scholarly journals Cementless Hemiarthroplasty Without Femoral Calcar Reconstruction Versus Cemented Hemiarthroplasty for Unstable Intertrochanteric Fractures in octogenarians

2021 ◽  
Author(s):  
Chang Sun ◽  
Meng Cai ◽  
Jia Meng ◽  
Yu Zhang ◽  
Hui Jiang ◽  
...  
Keyword(s):  
Good Choice ◽  
Harris Hip Score ◽  
Intertrochanteric Fractures ◽  
Training Time ◽  
Modular Stem ◽  
Estimated Blood Loss ◽  
Long Stem ◽  
One Year ◽  
Clinical And Radiological Results

Abstract Background The aim of this study was to compare the mid-term outcomes of cementless hemiarthroplasty without femoral calcar reconstruction with cemented hemiarthroplasty in patients aged 80 years or more. Methods From January 2015 to December 2017, 135 patients with unstable intertrochanteric fractures were retrospectively investigated, 70 patients were treated with the cemented hemiarthroplasty while 65 patients were treated with a modular long-stem cementless hemiarthroplasty without rebuilding calcar. Clinical and radiological results were analyzed. Results The 106 alive patients were followed for 62.1 ± 8.3 months, and 29 patients died during the follow-up period. No significant differences were found in terms of demographic and clinical characters of patients, weight training time, postoperative hospital stay length, postoperative ambulatory status and Harris hip score. Patients treated with cementless hemiarthroplasty had a shorter operative time, less estimated blood loss, less amount of blood transfusion and a lower one-year mortality compared with patients treated with cemented hemiarthroplasty. Conclusions Compared with cemented hemiarthroplasty, cementless hemiarthroplasty using a long modular stem without reconstruction of femoral calcar was a good choice for octogenarians with unstable intertrochanteric fractures.

EVALUATE INTRAOPERATIVE VARIABLES AND POSTOPERATIVE OUTCOMES OF INTERTROCHANTERIC FRACTURES WITH VULNERABLE/ BROKEN LATERAL WALL MANAGED WITH SHORT AND LONG CEPHALOMEDULLARY NAIL

2021 ◽  
pp. 36-37
Author(s):  
Rahul Kumar ◽  
Wasim Ahmed ◽  
Indrajeet Kumar
Keyword(s):  
Blood Loss ◽  
Functional Outcome ◽  
Postoperative Outcomes ◽  
Treatment Modalities ◽  
Harris Hip Score ◽  
Intertrochanteric Fractures ◽  
Neck Shaft Angle ◽  
Duration Of Surgery ◽  
One Year ◽  
Lateral Walls

Purpose: To evaluate intraoperative variables and postoperative outcomes of intertrochanteric fractures with vulnerable/broken lateral walls managed with short and long cephalomedullary nails. Materials & Methodology: Twenty prospective cases of patients treated with LCMN and twenty retrospective cases treated with SCMN were included in the study. Intraoperative variables compared were duration of surgery, blood loss during surgery, and surgeon's perception of surgery. Functional outcome was evaluated by Parker Palmer mobility score (PPMS), Harris hip score (HHS), and Short Form-12 at one year. Radiological assessment were done at six months/one year to look for progress of fracture union, change in neck-shaft angle, and any signs of implant failure. Results: Duration of surgery (p<0.001), blood loss during surgery (p=0.002), and surgeon's perception of surgery (p=0.002) were signicantly more in the LCMN group. The LCMN group had a better functional outcome. HHS for the LCMN group was 89.15±9.53, and for the SCMN group it was 81.53±13.21 (p=0.021). PPMS for LCMN group was 8.85± 0.67 and for the SCMN group was 7.53±1.807 (p=0.005). There were four implant failures in the LCMN group compared to none in the SCMN group (p=0.036). Conclusion: Both SCMN and LCMN are effective treatment modalities for unstable intertrochanteric fractures with vulnerable/broken lateral walls. In the absence of more extensive study and long-term follow-up, the superiority of one implant over the other cannot be recommended.

scholarly journals Short term results of modular bipolar hemiarthroplasty for the treatment of neglected trochanteric femur fracture in the elderly

2019 ◽  
Vol 6 (1) ◽  
pp. 53
Author(s):  
Towseef Ahmad Bhat ◽  
Zameer Ali ◽  
Manik Sehgal
Keyword(s):  
Femoral Fractures ◽  
The Elderly ◽  
Clinical Results ◽  
Good Choice ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures ◽  
Postoperative Rehabilitation ◽  
Cemented Bipolar Hemiarthroplasty ◽  
Fractures Of The Femur

<p class="abstract"><strong>Background:</strong> In rural India because of native practitioner culture people tend to neglect orthopaedic injuries and often present late to the hospitals. Bipolar hemiarthroplasty for neglected intertrochanteric fractures of the femur in the elderly yields good clinical results in terms of early postoperative ambulation. This will have a direct effect on the general condition and postoperative rehabilitation.</p><p class="abstract"><strong>Methods:</strong> Sixteen patients with proximal extracapsular femoral fractures presented average 10.4 weeks late from the day of injury, were treated with modular bipolar hemiarthroplasty. There were 11 men and 5 women, with mean age of 72.8 years (range: 65–83 years). Primary cemented bipolar hemiarthroplasty was performed using the Hardinge lateral approach in a lateral decubitus position. Harris hip score was used for the clinical evaluation of the patients.<strong></strong></p><p class="abstract"><strong>Results:</strong> Clinically, the Harris hip score at the last follow-up ranged from 92 to 59, with a mean value of 81.7. Postoperative radiographs showed a good position in all patients. 1 patient developed complication during cementing and 1 case came with dislocation. No case of infection, acetabular erosion, periprostheic fracture or implant loosening was reported in this study.</p><p class="abstract"><strong>Conclusions:</strong> Primary cemented bipolar hemiarthroplasty is a good choice in elderly patients with neglected intertrochanteric fractures of the femur.</p>

scholarly journals Sacrocolpopexy in management of vaginal vault prolapse

2016 ◽  
Vol 10 (4) ◽  
Author(s):  
Javed Iqbal ◽  
Fauzia Nausheen ◽  
Fozia Ali Bhatti ◽  
Arif Tajammul Khan ◽  
Shahida Sheikh
Keyword(s):  
Operation Time ◽  
Abdominal Hysterectomy ◽  
Vaginal Vault Prolapse ◽  
Vaginal Vault ◽  
Vault Prolapse ◽  
Abdominal Sacrocolpopexy ◽  
Estimated Blood Loss ◽  
One Year ◽  
Study Setting

Aims & Objectives: To review the efficacy of Sacrocolpopexy in the management of vaginal vault prolapse Study Design: Interventional study. Setting & Population: Department of Obstetrics & Gynaecology, Jinnah Hospital, Lahore. Women with vaginal vault prolapse after hysterectomy. Methods and Main-outcome measures: Abdominal Sacrocolpopexy using proline mesh. Follow-up in these patients were carried out at one week, four weeks, six months, and one year. Results: Sacrocolpopexy was carried out in ten patients for vaginal vault prolapse after vaginal (6) and abdominal hysterectomy (4). The mean age was 49.8 years. Parity was between P3 - P6 (Mean parity 4.3). Mean operation time was 79.3 minutes. Estimated blood loss was less than 200m1. No intra-operative or post-operative complications occurred in any case. Conclusion: Abdominal sacrocolpopexy is effective and safe in the treatment of vaginal vault prolapse. This procedure has high success rate in correcting prolapse without a time dependent decrease in efficacy.

Cementless Revision for Failed Cemented total Hip Arthroplasty

1996 ◽  
Vol 6 (2) ◽  
pp. 69-74 ◽  
Author(s):  
J.G. Hussell ◽  
E.J. Smith ◽  
I.D. Learmonth
Keyword(s):  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Late Dislocation ◽  
Hip Function ◽  
Long Stem ◽  
And Migration ◽  
Lost To Follow Up ◽  
Hip Arthroplasties ◽  
Cemented Total Hip Arthroplasty

Sixty-two consecutive revision hip arthroplasties were carried out in 57 patients between 1986 and 1990 using the long stem Porous Coated Anatomic (PCA) prosthesis. Fifty-two hips were available for clinical and radiological review. The remainder had either died or were lost to follow-up. The average follow-up was 4.8 years (range 3-7.8 years) and the mean age was 56 years (range 25-77 years). Using the Harris Hip Score, 38/53 (73%) were regarded as good/excellent, 6/52 (11.5%) as fair and 8/52 (15.5%) as poor. The incidence of femoral component subsidence (31/52 - 60%) was a cause of concern, and accounted for two cases of late dislocation. Of the remaining six hips regarded as failures, two had been revised for acetabular graft resorption and migration of the cup while four had moderate persistent pain despite fair hip function. The authors are unable to recommend the long stem PCA prosthesis for routine use in revision hip arthroplasty.

scholarly journals Patient-Specific Implants for Pelvic Tumor Resections

2021 ◽  
Vol 11 (8) ◽  
pp. 683
Author(s):  
Kevin Döring ◽  
Kevin Staats ◽  
Stephan Puchner ◽  
Reinhard Windhager
Keyword(s):  
Postoperative Complications ◽  
Median Number ◽  
Harris Hip Score ◽  
Patient Specific ◽  
Limb Salvage Surgery ◽  
Patient Specific Implants ◽  
Custom Made ◽  
Revision Reconstruction ◽  
One Year

Introduction Limb salvage surgery for periacetabular malignancies is technically demanding and associated with a considerable likelihood of postoperative complications and surgical revision. Reconstruction using custom-made implants represents the treatment of choice. This study was conducted to analyze treatment outcomes of custom-made implants in a single orthopaedic tumor center. Patients and Methods Twenty patients with a histologically verified periacetabular malignancy and a median follow up time of 5 (1–17) years were included. Results The median number of revision surgeries per patient was 1.5 (0–7). Complications were dislocations in 3 patients, aseptic loosening in 4 patients, deep infections in 9 patients, thromboembolic events in 5 patients and sciatic nerve lesions in 4 patients. Overall survival was 77% after one year, 69% after two years and 46% after five years. Median Harris Hip Score was 81 (37–92) points at last follow up. Conclusion Although internal hemipelvectomy and reconstruction using custom-made implants is linked with a high risk of postoperative complications, good functional outcomes can be regularly achieved. This information may help treating surgeons to find adequate indications, as eligible patients need to be critically selected and integrated into the decision-making process.

scholarly journals Open Lift, Drill, Fill and Fix (LDFF) for Talar OCDs: 2 to 4 Year Results in 16 Patients

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0001
Author(s):  
Nienke Altink ◽  
Kaj Lambers ◽  
Jari Dahmen ◽  
Jari Dahmen ◽  
Gino Kerkhoffs
Keyword(s):  
Rating Scale ◽  
Bone Ingrowth ◽  
Weight Bearing ◽  
Numeric Rating Scale ◽  
Long Term Follow Up ◽  
One Year ◽  
Pain At Rest ◽  
Clinical And Radiological Results

Category: Ankle Introduction/Purpose: The purpose of this study was to describe the mid to long-term clinical and radiological outcomes of an open fixation technique for large primary talar osteochondral defects (OCD): Lift, Drill, Fill and Fix (LDFF). Methods: Nineteen patients underwent an open LDFF surgery. Mean follow-up was 35 months (SD 3.6). Pre-and postoperative clinical assessment included the Foot and Ankle Outcome Score (FAOS) and a numeric rating scale (NRS) on pain at rest and during weight-bearing. Remodeling and bone ingrowth were analyzed on CT at one year post-operatively. Results: 15 out of 19 patients showed remodeling and bone ingrowth after the open LDFF procedure. Patients who did not show remodeling and bone ingrowth were treated by means of an OATS procedure. In the remaining 15 patients available at mid to long-term follow-up, LDFF led to a significant improvement of all FAOS subscales; FAOS-pain improved from 65 to 74 (p=0.014), FAOS-symptoms improved from 60 to 80 (p=0.005), FAOS-ADL improved from 80 to 85 (p=001), FAOS-sport improved from 38 to 61 (p=0.017) and FAOS-QoL improved from 38 to 64 (p=0.025). The NRS of pain at rest significantly improved from 3.2 to 1.2 (p=0.009), and pain during walking significantly improved from 6.5 to 1.6 (p<0.001). No complications occurred. Conclusion: Open LDFF of a talar OCDs show promising mid to long-term clinical and radiological results. A longer follow-up period with more study power is a subsequent necessary step in order to draw firmer conclusions about the longevity of this present procedure.

scholarly journals A modified single-armed microsurgical vasoepididymostomy for epididymal obstructive azoospermia: intraoperative choice and postoperative consideration

2019 ◽  
Author(s):  
Nachuan Liu ◽  
Peng Li ◽  
Erlei Zhi ◽  
Chencheng Yao ◽  
Chao Yang ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Clinical Findings ◽  
Good Choice ◽  
Distal Anastomosis ◽  
Obstructive Azoospermia ◽  
Proximal Anastomosis ◽  
Bilateral Surgery ◽  
The Mean ◽  
One Year

Abstract Background：To evaluate the clinical outcomes and the time of sperm returning to the ejaculate after a modified single-armed 2-suture longitudinal intussusception vasoepididymostomy (SA-LIVE). Methods：From March 2015 to December 2018, 134 patients with epididymal obstruction azoospermia underwent the modified single-armed vasoepididymostomy at Shanghai General Hospital. The outcomes and clinical findings were documented and evaluated. Results: The mean follow-up period was 17 months (range 3-36 months). Patency was assessed by the return of sperm in the ejaculate. The overall patency rate is 55.2 %, and the patency rates were 58.9%, 40.7%, 36.4%, and 58.9% for bilateral surgery, unilateral surgery, proximal anastomosis and distal anastomosis, respectively. The average time it took to achieve patency is 4.11±2.74 months. And in the first six months, 87.8% (65/74) patency patients were reported to found sperm in the ejaculate. The overall pregnancy rate was 40.9 % (29/66) at the follow-up of 3 to 36 months, and the natural pregnancy rate was 30.3 % (20/66). The natural pregnancy rate was 32.1% for bilateral surgery, 33.3% for the site of distal anastomosis，but surprisingly, it was 0% for the site of proximal anastomosis. Conclusion: Modified SA-LIVE is safe and may achieve favorable patency and pregnancy rates. When double-armed sutures are not accessible, single-armed ones may be a good choice. The expecting patency time is about within one year. Assisting with intraoperative sperm cryopreservation, patients can achieve better pregnancy outcomes. Moreover, the low natural pregnancy rate for the proximal anastomosis suggested that we should reconsider the indications of SA-LIVE for EOA patients. Key words: obstructive azoospermia; male infertility; vasoepididymostomy; patency; pregnancy

scholarly journals Functional and radiological outcome of osteosynthesis using proximal femoral nail antirotation II system in intertrochanteric femoral fractures

2021 ◽  
Vol 7 (2) ◽  
pp. 267
Author(s):  
Wajahat Ahmad Mir ◽  
Mohmad Nawaz Rather ◽  
Rasiq Rashid
Keyword(s):  
Morbidity And Mortality ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Common Source ◽  
Intertrochanteric Fractures ◽  
College Hospital ◽  
Femur Fractures ◽  
Femoral Nail ◽  
Proximal Femoral Nail Antirotation

<p class="abstract"><strong>Background:</strong> Intertrochanteric fractures are relatively common injuries in adults and a common source of morbidity and mortality among the elderly. Incidence of fractures is increasing because the general life expectancy of the population has increased significantly during the past few decades. Stable fixation and early mobilization is needed in these fractures to reduce the morbidity and mortality. Extra-medullary implants are biomechanically inferior in these cases. The proximal femoral nail antirotation-II (PFNA-II) is an intra-medullary nail system designed for such fractures. The purpose of this study was to assess the results and complications of PFNA-II in intertrochanteric femur fractures.</p><p class="abstract"><strong>Methods:</strong> After seeking approval from institutional Ethical committee, this study was conducted on 30 patients attending our emergency department with intertrochanteric femur fractures at SKIMS Medical College Hospital Bemina, Srinagar from February 2018 to June 2019. The patients were treated with proximal femoral nail antirotation-II. Follow up was done at 2, 6, 12 and 24 weeks.  The functional outcome was assessed at 6 months follow up using the Harris Hip Score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Based on the Harris hip score, 18 (60%) patients had excellent results, 10 (33%) had good results and 2 (7%) had Fair results. None of the patients had poor result. Average time to union was 12.27 weeks.</p><p class="abstract"><strong>Conclusions:</strong> This study found the PFNA-II to be a versatile, easy to use and dependable implant for stable as well as unstable intertrochanteric fractures. PFNA II is distinct advance over the previous methods of treatment, though it has an initial learning curve.</p>

OUTCOME ANALYSIS OF PROXIMAL FEMORAL NAIL IN MANAGEMENT OF UNSTABLE INTERTROCHANTERIC FRACTURES

2021 ◽  
pp. 55-56
Author(s):  
Anshul Khare ◽  
Shailandra Pandey ◽  
Aman Agrahari ◽  
Abhishek Pathak ◽  
Sanjiv Gaur
Keyword(s):  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Outcome Analysis ◽  
Intertrochanteric Fractures ◽  
Average Hospital ◽  
Incision Length ◽  
Femoral Nail ◽  
The Mean ◽  
Mean Time

There is no perfect implant for intertrochanteric fractures. Nowadays Proximal Femoral Nail (PFN) is getting popular in these fractures. In this study we tried to nd and analyse the outcome of using PFN in 20 cases of unstable intertrochanteric fractures which were operated at our centre and completed the follow up till 6 months. These patients were analysed on various intra-operative and post-operative parameters. Functional assessment was done using Harris Hip Score. The mean age of patients in our study was 64 years. Average incision length was around 6.5cm and mean blood loss was 97ml. Average surgery duration was 71 minutes while average hospital stay was 18.1 days. Mean time to union was 14.9 weeks. All cases have achieved union. Varus malalignment was observed in one case. Harris Hip Score showed excellent results in 60% cases and good results in 30% cases. Our study indicates that PFN is a good implant for xation of unstable intertrochanteric fractures. However it superiority over other implants can only be conrmed with larger comparative studies.

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