scholarly journals A combfejcsavar helyzetének prognosztikai jelentősége a csípőtáji törések esetén

2019 ◽  
Vol 160 (9) ◽  
pp. 338-342
Author(s):  
Ákos Csonka ◽  
Tamás Ecseri ◽  
Dávid Dózsai ◽  
István Csonka ◽  
István Gárgyán ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Hip Fracture ◽  
Femoral Neck ◽  
Reduction Method ◽  
Intramedullary Nails ◽  
Pertrochanteric Fractures ◽  
Hip Screw ◽  
Index Value ◽  
Gamma3 Nail

Abstract: Introduction: In our study, we analyzed one of the Hungarian population’s most frequent injuries, the hip fracture, focusing mainly on the lateral femoral neck and the pertrochanteric fractures. According to the classification of the Swiss Association for Ostheosynthesis (AO), we focused on 31–A1 and 31–A2 fractures, the incidence of which increases by ageing. Method: Between 2010 and 2016, we analyzed the data of 1179 patients. All of the fractures were stabilized with intramedullary nails. 992 patients received Stryker Gamma3®, whereas 187 patients’ fractures were solved with Synthes PFNA® nail. In all cases, closed reduction method was used with fluoroscopy on an extension table. The surgeries were done in general or epidural anesthesia and performed by traumatology residents or specialists using standard lateral exploration. Data were collected using GEPACS software and statistical analysis was done with MS Excel. Results: Cut-out occurred in 33 cases (2,79%): out of that 21 (1.78%) were left sided and 12 were (1,01%) right sided. 29 (87.87%) patients were treated with Gamma3 nail, and in 4 (12,12%) cases PFNA nail was used. The average TAD-index was 18 mm. Conclusion: According to recommendations of the TAD-index value, when using dynamic hip screw, it should be 20 mm or lower. The average index value was 18 mm which was equal in the complicated and non-complicated groups. Our study shows that the cut-out is independent from the TAD-index value, thus this recommendation cannot be applied for intramedullary nails. Orv Hetil. 2019; 160(9): 338–342.

scholarly journals Sub-Classification of AO/OTA-2018 Pertrochanteric Fractures Is Associated With Clinical Outcomes After Fixation of Intramedullary Nails

2021 ◽  
Vol 12 ◽  
pp. 215145932110567
Author(s):  
Hui Song ◽  
Sun-Jun Hu ◽  
Shou-Chao Du ◽  
Wen-Feng Xiong ◽  
Shi-Min Chang
Keyword(s):  
Blood Loss ◽  
Lateral Wall ◽  
Occurrence Rate ◽  
Lateral Migration ◽  
Intramedullary Nails ◽  
Pertrochanteric Fractures ◽  
Neck Shaft Angle ◽  
The Status ◽  
Varus Displacement

Background The new edited AO/OTA-2018 classification of pertrochanteric fractures was revised and no longer based on the status of lesser trochanter. This paper aimed to explore the clinical and technical outcomes among the subgroups (31A1 and 31A2) of the new classification treated with cephalomedullary nails. Methods A retrospective research of 154 patients diagnosed with pertrochanteric fractures (AO/OTA-2018 31A1.2/3 and 31A2.1/2/3) treated with intramedullary nails was conducted. The baseline data and outcomes were compared among the subgroups. The outcomes included tip-apex distance (TAD), Cal-TAD, Parker ratio, neck shaft angle (NSA), blood loss, varus displacement, and over lateral sliding rate of the blade. Results There were 154 cases involving 48 males and 106 females. The average age was higher in the sub-classifications of A2.2 and A2.3 than A1.2. Furthermore, the subgroups of A2.2 and A2.3 presented inferior outcomes with regard to blood loss and reduction quality score than A1.2 and A1.3. The subgroup of A2.3 was further poor with respect to calcar fracture gapping in the anteroposterior view and excessive lateral migration occurrence rate than A1.2. Conclusions Complex pertrochanteric fractures indicated inferior outcomes compared to simple sub-classifications, which might lead by the incompetent of lateral wall and instability of the fracture. The newly proposed AO/OTA-2018 classification was conductive to forecast the prognosis.

HIP FRACTURES IN 5 YEARS AT HUE UNIVERSITY HOSPITAL

2014 ◽  
pp. 47-50
Author(s):  
Duy Binh Ho ◽  
Nghi Thanh Nhan Le ◽  
Maasalu Katre ◽  
Koks Sulev ◽  
Märtson Aare
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Hip Fractures ◽  
Age Groups ◽  
Femoral Fractures ◽  
Femoral Neck Fractures ◽  
University Hospital ◽  
High Risk Population ◽  
Intertrochanteric Fractures ◽  
Significant Difference

Aim: This study aimed to review the clinical findings and surgical intervention of the hip fracture at the Hue University Hospital in Vietnam. Methods:The data of proximal femoral fractures was collected retrospectively. All patients, in a period of 5 years, from Jan 2008 to December 2012, suffered either from intertrochanteric or femoral neck fractures. The numbers of patients were gathered separately for each year, by age groups (under 40, 40-49, 50-59, 60-69, 70-79, older) and by sex. We analyzed what kind of treatment options were used for the hip fracture. Results:Of 224 patients (93 men and 131 women) studied, 71% patients are over 70 years old, 103 women and 56 men (p<0.05). For patients under 40 years, there were 1 woman and 11 men (p<0.05). There were 88 intertrochanteric and 136 femoral neck fractures. There was no significant difference in the two fractures between men and women. The numbers of hip fracture increased by each year, 29/224 cases in 2010, 63/224 cases in 2011, 76/224 cases in 2012. Treatment of 88 intertrochanteric fractures: 49 cases (55.7%) of dynamic hip screw (DHS), 14 cases of hemiarthroplasty (15.9%), 2 cases of total hip replacement (2.3%). Treatment of 136 femoral neck fractures: 48 cases of total replacement (35.3%), 43 cases of hemiarthroplasty (31.6%), 15 cases of screwing (11%). In cases of 40 patients (17.9%) hip fracture was managed conservatively, 23 were femoral neck fractures and 17 were intertrochanteric fractures. Conclusions: Hip fracture is growing challenge in Hue medical university hospital. The conservative approach is still high in people who could not be operable due to severe medical conditions as well as for patients with economic difficulties. Over 70% of the hip fractures in people 70+ are caused by osteoporosis. The number of hip fracture is increasing in the following years, most likely due to the increase in the prevalence of osteoporosis. Early detection and prevention of osteoporosis should be addressed, particularly in high risk population. More aggressive surgical approach should be implemented in order to improve the quality of life in patients with hip fractures. Key words:Hip fracture.

scholarly journals Hip geometry in hip fracture patients in Greenland occurring over a 7.7-year period

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Inuuteq Fleischer ◽  
Mogens Laursen ◽  
Stig Andersen
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Cortical Thickness ◽  
Geometric Analysis ◽  
Osteoporotic Fractures ◽  
Premature Death ◽  
Neck Length ◽  
Hip Geometry ◽  
Lesser Trochanter

Abstract Background Hip geometry influences hip fracture risk. Hip fractures are common, and they are associated with pain, disability, premature death and marked costs on society. Osteoporotic fractures are frequent in Arctic populations and increase with advancing age in this society with a steep rise in life expectancy. Greenland Inuit is a distinct ethnic group, and data on hip geometry is missing. We thus aimed to describe hip geometry in 7.7 years of consecutive hip fracture patients in Greenland. Methods We evaluated collodiaphysial angle, femoral neck length, the outer and inner diameter of the femur at 2 and 5 centimetres below the centre of the lesser trochanter and the cortical thickness from pelvic and hip radiographs in all patients operated in Greenland over 7.7 years. We included all 84 patients with one non-fractured hip visible for geometric analysis. Analyses were conducted in duplicate. Results We found a collodiaphysial angle of 134.8/132.6o in men/women (p = 0.06) and a femoral neck length of 38.0/33.9 mm in men/women (p = 0.001). Cortical thickness was affected by sex in the adjusted analysis (p < 0.001). Cortical thickness index at 5 cm below the centre of the lesser trochanter decreased with age (p = 0.026) and may be influenced by height (2 cm below the centre of the lesser trochanter, p = 0.053). Conclusion Our findings differed from European data and suggest a delicate balance in hip geometry in Arctic populations. Ethnic peculiarities influence the structure of the hip and may influence fracture risk. A focus on hip geometry and risk factors for osteoporotic fractures in Arctic populations is warranted.

scholarly journals Treatment of the Femoral Neck Fracture Using a Compression Hip Screw

1980 ◽  
Vol 29 (1) ◽  
pp. 1-4
Author(s):  
K. Ohno ◽  
J. Tokunaga ◽  
H. Ueno ◽  
A. Kobayashi ◽  
K. Fukumoto ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Neck Fracture ◽  
Hip Screw

scholarly journals Breakage of sliding hip screw after fixation of pertrochanteric hip fracture: A rare complication

2021 ◽  
pp. 106226
Author(s):  
Ali Hassan Chamseddine ◽  
Abbas A. Dib ◽  
Hassan M. Wardani ◽  
Mohammad O. Boushnak
Keyword(s):  
Hip Fracture ◽  
Rare Complication ◽  
Sliding Hip Screw ◽  
Hip Screw

scholarly journals Design and biomechanical study of slide-poking external fixator for hip fracture

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052095093
Author(s):  
Hua-Biao Chen ◽  
Hong-Bo Wu ◽  
Min Chen ◽  
Yu-Liang Huang
Keyword(s):  
Hip Fracture ◽  
Femoral Head ◽  
Hip Fractures ◽  
External Fixator ◽  
Dynamic Hip Screw ◽  
Control Groups ◽  
Vertical Loading ◽  
Hip Screw ◽  
The Mean ◽  
And Control

Background Femoral head collapse and coxa vara lead to internal fixator failure in elderly patients with hip fracture. External fixator application is an optimal choice; however, the existing methods have many disadvantages. Methods Type 31-A1.3 hip fracture models were developed in nine pairs of 1-year-old fresh bovine corpse femur specimens. Each left femur specimen was fixed by a dynamic hip screw (control group), and each right femur specimen was fixed by the slide-poking external fixator (experimental group). Vertical loading and torsion tests were then performed in both groups. Results In the vertical loading experiment, a 1000-N load was implemented. The mean vertical downward displacement of the femoral head in the experimental and control groups was 1.49322 ± 0.116280 and 2.13656 ± 0.166374 mm, respectively. In the torsion experiment, when the torsion was increased to 10.0 Nm, the mean torsion angle in the experimental and control groups was 7.9733° ± 1.65704° and 15.4889° ± 0.73228°, respectively. The slide-poking external fixator was significantly more resistant to compression and rotation than the dynamic hip screw. Conclusion The slide-poking external fixator for hip fractures that was designed and developed in this study can provide sufficient stability to resist compression and rotation in hip fractures.

scholarly journals Hip fractures among the elderly in Kyoto, Japan: a 10-year study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Maki Asada ◽  
Motoyuki Horii ◽  
Kazuya Ikoma ◽  
Tsuyoshi Goto ◽  
Naoki Okubo ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Incidence Rate ◽  
Acute Care ◽  
Hip Fractures ◽  
Age Groups ◽  
The Elderly ◽  
Femoral Neck Fractures ◽  
Age Group ◽  
Trochanteric Fractures

Abstract Summary In Kyoto Prefecture, Japan, the number of hip fractures increased during 2013–2017 compared to 2008–2012. However, the estimated overall incidence rate increased only in femoral neck fractures in men aged ≥75 and women aged ≥85. Purpose The incidence rate of hip fractures in Japan has plateaued or decreased. We investigated the annual hip fracture occurrences in Kyoto Prefecture, Japan, from 2008 to 2017. Methods Patients aged 65 years and above who sustained hip fractures between 2008 and 2017 and were treated at one of the participating 11 hospitals were included. The total number of beds in these institutions was 3701, accounting for 21.5% of the 17,242 acute-care beds in Kyoto Prefecture. The change in incidence rate was estimated utilizing the population according to the national census conducted in 2010 and 2015. Results The total number of hip fractures was 10,060, with 47.5% femoral neck fractures and 52.5% trochanteric fractures. A decrease in number was seen only in trochanteric fractures in the group of 75- to 84-year-old women. The population-adjusted numbers of femoral neck fractures showed a significant increase in all age groups in men, whereas in women, there was an increase in femoral neck fractures in the ≥85 group and trochanteric fractures in the age group 65–74, and a decrease in trochanteric fractures in the age group 75–84. The estimated change in incidence rate showed an increase in femoral neck fractures in men aged ≥75 and women aged ≥85. Conclusion In Kyoto Prefecture, the number of hip fractures increased in the second half of the study period (2013–2017) compared to the first half (2008–2012). However, the incidence rate had not increased, except in femoral neck fractures in men aged ≥75 and women aged ≥85.

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