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unstable trochanteric fracture

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
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
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
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
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
Sinan Zehir, Ercan Şahin, Regayip Zehir
BACKGROUND: The aim of this study was toreport our experience regarding the use of three different methods for intramedullary nailing in the treatment of intertrochanteric fractures. METHODS: Patients with A2 and A3 type fractures operated on for unstable trochanteric fractures were included into this retrospective cohort study. Patients were divided into three groups based on the technique used; Talon distal fix nail/lag screw (n=78; mean age, 78.5±6.6), PFNA nail (n=96; mean age, 77...
December 2015: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Daigo Sakagoshi, Takeshi Sawaguchi, Yosuke Shima, Daisuke Inoue, Takeshi Oshima, Sabine Goldhahn
BACKGROUND: Tip-apex distance (TAD) is reported as a good predictor for cut-outs of lag screws and spiral blades in the treatment of intertrochanteric fractures, and surgeons are advised to strive for TAD within 20 mm. However, the femoral neck axis and the position of the lower limb in the lateral radiograph are not clearly defined and can lead to measurement errors. We propose a refined TAD by defining these factors. The objective of this study was to analyze the reliability of this refined TAD...
July 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Richard Armelin Borger, Frederico Araújo Borger, Rodrigo Pires de Araújo, Thiago Ferreira Nunes Pereira, Roberto Dantas Queiroz
UNLABELLED: To assess the clinical, radiological and functional evolution of osteosynthesis using a cephalomedullary nail, in unstable trochanteric fractures of the femur, over a one-year postoperative follow-up. METHODS: Fourteen men and 23 women of mean age 77.7 years were evaluated. Twenty-seven of them had fractures classified as AO/ASIF 31A2 and ten as 31A3. The patients were evaluated clinically, radiologically and functionally one week, two weeks, one month, two months, six months and one year after the operation...
July 2011: Revista Brasileira de Ortopedia
Ali Yeganeh, Roozbeh Taghavi, Mehdi Moghtadaei
INTRODUCTION: Dynamic Hip Screw fixation is currently considered as a standard treatment for pre-trochanteric fractures; however, due to the long-term hospitalization and some other complications, some researchers have proposed intramedullary nailing as the alternative surgical treatment. The aim of this study was to compare and examine the consequences of the using intramedullary nailing method versus Dynamic Hip Screw. METHODS: In this study 114 patients with unstable Intertrochanteric fracture refer to Rasoul Akram hospital during 2011 to 2013 has been selected...
February 2016: Medical Archives
Jeetendra Bajpai, Rajesh Maheshwari, Akansha Bajpai, Sumit Saini
PURPOSE: To compare treatment outcome of screw proximal femoral nail (PFN) system with that of a helical PFN. METHODS: The study included 77 patients with closed unstable intertrochanteric fracture classified as AO 31A2&31A3, between June 2008 to August 2011. Inclusion criteria were: all mature skeletons above 50 years of age; closed unstable trochanteric fracture classified as AO 31A2&A3. Exclusion criteria were: immature skeleton, pathological fracture of any cause other than osteoporosis, inability to walk inde- pendently prior to injury...
2015: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Floran A Reynard, Alexandros N Flaris, Eric R Simms, Olivier Rouvière, Pascal Roy, Nicolas J Prat, Jean-Gabriel Damizet, Jean-Louis Caillot, Eric J Voiglio
INTRODUCTION: Pre-hospital pelvic stabilisation is advised to prevent exsanguination in patients with unstable pelvic fractures (UPFs). Kendrick's extrication device (KED) is commonly used to extricate patients from cars or crevasses. However the KED has not been tested for potential adverse effects in patients with pelvic fractures. The aim of this study was to examine the effect of the KED on pubic symphysis diastasis (SyD) with and without the use of a trochanteric belt (TB) during the extraction process following a MVC...
March 2016: Injury
Matthias Knobe, Philipp Nagel, Klaus-Jürgen Maier, Gertraud Gradl, Benjamin Buecking, Tolga T Sönmez, Ali Modabber, Andreas Prescher, Hans-Christoph Pape
OBJECTIVES: Third-generation cephalomedullary nails currently represent the gold standard in the treatment of unstable trochanteric femur fractures. Recently, an extramedullary rotationally stable screw-anchor system (RoSA) has been developed. It was designed to combine the benefits of screw and blade and to improve stability using a locked trochanteric stabilizing plate (TSP). The purpose of this study was to compare the biomechanical behavior of RoSA/TSP and the proximal femoral nail antirotation (PFNA)...
January 2016: Journal of Orthopaedic Trauma
Stefan Hajdu, Vilmos Vécsei
For nearly 40 years, extramedullary stabilization using the sliding hip screw and plate has been the standard fixation method for proximal femoral fractures. In patients with stable fractures, this device produces excellent results. However, in patients with unstable fractures, the sliding hip screw and plate is associated with an increased prevalence of complications, particularly cut-out, medialization of the shaft, shortening, and subsequent loss of reduction. For these reasons, there has been a sustained interest in the use of an intramedullary nail to treat proximal femoral fractures...
April 2007: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Chandrashekar J Thakkar, Savyasachi Thakkar, Rajshekhar T Kathalgere, Malhar N Kumar
BACKGROUND: The sliding screw-plate devices and cephalo-medullary nail devices have performed well in stable inter-trochanteric fractures in patients with reasonably good quality of bone. However, their suboptimal performance in comminuted fractures in the presence of osteoporotic bone has prompted many surgeons to consider bipolar hemiarthroplasty as the primary modality of management of comminuted inter-trochanteric fractures in elderly patients. However, long term stability of the hemiarthroplasty implant also may be compromised due to the presence of postero-medial bone loss at the area of the calcar...
November 2015: Indian Journal of Orthopaedics
Weiguang Yu, Xinchao Zhang, Xingfei Zhu, Jun Hu, Yunjiang Liu
BACKGROUND: The purpose of this study was to compare the clinical outcomes of elderly patients undergoing surgery for treatment of unstable trochanteric fractures receiving either proximal femoral nails anti-rotation-Asia (PFNA-IIs) or InterTan nails (ITs). METHODS: Between January 1, 2012, and June 31, 2015, 168 elderly patients with unstable intertrochanteric femur fractures enrolled in this study. The only intervention was ITs or PFNA-IIs of the unstable trochanteric femur fractures...
2016: Journal of Orthopaedic Surgery and Research
Adrian Todor, Adina Pojar, Dan Lucaciu
UNLABELLED: The aim of the study was to evaluate the results of minimally invasive treatment of trochanteric fractures with the use of intramedullary nails. PATIENTS AND METHODS: From September 2010 to September 2012 we treated 21 patients with pertrochanteric fractures by a minimally invasive technique using the Gamma 3 (Stryker, Howmedica) nail. There were 13 females and 8 men with a mean age of 74.1 years, ranging from 58 to 88 years. Fractures were classified as being stable (AO type 31-A1) in 5 cases and unstable (AO type 31-A2 and A3) in the rest of 16 cases...
2013: Clujul Medical (1957)
Henrik Palm, Jordi Teixidor
BACKGROUND: In hip fracture surgery, the exact choice of implant often remains somewhat unclear for the individual surgeon, but the growing literature consensus has enabled publication of evidence-based surgical treatment pathways. The aim of this article was to review author pathways and national guidelines for hip fracture surgery and discuss a method for future pathway/guideline implementation and evaluation. METHODS: By a PubMed search in March 2015 six studies of surgical treatment pathways covering all types of proximal femoral fractures with publication after 1995 were identified...
November 2015: Injury
Igor M Kostić, Milan M Mitković, Milorad B Mitković
UNLABELLED: BACGROUND/AIM. Intertrochanteric fractures of the femur are the third most common fractures among all bone fractures. Today in everyday orthopedic practice a number of different methods of treatment of trochanteric fractures of the femur are applied. Despite the improvement in the development of new implants, the percentage of serious complications of the treatment of these fractures remains very high, varying from 10% to 20%. One of the most serious complications of internal fixation of intertrochanteric fractures is nonunion of fractures due to the lack of additional axial dynamisation of implants...
July 2015: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Nobuaki Chinzei, Takafumi Hiranaka, Takahiro Niikura, Mitsuo Tsuji, Ryosuke Kuroda, Minoru Doita, Masahiro Kurosaka
BACKGROUND: Recently, various femoral head fixation devices (HFDs) for trochanteric fractures have become available. However, there are some cases in which femoral head rotation with excessive sliding of the HFD is observed and it is often followed by cutout. The purpose of this study is to compare the ability of the three types of HFDs to prevent femoral head rotation. METHODS: Between July 2005 and December 2009, 206 patients aged over 60 years with trochanteric fractures who had undergone surgical treatment using a short femoral nail in our institution were enrolled into the study...
September 2015: Clinics in Orthopedic Surgery
Bryan Yijia Tan, Adrian Cheng Kiang Lau, Ernest Beng Kee Kwek
PURPOSE: To describe a variant of intertrochanteric fracture not well-characterised in the existing classification systems. METHODS: 10 women and 2 men aged 59 to 98 (median, 80) years with intertrochanteric fractures characterised by a low intertrochanteric fracture, a basicervical fracture fragment, and a thin or fractured lateral wall with greater trochanteric comminution were reviewed. RESULTS: The 12 fractures were classified as A2.1 (n=1), A2...
August 2015: Journal of Orthopaedic Surgery
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