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Deqing Luo, Weitao Zou, Yijiao He, Hang Xian, Lei Wang, Jiazuo Shen, Kejian Lian, Dasheng Lin
INTRODUCTION: Management of Pauwels type-3 vertical femoral neck fractures has been a challenging clinical problem as they experience high shear forces and thus a greater risk of treatment failure. There is no apparent consensus on the optimal implant type for these injuries. We developed a modified dynamic hip screw (DHS), which was designed to a cage in the lag screw, loaded with autologous bone graft for the treatment of Pauwels type-3 vertical femoral neck fractures. METHODS: Between February 2010 and January 2012, 17 consecutive patients with Pauwels type-3 vertical femoral neck fractures were treated with the modified DHS loaded with autologous bone graft...
May 26, 2017: Injury
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
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
Karl Stoffel, Ivan Zderic, Florian Gras, Christoph Sommer, Ursula Eberli, David Mueller, Martin Oswald, Boyko Gueorguiev
OBJECTIVES: To evaluate the biomechanical performance of femoral neck system (FNS) in comparison with established methods for fixation of femoral neck fractures in a cadaveric model. METHODS: Twenty pairs of fresh-frozen human cadaveric femora were instrumented either with dynamic hip screw and antirotation screw (DHS-screw), DHS-blade, 3 cannulated screws (3CS) or with FNS in a partially paired design. The specimens were randomized to 2 paired treatment groups based on the bone mineral density (BMD), namely DHS-screw/DHS-blade and FNS/3CS...
March 2017: Journal of Orthopaedic Trauma
Shabnam Samsami, Sadegh Saberi, Nima Bagheri, Gholamreza Rouhi
BACKGROUND: Vertical femoral neck fractures in the youth could be happened in high-energy accidents, and because of dominant shearing forces, this fracture is considered as a troublesome injury with a controversy regarding selection of the best fixation method. OBJECTIVE: The long term goal of this quasi-experimental study was to find the more stable fixation method among cannulated screws (CSs), proximal femoral locking plate (PFLP), and dynamic hip screw with derotational screw (DHS+DS) for this kind of fracture...
September 28, 2016: Bio-medical Materials and Engineering
P Jettoo, P James
PURPOSE: To compare dynamic hip screw (DHS) fixation with multiple screw fixation for intracapsular hip fractures in terms of complications and conversion to hemiarthroplasty or total hip arthroplasty (THA). METHODS: Records of 52 884 patients aged ≥50 years who underwent internal fixation using a dynamic hip screw (n=18 014, 34.1%) or multiple screws (n=34 870, 65.9%) for intracapsular femoral neck fracture from September 2007 to September 2013 were extracted from the hospital admission database that covers all admissions to the National Health Service hospitals in England using the ICD-10 and OPCS-4 codes...
August 2016: Journal of Orthopaedic Surgery
A Tucker, O Diamond, S McDonald, A Johnston, M Neil, D Kealey, P Archbold
INTRODUCTION: The Variable angle Martin Plate (MP) is designed to offer patient-specific adaption for the treatment of intertrochanteric hip fractures. Its proposed benefits include optimization of lag screw placement, plate shaft congruence and reduced risk of failure. Often its use has been criticized as representing a poor reduction of the fracture. The purpose of this study was to assess for a poorer quality of reduction, and compare functional outcomes and mortality, using a MP to that of a fixed angle Dynamic Hip Screw (DHS) in a matched cohort of patients...
October 2016: Injury
Yue-Lei Zhang, Song Chen, Zi-Sheng Ai, You-Shui Gao, Jiong Mei, Chang-Qing Zhang
The present study was to analyze clinical outcome of Pauwels grade-3 femoral neck fractures treated by different surgical techniques. Potential risk factors associated with nonunion and osteonecrosis of the femoral head (ONFH) were investigated as well. The retrospective study comprised of 67 sequential patients treated between January 2008 and December 2011. Patients with Pauwels grade-3 femoral neck fractures were treated by operative reduction and internal fixation. Cannulated screws (CS) were used in 46 patients, dynamic hip screw plus CS (DHS+CS) in 14, and locking compression plate (LCP) for proximal femur in 7...
June 2016: Medicine (Baltimore)
Sameer Khalid Khan, Terence Savaridas, Jennifer S Hemers, Zouheir Maarouf, Jane M Orgee, Michael M Orr
We present 2 cases of elderly females presenting with atraumatic, near-vertical (Pauwells grade 3), intracapsular neck of femur fractures. Following diagnosis of osteoporosis on DEXA scans, they had received alendronic acid for 7 and 10 years respectively. Routine blood tests and serum estimations of calcium, vitamin-D and thyroid-stimulating hormone, done at admission, were within the normal ranges. These patients were managed with a hemiarthroplasty and a dynamic hip screw (DHS) respectively, following discontinuation of bisphosphonates...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Navraj S Nagra, Dmitri Van Popta, Sigrid Whiteside, Edward M Holt
OBJECTIVE: The aim of this study was to analyze the changes of hemoglobin levels in patients undergoing fixation for femoral neck fracture. METHODS: Peroperative hemoglobin levels of 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 was monitored. RESULTS: There was a statistically and clinically significant mean drop of 31...
2016: Acta Orthopaedica et Traumatologica Turcica
Daniel Lauxen, Carlos Roberto Schwartsmann, Marcelo Faria Silva, Leandro de Freitas Spinelli, Telmo Roberto Strohaecker, Ralf Wellis de Souza, Cinthia Gabriely Zimmer, Leonardo Carbonera Boschin, Ramiro Zilles Gonçalves, Anthony Kerbes Yépez
OBJECTIVE: The objective of this paper is to measure the volume occupied by the most widely used internal fixation devices for treating femoral neck fractures, using the first 30, 40 and 50 mm of insertion of each screw as an approximation. The study aimed to observe which of these implants caused least bone aggression. METHODS: Five types of cannulated screws and four types of dynamic hip screws (DHS) available on the Brazilian market were evaluated in terms of volume differences through water displacement...
2012: Revista Brasileira de Ortopedia
Naiyer Asif, Sohail Ahmad, Owais Ahmad Qureshi, Latif Zafar Jilani, Tajdar Hamesh, Tariq Jameel
BACKGROUND: Intertrochanteric fractures are one of the most common fractures encountered in our practice. Most of them need operative intervention and union is achieved. As per the literature dynamic hip screw (DHS) is the gold standard for the treatment of these fractures, however problem arises with maintenance of neck shaft angle and proper reduction in unstable intertrochanteric fractures. The situation gets more complex when "cut out" of femoral head screw occurs either alone or in combination with varus collapse when they are treated with DHS...
January 2016: Journal of Clinical and Diagnostic Research: JCDR
Wu-ren Hou, Min-ou Xu
OBJECTIVE: To compare the effect of three cannulated screws and dynamic hip screw (DHS) combined with antirotation screw in treating patients with comminuted fractures of femoral neck. METHODS: From January 2008 to December 2012,67 patients with comminuted fractures of femoral neck were treated with three cannulated screws or DHS combined with antirotation screw. Among them, 36 patients were treated with DHS combined with antirotation screw including 24 males and 12 females with an average of 43...
September 2015: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Sara Sciacca, Surjit Singh Lidder, Christoph Grechenig, Stephan Grechenig, Mario Staresinic, Bore Bakota, Axel Gänsslen
INTRODUCTION: Different modalities of treatment for hip fractures have been discussed in the literature; however, practice may vary between centres. A survey was conducted on participants at an international AO course to assess the current management of pertrochanteric fractures (AO/OTA 31-A2) and displaced, non-impacted, subcapital fractures (AO/OTA 31-B3) in a 35-year-old patient and an 85-year-old patient. METHODS: Surgeons taking part in an international orthopaedic course were invited to participate in a survey and were divided into two groups: inexperienced (one-to-three years since qualification) and experienced (four or more years)...
November 2015: Injury
O Popelka, J Skála-Rosenbaum, R Bartoška, P Waldauf, M Krbec, V Džupa
PURPOSE OF THE STUDY: The aim of the study was to investigate the occurrence of avascular necrosis (AVN) of the femoral head following the osteosynthesis of intracapsular fracture of the femoral neck in relation to the time interval between injury and surgery and the type of fracture. MATERIAL AND METHODS: The data of patients with intracapsular fractures of the femoral neck surgically treated in the period from 2001 to 2011 were reviewed. Of 1555 patients treated for this fracture, 125 (7%) underwent osteosynthesis...
2015: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Shabnam Samsami, Sadegh Saberi, Sanambar Sadighi, Gholamreza Rouhi
Femoral neck fractures in young patients are usually caused by a high-energy trauma, which results in a perpendicular fracture. Although efforts are focused on preserving the femoral head in young patients, vertical femoral neck fracture is a problematic orthopedic injury due to the domination of shear forces. Due to controversy regarding which fixation method is the best choice, the purpose of this study was to find the most stable fixation method for this kind of fracture. This study includes experimental testing on cadaveric bone samples and finite element analysis (FEA) for three fracture fixation techniques, namely cannulated screws (CSs), dynamic hip screw with derotational screw (DHS + DS), and proximal femoral locking plate (PFLP)...
2015: Journal of Medical and Biological Engineering
Y Imren, V Gurkan, K Bilsel, E E Desteli, M Tuna, C Gurcan, I Tuncay, C Sen
PURPOSE OF THE STUDY The objective of this study was to establish relative fixation strengths of proximal femoral nail (PFN), dynamic hip screw (DHS), monolateral external fixator (EF), and cannulated screw (CS) in basicervical hip fracture model. MATERIAL AND METHODS The study involved four groups of implanted composite proximal femoral synthetic bones of eight specimens per group; nailing with PFN, DHS, fixation with three cannulated screws, and EF. 70˚ osteotomy was performed to simulate a Pauwels Type 3 basicervical fracture...
2015: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Babak Siavashi, Arash Aalirezaei, Mersad Moosavi, Mohammad Reza Golbakhsh, Dariush Savadkoohi, Mohammad Javad Zehtab
PURPOSE: In younger adults with fractures of the femoral neck, anatomic reduction is compulsory and maintaining the reduction is crucial. Both cannulated screws and dynamic hip screw (DHS) have the capacity of compression in the fracture site but the strength for keeping reduction is not the same. The aim of this study was to compare the results with fixations of the femoral neck fractures with cannulated screws versus dynamic hip screw. METHODS: This is a randomized clinical trial study on 58 cases with a minimum of one year follow-up...
October 2015: International Orthopaedics
Dasheng Lin, Shenjia Zuo, Lin Li, Lei Wang, Kejian Lian
BACKGROUND: The neglected femoral neck fracture is one where there has been a delay of more than 30 days to seek medical help from the time of the original injury. Salvage procedures, such as osteotomy and other treatment options such as vascularized and nonvascularized bone grafts have high failure rates and arthroplasty procedures are not ideal, given the patient's young age and higher levels of activity. We designed a hollow bone graft dynamic hip screw (Hb-DHS) (modified DHS, Hb-DHS) for use in neglected femoral neck fractures...
May 2015: Indian Journal of Orthopaedics
Ravi Mittal, Sumit Banerjee
UNLABELLED: The purpose of this study was to review the principles involved in the management of proximal femoral fractures as reported in the literature. METHODS: A medical literature search in the MEDLINE (PubMed) and Cochrane database was undertaken to review strategies and principles in proximal femoral fracture treatment. Randomized control trials and meta analysis were given preference while case reports/small series were rejected. RESULTS AND CONCLUSIONS: Early anatomical reduction and surgical fixation remains the best option to reduce the risk of complications like non-union and avascular necrosis in treating fracture neck femurs...
June 2012: Journal of Clinical Orthopaedics and Trauma
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