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https://www.readbyqxmd.com/read/28097113/clinical-and-functional-outcomes-of-treatment-for-type-a1-intertrochanteric-femoral-fracture-in-elderly-patients-comparison-of-dynamic-hip-screw-and-proximal-femoral-nail-antirotation
#1
Hong Man Cho, Kyujung Lee
PURPOSE: We aimed to evaluate and compare the clinical and functional outcomes of dynamic hip screw (DHS) and proximal femoral nail antirotation (PFNA) treatment of AO type 1 intertrochanteric fractures in elderly patients. MATERIALS AND METHODS: We retrospectively reviewed 194 consecutive patients with type A1 intertrochanteric femoral fractures who were treated with DHS (n=113) or PFNA (n=81). We evaluated operation time, intraoperative blood loss, and functional outcomes, walking ability, and the Barthel activities index...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28094687/successful-management-of-femoral-trauma-in-a-through-knee-amputee-with-a-previous-malunited-fracture-implications-and-functional-outcome
#2
Beth Lineham, Paul Harwood, Peter Giannoudis
BACKGROUND: After amputation patients are more likely to injure their residual limb. An injury of a previously amputated limb, especially if the residuum is not anatomically normal, poses a dilemma for management. Case Description and Methods: This case report discusses a femoral fracture sustained proximal to a through-knee amputation. Findings and outcomes: The fracture was at the site of a malunited fracture. A shortening osteotomy with bone graft was undertaken to improve alignment and prosthetic fit and remove poor-quality bone...
January 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28073094/the-role-of-lesser-trochanter-fragment-in-unstable-pertrochanteric-a2-proximal-femur-fractures-is-refixation-of-the-lesser-trochanter-worth-the-effort
#3
Christian Ehrnthaller, Alain Christoph Olivier, Florian Gebhard, Lutz Dürselen
BACKGROUND: Instability of osteoporotic pertrochanteric fractures is defined by loss of medial/lateral cortical integrity with the posteromedial fragment including the lesser trochanter being pivotal for load distribution. Literature addressing the importance of lesser trochanter refixation is scarce. To clarify the effect of lesser trochanter refixation on primary stability in these fractures, following study was performed. METHODS: 21 femora were match-paired in 3 groups and osteotomized, creating pertrochanteric fractures (AO-31A2)...
December 30, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/28050546/medial-migration-of-the-intramedullary-gamma-3-nail-a-case-report
#4
Ana Costa Pinheiro, Bruno Alpoim, António Félix, Carlos Alves, Cristina Sousa, António Rodrigues
Intertrochanteric femur fractures are very common in patients over 65 years old, and are often associated with osteoporosis. Proximal femoral nails are preferred because of their biomechanical advantages in the treatment of these fractures, especially if the fracture is unstable. However, many complications associated with intramedullary fracture fixation have been described. The medial migration of the intramedullary gamma nail is a rare complication. The authors report an uncommon but potentially fatal complication, medial and intrapelvic migration of the intramedullary Gamma 3 nails, recorded after one month of osteosynthesis...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28041612/evaluation-of-a-routine-follow-up-visit-after-an-internal-fixation-of-proximal-femoral-fracture
#5
Joonas Mm Kuorikoski, Tim P Söderlund
BACKGROUND AND PURPOSE: Post-operative follow-up after internal fixation of fractures is a common practice. The goal of this study was to evaluate the necessity of a routine follow-up visit after internal fixation of a proximal femoral fracture. Our hypothesis is that these follow-up visits do not result in a change in the treatment plan, but add an extra cost to the health care system and lead to the purposeless utilisation of limited resources. PATIENTS AND METHODS: A retrospective study of 428 consecutive patients (431 fractures) with a scheduled outpatient clinic visit after internal fixation of proximal femoral fractures in a single hospital during years 2012-2013...
December 23, 2016: Injury
https://www.readbyqxmd.com/read/28040074/the-art-of-trochanteric-fracture-reduction
#6
Roland Biber, Johanna Berger, Hermann Josef Bail
The name of Ender is primarily associated with the Ender nails, which were popular for trochanteric fracture fixation more than thirty years ago. However, Ender's concepts were not limited to the implant. Ender developed a unique classification system for trochanteric and subtrochanteric fractures, which provided the theory for closed reduction maneuvers that made the method so successful in his hands. While Ender's nails have become history in the meantime, his principles of fracture reduction can be readily applied on surgery with modern implants such as proximal femoral nails...
December 2016: Injury
https://www.readbyqxmd.com/read/28032707/surgical-technique-for-subtrochanteric-fracture-of-femur
#7
Peng-Cheng Wang, Dong Ren, Chao-Hui Song, Bing Zhou
A 56-year-old woman had fell over herself 4 h prior to her presentation to our hospital. The diagnosis was a subtrochanteric fracture of the right femur (AO-32-A3). The patient was placed in a supine position was set up on a fracture traction table after general anesthesia. The right leg was placed in abduction while the left leg was positioned so that there was flexion of the knee and hip joint. The C-arm was placed on the left side. The surgical field was sterilized and draped. Deformity and external rotation are always present for this type of fracture, so the first step was to place a joystick in the proximal fragment to correct the external rotation...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/27904220/pfna-ii-protrusion-over-the-greater-trochanter-in-the-asian-population-used-in-proximal-femoral-fractures
#8
Sun-Jun Hu, Shi-Min Chang, Zhuo Ma, Shou-Chao Du, Liang-Ping Xiong, Xin Wang
BACKGROUND: The treatment of proximal femoral fractures in geriatric osteoporotic patients continues to be a challenge in orthopaedic trauma. Various kinds of cephalomedullary nails, such as gamma nail, InterTan and PFNA were used clinically. The latest generation PFNA II, specially designed for Asian population, is commonly used for geriatric per-/intertrochanteric fractures. The aim of this study was to determine whether the current PFNA-II proximal segment length is suitable for the greater trochanter height, as assessed by postoperative radiograph measurements...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27889112/risk-factors-for-cut-out-of-double-lag-screw-fixation-in-proximal-femoral-fractures
#9
Kadir Buyukdogan, Omur Caglar, Samet Isik, Mazhar Tokgozoglu, Bulent Atilla
OBJECTIVE: We assessed factors associated with cut-out after internal fixation of proximal femoral fractures using double lag screw nails. DESIGN: Retrospective cohort study. SETTING: A university hospital. PATIENTS AND METHODS: Patients with non-pathological intertrochanteric femur fractures and a minumum 90days follow-up who underwent internal fixation with dual lag screw nails were included. Potential risk factors for lag screw cut-out investigated by our study were: age, gender, body mass index, comorbidities (American Society of Anesthesiologists [ASA] classification), type of fracture (AO/OTA classification), fracture stability, side, operation time, implant length, reduction quality, tip-apex distance (TAD), and lag screw configuration...
November 19, 2016: Injury
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
#10
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/27843357/proximal-femoral-fracture-surgery-in-a-patient-with-osteopetrosis-tarda-complications-and-treatment-strategy
#11
Fırat Seyfettinoglu, Ümit Tuhanioğlu, Hasan Ulas Ogur, Hakan Cicek
Osteopetrosis is a rare, inherited disease characterized by defects in osteoclastic function that results in defective bone resorption. When fractures are encountered, fixation is extremely difficult. Osteopetrosis patients have an increased predisposition to infection. If infection develops after a fracture, treatment is more difficult. In this paper, treatment is presented of a 49-year old female to whom proximal femoral nailing was applied for fixation of an osteopetrotic proximal femur fracture; and when it was unsuccessful, revision was made with a locked anatomic plate, which subsequently led to development of infection...
2016: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/27810151/markers-of-muscle-damage-for-comparing-soft-tissue-injury-following-proximal-femur-nail-and-dynamic-hip-screw-operations-for-intertrochanteric-hip-fractures
#12
Yonathan Wagman, Ortal Segal, Israel Dudkiewicz, Ely Steinberg
BACKGROUND: Femoral neck fractures are the most common fractures among the elderly. The two operative approaches used for the treatment of AO/OTA 31 intertrochanteric fractures include an intramedullary device (proximal femoral nail [PFN]) or an extramedullary device (sliding/dynamic hip screw [DHS]). The aim of this study was to provide objective evidence of local soft tissue injury by measuring serum creatine phosphokinase (CPK), a biochemical marker, to quantify muscle damage and inflammation in patients treated by the two approaches...
December 2016: Injury
https://www.readbyqxmd.com/read/27789875/biomechanical-analysis-of-the-cephalomedullary-nail-versus-the-trochanteric-stabilizing-plate-for-unstable-intertrochanteric-femur-fractures
#13
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/27780504/treatment-of-osteoporotic-intertrochanteric-fractures-by-zoledronic-acid-injection-combined-with-proximal-femoral-nail-anti-rotation
#14
Yong Li, Wen-Bo Zhao, De-Li Wang, Qing He, Qin Li, Fu-Xing Pei, Lei Liu
OBJECTIVE: To observe the clinical results of proximal femoral nail anti-rotation (PFNA) combined with zoledronic acid injection in the treatment of osteoporotic intertrochanteric fractures in the elderly. METHODS: 60 elderly patients with osteoporotic intertrochanteric fractures were diagnosed using a dual energy X-ray bone density instrument. Patients were randomly divided into treatment or control groups (30 cases in each group). Patients in both groups were treated by closed/open reduction and internal fixation using PFNA...
October 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/27718658/-analysis-of-hip-fracture-care-in-hungary-between-2004-2009
#15
István Flóris, Éva Belicza
INTRODUCTION: Proximal femoral fractures with severe outcome are most common in the increasing group of elderly patients. AIM: Based on the regular data gathered by the EuroHOPE research, the most important aspects and results of the treatment of proximal femoral fractures were studied. METHOD: Data of hospital admissions due to proximal femoral fractures were analyzed. RESULTS: There was a slight increase in the number of hospitalized patients between 2004 and 2009 in Hungary...
October 2016: Orvosi Hetilap
https://www.readbyqxmd.com/read/27682303/atypical-femur-fractures-patient-characteristics-and-results-of-intramedullary-nailing-for-a-series-of-21-patients
#16
COMPARATIVE STUDY
S Subramanian, M J Parker
Atypical femoral fractures have been associated with long term use of bisphosphonates. Our study plan was to report the outcome of treatment for a series of -patients with an atypical femoral fracture and to compare the characteristics of those patients with a proximal femoral fracture. 21 atypical fractures were identified over a seven year period and these were compared with those of 2.547 hip fracture patients treated over the same time period at a single centre. The mean age of patients with an atypical fracture was on average nine years less than that for the hip fracture patients (72 as against 81 years, p = 0...
August 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/27682295/does-the-implant-make-the-difference%C3%A2-prospective-comparison-of-two-different-proximal-femur-nails
#17
RANDOMIZED CONTROLLED TRIAL
S Hopp, R Wirbel, I Ojodu, A Pizanis, T Pohlemann, J Fleischer
The aim of this study was to compare two proximal femur nails with regard to the complication rate and midterm clinical outcome : the InterTAN nail (ITN) versus the third generation gamma nail (GN). 78 patients older than 60 years with an unstable intertrochanteric femoral fracture (AO/OTA 31 A2/A3) were randomised over a 20 month period into either ITN (n = 39) or GN (n = 39). The outcomes of interest were the perioperative implant-related complications and the functional status (Harris Hip Score) at 6 months postoperatively...
August 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/27665226/three-dimensional-correlation-between-trochanteric-fossa-and-the-ideal-entry-point-for-antegrade-femoral-nailing
#18
Young-Soo Byun, Gu-Hee Jung
PURPOSE: To verify the practical correlation between the topographical features of the femur neck base and the ideal entry point by analyzing three-dimensional (3D) models virtually implanted with an antegrade femoral nail. MATERIALS AND METHODS: A total of 103 cadaveric femurs (50 males and 53 females) were enrolled. Specimens underwent continuous 1.0mm slice computed tomography (CT) scans. CT images were rendered into 3D images using image-processing software (Mimics(®)) to reconstruct the geometry of the cortex and medullary canal...
September 12, 2016: Injury
https://www.readbyqxmd.com/read/27659368/risk-factors-for-intramedullary-nail-breakage-in-proximal-femoral-fractures-a-10-year-retrospective-review
#19
N A Johnson, C Uzoigwe, M Venkatesan, V Burgula, A Kulkarni, J N Davison, R U Ashford
INTRODUCTION Intramedullary nailing is a common treatment for proximal femoral fractures. Fracture of the nail is a rare but devastating complication that exposes often frail patients to complex revision surgery. We investigated which risk factors predict nail failure. METHODS We reviewed all cases of nail breakage seen over a 10-year period in a single busy trauma unit; 22 nail fractures were seen in 19 patients. Comparison was made with a group of 209 consecutive patients who underwent intramedullary fixation of a proximal femur fracture with no nail breakage over a 2-year period...
September 23, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27652085/the-choice-of-internal-fixator-for-fractures-around-the-femoral-trochanter-depends-on-area-classification
#20
Hiroaki Kijima, Shin Yamada, Natsuo Konishi, Hitoshi Kubota, Hiroshi Tazawa, Takayuki Tani, Norio Suzuki, Keiji Kamo, Yoshihiko Okudera, Ken Sasaki, Tetsuya Kawano, Naohisa Miyakoshi, Yoichi Shimada
PURPOSE: In femoral trochanteric fractures, fractures whose fracture lines extend to the basal neck or to the subtrochanteric part have high instability. Area classification can identify such instable fractures. The best choices of internal fixators for femoral trochanteric fractures were investigated according to area classification. METHODS: Femoral trochanteric fractures were investigated with respect to area classification. In area classification, the proximal femur is divided into 4 areas with 3 boundary lines: Line-1 is the center of the neck; Line-2 is the border between the neck and the trochanteric zone; and Line-3 links the inferior borders of the greater and lesser trochanters...
2016: SpringerPlus
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