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https://www.readbyqxmd.com/read/29668448/tranexamic-acid-in-pertrochanteric-femoral-fracture-is-it-a-safe-drug-or-not
#1
Andrea Schiavone, Michele Bisaccia, Ivan Inkov, Giuseppe Rinonapoli, Mattia Manni, Giuseppe Rollo, Luigi Meccariello, Cristina Ibáñez Vicente, Paolo Ceccarini, Carmelinda Ruggiero, Auro Caraffa
BACKGROUND: There is a high incidence of blood transfusion following hip fractures in elderly patients. AIM: The aim of this study is to evaluate the effectiveness and complications of use of tranexamic acid in proximal femur nailing surgery. MATERIALS AND METHODS: Our sample group consisted of 90 patients suffering from pertrochanteric fractures surgically treated with osteosynthesis with SupernailGT(LimaCorporate). The classification system AO/OTA was used to divide the fractures into 31A1 (n=45) and 31A2 (n=45)...
March 1, 2018: Folia Medica
https://www.readbyqxmd.com/read/29649099/functional-and-radiological-results-of-proximal-femoral-nail-antirotation-pfna-osteosynthesis-in-the-treatment-of-unstable-pertrochanteric-fractures
#2
Ahmad M Radaideh, Hashem A Qudah, Ziad A Audat, Rami A Jahmani, Ibraheem R Yousef, Abed Allah A Saleh
Pertrochanteric femur fractures are considered amongst the most commonly encountered fractures in the geriatric age group. We evaluated radiographic and functional outcomes of patients with unstable pertrochanteric fractures treated with the proximal femur nail antirotation (PFNA). Between March 2013 and December 2015, fifty patients (28 male and 22 females with a mean age of 72.8 years (range, 20-94)) with unstable pertrochanteric fractures (AO 31.A2 and 31.A3) were fixed with the PFNA at our institution, and they were retrospectively evaluated...
April 12, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29590718/analysis-of-the-hemoglobin-level-drop-in-patients-with-hip-fracture-after-admission
#3
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
https://www.readbyqxmd.com/read/29450105/infection-versus-hematoma-following-surgical-treatment-of-proximal-femoral-fractures-in-geriatric-patients
#4
Franz Müller, Michael Galler, Christina Roll, Bernd Füchtmeier
Introduction: The surgical treatment of proximal femoral fractures predominantly involves geriatric patients and is associated with high morbidity and mortality. However, analyses on postoperative infections or hematoma are rare. Methods: Patients requiring surgical revision due to infection (n = 90) or hematoma (n = 77) in the postoperative phase were identified from an electronic database of 2000 consecutive patients surgically treated for proximal femoral fractures between 2006 and 2014...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29441191/studying-the-effects-of-primary-arthroplasty-on-post-treatment-results-among-elderly-patients-with-pertrochanteric-fracture
#5
Mostafa Shahrezaee, Mohammad Ali Okhovatpour, Mohammad Banasiri, Seyyed Reza Sharifzadeh
Various therapeutic methods are available to treat patients with intertrochantric fracture, which is usually caused by falling down. This complication is usually observed among the elderly, particularly old women. The choice of the proper therapeutic method depends on many factors including patient's condition, type of fracture, and the amount of movement. Hip arthroplasty is one of these therapeutic methods, which have certain advantages and disadvantages. Immediate resumption of walking with the ability of weight toleration and absence of complications such as aseptic necrosis are some advantages of this method...
January 8, 2018: Clinics and Practice
https://www.readbyqxmd.com/read/29377850/does-the-angle-of-the-nail-matter-for-pertrochanteric-fracture-reduction-matching-nail-angle-and-native-neck-shaft-angle
#6
Joshua A Parry, Ian Barrett, Bradley Schoch, Brandon Yuan, Joseph Cass, William Cross
OBJECTIVES: To determine whether fixation of pertrochanteric hip fractures with cephalomedullary nails (CMNs) with a neck-shaft angle (NSA) less than the native NSA affects reduction and lag screw cutout. DESIGN: Retrospective comparative study. SETTING: Level I trauma center. PATIENTS/PARTICIPANTS: Patients treated with a CMN for unstable pertrochanteric femur fractures (OTA/AO 31-A2.2 and 31-A2.3) between 2005 and 2014...
April 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29326497/is-the-modified-harris-hip-score-valid-and-responsive-instrument-for-outcome-assessment-in-the-indian-population-with-pertrochanteric-fractures
#7
Karthik Vishwanathan, Keyur Akbari, Amit J Patel
Introduction: The original Harris hip score (HHS) does not contain ability to perform squatting and sitting cross legged as items in the questionnaire and hence a need was felt to modify the Harris hip score so that it could stay relevant in functional assessment of Indian patients in the rural setting. Validity, responsiveness and ceiling floor effect of the Harris hip score after internal fixation of pertrochanteric fracture has not been previously described. The objective of the study was to investigate construct validity, responsiveness and ceiling floor effects of the modified Harris hip score (mHHS)...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29273922/predictors-of-cut-out-after-cephalomedullary-nail-fixation-of-pertrochanteric-fractures-a-retrospective-study-of-813-patients
#8
Luigi Murena, Antonio Moretti, Francesca Meo, Enrico Saggioro, Giulia Barbati, Chiara Ratti, Gianluca Canton
BACKGROUND: Cut-out is the most common mechanical complication of the osteosynthesis of pertrochanteric fractures. This complication determines a significant increase in morbidity in elderly patient. Cut-out is defined as the varus collapse of the femoral head-neck fragment with the extrusion of the cephalic screw. Surgical treatment of cut-out might lead to further complications, longer rehabilitation, increased social burden and healthcare system costs. The aim of the study is to identify the predictors of cut-out to prevent its occurrence...
March 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29216695/-factor-associated-in-the-failure-of-the-ostheosyntesis-of-transtrocantheric-fractures
#9
L D Aguilar-Alcalá, J Atri-Levy, A Torres-Gómez, L Ochoa-Olvera
Pertrochanteric fractures account approximately a half of the proximal femoral fractures. Incidence of these fractures is highest in women, age > 65 years and presents a mortality rate of 14 to 50%. Treatment goals include stable fixation, immediate mobilization and restore activities. Complications after treatment present in 17% and include: nonunion, cut out and varus displacement. OBJECTIVE: Correlation between complications after surgical treatment and presence of instability, inadequate reduction, Tip Apex Index (TAI) > 25 mm, Tip Apex Index to calcar (TAIcal) > 20 mm and parker index...
July 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/29196226/clinical-assessment-of-patients-with-isolated-hip-fractures-associated-with-an-upper-limb-fracture
#10
J Gómez-Álvarez, S González-Escobar, E Gil-Garay
INTRODUCTION: Some patients with a hip fracture also present a concomitant upper limb fracture. We want to know whether these patients have a worse functional level and whether they have any differences in various clinical parameters compared with patients with an isolated hip fracture. MATERIAL AND METHODS: We retrospectively reviewed 1061 discharge reports from the Orthogeriatrics Unit. We collected information on several clinical parameters of the fractures. Subsequently, we performed a statistical analysis of the data by comparing the associated fracture group with the isolated fracture group...
November 28, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29174882/optimizing-intraoperative-imaging-during-proximal-femoral-fracture-fixation-a-performance-improvement-program-for-surgeons
#11
Daniel Rikli, Sabine Goldhahn, Michael Blauth, Samir Mehta, Michael Cunningham, Alexander Joeris
INTRODUCTION: Formal training for surgeons regarding intraoperative imaging is lacking. This project investigated the effect of an educational intervention focusing on obtaining and assessing a standardized lateral view of the proximal femur during intramedullary nailing of a pertrochanteric fracture. MATERIALS AND METHODS: Anatomical landmarks of the proximal femur that can be identified using intraoperative fluoroscopy and criteria for image quality, i.e. quality of projection were defined in a consensus process, followed by the development of educational materials and a 7-item checklist...
February 2018: Injury
https://www.readbyqxmd.com/read/29145969/late-postoperative-analysis-of-the-tip-apex-distance-tad-in-pertrochanteric-fractures-is-there-an-accommodation-of-the-implant-within-the-bone
#12
Leandro Jun Aihara, Rafael Augusto Nanni, Marina Sousa Carvalho, Caio Zamboni, Jorge R Durigan, José S Hungria Neto, Marcelo T Mercadante, Ralph W Christian, José O S Hungria
INTRODUCTION: This study measured the tip-apex distance (TAD) values in the immediate postoperative period and following weight-bearing and fracture impaction in patients undergoing osteosynthesis with dynamic hip screw and cephalomedullary nail. OBJECTIVE: To correlate the Baumgaertner index in the immediate postoperative period with values obtained after impaction of the fracture with the accommodation of the cephalic implant in the femoral head. PATIENTS AND METHODS: Radiographic TAD measurements were taken with AGFA-VIEW® of 82 patients with a mean age of 72 years with pertrochanteric fractures who were operated on and the fracture fixed with DHS- Synthes® , TFN-Synthes® , or Gamma Nail III-Stryker® in the immediate postoperative period, and following weight-bearing and fracture impaction (mean 3-8 weeks after surgery)...
October 2017: Injury
https://www.readbyqxmd.com/read/29062210/evaluation-of-outcome-of-proximal-femur-locking-compression-plate-pflcp-in-unstable-proximal-femur-fractures
#13
Malkesh D Shah, Chirag S Kapoor, Rishit J Soni, Jagdish J Patwa, Paresh P Golwala
INTRODUCTION: Pertrochanteric fractures are most frequent factures of the proximal femur, accounts for nearly 50% of all proximal femur fractures and are most devastating and also a major cause of disability in elderly. The aim and objective of this study was to evaluate the role of proximal femoral locking compression plate in unstable proximal femur fractures. MATERIAL AND METHOD: A total of 20 cases were included in our study (M:F - 16:4), who suffered proximal femur fracture due to various modalities and all of them were operated using proximal femoral locking compression plate...
October 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29022791/x-bolt-unforeseen-placement-complication-case-report
#14
A D Clarke, Jbt Herron, J L McVie
With the introduction of the World Hip Trauma Evaluation Four clinical trial, fixation of pertrochanteric neck of femur fractures is becoming a hot topic. In this trial, the novel X-Bolt expanding bolt implant is being compared with the current gold standard of a sliding hip screw. We present a previously undescribed complication when inserting the bolt into the femoral head, where the expandable wings penetrate the femoral neck due to misplacement of the bone crusher or the X-Bolt prosthesis. This unforeseen complication required the introduction of several additional corrective intraoperative steps...
November 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28983383/the-incidence-of-hip-fractures-in-long-term-care-homes-in-saskatchewan-from-2008-to-2012-an-analysis-of-provincial-administrative-databases
#15
Lilian U Thorpe, Susan J Whiting, Wenbin Li, William Dust, Thomas Hadjistavropoulos, Gary Teare
BACKGROUND: Hip fractures (HFs) represent an important cause of morbidity and mortality among adults in long-term care (LTC), but lack of detailed epidemiological data poses challenges to intervention planning. We aimed to determine the incidence of HFs among permanent LTC residents in Saskatchewan between 2008 and 2012, using linked, provincial administrative health databases, exploring associations between outcomes and basic individual and institutional characteristics. METHODS: We utilized the Ministry of Health databases to select HF cases based on ICD 10 diagnoses fracture of head and neck of femur, pertrochanteric fracture and subtrochanteric fracture of femur...
September 2017: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28951636/management-of-unstable-pertrochanteric-fractures-with-proximal-femoral-locking-compression-plates-and-affect-of-neck-shaft-angle-on-functional-outcomes
#16
Emrah Kovalak, Cenk Ermutlu, Tolga Atay, Özgür Başal
BACKGROUND: Management of unstable pertrochanteric fractures remains a challenge with various implant choices. Intramedullary devices are usually preferred for the management of the unstable fractures. When nailing is unsuitable for the configuration of the fracture extra medullary procedures are preferred. PFLCP is a contact limited implant that allows multiple angularly stable fixations with preserving more bone stock after implantation as an extramedullary implant. There are only a few reports in the literature about the osteosynthesis of unstable trochanteric fractures with proximal femoral locking compression plates and their results are conflicting...
July 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28891021/anteromedial-cortical-support-reduction-in-unstable-pertrochanteric-fractures-a-comparison-of-intra-operative-fluoroscopy-and-post-operative-three-dimensional-computerised-tomography-reconstruction
#17
Shi-Min Chang, Ying-Qi Zhang, Shou-Chao Du, Zhuo Ma, Sun-Jun Hu, Xi-Zhou Yao, Wen-Feng Xiong
PURPOSE: Anteromedial cortical support reduction is favourable for secondary stability after limited sliding in unstable pertrochanteric fractures. The aim of this study was to compare the accuracy and agreement between intra-operative fluoroscopy and post-operative 3D reconstruction. MATERIALS AND METHODS: A retrospective analysis of 28 patients (mean 81.6 years) treated with short cephalomedullary nails was performed. All patients had full sets of intra-operative fluoroscopy and post-operative 3D CT images...
January 2018: International Orthopaedics
https://www.readbyqxmd.com/read/28836973/comparison-and-analysis-of-reoperations-in-two-different-treatment-protocols-for-trochanteric-hip-fractures-postoperative-technical-complications-with-dynamic-hip-screw-intramedullary-nail-and-medoff-sliding-plate
#18
Johnny Paulsson, Josefine Corin Stig, Ola Olsson
BACKGROUND: In treatment of unstable trochanteric fractures dynamic hip screw and Medoff sliding plate devices are designed to allow secondary fracture impaction, whereas intramedullary nails aim to maintain fracture alignment. Different treatment protocols are used by two similar Swedish regional emergency care hospitals. Dynamic hip screw is used for fractures considered as stable within the respective treatment protocol, whereas one treatment protocol (Medoff sliding plate/dynamic hip screw) uses biaxial Medoff sliding plate for unstable pertrochanteric fractures and uniaxial Medoff sliding plate for subtrochanteric fractures, the second (intramedullary nail/dynamic hip screw) uses intramedullary nail for subtrochanteric fractures and for pertrochanteric fractures with intertrochanteric comminution or subtrochanteric extension...
August 24, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28819608/profunda-femoris-artery-pseudoaneurysm-after-intramedullary-fixation-for-a-pertrochanteric-hip-fracture
#19
Nicola Piolanti, Michele Giuntoli, Anna Maria Nucci, Pietro Battistini, Michele Lisanti, Lorenzo Andreani
INTRODUCTION: Vascular complications after femoral fixation are rare and not only easy to recognize but also potentially life-threatening. The aim of this case report is to describe how a pseudoaneurysm of the deep femoral artery can complicate an intramedullary nailing after a pertrochanteric fracture and how it can be treated. CASE REPORT: We report the case of a 90-year-old female who developed a pseudoaneurysm of the profunda femoris artery 16 days after intramedullary femoral nailing for a pertrochanteric hip fracture...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28817157/extent-and-morbidity-of-lateralization-of-a-trochanteric-fixation-nail-blade
#20
Phillip A Sandifer, Robert M Hulick, Matthew L Graves, Clay A Spitler, George V Russell, Josie M Hydrick, LaRita C Jones, Patrick F Bergin
This study examined the incidence and risk factors associated with lateral helical blade migration and trochanteric pain with the trochanteric fixation nail. A retrospective review was performed of 141 cases of pertrochanteric femur fracture treated with a trochanteric fixation nail at a level I trauma center over a period of 42 months. Exclusion criteria included follow-up of less than 60 days, preexisting osteonecrosis of the femoral head, and prophylactic trochanteric fixation nail treatment. Patient demographics, operative findings, and radiographic findings were recorded...
September 1, 2017: Orthopedics
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