scholarly journals A Larger Sized Cup Accelerates Cartilage Erosion of Acetabulum after Bipolar Hemiarthroplasty in Elderly with Femur Neck Fracture

2021 ◽  
Author(s):  
Sang Min Kim ◽  
Saumil Ashvin Shah ◽  
Jae Young Kim ◽  
Hyun Woo Cho ◽  
Won Yong Shon
Keyword(s):  
Head Size ◽  
Bipolar Hemiarthroplasty ◽  
Femur Neck ◽  
Femur Neck Fracture ◽  
Neck Fracture ◽  
Group A ◽  
Cartilage Erosion ◽  
Group B ◽  
Acetabular Erosion

Abstract Purpose: Bipolar Hemiarthroplasty (BHA) is one of the common procedures done for the treatment of femur neck fracture. One of the frequently encountered complication with this surgery is erosion of the acetabular cartilage. This study was conducted to investigate acetabular erosion after BHA according to the difference in diameter between femoral head and implanted cup at minimum 10-year follow-up.Patients and Methods: We retrospectively reviewed 117 patients (117 hips) undergoing BHA with fracture of neck of the femur. Their mean age was 77.8 years (range, 65-96 years) and male: female ratio was 32:85. Patients were divided into 3 groups; Group A- bipolar cup size > actual head size, Group B- cup size < head size, Group C- cup size = head size. The degree of both superior and medial acetabular cartilage erosion was identified and calculated on postoperative radiographs using line of acetabular margin and Kohler’s line.Results: The mean superior and medial acetabular erosion were 1.62 ± 1.6 mm (range, 0 – 4.4) and 4.15 ± 2.7 mm (range, 0 – 8.2) in Group A, 1.30 ± 1.3 mm (range, 0 – 3.8) and 4.11 ± 2.7 mm (range, 0 – 7.8) in Group B, and 0.90 ± 1.1 mm (range, 0 – 2.6) and 3.16 ± 2.9 mm (range, 0 – 7.9) in Group C (p=0.039 and p=0.187, respectively). The superior acetabular erosion showed significant difference between the three groups. During mean follow-up period of 12.3 years, five patients (5/117, 4.3%) underwent conversion to THA due to superior acetabular erosion. All of three patient underwent BHA with a larger bipolar cup than the actual femoral head.Conclusion: A lager sized cup accelerated superior cartilage erosion of acetabulum after bipolar hemiarthroplasty. An optimal cup size should be considered when undergoing BHA in elderly patients.

scholarly journals Multiple screw fixation versus cementless bipolar hemiarthroplasty for femur neck fracture using a nationwide hip fracture registry

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jin-Woo Kim ◽  
Kyung-Soon Park ◽  
Young-Kyun Lee ◽  
Ji Wan Kim ◽  
Yong-Chan Ha ◽  
...  
Keyword(s):  
Operation Time ◽  
Reoperation Rate ◽  
Bipolar Hemiarthroplasty ◽  
Systemic Complications ◽  
Femur Neck ◽  
Femur Neck Fracture ◽  
Estimated Blood Loss ◽  
Neck Fracture ◽  
Group A ◽  
Group B

AbstractCementless bipolar hemiarthroplasty (BHA) recently gained popularity as a treatment for femur neck fracture (FNF), but there have been few studies comparing this with multiple screw fixation (MSF) in the elderly population. The purpose of this study is to compare (1) surgery-related parameters, (2) reoperation rate as a local complication, (3) in-hospital systemic complication rate, and (4) mortality rate at 1 year after MSF and cementless BHA in patients with FNF using nationwide data. Six-hundred sixty-six hips (aged ≥ 50 years) extracted from nationwide Hip Fracture Registry were included in this study (133 MSF and 533 cementless BHA). One hundred fifty-six hips were divided into nondisplaced FNF (Group A) and 510 into displaced FNF (Group B). We evaluated (1) surgery-related parameters (anesthesia type, time to surgery, operation time, estimated blood loss and volume of postoperative transfusion), (2) the rate of and reasons for reoperation, (3) the rate and type of in-hospital systemic complications and (4) one-year mortality rate after surgery. In Group A, MSF showed shorter operation time (p = 0.004) and lower incidence of in-hospital systemic complications (p = 0.003). In Group B, cementless BHA demonstrated lower reoperation rate than MSF (p < 0.001). In both Group A and B, cementless BHA was associated with higher estimated blood loss than MSF (p < 0.001). Based on findings in our study, MSF might be a more favorable option for nondisplaced FNF, whereas cementless BHA might be a better one for displaced FNF in patients older than fifty. Nevertheless, our nationwide study also showed that numbers of cementless BHAs were being performed for nondisplaced FNF even in teaching hospitals.

scholarly journals SIMULTANEOUS INSUFFICIENCY FRACTURE OF BILATERAL NECK OF FEMUR WITH COXA VARA

2020 ◽  
pp. 41-42
Author(s):  
Rishabh Surana ◽  
Saurabh Singh ◽  
Alok Rai
Keyword(s):  
Weight Bearing ◽  
Insufficiency Fracture ◽  
Young Female ◽  
Full Weight Bearing ◽  
Coxa Vara ◽  
Neck Of Femur ◽  
Femur Neck ◽  
Femur Neck Fracture ◽  
Neck Fracture

Simultaneous insufficiency fracture of bilateral neck of femur with displacement and coxa vara is very uncommon , and very challenging. Osteomalacia is a known cause of insufficiency fracture. We present a case of a young female with non traumatic simultaneous bilateral femur neck fracture. On radiological and laboratory investigation fracture was diagnosed as insufficiency fracture due to osteomalacia with coxa vara. Treatment was done by intertrochanteric valgus osteotomy and fixation by dynamic condylar screw with a prebend plate along with oral and parentral vitamin D therapy. On six month follow up both side fractures were well united and patient was able to walk without pain with full weight bearing and with normal gait .Her lab investigations also returned to normal during follow up.

scholarly journals Assessing the effect of gotfried reduction with positive buttress pattern in the young femoral neck fracture

2020 ◽  
Author(s):  
Kai Huang ◽  
Xiaohui Fang ◽  
Guijun Li ◽  
Jiajun Yue
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Clinical Results ◽  
Anatomic Reduction ◽  
Significant Difference ◽  
Reduction Group ◽  
Neck Fracture ◽  
Group A ◽  
Group B

Abstract Background: Although many available surgical procedures for displaced femoral neck fractures in young patients, there are still many challenges to achieve satisfactory results. The incidence of avascular necrosis and nonunion rates remain relatively high despite the progress in our understanding and surgical technique. The purpose of this study was to evaluate the clinical efficacy of gotfried reduction and cannulated screw fixation in the treatment of femoral neck fracture for young adults. Methods: A retrospective analysis was made on 67 cases from May 2013 to March 2019. They were divided into three groups according to the first postoperative anteroposterior view of hip X-ray: Anatomic reduction (group A), Gotfried positive buttress reduction (group B), and Gotfried negative buttress reduction (group C). The incidence of avascular osteonecrosis of the femoral head ( AVN ) and the Harris scores of hip joints were compared in three groups at the last follow-up. Results: The mean follow-up period after surgery was 22.5 ± 11.3 (range, 11–34) months. There were 21 cases (mean age,49.7 ± 11.6) in group A, 24 cases (mean age, 48.6 ± 11.3) in group B, 22 cases (mean age,48.3 ± 12.4) in group C. No significant difference in general preoperative demographics (P>0．05). The incidence of avascular necrosis of femoral head in Group A, B, and C was 19.05%,20.83%, and 22.73 %, respectively, showing no significant difference between groups(P=0．156). The mean Harris hip scores at the final follow-up for groups A (85．6±6．7)and B (84．5±6．2) were significantly higher than group C (74．3±8.3), and the difference was statistically significant(P=0．043). The incidence of femoral neck shortening in group A and group B was significantly lower than that in group C in postoperative one year, and the difference was statistically significant (P<0.05). Conclusions: Gotfried positive buttress reduction and fixation for femoral neck fracture may lead to similar clinical results with anatomic reduction, but much better than Gotfried negative buttress reduction. For the patients of femoral neck fracture with severe displacement and difficulty reduction, it is not necessary to pursue anatomical reduction。 Achieving positive valgus reduction can also obtain satisfactory clinical results, and should try to avoid negative buttress.

scholarly journals A comparative study on functional outcome of unstable intertrochanteric fractures in elderly treated with bipolar hemiarthroplasty and dynamic hip screw fixation: a short term perspective analysis

2020 ◽  
Vol 6 (2) ◽  
pp. 319
Author(s):  
M. R. Anand ◽  
N. S. Ramachandren
Keyword(s):  
Comparative Study ◽  
Internal Fixation ◽  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures ◽  
Short Term ◽  
Bipolar Prosthesis ◽  
Group A ◽  
Hip Screw ◽  
Group B

<p class="abstract"><strong>Background:</strong> Trochanteric hip fractures in elderly patients have benefited from advances in internal fixation. Early failure of internal fixation occurs however in a number of cases. The failure after internal fixation had been due to initial fracture pattern, communication, sub-optimal fracture fixation and poor bone quality. The aim of this prospective comparative study is to analyze the short term follow up results of unstable Intertrochanteric fractures in elderly treated with bipolar hemiarthroplasty and dynamic hip screw (DHS) fixation.</p><p class="abstract"><strong>Methods:</strong> This is a study conducted in the Department of Orthopaedics, Government Tiruvarur Medical College, Tiruvarur. 42 elderly osteoporotic patients with unstable intertrochanteric fractures who were divided into two groups with group A-bipolar prosthesis (21 cases) and group B-DHS (21 cases).<strong></strong></p><p class="abstract"><strong>Results:</strong> 42 elderly osteoporotic patients with unstable intertrochanteric fractures who were divided into two groups with group A-bipolar prosthesis (21 cases) and group B-DHS (21 cases). Patients were evaluated clinically using the Harris hip score during their follow up period. In both groups, the most common Singh’s index was grade III, 61.90%in both group A and group B.</p><p class="abstract"><strong>Conclusions:</strong> From our results, we are of the opinion that bipolar hemiarthroplasty may be an efficient option in elderly osteoporotic intertrochanteric fractures. It reduces the potential complications of prolonged immobilization such as pressure sores, pulmonary complications by early mobilization.</p>

scholarly journals Gotfried reduction and cannulated screws fixation in the treatment of femoral neck fracture in young adults

2020 ◽  
Author(s):  
Kai Huang ◽  
Xiaohui Fang ◽  
Guijun Li ◽  
Jiajun Yue
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Clinical Results ◽  
Anatomic Reduction ◽  
Significant Difference ◽  
Reduction Group ◽  
Neck Fracture ◽  
Group A ◽  
Group B

Abstract Background: Although many available surgical procedures for displaced femoral neck fractures in young patients, there are still many challenges to achieve satisfactory results. The incidence of avascular necrosis and nonunion rates remain relatively high despite the progress in our understanding and surgical technique. The purpose of this study was to evaluate the clinical efficacy of gotfried reduction and cannulated screw fixation in the treatment of femoral neck fracture for young adults.Methods: A retrospective analysis was made on 67 cases from May 2013 to March 2019. They were divided into three groups according to the first postoperative anteroposterior view of hip X-ray: Anatomic reduction (group A), Gotfried positive buttress reduction (group B), and Gotfried negative buttress reduction (group C). The incidence of avascular osteonecrosis of the femoral head (AVN) and the Harris scores of hip joints were compared in three groups at the last follow-up.Results: There were 21 cases (mean age,49.7 ± 11.6) in group A, 24 cases (mean age, 48.6 ± 11.3) in group B, 22 cases (mean age,48.3 ± 12.4) in group C. No significant difference in general preoperative demographics (P>0．05).The incidence of avascular necrosis of femoral head in Group A, B, and C was 19.05%,20.83%, and 22.73 %, respectively, showing no significant difference between groups(P=0．156). The mean Harris hip scores at the final follow-up for groups A (85．6±6．7)and B (84．5±6．2) were significantly higher than group C (74．3±8.3), and the difference was statistically significant(P=0．043).Conclusions: Gotfried positive buttress reduction and fixation for femoral neck fracture may lead to similar clinical results with anatomic reduction, but much better than Gotfried negative buttress reduction. For the patients of femoral neck fracture with severe displacement and difficulty in reduction, it is not necessary to pursue anatomical reduction。Achieving positive valgus reduction can also obtain satisfactory clinical results, and should try to avoid negative buttress.

scholarly journals Assessing the effect of Gotfried reduction with positive buttress pattern in the young femoral neck fracture

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Kai Huang ◽  
Xiaohui Fang ◽  
Guijun Li ◽  
Jiajun Yue
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Clinical Results ◽  
Anatomic Reduction ◽  
Significant Difference ◽  
Reduction Group ◽  
Neck Fracture ◽  
Group A ◽  
Group B

Abstract Background Although many available surgical procedures for displaced femoral neck fractures in young patients, there are still many challenges to achieve satisfactory results. The incidence of avascular necrosis and nonunion rates remains relatively high despite the progress in our understanding and surgical technique. The purpose of this study was to evaluate the clinical efficacy of Gotfried reduction and cannulated screw fixation in the treatment of femoral neck fracture for young adults. Methods A retrospective analysis was made on 67 cases from May 2013 to March 2019. They were divided into three groups according to the first postoperative anteroposterior view of hip X-ray: Anatomic reduction (group A), Gotfried positive buttress reduction (group B), and Gotfried negative buttress reduction (group C). The incidence of avascular osteonecrosis of the femoral head (AVN) and the Harris scores of hip joints were compared in three groups at the last follow-up. Results The mean follow-up period after surgery was 22.5 ± 11.3 (range, 11–34) months. There were 21 cases (mean age, 49.7 ± 11.6) in group A, 24 cases (mean age, 48.6 ± 11.3) in group B, 22 cases (mean age, 48.3 ± 12.4) in group C. No significant difference in general preoperative demographics (P > 0.05). The incidence of avascular necrosis of femoral head in group A, B, and C was 19.05%, 20.83%, and 22.73%, respectively, showing no significant difference between groups (P = 0.156). The mean Harris hip scores at the final follow-up for groups A (85.6 ± 6.7) and B (84.5 ± 6.2) were significantly higher than group C (74.3 ± 8.3), and the difference was statistically significant (P = 0.043). The incidence of femoral neck shortening in group A and group B was significantly lower than that in group C in postoperative 1 year, and the difference was statistically significant (P < 0.05). Conclusions Gotfried positive buttress reduction and fixation for femoral neck fracture may lead to similar clinical results with anatomic reduction, but much better than Gotfried negative buttress reduction. For the patients of femoral neck fracture with severe displacement and difficulty reduction, it is not necessary to pursue anatomical reduction. Achieving positive valgus reduction can also obtain satisfactory clinical results, and should try to avoid negative buttress.

Absorbable suture material in carotid surgery

VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  
Keyword(s):  
Suture Material ◽  
Absorbable Suture ◽  
Paediatric Surgery ◽  
Carotid Surgery ◽  
Suture Materials ◽  
Absorbable Suture Material ◽  
Absorbable Sutures ◽  
Group A ◽  
Group B

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

A Study on Frozen Shoulder and its clinical management through Nasaapana and Nasya

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Praveenkumar H. Bagali ◽  
A. S. Prashanth
Keyword(s):  
Medical Science ◽  
Frozen Shoulder ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Animal Kingdom ◽  
Shoulder Joints ◽  
Group A ◽  
Group B

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.

A Comparative Study of Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana in the Management of Shweta Pradara

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Renuka M. Tenahalli
Keyword(s):  
Vitamin C ◽  
Early Stage ◽  
Pathological Condition ◽  
Before And After ◽  
Group A ◽  
Phosphorus Iron ◽  
Group B ◽  
Busy Schedule ◽  
Iron And Calcium

Shweta Pradara (Leucorrhoea) is the disease which is characterized by vaginal white discharge. Vaginal white discharge this symptom is present in both physiological and pathological condition, when it becomes pathological it disturbs routine life style of the woman. Most of the women in the early stage will not express the symptoms because of hesitation and their busy schedule. If it is not treated it may leads to chronic diseases like PID (Garbhashaya Shotha etc.) Charaka mentioned Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana. This treatment is used in Shweta Pradara shown positive results, hence a study was under taken to assess its clinical efficacy. 30 diagnosed patients of Shweta Pradara were randomly selected, allocated in three groups. Group A and Group B received Amalaki Choorna with Madhu and Vata Twak Kashaya Yoni Pichu Dharana respectively and Group C received Amalaki Choorna with Madhu followed by Vata Twak Kashaya Yoni Pichu Dharana for 15 days. The patients were assessed for the severity of the symptoms subjectively and objectively before and after the treatment and at the end of the follow up. Data from each group were statistically analyzed and were compared. No side effects were noted and it may be considered as an effective alternative medicine in Shweta Pradara (leucorrhea). Amalaki is rich in natural source of vitamin C and contains phosphorus, iron and calcium. Honey contains carbohydrate, vitamin C, phosphorus iron and calcium. All together these help to increase Hb% and immunity. Vata Twak Kashaya contains tannin which helps to maintain normal pH of the vagina.

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