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https://www.readbyqxmd.com/read/28326420/proximal-femoral-reconstruction-for-failed-internal-fixation-of-a-bisphosphonate-related-femur-fracture
#1
Rishabh G Jethanandani, Chima Nwankwo, Philip R Wolinsky, Mauro Giordani, Derek F Amanatullah
We present a case of a bisphosphonate-related femur fracture in an elderly woman, who failed treatment with both cephalomedullary nail and proximal femoral locking plate, leading to successful treatment with total hip arthroplasty. Hardware failure should be included in the differential of patients with previous internal fixation of bisphosphonate-related femur fracture that present with hip or groin pain. Arthroplasty can be an acceptable salvage option in an active elderly patient with a bisphosphonate-related femur fracture...
December 2016: Arthroplast Today
https://www.readbyqxmd.com/read/28316963/the-results-of-proximal-femoral-nail-for-intertrochanteric-fracture-in-hemodialysis-patient
#2
Kyung Sub Song, Sang Phil Yoon, Su Keon Lee, Seung Hwan Lee, Bong Seok Yang, Byeong Mun Park, Ick Hwan Yang, Beom Seok Lee, Ji Ung Yeom
PURPOSE: Hip fractures in hemodialysis patients are accompanied by high rates of complications and morbidities. Previous studies have mainly reported on nonunion and avascular necrosis of femoral neck fractures in this patient group. In this study the complication and clinical results of hemodialysis patients with intertrochanteric fractures treated with proximal femoral intramedullary nailing have been investigated through comparison with patients with normal kidney function. MATERIALS AND METHODS: Forty-seven patients were included; the hemodialysis group (n=17) and the control group with normal kidney function (n=30)...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28295123/new-proximal-femoral-compaction-blade-provides-strong-antirotation-stability-of-the-femoral-head
#3
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/28291437/evaluation-of-proximal-femoral-nail-antirotation-and-cemented-bipolar-hemiarthroplasty-with-calcar-replacement-in-treatment-of-intertrochanteric-femoral-fractures-in-terms-of-mortality-and-morbidity-ratios
#4
Erdinç Esen, Hakan Dur, M Baybars Ataoğlu, Tacettin Ayanoğlu, Sacit Turanlı
OBJECTIVES: This study aims to assess the mortality and morbidity rates of patients with intertrochanteric femoral fractures who were performed proximal femoral nail-antirotation (PFNA) or cemented, bipolar hemiarthroplasty with calcar replacement. PATIENTS AND METHODS: A total of 127 patients (42 males, 85 females; mean age 79.2 years; range 55 to 98 years) who were treated due to proximal femoral fracture between January 2008 and January 2011 were compared retrospectively in terms of intraoperative mortality, total mortality, and monthly distribution of mortality rates...
April 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/28288607/influence-of-different-great-trochanteric-entry-points-on-the-outcome-of-intertrochanteric-fractures-a-retrospective-cohort-study
#5
Shuo Pan, Xiao-Hui Liu, Tao Feng, Hui-Jun Kang, Zhi-Guang Tian, Chun-Guang Lou
BACKGROUND: The Proximal Femoral Nail Antirotation (PFNA) system for treatment of intertrochanteric fractures is currently widely applied worldwide. However, even though the PFNA has produced good clinical outcomes, a poor introduction technique with an inappropriate entry point can cause surgical complications. Some researchers suggest improving clinical outcomes by modifying the entry point, but no research has focused on this issue. The purpose of the present study is to compare the clinical and radiological outcomes of two different trochanteric entry points for the treatment of intertrochanteric fractures using the PFNA system...
March 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28287002/poor-relation-between-biomechanical-and-clinical-studies-for-the-proximal-femoral-locking-compression-plate
#6
Bjarke Viberg, Katrine M V Rasmussen, Søren Overgaard, Cecilia Rogmark
Background and purpose - The proximal femur locking compression plate (PF-LCP) is a new concept in the treatment of hip fractures. When releasing new implants onto the market, biomechanical studies are conducted to evaluate performance of the implant. We investigated the relation between biomechanical and clinical studies on PF-LCP. Methods - A systematic literature search of relevant biomechanical and clinical studies was conducted in PubMed on December 1, 2015. 7 biomechanical studies and 15 clinical studies were included...
March 13, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28244909/predictors-of-reoperation-for-adult-femoral-shaft-fractures-managed-operatively-in-a-sub-saharan-country
#7
Edmund N Eliezer, Billy T Haonga, Saam Morshed, David W Shearer
BACKGROUND: The optimal treatment for femoral shaft fractures in low-resource settings has yet to be established, in part, because of a lack of data supporting operative treatment modalities. We aimed to determine the reoperation rate among femoral fractures managed operatively and to identify risk factors for reoperation at a hospital in a Sub-Saharan country. METHODS: We conducted a prospective clinical study at a single tertiary care center in Tanzania, enrolling all skeletally mature patients with diaphyseal femoral fractures managed operatively from July 2012 to July 2013...
March 1, 2017: Journal of Bone and Joint Surgery. American Volume
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/28178228/imaging-evaluation-of-the-safe-region-for-distal-locking-screw-of-proximal-femoral-nail-anti-rotation-in-patients-with-proximal-femoral-fracture
#9
Jinpeng Gong, Pengcheng Liu, Ming Cai
BACKGROUND Proximal femoral nail anti-rotation (PFNA) is a standard femoral intertrochanteric fracture operation. Iatrogenic vascular injury, although uncommon, is a reported complication of PFNA surgery as well as a complication of hip fracture surgery. This study aimed to compare the safety and best use of the distal locking screw in 170 mm PFNA and 240 mm PFNA devices, and to determine the safe region for placement of the distal locking screw in PFNA surgery. MATERIAL AND METHODS A retrospective analysis of 100 patients with 170 mm PFNA and 80 patients with 240 mm PFNA were retrospectively analyzed...
February 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28164049/a-case-report-of-bisphosphonate-induced-bilateral-osteoporotic-subtrochanteric-fracture-femurii-review-of-literature
#10
Rajendra Uppin, Srinath Gupta, Shivank Prakash
INTRODUCTION: Osteoporosis is a significant health-care problem characterized by excessive skeletal fragility, susceptibility to low-trauma fractures in men as well as women. Any abnormality of the bone that reduces the strength of the bone predisposes it to mechanical failure during normal activity or with minimum trauma. The mechanical failure manifests itself as a fracture, and this fracture must be recognized as a pathological fracture if the patient is to be treated properly. Osteoporosis is one of the leading causes of such pathological fractures and accounts for 1...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28134676/strategies-for-proximal-femoral-nailing-of-unstable-intertrochanteric-fractures-lateral-decubitus-position-or-traction-table
#11
Mesut Mehmet Sonmez, Savas Camur, Erden Erturer, Meric Ugurlar, Adnan Kara, Irfan Ozturk
BACKGROUND: The aim of this prospective randomized study was to compare the traction table and lateral decubitus position techniques in the management of unstable intertrochanteric fractures. METHODS: Eighty-two patients with unstable intertrochanteric fractures between 2011 and 2013 were included in this study. All patients were treated surgically with the Proximal Femoral Nail Antirotation implant (DePuy Synthes). Patients were randomized to undergo the procedure in the lateral decubitus position (42 patients) or with the use of a traction table (40 patients)...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28122548/conversion-to-total-hip-arthroplasty-after-failed-proximal-femoral-nail-antirotations-or-dynamic-hip-screw-fixations-for-stable-intertrochanteric-femur-fractures-a-retrospective-study-with-a-minimum-follow-up-of-3%C3%A2-years
#12
Xianshang Zeng, Ke Zhan, Lili Zhang, Dan Zeng, Weiguang Yu, Xinchao Zhang, Mingdong Zhao
BACKGROUND: Conversion to total hip arthroplasty (CTHA) is a relatively common procedure after a failed dynamic hip screw (DHS) or proximal femoral nail anti-rotation (PFNA) fixation of intertrochanteric fractures, but there have been far fewer reports specifically describing the long-term results of CTHA after failed treatments of stable intertrochanteric fractures with DHS or PFNA. The aim of the present study was to compare the clinical and radiological outcomes of CTHA after failed PFNA or DHS fixations of stable intertrochanteric fractures after a minimum follow-up of 3 years...
January 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28116256/a-technical-note-for-extracting-an-incarcerated-femoral-kuntscher-nail
#13
Marí R, Valverde Vilamala D, León García A, Guirro P, Marqués López F
INTRODUCTION: The use of the Kuntscher nail has been the most important advancement in trauma surgery. One of the problems is the difficulty to remove it. A new extraction technique is described in the present case report. CASE REPORT: A 46-year-old man was referred for hip osteoarthritis. He had an acetabulum fracture and a femoral shaft fracture treated 30 years ago with a reamed Kuntscher femoral nail. Lateral hip approach was performed and after attempting to remove the nail with the specific tools being unsuccessful we decided to be more aggressive...
July 2016: Journal of Orthopaedic Case Reports
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
#14
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
#15
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
#16
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
#17
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
#18
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...
February 2017: Injury
https://www.readbyqxmd.com/read/28040074/the-art-of-trochanteric-fracture-reduction
#19
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
#20
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
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