A Meta-analysis About The Failure Of Proximal Femoral Locking Compression Plates To Fix Intertrechanteric Or Subtrochanteric Fractures

Objective:To explore the fixation failure incidence and related factors about proximal femoral locking compression plate(PFLCP) to fix the intertroc-hanteric and subtrochanteric fractures.Methods:“Proximal Femoral Locking Comp-ression Plate”, “PFLCP”and“treatment” were regarded as the search terms, which were searched in the PubMed Medline, Ovid Medline, Cochrane Database, and Embase Database.The collected references were published in English from Januar-y 2005 to January 2015,which is about PFLCP treatment of the intertrochanteric and subtrochanteric fractures.The methodological quality of the included studies was critically appraised and the data were extracted.The 10 references, including 364 cases, were analyzed by the software of State12.0 and RevMan5.2.Results:T-he fixation failure incidence of PFLCP was 20.05%(3.64%-73.68%),when PFL-CP is used to treat intertrochanteric and subtrochanteric fractures.While the plate broken incidence is 2.2%(95% CI 0.4%-4.0%),the incidence of screw breakage,l-oose,and cut is 12.9%(95% CI 5.2%-20.6%), and the incidence of postoperativ-e fracture displacement is 13.9%(95% CI 5.3%-22.4%),respectively.When the pa-tient age is more than 60 years or the posterior-medial cortical bone of intertroc-hanteric area cannot contact,the fixation failure rate of PFLCP was high,which was not relative to the site of fracture and the start time of postoperative partial-weight-bearing walk.Conclusion:A high failure incidence can be predicted when PFLCP is used to fix the intertrechanteric or subtrochanteric fractures of old pa-tients or with posterior-medial cortex defect. In these circumstances, intramedulla-ry fixation is strongly recommended.