scholarly journals Banding with lesser trochanter fragment using nonabsorbable tape in trochanteric femoral fractures

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 33
Author(s):  
Takuya Usami ◽  
Naoya Takada ◽  
Kazuki Nishida ◽  
Hiroaki Sakai ◽  
Hidetoshi Iwata ◽  
...  
Keyword(s):  
Femoral Fracture ◽  
Poor Prognosis ◽  
Femoral Fractures ◽  
The Elderly ◽  
Bone Union ◽  
Trochanteric Fractures ◽  
Lesser Trochanter ◽  
Computed Tomography Images ◽  
Trochanteric Femoral Fracture ◽  
Group B

Introduction: Trochanteric femoral fracture is one of the most common fractures in the elderly. Trochanteric femoral fracture with involvement of the lesser trochanter is considered unstable and recognized as having a poor prognosis. However, fixation of lesser trochanter fragment is scarce because of technical difficulties. In this study, we reported the simple surgical procedure and the effect of using nonabsorbable tape in lesser trochanter fixation. Methods: From January 2014 to December 2017, 114 patients treated with proximal intramedullary nailing for trochanteric fractures with the lesser trochanter fragment were reviewed. Among patients enrolled in this study, 73 were followed up until radiographic bone union, of which 26 were treated with lesser trochanter fragment banding (group B) and 47 without banding (group N). Radiographs and/or computed tomography images were used to evaluate bone union of the lesser trochanter fragment at three months postoperatively. Results: The bone union of the lesser trochanter fragment was achieved in 24 cases (92%) in group B and 30 cases (64%) in group N. Compared with group N, group B showed a significantly increased number of mild and moderate deformities but decreased number of severe deformity and nonunion (P < 0.001). Postoperative complications were not observed in both groups. Conclusions: From the viewpoint of increasing lesser trochanteric bone union ratio, fixation of the lesser trochanter fragment using nonabsorbable tape in the treatment of trochanteric fractures could be an effective procedure.

scholarly journals Endoprosthetic Reconstruction for a Displaced Atypical Femoral Fracture in a Cancer Patient with Poor Prognosis

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Hironari Tamiya ◽  
Hiroki Hagizawa ◽  
Takaaki Nakai ◽  
Yoshinori Imura ◽  
Takaaki Tanaka ◽  
...  
Keyword(s):  
Cancer Patient ◽  
Activities Of Daily Living ◽  
Cancer Patients ◽  
Femoral Fracture ◽  
Daily Living ◽  
Poor Prognosis ◽  
Femoral Fractures ◽  
Endoprosthetic Reconstruction ◽  
Atypical Femoral Fractures ◽  
Patients With Poor Prognosis

Zoledronate or denosumab treatment is beneficial for cancer patients with bone metastasis. However, each agent may trigger atypical femoral fractures. Incomplete atypical femoral fractures can be successfully treated with prophylactic intramedullary nailing. On the other hand, intramedullary nailing for displaced atypical femoral fractures occasionally causes problems with regard to bone healing, resulting in long-term treatment. In cancer patients with poor prognosis who experience atypical femoral fractures, improvement in activities of daily living should be the priority. Thus, we performed endoprosthetic reconstruction for a displaced atypical femoral fracture in a breast cancer patient with poor prognosis to enable walking in the early stage after the operation. Two weeks after the operation, she could successfully walk. The postoperative Musculoskeletal Tumor Society score was 47%, and it had improved to almost the preoperative level before injury (50%). In conclusion, endoprosthetic reconstruction for displaced atypical femoral fractures may be a first-line treatment approach to acquire early postoperative walking ability for improving activities of daily living in cancer patients with poor prognosis.

scholarly journals Peri-implant fracture: a rare complication after intramedullary fixation of trochanteric femoral fracture

2021 ◽  
Author(s):  
Lauri M. Halonen ◽  
Antti Stenroos ◽  
Henri Vasara ◽  
Jussi Kosola
Keyword(s):  
Rare Complication ◽  
Treatment Strategies ◽  
Femoral Fractures ◽  
Delayed Union ◽  
Intramedullary Fixation ◽  
Fixation Method ◽  
Trochanteric Fractures ◽  
Non Union ◽  
Trochanteric Femoral Fracture ◽  
Exchange Nailing

Abstract Introduction Trochanteric femoral fractures are among the most common operatively treated fractures. Intramedullary fixation has become the treatment of choice in many centers around the world. Nevertheless, the knowledge of rare complications of these fractures is limited. In this study, the incidence and treatment strategies for peri-implant fractures (PIF) were assessed. Materials and methods A single-center retrospective cohort study was done on 987 consecutive operatively treated trochanteric fractures. PFNA cephalomedullary nail was used as a fixation method. All patients were followed up from patient records for peri-implant fractures. Plain radiographs as well as different salvage methods were analyzed and compared. Results The total rate of peri-implant fractures was 1.4% (n = 14). The rate of PIF for patients treated with short (200 mm) nails, intermediate-length (240 mm) nails, and long nails was 2.7% (n = 2), 1.5% (n = 11), and 0.7% (n = 1), respectively (ns, p > 0.05 for difference). Treatment of choice for PIF was either ORIF with locking plate (57%, n = 8) or exchange nailing (43%, n = 6). None of the PIF patients needed additional surgeries for non-union, malunion, or delayed union. Conclusions A PIF is a rare complication of intramedullary fixation of trochanteric fractures. It can be treated with either locking plates or exchange nailing with sufficient results. There are no grounds for favoring long nails to avoid PIFs.

scholarly journals Mechanism of Unstable Inter-trochanteric Fractures in the Elderly

2020 ◽  
pp. 120-134
Author(s):  
S. Santhosh
Keyword(s):  
Femoral Fractures ◽  
Early Mobilization ◽  
The Elderly ◽  
Trochanteric Fractures ◽  
Non Union ◽  
Prospective Comparative Study ◽  
Hip Screw ◽  
Hemi Arthroplasty ◽  
Tremendous Impact

The aim of this prospective comparative study is to analyse the short term follow-up results of unstable inter-trochanteric fractures in the elderly treated with Bipolar hemi-arthroplasty and Dynamic hip screw fixation done in our institution from March 2017 to October 2018. Proximal femoral fractures in the elderly individuals have a tremendous impact on both the health care system and society. Upon treatment of inter-trochanteric factures with conservative management, it usually unites with a mal-union, non-union and with shortening, but the problem of non –union in trochanteric fractures has less incidence. Because of complications associated with prolonged recumbency and its associated morbidities. Primary hemiarthroplasty in these patients provides for adequate fixation and early mobilization. It alleviates pain and improves function. It also prevents post-operative complications such as pneumonia, lung atelectasis and pressure sores. From our clinical observation we would suggest that unstable intertrochanteric fractures in elderly result most frequently from accidental fall (52.5%), being the most common described mechanism of injury.

scholarly journals Comparison between the outcome of proximal femoral locking compression plate and dynamic hip screw in intertrochanteric femoral fractures

2021 ◽  
Vol 8 (10) ◽  
pp. 2880
Author(s):  
Adnan Arif ◽  
Hamza Waqar Bhatti ◽  
Noman Ahmed Chaudhary ◽  
Abdullah Sadiq
Keyword(s):  
Demographic Data ◽  
Randomized Study ◽  
Femoral Fractures ◽  
Locking Compression Plate ◽  
Bone Union ◽  
Trochanteric Fractures ◽  
Implant Complications ◽  
Compression Plate ◽  
Hip Screw ◽  
Better Than

Background: Inter-trochanteric femoral fractures are associated with a high complication rate and mortality. This study aims to compare the proximal femoral locking compression plate (PFLCP) with dynamic hip screws (DHS) for inter-trochanteric femoral fractures in terms of mean bone union time.Methods: It was a prospective randomized study conducted at the department of orthopedics, Benazir Bhutto Hospital, Rawalpindi, Pakistan from June 2015 to December 2015. Sixty patients with a diagnosis of inter-trochanteric fractures, requiring orthopedic surgery, were included in the study. After randomization thirty patients underwent PFLCP fixation and the other thirty patients underwent DHS fixation. Patient information, demographic data, and functional level were assessed. Mean bone union time and implant complications were compared for the two treatment groups.Results: Patients who underwent PFLCP fixation demonstrated shorter bone union time (2.8±0.2 months) than those who underwent DHS fixation (3.2±0.1 months) (p<0.000). PFLCP group had 90% bone union whereas DHS group had 76.66% bone union at 12 weeks (p=0.16). Conclusions: PFLCP is better than DHS for intertrochanteric femoral fractures in terms of shorter mean bone union time and fewer complications.

scholarly journals A Evaluation of Initial Treatment of Trochanteric Fractures using Gamma Nails

10.3823/2619 ◽  
2020 ◽  
Vol 13 ◽  
Author(s):  
Quang-Tri LE ◽  
Minh-Hoang Nguyen
Keyword(s):  
Range Of Motion ◽  
Initial Treatment ◽  
Treatment Effectiveness ◽  
Trochanteric Fracture ◽  
The Elderly ◽  
Bone Union ◽  
Military Hospital ◽  
Trochanteric Fractures ◽  
Functional Rehabilitation ◽  
Neck Shaft Angle

Background: Trochanteric fractures are extra-joint fractures, account for 55% of femoral proximal fractures. They often happen in the elderly with increased frequency due to age. Treatment experiences at 7A Military Hospital showed increased trochanteric fracture cases. To properly assess treatment effectiveness and select proper treatment methods, the study of “Evaluation of initial treatment of trochanteric fractures using gamma nails at 7A Military Hospital and made the conclusions of indications and applied techniques” was carried out. The study objectives are evaluating the initial treatment of trochanteric fractures using gamma nails at 7A Military Hospital and made the conclusions of indications and applied techniques. Methods and findings: nineteen patients diagnosed with traumatic trochanteric fractures and surgically treated with Gamma nails were monitored and evaluated for bone fusion, bone union, range of motion, limb shortening, and functional rehabilitation according to Merle D'Aubigné scale. Fourteen patients (82.35%) achieved proper bone union with the femoral neck-shaft angle of 1250 - 1300, three patients (17.65%) got slightly deviated bone union. Amongst patients aged under 60, 14/17 cases (82.35%) achieved “good” and “very good” functional rehabilitation, scored over 15 points according to Merle D΄aubigne Index; 3/17 cases (17.65%) got “average” recovery. Hip range of motion in 14 cases (82.35%) achieved “very good” (normal movement) or “good” (over 10% movement limitation) outcome, 3 cases had “average” movement (17.65%). Limb shortening of below 1cm took place in 10 patients (58.82%), 1 – 2 cm in 4 patients (23,53%) and over 3 cm in 3 patients (17.65%). Conclusions: The surgical treatment of trochanteric fractures using gamma nails yielded positive outcomes. Keywords: Gamma nails, trochanteric fractures, elderly, extra-joint.

scholarly journals The Influence of Position of the Displaced Lesser Trochanter on Clinical Outcome of Unstable Trochanteric Femur Fractures in the Elderly

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Qi Sun ◽  
Wei Ge ◽  
Hengda Hu ◽  
Gen Li ◽  
JieZhou Wu ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Complication Rate ◽  
Trochanteric Fractures ◽  
Surgical Time ◽  
Lesser Trochanter ◽  
Femur Fractures ◽  
Significant Difference ◽  
Reduction Group ◽  
Group A ◽  
Group B

Purpose. This study aimed to evaluate whether position of the displaced lesser trochanter affected clinical outcome in the treatment of unstable trochanteric fractures with intramedullary fixation. Patients and Methods. Patients with unstable trochanteric fractures and displaced lesser trochanter who received intramedullary fixation were retrospectively reviewed in this study. Based on displacement distance of the lesser trochanter and whether the lesser trochanter was reduced operatively, patients were divided into three groups: patients with the displaced lesser trochanter less than 1cm (Group A), those with the displaced lesser trochanter more than 1 cm without operative reduction (Group B), or those with operative reduction (Group C). The surgical time, reduction quality, Harris Hip Score (HHS), Visual Analog Score (VAS), and complication rate were reviewed. Results. There were 42 patients in Group A, 33 in Group B, and 36 in Group C with comparable demographic characteristics. The surgical time was significantly longer in Group C (P=0.009), compared with Groups A and B. Fracture reduction quality was comparable with over 85% good reduction among the three groups. The VAS score was significantly higher in Group B (P=0.023) without significant difference between Groups A and B. The HHS score was slightly lower in Group B, but it did not reach significant difference. The complication rate was statistically higher in Group B (p=0.043) than Groups A and C. Conclusion. The severe displaced lesser trochanter may increase postoperative complications and postoperative pain in the treatment of unstable trochanteric femur fractures. However, the displaced lesser trochanter may not affect hip function.

scholarly journals Medial Pelvic Migration of the Lag Screw after Intramedullary Nailing for Trochanteric Femoral Fracture

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Kohei Kuroshima ◽  
Koichi Kasahara ◽  
Shinsuke Kihara ◽  
Yoshifumi Harada ◽  
Masatoshi Sumi
Keyword(s):  
Femoral Fracture ◽  
Rare Complication ◽  
Femoral Fractures ◽  
Careful Attention ◽  
Older Individuals ◽  
Intramedullary Nails ◽  
Screw Insertion ◽  
Lag Screw ◽  
Trochanteric Femoral Fracture ◽  
Femoral Side

Internal fixation with intramedullary nails has gained popularity for the treatment of trochanteric femoral fractures, which are common injuries in older individuals. The most common complications are lag screws cut-out from the femoral head and femoral fracture at the distal tip of the nail. Herein, we report a rare complication of postoperative medial pelvic migration of the lag screw with no trauma. The patient was subsequently treated by lag screw removal via laparoscopy. This case suggests that optimal fracture reduction, adequate position of the lag screw, and careful attention to set screw insertion are important to prevent complications. Additionally, laparoscopic surgery might be able to remove the lag screw more safely than removal from the femoral side.

scholarly journals Treatment of trochanteric femoral fractures with double dynamic internal fixation

2007 ◽  
Vol 60 (5-6) ◽  
pp. 267-271
Author(s):  
Zoran Golubovic ◽  
Milorad Mitkovic ◽  
Djordje Gajdobranski ◽  
Lana Macukanovic-Golubovic ◽  
Ivan Micic ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Femoral Fractures ◽  
The Elderly ◽  
Fracture Site ◽  
Activity Level ◽  
Internal Fixator ◽  
Trochanteric Fractures ◽  
Average Patient ◽  
Life Threatening ◽  
Male Patients

Introduction: Trochanteric fractures are extracapsular fractures of the proximal femur. The increasing number of trochanteric fractures is a great sociomedical problem. These fractures usually occur in elderly people (older than 65 years) with osteoporosis. Lateral and frontal falls are the most frequent cause of trochanteric fractures in the elderly. The aim of this paper is to present our results of applying the Mitkovic selfdynamisable internal fixator (SIF). Material and methods: From January 2001 to December 2005, 238 patients with trochanteric femoral fractures were treated operatively using the Mitkovic selfdynamisable internal fixator at the Clinic of Orthopedics and Traumatology in Nis. The average patient age was 69,11 years (range 17 to 88). In the analyzed group there were 152 (64%) female and 86 (36%) male patients, whereas patients in the eighth 101 (43%) and seventh 65 (27%) decade of life prevailed. Results: Excellent results in the treatment of trochanteric femoral fractures with a Mitkovic dynamic internal fixator were achieved in 143 (60%) patients, good in 49 (21%) patients, poor in 41 (17%) and unsatisfactory in 5 (2%) patients. Discussion and conclusion: The treatment of trochanteric fractures may be operative and nonoperative. The aim of the operative treatment, considered to be the "gold standard" for these fractures, is to restore the patient's pretraumatic activity level and to reduce life-threatening complications. The operative stabilization is performed using various types of implants. Surgical treatment by using dynamic implants is a method of choice in the treatment of trochanteric fractures. Internal fixation using the Mitkovic selfdynamisable internal fixator is a method of choice in the treatment of trochanteric femoral fractures, providing dynamization and compression of the fracture site in two axes (axis of the femoral neck and femoral diaphyseal axis) and balanced biomehancal 3D.

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

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