scholarly journals As an unusual traumatic presentation, acetabular fracture and concomitant ipsilateral intertrochanteric femur fracture: a retrospective case series of 18 patients

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Bo Liu ◽  
Wenhui Ma ◽  
Sikai Liu ◽  
Xiao Chen ◽  
Mengnan Li ◽  
...  
Keyword(s):  
Risk Factor ◽  
Internal Fixation ◽  
Acetabular Fracture ◽  
Poor Prognosis ◽  
Femur Fracture ◽  
Acetabular Fractures ◽  
Intertrochanteric Fractures ◽  
Harris Score ◽  
Intertrochanteric Femur Fracture ◽  
Dislocation Of The Hip

Abstract Background Acetabular fracture and concomitant ipsilateral intertrochanteric femur fracture has been suggested as an unusual traumatic presentation and rarely reported in the literature. The aims of this study were (1) to identify the etiological characteristics, (2) to summarize the treatment strategy, and (3) to present the mid- to long-term results of patients with this rare traumatic presentation. Methods In this retrospective study, 18 patients (15 males, 3 females; mean age = 42.77 ± 17.74 years, range = 16 to 87 years) who were diagnosed and treated for simultaneous acetabular fracture and ipsilateral intertrochanteric fracture were included. Injury mechanisms, fracture classifications, and treatment strategies were noted. To assess functional status, the Harris score was used. To evaluate pain intensity, visual analogous scale (VAS) was used. The reduction quality of acetabular fractures was examined as per Matta’s standard. Postoperative complications were also recorded. Results The mean follow-up was 10.04 ± 3.38 (range = 6.2 to 16 years). The most common injury mechanism was traffic accident, followed by falling from a tall height. As per the Evans classification, intertrochanteric fractures were defined as type 3 in 13 patients, type 2 in one patient, and type 4 in 4 patients. In acetabular fracture site, the most common fractures were posterior wall fractures, followed by anterior column fractures. All patients received internal fixation for their intertrochanteric fractures. Ten out of 18 patients also received internal fixation for their acetabular fracture. However, for the remaining patients, acetabular fractures were treated conservatively or with fracture fragment resection. Bony healing was achieved in all but one patient who died postoperatively. Twelve patients achieved excellent and good results (Harris score ≥ 80 points) whereas five patients achieved fair and poor results (Harris score < 80 points). The proportion of patients who achieved an excellent-good Harris score was 70.6%. Dislocation of the hip was found to be an independent risk factor (HR = 9.194, 95% CI = 1.024-82.515) for the poor patient outcome. Conclusion To sum up, high-impact trauma is the main cause of acetabular fracture and concomitant ipsilateral intertrochanteric femur fracture. For patients who have undergone surgical treatment, fracture healing is usually achieved. However, the occurrence of complications, especially avascular necrosis, is the major cause of a poor prognosis. Dislocation of the hip joint at the time of injury is considered to be an important risk factor for a poor prognosis.

scholarly journals Rare injury - acetabular fracture combined with ipsilateral intertrochanteric fracture: treatment and outcome in patients with at least 6 years of follow-up

2020 ◽  
Author(s):  
Bo Liu ◽  
Wenhui Ma ◽  
Sikai Liu ◽  
Xiao Chen ◽  
Mengnan Li ◽  
...  
Keyword(s):  
Risk Factor ◽  
Internal Fixation ◽  
Hip Joint ◽  
Acetabular Fracture ◽  
Poor Prognosis ◽  
Intertrochanteric Fracture ◽  
Acetabular Fractures ◽  
Rare Injury ◽  
Harris Score ◽  
Dislocation Of The Hip

Abstract Background Fractures involving both the acetabulum and the ipsilateral femoral trochanter are rarely reported. The aims of our study were to identify the etiological characteristics, summarize the treatment methods, and analyze the mid- to long-term prognosis for this kind of rare injury. Methods A total of 18 patients who were treated in our hospital for a combination of ipsilateral acetabular fracture and intertrochanteric fracture from 2003 to 2013 was retrospectively analyzed. The etiology, fracture classifications, treatment and prognosis of patients were identified. Results We followed up with patients for 6.2 years to 16 years. In this study, injuries occurred most commonly via traffic accidents, followed by falls from a tall height and crushing injury. Six patients had posterior dislocation of the hip joint. Evans type 3 fracture and Letournel type 1 fracture were the most common fractures among these patients. All patients received internal fixation for their intertrochanteric fracture. Some patients also received internal fixation for their acetabular fracture. However, for the other patients, acetabular fractures were treated conservatively or with fracture fragment resection. One elderly (87 years) female patient had pulmonary disease and died at 24 days postoperatively. In other patients, fractures all achieved bony healing. Twelve patients achieved excellent and good results (Harris score ≥ 80 points), and 5 patients achieved fair and poor results (Harris score < 80 points). The proportion of patients who achieved an excellent-good Harris score was 70.6%. Dislocation of the hip was found to be an independent risk factor (HR = 9.194, 95% CI = 1.024–82.515) for poor patient outcomes. Conclusion The detailed characteristics of patients with acetabular fracture and ipsilateral intertrochanteric fracture were identified in this study. For patients who undergo surgical treatment, fracture healing is usually achieved. However, the occurrence of complications, especially avascular necrosis, is the major cause of poor prognosis. Dislocation of the hip joint at the time of injury is considered to be an important risk factor for poor prognosis.

scholarly journals Functional Outcome of Traumatic Acetabulum Fractures : A 6 Months Comprehensive Follow Up Following Open Reduction Internal Fixation Surgery at Saiful Anwar General Hospital Malang

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0003
Author(s):  
DP Putra ◽  
AS Pradana ◽  
KY Phatama ◽  
E Mustamsir ◽  
M Hidayat
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
General Hospital ◽  
Open Reduction ◽  
Open Reduction Internal Fixation ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Acetabulum Fractures ◽  
Harris Score ◽  
The Mean

Acetabular fractures commonly occurred in young adult patient who suffered from high impact trauma which often associated with life threatening injuries. Displaced acetabular fractures lead to abnormal distribution on joint cartilage pressures. It produces early cartilage disruption and development of premature osteoarthritis at the hip. Anatomical reduction and fixation operation in acetabulum fractures still a major challenges due to its complications such as poor functional outcome after surgery. Despite its difficulty to predict the outcomes of acetabular fractures surgeries, functional outcomes scoring such as Oxford Hip Score (OHS) and Harris score may help surgeon to measure long term outcome following acetabular fractures. A total of 13 patients were treated over period of January 2018 until March 2019 in Saiful Anwar General Hospital Malang. The mean age of patients in this serial case is 37 years old and were operated within 2 weeks of injury. All the patients undergone an ORIF (Open Reduction Internal Fixation) operation and observed for the OHS and also Harris score 6 months following surgeries to measure functional outcome of the patients. The mean score of OHS in this serial case is 41 (satisfactory joint function) and the mean score of harris hip score is 91 (excellent). Some patients experience pain during activities, tingling sensation after standing in some periods of time, and heaviness when taking stairs 6 months after operation. This results conclude that the preoperative, operative and post operative management of patient with acetabular fracture in Saiful Anwar Hospital has satisfactory results.

scholarly journals Complex fracture pattern involving ipsilateral intertrochanteric fracture associated with ipsilateral posterior hip dislocation and posterior acetabular wall fracture: A rare combination of injuries

2021 ◽  
Vol 11 (9) ◽  
Author(s):  
Hind Alraeh ◽  
Hatem Sultan ◽  
Hassan Maghfori ◽  
Abdullah Almanea
Keyword(s):  
Intertrochanteric Fracture ◽  
Road Traffic ◽  
Hip Dislocation ◽  
Fracture Pattern ◽  
Fracture Dislocation ◽  
Acetabular Fractures ◽  
Acetabulum Fractures ◽  
Hip Screw ◽  
Intertrochanteric Femur Fracture ◽  
Dislocation Of The Hip

Introduction:High-energy trauma has increased the incidence of traumatic hip dislocation. In most cases, dislocation of the hip is associated with fractures of the acetabulum. However, its association with ipsilateral intertrochanteric fracture is very rare. Case Report:We present a case of a 54-year-old male who had uncommon fracture pattern involving ipsilateral intertrochanteric femur fracture associated with ipsilateral posterior fracture dislocation of hip following a road traffic accident. He underwent closed reduction of the dislocation followed by an open reduction and internal fixation of the fractures. Through Kocher-Langenbeck approach, the intertrochanteric fracture was reduced and fixed with dynamic hip screw and derotation anti-rotation screw. Acetabulum fractures then fixed after reduction with two reconstruction plates. Conclusion:Early recognition and orthopedic intervention constitute the cornerstones of satisfactory outcomes in cases with such complex injuries. Keywords:Posterior hip dislocation, acetabular fractures, intertrochanteric fracture.

scholarly journals AN ALTERNATE METHOD TO MAINTAIN REDUCTION IN PROXIMAL FEMUR NAILING OF INTERTROCHANTERIC FEMUR FRACTURE : TEMPORARY K WIRE FIXATION.

2020 ◽  
pp. 1-2
Author(s):  
Digambar S Maraskolhe ◽  
Ankur B Chawla ◽  
Nandkishor M Harne
Keyword(s):  
Retrospective Analysis ◽  
Proximal Femur ◽  
Femur Fracture ◽  
Intertrochanteric Fractures ◽  
X Ray ◽  
Loss Of Reduction ◽  
Wire Fixation ◽  
Reasonable Approach ◽  
Intertrochanteric Femur Fracture ◽  
Intramedullary Implants

Intramedullary implants for fracture intertrochanteric fractures, there is always risk of loss of reduction despite of reduction after percutaneous procedure. Loss of reduction intraoperatively is not uncommon. Temporary k wire fixation is a good alternate to maintain the reduction during procedure. Retrospective analysis of intraoperative C-arm image with x ray proves this method as a reasonable approach for maintaining reduction of intertrochanteric fractures during nailing.

scholarly journals AN ALTERNATE METHOD TO MAINTAIN REDUCTION IN PROXIMAL FEMUR NAILING OF INTERTROCHANTERIC FEMUR FRACTURE : TEMPORARY K WIRE FIXATION

2020 ◽  
pp. 1-2
Author(s):  
Digambar S Maraskolhe ◽  
Ankur B Chawla ◽  
Nandkishor M Harne
Keyword(s):  
Retrospective Analysis ◽  
Proximal Femur ◽  
Femur Fracture ◽  
Intertrochanteric Fractures ◽  
X Ray ◽  
Loss Of Reduction ◽  
Wire Fixation ◽  
Reasonable Approach ◽  
Intertrochanteric Femur Fracture ◽  
Intramedullary Implants

Intramedullary implants for fracture intertrochanteric fractures, there is always risk of loss of reduction despite of reduction after percutaneous procedure. Loss of reduction intraoperatively is not uncommon. Temporary k wire fixation is a good alternate to maintain the reduction during procedure. Retrospective analysis of intraoperative C-arm image with x ray proves this method as a reasonable approach for maintaining reduction of intertrochanteric fractures during nailing.

scholarly journals Overexpressed XRCC2 as an independent risk factor for poor prognosis in glioma patients

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Zhendong Liu ◽  
Wang Zhang ◽  
Xingbo Cheng ◽  
Hongbo Wang ◽  
Lu Bian ◽  
...  
Keyword(s):  
Risk Factor ◽  
Expression Pattern ◽  
Poor Prognosis ◽  
Independent Risk Factor ◽  
Cox Regression ◽  
Enrichment Analysis ◽  
Gene Set Enrichment Analysis ◽  
Cellular Mechanisms ◽  
Molecular Features ◽  
Meta Analyses

Abstract Background XRCC2, a homologous recombination-related gene, has been reported to be associated with a variety of cancers. However, its role in glioma has not been reported. This study aimed to find out the role of XRCC2 in glioma and reveal in which glioma-specific biological processes is XRCC2 involved based on thousands of glioma samples, thereby, providing a new perspective in the treatment and prognostic evaluation of glioma. Methods The expression characteristics of XRCC2 in thousands of glioma samples from CGGA and TCGA databases were comprehensively analyzed. Wilcox or Kruskal test was used to analyze the expression pattern of XRCC2 in gliomas with different clinical and molecular features. The effect of XRCC2 on the prognosis of glioma patients was explored by Kaplan–Meier and Cox regression. Gene set enrichment analysis (GSEA) revealed the possible cellular mechanisms involved in XRCC2 in glioma. Connectivity map (CMap) was used to screen small molecule drugs targeting XRCC2 and the expression levels of XRCC2 were verified in glioma cells and tissues by RT-qPCR and immunohistochemical staining. Results We found the overexpression of XRCC2 in glioma. Moreover, the overexpressed XRCC2 was associated with a variety of clinical features related to prognosis. Cox and meta-analyses showed that XRCC2 is an independent risk factor for the poor prognosis of glioma. Furthermore, the results of GSEA indicated that overexpressed XRCC2 could promote malignant progression through involved signaling pathways, such as in the cell cycle. Finally, doxazosin, quinostatin, canavanine, and chrysin were identified to exert anti-glioma effects by targeting XRCC2. Conclusions This study analyzed the expression pattern of XRCC2 in gliomas and its relationship with prognosis using multiple datasets. This is the first study to show that XRCC2, a novel oncogene, is significantly overexpressed in glioma and can lead to poor prognosis in glioma patients. XRCC2 could serve as a new biomarker for glioma diagnosis, treatment, and prognosis evaluation, thus bringing new insight into the management of glioma.

scholarly journals Compartment Syndrome following Open Femoral Fracture with an Isolated Femoral Vein Injury Treated with Acute Repair

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
David Walmsley ◽  
Terry Axelrod ◽  
Sebastian Rodriguez-Elizalde
Keyword(s):  
Risk Factor ◽  
Compartment Syndrome ◽  
Femoral Fracture ◽  
Femur Fracture ◽  
Femoral Vein ◽  
Lower Leg ◽  
Acute Compartment Syndrome ◽  
Therapeutic Anticoagulation ◽  
Vein Injury ◽  
Grade Iii

Acute compartment syndrome is a surgical emergency and its diagnosis is more difficult in obtunded or insensate patients. We present the case of a 34-year-old woman who sustained a Gustilo-Anderson grade III open midshaft femur fracture with an isolated femoral vein injury treated with direct repair. She developed lower leg compartment syndrome at 48 hours postoperatively, necessitating fasciotomies. She was subsequently found to have a DVT in her femoral vein at the level of the repair and was started on therapeutic anticoagulation. This case highlights the importance of recognition of isolated venous injuries in a trauma setting as a risk factor for developing compartment syndrome.

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