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Subtrochanteric Fracture

Ersin Sensoz, Fatih Mehmet Özkal, Volkan Acar, Ferit Cakir
Iatrogenic subtrochanteric fractures are rarely encountered after cannulated screw fixation of femoral neck fractures; however, when they do occur, there can be several complications. Many orthopedic surgeons have concerns about the potential for iatrogenic subtrochanteric fractures after screw fixation distal to the trochanter minor; therefore, some surgeons are typically reluctant to perform this procedure. This study focused on the risk of an iatrogenic subtrochanteric fracture after treating femoral neck fractures with cannulated screws...
August 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Yunlan Xu, Jingxia Bian, Kaiying Shen, Bin Xue
The treatment of children between 5 and 12 years of age suffering from subtrochanteric femoral fracture is challenging. The optimal choice of internal fixation for these patients is controversial. The purpose of this study is to compare the outcomes and complications of titanium elastic nail and open reduction with plate fixation of subtrochanteric femur fractures in school-aged children.A total of 67 children aged 5 to 12 years with subtrochanteric femur fractures treated with titanium elastic nails or open plating were identified at our institution from January 2007 to December 2017...
July 2018: Medicine (Baltimore)
Bekir Eray Kilinc, Yunus Oc, Adnan Kara, Ramazan Erden Erturer
INTRODUCTION: To present the effect of the cerclage fixation, which was performed for the purpose of preserving the alignment obtained by open reduction, on the long-term clinical and radiological results of subtrochanteric fractures. MATERIALS AND METHODS: The inclusion criterias were at least 2 years of follow-up, no severe cognitive impairment, and to be able to walk independently prior to fracture. Patients with transverse or short oblique subtrochanteric hip fractures (AO/OTA class 32-A3...
June 28, 2018: International Journal of Surgery
Kimia Khalatbari Kani, Jack A Porrino, Hyojeong Mulcahy, Felix S Chew
Proximal femoral fragility fractures are common and result in significant morbidity and mortality along with a considerable socioeconomic burden. The goals of this article are to review relevant proximal femoral anatomy together with imaging, classification, and management of proximal femoral fragility fractures, and their most common complications. Imaging plays an integral role in classification, management and follow-up of proximal femoral fragility fractures. Classification of proximal femoral fragility fractures is primarily based on anteroposterior hip radiographs...
June 29, 2018: Skeletal Radiology
Leif Mattisson, Lasse J Lapidus, Anders Enocson
BACKGROUND: Hip fracture patients in general are elderly and they often have comorbidities that may necessitate anticoagulation treatment, such as warfarin. It has been emphasized that these patients benefit from surgery without delay to avoid complications and reduce mortality. This creates a challenge for patients on warfarin and especially for those with trochanteric or subtrochanteric hip fractures treated with intramedullary nailing, as this is associated with increased bleeding compared to other types of hip fractures and surgical methods...
June 26, 2018: BMC Musculoskeletal Disorders
Diogo Lino Moura, António Figueiredo
Objective: Retrospective case-control study on the authors' experience regarding arthroplasty in high congenital dislocations of the hip in adults. Methods: Sample with 11 high congenital hip dislocations (Hartofilakidis type C) that occurred in seven patients, who were submitted to hip arthroplasty by the same surgeon and with the same surgical technique. Mean follow-up period was 4.32 ± 2.67 years (minimum one year) and all patients were evaluated by the same examiner...
March 2018: Revista Brasileira de Ortopedia
Xuepeng Xu, Xiaobo Lu, Leiming Luo, Xihai Zhang, Yuanhui Wang
Objective: To compare the effectiveness of titanium elastic nail (TEN) and locking compression plate fixation in treating femoral subtrochanteric fracture in older children. Methods: Between April 2015 and September 2016, 35 older children (aged 7-13 years) with femoral subtrochanteric fractures were treated, the clinical data were retrospectively reviewed. TEN fixation was used in 19 cases (group A) and locking compression plate fixation in 16 cases (group B). There was no significant difference in age, gender, sides, fracture causes, type of fracture, and time from injury to operation between 2 groups ( P >0...
October 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Qi Sun, Gen Li, Wei Ge, Guanghua Lu, Ming Cai, Shaohua Li
Objective: To discuss the effectiveness of intramedullary nail fixation with selective cable wiring in the treatment of ipsilateral femoral neck fracture and subtrochanteric fracture. Methods: Between June 2012 and December 2015, a total of 19 patients with ipsilateral femoral neck fracture and subtrochanteric fracture underwent closed reduction of femoral neck fracture and intramedullary nail fixation combined with selective cable wiring. There were 5 males and 14 females with a median age of 52 years (range, 35-77 years)...
September 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
P Codesido-Vilar, A Mejía-Casado, J Riego-Fernández, N Rodriguez-Casas, S García-Cabanas, J Rivas-Felice, L García-Quevedo
OBJECTIVE: To compare results in terms of orthopaedic complications and quality of life in elderly patients with subtrochanteric fracture treated with intramedullary nailing according to fracture reduction status. PATIENTS AND METHODS: A prospective cohort study including 90 elderly patients with subtrochanteric fractures of the femur treated with a cephalomedullary nail, with a minimum 1-year follow up. The inclusion criteria were: aged 60 years or older, without severe cognitive dysfunction and independent ambulatory capability before the fracture...
May 18, 2018: Revista Española de Cirugía Ortopédica y Traumatología
F Genest, L Seefried
Risk for subtrochanteric and diaphyseal femoral fractures is considered increased in patients with hypophosphatasia (HPP). Evaluating a large cohort of HPP patients, we could for the first time quantify the prevalcence and identify both morphometric features as well as predisposing factors for this complication of severe HPP. INTRODUCTION: Subtrochanteric and diaphyseal femoral fractures have been associated with both, long-term antiresorptive treatment and metabolic bone disorders, specifically Hypophosphatasia (HPP)...
May 17, 2018: Osteoporosis International
Leif Mattisson, Lasse J Lapidus, Anders Enocson
OBJECTIVES: To evaluate the influence of delay to surgery >24 hours on the rate of red blood cell transfusion in a selected population of hip fracture patients. DESIGN: Cohort study. SETTING: Tertiary care university hospital. PATIENTS: A consecutive series of 987 patients (714 females) with a mean age of 86.3 (range 50-106) years operated with an intramedullary nail due to an unstable intertrochanteric or subtrochanteric hip fracture...
August 2018: Journal of Orthopaedic Trauma
Siu-Wai Choi, Frankie K L Leung, Tak-Wing Lau, Gordon T C Wong
INTRODUCTION: Perioperative blood transfusion is not without risk and effort should be made to limit patients' exposure to allogeneic blood. However, there is conflicting data regarding the impact of anaemia on postoperative recovery in patients with repaired hip fractures. It is hypothesised that for a given baseline functional status and fracture type, lower postoperative haemoglobin will increase rehabilitation time and prolong total length of hospital stay. METHODS: This is a retrospective study on data collected prospectively on patients entered into the Clinical Pathway aged >65 years admitted to Queen Mary Hospital (QMH) with a fractured neck of femur during 2011-2013...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Yoon-Je Cho, Kyung-Chung Kang, Young-Soo Chun, Kee Hyung Rhyu, Sang-Jun Kim, Tae-Su Jang
There still remains controversy on the pathomechanism of atypical femoral fracture (AFF). The angle of lateral bowing and bone mineral density showed significant differences between subtrochanteric and diaphyseal atypical fracture groups. In addition to the use of bisphosphonate, mechanical factors might play important roles in the occurrence of AFFs. INTRODUCTION: Although AFF could be divided into subtrochanteric and diaphyseal fracture according to the location of fractures, there is a lack of evidence regarding differences between two fractures and etiology of the occurrence...
May 3, 2018: Archives of Osteoporosis
M H Jonsson, P Bentzer, A Turkiewicz, A Hommel
BACKGROUND: Little is known about accuracy of common risk prediction scores in elderly patients suffering from hip fractures. The objective of this study was to investigate accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) score, Portsmouth-POSSUM (P-POSSUM) score and the Nottingham Hip Fracture Score (NHFS) for prediction of mortality and morbidity in this patient group. METHODS: This was a prospective single centre observational study on 997 patients suffering out-of-hospital cervical, trochanteric or subtrochanteric fracture of the neck of the femur...
April 23, 2018: Acta Anaesthesiologica Scandinavica
Viktor Kamiloski, Katerina Kasapinova
The studies that evaluated blood loss during hip surgery found a relatively small loss that does not explain the large hemoglobin drop postoperatively. The aim of this study was to determine the fall in hemoglobin level after admission and rehydration in patients with hip fractures and to identify the patients that need blood transfusion. This retrospective study included data on 374 patients with hip fracture with surgery delayed by more than 24 hours and complete blood count repeated prior to surgery after fluid resuscitation for a minimum of 24 hours...
December 2017: Acta Clinica Croatica
Jong Ho Noh, Sung Jun Koh, Kee Haeng Lee
Antibiotic cement-coated intramedullary nails maintain a locally high antibiotic concentration while contributing to bone stability. We present a case of femoral subtrochanteric fracture in a patient with an infected nonunion who was successfully treated for an infection and nonunion using an antibiotic cement-coated tibial intramedullary nail. A 79-year-old woman with a right femoral subtrochanteric fracture underwent internal fixation using proximal femoral nail antirotation (PFNA). She developed osteomyelitis with nonunion at the surgical site 10 months postoperatively...
March 2018: Hip & Pelvis
P Y Mathonet, S Willems, J F Ciornohac
Bisphosphonates have frequently shown their efficacy in the treatment of osteoporosis, including ibandronate and alendronate. But more and more mention is made in the literature of patients taking a long-term bisphosphonate and undergoing an atypical fracture associated with this therapy. These complications are most often femoral fractures in the proximal part of the femoral diaphysis. We report the case of a 73-year-old patient who had a subtrochanteric pathological fracture after a prolonged intake of alendronate followed by ibandronate...
February 2018: Revue Médicale de Liège
Ifaz T Haider, Prism Schneider, Andrew Michalski, W Brent Edwards
INTRODUCTION: Atypical femoral fractures (AFF) are characterized as low-energy fractures of the femoral shaft or subtrochanteric region. Femoral geometry is known to play a role in AFF risk; it is hypothesized that high-risk geometries are associated with elevated femoral shaft strain. However, it is not well known which geometric parameters have the greatest effect on strain, or whether interaction between parameters is significant. The purpose of this study was to thoroughly quantify the relationship between femoral geometry and diaphyseal strain, using patient specific finite element (FE) modelling in concert with parametric mesh morphing...
May 2018: Bone
Vivek Trikha, Saubhik Das, Prabhat Agrawal, Arkesh M, Sunil Kumar Dhaka
PURPOSE: Cerclage wire application has emerged as a potential therapeutic adjunct to intramedullary nailing for subtrochanteric fractures. But its popularity is plagued by the concern of possible negative effect on fracture zone biology. This study was intended to analyze the clinico-radiological outcome and complications associated with cerclage wire application. METHODS: Retrospective analysis was performed on all the subtrochanteric fractures operated with intramedullary nailing between January 2012 and January 2016...
February 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Lei Han, Yun-Gen Hu, Wei-Li Fang, Bo Jin, Shi-Chao Xu
OBJECTIVE: To study clinical effects of inversive LISS(less invasive stabilization system, LISS) plate for the treatment of intertrochanteric and subtrochanteric fractures combined with femoral shaft fractures. METHODS: From January 2012 to January 2015, 24 patients with intertrochanteric and subtrochanteric fractures combined with femoral shaft fractures were treated with inversive LISS plate, included 16 males and 8 females with an average age of 62.5 years old ranged from 35 to 81 years old...
July 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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