scholarly journals Arterial Injury to the Profunda Femoris Artery following Internal Fixation of a Neck of Femur Fracture with a Compression Hip Screw

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Simon Craxford ◽  
Michael Gale ◽  
Kimberly Lammin
Keyword(s):  
Internal Fixation ◽  
Femur Fracture ◽  
Treatment Options ◽  
Anatomical Variations ◽  
Arterial Injury ◽  
Neck Of Femur ◽  
Profunda Femoris Artery ◽  
Hip Screw ◽  
Neck Of Femur Fracture ◽  
Profunda Femoris

We report the case of an 82-year-old woman who developed extensive proximal thigh swelling and persistent anaemia following internal fixation of an extracapsular neck of femur fracture with a dynamic hip screw (DHS). This was revealed to be a pseudoaneurysm of a branch of profunda femoris artery on angiography. Her case was further complicated by a concurrent pulmonary embolism (PE). She underwent endovascular coil embolisation of the pseudoaneurysm. An IVC filter was inserted and the patient was fully anticoagulated once it had been ensured that there was no active bleeding. In this case, we review the potential for anatomical variations in the blood supply to this region and discuss treatment options for a complicated patient. We recommend that a pseudoaneurysm should be part of a differential diagnosis for postoperative patients with anaemia refractory to blood transfusion so as not to miss this rare but potentially serious complication.

Orthopaedics

2017 ◽  
Author(s):  
Anil Agarwal ◽  
Neil Borley ◽  
Greg McLatchie
Keyword(s):  
Surgical Approach ◽  
Femur Fracture ◽  
Surgical Approaches ◽  
Great Toe ◽  
Kirschner Wires ◽  
Neck Of Femur ◽  
Diagnostic Arthroscopy ◽  
Traumatic Wound ◽  
Hip Screw ◽  
Neck Of Femur Fracture

This chapter on orthopaedics outlines the application of a secondary cast to a forearm or leg manipulation under anaesthetic (MUA) of distal radius fracture plus minus insertion of Kirschner wires, intra-articular injections, joint aspirations, and diagnostic arthroscopy. Operations included are fixation of Weber B fracture of ankle, dynamic hip screw (DHS) for extra-capsular neck of femur fracture, fixation of patella fracture by tension band wiring, insertion of traction pins, surgical debridement of traumatic wound, fasciotomy for compartment syndrome of leg, carpal tunnel decompression, surgical approaches to the hip, surgical approach to great toe metatarsophalangeal (MTPJ), and surgical approach to lumbar spine.

OUTCOME COMPARISON OF TREATMENT BASICERVICAL NECK OF FEMUR FRACTURE USING HEMIARTHROPLASTY VERSUS DYNAMIC HIP SCREW

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Manpreet Singh ◽  
Anurag Dhaker ◽  
Pradeep Kumar Mundotiya
Keyword(s):  
Femur Fracture ◽  
Age Groups ◽  
Clinical Score ◽  
Dynamic Hip Screw ◽  
Neck Of Femur ◽  
Medical College ◽  
Significant Difference ◽  
Outcome Comparison ◽  
Hip Screw ◽  
Neck Of Femur Fracture

Background: The present study was conducted to compare outcome of hemiarthroplasty with dynamic hip screw for basicervical neck of femur fracture. Methods: Hospital based, randomized prospective, comparative interventional study conducted on Basicervical neck of femur fracture cases attending with orthopaedics department of S.M.S. Medical College and Hospital, Jaipur (Rajasthan, India) Results: As per the post operative complications in Hemiarthroplasty and DHS groups respectively, no significant difference was observed among the group. As per the age groups clinical score (merle's d aubigne), at 6m and 12 m Group H was better than group D. As per average functional outcome at 3,6 ,12months. Score improved with the time. Conclusion: We concluded that Hemiarthroplastymay allow better restoration of function and should be favoured for treatment of fracture neck of femur in patients that meet the indications for surgery whenever the technical competence and facilities exist. Keywords: Femur, Hemiarthroplasty, DHS

scholarly journals Is There a Role for Early Palliative Intervention in Frail Older Patients With a Neck of Femur Fracture?

2018 ◽  
Vol 9 ◽  
pp. 215145931878223 ◽  
Author(s):  
Andrew Davies ◽  
Thomas Tilston ◽  
Katherine Walsh ◽  
Michael Kelly
Keyword(s):  
Palliative Care ◽  
Femur Fracture ◽  
Trauma Centre ◽  
Care Plan ◽  
X Rays ◽  
Neck Of Femur ◽  
Early Palliative Care ◽  
Multidisciplinary Meeting ◽  
Major Trauma Centre ◽  
Neck Of Femur Fracture

Background: Patients with a neck of femur fracture have a high mortality rate. National outcomes have improved significantly as the management of this patient group is prioritized. In 2016, however, 4398 (6.7%) patients died within 30 days of admission. Objective: To investigate whether palliative care could be integrated early in the care plan for high-risk patients. Methods: All cases of inpatient mortality following neck of femur fracture at North Bristol Major Trauma Centre over a 24-month period were reviewed. A comprehensive assessment of care was performed from the emergency department until death. All investigations, interventions, and management decisions were recorded. A consensus decision regarding expected mortality was made for each case at a multidisciplinary meeting which included surgical, orthogeriatric, nursing, and anesthetic team input. Results: A total of 1033 patients were admitted following a neck of femur fracture. There were 74 inpatient deaths, and 82% were considered predictable at our multidisciplinary meeting. The mean length of stay was 18 days (range: 0-85, median 14). In 42% of cases, mortality was considered predictable on admission, and 40% were considered predictable following acute deterioration. These patients received on average 28 blood tests (range: 4-114) and 6.8 X-rays and computed tomographies (range: 2-20). Of this, 66% received end-of-life care; mean duration 2.3 days (range: 0-17). Conclusions: Mortality rates remain high in a subset of patients. This study demonstrates that intensive investigation and medical management frequently continues until death, including in patients with predictably poor outcomes. Early palliative care input has been integrated successfully into patient management in other specialties. We demonstrate that it is feasible to identify patients with hip fracture who may benefit from this expertise.

scholarly journals A simple screening question for cognitive impairment in neck of femur fracture patients

Injury Extra ◽  
2012 ◽  
Vol 43 (10) ◽  
pp. 104
Author(s):  
N. Gunasekera ◽  
D. Ramoutar ◽  
C. Morris ◽  
T. Aung ◽  
C. Moran
Keyword(s):  
Cognitive Impairment ◽  
Femur Fracture ◽  
Neck Of Femur ◽  
Screening Question ◽  
Neck Of Femur Fracture ◽  
Simple Screening

scholarly journals P16 An audit of elderly patients with a femoral fracture: is the quality of care received by patients affected by where in the femur the fracture occurs?

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
O A Javed ◽  
M J Khan ◽  
Y Abbas ◽  
S Pillai ◽  
K Hristova ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Elderly Patients ◽  
Bone Health ◽  
Nutritional Assessment ◽  
Femur Fracture ◽  
Femoral Fractures ◽  
Neck Of Femur ◽  
Femur Fractures ◽  
Neck Of Femur Fracture ◽  
Health Review

Abstract Introduction Elderly patients with femoral fractures are often frail and require a multidisciplinary approach to optimise medical care, rehabilitation and prevention of further injury. Previously, neck of femur fracture patients were the focus of such an approach, but NICE and BOAST guidelines emphasise extending this care to other elderly trauma patients. Methods A retrospective analysis of 43 patients over 60 years old at Gloucestershire Hospitals NHS Foundation Trust in 2019 with a femoral fracture other than a neck of femur fracture. BOAST guideline standards were surgery within 36 hours, orthogeriatric assessment within 72 hours, a documented ceiling of treatment, falls risk assessment, bone health review, nutritional assessment and physiotherapy review. Results Our study showed worse outcomes in all standards for patients with femoral shaft, distal femur and periprosthetic femur fractures compared to neck of femur fractures: surgery within 36 hours (63.9% vs. 66%); orthogeriatric assessment within 72 hours (32.6% vs. 91.9%); falls risk assessment (76.7% vs. 99.6%); bone health review (41.9% vs. 99.7%); nutritional assessment (55.8% vs. 99.6%); physiotherapy review (97.7% vs. 98.9%). The group also had worse outcomes for average length of stay (19 days vs. 14 days) and 30 day mortality (9.3% vs. 8.6%). Discussion Our study showed a discrepancy in care received by elderly patients with femoral fractures other than neck of femur. We will introduce a proforma for all femoral fractures, present our findings to orthogeriatric, bone health and physiotherapy teams to involve them in the care of such patients and re-audit following these recommendations.

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