DHS,Gamma nail and PFNA in treatment of osteoporotic intertrochanteric fracture in the elderly:a retrospective study

Background: An unstable intertrochanteric fracture in osteoporotic elderly patients presents a very challenging problem to the surgeons. This category of patients if kept in bed for long tends to have many complications like deep vein thrombosis, pneumonia, bed sores, etc. Surgeon’s worldwide face difficulty in getting a good anatomical reduction and do not allow early mobility to these patients because of risk of loss of reduction and implant cut out. The purpose of our study is to study the usefulness of arthroplasty in these patients in terms of better functional outcomes and no increase in complication rates.Methods: It was a retrospective study involving 25 patients (17 females, 8 males) with mean age of 76±2.3 years having intertrochanteric femur fractures (AO type A 2.2 and above) with osteoporosis operated upon with bipolar hemiarthroplasty at IQ City Medical College and NM Hospital between January 2015 and January 2017.Results: All the patients were followed up for a period of 1 year. We had a mean operative time of 75 min (range 55-125 min) with an average blood loss of 450 ml. 4 of our patients required postoperative blood transfusion. All patients walked on 2nd postoperative day. We had a mean Harris hip score of 82 and mean VAS of 1 at the end of 1 year.Conclusions: Hemiarthroplasty done in cases of unstable intertrochanteric femur fractures in elderly patients with osteoporotic bones allows early weight bearing thus improves the final functional outcomes. Further randomized trials are required before deriving any conclusions.

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The Asian-Pacfic Gamma Nail for Intertrochanteric Fracture of the Femur

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.1999.34.5.819 ◽

1999 ◽

Vol 34 (5) ◽

pp. 819 ◽

Cited By ~ 1

Author(s):

Sang Hong Lee ◽

Sang Ho Ha ◽

Sung Joon Park

Keyword(s):

Intertrochanteric Fracture ◽

Gamma Nail

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Treatment of Intertrochanteric Fracture with Dynamic Hip Screw and Gamma Nail: A Retrospective Matched Pair Study

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2001.36.5.423 ◽

2001 ◽

Vol 36 (5) ◽

pp. 423 ◽

Cited By ~ 2

Author(s):

Joon Soon Kang ◽

Seung Rim Park ◽

Hyung Soo Kim ◽

Woo Hyeong Lee ◽

Ki Wook Kim ◽

...

Keyword(s):

Intertrochanteric Fracture ◽

Gamma Nail ◽

Dynamic Hip Screw ◽

Matched Pair ◽

Hip Screw

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Intertrochanteric fracture non-unions with implant failure of the gamma nail

Pan African Medical Journal ◽

10.11604/pamj.2016.23.57.7965 ◽

2016 ◽

Vol 23 ◽

Author(s):

Mouhcine Sbiyaa ◽

Adil El Alaoui ◽

Mohammed Admi ◽

Kamal Lahrach ◽

Amine Marzouki ◽

...

Keyword(s):

Intertrochanteric Fracture ◽

Gamma Nail ◽

Implant Failure

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Treatment of trochanteric fractures using the Gamma nail

ARS Medica Tomitana ◽

10.1515/arsm-2015-0020 ◽

2015 ◽

Vol 21 (1) ◽

pp. 52-56

Author(s):

V. Botnaru ◽

Al. O. Șerban ◽

Al. Valcu ◽

B. Obadă

Keyword(s):

Retrospective Study ◽

Weight Bearing ◽

Gamma Nail ◽

Fracture Reduction ◽

Trochanteric Fractures ◽

Surgical Indications ◽

Septic Complications ◽

Female Sex ◽

Reduction Stability ◽

Consolidation Time

Abstract A retrospective study on 2 years and 4 months (April 2012 - August 2014) on 430 patients admitted with trochanteric fractures in our Clinic. The surgical indications depended on the patients age, degree of osteoporosis, level activity, associated pathologies and the anatomo-clinical particularity of the fractures. The fractures were operated with gamma nail. The surgery was done in the first 24-72 hours, patients were followed clinically and radiographically at 2, 4, 6 months postoperative. The age of the patients were between 28-95 years, female sex was predominant in 65% of case. It was reported a case of a fracture produced intraoperatory during progression of the nail, 11 bronhopulmonary complications, 5 phlebitis, 7 cases of hematoma after surgery, a case of pseudarthrosis with loosening of implant and 4 dead. There were no septic complications. Fractures consolidate within 12- 14 weeks. The results were appreciated according to fracture reduction, stability of implant, consolidation time and possibility of walking and weight bearing on operated limb.

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