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unstable trochanteric fracture

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https://www.readbyqxmd.com/read/28437506/treatment-of-unstable-trochanteric-femur-fractures-proximal-femur-nail-versus-proximal-femur-locking-compression-plate
#1
Ashutosh Kumar Singh, Nidi Narsaria, Arun G R, Vivek Srivastava
Unstable trochanteric femur fractures are common fractures that are difficult to manage. We conducted a prospective study to compare functional outcomes and complications of 2 different implant designs, proximal femur nail (PFN) and proximal femur locking compression plate (PFLCP), used in internal fixation of unstable trochanteric femur fractures. On hospital admission, 48 patients with unstable trochanteric fractures were randomly assigned (using a sealed envelope method) to treatment with either PFN (24 patients) or PFLCP (24 patients)...
March 2017: American Journal of Orthopedics
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
#2
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/28404548/the-tip-apex-distance-in-the-x-bolt-dynamic-plating-system
#3
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/28316964/the-fixation-method-according-to-the-fracture-type-of-the-greater-trochanter-in-unstable-intertrochanteric-fractures-undergoing-arthroplasty
#4
Doohoon Sun, Byeong-Seop Park, Gun-Il Jang, Bongjoo Lee
PURPOSE: We conducted a study on patients who underwent hip joint arthroplasty because of unstable femur intertrochanteric fractures with greater trochanter bony fragments. After dividing patients into three groups depending on their fracture patterns, we evaluated the clinical and radiological outcomes of different operation methods applied to each of these groups. MATERIALS AND METHODS: Using Evan's classification, we defined an unstable intertrochanteric fracture as those characterized as stage 4 or 5...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28295123/new-proximal-femoral-compaction-blade-provides-strong-antirotation-stability-of-the-femoral-head
#5
Shinya Hayashi, Yukiaki Hirata, Daiki Okamoto, Satoshi Kakunai, Shingo Hashimoto, Koji Takayama, Tomoyuki Matsumoto, Takahiro Niikura, Takaaki Fujishiro, Takafumi Hiranaka, Kotaro Nishida, Ryosuke Kuroda
This study investigated the mechanical properties of a new rectangular compaction blade and compared this blade with other types of nail. Three types of nail were tested: the Magnum lag screw (Robert Reid Inc, Tokyo, Japan), proximal femoral nail, and Magnum Fid blade (Robert Reid Inc). The nails were inserted into solid rigid polyurethane foam, and the torsional moments were loaded with an Instron testing machine (Instron, Kanagawa, Japan). The force curve was recorded, and the average maximum torque was calculated from this curve...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28284469/unstable-trochanteric-fractures-issues-and-avoiding-pitfalls
#6
REVIEW
Sushrut Babhulkar
The incidence of trochanteric fractures is rising because of increasing number of senior citizens with osteoporosis. There are various modalities for reduction and internal fixation. However, the incidence of complications remains high. In the herein article we discuss issues that influence the fixation and outcomes of unstable trochanteric fractures. Moreover, the results of a prospective, randomised, cohort, time bound, hospital based, comparative study is presented.
February 27, 2017: Injury
https://www.readbyqxmd.com/read/28211303/proposal-of-new-classification-of-femoral-trochanteric-fracture-by-three-dimensional-computed-tomography-and-relationship-to-usual-plain-x-ray-classification
#7
Etsuo Shoda, Shimpei Kitada, Yu Sasaki, Hitoshi Hirase, Takahiro Niikura, Sang Yang Lee, Atsushi Sakurai, Keisuke Oe, Takeharu Sasaki
PURPOSE: Classification of femoral trochanteric fractures is usually based on plain X-ray findings using the Evans, Jensen, or AO/OTA classification. However, complications such as nonunion and cut out of the lag screw or blade are seen even in stable fracture. This may be due to the difficulty of exact diagnosis of fracture pattern in plain X-ray. Computed tomography (CT) may provide more information about the fracture pattern, but such data are scarce. In the present study, it was performed to propose a classification system for femoral trochanteric fractures using three-dimensional CT (3D-CT) and investigate the relationship between this classification and conventional plain X-ray classification...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28186871/augmentation-of-proximal-femoral-nail-in-unstable-trochanteric-fractures
#8
Wasudeo M Gadegone, Bhaskaran Shivashankar, Vijayanad Lokhande, Yogesh Salphale
INTRODUCTION: Biomechanically proximal femoral nail (PFN) is a better choice of implant, still it is associated with screw breakage, cut out of screw through femoral head, Z effect, reverse Z effect, and lateral migration of screws. The purpose of this study is to evaluate the results of augmented PFN in terms of prevention of postoperative complications and failure rates in unstable trochanteric fractures. MATERIAL AND METHODS: We carried out a prospective study of 82 cases with unstable trochanteric femoral fractures from April 2010 to December 2015...
2017: SICOT-J
https://www.readbyqxmd.com/read/28139187/cementless-calcar-replacement-stem-with-integrated-greater-trochanter-plate-for-unstable-intertrochanteric-fracture-in-very-elderly-patients
#9
Keizo Wada, Hiroshi Mikami, Koichi Oba, Hiroshi Yonezu, Koichi Sairyo
PURPOSE: To evaluate the clinical results of rigid fixation of the greater trochanter fragment through a consecutive hemiarthroplasty series using a cementless and modular calcar-replacement prosthesis with an integrated plate (MOD-Centaur stem) with 1-year follow-up in very elderly patients with unstable intertrochanteric fractures. METHODS: We assessed 44 consecutive very elderly patients (age >85 years; 2 men, 42 women; mean age at surgery: 89.6 years) with an unstable intertrochanteric fracture who underwent bipolar hemiarthroplasty using the MOD-Centaur stem by the same surgeon...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/27904219/results-of-a-compression-pin-alongwith-trochanteric-external-fixation-in-management-of-high-risk-elderly-intertrochanteric-fractures
#10
Aydın Arslan, Ali Utkan, Tuba Tulay Koca
BACKGROUND: External fixation is a well-known procedure for the management of intertrochanteric fractures in very elderly high-risk patients. A new compression pin that can be adapted to all fixators was designed to provide inter fragmentary compression. In the present study, its effects on the fracture stability and healing were evaluated. MATERIALS AND METHODS: Thirty-one patients treated using compression pin and thirty-six patients treated using standard pins were evaluated retrospectively between January 2009 and July 2014...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27875489/femoral-medialization-fixation-failures-and-functional-outcome-in-trochanteric-hip-fractures-treated-with-either-a-sliding-hip-screw-or-an-intramedullary-nail-from-within-a-randomized-trial
#11
Christopher P Bretherton, Martyn J Parker
OBJECTIVES: The aim of this study was to determine if femoral medialization influences residual pain and mobility and to determine if fixation method or fracture pattern influences the tendency to medialize. DESIGN: This study used data from within a randomized controlled trial. SETTING: Peterborough City Hospital, UK. PATIENT/PARTICIPANTS: Eight hundred forty-four patients presenting with a trochanteric hip fracture were randomized...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27854071/staged-laparotomies-based-on-the-damage-control-principle-to-treat-hemodynamically-unstable-grade-iv-blunt-hepatic-injury-in-an-eight-year-old-girl
#12
Takashi Kobayashi, Masayuki Kubota, Yuhki Arai, Toshiyuki Ohyama, Naoki Yokota, Kohei Miura, Hirosuke Ishikawa, Daiki Soma, Kazuyasu Takizawa, Jun Sakata, Masayuki Nagahashi, Hitoshi Kameyama, Toshifumi Wakai
BACKGROUND: Severe blunt hepatic injury is a major cause of morbidity and mortality in pediatric patients. Damage control (DC) surgery has been reported to be useful in severely compromised children with hepatic injury. We applied such a technique in the treatment of a case of hemodynamically unstable grade IV blunt hepatic injury in an eight-year-old girl. This case is the first to use multimodal approaches including perihepatic packing, temporary closure of the abdominal wall with a plastic sheet, transarterial embolization (TAE), and planned delayed anatomical hepatic resection in a child...
December 2016: Surgical Case Reports
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
#13
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/27789875/biomechanical-analysis-of-the-cephalomedullary-nail-versus-the-trochanteric-stabilizing-plate-for-unstable-intertrochanteric-femur-fractures
#14
David Walmsley, Bruce Nicayenzi, Paul Rt Kuzyk, Alan Machin, Habiba Bougherara, Emil H Schemitsch, Radovan Zdero
Unstable intertrochanteric fractures are commonly treated with a cephalomedullary nail due to high failure rates with a sliding hip screw. The Omega3 Trochanteric Stabilizing Plate is a relatively new device that functions like a modified sliding hip screw with a proximal extension; however, its mechanical properties have not been evaluated. This study biomechanically compared a cephalomedullary nail, that is, Gamma3 Nail against the Omega3 plate. Unstable intertrochanteric fractures were created in 24 artificial femurs...
October 26, 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/27770169/-the-rotationally-stable-screw-anchor-with-trochanteric-stabilizing-plate-rosa-tsp-first-results-in-unstable-trochanteric-femur-fractures
#15
K-J Maier, B Bücking, K Horst, H Andruszkow, F Hildebrand, M Knobe
BACKGROUND: In unstable trochanteric fractures, the extramedullary rotationally stable screw-anchor (RoSA) combines the benefits of the load and rotational stability of the blade with the advantages of the screw (pull-out resistance, compression capability) in a single load carrier, and was designed to prevent femoral neck shortening by using an additional locked trochanteric stabilizing plate (TSP). OBJECTIVES: The aim of the current prospective cohort study was the clinical evaluation of the RoSA/TSP system regarding the mechanical re-operation rate and the amount of postoperative femoral neck shortening...
October 21, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27536574/primary-cementless-hip-arthroplasty-in-unstable-intertrochanteric-femur-fracture-in-elderlys-short-term-results
#16
Su-Hyun Cho, Hyung Lae Cho, Hong Cho
PURPOSE: This study was aimed to explore and report the short term results of primary cementless hip arthroplasty in treatment of unstable intertrochanteric femur fracture in elderlys. MATERIALS AND METHODS: Between March 2009 and Feburary 2012, 35 arthroplasty cases performed by single surgeon and followed up for more than one year were evaluated. They were 21 females and 14 males with mean age of 78 years (range, 71-92 years). Preoperative evaluation was performed by American Society of Anesthesia score...
September 2014: Hip & Pelvis
https://www.readbyqxmd.com/read/27435361/the-outcome-of-unstable-proximal-femoral-fracture-treated-with-reverse-liss-plates
#17
Shih-Jie Lin, Kuo-Chin Huang, Po-Yao Chuang, Chien-Yin Lee, Tsan-Wen Huang, Mel S Lee, Robert Wen-Wei Hsu
BACKGROUND: The Russel-Taylor type 2B fractures compromised the trochanteric region and medial buttress of proximal femur. This fracture pattern limits the choice of implants and raises the risk of adverse outcomes. We aimed to (i) determine the outcome of Russel-Taylor type 2B fractures treated using reverse less invasive stabilization system plates (LISS-DF) and to (ii) learn what factors affected outcomes after osteosynthesis with reverse LISS plates. DESIGN: A retrospective study SETTING: The study was conducted at a Level III trauma center in Taiwan...
October 2016: Injury
https://www.readbyqxmd.com/read/27293287/assessment-of-the-geometry-of-proximal-femur-for-short-cephalomedullary-nail-placement-an-observational-study-in-dry-femora-and-living-subjects
#18
Devendra Pathrot, Rehan Ul Haq, Aditya N Aggarwal, Mahindra Nagar, Shuchi Bhatt
BACKGROUND: Intramedullary devices have increasingly become popular and are widely used for fixation of unstable intertrochanteric and subtrochanteric fractures. These implants have been designed taking into consideration of the anthropometry of the western population which varies from those of other ethnic groups. This study was carried out to assess the geometry of proximal femur for the placement of short cephalomedullary nails in our subset of patients and suggest suitable design modifications based on these parameters...
May 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27163063/trans-trochanteric-approach-with-coronal-osteotomy-of-the-great-trochanter-a-new-technique-for-extra-capsular-trochanteric-fracture-patients-treated-by-total-hip-arthroplasty-tha-in-elderly
#19
Francois Steffann, Jean-Louis Prudhon, Jean-Marc Puch, André Ferreira, Loys Descamps, Régis Verdier, Jacques Caton
Several surgical approaches could be used in hip arthroplasty or trauma surgery: anterior, anterolateral, lateral, posterior (with or without trochanterotomy), using or not an orthopedic reduction table. Subtrochanteric and extra-capsular trochanteric fractures (ECTF) are usually treated by internal fixation with mandatory restrictions on weight bearing. Specific complications have been widely described. Mechanical failures are particularly high in unstable fractures. Hip fractures are a major public health issue with a mortality rate of 12%-23% at 1 year...
2015: SICOT-J
https://www.readbyqxmd.com/read/27100036/rigid-intramedullary-nailing-of-femoral-shaft-fractures-for-patients-age-12-and-younger-indications-and-technique
#20
Jeffrey E Martus
Femoral shaft fractures are common injuries in the pediatric and adolescent age groups. Rigid intramedullary nailing is an excellent treatment option for older children and adolescents, particularly for length-unstable fractures and larger patients (>49 kg). Appropriate indications, contraindications, and preoperative assessment are described. The rigid nailing surgical technique is detailed including positioning, operative steps, pearls, and pitfalls. Complications and the reported outcomes of lateral trochanteric entry nailing are reviewed from the published series...
June 2016: Journal of Pediatric Orthopedics
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