March 29, 2007

LCP Proximal Femoral Hook Plate 4.5

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The LCP Proximal Femoral Hook Plate 4.5 is a stainless steel plate with a limited-contact profile. The proximal portion of the plate is anatomically contoured to approximate the lateral profile of the proximal femur with two proximal hooks for engaging the greater trochanter. The proximal screw hole accepts 7.3 mm cannulated locking and 7.3 mm cannulated conical screws, oriented at 95 to the plate shaft. The second locking hole accepts a 5.0 mm cannulated locking screw, oriented at 110 to the plate shaft and is angled to converge with the proximal 7.3 mm screw. The remaining screw holes are combination holes and accept 4.0 mm or 5.0 mm locking head screws in the threaded portion or 4.5 mm cortex screws in the dynamic compression unit (DCU).

The LCP Proximal Femoral Hook Plate 4.5 is indicated for fractures in the peritrochanteric and subtrochanteric region of the femur that have in common a primary fracture plane that can be tensioned (compressed) utilizing the plate to create a load sharing construct. The most frequent of these patterns are the reverse obliquity and transverse (true intertrochanteric) fractures. The typical insertion technique involves seating of the trochanteric hooks followed by proximal screw insertion (taking into account frontal and sagittal alignment). The side plate is then reduced to the shaft with an atraumatic plate reduction forceps. Horizontal plane alignment (rotation) is then verified and the plate is tensioned utilizing the articulated tension device (ATD). Side plate fixation follows.

The plate is also useful for ipsilateral combinations of the above patterns with shaft fractures. Nonunions and malunions in this region that meet the criteria of compressibility are also well suited to this plate.

An additional important indication is periprosthetic fracture about the femoral component of a total hip arthroplasty. The trochanteric fixation of the plate (both hook and screws) affords improved proximal fixation, in many cases limiting the need for circlage wires and screws angled around the stem. Compression of primary fracture planes remains desirable in the periprosthetic setting, but is often not possible and does not limit the utility of the plate in this clinical setting. The Plate is available in lengths of 133385 mm, or 216 holes.

83-year-old male trapped under tree he had cut down IDDM, HTN, CAD, Jehovahs witness on Plavix

Case provided by Keith Mayo, Tacoma, USA

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Open procedure hosp day 2 (EBL 350cc, Prox wound to fracture, distal to tension). 6 weeks postoperative (right).
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4 and 5 months postoperative

46-year-old female with an transverse intertrochanteric fracture

Case provided by Keith Mayo, Tacoma, USA
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Intraoperative x-rays with ATD attached
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X-rays 6 months after surgery

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