtrochanteric fractures, offering outcomes comparable to CM nails with minimal complications. Its advantages in anatomical reduction, rotational stability, and bone preservation suggest CBP is underutilized in current practice and deserves reconsideration as a valuable treatment option.