scholarly journals Treatment of Proximal Femoral Fractures in Patients with COVID-19

2021 ◽  
Vol 27 (3) ◽  
pp. 9-18
Author(s):  
Konstantin S. Egorov ◽  
Valery V. Strizheletsky ◽  
Igor G. Ivanov ◽  
Valentin A. Neverov ◽  
Natalia V. Siverskaya ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Proximal Femur ◽  
Femoral Fractures ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Results Of Treatment ◽  
Neck Fracture ◽  
Coronavirus Infection

Background. In relation with the COVID-19 new coronavirus infection epidemic that began in Russia in the spring of 2020, a completely new group of patients appeared: patients whose coronavirus infection was combined with the proximal femur fractures. In the course of practical work, hospital doctors had to gain experience in treating these complex patients, solve new organizational and medical tasks. The aim of the study was to evaluate the results of treatment of patients with the proximal femur fractures in combination with coronavirus infection in a covid hospital at the hospital stage, 30-day and 6-month terms. Materials and Methods. The retrospective study is based on the collection and generalization of data from 64 patients with the proximal femur fractures in combination with confirmed coronavirus infection who underwent inpatient treatment from 16.03.2020 to 31.05.2021. 38 (59.4%) patients had a femoral neck fracture, 26 (40.6%) had a fracture of the trochanter region. Forty (62.5%) patients underwent surgical treatment (hip replacement was performed in 23 cases, osteosynthesis was performed in 17 cases), 24 (37.5%) patients did not undergo surgery. Results. With conservative treatment, the hospital mortality rate was 41.6%, the 30-day mortality rate was 72.7%, and the 6 month mortality rate was 95.5%. During surgical treatment, the hospital mortality rate was 5.0% (2 patients died). Early postoperative complications were detected in 5 (12.5%) patients. Thirty-one (77.5%) patients walked or stood with a walker on their own at the time of discharge; 7 (17.5%) patients could not be activated. The thirty-day mortality rate in the group of patients who underwent surgical treatment was 8.6%, and the 6-month mortality rate was 32.1%. Conclusion. Surgical treatment of patients with the proximal femur fractures in combination with coronavirus infection is much more difficult than the treatment of patients without infectious pathology. However, despite number of unresolved problems, surgical treatment of such patients is possible with good results and should be actively applied.

scholarly journals Role of cephalomedullary nail in proximal femur fractures

2017 ◽  
Vol 3 (5) ◽  
pp. 929
Author(s):  
Nishant Kumar ◽  
Dhruv Sharma ◽  
Kuljit Kumar
Keyword(s):  
Hip Fractures ◽  
Proximal Femur ◽  
Femoral Fractures ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Cephalomedullary Nail ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Bending Loads ◽  
Cephalomedullary Nails

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Hip fractures are recognized to be a major public health problem. Key determinants of hip fractures include age, osteoporosis, and falls. In these determinants socioeconomic status, have not been well explored. Under eccentric loading, high bending loads occur, leading to failure of the osteosynthetis anchorage at the center of the femoral head.The introduction of the reconstruction nail has broadened the indications for the intramedullary fixation of difficult femoral fractures. The operative technique is however complicated. Some technical difficulties encountered during its use are presented together with guidance to allow these problems to be avoided.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This Study had included 47 cases which were operated by single surgeon and use of different implant (cephalomedullary nail) was randomized irrespective of fracture types and pattern. This study was done over a period of 12 months (October 2013 to October 2014) with 1 month, 3 months, 6 months, 12 months follow up. At every visit patient were assessed as per Oxford hip score. Type of implant used was<strong> </strong>PFNA<strong>,</strong> Intertan<strong>, </strong>Sirus Nail</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The mean age of the patients was 65.68 (±13.55) years. Severe pain was observed among majority of the patients at one month (70.2%) which became mild (40.4%) and moderate (34%) at 3 months. Very mild pain was found in 36.2% patients at 6 months and in 61.7% at 12 months. The limping was all the time among all the patients at one month. However, the limping was found often in 46.8% at 3 months and sometimes in 57.4% at 6 months and 53.2% at 12 months. The hip score was found to be severe among all the patients at one month. However, moderate to severe hip was in 46.8% patients at 3 months, mild to moderate was in 57.4% at 6 months and satisfactory joint function was in 68.1% at 12 months. The comparison of Hip score according to long or short nail at one 3, 6 and 12 months showed no difference. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Cephalomedullary nails with adequate technique so that the lag screws by purchase in the centre-centre or posterior-inferior quadrant combines the benefit of sliding hip screw as well as intramedullary implants. So we recommend the use of cephalomedullary nails in proximal femur fractures especially the unstable fractures.</span></p>

scholarly journals Bone remodeling features in elderly and senile patients with the proximal femur fractures after hip replacement

2020 ◽  
Vol 73 (2) ◽  
pp. 259-265
Author(s):  
Oleksandr M. Khvysyuk ◽  
Volodymyr O. Babalian ◽  
Serge B. Pavlov ◽  
Galina B. Pavlova
Keyword(s):  
Treatment Outcome ◽  
Proximal Femur ◽  
Enzyme Linked Immunosorbent Assay ◽  
Regulatory Pathways ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Results Of Treatment ◽  
Group 2 ◽  
Tgf Β1 ◽  
Group 1

The aim of this study is to identify the dependence of the result of surgical treatment of patients of elderly and senile age with fractures of the proximal femur on the characteristics of the response cytokine-mediated regulatory response to trauma and surgery. Materials and methods: In 74 patients after hip arthroplasty, serum levels of bone metabolism markers were determined using enzyme-linked immunosorbent assay. Patients were divided into 2 groups depending on the results of treatment. Results: It was found that compared with group 2 (treatment outcome is worse) in group 1 (treatment outcome is better) there was a greater number of correlations. In group 1, correlations were found between OPG and RANKL (r = 0.88; p = 0.000), OPG and OPG/RANKL (r = 0.44; p = 0.006), TGF-β1 and OPG/RANKL (r = 0.66; p = 0.000) , IL-6 and OPG (r = 0.67; p = 0.000), IL-6 and RANKL (r = 0.53; p = 0.001), IL-6 and OPG/RANKL (r = 0.39; p = 0.016). In group 2, only between OPG and OPG/RANKL (r = 0.72; p = 0.000), RANKL and OPG/RANKL (r = −0.53; p = 0.0007). In patients of group 2, there was a decrease in the level of OPG relative to the control and a less significant increase in TGF-β1 and IL-6 relative to group 1. Conclusion: The prognosis of the results of treatment of patients with proximal femur fractures is largely determined by the nature of the adaptive response to injury and the implant, the synchronism of the mechanism of stress remodeling of the bone. A less favorable prognosis after arthroplasty is associated with exacerbation of the initial metabolic disorders in the bone tissue due to severe cytokine-mediated dysfunction of the regulatory pathways.

Trends in the surgical treatment of pathological proximal femur fractures in the United States

2019 ◽  
Vol 120 (6) ◽  
pp. 994-1007 ◽  
Author(s):  
Nathan H. Varady ◽  
Bishoy T. Ameen ◽  
Pierre‐Emmanuel Schwab ◽  
Caleb M. Yeung ◽  
Antonia F. Chen
Keyword(s):  
United States ◽  
Surgical Treatment ◽  
Proximal Femur ◽  
The United States ◽  
Proximal Femur Fractures ◽  
Femur Fractures

scholarly journals In-Hospital Mortality following Proximal Femur Fractures in Elderly Population

2019 ◽  
Vol 05 (02) ◽  
pp. e53-e56 ◽  
Author(s):  
Ganesan G. Ram ◽  
Praveen Govardhan
Keyword(s):  
Hip Fracture ◽  
Hospital Mortality ◽  
Proximal Femur ◽  
Categorical Variables ◽  
Proximal Femur Fracture ◽  
P Value ◽  
Exclusion Criteria ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Significant Difference

Context In India, hip fracture crude incidence above the age of 50 years was 129 per 100,000. Aims The aim of this study is to analyze the in-hospital mortality following proximal femur fractures in elderly Indian population. Methods and Material The study was done in Sri Ramachandra Medical Center, Chennai, India. Patient's records were retrospectively evaluated for a period of 3 years from January 1, 2015 to January 1, 2018. The inclusion criteria were patients both male and female aged more than 65 years admitted with the diagnosis of neck of femur or intertrochanteric or subtrochanteric fractures. The exclusion criteria were patients having any associated fracture or previous hip fracture history or diagnosed primary or secondary malignancies. To evaluate any surgical delay two groups were formed. After eliminating cases based on exclusion criteria, we had 270 patients for evaluation. Statistical Analysis Used The collected data were analyzed with IBM.SPSS statistics software 23.0 Version. To describe about the data descriptive statistics frequency analysis, percentage analysis were used for categorical variables and the mean and standard deviation (SD) were used for continuous variables. To find the significant difference between the bivariate samples, Student's t-test and analysis of variance (ANOVA) were used. The p-value of 0.05 is considered as significant level. Results We had a total of 24 mortalities with 15 males and 9 females. The in-hospital mortality of patients who underwent replacement surgeries for proximal femur fractures was 14 in our study. Sixteen of the in-hospital mortality patients had low Parker's mobility score. Twenty patients had mortality when surgery was delayed more than 48 hours. Conclusions In-hospital mortality in elderly patients having proximal femur fracture increases significantly if the patient was having low-preoperative mobility status, if surgery was delayed more than 48 hours, and if patient undergoes replacement surgeries.

Outcome of non-surgical treatment of proximal femur fractures in the fragile elderly population

Injury ◽  
2019 ◽  
Vol 50 (7) ◽  
pp. 1347-1352 ◽  
Author(s):  
Tal Frenkel Rutenberg ◽  
Aseel Assaly ◽  
Maria Vitenberg ◽  
Shai Shemesh ◽  
Alon Burg ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Proximal Femur ◽  
Elderly Population ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Non Surgical Treatment

Analysis of surgical treatment in elderly and senile patients with proximal femur fractures by extracortical plate osteosynthesis

TRAUMA ◽  
2017 ◽  
Vol 18 (3) ◽  
pp. 80-85 ◽  
Author(s):  
А.V. Kalchenko ◽  
V.А. Babalyan ◽  
А.N. Khvysyuk ◽  
Т.S. Gurbanova ◽  
V.V. Cherepov
Keyword(s):  
Surgical Treatment ◽  
Proximal Femur ◽  
Plate Osteosynthesis ◽  
Proximal Femur Fractures ◽  
Femur Fractures

scholarly journals THE USE OF THE PROXIMAL FEMORAL NAIL IN THE TREATMENT OF PROXIMAL FEMUR FRACTURES IN THE OLD PATIENTS

2010 ◽  
Vol 16 (2) ◽  
pp. 27-31
Author(s):  
V. N. Borovkov ◽  
A. A. Khrupalov ◽  
G. V. Sorokin
Keyword(s):  
Surgical Treatment ◽  
Proximal Femur ◽  
Proximal Femoral Nail ◽  
Municipal Hospital ◽  
Old Patients ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Femoral Nail ◽  
Analysis Of Results ◽  
Proximal Femur Nail

The analysis of results of surgical treatment of 157 patients with proximal femur fractures was presented. In all cases the osteosynthesis using fixator PFN was performed in clinic of traumatology amd orthopedics of Moscow Municipal Hospital N 71 from 2005 till 2009. The authors concluded: proximal femur nail is mini-invasive and mini-traumatic fixator that is essential at treatment of elderly and old patients.

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