scholarly journals Fracture neck of femur treated with hemiarthroplasty and cannulated cancellous screw fixation: a comparative study

2017 ◽  
Vol 3 (4) ◽  
pp. 849
Author(s):  
S. K. Rai ◽  
Rohit Vikas ◽  
Vyom Sharma ◽  
S. S. Wani ◽  
Rohit Varma
Keyword(s):  
Fracture Fixation ◽  
Screw Fixation ◽  
Type I ◽  
Age Group ◽  
Cancellous Screw ◽  
Neck Of Femur ◽  
Non Union ◽  
Fracture Neck Of Femur ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Intracapsular fracture neck of femur has always presented great challenges to every Orthopaedic surgeons and it is remain a mystery whether to fix or to replace the fracture in the elderly. The aim of the study was to analyze the functional outcome of two widely used and accepted modalities of treatment in the age group 57-75 years, in Garden’s type I and II fractures, namely (a) cannulated cancellous screw fixation(internal fixation) and (b) modular bipolar prosthetic replacement of the femoral head (hemiarthroplasty).</p><p class="abstract"><strong>Methods:</strong> The total 110 patients were including in the study from age groups 57-75 (mean age 66). The Garden classification of fracture neck of femur was used to evaluate the displacement of femoral neck fractures. Only grade 1 and 2 was included in the study. 55 patients were included in each group A and B. Osteosynthesis (fracture fixation) was carried out by closed reduction and insertion of cannulated cancellous screw and in other group hemiarthroplasty was done.<strong></strong></p><p class="abstract"><strong>Results:</strong> In group A 55 patient with fracture neck of femur was treated by osteosynthesis i.e. fixation using 02 or 03 cannulated cancellous screw and in group B, 55 patients with fracture neck of femur was treated by modular bipolar replacement hemiarthroplasty. In Group A out of 55, 41 patients union was achieved between 08 to 14 months (mean 11.5 month), 09 patients developed non-union even after 16 months and 05 patients develop collapse of head with AVN with shortening at end of 02 year, however in Group B out of 55 patients 51 patients started walking after 2<sup>nd</sup> postoperative days, 02 patients developed infection, and 02 patients developed posterior dislocation.</p><p><strong>Conclusions:</strong> The fracture fixation may be tempting for fracture neck femur in age group 57-75 especially of Garden Type I but internal fixation put risk of non-union and AVN and second surgery may be required after few months or years  if patients survive. Based on results in our study we therefore can conclude that in Garden Type I and II femur neck fractures in the patients between 57-75 years of age, hemiarthroplasty is the better modality of treatment.</p>

Cannulated cancellous screws fixation in intracapsular fracture neck femur: a study with an emphasis on result of osteosynthesis

2016 ◽  
Vol 2 (3) ◽  
pp. 180
Author(s):  
Varun Vijay ◽  
Naveen Srivastava
Keyword(s):  
Scoring System ◽  
Screw Fixation ◽  
Fracture Site ◽  
Cancellous Screw ◽  
Intracapsular Fracture ◽  
Neck Of Femur ◽  
Non Union ◽  
Fracture Neck Of Femur ◽  
Post Surgery ◽  
Fracture Neck Femur

<p class="abstract"><strong>Background:</strong> Fracture neck of femur has always presented a great challenge to the orthopaedic surgeons. It is rightly called as “unsolved fracture” as far as treatment and results are concerned. Results generally depend upon time period elapsed from fracture to surgery, adequacy of reduction and fixation. Fixation with cannulated cancellous screw is usually adequate for femoral neck fractures. The aim of the study was to analyse the results of treatment of fracture neck of femur with cannulated cancellous screw fixation and to compare the results with others in the literature using the same modality.  </p><p class="abstract"><strong>Methods:</strong> 25 patients with intra capsular neck of femur fracture were followed for a period of two years post-surgery and their functional outcome was assessed based upon harris hip scoring system.<strong></strong></p><p class="abstract"><strong>Results:</strong> According to harris hip scoring system, we had excellent results in 72% cases, good in 16% cases, fair in 8% and poor in 4%. One patient went into non-union and two developed avascular necrosis of femoral head.</p><p><strong>Conclusions:</strong> Management of intracapsular fracture neck of femur with cannulated cancellous screw fixation is a very good method of treatment being a surgically easy procedure. Use of multiple cannulated cancellous screw have a compression effect at the fracture site. It also avoids re displacement and rotation.</p>

WITH REGARDS TO THE CLINICO-FUNCTIONAL OUTCOMES, IN BETWEEN FQPP OR BDSF TECHNIQUE, WHICH IS SUPERIOR, AS A CANCELLOUS SCREW FIXATION OPTION, FOR FRACTURE NECK OF FEMUR.

2021 ◽  
pp. 53-56
Author(s):  
Vijayaselvan S ◽  
Venkatachalam K
Keyword(s):  
Femoral Head ◽  
Screw Fixation ◽  
Harris Hip Score ◽  
Cancellous Screw ◽  
Neck Of Femur ◽  
Double Support ◽  
Fracture Neck Of Femur ◽  
Classi Cation ◽  
Poor Outcomes ◽  
Four Quadrant

Fracture Neck of Femur are common and one among the most challenging Orthopaedic trauma cases. Many a factors like age, time elapsed after occurrence of injury, presence of other musculo-skeletal trauma and presence of other co-morbid conditions, are all to be taken into account, before embarking on any surgical intervention. Given the precarious blood supply of the femoral head, AVN of the femoral head is a signicant complication in the displaced fractures. Among the various classication systems available, the Garden classication is still in vogue, as highlighted by Guyton J.L et al; (1). The purpose of this prospective study, is to establish the superiority or otherwise of the 'Four Quadrant Peripheral Parallel (FQPP) Screw Fixation” technique, over the “Biplanar Double Support Screw Fixation (BDSF)” technique, when opting for multiple percutaneous cancellous screw xation, for fracture neck of femur. The age group in our study included patients from 26 years to 55 years and had a total of 18 patients, who were recruited in between March 2018 to February 2020. Of these 18 patients, 9 patients were treated by the FQPP technique and another 9 patients by the BDSF technique. All cases were followed-up for at least 1 year (range: 12 to 35 months, mean 18 months). Evaluation was done by Harris Hip Score (HHS) (2). In the FQPP group, 55.56% (n=5) patients had good to excellent results, 22.22% (n=2) patients had fair and 22.22% (n=2) patients had poor outcomes. In the BDSF group 66.67% (n=6) patients had good to excellent results, 22.22% (n=2) patients had fair and 11.11% (n=1) patient had poor outcome. Thus, the results were only just marginally better for the BDSF group, in comparison to the FQPP group and hence, no substantial deductions could be made favoring the superiority of one xation type over the other.

scholarly journals Outcome of management of intracapsular fracture neck of femur in young adult patients

2020 ◽  
Vol 8 (12) ◽  
pp. 4456
Author(s):  
Sakib Arfee ◽  
Asma Jabeen ◽  
Akib Arfee ◽  
Adnan Aadil Arfee
Keyword(s):  
Young Adult ◽  
Adult Patients ◽  
Intracapsular Fracture ◽  
Neck Of Femur ◽  
Medical College ◽  
Fracture Neck Of Femur ◽  
High Incidence ◽  
Group A ◽  
Group B

Background: Almost four centuries back fracture neck of femur was described, but till today this fracture is unsolved, though situation has largely improved from the days of Sir Astley Cooper, who had said “I have never met one in whom union had taken place”. High incidence of complications with this fracture even in modern day show that we still have not found way to treat this fracture appropriately and its treatment remains a challenging problem. The objective of the study was to assess the final outcome of management of intracapsular fracture neck of femur in young adult patients after internal fixation.Methods: This study has been conducted at Orthopedic Department of Government Medical College and hospital, Jammu from 2018 to 2020. 30 young adult patients with fractures neck of femur treated with CCS (27 patients) and DHS (3 patients) after taking informed consent were selected for the study.Results: 30 young adult patients in age group of 18-60 years, constituted this study. 27 patients were treated with closed reduction and internal fixation with CCS (group A) and 3 patients were treated with DHS (group B). 3 patients were lost to the follow up, all of them from group A.Conclusions: DHS appears to be more forgiving implant than CCS in fracture neck of femur in young adult patients. However number in this group is very small and hence larger studies are needed. In fixation with CCS anatomical reduction of fracture, proper screw placement is the most important criterion for achieving better results.

scholarly journals Cannulated cancellous screw fixation in fracture neck of femur in children

2018 ◽  
Vol 4 (3.4) ◽  
pp. 436-438
Author(s):  
Dr. Surendra Singh Yadav ◽  
Dr. Prashant Patel ◽  
Dr. Shailendra Chauhan ◽  
Dr. Gaurav Rai ◽  
Dr. Shailendra Bhavel
Keyword(s):  
Screw Fixation ◽  
Cancellous Screw ◽  
Neck Of Femur ◽  
Fracture Neck Of Femur

Comparative Study of effectiveness of mobilization with movement (MWM) and End range mobilization (ERM) techniques in frozen shoulder

2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Type I ◽  
Mean Values ◽  
Functional Activities ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.

Echocardiographic Evaluation of Cardiac Remodeling After Surgical Closure of Ventricular Septal Defect in Different Age Group

2017 ◽  
Vol 2 (2) ◽  
pp. 69-74
Author(s):  
Mohammad Aminullah ◽  
Fahmida Akter Rima ◽  
Asraful Hoque ◽  
Mokhlesur Rahman Sazal ◽  
Prodip Biswas ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Ejection Fraction ◽  
Cardiac Remodeling ◽  
Septal Defect ◽  
Left Ventricular ◽  
Age Group ◽  
Surgical Closure ◽  
Group A ◽  
Group B ◽  
Fractional Shortening

Background: Cardiac remodeling is important issue after surgical closure of ventricular septal defect.Objective: The purpose of the present study was to evaluate cardiac remodeling by echocardiography by measuring the ejection fraction, fractional shortening, left ventricular internal diameter during diastole (LVIDd) and left ventricular internal diameter during systole (LVIDs) after surgical closure of ventricular septal defect in different age group. Methodology: This prospective cohort studies was conducted in the Department of Cardiac Surgery at National Institute of Cardiovascular Disease (NICVD), Dhaka. Patient with surgical closure of VSD were enrolled into this study purposively and were divided into 3 groups according to the age. In group A (n=10), patients were within the age group of 2.0 to 6.0 years; age of group B (n=8) patients were 6.1-18.0 years and the group C (n=6) aged range was 18.1-42.0 years. Echocardiographic variables such as ejection fraction, fractional shortening, LVIDd, LVIDs were taken preoperatively and at 1st and 3rd month of postoperative values. Result: A total number of 24 patients was recruited for this study. The mean ages of all groups were 12.60±12.09. After 1 month ejection fraction were decreased by 5.97%, 6.71% and 5.66% in group A, group B and group C respectively. After 3 months ejection fraction were increased by 6.13%, 5.13% and 5.14% in group A, group B and group C respectively. After 1 month fractional shortening were decreased by 13.55%, 9.30% and 9.09% in group A, group B and group C respectively. After 3 months fractional shortening were increased by 7.23%, 7.35% and 4.55% in group A, group B and group C respectively. After 1 month LVIDd were increased by 1.97%, 1.91% and 1.32% in group A, group B and group C respectively. After 3 months LVIDd were decreased by 10.84%, 9.89% and 7.34% in group A, group B and group C respectively. After 1 month LVIDs were increased by 2.19%, 2.86% and 1.98% in group A, group B and group C respectively. After 3 months LVIDs were decreased by 11.68%, 10.97% and 8.87% in group A, group B and group C respectively.Conclusion: Cardiac remodeling occurred after surgical closure of ventricular septal defect and remodeling were more significant in younger age group. Journal of National Institute of Neurosciences Bangladesh, 2016;2(2):69-74

scholarly journals Augmented cerclage wire improves the fixation strength of a two-screw construct for humerus split type greater tuberosity fracture: a biomechanical study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chao-Jui Chang ◽  
Wei-Ren Su ◽  
Kai-Lan Hsu ◽  
Chih-Kai Hong ◽  
Fa-Chuan Kuan ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Biomechanical Study ◽  
Fixation Strength ◽  
Myotendinous Junction ◽  
Steel Cable ◽  
Simple Modification ◽  
Greater Tuberosity ◽  
Cerclage Wire ◽  
Group A ◽  
Group B

Abstract Background Poor functional outcome can result from humeral greater tuberosity (GT) fracture if not treated appropriately. A two-screw construct is commonly used for the surgical treatment of such injury. However, loss of reduction is still a major concern after surgery. To improve the biomechanical strength of screw fixation in GT fractures, we made a simple modification of the two-screw construct by adding a cerclage wire to the two-screw construct. The purpose of this biomechanical study was to analyze the effect of this modification for the fixation of GT fractures. Materials and methods Sixteen fresh-frozen human cadaveric shoulders were used in this study. The fracture models were arbitrarily assigned to one of two fixation methods. Group A (n = 8) was fixed with two threaded cancellous screws with washers. In group B (n = 8), all screws were set using methods identical to group A, with the addition of a cerclage wire. Horizontal traction was applied via a stainless steel cable fixed directly to the myotendinous junction of the supraspinatus muscle. Displacement of the fracture fixation under a pulling force of 100 N/200 N and loading force to construct failure were measured. Results The mean displacements under 100 N and 200 N traction force were both significantly decreased in group B than in group A. (100 N: 1.06 ± 0.12 mm vs. 2.26 ± 0.24 mm, p < 0.001; 200 N: 2.21 ± 0.25 mm vs. 4.94 ± 0.30 mm, p < 0.001) Moreover, the failure load was significantly higher in group B compared with group A. (415 ± 52 N vs.335 ± 47 N, p = 0.01), Conclusions The current biomechanical cadaveric study demonstrated that the two-screw fixation construct augmented with a cerclage wire has higher mechanical performance than the conventional two-screw configuration for the fixation of humeral GT fractures. Trial registration Retrospectively registered.

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