Reverse oblique fracture needs more augmentation with IM nail: A use of trochanteric support plate (TSP)

Background: There are various type of unstable intertrochanteric femur fracture of which reverse oblique fracture is most challenging to fix because of its displacement. Reverse oblique fracture accounts for 1/3rd of all hip fractures and are very unstable. Posteromedial part is effectively support by intramedullary nail but fail to support broken lateral wall. Objective: A Prospective study to evaluate the comparative outcome of buttressing lateral wall with trochanteric support plate(Long PFN + TSP) & without trochanteric support plate(long PFN alone). Materials and Methods: A study was carried out from 2018 to 2023; 60 cases of acute reverse oblique intertrochanteric femur fracture were studied, out of which 28 were treated with long PFN +TSP plate & 32 were treated with Long PFN. Result: Bone healing is observed in all patient. Minimum average follow up of patients was 10.2 months. Patient treated with only Long PFN have mean bone healing time of 116.06 days whereas patients treated with Long PFN + TSP plate have mean time of 61.56 days. Conclusion: With proper pre operative planning, with anatomical/acceptable reduction long PFN + TSP plate is an ideal modality for reverse oblique intertrochanteric femur fracture.