scholarly journals Treatment of Proximal Femur Fractures on the Background of Osteoporosis

2004 ◽  
Vol 11 (1) ◽  
pp. 27-31 ◽  
Author(s):  
A F Lazarev ◽  
E I Solod ◽  
A O Ragozin ◽  
M G Kakabadze ◽  
A F Lazarev ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Femoral Neck Fractures ◽  
Mineral Density ◽  
Stable Fixation ◽  
Fracture Characteristics ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Choice Of Treatment ◽  
Density Evaluation

Analysis of treatment of 526 patients with proximal femur fractures (362 patients with femoral neck fractures and 164 patients with trochanteric zone fractures) was performed. Patients' age ranged from 34 to 92 (mean 67). Algorithm of differentiated choice of operative tactics depending on fracture characteristics and injury term was presented. Low invasive osteosynthesis of femoral neck with bundle of stressed V-shaped pins was suggested. Theoretical and practical ground of that technique was given. Stress within fixative-bone system created after osteosynthesis by V-shaped pins, provided stable fixation even in marked osteoporosis. The importance of bone mineral density evaluation for the choice of treatment tactics as well as the necessity of medicamental correction of the disturbed bone remodeling after surgical treatment was noted.

scholarly journals Outcomes of the proximal femur fractures repaired with half-pin devices as compared with various types of osteosynthesis

2021 ◽  
Vol 27 (2) ◽  
pp. 175-181
Author(s):  
F.B. Salokhiddinov ◽  
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Fixation Device ◽  
Group Iii ◽  
Proximal Femur Fractures ◽  
Bone Fixation ◽  
Femur Fractures ◽  
Group I ◽  
Pin Fixation ◽  
Poor Outcomes

Objective To review outcomes of the proximal femur fractures repaired with half-pin apparatus in comparison with various types of osteosynthesis. Material and methods The study enrolled 86 patients with proximal femur fractures treated at the general hospital of the Tashkent Medical Academy. Of these, 52 were females and 34 were males. The mean age of the participants was 54.1 ± 1.1 years (range, 22 to 92 years). The effectiveness of the treatment was evaluated depending on the treatment method used. The patients were divided into 3 groups: group I included 39 patients who underwent closed percutaneous osteosynthesis with Ilizarov wires; group II consisted of 29 patients who underwent osteosynthesis with bone plates; group III included 18 patients who underwent surgical treatment using the external half-pin fixator we developed. Results Outcomes were evaluated in 58 patients at one to two years. In group I, good results were rated as good obtained in 45.8% (n = 11), as fair in 33.3% (n = 8) and poor in 20.9 % (n = 5) of patients due to nonunited fracture, avascular necrosis of the femoral head and hip joint ankylosis. Group II showed 68.4 % (n = 12) good, 4 (21 % (n = 4) fair and 10.5 % (n = 2) poor results. The latter occurred due to patient noncompliance and unauthorized early removal of the plaster cast. Group III demonstrated 73.4 % (n = 11) good, 13.3% (n = 2) fair and 13.3 % (n = 2) poor outcomes. Patients with poor outcomes developed lesion of the femoral neck following a subcapital femoral neck fracture at 2 months of frame removal that healed with a 2.0 cm limb length discrepancy. Conclusion The external half-pin fixator offered could facilitate stable bone fixation after reduction and gradual dynamic compression for successful bone healing. The bone fixation period with external half-pin fixation device was dependent on the fracture type and averaged to 4 ± 1 months in type A fracture and 5 ± 1 months in type B fractures. Fixation of the proximal femur fractures with half-pin fixation device allows stabilization of the general state of patients, easier postoperative care, prevention of secondary complications and early exercises for the adjacent joints. The technique offered can be a method of choice among the current technologies.

Femoral Neck Shaft Angle and Management of Proximal Femur Fractures

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Miranda J. Rogers ◽  
Taylor L. King ◽  
Jaewhan Kim ◽  
Temitope F. Adeyemi ◽  
Thomas F. Higgins ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Neck Shaft Angle ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Shaft Angle

A-mode Ultrasound Analysis of Postoperative Thigh Edema in Patients with Hip Fracture

2017 ◽  
Vol 54 (3) ◽  
pp. 553-556 ◽  
Author(s):  
Horia Haragus ◽  
Radu Prejbeanu ◽  
Bogdan Timar ◽  
Dinu Vermesan
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Body Mass ◽  
Proximal Femur ◽  
Muscle Layer ◽  
Superficial Layer ◽  
Thigh Circumference ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Significant Difference

Postoperative edema and lean body mass may contribute to functional outcome in frailty hip fracture patients. Advances in body mass determination have produced consistent results with A-mode ultrasound. We therefore aimed to determine the utility of A-mode ultrasound in analyzing postoperative limb edema in patients receiving treatment for proximal femur fractures. 4 males and 6 females, with an average age of 74.3 years were included. 4 had fractures of the femoral neck treated by hemiarthroplasty and the rest had extracapsular fractures which were stabilized with short intramedullary nails. Measurements were done using a commercially available A-mode 2.5MHz transducer on the thighs approximately 15 cm proximal to the patella. Comparison showed significant difference between the operated and contralateral thigh circumference (P=0.001) as well as muscle layer thickness differences between femoral neck patients and those with fractures of the trochanteric region (P=0.016). There was no correlation between the A-mode ultrasound determined superficial layer difference and entire layer difference (R2=0.037; P=0.59). However, there was linear correlation between the A-mode ultrasound determined entire layer difference and limb circumference difference, (R2=0.414; P=0.044). Postoperative thigh edema is present in all surgically treated patients for proximal femur fractures. A-mode ultrasound might be a reliable tool to examine adipose and muscle layers separately in the immediate postoperative period. There may be a difference in edema distribution between femoral neck and peritrochanteric fractures but larger samples are required.

scholarly journals The PFNA® Augmented in Revision Surgery of Proximal Femur Fractures

2014 ◽  
Vol 8 (1) ◽  
pp. 232-236 ◽  
Author(s):  
Alexander Scola ◽  
Florian Gebhard ◽  
Christoph Dehner ◽  
Götz Röderer
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Revision Surgery ◽  
Cement Leakage ◽  
Clinical Results ◽  
Proximal Femur Fracture ◽  
Bone Stock ◽  
Proximal Femur Fractures ◽  
Femur Fractures

Objectives: Modern implants for proximal femur fracture treatment have clearly improved clinical results. However, complications, including cut-out and loss of reduction, requiring revision surgery still occur. A major challenge in these cases is a loss of bone stock due to the existing implant, which is usually exacerbated by osteoporosis. A potential solution is the augmentation of implants, for example, of the femoral neck blade using bone cement. Materials and Methods: Ten patients (five loosening of femoral neck implant, two pseudarthrosis, two implant failures and one acute fracture) were included. The initial hardware was removed and a PFNA augmented was implanted. The perforated femoral neck blade was augmented using polymethyl methacrylate cement. Clinical and radiological follow-up was performed at a mean of 5.4 months (SD ±4.34). The main outcome parameters were fracture healing and implant-related complications. Results: Technical handling was uneventful in all cases. No cement leakage into the joint occurred in any of the cases. The mean amount of cement injected was 5.3 ml. The fracture healed during follow-up in all cases except two patients who died from causes unrelated to the procedure and prior to complete consolidation. Problem-free elective hardware removal of the PFNA augmented was performed in two cases. Discussion: The PFNA augmented is a potential implant for joint-preserving revision surgery in proximal femur fractures. The augmentation improves implant anchorage in the impaired bone stock. In this preliminary series, no negative biological side effects of the cement (i.e. osteonecrosis) were observed.

Bone-Plastic Reconstruction of Proximal Femur in Patients with Femoral Neck Fractures and Pseudarthroses

2009 ◽  
Vol 16 (4) ◽  
pp. 23-28
Author(s):  
Valentina Afanas'evna Kopysova ◽  
V A Kaplun ◽  
V Z Gorodilov ◽  
A A Kutkov ◽  
I V Kaplun ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Dynamic Compression ◽  
Femoral Neck Fractures ◽  
Treatment Technique ◽  
Intervention Efficacy ◽  
Rehabilitation Potential ◽  
Choice Of Treatment ◽  
Bone Fragments ◽  
Reconstructive Plastic

Rehabilitation potential of medializing valgus osteotomy with formation of bone lock by Konforti-Ivanov and reconstructive bone-plastic operation by Luck was studied in 122 patients with femoral neck fractures and pseudarthroses. The guarantee of surgical intervention efficacy is differentiated approach to the choice of treatment technique with due regard for the peculiarities of proximal femur injuries, stable functional osteosynthesis in combination with dynamic compression of bone fragments by tightening bows with shape memory effect. Good treatment results with long lasting functional effect achieved in 104 (89.7%) patients allowed to recommend using organ saving reconstructive plastic operations as an alternative to joint replacement in patients without presence of coxarthrosis and pathologic femoral head transformation.

scholarly journals Остеосинтез у разі переломів шийки та вертлюгової зони стегнової кістки в дітей

2021 ◽  
pp. 10-16
Author(s):  
Olexii Popsuishapka ◽  
Serhii Dovhan ◽  
Oleksandr Khomyak
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Weight Bearing ◽  
Bone Destruction ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Fractures In Children ◽  
Fracture Consolidation ◽  
Tissue Reactions ◽  
Partial Weight

Proximal femur fractures are uncommon injuries in children, accounting for less than 1 % of all fractures per year, but usually result in hospitalization and are at risk of complications. We have designed a device for bone fragments fixation in the case of proximal femur fractures and the method of its application in adults. The device consists of rods that are screwed into the cap of the head, the diaphyseal part and the module, which is located in the subtrochanter area. The rods can be connected to the module at any angle in the frontal plane.  The device provides a certain stage of installation of the elements, which allows you to effectively place it with minimal bone destruction. Objective. Share your own experience in the treatment of femoral neck and proximal femur fractures in children. Material. The experience of treatment of 28 children with femoral neck fracture or proximal femur fractures for the period 2005–2020 is presented, 11 of them were treated conservatively with the skeletal traction. Osteosynthesis by the author’s device was performed in 17 patients: 15 closed reduction, 2 in case of intertrochanteric fracture, — open reduction. The method of osteosynthesis and postoperative management of patients is described in detail. Results. In children who were treated conservatively, the fracture consolidation was achieved within 5–7 months, in one of them — in the position of varus deformity. In contrast to conservative treatment, children began to walk with crutches after a few days after surgery, with partial weight-bearing on injured limb. The device was removed in 16 patients after 5–8 months, and complete fracture consolidation of the fragments in their anatomical position was noted. There were no pathological tissue reactions to the metal device. Conclusions. The proposed device and method of closed osteosynthesis with its usage in the case of proximal femur and femoral neck fractures in children can be recommended in the practice of pediatric traumatology.

scholarly journals The Interdependence of Medical-Epidemiological and Anamnestic Characteristics of Patients with Proximal Femur Fractures

2020 ◽  
Vol 5 (5) ◽  
pp. 105-117
Author(s):  
T. S. Hurbanova ◽  
◽  
Keyword(s):  
Functional Status ◽  
Functional State ◽  
Proximal Femur ◽  
Functional Condition ◽  
Weak Correlation ◽  
Proximal Femur Fractures ◽  
Asa Classification ◽  
Femur Fractures ◽  
Choice Of Treatment ◽  
One Year

Many studies have confirmed that the incidence of fractures of the proximal femur increases significantly with age and doubles every ten years after the age of 50. It was found out that these patients average age increases by one year every five years, and more than 50.00% with damage to this location are over 60 years old. The purpose of the study was to determine the regional correlation features of the interdependence of medical-epidemiological and anamnestic characteristics of patients with proximal femur fractures. Material and methods. To achieve the main goal, we conducted a retrospective study of patients with such fractures according to seven medical institutions in Kharkiv. Results and discussion. When studying the correlation levels of interdependence between various medical-epidemiological and anamnestic characteristics of the examined patients we stated that the female sex correlated with all age periods, which confirmed the predominance of females among the examined all age categories: the sex of patients determined reliable (average <0.001); forces correlation with age characteristics: k = 0.349; the possible influence of gender characteristics on the choice of treatment tactics was stated reliable (p = 0.003); the inverse weak correlation with the type of treatment was recorded: k = -0.041; the possibilities of the influence of age characteristics on comorbid burden; the presence of concomitant pathology and the choice of treatment tactics were clarified: it was determined that the age of the examined patients was significantly (p = 0.014) inversely weakly correlated with the presence of comorbidities and comorbid burden (respectively k = -0.050 (p < 0.001) and k = -0.047 (p <0.001)) and the type of treatment: k = -0.193 (p <0.001); possibilities of influence of more significant comorbid burden on indicators of levels of functional condition and increase in duration of terms of receipt to traumatological departments and reception of qualitative medical care were established: reliable (p <0.001) direct weak correlation was received between indicators of age of trauma and presence of concomitant diseases k = 0.081), comorbid load (k = 0.087) and functional state according to the ASA classification (k = 0.084); determined the stable effect of the existing concomitant pathology and comorbid burden at the level of functional status and its possible impact on using conservative treatment: the presence of comorbidities correlated strongly with comorbid burden (k = 0.989, p <0.001); functional state was evaluated according to ASA classification k = 0.985, p <0.001) and directly weak with the type of treatment (k = 0.228, p <0.001); a direct strong correlation was found between the comorbid burden and functional status according to the ASA classification and the type of treatment performed (respectively k = 0.979 and k = 0.226; p <0.001); the possible influence of low functional state on the choice of treatment tactics was stated: it was proved that the functional state significantly weakly correlated with the type of treatment: k = 0.229, p <0.001. Further research is planned to establish the possibility of predicting the use of treatment tactics and the development of reliable prognostic statistical models of the dependence of the results of different treatment methods on the medical-epidemiological and anamnestic characteristics of patients

scholarly journals Geriatric Proximal Femur Fractures During the Covid-19 Pandemic - Fewer Cases, But More Comorbidities

2021 ◽  
Vol 12 ◽  
pp. 215145932110096
Author(s):  
Christina Polan ◽  
Heinz-Lothar Meyer ◽  
Manuel Burggraf ◽  
Monika Herten ◽  
Paula Beck ◽  
...  
Keyword(s):  
Nursing Home ◽  
Elderly Patients ◽  
Proximal Femur ◽  
Minor Trauma ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Number Of Patients ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Background: The COVID-19 pandemic is challenging healthcare systems worldwide. This study examines geriatric patients with proximal femur fractures during the COVID-19 pandemic, shifts in secondary disease profile, the impact of the pandemic on hospitalization and further treatment. Methods: In a retrospective monocentric study, geriatric proximal femur fractures treated in the first six months of 2020 were analyzed and compared with the same period of 2019. Pre-traumatic status (living in a care home, under supervision of a legal guardian), type of trauma, accident mechanism, geriatric risk factors, associated comorbidities, time between hospitalization and surgery, inpatient time and post-operative further treatment of 2 groups of patients, aged 65-80 years (Group 1) and 80+ years (Group 2) were investigated. Results: The total number of patients decreased (70 in 2019 vs. 58 in 2020), mostly in Group 1 (25 vs. 16) while the numbers in Group 2 remained almost constant (45 vs. 42). The percentage of patients with pre-existing neurological conditions rose in 2020. This corresponded to an increase in patients under legal supervision (29.3%) and receiving pre-traumatic care in a nursing home (14.7%). Fractures were mostly caused by minor trauma in a home environment. In 2020, total number of inpatient days for Group 2 was lower compared to Group 1 (p = 0.008). Further care differed between the years: fewer Group 1 patients were discharged to geriatric therapy (69.6% vs. 25.0%), whereas in Group 2 the number of patients discharged to a nursing home increased. Conclusions: Falling by elderly patients is correlated to geriatric comorbidities, consequently there was no change in the case numbers in this age group. Strategic measures to avoid COVID-19 infection in hospital setting could include reducing the length of hospital stays by transferring elderly patients to a nursing home as soon as possible and discharging independent, mobile patients to return home.

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