scholarly journals Reverse distal femoral locking plate for subtrochanter femur fracture

2018 ◽  
Vol 27 (2) ◽  
Author(s):  
Peter Giarso ◽  
Ismail H. Dilogo
Keyword(s):  
Distal Femur ◽  
Locking Plate ◽  
Femur Fracture ◽  
Case Series ◽  
Subtrochanteric Fracture ◽  
Locking Compression Plate ◽  
Non Union ◽  
Functional Scores ◽  
The Right ◽  
Subtrochanteric Femur Fracture

In these case series, we used titanium locking compression plate-distal femur (LCP-DF) plate (Synthes) 9–11 hole using less invasive stabilization system or open reduction technique. This case series aims to determine the functional scores on reverse distal femoral locking plate for subtrochanteric femur fracture. A 34-year-old male with closed subtrochanteric fracture of the right femur (Seinsheimer 2B) with Harris hip scores (HHS) of 17, 96, and 97 obtained consecutively in 0, 6, and 12 months, respectively. A 24-year-old male with closed comminuted subtrochanteric fracture of the right femur (Seinsheimer V) with HHS of 13, 93, and 97 at 0, 6, and 12 months respectively. A 39-year-old male with non-union, left subtrochanteric femur fracture (Seinsheimer 2C) yielded HHS of 38, 73, and 77 at 0, 6, and 12 months, respectively. A 35-year-old female with close subtrochanteric fracture of the right femur (Seinsheimer IIB) yielded HHS of 23, 40, and 73 at 0, 6, and 12 months, respectively. Mean initial HHS and scores at 6 and 12 months reached 22, 75, and 86, respectively.

scholarly journals Assessment of complications in treating the fracture around knee joint by using locking compression plate

2021 ◽  
Vol 7 (2) ◽  
pp. 386
Author(s):  
Surender Kumar ◽  
Himanshu Khichar
Keyword(s):  
Distal Femur ◽  
Proximal Tibia ◽  
Femur Fracture ◽  
Locking Compression Plate ◽  
Tibia Fracture ◽  
Fracture Group ◽  
Proximal Tibia Fracture ◽  
Distal Femur Fracture ◽  
Non Union ◽  
Compression Plate

<p><strong>Background:</strong> Aim of the study was to describe complications and problems in treating the fracture around knee joint by using LCP (locking compression plate).</p><p><strong>Methods:</strong> This multicentric prospective functional out-come study has been conducted in the department of orthopedics, Barmer medical college and hospital, Barmer, Rajasthan and department of orthopedics, Pacific institute of medical sciences, Udaipur, Rajasthan. A total of 90 patients were studied, out of which 60 patients were with fracture distal femur and 30 patients were with proximal tibia fractures.</p><p><strong>Results:</strong> Out of 44 patients of distal femur fracture group 10 (22.72%) had infection where as in proximal tibia fracture group 4 (15.38%) out of 26 patients (all were operated by ORIF technique) had infection.<strong> </strong>Varus deformity was found in 3 patients (6.66%) of distal femur fracture patients and 4 patients (15.38%) of proximal tibia fracture patients out of these 3 were operated by ORIF and 1 by MIPO.<strong> </strong>Muscle wasting was found in 20 patients (40.44%) of distal femur fracture patients. Limb shortening was found in 7 patients (15.90%) of distal femur fracture. Limp shortening was present in 17 patients (38.60%) of distal femur fracture and 4 patients (15%) of proximal tibia fracture out of these 4 were operated by ORIF and 1 by MIPO.<strong> </strong>Delayed Union was found in two patients (4.54%) of distal femur fracture patients. Non-union with plate breakage and Non-union with plate loosening each were found in one patient (2.25%). Extension lapse was found in four patients (9.09%) of distal femur fracture and 1 patient (5.88%) of proximal tibia fracture.<strong></strong></p><p><strong>Conclusion:</strong> We concluded that MIPO technique was best.</p>

scholarly journals Novel technique of removal of broken intra-medullary nail from femur with secondary DCS plating

2021 ◽  
Vol 7 (5) ◽  
pp. 1039
Author(s):  
Neetin Pralhad Mahajan ◽  
Kartik Prashant Pande ◽  
Pramod K. Bagimani
Keyword(s):  
Femur Fracture ◽  
Weight Bearing ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Femur Shaft Fracture ◽  
Non Union ◽  
History Of ◽  
The Right ◽  
Femur Shaft ◽  
Subtrochanteric Femur Fracture

<p class="abstract">Femoral shaft fractures are one of the commonest fractures of the lower limb which are frequently operated with intramedullary nailing which enables immediate post-operative mobilization of the patient. There could be various causes of nail breakage – some of the notable being weight bearing over the non-union of the femur shaft, or a re-trauma over the operated limb causing both the implant and the nail to be broken. There are various methods of removal of the broken implant the commonest being the use of T-reamer technique. However not always can this be used due to varied intra-operative obstacles in different cases as described in this case below. We have a 35 year old male patient who was brought to us 2 hours after an alleged history of slip and fall following which he had sustained right sided subtrochanteric femur fracture with a broken implant – intramedullary interlock nail. The patient is a previously operated case of right sided femur shaft fracture with interlocking nailing done 15 years back. The patient was operated with – broken implant removal on the right side along with a secondary DCS plating with bone grafting for the subtrochanteric femur fracture. Intra operative period was met with a certain number of challenges and difficulties in view of a 15 year old implant for removal which was successfully with removed with DCS plating done. As is obvious with the above case, it would be quite imperative to say that older the implant, more difficult it becomes for its removal.  </p>

scholarly journals Management of intercondylar femur fracture with distal femur locking compression plate: outcome analysis of 72 cases

2020 ◽  
Vol 6 (5) ◽  
pp. 1022
Author(s):  
Nadeem Ashraf Khan ◽  
A. M. Atif ◽  
Abhinandan Chatterjee
Keyword(s):  
Range Of Motion ◽  
Distal Femur ◽  
Femur Fracture ◽  
Locking Compression Plate ◽  
Open Fractures ◽  
Knee Score ◽  
Compression Plate ◽  
Special Surgery ◽  
Closed Fractures ◽  
Hospital For Special Surgery

<p class="abstract"><strong>Background:</strong> Supra-condylar and inter-condylar fractures of the distal femur account for 7% of all femoral fractures and have always been difficult to treat and regaining full knee function is often difficult. The purpose of this study is to evaluate the functional outcome, fracture healing, complications of distal femoral intercondylar fractures managed by locking compression plate.</p><p class="abstract"><strong>Methods:</strong> Total 72 patients of intercondylar femur fracture were operated by ORIF with distal femur-locking compression plate via the standard swashbuckler approach.<strong> </strong>The functional outcomes were analyzed using modified hospital for special surgery scoring system.<strong></strong></p><p class="abstract"><strong>Results:</strong> Muller type C2 fracture was the most common fracture type with 50 out of 72 patients. The average range of motion achieved was about 99.03°±24.73° (Closed fractures =105.83°±19.41°and open fractures = 89.50°±28.36°). There was also a significant difference in the duration of operative time, 84.28±18.32 minutes for closed fractures and 98.46±22.47 minutes for open fractures. The average duration for radiological union was 14.52±2.21 weeks for closed and 17.20±2.44 weeks for open fractures. The average knee score was 80.13±13.38 using modified Hospital for Special Surgery score.</p><p class="abstract"><strong>Conclusions:</strong> Closed fractures have a higher range of motion and a better knee score compared to open fractures, supporting the fact that soft tissue compromise also affects range of motion and post-op rehabilitation of the limb. The outcome seems to correlate with the nature of injury i.e. high vs low velocity, type of fracture, anatomic reduction, associated injuries, time elapsed since injury to fixation and the stability of fixation.</p>

Decision making in the management of malunion and nonunion of intertrochanteric fractures of the hip

2019 ◽  
Vol 30 (6) ◽  
pp. 793-798 ◽  
Author(s):  
Kaushik Bhowmick ◽  
Thomas Matthai ◽  
Perumal Ramaswamy JVC Boopalan ◽  
Thilak S Jepegnanam
Keyword(s):  
Decision Making ◽  
Functional Outcomes ◽  
Intertrochanteric Fracture ◽  
Distal Femur ◽  
Femur Fracture ◽  
Intertrochanteric Fractures ◽  
Non Union ◽  
Shaft Angle ◽  
Head Shaft Angle

Aim: Intertrochanteric fractures account for almost 50% of hip fractures.Nonunion and malunion of these fractures are relatively uncommon. This study reviews the outcome of 31 cases of intertrochanteric fracture failures. An algorithm for the management of these injuries is also proposed. Methods: 19 patients with intertrochanteric malunion and 12 patients with non-union were included in this study. Treatment of these injuries was initiated according to the algorithm proposed in this study. Treatment outcomes were evaluated by assessing union, pre and postoperative shortening and HSA (head-shaft angle). Functional outcomes were assessed by the Parker mobility scale and presence or absence of pain. Results: All the patients with intertrochanteric malunion with follow-up had united. The postoperative shortening in all patients were ⩽2.5 cms. Patients having intertrochanteric nonunion with follow-up, who underwent internal fixation had united with an acceptable Parker mobility scale score, except in 1 patient who sustained an ipsilateral distal femur fracture. The average HSA correction obtained was 21° (range 3–60°). Conclusion: The algorithm proposed in this study helps streamline the treatment according to each case scenario.It helps in planning and managing patients with intertrochanteric fracture failures.

scholarly journals Is Distal Femur Locking Plate a Superior Implant in Distal Femur Fracture?

2015 ◽  
Vol 05 (09) ◽  
pp. 258-263 ◽  
Author(s):  
Anil Chander ◽  
Ganesan Ram Ganesan ◽  
Vignesh Jayabalan
Keyword(s):  
Distal Femur ◽  
Locking Plate ◽  
Femur Fracture ◽  
Distal Femur Fracture

scholarly journals A case of subtrochanteric femur fracture nonunion with failed implant in situ treated with exchange nailing using interlock nail and autologous bone grafting: a case report

2021 ◽  
Vol 7 (4) ◽  
pp. 864
Author(s):  
Neetin P. Mahajan ◽  
Pranay Kondewar ◽  
Lalkar Gadod ◽  
Amey Sadar ◽  
Shubham Atal
Keyword(s):  
Clinical Outcome ◽  
Bone Grafting ◽  
Femur Fracture ◽  
Good Clinical Outcome ◽  
Non Union ◽  
Autologous Bone Grafting ◽  
Exchange Nailing ◽  
Autologous Bone ◽  
Subtrochanteric Femur Fracture

<p class="abstract">Subtrochanteric femur fracture accounts for 25% of all hip fracture and may land up in non-union due to the inadequate reduction and fixation tech, local muscle pull over fragments, biomechanical stress in subtrochanteric region and soft tissue interposition etc., non-union are managed with various choices of implants like exchange nailing , angle blade plate , dynamic condylar screw, augmentation of previous hardware with plate and by providing biological environments at fracture site using  bone graft. Strict adherence to principles of providing stability to fracture and providing environment for bony growth gives good clinical outcome. A 52 years old male with subtrochanteric femur fracture was operated with long PFN, later presented to us after 18 months with failure of the hardware and atrophic non-union manifesting as pain during walking and limping. Patient was operated with removal of implant and exchange nailing using femur interlock nail and autologous bone grafting from iliac crest graft. 1 year follow up showed complete bony union and abundant of callus formation. Patient is currently doing all the daily activities and have no complaints at present. At 1 year follow up there is complete union at non-union site and good clinical outcome is achieved. Exchange nailing with interlock nail and autologous bone grafting for treatment of atrophic non-union of subtrochanteric femur fractures gives good clinical outcome.</p>

scholarly journals Pitfalls and Remedial Technique of Intramedullary Nail for Subtrochanteric Femur Fractures: A Case Series

2021 ◽  
Author(s):  
Botao Chen ◽  
Xiaohong Fan
Keyword(s):  
Internal Fixation ◽  
Intramedullary Nailing ◽  
Intramedullary Nail ◽  
Locking Plate ◽  
Case Series ◽  
Trochanteric Fracture ◽  
Subtrochanteric Fracture ◽  
Chinese Patients ◽  
Good Reduction ◽  
Subtrochanteric Fractures

Abstract Background: Intraoperative technical complications are occasionally encountered while implanting intramedullary nails for subtrochanteric fractures. Surgeons must pay attention to the pitfalls and remedial technique of this operation.Methods: We report on three cases in which intraoperative difficulties occurred during the implantation of an intramedullary nail among Han Chinese patients from mainland China. In Case 1, during an operation on a 57-year-old man, a seinsheimer type V in a right subtrochanteric fracture was not fully realized, and the dislocation of intertrochanteric fracture was aggravated after reduction of the subtrochanteric fracture. The intramedullary nail fixation was completed with the aid of an additional anterolateral plate. Case 2 involved a transverse subtrochanteric fracture. The surgeon neglected the coronal dislocation when considering good sagittal reduction. Although an auxiliary reduction device was used during the operation, there was unacceptable coronal dislocation after the intramedullary nail was inserted. A temporary anterolateral locking plate fixation was used to complete the intramedullary nail fixation. Case 3 involved an old trochanteric fracture combined with a new subtrochanteric fracture in an 81-year-old woman. After reducing the subtrochanteric fractures, the intramedullary nail fixation was successfully completed by releasing the poorly healed intertrochanteric fractures and fixing the anterior lateral plate.Results: With the development of techniques, reliable results can be obtained with fewer complications. Of the various internal fixation methods, we favor using a trochanteric start intramedullary nail.Conclusions: The treatment of subtrochanteric fractures presents challenges. Good reduction and reliable temporary fixation are key to completing the intramedullary nailing. If percutaneous joysticks, finger reduction tools, blocking screws, clamps, and Schanz pins cannot be used for effective auxiliary reduction or temporary reliable fixation, reduction after intramedullary nailing will not be satisfactory. The temporary addition of a reconstruction locking plate can achieve good reduction and temporary stability, and an extra reconstruction locking plate should be retained when the temporary fixation device is removed to reduce the risk of internal fixation failure during fracture healing.

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