scholarly journals Primary arthroplasty as a method of choice for the treatment of pertrochanteric fractures in elderly and senile patient

TRAUMA ◽  
2020 ◽  
Vol 21 (5) ◽  
pp. 20-26
Author(s):  
A.I. Kanziuba ◽  
V.G. Klimovitskiy ◽  
P.P. Popurkanich
Keyword(s):  
Pertrochanteric Fractures ◽  
Primary Arthroplasty ◽  
Senile Patient

Operated unstable pertrochanteric fractures leading to osteonecrosis of femoral head

2015 ◽  
Vol 2 (2) ◽  
pp. 113-116
Author(s):  
Neetin P. Mahajan ◽  
Ankit A. Marfatia ◽  
Nadir Z. Shah ◽  
F Memon ◽  
S. Mukherjee ◽  
...  
Keyword(s):  
Femoral Head ◽  
Osteonecrosis Of Femoral Head ◽  
Pertrochanteric Fractures

scholarly journals Medial abrasion syndrome: a neglected cause of persistent pain after knee arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shaw-Ruey Lyu ◽  
Chia-Chen Hsu ◽  
Jung-Pin Hung
Keyword(s):  
Knee Arthroplasty ◽  
Surgical Techniques ◽  
Varus Deformity ◽  
Outcome Study ◽  
Primary Arthroplasty ◽  
Post Operative Pain ◽  
Plateau Fracture ◽  
Advanced Stages ◽  
Total Knee ◽  
Medial Release

Abstract Introduction Persistent post-operative pain (PPOP) has detracted from some otherwise successful knee arthroplasties. This study investigated medial abrasion syndrome (MAS) as a cause of PPOP after knee arthroplasty. The surgical techniques and outcomes of incorporating this concept into the management of both primary arthroplasty cases and patients suffering from unknown causes of PPOP after arthroplasties were presented. Materials and methods In a 1-year period, the author performed unicompartmental or total knee arthroplasty (the UKA or TKA group) that also eliminated medial abrasion phenomenon (MAP) on 196 knees of 150 patients at advanced stages of knee osteoarthritis (OA). During the same year, 16 knees of 16 patients with unknown causes of PPOP after knee arthroplasties were referred to the author for the arthroscopic medial release procedure (the AMR group) after being diagnosed as MAS. Subjective satisfaction, Knee Society Score (KSS), and Knee injury and Osteoarthritis Outcome Score (KOOS) evaluations were used for outcome study. Results All 166 patients were followed for more than 3 years (mean 3.7 years, 3.1–4.2) for the outcome study. All knees receiving arthroplasty showed medial plicae with MAP at the time of surgery. Only 2 of them suffered from PPOP: one was a neglected tibial plateau fracture with residual varus deformity after UKA, and the other was a late infection after TKA and received revision. The satisfactory rate was 98.8% in the UKA group, 99.1% in the TKA group, and 100% in the AMR group. The Knee Society Scores and all subscales of KOOS were statistically improved in all groups. Conclusions MAS is a cause of pain in patients who have received knee arthroplasties, and MAP should be eliminated to ensure a successful knee arthroplasty. PPOP after knee arthroplasty can be caused by MAS, which can be managed by AMR.

Which AO/OTA 31-A2 pertrochanteric fractures can be treated with a dynamic hip screw without developing a lateral wall fracture? A CT-based study

2015 ◽  
Vol 40 (5) ◽  
pp. 1009-1017 ◽  
Author(s):  
Gaurav Sharma ◽  
Ravijot Singh ◽  
Kiran Kumar GN ◽  
Vaibhav Jain ◽  
Ankit Gupta ◽  
...  
Keyword(s):  
Lateral Wall ◽  
Dynamic Hip Screw ◽  
Pertrochanteric Fractures ◽  
Hip Screw

Outcomes of Revision of Interposition Implant Trapeziometacarpal Arthroplasty

Hand ◽  
2021 ◽  
pp. 155894472110289
Author(s):  
Simo Mattila ◽  
Eero Waris
Keyword(s):  
Revision Surgery ◽  
Trapeziometacarpal Osteoarthritis ◽  
Primary Arthroplasty ◽  
Significant Difference ◽  
Functional Scores ◽  
Ceramic Implants ◽  
Evaluation Measure ◽  
Surgery Rates ◽  
Implant Dislocation ◽  
Surgical Unit

Background Implant arthroplasties for trapeziometacarpal osteoarthritis are often associated with high complication and revision surgery rates. There are no previous studies reporting revision outcomes of failed interposition implant arthroplasty. Methods A patient register search was done for all implant arthroplasties performed for trapeziometacarpal osteoarthritis during a 10-year period in a single hand surgical unit. Altogether, 32 patients had primary interposition implant arthroplasty (Artelon 22, Pyrosphere 6, Ortosphere 2, and Pyrodisk 2), and 19 of these patients had revision surgery with 23 revision procedures performed. In all, 15 of the revised 19 patients were reexamined clinically (Connolly-Rath score, Quick Disabilities of the Arm Shoulder and Hand, patient evaluation measure, the visual analog score for pain, thumb range of motion and strength measurements) and radiographically. Results The indication for revision surgery was pain alone or implant dislocation accompanied by pain in all cases. Thirteen of the revised 15 patients reported functional deficit and pain after revision. There was no statistically significant difference in the revision outcomes between patients operated on primarily with the Artelon implant versus pyrocarbon/ceramic implants. Compared to previous studies on revision surgery and primary trapeziometacarpal arthroplasty, our results showed slightly higher pain and poorer functional scores. Conclusions Interposition implant arthroplasty may yield high revision rates. The results after revision surgery may be worse than previously described, and there may also be a tendency for worse results than those of primary arthroplasty. Interposition implant arthroplasty should always be thoroughly contemplated.

A higher reoperation rate following arthroplasty for failed fixation versus primary arthroplasty for the treatment of proximal humeral fractures

2019 ◽  
Vol 101-B (10) ◽  
pp. 1272-1279 ◽  
Author(s):  
Lauren. L Nowak ◽  
Jeremy Hall ◽  
Michael D. McKee ◽  
Emil H. Schemitsch
Keyword(s):  
Prognostic Factors ◽  
Proximal Humerus ◽  
Revision Arthroplasty ◽  
Reoperation Rate ◽  
Multilevel Logistic Regression ◽  
Proximal Humerus Fractures ◽  
Primary Arthroplasty ◽  
Humerus Fractures ◽  
Reoperation Rates ◽  
High Reoperation Rate

Aims To compare complication-related reoperation rates following primary arthroplasty for proximal humerus fractures (PHFs) versus secondary arthroplasty for failed open reduction and internal fixation (ORIF). Patients and Methods We identified patients aged 50 years and over, who sustained a PHF between 2004 and 2015, from linkable datasets. We used intervention codes to identify patients treated with initial ORIF or arthroplasty, and those treated with ORIF who returned for revision arthroplasty within two years. We used multilevel logistic regression to compare reoperations between groups. Results We identified 1624 patients who underwent initial arthroplasty for PHF, and 98 patients who underwent secondary arthroplasty following failed ORIF. In total, 72 patients (4.4%) in the primary arthroplasty group had a reoperation within two years following arthroplasty, compared with 19 patients (19.4%) in the revision arthroplasty group. This difference was significantly different (p < 0.001) after covariable adjustment. Conclusion The number of reoperations following arthroplasty for failed ORIF of PHF is significantly higher compared with primary arthroplasty. This suggests that primary arthroplasty may be a better choice for patients whose prognostic factors suggest a high reoperation rate following ORIF. Prospective clinical studies are required to confirm these findings. Cite this article: Bone Joint J 2019;101-B:1272–1279

scholarly journals Surgical treatment of pertrochanteric fractures by dynamic methods of external and internal fixation

2003 ◽  
Vol 60 (6) ◽  
pp. 663-667 ◽  
Author(s):  
Sasa Milenkovic ◽  
Milorad Mitkovic ◽  
Mile Radenkovic ◽  
Desimir Mladenovic ◽  
Gordana Soldatovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
External Fixation ◽  
Functional Results ◽  
Surgical Trauma ◽  
Pertrochanteric Fractures ◽  
Skeletal Mass ◽  
Dynamic Methods ◽  
Life Threat ◽  
Methods Of Treatment

Pertrochanteric fractures usually occur in patients over 65 years of age, with greater loss of skeletal mass (osteoporosis). Nonsurgical methods of treatment are accompanied by relatively high lethality rate. Moreover, they do not produce satisfactory anatomical and functional results. Surgical treatment by using dynamic implants represents a method of choice in the fixation of pertrochanteric fractures. This paper presents the treatment results of 110 patients, 61 with pertrochanteric fractures, who were surgically treated by the dynamic method of internal fixation, and 49 patients who were treated by the method of external fixation. Dynamical implants enabled both dynamization and compression of the fracture in the axis of the neck, as well as the diaphysis of the femur, which lowered the risk of mechanical complications, and, at the same time, provided effective healing of the fracture, early activation, and mobilization of the patients on whom the surgery was performed. In patients infected by various diseases, for whom surgical trauma represents a life threat, the external fixation is recommended as a method of choice.

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