scholarly journals The visible and hidden blood loss of Asia proximal femoral nail anti-rotation and dynamic hip screw in the treatment of intertrochanteric fractures of elderly high- risk patients: a retrospective comparative study with a minimum 3 years of follow-up

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Weiguang Yu ◽  
Xinchao Zhang ◽  
Rongbo Wu ◽  
Xingfei Zhu ◽  
Jun Hu ◽  
...  
Author(s):  
Mahendra Kumar Reddy Mundla ◽  
Mohammad Rafi Shaik ◽  
Someswara Reddy Buchupalli ◽  
Chandranna B.

<p class="abstract"><strong>Background:</strong> Intertrochanteric (IT) fracture is one of the most common fractures of the femur in the female and elderly with osteoporotic bones, usually due to simple falls. Not many studies compared the treatment of dynamic hip screw (DHS) and proximal femoral nail (PFN), in type II intertrochanteric fractures. Hence, this study was done to compare the management, complications, functional and radiological outcome of PFN with DHS in management of type II intertrochanteric fractures<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> This prospective comparative study was conducted on 60 patients of IT fractures at Santhiram General Hospital, Nandyal, Kurnool (Dist.) during the period May 2016 to September 2017. 30 cases were operated with proximal femoral nail (PFN) and 30 by using dynamic hip screw (DHS). Intraoperative details, complications and outcome of the procedures were noted, compared and analysed statistically.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age in DHS group was 57.5 and PFN group was 56.5 yrs. Female preponderance was observed in the study. Most of the injuries were on right side due to slip and fall in both the groups. Mean radiographic exposure (60 sec) and duration of operation (90 min) were more in PFN group compared to DHS group. Mean blood loss was 230 ml in PFN group and 320 ml in DHS group. Better anatomical and functional results were observed in PFN group compared to DHS group<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> PFN is the better surgical procedure for elderly patients with IT fractures in terms of reduced blood loss, shorter operating time, rotational stability, good fixation, less morbidity and good outcome (anatomical and functional)<span lang="EN-IN">.</span></p><p> </p>


Author(s):  
M. R. Anand ◽  
N. S. Ramachandren

<p class="abstract"><strong>Background:</strong> Trochanteric hip fractures in elderly patients have benefited from advances in internal fixation. Early failure of internal fixation occurs however in a number of cases. The failure after internal fixation had been due to initial fracture pattern, communication, sub-optimal fracture fixation and poor bone quality. The aim of this prospective comparative study is to analyze the short term follow up results of unstable Intertrochanteric fractures in elderly treated with bipolar hemiarthroplasty and dynamic hip screw (DHS) fixation.</p><p class="abstract"><strong>Methods:</strong> This is a study conducted in the Department of Orthopaedics, Government Tiruvarur Medical College, Tiruvarur. 42 elderly osteoporotic patients with unstable intertrochanteric fractures who were divided into two groups with group A-bipolar prosthesis (21 cases) and group B-DHS (21 cases).<strong></strong></p><p class="abstract"><strong>Results:</strong> 42 elderly osteoporotic patients with unstable intertrochanteric fractures who were divided into two groups with group A-bipolar prosthesis (21 cases) and group B-DHS (21 cases). Patients were evaluated clinically using the Harris hip score during their follow up period. In both groups, the most common Singh’s index was grade III, 61.90%in both group A and group B.</p><p class="abstract"><strong>Conclusions:</strong> From our results, we are of the opinion that bipolar hemiarthroplasty may be an efficient option in elderly osteoporotic intertrochanteric fractures. It reduces the potential complications of prolonged immobilization such as pressure sores, pulmonary complications by early mobilization.</p>


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