Comparison of Side Effects and Cost Effectiveness of Proximal Femur Locking Compression Plate with Intramedullary Nailing in the Treatment of Sub-Trochanteric Fractures

Background: The sub-trochanteric (ST) fracture is relatively common and does not have a single treatment. It can be repaired in a variety of ways each of which has different complications as well as different treatment costs. Accordingly, the purpose of this research is comparing the side effects and cost effectiveness of proximal femur locking compression plate (PFLCP) with intramedullary nailing in the treatment of sub-trochanteric fractures.Method: This cross-sectional study was performed on ۵۶ patients with ST fracture who were referred to Firoozgar hospital between January ۲۰۱۴ and December ۲۰۱۸. Two methods were used for treatment of fractures by physicians. The method of surgery for group A was the PFLCP while for group B it was the nailing. The postoperative complications and treatment costs were evaluated and recorded in a specific sheet for each patient.Result: In this study, of the ۵۶ eligible patients examined, ۴۹ (۸۷.۵%) of the participants were male. The mean age of the all patients was ۴۲.۷±۱۶.۲ years. The motion restriction in group A was significantly (P=۰.۰۴۱) milder than group B. So, the total cost of treatment in group A was significantly (P=۰.۰۴۵) lower than in group B. Also, the results of logistic regression model revealed that sex and age could significantly reduce the incidence of side effects with males [OR=۰.۸۵۱] and those younger than ۳۰ years [OR=۱.۶۲۹] having fewer side effects.Conclusion: Use of a PFLCP first causes fewer side effects and less motion restriction after operation. The cost of treatment is lower and it is more cost-effective.Background: The sub-trochanteric (ST) fracture is relatively common and does not have a single treatment. It can be repaired in a variety of ways each of which has different complications as well as different treatment costs. Accordingly, the purpose of this research is comparing the side effects and cost effectiveness of proximal femur locking compression plate (PFLCP) with intramedullary nailing in the treatment of sub-trochanteric fractures. Method: This cross-sectional study was performed on ۵۶ patients with ST fracture who were referred to Firoozgar hospital between January ۲۰۱۴ and December ۲۰۱۸. Two methods were used for treatment of fractures by physicians. The method of surgery for group A was the PFLCP while for group B it was the nailing. The postoperative complications and treatment costs were evaluated and recorded in a specific sheet for each patient. Result: In this study, of the ۵۶ eligible patients examined, ۴۹ (۸۷.۵%) of the participants were male. The mean age of the all patients was ۴۲.۷±۱۶.۲ years. The motion restriction in group A was significantly (P=۰.۰۴۱) milder than group B. So, the total cost of treatment in group A was significantly (P=۰.۰۴۵) lower than in group B. Also, the results of logistic regression model revealed that sex and age could significantly reduce the incidence of side effects with males [OR=۰.۸۵۱] and those younger than ۳۰ years [OR=۱.۶۲۹] having fewer side effects. Conclusion: Use of a PFLCP first causes fewer side effects and less motion restriction after operation. The cost of treatment is lower and it is more cost-effective.

Keywords:

PFLCP , Intramedullary nailing , Subtrochanteric fracture , Side effects , Cost effectiveness.