Comparison of locking plate and cephalomedullary nailing in unstable proximal femur fractures

PURPOSE- All type of plates when used for proximal femur fractures always has chances of mechanical failure due to lack of strength of the construct, but addition of ‘kick stand screw’ has some effects on stability of the construct. Aim of our study is to evaluate the efficacy of kick stand screw in fixation of subtrochanteric fractures using contralateral reversed distal femoral locking plate. METHOD- 30 patients of subtrochanteric fractures fixed using contralateral reversed distal femoral locking plate. N(1st)=15 fixed without kick stand screw and other N(2nd)=15 fixed using kick stand screw. Calcar screw( Kick Stand Screw) is placed to support calcar region (inferior to the center in AP view and central in Lateral view). In other group screws are placed as oriented in screw holes. Outcome was assessed using Harris Hip Score and VAS score and change in the neck shaft angle is also followed. RESULT- Union rate was 80% in 1st group as compare to 94% in second group. Mean Harris hip score at the one year follow up was 71.2 in 1st group as compare to 89.2 in 2nd group. Mean Visual analogue scale was 3.2 in first group as compare to 1.6 in second group at final follow up. Mean neck shaft angle at final follow-up was 120 degree in first group as compared to135 degree in second group. Complication- 1st Group of patients had three failures 2 in the form of screw break down and one in the form of plate bending, all three lend up in to varus deformity but the 2nd group had only one failure in the form of plate bending. CONCLUSION-In our study cases in which kick stand screw was used they showed better mechanical strength and gave better clinical results. So in proximal femur fractures including subtrochanteric fracture fixation ‘kick stand screw’ must be used.

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Minimally invasive surgery and the use of locking plate in the management of proximal femur fractures

Türk Ortopedi ve Travmatoloji Birliği Derneği ◽

10.5606/totbid.dergisi.2012.07 ◽

2012 ◽

Vol 11 (1) ◽

pp. 49-54

Author(s):

Mahir Mahiroğulları

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Proximal Femur ◽

Locking Plate ◽

Proximal Femur Fractures ◽

Femur Fractures

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Costs and Complications of Short Versus Long Cephalomedullary Nailing of OTA 31-A2 Proximal Femur Fractures in U.S. Veterans

Journal of Orthopaedic Trauma ◽

10.1097/bot.0000000000000521 ◽

2016 ◽

Vol 30 (3) ◽

pp. 125-129 ◽

Cited By ~ 11

Author(s):

Henry Krigbaum ◽

Steven Takemoto ◽

Hubert T. Kim ◽

Alfred C. Kuo

Keyword(s):

Proximal Femur ◽

Proximal Femur Fractures ◽

Femur Fractures ◽

Cephalomedullary Nailing

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Geriatric Proximal Femur Fractures During the Covid-19 Pandemic - Fewer Cases, But More Comorbidities

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/21514593211009657 ◽

2021 ◽

Vol 12 ◽

pp. 215145932110096

Author(s):

Christina Polan ◽

Heinz-Lothar Meyer ◽

Manuel Burggraf ◽

Monika Herten ◽

Paula Beck ◽

...

Keyword(s):

Nursing Home ◽

Elderly Patients ◽

Proximal Femur ◽

Minor Trauma ◽

Proximal Femur Fractures ◽

Femur Fractures ◽

Number Of Patients ◽

Group 2 ◽

The Impact ◽

Group 1

Background: The COVID-19 pandemic is challenging healthcare systems worldwide. This study examines geriatric patients with proximal femur fractures during the COVID-19 pandemic, shifts in secondary disease profile, the impact of the pandemic on hospitalization and further treatment. Methods: In a retrospective monocentric study, geriatric proximal femur fractures treated in the first six months of 2020 were analyzed and compared with the same period of 2019. Pre-traumatic status (living in a care home, under supervision of a legal guardian), type of trauma, accident mechanism, geriatric risk factors, associated comorbidities, time between hospitalization and surgery, inpatient time and post-operative further treatment of 2 groups of patients, aged 65-80 years (Group 1) and 80+ years (Group 2) were investigated. Results: The total number of patients decreased (70 in 2019 vs. 58 in 2020), mostly in Group 1 (25 vs. 16) while the numbers in Group 2 remained almost constant (45 vs. 42). The percentage of patients with pre-existing neurological conditions rose in 2020. This corresponded to an increase in patients under legal supervision (29.3%) and receiving pre-traumatic care in a nursing home (14.7%). Fractures were mostly caused by minor trauma in a home environment. In 2020, total number of inpatient days for Group 2 was lower compared to Group 1 (p = 0.008). Further care differed between the years: fewer Group 1 patients were discharged to geriatric therapy (69.6% vs. 25.0%), whereas in Group 2 the number of patients discharged to a nursing home increased. Conclusions: Falling by elderly patients is correlated to geriatric comorbidities, consequently there was no change in the case numbers in this age group. Strategic measures to avoid COVID-19 infection in hospital setting could include reducing the length of hospital stays by transferring elderly patients to a nursing home as soon as possible and discharging independent, mobile patients to return home.

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