Timing of surgery for internal fixation of intracapsular hip fractures and complications at 1 year; a 32-year clinical study of 2,366 patients at a single centre

Introduction: The TFN-ADVANCED Proximal Femoral Nailing System (TFNA) 235 mm (DePuySynthes) and Proximal Femoral Nail Antirotation (PFNA)-II 240 mm (DePuySynthes) were developed to obtain better stability for patients with trochanteric hip fractures without increasing surgical time and amount of blood loss. However, there are currently no studies concerning clinical and radiological outcomes of patients treated using these proximal femoral nails (PFNs) that have been performed in the Japanese population. The aim of this study was to retrospectively evaluate the clinical outcomes associated with 235 to 240 mm PFNs for Japanese patients >70 years old with trochanteric hip fractures who could walk independently before the injury. Materials and Methods: This study involved a retrospective analysis of data on trochanteric hip fracture patients who had undergone internal fixation from March 2016 to June 2018. The inclusion criteria were patients >70 years old with trochanteric hip fractures who could walk independently before the injury and were followed up for ≥3 months after surgery. Initially, 124 patients were identified, but 33 of these were excluded because other implants were used for internal fixation. Of the remaining 91 patients in whom PFNs were used at the time of internal fixation who were included for the perioperative evaluation, 66 patients followed up for ≥3 months were included in the clinical evaluations. Results: The average surgical time was 56.8 ± 19.6 minutes (range, 23-123 minutes). The average blood loss was 89 ± 41 mL (range, 0-245 mL). The union rate was 98%. Discussion: There were no cases of nail jamming, and all nails were successfully inserted below the end of the distal isthmus without additional reaming to dilate the canal. Conclusions: Proximal femoral nails were a useful implant in Japanese elderly patients with trochanteric hip fractures and gave comparable clinical outcomes despite the femoral length being short and occurrence of intensive bowing.

Download Full-text

Sa1588 Management of Acute Malignant Colorectal Obstruction With Self-Expanding Metal Stent in General Endoscopic Practice: A Retrospective, Single Centre, Clinical Study

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2011.03.323 ◽

2011 ◽

Vol 73 (4) ◽

pp. AB216

Author(s):

Luca De Luca ◽

Valerio Sisti ◽

Paolo Cioccolini ◽

Maria Teresa Fabi ◽

Mario Rogheto ◽

...

Keyword(s):

Clinical Study ◽

Metal Stent ◽

Single Centre ◽

Colorectal Obstruction ◽

Acute Malignant Colorectal Obstruction

Download Full-text

Perioperative Morbidity and 30-Day Mortality After Intertrochanteric Hip Fractures Treated by Internal Fixation or Arthroplasty

The Journal of Arthroplasty ◽

10.1016/j.arth.2005.04.035 ◽

2005 ◽

Vol 20 (8) ◽

pp. 963-966 ◽

Cited By ~ 33

Author(s):

Ryan E. Dobbs ◽

Javad Parvizi ◽

David G. Lewallen

Keyword(s):

Internal Fixation ◽

Hip Fractures ◽

Perioperative Morbidity

Download Full-text

Evaluation of functional outcome of pilon fractures managed with limited internal fixation and external fixation: A prospective clinical study

Journal of Clinical Orthopaedics and Trauma ◽

10.1016/j.jcot.2017.05.005 ◽

2017 ◽

Vol 8 ◽

pp. S16-S20 ◽

Cited By ~ 2

Author(s):

Umesh Kumar Meena ◽

Mahesh Chand Bansal ◽

Prateek Behera ◽

Rahul Upadhyay ◽

Gyan Chand Gothwal

Keyword(s):

Clinical Study ◽

Internal Fixation ◽

Functional Outcome ◽

External Fixation ◽

Prospective Clinical Study ◽

Pilon Fractures

Download Full-text

SURVIVAL OF NONAGENARIAN PATIENTS WITH HIP FRACTURES: A COHORT STUDY

Acta Ortopédica Brasileira ◽

10.1590/1413-785220172504167561 ◽

2017 ◽

Vol 25 (4) ◽

pp. 132-136 ◽

Cited By ~ 4

Author(s):

Alexa Ovidiu ◽

Gheorghevici Teodor Stefan ◽

Popescu Dragos ◽

Veliceasa Bogdan ◽

Alexa Ioana Dana

Keyword(s):

Internal Fixation ◽

Hip Fractures ◽

Survival Data ◽

Demographic Data ◽

Level Of Evidence ◽

Asa Score ◽

Kaplan Meier ◽

Trochanteric Region ◽

One Year ◽

Retrospective Comparative Study

ABSTRACT Objective: The objective of this study was to assess survival and factors that may influence survival in nonagenarians with hip fracture. Methods: We retrospectively analyzed 134 nonagenarian patients admitted for hip fractures over a period of 9 years, and reviewed medical records and survival data from the National Population Register. The analysis included demographic data, ASA score, surgical delay, type of treatment, and mortality. Results: Mean patient age was 92.53 years (range 90-103 years). Of the total, 35.8% of the fractures involved the femoral neck and 64.2% were in the trochanteric region. Overall mortality was 18.7% at 30 days, and 9% at one year. Mean survival for the entire sample was 683±78.1 days, with a median of 339 days; survival in men and women was 595±136.8 days and 734±94.6 days, respectively. We found that type of fracture (p=0.026) and ASA score (p=0.004) were the main factors influencing survival. Kaplan-Meier survival analysis indicated that patients with extracapsular fractures treated by internal fixation had a better survival rate (p=0.047). There was no significant differences between sexes (p = 0.102) or diagnosis (p = 0.537) Conclusion: Although nonagenarian patients have numerous comorbidities, surgical treatment using internal fixation seems superior to a conservative approach. Level of Evidence III, Retrospective Comparative Study.

Download Full-text