Salvage procedures for trochanteric femoral fractures after internal fixation failure: Biomechanical comparison of a plate fixator and the dynamic condylar screw

2011 ◽  
Vol 225 (7) ◽  
pp. 710-717 ◽  
Author(s):  
L Konstantinidis ◽  
C Papaioannou ◽  
A Mehlhorn ◽  
A Hirschmüller ◽  
N P Südkamp ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Femoral Fractures ◽  
Fixation Failure ◽  
Plate Fixator ◽  
Dynamic Condylar Screw ◽  
Biomechanical Comparison

scholarly journals COMPARATIVE STUDY OF INTERNAL FIXATION OF DISTAL FEMORAL FRACTURES IN ADULTS USING DYNAMIC CONDYLAR SCREW AND DISTAL FEMORAL NAIL

2020 ◽  
pp. 15-17
Author(s):  
Anindya Basu ◽  
Imran Khan ◽  
Debarshi Jana
Keyword(s):  
Internal Fixation ◽  
Operating Time ◽  
Femoral Fractures ◽  
Simple Type ◽  
Distal Femoral Fractures ◽  
Medical College ◽  
Femur Fractures ◽  
Dynamic Condylar Screw ◽  
Femoral Nail ◽  
Intraarticular Fractures

Background: Distal femoral fractures are uncommon, usually complex and account for about 7% of all femoral fractures. These fractures often are unstable and comminuted and tend to occur in elderly or multiply injured patients. The incidence is highest in women older than 75 years and in adolescent boys and men 15-24 years. Aim: To compare the results of different modes of internal fixation of different type of distal femur fractures by Distal Femoral Nail and Dynamic Condylar Screw. Materials and Methods: The study was conducted in the department of orthopedics, R.G. Kar Medical College & Hospital; 1,K.B. Sarani, Kolkata – 700004. The main source of patients was those adults presenting with distal femoral fractures attending either emergency or outdoor & also patients referred from peripheral hospitals. Distal femoral fractures of AO/OTA type A fractures (i.e. extra-articular supracondylar) & AO/OTA type C1 & C2 fractures (i.e. articular simple, metaphyseal simple type & articular simple & metaphyseal multifragmentary type respectively). Results: Most of the patients were operated on an average of 6.5th day from injury. Average intra-operative blood loss and operating time for DFN were significantly low compared to the other group. The average duration of hospital stay was 14.7 days overall. No groups showed significant higher duration of the same. Conclusion: Dynamic condylar Screws give results in treating pure supracondylar or complete intraarticular fractures, although with less satisfactory outcomes especially in the latter.

Compensatory Tibial Overgrowth Following Healing of Closed Femoral Fractures in Young Dogs

1995 ◽  
Vol 08 (03) ◽  
pp. 159-162 ◽  
Author(s):  
L. Susan ◽  
R. T. O’Brien ◽  
K. A. Johnson
Keyword(s):  
Internal Fixation ◽  
Femoral Fractures ◽  
Surgical Reduction ◽  
Femoral Shortening ◽  
Hindlimb Lameness ◽  
Femoral Condyles

SummaryTwo young dogs examined for hindlimb lameness were found to have healed femoral fractures, 2-4 cm of femoral shortening, and 1 cm of compensatory ipsilateral tibial overgrowth. Neither dog had had surgery or internal fixation. Although tibial overgrowth partially corrected for limb shortening, both dogs had chronic intermittent lameness due to malformation of the femoral condyles and secondary stifle osteoarthritis.Compensatory tibial overgrowth was found in two young dogs with femoral fractures which had healed without any surgical reduction or internal fixation. Tibial overgrowth of approximately 1 cm in each case partially compensated for 2-4 cm of femoral shortening.

scholarly journals Surgical Treatment of Internal Fixation Failure of Femoral Peritrochanteric Fracture

2021 ◽  
Author(s):  
Gang Zhong ◽  
Lin Teng ◽  
Hai‐bo Li ◽  
Fu‐guo Huang ◽  
Zhou Xiang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Fixation Failure

scholarly journals Treatment of Intertrochanteric Femur Fractures with Hip Arthroplasty in Older Patients: A Narrative Review of Indications and Outcomes

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 763
Author(s):  
Tiago Martinho ◽  
Karl Stoffel
Keyword(s):  
High Risk ◽  
Surgical Technique ◽  
Internal Fixation ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Older Patients ◽  
Bipolar Hemiarthroplasty ◽  
Intramedullary Nails ◽  
Fixation Failure ◽  
Femur Fractures

Intertrochanteric femur fractures are common in older patients and often have a significant impact on disability. The treatment aims to achieve a rapid return to the prior functional level with a low rate of complications and mortality. Surgical management by internal fixation is the mainstay of treatment for most of these fractures. Even when treated with intramedullary nails, the overall complication rates are high, especially for unstable or highly comminuted fractures or in the presence of poor bone quality. Hip arthroplasty is an alternative in older patients with intertrochanteric femur fractures at high risk of fixation failure or with concomitant intraarticular pathologies. Especially patients whose condition precludes prolonged bedrest and who are at risk of significant deterioration if their locomotor function cannot be restored rapidly are likely to benefit from hip arthroplasty. The choice of the surgical technique mainly depends on the surgeon’s preferences and the fracture characteristics. Bipolar hemiarthroplasty is the most common type of prosthesis used with primary or revision femoral stems. Compared with intramedullary nails, hip arthroplasty has a better early functional outcome and lower rates of surgical complications as well as reoperations. However, the functional outcome and the mortality rate in the longer term tend to favor intramedullary nails, even though the results are inconsistent, and a statistically significant difference cannot always be obtained. Currently, there are no guidelines that define the role of hip arthroplasty in the treatment of intertrochanteric femur fractures in older patients. The literature only offers an overview of the possibilities of the usage of hip arthroplasty, but methodological limitations are common, and evidence levels are low. Further studies are needed to identify the intertrochanteric fractures that are at high risk of internal fixation failure, the characteristics that determine which patients may benefit most from hip arthroplasty, and the optimal surgical technique.

A Biomechanical Evaluation of Three Forms of Internal Fixation Used in Ankle Arthrodesis

1994 ◽  
Vol 15 (6) ◽  
pp. 297-300 ◽  
Author(s):  
Michael P. Dohm ◽  
James B. Benjamin ◽  
Jeffrey Harrison ◽  
John A. Szivek
Keyword(s):  
Internal Fixation ◽  
Plate Fixation ◽  
Ankle Arthrodesis ◽  
Biomechanical Study ◽  
The Other ◽  
Fixation Failure ◽  
Plate Group ◽  
Biomechanical Evaluation ◽  
The Stability ◽  
Fibular Strut

A biomechanical study was undertaken to evaluate the relative stability of three types of internal fixation used for ankle arthrodesis. Crossed screw fixation, RAF fibular strut fixation, and T-plate fixation were tested in 30 cadaver ankles using an MTS machine. T-plate fixation consistantly provided the stiffest construct when compared with the other types of fixation. Failure occurred by distraction of bony surfaces, posterior to the plane of fixation, in the crossed screw and RAF groups. In contrast, failure in the T-plate group occurred through compression of bone anterior to the midcoronal plane of the tibia. Although the stability of fixation is only one factor in determining the success or failure of ankle arthrodesis, the results of this study would support T-plate fixation over the other forms tested.

scholarly journals Failure of Internal Fixation of The Anterior Ring For Unstable Pelvic Fractures, The Experience of A Single Institute

2021 ◽  
Author(s):  
Sheng Zhang ◽  
Huagui Mo ◽  
Yucheng Liu ◽  
Guohua Zhu ◽  
Bin Yu
Keyword(s):  
Internal Fixation ◽  
Pelvic Ring ◽  
Treatment Strategies ◽  
Pubic Symphysis ◽  
Pelvic Fractures ◽  
Fixation Failure ◽  
Initial Surgery ◽  
Multidisciplinary Cooperation ◽  
Preoperative Plan ◽  
Anterior Ring

Abstract Background: This study aimed to share our experience of anterior ring fixation failure for unstable pelvic fractures and propose corresponding treatment strategies. Materials: From January 2009 to December 2018, 93 patients with pelvic fractures were retrospectively reviewed. Patients with failure of the anterior ring internal fixation within 3 months after initial surgery were analyzed. Quality of reduction was evaluated using the Majeed scoring system.Results: According to the Tile classification of fracture, there were 23 cases of type B1, 17 cases of type B2, 11 cases of type B3, 28 cases of type C1, 6 cases of type C2, and 8 cases of type C3. The duration from injury to pelvic internal fixation ranged from 5-28 days. Seven out of 93 patients experienced failure of internal fixation of the anterior pelvic ring within 3 months, including 2 patients fixed with an external fixator and 5 patients were fixed with a plate. Five patients undergoing revision surgery were followed up for 6-36 months with an average of 18 months. According to Majeedscore at the last follow-up, there were 2 cases of excellent, 2 cases of good, 1 case of fair, and the excellent and good rate reached 80%.Conclusion: The treatment of complicated unstable pelvic fractures requires early multidisciplinary cooperation, proper management of hemodynamic stability and other comorbidities, and performing internal fixation surgery within 2 weeks. It is necessary to make a preoperative plan and stabilize the posterior ring first, avoiding a single steel plate crossing the pubic symphysis.

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