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late proximal head femur fractures fixation

Tjibbe J Gardenbroek, Michiel J M Segers, Rogier K J Simmermacher, Eric R Hammacher
BACKGROUND: The optimal surgical treatment of patients with an unstable extracapsular proximal femoral fracture is yet to be found. From the biomechanical point of view, the use of an intramedullary device in combination with a dynamic femoral head/neck stabilization implant seems an optimal technique. One of these intramedullary devices, the Proximal Femoral Nail (PFN), has several drawbacks in practice. The Proximal Femur Nail Antirotation (PFNA) has been designed to address these. We hypothesized that the placement of one femoral head/neck fixation device in the PFNA would improve positioning of the implant in the femoral head compared with the PFN and reduce the number of reoperations in both short and long term...
July 2011: Journal of Trauma
M Hrubina, M Skoták, J Běhounek
PURPOSE OF THE STUDY: To present the results of Dynamic Hip Screw (DHS) osteosynthesis for the treatment of proximal femoral fractures with a focus on specific complications of this method. MATERIAL From 1997 till 2007, the authors performed 367 DHS osteosyntheses to treat 341 patients with fractures of the proximal femur. The average patient age was 81.8 years (21-101). Twenty-six patients had surgery for bilateral fractures. METHODS: Osteosynthesis was always carried out using a 135° DHS (Medin, Nové Město na Moravě, Czech Republic) to manage fractures of the femoral neck (13 ); trochanteric and basic cervical fractures (349 ) and subtrochanteric fractures (5)...
October 2010: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Yoshinobu Watanabe, Yuichiro Terashima, Nobuyuki Takenaka, Makoto Kobayashi, Takashi Matsushita
OBJECTIVE: To measure the intramedullary oxygen tension of the proximal femur after a femoral neck fracture and to evaluate the usefulness of that monitoring for prediction of subsequent avascular necrosis. DESIGN: Prospective case series with comparison group. SETTING: University hospital. INTERVENTION: Measurement of intramedullary oxygen tension of the femoral head and neck during internal fixation using the Hansson hook-pin system...
August 2007: Journal of Orthopaedic Trauma
J Matejka, T Pavelka, J Kostál, H Cervenková
PURPOSE OF THE STUDY: This retrospective study was designed to evaluate the severity and nature of long-term sequelae of femoral neck fractures in children in relation to the strategy and technique of therapy. MATERIAL: The study included 15 patients with a fracture of the femoral neck who, at the time of injury, had an opened proximal physis. The average age at the time of injury was 11.5 years (range, 4 to 16.3 years). There were eight boys and seven girls. Twelve children suffered injury due to a fall varying in gravity, two were knocked down by a vehicle, and one was injured as a co-driver in a car accident...
2005: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
N K Magu, Roop Singh, Rahul Mittal, Ravinder Garg, Ashim Wokhlu, Ashwini K Sharma
Fifty-three adults sustaining intracapsular femoral neck fractures (subcapital 38 and transcervical 15) with osteoporosis were treated primarily by osteosynthesis with valgus intertrochanteric osteotomy. Final evaluation was done in 50 patients (1 patient died and 2 lost to follow up, were not considered). Union was achieved in 47 (94%) patients in an average period of 12.2 weeks (range 10-18 weeks) with 100% union at osteotomy site. An axial collapse between 2 and 14 mm was observed in 74% of patients at the fracture site...
January 2005: Injury
T Pavelka, J Kortus, M Linhart
PURPOSE OF THE STUDY: A group of 147 patients with proximal femoral fractures treated with the use of the proximal femoral nail, manufactured by the Synthes company, in the period between October 1997 and June 2001 were retrospectively evaluated. MATERIAL: The group of 147 patients whose average age was 69 years consisted of 59 men (average age, 59 years) and 88 women (average age, 75 years). The most frequent fracture occurring in 54% of the patients was an unstable pertrochanteric fracture (Kyle III); persubtrochanteric and subtrochanteric fractures were treated in 27% and 19% of the patients, respectively...
2003: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Asit K Shah, Jesse Eissler, Timothy Radomisli
Worldwide prevalence of femoral neck fractures is increasing, doubling for patients older than 50 years. Age of the patient, prefracture activity level, and associated comorbidities must be considered when determining treatment. It seems that hemiarthroplasty is best suited for an elderly patient who is a household ambulator with low demands on the prosthesis. Younger patients, and those with minimally displaced fractures, should be treated with internal fixation in an attempt to preserve the natural hip. Proximal femur fractures in the pediatric population are associated with high complication rates...
June 2002: Clinical Orthopaedics and related Research
J Palarcík
In 1993-1999 in the Traumatological Hospital in Brno 141 syntheses DHS Medin were made in patients with fractures of the proximal femur. (Eighteen DHS syntheses of other manufacturers were also made. The latter were however not analyzed). During the primary operations twice revision was necessary on account of a technical mistake of the surgeon ad twice an early infection developed. Seven late complications occurred--4 times a pseudoarthrosis and three times an aseptic necrosis of the head of the femur. All complications were resolved by total replacement of the hip joint...
January 2001: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
W Knopp, G Muhr, J Rehn
Post-traumatic axial malalignment of the lower limbs causes osteoarthrosis of the adjacent joints. Whether or not correction osteotomy is indicated depends upon the degree and the location of the deformity. Malalignment of the proximal femur should be corrected if the axis of the leg does not pass through the knee joint. If the axis is outside the central half of the tibial head, the indication for correction osteotomy is a relative one: varus deformities are more difficult to compensate and it is more urgent that these be corrected...
December 1989: Der Unfallchirurg
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