"FLUOROSCOPIC LANDMARKS TO RECOGNIZE IATROGENIC VARUS DISPLACEMENT (WEDGE EFECT) DURING CEPHALOMEDULLARY NAILING OF INTERTROCHANTERIC FRACTURES"

Injury ◽  
2021 ◽  
Author(s):  
Mingo-Robinet Juan ◽  
Gonzalez-Alonso Alonso del Olmo ◽  
Juan Antonio
Keyword(s):  
Intertrochanteric Fractures ◽  
Varus Displacement ◽  
Cephalomedullary Nailing

Short versus long cephalomedullary nailing of intertrochanteric fractures: a meta-analysis of 3208 patients

2021 ◽  
Author(s):  
Mark E. Cinque ◽  
L. Henry Goodnough ◽  
Blake J. Schultz MD ◽  
Andrew T. Fithian ◽  
Malcolm DeBaun ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Intertrochanteric Fractures ◽  
Cephalomedullary Nailing

scholarly journals Functional outcome of intertrochanteric fractures in elderly patients with proximal femoral nail: retrospective study

2019 ◽  
Vol 5 (4) ◽  
pp. 619
Author(s):  
Angatha Kumar Murugesan ◽  
Rajesh Govindasamy ◽  
Patel Yahya Ismail
Keyword(s):  
Retrospective Study ◽  
Elderly Patients ◽  
Fracture Pattern ◽  
High Rate ◽  
Proximal Femoral Nail ◽  
Intertrochanteric Fractures ◽  
Non Union ◽  
Femoral Nail ◽  
Varus Displacement ◽  
One Year

<p class="abstract"><strong>Background:</strong> Intertrochanteric fractures are disabling injuries in elderly population and they are the most frequently operated fracture type which has the highest postoperative fatality rate of all surgically treated fractures. The objective of the study was to evaluate the functional outcomes of intertrochanteric fractures treated with proximal femoral nail (PFN) in elderly patients.</p><p class="abstract"><strong>Methods:</strong> A retrospective study of 24 patients, all above 60 years treated with PFN between March 2016 to April 2018. Data collected include age, sex, mechanism of injury, type of fracture pattern according to Boyd and Griffin’s classification. Patients were followed up at intervals of 6, 12, 18 and 24 weeks and final results were evaluated using Kyle’s criteria at the end of 24<sup>th</sup> week. All patients had a minimum follow up of one year.<strong></strong></p><p class="abstract"><strong>Results:</strong> The study included 24 patients, 10 males, 14 females with mean age of 75.77 years (range: 60-82 years). The fracture union rate was 96% and average union time was 14.2 weeks. Our results were excellent (80%), good (8%), fair (8%) and poor (4%). Our complications include thigh pain (20%) shortening (20%), varus displacement (8%), knee and hip stiffness (8%), z effect (4%) and non-union (4%).</p><p class="abstract"><strong>Conclusions:</strong> PFN is a reliable fixation in intertrochanteric fractures only after good intraoperative reduction leading to high rate of bone union and with reduced rate of implant failure or complications.</p>

scholarly journals Posterior Sagging After Cephalomedullary Nailing for Intertrochanteric Femur Fracture is Associated with a Separation of the Greater Trochanter

2020 ◽  
Vol 11 ◽  
pp. 215145932094601
Author(s):  
Keong-Hwan Kim ◽  
Michael Seungcheol Kang ◽  
Eic Ju Lim ◽  
Mi Lan Park ◽  
Jung Jae Kim
Keyword(s):  
Risk Factor ◽  
Significant Risk ◽  
Multivariate Logistic Regression Analysis ◽  
Significant Risk Factor ◽  
Proximal Fragment ◽  
Intertrochanteric Fractures ◽  
Greater Trochanter ◽  
Ambulatory Ability ◽  
Significant Difference ◽  
Cephalomedullary Nailing

Introduction: Cephalomedullary nailing presents several biomechanical benefits for treatment of intertrochanteric fractures, but posterior sagging (PS) of the proximal fragment occurs postoperatively in some patients despite intraoperative achievement of an adequate reduction. We investigated the risk factors for PS in those patients, with specific attention to posterior split fragment involving the greater trochanter (GT separation) as a possible significant risk factor. Methods: We retrospectively reviewed 50 (12 males, 38 females) patients ≥50 years old at diagnosis of an intertrochanteric fracture after low-energy trauma who underwent cephalomedullary nailing between April 2015 and February 2017 and were not lost to follow-up within 12 months postoperatively. Results: Thirteen (26%) patients experienced PS postoperatively. Average time to bone union was significantly longer in the PS (9.5 months) than in the non-PS (4.8 months) groups ( P = .002). Three patients in the PS group experienced nonunion compared to none in the non-PS group ( P = .015). Significant difference was found in postoperative level of ambulatory ability (Koval score) and deterioration of the score after the injury between 2 groups (4.2 vs 2.8, P = .043 and 2.5 vs 0.8, P = .005). On multivariate logistic regression analysis, GT separation ( P = .010) was a significant risk factor for PS. Discussion and Conclusion: The presence of GT separation in cases of intertrochanteric fractures seems to weaken posterior stability in the proximal fragment, thus showing poor clinical outcomes.

HIP FRACTURES IN 5 YEARS AT HUE UNIVERSITY HOSPITAL

2014 ◽  
pp. 47-50
Author(s):  
Duy Binh Ho ◽  
Nghi Thanh Nhan Le ◽  
Maasalu Katre ◽  
Koks Sulev ◽  
Märtson Aare
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Hip Fractures ◽  
Age Groups ◽  
Femoral Fractures ◽  
Femoral Neck Fractures ◽  
University Hospital ◽  
High Risk Population ◽  
Intertrochanteric Fractures ◽  
Significant Difference

Aim: This study aimed to review the clinical findings and surgical intervention of the hip fracture at the Hue University Hospital in Vietnam. Methods:The data of proximal femoral fractures was collected retrospectively. All patients, in a period of 5 years, from Jan 2008 to December 2012, suffered either from intertrochanteric or femoral neck fractures. The numbers of patients were gathered separately for each year, by age groups (under 40, 40-49, 50-59, 60-69, 70-79, older) and by sex. We analyzed what kind of treatment options were used for the hip fracture. Results:Of 224 patients (93 men and 131 women) studied, 71% patients are over 70 years old, 103 women and 56 men (p<0.05). For patients under 40 years, there were 1 woman and 11 men (p<0.05). There were 88 intertrochanteric and 136 femoral neck fractures. There was no significant difference in the two fractures between men and women. The numbers of hip fracture increased by each year, 29/224 cases in 2010, 63/224 cases in 2011, 76/224 cases in 2012. Treatment of 88 intertrochanteric fractures: 49 cases (55.7%) of dynamic hip screw (DHS), 14 cases of hemiarthroplasty (15.9%), 2 cases of total hip replacement (2.3%). Treatment of 136 femoral neck fractures: 48 cases of total replacement (35.3%), 43 cases of hemiarthroplasty (31.6%), 15 cases of screwing (11%). In cases of 40 patients (17.9%) hip fracture was managed conservatively, 23 were femoral neck fractures and 17 were intertrochanteric fractures. Conclusions: Hip fracture is growing challenge in Hue medical university hospital. The conservative approach is still high in people who could not be operable due to severe medical conditions as well as for patients with economic difficulties. Over 70% of the hip fractures in people 70+ are caused by osteoporosis. The number of hip fracture is increasing in the following years, most likely due to the increase in the prevalence of osteoporosis. Early detection and prevention of osteoporosis should be addressed, particularly in high risk population. More aggressive surgical approach should be implemented in order to improve the quality of life in patients with hip fractures. Key words:Hip fracture.

scholarly journals The Correlation Between Timing of Surgery and the Need for RBC Transfusions in the Geriatric Intertrochanteric Fracture Population

2021 ◽  
Vol 12 ◽  
pp. 215145932199861
Author(s):  
Yun-fa Yang ◽  
Jian-wen Huang ◽  
Xiao-sheng Gao ◽  
Zai-li Liu ◽  
Jian-wei Wang ◽  
...  
Keyword(s):  
Intertrochanteric Fracture ◽  
The Elderly ◽  
Timing Of Surgery ◽  
Intertrochanteric Fractures ◽  
The Third ◽  
Transfusion Requirements ◽  
Surgical Fixation ◽  
Fracture Population ◽  
The Relationship ◽  
Rbc Transfusion

Objective: To identify whether the timing of surgery affects red blood cell (RBC) transfusion requirements in the elderly with intertrochanteric fractures. Methods: We retrospectively studied all patients undergoing surgical fixation of their intertrochanteric fractures in our hospital between January 2009 and December 2018 and analyzed the relationship between the timing of surgery and RBC transfusion. Results: A total of 679 patients were included in this study. The need for RBC transfusion was lower in the patients who underwent surgery within 12 h after admission (timing of surgery <12 h, <12 h group) than those who underwent surgery over 12 h after admission (timing of surgery >12 h, >12 h group) (P = 0.046); lower in the the patients who underwent surgery within 24 h after admission (timing of surgery <24 h, <24 h group) than in those who underwent surgery over 24 h after admission (timing of surgery >24 h, >24 h group) (P = 0.008), and lower in the <24 h group compared to the patients who underwent surgery within 48 h after admission (timing of surgery <48 h, <48 h group) (P = 0.035). Moreover, the need for RBC transfusion was lower in the <24 h group (in the first 24 h from admission to surgery) than in the 24-48 h group (in the second 24 h from admission to surgery) (P = 0.016), and also lower in the <24 h group compared to the 48-72 h group (in the third 24 h from admission to surgery) (P = 0.047). However, there were no differences between the <12 h group and 12-24 h group, between the <12 h group and <24 h group, and between the 12-24 h group and <24 h group, respectively. Conclusion: Timing of surgery within 24 h contributes to the reduction of RBC transfusion in the elderly with intertrochanteric fractures.

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