scholarly journals Comparison of proximal femoral nailing (PFN) and proximal femoral locking plate (PFLP) for intertrochanteric femur fracture in elderly.

2021 ◽  
Vol 28 (10) ◽  
pp. 1418-1421
Author(s):  
Syed Muhammad Khalid Karim ◽  
Sheikh Naeem Ul Haq ◽  
Abdul Rehman Khan ◽  
Abdur Rab Nawaid
Keyword(s):  
Functional Outcome ◽  
Femur Fracture ◽  
Controlled Trial ◽  
Harris Hip Score ◽  
Functional Evaluation ◽  
Medical College ◽  
Duration Of Surgery ◽  
Fracture Study ◽  
Score Result ◽  
Intertrochanteric Femur Fracture

Objective: To compare the functional outcome of PFN and PFLP for the treatment of unstable four part intertrochanteric femur fracture. Study Design: Randomized Controlled Trial study. Setting: Orthopedics Department, Dow International Medical College, Karachi. Period: February 2019 to January 2020. Material & Methods: 281 patients were included and assigned to each group PFNA and PFLP alternatively. Both groups were compared for functional evaluation by Harris hip score. Result: Duration of surgery, perioperative hemoglobin loss, and duration of fracture healing were significantly lower in PFNA group as compared to PFLP, P<0.05. But Harris Hip score was significantly higher in PFNA group as compare to PFLP P>0.05. Conclusion: PFN has better functional outcome. This makes it a better method of fixation as compared to PFLP in elderly intertrochanteric femur fracture.

scholarly journals Functional Outcome & Revision Rate Of Pfna Vs Dhs For Osteoporotic Intertrochanteric Femur Fracture: A Meta Analysis

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0003
Author(s):  
Sherly Desnita Savio ◽  
I Made Arya Susila ◽  
Cokorda Gde Oka Dharmayuda
Keyword(s):  
Functional Outcome ◽  
Femur Fracture ◽  
Revision Rate ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Harris Hip Score ◽  
Significant Difference ◽  
The Mean ◽  
Intertrochanteric Femur Fracture

Objectives: Intertrochanteric femur fracture in elderly presents a challenge as the source of morbidity and mortality if not well-treated. This study investigates the functional outcome and revision rate of two of the most common treatments of choice for this condition, Proximal Femoral Nail Antirotation (PFNA) and Dynamic Hip Screw (DHS), while furthermore investigate the secondary functional outcome of the two procedures if proceeded to Conversion to Total Hip Arthroplasty (CTHA). Methods: A systematic search was conducted to identify relevant studies through PubMed, Google Scholar, and Cochrane database. A total of 9 studies (2.251 patients) were included, divided into 3 meta-analysis. Random effect model was used for continuous outcomes using Review Manager. Results: For primary Harris Hip Score (HHS), the mean HHS at 12-months follow-up for PFNA (n = 184) was 77.77, as for DHS (n = 187) was 78.33, indicating no significant difference (P = 0.73). The mean revision rates for PFNA (n=784) was 2.68%, as for DHS (n=766) was 2.48%, indicating no significant difference (P = 0.61). For secondary HHS after CTHA, the mean HHS 12-months postoperatively for PFNA (n =142) was 83.97, as for DHS (n = 190) was 83.65, indicating no significant difference (P = 0.59). Discussion: PFNA and DHS can both be considered in osteoporotic intertrochanter femur fracture, as the two procedures offer similar 1-year functional outcome and revision rate. However, PFNA may benefit with less blood loss and operation time. Some potential revision causes, such as peri-implant femoral fracture, infection, and implant failure should always be monitored perioperatively. Furthermore, when CTHA is indicated for revision, the two procedures offer comparable secondary functional outcome. Conclusion: Current meta-analysis suggests that PFNA and DHS both have comparable primary functional outcome, revision rate, and post-CTHA secondary functional outcome.

Dynamic Hip Screw in Comparison with Proximal Femoral Nail Technique in Intertrochanteric Femur Fracture Patients

2021 ◽  
Vol 15 (11) ◽  
pp. 2966-2968
Author(s):  
Mudir Khan ◽  
Muhammad Siraj ◽  
Abbas Ali
Keyword(s):  
Blood Loss ◽  
Femur Fracture ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Femoral Nail ◽  
Duration Of Surgery ◽  
Hip Screw ◽  
Intertrochanteric Femur Fracture ◽  
Better Than

Background: Hip bone fractures are the main cause of concern on a worldwide level. The main two operative techniques involve dynamic hip screw and proximal femoral nail technique. Aim: To compare the dynamic hip screw with proximal femoral nail technique in intertrochanteric femur fracture patients. Study design: Retrospective study Place and duration of study: Department of Orthopaedics, Khyber Teaching Hospital, Peshawar from 1-7-2019 to 30-12- 2021. Methodology: Seventy patients were enrolled and they were divided in two groups; Group 1 patients were operated with dynamic hip screw (DHS) while group 2 patients were operated by proximal femoral nail (PFN) technique. The detailed pre and post-operative clinical information including blood loss, incision size, Harris hip score and rate of complication was documented. Results: The mean age of patients was 58.62±6.71 year with more male patients than females. The Harris hip score of proximal femoral nail technique was better than distal hip screw. The incision length of distal hip screw cases was 7.61±0.89 in comparison to 4.72±0.73 in proximal femoral nail technique cases with a longer duration of surgery and inter-operative blood loss in case of distal hip screw cases. Conclusion: Proximal femoral nail technique is comparatively better than the distal hip screw procedure. Keywords: Proximal femoral nail technique, distal hip screw, Hip fracture

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 Study of functional outcome of total hip arthroplasty in a series of cases of hip pathologies done in rural population

2016 ◽  
Vol 2 (4) ◽  
pp. 269
Author(s):  
Rahul Kadam ◽  
Pankaj Bansal ◽  
Abhay Chhallani
Keyword(s):  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Rural Population ◽  
Harris Hip Score ◽  
Controlled Study ◽  
Walking Ability ◽  
Total Hip ◽  
Medical College

<p class="abstract"><strong>Background:</strong> The objective of the study was to assess the functional outcome of total hip arthroplasty (THA) done in a series of cases of hip pathologies rural population.</p><p class="abstract"><strong>Methods:</strong> A retrospective randomized controlled study conducted in 50 cases of hip arthritis (38 males and 12 females)  treated with uncemented THA for an average follow-up of  2 years  at department of orthopedics MGM Medical College, Kamothe, Navi Mumbai. Harris hip scoring system was used for the functional scoring and the postoperative radiographs were assessed by Gruen zones for the femoral component and DeLee and Charnley zones for the acetabular component. All patients were evaluated pre operatively and post operatively 3 months 6 months, 12months, 2years with Harris Hip score.<strong></strong></p><p class="abstract"><strong>Results:</strong> 81% of our patients scored 85 points or better for a rating of excellent by Harris hip score system. 90% patients had little /no pain post operatively, whereas walking ability improved and was unlimited in 80% of the patients post operatively. Harris hip score improved from 40 to 80. 80.5% -excellent, 13.80% -good, 5.7% -fair results. Poor results were not seen in any patient.</p><p class="abstract"><strong>Conclusions:</strong> THR provided excellent pain relief, adequate stability, and remarkable range of motion in severely painful, refractory hip. A significant improvement was seen at two year follow-up. </p>

LONG TERM FUNCTIONAL EVALUATION AUTOFIBULAR STRUT GRAFT IN CASE OF FRACTURES NECK FEMUR IN RSUD DR SOETOMO SURABAYA

2019 ◽  
Vol 7 (1) ◽  
pp. 55
Author(s):  
Achmad Sjarwani ◽  
OK Ilham Abdullah Irsyam
Keyword(s):  
Medical Record ◽  
Operating Room ◽  
Femur Fracture ◽  
Primary Data ◽  
Harris Hip Score ◽  
Functional Evaluation ◽  
Medical Record Data ◽  
Strut Graft ◽  
Record Data

Background: Neck femur fracture has a poor prognosis due to its anatomical structure. Fractures that occur in the elderly often have a heavy comorbid so that the mortality rate in 1 year in this case reaches 30-50%. The techniques that have been developed at this time are not satisfactory results with non-union rate of about 30%.Purpose: Assessing the long-term effectiveness of fibular auto strut graft techniques for neck femoral fracture therapy.Methods: The study was conducted retrospectively using primary data in the form of clinical evaluation and secondary data in the form of medical record data and questionnaires of neck femur fracture patients who performed non-vascularized autofibular strutgraft therapy in the period January 2005 to August 2015 in operating room IRD RSUD Dr. Soetomo Surabaya. Patients were evaluated with Harris Hip Score.Result: Medical record data shows that surgery was performed in January 2005 until August 2015 in the IRD hospital operating room. Soetomo Surabaya with 15 patients that fit criteris inclusion. The final result of Harris Hip Score is excellent in 66.66% of patients, good in 20% of patients, and poor on 13.33% of patients. It can be seen that in large part, the technique of autofibular strutgraft (Surabaya Technique) gives good results to the sufferer.Conclusion: Autofibular strutgraft and reinforcement with cancellous lag screw on neck femur fracture can generally provide good functional results in long term evaluation. From the assessment of functional aspects, abnormal anatomical conditions, and Range of Motion (ROM), obtained satisfactory results. This supports autofibular strutgraft as a neck femur fracture therapy as a major therapeutic option at a young age.

scholarly journals Double reverse traction repositor versus traction table for the treatment of intertrochanteric femur fracture: A comparative Study

2020 ◽  
Author(s):  
Mingming Yan ◽  
letian kuang ◽  
jiangdong ni ◽  
muliang ding ◽  
jun huang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Femur Fracture ◽  
Patient Positioning ◽  
Clinical Results ◽  
Healing Time ◽  
Harris Hip Score ◽  
Proximal Femur Fracture ◽  
Intertrochanteric Femur Fracture ◽  
Fracture Complication

Abstract Background The aim of this study was to compare the clinical results between double reverse traction repositor and traction table used for the treatment of unstable intertrochanteric femur fracture. Methods This retrospective study included 95 patients with AO/OTA 31- A2 and A3 proximal femur fracture, who underwent double reverse traction repositor or traction table facilitated Asian proximal femoral nail antirotation (PFNA-II) nailing. The demographics, duration of operation, blood loss, part loading time after surgery, the period of union of fracture, complication were assessed. Clinical and radiological outcomes were evaluated. Results There were no significant differences in respect to demographics and fracture characteristics. Duration of patient positioning and total operative time were significant longer in traction table group than that in double reverse traction repositor group(p<0.001). No differences were found intraoperative blood loss, part loading time after surgery, fracture healing time and Harris Hip Score between two groups. Conclusion When treating unstable intertrochanteric fractures, double reverse traction repositor is superior to tract table in respect to operative time and duration of patient position, despite an additional ipsilateral anterior superior iliac spine (ASIS)incision and drilling of ASIS and femur condyle.

scholarly journals EVALUATION FUNCTIONAL OUTCOME OF HELICAL FIXATION PFN A2 IN PROXIMAL FEMUR FRACTURE IN ELDERLY

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Sawai Singh ◽  
Ram Chander
Keyword(s):  
Comparative Study ◽  
Functional Outcome ◽  
Proximal Femur ◽  
Femur Fracture ◽  
Proximal Femoral Nail ◽  
Proximal Femur Fracture ◽  
Mortality And Morbidity ◽  
Femoral Nail ◽  
Proper Training ◽  
Intertrochanteric Femur Fracture

Background: Intertrochantric fractures are the most frequently operated fractures and has the highest mortality and morbidity rates. Evaluation functional outcome of helical fixation pfn a2 in proximal femur fracture in elderly Methods: Hospital based prospective randomized comparative study conducted on 30 patients with  Close  stable &unstable intertrochanteric femur fracture. Results: As per HHS, we have found that 76.67% cases (23) under excellent category and 20.00% (6) good and 3.33% (1) fair of HHS. Conclusion: We can conclude that the PROXIMAL FEMORAL NAIL ANTIROTATION2 is after proper training and technique a safe and easy implant option for treatment of complex peritertrochanteric fractures. Keywords: HHS, Femur, fracture

scholarly journals Study on functional outcome and mechanical failure in intertrochanteric femur fracture treated with proximal femoral nail antirotation-II

2021 ◽  
Vol 7 (2) ◽  
pp. 350-358
Author(s):  
Dr. Siddharth Bhaginath Jadhav ◽  
Dr. Rahul Ajit Damle ◽  
Dr. Janmajay Dalal ◽  
Dr. Saumitra Dubey ◽  
Dr. Abhijeet Nalkar ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Femur Fracture ◽  
Mechanical Failure ◽  
Proximal Femoral Nail ◽  
Femoral Nail ◽  
Proximal Femoral Nail Antirotation ◽  
Intertrochanteric Femur Fracture
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