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Dynamic hip screw

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https://www.readbyqxmd.com/read/28434124/comparative-outcome-of-pfna-gamma-nails-pccp-medoff-plate-liss-and-dynamic-hip-screws-for-fixation-in-elderly-trochanteric-fractures-a-systematic-review-and-network-meta-analysis-of-randomized-controlled-trials
#1
Alisara Arirachakaran, Tanawat Amphansap, Pichaya Thanindratarn, Peerapong Piyapittayanun, Phutsapong Srisawat, Jatupon Kongtharvonskul
The ideal implant for the treatment of an unstable intertrochanteric femoral fracture is still a matter of discussion. The aim of this systematic review is to conduct a network meta-analysis of randomized controlled trials (RCTs) comparing clinical outcomes between dynamic hip screws (DHS), Medoff sliding plating, percutaneous compression plating (PCCP), proximal femoral nails (PFN), Gamma nails and less invasive stabilization system fixation in femoral trochanteric fractures in the elderly. These clinical outcomes consist of total intra-operative time, intra-operative fluoroscopy time, intra-operative blood loss, blood component transfusion, length of hospital stay, postoperative general complications, wound complications, late complications and reoperation rates...
April 22, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28417681/proximal-femoral-nail-antirotation-versus-dynamic-hip-screw-fixation-for-treatment-of-osteoporotic-type-31-a1-intertrochanteric-femoral-fractures-in-elderly-patients
#2
Xianshang Zeng, Nan Zhang, Dan Zeng, Lili Zhang, Ping Xu, Lei Cao, Weiguang Yu, Ke Zhan, Xinchao Zhang
Objective To evaluate long-term radiographic and functional outcomes between dynamic hip screw (DHS) and proximal femoral nail antirotation (PFNA) fixation for treatment of osteoporotic type 31-A1 intertrochanteric femoral fractures (IFFs) among elderly patients Methods A retrospective comparative study was carried out. Follow-up was performed at 1, 3, 6, 9, and 12 months postoperatively and yearly thereafter. The primary outcome was the radiographic outcome, and the secondary outcome was the functional outcome...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28416833/-diagnosis-and-treatment-for-the-basicervical-fractures-of-the-trochanteric-region
#3
T C Zhang, Z S Zhang, F Zhou, Y Tian, H Q Ji, Y Guo, Y Lv, Z W Yang, G J Hou
OBJECTIVE: To evaluate the rate of basicervical fractures and document their diagnosis and treatment. METHODS: From January 2005 to May 2016, 28 basicervical fractures of the 832 trochanteric fractures were collected and evaluated. The patients were treated with multiple screws, dynamic hip screw (DHS), intramedullary nail. Via the operation time, postoperative hospitalization, loss of blood duration the operation, hidden blood loss, total blood loss, mean union time and the final follow-up Harris hip score, the characteristics of different internal fixations were compared and analyzed...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28415470/spatial-stress-distribution-analysis-by-thermoelastic-stress-measurement-and-evaluation-of-effect-of-stress-concentration-on-durability-of-various-orthopedic-implant-devices
#4
Yoshimitsu Okazaki, Daisuke Ishii, Atsushi Ogawa
Toward the development of highly durable devices, we investigated the effect of the thermoelastic constants of implantable raw metals and the surface stress distribution on the durability of various types of implant device by thermoelastic stress measurement and by evaluating the effect of the stress concentration. Surface stress was dynamically calculated from the bending moment, and the modulus of a section of a device was found to be consistent with the surface stress obtained by thermoelastic stress measurement...
June 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28404548/the-tip-apex-distance-in-the-x-bolt-dynamic-plating-system
#5
M A Fernandez, A Aquilina, J Achten, N Parsons, M L Costa, X L Griffin
OBJECTIVES: The Sliding Hip Screw (SHS) is commonly used to treat trochanteric hip fractures. Fixation failure is a devastating complication requiring complex revision surgery. One mode of fixation failure is lag screw cut-out which is greatest in unstable fracture patterns and when the tip-apex distance of the lag screw is > 25 mm. The X-Bolt Dynamic Hip Plating System (X-Bolt Orthopaedics, Dublin, Ireland) is a new device which aims to reduce this risk of cut-out. However, some surgeons have reported difficulty minimising the tip-apex distance with subsequent concerns that this may lead to an increased risk of cut-out...
April 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28396949/factors-influencing-radiation-exposure-during-internal-fixation-of-hip-fractures
#6
G A Kelly, F E Rowan, C Hurson
The use of fluoroscopy is of great importance for operative fixation of fractures. Previous studies have shown an increased fluoroscopy time for intramedullary nails and with junior surgeons in comparison with more experienced surgeons. We examined the impact of operation length on fluoroscopy dose, cumulative fluoroscopy time between consultant and registrar surgeons and cumulative fluoroscopy time between dynamic hip screw and intramedullary nailing. We performed a retrospective cohort study of all patients admitted to our centre over the period of 1 year...
April 10, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28318949/wing-augmentation-reduces-femoral-head-cutting-out-of-dynamic-hip-screw
#7
Chih-Yu Chen, Shu-Wei Huang, Jui-Sheng Sun, Shin-Yiing Lin, Chih-Sheng Yu, Hsu-Pin Pan, Ping-Hung Lin, Fan-Chun Hsieh, Yang-Hwei Tsuang, Feng-Huei Lin, Rong-Sen Yang, Cheng-Kung Cheng
The dynamic hip screw (DHS) is commonly used in the treatment of femoral intertrochanteric fracture with high satisfactory results. However, post-operative failure does occur and result in poor prognosis. The most common failure is femoral head varus collapse, followed by lag screw cut-out through the femoral head. In this study, a novel-designed DHS with two supplemental horizontal blades was used to improve the fixation stability. In this study, nine convention DHS and 9 Orthopaedic Device Research Center (ODRC) DHSs were tested in this study...
March 17, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28265527/aneurysmal-bone-cyst-of-the-proximal-femur-and-its-management-a-case-report
#8
Chirag Kapoor, Malkesh Shah, Rishit Soni, Jagdish Patwa, Aditya Merh, Paresh Golwala
Aneurysmal bone cyst (ABC) is a benign, expansile, non-neoplastic lesion of the bone, characterized by channels of blood and spaces that are separated by fibrous septae. Giant ABC is an uncommon condition and can be difficult to handle because of the destructive effect of the cyst on the bones and the compressive effect on the nearby structures, especially in weight-bearing bones of the body. We report a case of a giant aneurysmal bone cyst in the proximal femur of a six-year-old child, which was treated with a sclerosing agent and ender's nail fixation first...
January 23, 2017: Curēus
https://www.readbyqxmd.com/read/28250681/dynamic-hip-screw-versus-proximal-femur-locking-compression-plate-in-intertrochanteric-femur-fractures-ao-31a1-and-31a2-a-prospective-randomized-study
#9
Prabhat Agrawal, Sahil Gaba, Saubhik Das, Ranjit Singh, Arvind Kumar, Gajanand Yadav
INTRODUCTION: Intertrochanteric fractures are common in elderly population and pose a significant financial burden to the society. Anatomically contoured proximal femur locking compression plate (PFLCP) is the latest addition in the surgeons' armamentarium to deal with these fractures. It creates an angular stable construct, which will theoretically lessen the risk of failure by screw cut-out and varus collapse, the common mode of DHS failure. We compared DHS with PFLCP in AO type 31A1 and 31A2 intertrochanteric fractures...
January 2017: Journal of Natural Science, Biology, and Medicine
https://www.readbyqxmd.com/read/28122548/conversion-to-total-hip-arthroplasty-after-failed-proximal-femoral-nail-antirotations-or-dynamic-hip-screw-fixations-for-stable-intertrochanteric-femur-fractures-a-retrospective-study-with-a-minimum-follow-up-of-3%C3%A2-years
#10
Xianshang Zeng, Ke Zhan, Lili Zhang, Dan Zeng, Weiguang Yu, Xinchao Zhang, Mingdong Zhao
BACKGROUND: Conversion to total hip arthroplasty (CTHA) is a relatively common procedure after a failed dynamic hip screw (DHS) or proximal femoral nail anti-rotation (PFNA) fixation of intertrochanteric fractures, but there have been far fewer reports specifically describing the long-term results of CTHA after failed treatments of stable intertrochanteric fractures with DHS or PFNA. The aim of the present study was to compare the clinical and radiological outcomes of CTHA after failed PFNA or DHS fixations of stable intertrochanteric fractures after a minimum follow-up of 3 years...
January 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28116977/feasibility-of-detecting-orthopaedic-screw-overtightening-using-acoustic-emission
#11
Rhys Pullin, Bryan J Wright, Richard Kapur, John P McCrory, Matthew Pearson, Sam L Evans, Davide Crivelli
A preliminary study of acoustic emission during orthopaedic screw fixation was performed using polyurethane foam as the bone-simulating material. Three sets of screws, a dynamic hip screw, a small fragment screw and a large fragment screw, were investigated, monitoring acoustic-emission activity during the screw tightening. In some specimens, screws were deliberately overtightened in order to investigate the feasibility of detecting the stripping torque in advance. One set of data was supported by load cell measurements to directly measure the axial load through the screw...
March 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28097113/clinical-and-functional-outcomes-of-treatment-for-type-a1-intertrochanteric-femoral-fracture-in-elderly-patients-comparison-of-dynamic-hip-screw-and-proximal-femoral-nail-antirotation
#12
Hong Man Cho, Kyujung Lee
PURPOSE: We aimed to evaluate and compare the clinical and functional outcomes of dynamic hip screw (DHS) and proximal femoral nail antirotation (PFNA) treatment of AO type 1 intertrochanteric fractures in elderly patients. MATERIALS AND METHODS: We retrospectively reviewed 194 consecutive patients with type A1 intertrochanteric femoral fractures who were treated with DHS (n=113) or PFNA (n=81). We evaluated operation time, intraoperative blood loss, and functional outcomes, walking ability, and the Barthel activities index...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28073094/the-role-of-lesser-trochanter-fragment-in-unstable-pertrochanteric-a2-proximal-femur-fractures-is-refixation-of-the-lesser-trochanter-worth-the-effort
#13
Christian Ehrnthaller, Alain Christoph Olivier, Florian Gebhard, Lutz Dürselen
BACKGROUND: Instability of osteoporotic pertrochanteric fractures is defined by loss of medial/lateral cortical integrity with the posteromedial fragment including the lesser trochanter being pivotal for load distribution. Literature addressing the importance of lesser trochanter refixation is scarce. To clarify the effect of lesser trochanter refixation on primary stability in these fractures, following study was performed. METHODS: 21 femora were match-paired in 3 groups and osteotomized, creating pertrochanteric fractures (AO-31A2)...
December 30, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/28031511/use-of-tranexamic-acid-in-dynamic-hip-screw-plate-fixation-for-trochanteric-fractures
#14
Ranjit Kumar Baruah, Pranab Jyoti Borah, Russel Haque
PURPOSE: To evaluate perioperative blood loss and blood transfusion requirement in patients who underwent dynamic hip screw plate fixation for a stable trochanteric fracture with or without preoperative intravenous tranexamic acid (TXA). METHODS: 49 men and 11 women (mean age, 56.5 years) who underwent open reduction and internal fixation with a dynamic hip screw plate for a stable trochanteric fracture by a single surgeon were equally randomised to receive either a single dose of intravenous TXA (15 mg/kg) 15 minutes prior to surgery or an equal volume of normal saline by slow infusion...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/27995133/comparison-of-the-lag-screw-placements-for-the-treatment-of-stable-and-unstable-intertrochanteric-femoral-fractures-regarding-trabecular-bone-failure
#15
Talip Celik, Ibrahim Mutlu, Arif Ozkan, Yasin Kisioglu
Background. In this study, the cut-out risk of Dynamic Hip Screw (DHS) was investigated in nine different positions of the lag screw for two fracture types by using Finite Element Analysis (FEA). Methods. Two types of fractures (31-A1.1 and A2.1 in AO classification) were generated in the femur model obtained from Computerized Tomography images. The DHS model was placed into the fractured femur model in nine different positions. Tip-Apex Distances were measured using SolidWorks. In FEA, the force applied to the femoral head was determined according to the maximum value being observed during walking...
2016: Journal of Medical Engineering
https://www.readbyqxmd.com/read/27928639/the-epidemiology-and-functional-outcomes-of-operative-fixation-of-extracapsular-proximal-femoral-fractures-ao-31-a-in-young-adults
#16
D N Ramoutar, P Kodumuri, J N Rodrigues, S Olewicz, C G Moran, B J Ollivere, D P Forward
Proximal femoral fractures in adults under 50 years are not as common as in the elderly, but may have just as significant an impact. There is little in the literature describing the functional outcomes of fixation in this age group. Our aim was to assess the clinical and functional outcomes of operative management of extracapsular proximal femoral fractures (AO 31-A) in the young adult (<50 years). Consecutive skeletally mature patients <50 years undergoing operative fixation of these fractures were obtained from a prospective database over a 12-year period...
February 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27859357/postoperative-ambulatory-performance-status-significantly-affects-implant-failure-rate-among-surgical-treatment-strategies-in-patients-with-proximal-femur-metastasis
#17
Shang-Wen Tsai, Po-Kuei Wu, Cheng-Fong Chen, Ming-Chau Chang, Wei-Ming Chen
Surgical treatment strategies for proximal femur metastasis have been reported with mixed results. Little is known about risk factor for implant failure except for longer patient survival. Therefore, we determined whether implant survivorship differed among treatment strategies, as well as risk factors for implant failure. We retrospectively reviewed a consecutive 106 patients with proximal femur metastasis treated with prosthesis replacement (n = 38), intramedullary nail (n = 32), and dynamic hip screw (DHS) (n = 36)...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27810151/markers-of-muscle-damage-for-comparing-soft-tissue-injury-following-proximal-femur-nail-and-dynamic-hip-screw-operations-for-intertrochanteric-hip-fractures
#18
Yonathan Wagman, Ortal Segal, Israel Dudkiewicz, Ely Steinberg
BACKGROUND: Femoral neck fractures are the most common fractures among the elderly. The two operative approaches used for the treatment of AO/OTA 31 intertrochanteric fractures include an intramedullary device (proximal femoral nail [PFN]) or an extramedullary device (sliding/dynamic hip screw [DHS]). The aim of this study was to provide objective evidence of local soft tissue injury by measuring serum creatine phosphokinase (CPK), a biochemical marker, to quantify muscle damage and inflammation in patients treated by the two approaches...
December 2016: Injury
https://www.readbyqxmd.com/read/27790531/dynamic-hip-screw-with-trochanteric-stablization-plate-fixation-of-unstable-inter-trochanteric-fractures-a-prospective-study-of-functional-and-radiological-outcomes
#19
Ashwin Shetty, Arjun Ballal, Anand Kumar Sadasivan, Anoop Hegde
INTRODUCTION: Management of unstable intertrochanteric fractures have posed a unique challenge to orthopaedicians over years. Several surgical techniques and implants have been developed for the same. Fractures of the lateral wall have been considered as the major cause of femoral medialization after fixation by Dynamic Hip Screw (DHS). Studies have shown that supplementation of trochanteric stabilization plate reduces the incidence of femoral medialization. AIM: To assess the radiological union and hip function after fixation of unstable intertrochanteric fractures with DHS and Trochanteric Stabilization Plate (TSP)...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27756504/an-analysis-of-postoperative-hemoglobin-levels-in-patients-with-a-fractured-neck-of-femur
#20
Navraj S Nagra, Dmitri van Popta, Sigrid Whiteside, Edward M Holt
OBJECTIVES: The aim of this study was to analyze the changes in hemoglobin level and to determine a suitable timeline for post-operative hemoglobin monitoring in patients undergoing fixation of femoral neck fracture. PATIENTS AND METHODS: Patients who underwent either dynamic hip screw (DHS) fixation (n = 74, mean age: 80 years) or hip hemiarthroplasty (n = 104, mean age: 84 years) for femoral neck fracture were included into the study. The hemoglobin level of the patients was monitored perioperatively...
October 2016: Acta Orthopaedica et Traumatologica Turcica
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