scholarly journals Management Femoral Fracture in Cats using Intramedullary Pin and Wires Fixation

2018 ◽  
Vol 3 (2) ◽  
pp. 32-35
Author(s):  
Erwin Erwin ◽  
Deni Noviana ◽  
Dany Umbu ◽  
Tri Isyani Tungga Dewi
Keyword(s):  
Veterinary Medicine ◽  
Teaching Hospital ◽  
Femoral Fracture ◽  
Open Surgery ◽  
Femoral Fractures ◽  
Trochanter Major ◽  
Epiphyseal Fracture

On April 2016, Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Bogor Agricultural University (VTH FKH IPB) received 4 cases of femoral fractures in cats caused by trauma. Two cats suffered oblique diaphysis fracture femoral, one cat suffered comminuted diaphysis fracture femoral, and one cat suffered epiphyseal fracture femoral (column femoral and trochanter major). All cats were treated by open surgery using intramedullary pins (Steinmann) and cerclage wires (Kirschner). Fracture recovery went without complication and all cats were able to move their feet one week after surgery.

Necrosis avascular

2020 ◽  
Vol 63 (2) ◽  
pp. 18-23
Author(s):  
Alejandro Jardón Gómez ◽  
Ana Cristina King ◽  
Carlos Pacheco Díaz
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Femoral Fracture ◽  
Open Fracture ◽  
Clinical Presentation ◽  
Femoral Fractures ◽  
Proximal Femoral Fracture ◽  
Young Population ◽  
Steroid Use

The clinical presentation of a proximal femoral fracture is completely different between young and adult patients. Unlike closed proximal femoral fractures, the incidence of exposed fractures is found in the young population between 15 and 30 years of age. Osteonecrosis of the femoral head is one the complications we can find in this type of fractures. Avascular necrosis (AVN or osteonecrosis) is defined as the interruption of blood supply to the femoral head due to trauma, infectionalcohol or steroid use, resulting in bone necrosis, joint collapse and osteoarthrosis. The treatment will depend on the clinical presentation, age of the patient and when the diagnosis is made. This is a case report of a 16-year-old patient with a gunshot wound on the hip. Surgical cleansing and closed reduction plus internal fixation with a nail in the center of the spine were performed. A 3-year clinical and radiographic follow up was made, observing the evolution of the fracture and the subsequent avascular necrosis that the patient presented. Key words: Proximal femoral fracture; hip; avascular necrosis (AVN, osteonecrosis); open fracture; osteoarthritis.

“FUNCTIONAL OUTCOME OF RETROGRADE NAILING IN THE MANAGEMENT OF SUPRACONDYLAR AND DISTAL FEMORAL FRACTURE”

2021 ◽  
pp. 107-109
Author(s):  
Avinash Kumar Choudhary ◽  
M.K Aseri ◽  
Sumit Machra ◽  
Devendra Singh
Keyword(s):  
Femoral Fracture ◽  
Distal Femur ◽  
Femoral Fractures ◽  
High Energy ◽  
Valgus Deformity ◽  
Minor Trauma ◽  
Rating Score ◽  
Joint Congruency ◽  
Distal Femoral Fractures

INTRODUCTION: Fractures of the Distal femur are complex injuries that pose a challenge to the orthopaedic surgeon. It constitutes about 6 % of all femoral fractures. It usually occurs during high energy trauma in younger patients and frequently are associated with concomitant injuries. In contrast, elderly patients with severe osteopenia might sustain solitary distal femoral fractures from minor trauma such as a simple fall. Proper diagnosis and treatment leads to early mobilization and rehabilitation of patients. MATERIAL AND METHODS :This prospective study was conducted in Department of Orthopedics at Dr. S. N. Medical College and Associated group of Hospital, Jodhpur ,Rajasthan ,India on 30 patients who underwent the surgery with retrograde intramedullary interlocking nail in the management of extra-articular supracondylar femoral fracture from August 2019 to November 2020. On follow up axial alignment was assessed and functional analysis was quantied using NEERS RATING SYSTEM, Radiographs was analyzed for correction, maintenance of position or loss of reduction. function around knee was accessed according to Schatzker and Lambert Criteria, measures the exion/extension , varus/valgus deformity , joint congruency and pain in operated patients. RESULTS: In our study 30 patients with supracondylar & distal femoral fractures based on AO Classication on MULLER ET AL underwent retrograde supracondylar nail, long term nal result were rated using NEER'S RATING SCORE , which gives point for pain, function, working, joint movement ,gross and radiological appearance. NEER'S RATING SCORE assigned for each patient after 24 weeks of follow up. After accessing this score out of total 30 patients, 10 have excellent score, 10 have good score, 8 have fair score and next 2 have poor score. Function around knee was accessed according to Schatzker and Lambert Criteria, measures the exion/extension , varus/valgus deformity , joint congruency and pain in operated patients,out of 30 patients 9 patients have an excellent result , 8 have good ,12 have fair and only 1 patient have poor result CONCLUSION:The retrograde intramedullary locked nail provides the surgeon with a different option in treatment of specic supracondylar fracture patterns. It offers a practical advantages of simple and efcient technique for patients with polytrauma, oating knee injuries and in elderly. this technique is very useful in distal femur fracture where antegrade nailing does not provide stability and also where plate xation is not suitable due to soft tissue condition.

scholarly journals Endoprosthetic Reconstruction for a Displaced Atypical Femoral Fracture in a Cancer Patient with Poor Prognosis

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Hironari Tamiya ◽  
Hiroki Hagizawa ◽  
Takaaki Nakai ◽  
Yoshinori Imura ◽  
Takaaki Tanaka ◽  
...  
Keyword(s):  
Cancer Patient ◽  
Activities Of Daily Living ◽  
Cancer Patients ◽  
Femoral Fracture ◽  
Daily Living ◽  
Poor Prognosis ◽  
Femoral Fractures ◽  
Endoprosthetic Reconstruction ◽  
Atypical Femoral Fractures ◽  
Patients With Poor Prognosis

Zoledronate or denosumab treatment is beneficial for cancer patients with bone metastasis. However, each agent may trigger atypical femoral fractures. Incomplete atypical femoral fractures can be successfully treated with prophylactic intramedullary nailing. On the other hand, intramedullary nailing for displaced atypical femoral fractures occasionally causes problems with regard to bone healing, resulting in long-term treatment. In cancer patients with poor prognosis who experience atypical femoral fractures, improvement in activities of daily living should be the priority. Thus, we performed endoprosthetic reconstruction for a displaced atypical femoral fracture in a breast cancer patient with poor prognosis to enable walking in the early stage after the operation. Two weeks after the operation, she could successfully walk. The postoperative Musculoskeletal Tumor Society score was 47%, and it had improved to almost the preoperative level before injury (50%). In conclusion, endoprosthetic reconstruction for displaced atypical femoral fractures may be a first-line treatment approach to acquire early postoperative walking ability for improving activities of daily living in cancer patients with poor prognosis.

scholarly journals Atypical periprosthetic femoral fracture associated with long-term bisphosphonate therapy

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Dávid Dózsai ◽  
Tamás Ecseri ◽  
István Csonka ◽  
István Gárgyán ◽  
Péter Doró ◽  
...  
Keyword(s):  
Femoral Fracture ◽  
Case Reports ◽  
Femoral Stem ◽  
Femoral Fractures ◽  
Atypical Femoral Fracture ◽  
Periprosthetic Fractures ◽  
Periprosthetic Femoral Fracture ◽  
Mineral Research ◽  
Periprosthetic Femoral Fractures

Abstract Background Atypical femoral fracture is one of the many complications after the long-term use of bisphosphonates. The American Society for Bone and Mineral Research has officially excluded periprosthetic femoral fractures (PFFs) from the definition of atypical femoral fractures (AFFs). Several case reports found that PFFs can occur with characteristics similar to those of AFFs. The purpose of our study was to evaluate the proportion of atypical fractures among Vancouver type B1 fractures, and to determine the association between the long-term use of bisphosphonates and the occurrence of atypical periprosthetic femoral fractures (APFFs). Methods In this retrospective study, we reviewed 41 patients with Vancouver type B1 periprosthetic fractures between January 1, 2011 and December 31, 2018. We classified them into two groups, namely atypical and typical PFFs, based on the fracture morphology. We noted the proportion of atypical periprosthetic fractures among B1 fractures and identified risk factors. Results Among the 41 PFFs, 5 (13%) fractures were classified as atypical PFF based on the radiological characteristics. The longer duration of bisphosphonate use was probably the only independent risk factor that significantly increases the occurrence of APFF (p = 0.03, 0.08 (CI 0.008 – 0.16)). There were no significant differences in age, gender, body mass index, comorbidities, corticosteroid use, positioning of the femoral stem, the method of fixation (cemented or cementless) and time lapse from before the primary prosthesis implantation to the PFF in the development of atypical fracture type. Conclusions There seems to be a correlation between the long-term intake of bisphosphonates and the atypical periprosthetic fracture. Atypical femoral fracture can also occur in the periprosthetic form. Trial registration Study number: 22/2019-SZTE, http://www.klinikaikutatas.hu/hu/kutatasetika/jovahagyott-vizsgalatok-koezerdeku-adatai/category/25-jovahagyott-vizsgalatok-kozerdeku-adatai-rkeb-2019.html?download=985:22-2019.

scholarly journals The Prognostic Value of Metabolic Profiling in Older Patients With a Proximal Femoral Fracture

2020 ◽  
Vol 11 ◽  
pp. 215145932096009
Author(s):  
Max P.L. van der Sijp ◽  
H. Eka D. Suchiman ◽  
Monica Eijk ◽  
Dina Vojinovic ◽  
Arthur H. P. Niggebrugge ◽  
...  
Keyword(s):  
Risk Score ◽  
Functional Recovery ◽  
Mortality Risk ◽  
Femoral Fracture ◽  
Patient Population ◽  
Prediction Accuracy ◽  
Prognostic Value ◽  
Femoral Fractures ◽  
Proximal Femoral Fracture ◽  
Proximal Femoral Fractures

Introduction: High mortality rates of approximately 20% within 1 year after treatment are observed for patients with proximal femoral fractures. This preliminary study explores the prognostic value of a previously constructed mortality risk score based on a set of 14 metabolites for the survival and functional recovery in patients with proximal femoral fractures. Materials and Methods: A prospective observational cohort study was conducted including patients admitted with a proximal femoral fracture. The primary outcome was patient survival, and the recovery of independence in activities of daily living was included as a secondary outcome. The mortality risk score was constructed for each patient and its prognostic value was tested for the whole population. Results: Data was available form 136 patients. The mean age of all patients was 82.1 years, with a median follow-up of 6 months. Within this period, 19.0% of all patients died and 51.1% recovered to their prefracture level of independence. The mortality score was significantly associated with mortality (HR, 2.74; 95% CI, 1.61-4.66; P < 0.001), but showed only a fair prediction accuracy (AUC = 0.68) and a borderline significant comparison of the mortality score tertile groups in survival analyses (P = 0.049). No decisive associations were found in any of the analyses for the functional recovery of patients. Discussion: These findings support the previously determined prognostic value of the mortality risk score. However, the independent prognostic value when adjusted for potential confounding factors is yet to be assessed. Also, a risk score constructed for this specific patient population might achieve higher accuracies for the prediction of survival and functional recovery. Conclusions: A modest prediction accuracy was observed for the mortality risk score in this population. More elaborate studies are needed to validate these findings and develop a tailored model for clinical purposes in this patient population.

scholarly journals SAT-LB40 Adrenalectomy - A Rural Teaching Hospital Experience

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Alice S Shen
Keyword(s):  
Length Of Stay ◽  
Teaching Hospital ◽  
Regression Models ◽  
Open Surgery ◽  
Negative Binomial ◽  
Rural Hospitals ◽  
Hospital Length Of Stay ◽  
Adrenal Tumors ◽  
Adrenocortical Adenoma ◽  
Rural Teaching

Abstract Background: Studies characterize the surgical managements of adrenal tumors are not common in rural hospitals. Methods: A retrospective study conducted at a single rural teaching hospital with subjects including 37 patients who had laparoscopic or open adrenalectomy between 2011 and 2017. Baseline characteristics and postoperative outcomes of patients were examined using univariate and multivariate methods. Logistic regression models were used to analyze perioperative complications. Truncated negative binomial regression models was used to analyze hospital length of stay. Pathologic distribution, correlation of pre-op and pathologic diagnoses were also analyzed.Results: On average, five adrenalectomies per year were done for primary adrenal pathology. Adrenocortical adenoma and pheochromocytoma were the two most common pathologic diagnoses. Length of stay increased in patients with open surgery, RR 3.78 (1.60-8.91), and malignancy, RR 3.18 (1.43-7.06), based on multivariate analysis. Factors associated with post-operative complications in univariable analysis are tumor size odds ratio (OR) 1.02 (95% confidence interval 1.00 to 1.05), and open surgery, OR 4.29 (0.96-21.52). This significance was not present at the multivariable analysis. Conclusions: Evaluation and surgical management of adrenal tumors in a rural hospital for seven years were characterized. The results of this study will contribute to future epidemiological research on adrenal incidentalomas and surgical managements of adrenal tumors in rural hospitals.

scholarly journals Violation of consolidation of the femur after untimely dynamization of the intramedullary blocking rod

2021 ◽  
pp. 69-72
Author(s):  
Diomyd Chabanenko ◽  
Oleksandr Polіvoda
Keyword(s):  
Femoral Fracture ◽  
Distal Part ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
Femoral Shaft ◽  
Joint Control ◽  
Posterior View ◽  
Intramedullary Osteosynthesis ◽  
Fracture Consolidation ◽  
The Right

Violation of femoral fracture consolidation after blocking intra­medullary osteosynthesis is a fairly common pathology, and requires the attention of physicians due to its prevalence. There are several reasons for this complication: it is the instabi­lity in the system «bone-implant», and the untimely dynamization of the locking nail. Methods. This article presents a case of fracture violated consolidation after blocking intramedullary osteosynthesis caused a nonunion due to nail failure. Results. Patient was injured on 29.12.2018, as a result of a traffic accident. 01.15.2019, the surgery was performed:  closed reduction, blocking intramedullary osteosynthesis of the fracture of the middle shaft of the right thigh, static fixation of the nail. Next visit to the clinic was on 02.01.2020, because of pain in the middle third of the thigh, problems with axial weight-bearing on the right leg, limitation of the flexion in the right knee joint. Control radiographs demonstrated no signs of consolidation of the femoral shaft fracture, and migration of the distal locking screw. 08.01.2020 revision surgical treatment was performed. Given the presence of 5 mutually perpendicular holes in the distal part of the nail, two of them were locked in the anterio-posterior view by the free hand method, the migrated screw in the distal part of the nail was replaced, and the nail was dynamized in the proximal part taking into account its design features. Conclusions. To normalize the consolidation processes in patients with nonunion femoral fractures, bone physiology and the positive effect of autocompression should be considered. The described case demonstrates the necessity for timely dynamization of the blocking nail, which confirms our own observations and literature data. Despite the fact that the dynamization of the nail was performed 1 year after blocking intramedullary osteosynthesis, fracture consolidation occurred 5 months after its implementation. Key words. Femoral fracture, blocked intramedullary osteosynthesis, disorders consolidation, dynamization of the construction.

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