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Subtrochanteric Fracture

E J Corona-Juárez, O Catalán-Arizmendi, I Alvarado-Ortega, E García-Cano, A Montiel-Jarquín
BACKGROUND: fibrous dysplasia is characterized by the formation of fibrous tissue that generates immature malformed trabeculae. Their involvement may be monostotic or poliostotic. CASE REPORT: Thirty years old female with fibrous dysplasia of the left hip. At age 15 suffered hip fracture without apparent trauma, she was managed conservatively and significant shortening of the same limb was observed. At 30 years old, is pregnant, it had left hip pain, deformity and shortening is exacerbated...
July 2018: Acta Ortopédica Mexicana
Kyung-Jae Lee, Byung-Woo Min
Atypical femoral fractures differ from ordinary femoral diaphyseal or subtrochanteric fractures in several aspects. Although several authors have reported the results of surgical treatment for atypical femoral fractures, the rate of complications (e.g., delayed union, nonunion, fixation failure, and reoperation) is still high. Therefore, we reviewed principles of surgical treatment and describe useful methods for overcoming femoral bowing in these high-risk patients.
December 2018: Hip & Pelvis
Pietro De Biase, Edy Biancalani, Daniela Martinelli, Andrea Cambiganu, Stefano Bianco, Roberto Buzzi
Proximal femoral fractures are a very common disease which affect elderly patients after low energy trauma, but can also affect the young population as a consequence of high energy trauma. Classification of sub trochanteric fractures has not yet been clearly defined representing a major issue in comparing different treatment techniques among the scientific literature.These fractures are well known by orthopaedic surgeons for intraoperative difficulties in reduction and post-operative high rate of non-unions and malunions...
December 2018: Injury
R Pascarella, S Cerbasi, A Maresca, P Sangiovanni, R Fantasia
This case report describes the management and therapeutic solution for the treatment of subtrochanteric non-union in a patient with hip arthrodesis. Two techniques can be used in the treatment of these non-unions: a closed intramedullary nailing or an open technique with plate, preferably carried out together with cortical bone graft. The surgical technique varies depending on the fixation method used for the initial treatment of the fracture and on the characteristics of the non-union. We report an unusual case of a patient who started her long clinical history more than 40 years ago with a septic arthritis of the hip healed in arthrodesis...
December 2018: Injury
Christopher Jackson, Mina Tanios, Nabil Ebraheim
Subtrochanteric femur fractures are an uncommon injury in orthopedics, but when they are encountered they may present difficulties in management. The purpose of this paper is to examine the recent literature on the epidemiology, classification, initial evaluation, and definitely treatment for these injuries. These will assist the physician to determine the optimal treatment strategy and avoid potential surgical complication.
2018: Advances in Orthopedics
Justin Roth, Brian Goldman, Lewis Zirkle, John Schlechter, John Ibrahim, David Shearer
BACKGROUND: As the population ages, the developing world industrializes, and more urban centers emerge, the burden of orthopedic trauma will steadily increase. SIGN Fracture Care International has developed a unique intramedullary device for fixation of hip fractures in low-resource settings lacking fluoroscopy. The purpose of this study is to report the safety profile and complication rate for a consecutive series of hip fracture patients managed using this implant. METHODS: We conducted a retrospective analysis of the first 170 patients treated with the SIGN Hip Construct (SHC) from 2009 to 2014 using the SIGN Online Surgical Database (SOSD)...
2018: SICOT-J
Jun Il Yoo, Young Kyun Lee, Kyung Hoi Koo, Young Jin Park, Yong Chan Ha
PURPOSE: The purpose of this study was to identify concerns among older adult patients with acute hip fracture. MATERIALS AND METHODS: This study was performed with 152 consecutive patients with hip fracture. Details were obtained on perioperative concerns about hip fracture using a questionnaire that was specifically designed for this study and was administered face to face upon admission. The study inclusion criteria were age older than 65 years and having experienced femur neck, intertrochanteric, or subtrochanteric fracture...
December 2018: Yonsei Medical Journal
Liangjun Jiang, Qiang Zheng, Zhijun Pan
Introduction: The fracture displacement in intramedullary nail in femoral subtrochanteric fracture may cause fracture non-union. We retrospectively analysed our recent experience to clear the influence about fracture displacement in intramedullary nail in femoral subtrochanteric fracture. Materials and methods: This study includes 36 patients in the intramedullary nail group followed up for more than 12 months; these patients suffered from femoral subtrochanteric fracture from 2009...
October 2018: Journal of Clinical Orthopaedics and Trauma
Young-Kyun Lee, Dong Won Byun, Sung-Mok Jung, Hye-Young Kwon, Ha-Young Kim, Se Hwa Kim, Tae-Young Kim, Sunmee Jang, Yong-Chan Ha
Although Asian with bisphosphonate has been considered to have higher risk of subtrochanteric and diaphyseal femur (ST/DF) fractures, the occurrence of those fractures has been still unclear in Asia. The purpose of this study was to investigate the incidence rate of ST/DF fractures among bisphosphonate users from nationwide database in South Korea. Using national health insurance claim database, we only included the bisphosphonate users who took bisphosphonate for the first time in 2008 and evaluated the incidence rate of ST/DF fracture from 2008 to 2013...
November 16, 2018: Calcified Tissue International
S M Kim, K H Rhyu, S J Lim
AIMS: The aim of this study was to evaluate the outcomes of a salvage procedure using a 95° angled blade plate for failed osteosynthesis of atypical subtrochanteric femoral fractures associated with the long-term use of bisphosphonates. These were compared with those for failed osteosynthesis of subtrochanteric fractures not associated with bisphosphonate treatment. PATIENTS AND METHODS: Between October 2008 and July 2016, 14 patients with failed osteosynthesis of an atypical subtrochanteric femoral fracture were treated with a blade plate (atypical group)...
November 2018: Bone & Joint Journal
Siddhart Yadav, Vikram Khanna
A 71-year-old female came to our institute with a subtrochanteric left femur fracture following a fall from her bed. It was a low-energy trauma, and the X-rays were suggestive of an atypical fracture following bisphosphonate therapy for five years. The fracture was fixed with intramedullary nailing following which she was started on partial weight-bearing walking after three weeks. The fracture went on to a nonunion; after one year, the fracture site was opened and bone grafting with bone marrow injection, along with augmented plating, was done...
July 6, 2018: Curēus
Won Chul Shin, Nam Hoon Moon, Jae Hoon Jang, Jae Yoon Jeong, Kuen Tak Suh
BACKGROUND: The main purpose of this study is to introduce our surgical technique and report surgical outcomes for percutaneous cable fixation in the treatment of subtrochanteric femoral fractures. METHODS: Between May 2013 and April 2017, 51 patients with subtrochanteric femoral fractures treated with closed intramedullary nailing and percutaneous cable fixation were enrolled in this study. Postoperative angulation, union rate, time from injury to union, and femoral shortening were also evaluated to assess radiologic outcomes...
October 29, 2018: Injury
Carlo Biz, Ilaria Fantoni, Nicola Crepaldi, Filippo Zonta, Lisa Buffon, Marco Corradin, Alessandra Lissandron, Pietro Ruggieri
BACKGROUND: Femoral fractures are a major healthcare problem worldwide. One of the most difficult issues is their preoperative care, which is still managed by either skeletal or skin traction in some countries, including Italy. These issues are discussed and compared with the contemporary literature. OBJECTIVE: This study aims to analyse the distribution of these treatment options within the orthopaedic community and the reasons for their use, as well as to identify how this may impact nursing care in terms of pain management, hygiene care, venous thromboembolism (VTE)prophylaxis and prevention of pressure ulcers...
October 12, 2018: International Journal of Orthopaedic and Trauma Nursing
Karem M Zekry, Norio Yamamoto, Katsuhiro Hayashi, Akihiko Takeuchi, Ali Zein A A Alkhooly, Ahmed Saleh Abd-Elfattah, Ezzat H Fouly, Adel Refaat Ahmed, Hiroyuki Tsuchiya
BACKGROUND: Benign bone tumors and tumor-like conditions are commonly located in the proximal femur. The main indications for surgical treatment are lesions with impending or actual pathological fractures, or with aggressive or recurrent lesions. However, patients complaining of persistent pain, limping, or abnormal gait patterns are also considered for surgical treatment. In this study, we describe the outcomes of the surgical treatment of benign lytic lesions of the proximal femur by curettage followed by implantation of synthetic bone graft...
October 29, 2018: Journal of Orthopaedic Surgery and Research
J Yoo, J S Lee, S Kim, B S Kim, H Choi, D Y Song, W B Kim, C W Won
There is ongoing effort to discharge patients early after hip fracture surgery to reduce the medical and economic burden. We tried to find whether there is any related side effect, and discovered that early discharge, especially before 10 days after surgery, is associated with higher mortality. INTRODUCTION: The aim of this study was to analyze the association between the length of hospital stay after hip fracture and 1-year mortality in older adults aged ≥ 65 years old. METHODS: We conducted a retrospective cohort study using the Korean National Health Insurance Service data to identify patients who were discharged after hip fracture surgery from 2007 to 2009 among 487,460 older adults of age ≥ 65 years...
October 25, 2018: Osteoporosis International
Christian Zeckey, Miriam Bogusch, Martin Borkovec, Christopher A Becker, Carl Neuerburg, Simon Weidert, Eduardo M Suero, Wolfgang Böcker, Axel Greiner, Christian Kammerlander
Radiographic assessment tools such as the cortical step sign (CSS) or the diameter difference sign (DDS) aim to identify clinically relevant rotational malalignment after long bone fracture fixation. We aimed to analyze the effect of rotational malalignment on CSS and DDS parameters in a subtrochanteric fracture model and to construct a prognostic model to identify clinically relevant rotational malalignment. A subtrochanteric transverse osteotomy was set in human femora. Rotation was set stepwise from 0° to 30° in internal and external rotation...
October 22, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Kira Vande Voorde, Jan Dauwe, Jan Van Oost
Introduction: Hip fractures are one of the most common osteoporotic fractures, and the incidence is expected to increase in the future. Vascular injury of the femoral vessels, although uncommon, is an intermittently reported complication in the treatment of proximal femoral fractures. This may be iatrogenic or less frequently as a result of the fracture itself. The profunda femoris artery is most commonly involved, probably because of its close relationship to the femur in the subtrochanteric region...
2018: Case Reports in Orthopedics
Leif Mattisson, Alicja Bojan, Anders Enocson
BACKGROUND: Hip fractures are a major worldwide public health problem and includes two main types of fractures: the intracapsular (cervical) and the extracapsular (trochanteric and subtrochanteric) fractures. The aim of this study on patients with trochanteric and subtrochanteric hip fractures was to describe the epidemiology, treatment and outcome in terms of mortality within the context of a large register study. METHODS: A descriptive epidemiological register study including patients registered in the national Swedish Fracture Register from January 2014 to December 2016...
October 12, 2018: BMC Musculoskeletal Disorders
Toru Iga, Ken Kato, Tatsuro Karita
A subtrochanteric fracture of the femur accompanying pre-existing osteoarthritis of the ipsilateral hip is rare. A deformity of the hip joint complicates the insertion of the intramedullary nail and varus malreduction is anticipated when surgery is performed on a fracture table with a perineal post. We report a successful case of intramedullary fixation performed in the lateral decubitus position and discuss the importance of avoiding varus and the superiority of the lateral position in surgery.
July 31, 2018: Curēus
Morten Schultz Larsen, Hagen Schmal
Atypical femoral fractures (AFF) are stress or 'insufficiency' fractures, often complicated by the use of bisphosphonates or other bone turnover inhibitors. While these drugs are beneficial for the intact osteoporotic bone, they probably prevent a stress fracture from healing which thus progresses to a complete fracture.Key features of atypical femoral fractures, essential for the diagnosis, are: location in the subtrochanteric region and diaphysis; lack of trauma history and comminution; and a transverse or short oblique configuration...
September 2018: EFORT Open Reviews
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