In the past in reverse oblique sub-trochanderic fractures which failed to unite with the use of reconstruction IM nailing, the L plate which usually was fixing supra- or intra- condylar fractures of the femur, was also used with a great success. The trick at that time was, that not only the stability and reconstruction of the medial cortex was achieved, but also the extra reaming we were doing following the extraction of the nail was producing reamings that were used as graft. I believe that a well moulded plate will be as successful as the L plate and mainly if it is used with the same mentality as the Philos plate used for the proximal humerus and without using the "bridging plate technique". 

We have found this implant to be an excellent choice for bail out situations esp after a failed PFN with compromised lateral wall. Recently published our first experience. Sharing it with you all

Dear Raju

Great work. I liked your publication

Thank you

George

Locking construct whether DF-LCP or dedicated proximal femoral LCP have all reasons to be an ideal alternative in aforementioned settings, but with meticulous technique and good reduction before its appropriate placement. We had managed a few failed DCS cases with nonunion managed by DF-LCP but none with PFN failure yet..

Thank you George and Ganesh. It is an excellent bail out implant in difficult situations. Worth trying!!!