The versatility of the contoured AO plate as a mode of fixation for proximal femoral fractures.

Proximal femoral fractures, especially in young adults, usually are high-energy injuries associated with severe comminution. Presently available fixation devices such as the blade plate and DHS are difficult to apply in comminuted cases, their application requires the use of an image intensifier, and their versatility is limited. This report describes the use of the AO plate molded according to the proximal femoral anatomy in 21 cases (seven subtrochanteric and 14 trochanteric fractures) in which high-energy injuries were sustained. Eleven cases were primarily bone grafted. Postoperative mobilization was started by an average of 5.4 weeks. All cases united by an average of 3.2 months. There were six excellent, ten good, three fair, and one poor result (one patient died). This method was found to be superior to conventional devices as it offers more versatility in placement of screws and plate contouring. The inventory of implants is also reduced, and there is no need for specialized instruments, a significant factor in Third World countries.