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Intracapsular hip fracture

C Huxley, J Achten, M L Costa, F Griffiths, X L Griffin
OBJECTIVES: The annual incidence of hip fracture is 620 000 in the European Union. The cost of this clinical problem has been estimated at 1.75 million disability-adjusted life years lost, equating to 1.4% of the total healthcare burden in established market economies. Recent guidance from The National Institute for Health and Clinical Excellence (NICE) states that research into the clinical and cost effectiveness of total hip arthroplasty (THA) as a treatment for hip fracture is a priority...
October 2016: Bone & Joint Research
José Cordero, Alfonso Maldonado, Sergio Iborra
PURPOSE: Analysis of significant risk factors for mortality and for medical and orthopaedic complications. PATIENTS AND METHODS: Observational study of a prospective consecutive cohort of 697 patients diagnosed of hip fracture from December 2012 to December 2014. Average age was 85±9years and 520 were female (75%). Intracapsular fractures (308, 44%) were treated non-operatively, (19 patients), with cannulated screws (58) or with hip arthroplasty (228 bipolar, 3 total hip atrhoplasty)...
September 2016: Injury
D P Dargan, F Callachand, O J Diamond, C K Connolly
INTRODUCTION: Intracapsular femoral neck fractures remain associated with high rates of post-traumatic femoral head necrosis, non-union, and revision surgery. AIM: Our aim was to identify factors associated with revision surgery in intracapsular femoral neck fractures treated with sliding hip screws (SHS) in adults aged <65 years. PATIENTS AND METHODS: Consecutive admissions were identified retrospectively from the Royal Victoria Hospital, Belfast, which was the largest volume hospital on the National Hip Fracture Database...
September 6, 2016: Injury
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
T M Wong
No abstract text is available yet for this article.
August 2016: Journal of Orthopaedic Surgery
Massimo Mariconda, Giovangiuseppe Costa, Mario Misasi, Pasquale Recano, Giovanni Balato, Maria Rizzo
BACKGROUND: Total hip arthroplasty (THA) has not only been associated with best functional outcomes but also with higher dislocation risk when compared with bipolar hemiarthroplasty (HA). The functionality and activities of daily living (ADL) of patients treated with THA or HA for intracapsular hip fracture (IHF) have been scarcely investigated in comparison with the preoperative status. METHODS: Two comparable groups of 60 patients with an IHF who had undergone either THA or bipolar HA were created matching several preoperative characteristics...
July 21, 2016: Journal of Arthroplasty
Jan Vaculík, Martin Braun, Pavel Dungl, Karel Pavelka, Jan J Stepan
BACKGROUND: Femoral neck fractures are a common occurrence in patients suffering from osteoporosis, while intracapsular hip fracture is rare in cases of osteoarthritis of the hip. Previous histomorphometric studies have emphasized the association between bone microarchitecture and the risk of low-impact fractures in osteoarthritis and osteoporosis patients. However, the strength of bone material is also a function of composition of organic bone matrix. In order to compare tissue material properties in these two clinical conditions, serum and bone pentosidine, a non-enzymatic collagen crosslinking element, was measured in patients who suffered a low-impact fracture, and in patients with advanced osteoarthritis...
2016: BMC Musculoskeletal Disorders
Ayman M Ebied, Adel I Elseedy, Osama Gamal
BACKGROUND: Nonunion of hip fractures is not uncommon. Total hip arthroplasty is used to salvage cases of non union or secondary arthritis in these fractures. However, this option may not be available or may be difficult to achieve when infection has superseded the site of nonunion. The objective of this prospective study was to assess if a staged protocol of treatment yields good results in these difficult cases. MATERIALS AND METHODS: Twenty-seven consecutive patients who had deep hip infection with failed treatment of hip fractures (intracapsular in 16 cases and extracapsular in 11) were treated between June 2007 and September 2011...
July 11, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Eitan Dickman, Illya Pushkar, Antonios Likourezos, Knox Todd, Ula Hwang, Saadia Akhtar, Sean Morrison
No abstract text is available yet for this article.
May 25, 2016: American Journal of Emergency Medicine
G Zarattini, L Breda, M Zacharia, F Sibona
INTRODUCTION: Hip fractures, which are common among old patients, are classified into two groups: intracapsular and extracapsular fractures. Extracapsular fractures can be treated with extramedullary implants [e.g. dynamic hip screw (DHS)] or intramedullary nails. Dynamic hip screw is the treatment of choice in stable pertrochanteric fractures. Intrapelvic migration of the sliding screw is a very rare complication. CASE REPORT: We report a case of a 90-year old Caucasian woman who had an unusual intraoperative complication during osteosynthesis procedure for extracapsular hip fracture fixation...
July 2015: Journal of Orthopaedic Case Reports
Farhan Syed, Perrico Nunag, Abubakar Mustafa, Anand Pillai
INTRODUCTION: Sustaining an intracapsular fracture in a hip which was previously fixed with dynamic hip screw for extracapsular fracture, is a very rarely reported occurrence. We present one such case in order to discuss the presentation and management of this fracture. We have also reviewed the literature and pooled the previously reported cases to look at potential cause & risk factors. CASE REPORT: A 92 year old female, presented with new onset hip pain following a trivial injury...
April 2015: Journal of Orthopaedic Case Reports
Dror Lakstein, Ira Bachar, Ronen Debi, Omri Lubovsky, Ornit Cohen, Zachary Tan, Ehud Atoun
PURPOSE: The purpose of this study was to evaluate the use of pre-operative digital templating to minimize complications including limb length discrepancy (LLD), intraoperative fractures and early dislocations in patients with intracapsular femoral neck fractures. METHODS: We retrospectively compared 23 patients undergoing total hip arthroplasty (THA) for intracapsular femoral fractures with pre-operative digital templating and 48 patients without templating. RESULTS: The mean post-operative LLD was significantly lower in patients who had pre-operative templating than in the control group (6...
June 7, 2016: International Orthopaedics
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
Maximilian J Hartel, Shahab Maafi Mandani, Jakob Nuechtern, Norbert Stiel, Wolfgang Lehmann, Johannes M Rueger, Lars G Grossterlinden
INTRODUCTION: At the present time, it is generally recommended to use hip replacement in dislocated fractures to avoid failure after internal fixation. A problem is that previous research has demonstrated that observers have problems in discriminating between dislocated and undislocated fractures. A possible solution to this problem would be to use arthroplasty in the majority of the cases. However, this also means that many fractures with the potential for uneventful healing would be replaced...
July 2016: Archives of Orthopaedic and Trauma Surgery
Aysha Rajeev, Paul Banaszkiewicz
INTRODUCTION: Hemiarthroplasty of the hip is one of the commonest procedures done for intracapsular fractures of the neck of femur in elderly. Dislocation of the hemiarthroplasty is a recognised and significant complication. This is associated with considerable morbidity and mortality. The treatment options include closed manipulation, skin and skeletal traction, conversion to total hip replacement, exploration and open reduction and leaving it out of the acetabulum. PRESENTATION OF CASE: A retrospective review of ten patients with recurrent and failed closed manipulative reduction of hemiarthroplasty who underwent revision using a cemented captive acetabular cup and cement to cement revision of femoral component with Exeter CDH stem was carried out...
2016: International Journal of Surgery Case Reports
Daniel C Perry, David Metcalfe, Xavier L Griffin, Matthew L Costa
OBJECTIVES:  To determine whether the use of total hip arthroplasty (THA) among individuals with a displaced intracapsular fracture of the femoral neck is based on national guidelines or if there are systematic inequalities. DESIGN:  Observational cohort study using the National Hip Fracture Database (NHFD). SETTING:  All hospitals that treat adults with hip fractures in England, Wales, and Northern Ireland. PARTICIPANTS:  Patients within the national database (all aged ≥60) who received operative treatment for a non-pathological displaced intracapsular hip fracture from 1 July 2011 to 31 April 2015...
2016: BMJ: British Medical Journal
Luigi Murena, Roberto Fattori, Veronica Scamacca, Paolo Cau, Chiara Ratti, Gianluca Canton
BACKGROUND AND AIM OF THE WORK: Hemiarthroplasty (HA) for femoral neck fractures in relatively young patients has been reported to have poor results. Moreover, cotyloiditis has been described for HA as a possible cause of revision. Nontheless, in the literature there is lack of studies specifically evaluating this topic, particularly in relatively young patients. Aim of the study was to evaluate bipolar HA clinical and radiographic results at long term follow up in patients treated under the age of 70...
2016: Acta Bio-medica: Atenei Parmensis
A Fishlock, C Scarsbrook, R Marsh
Introduction In 2011 the National Institute for Health and Care Excellence (NICE) published guidelines suggesting that clinicians offer total hip replacement (THR) to patients with displaced intracapsular hip fractures who could walk independently outside with no aids or one stick, who are not cognitively impaired and are ASA (American Society of Anesthesiologists) grade ≤2. They also stated that best practice is operating within 36 hours of presentation. This audit aimed to determine whether Scarborough Hospital was following these guidelines and compared the results with the national average...
July 2016: Annals of the Royal College of Surgeons of England
O Riaz, R Arshad, S Nisar, R Vanker
Introduction Internal fixation of undisplaced intracapsular femoral neck fractures with cannulated hip screws is a widely accepted surgical technique, despite reported failure rates of 12%-19%. This study determined whether preoperative serum albumin levels are linked to fixation failure. Methods We retrospectively reviewed 251 consecutive undisplaced intracapsular femoral neck fracture patients treated with cannulated hip screws in a district general hospital. Preoperative albumin levels were measured, and the fixation technique, classification and posterior tilt on radiography assessed...
July 2016: Annals of the Royal College of Surgeons of England
S S S Mahmoud, E O Pearse, T O Smith, C B Hing
AIMS: The optimal management of intracapsular fractures of the femoral neck in independently mobile patients remains open to debate. Successful fixation obviates the limitations of arthroplasty for this group of patients. However, with fixation failure rates as high as 30%, the outcome of revision surgery to salvage total hip arthroplasty (THA) must be considered. We carried out a systematic review to compare the outcomes of salvage THA and primary THA for intracapsular fractures of the femoral neck...
April 2016: Bone & Joint Journal
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