scholarly journals Outcomes of Wedge Wing in the Lag Screw for Unstable Intertrochanteric Fractures in Elderly Patients

Hip & Pelvis ◽  
2021 ◽  
Vol 33 (2) ◽  
pp. 71
Author(s):  
Jong Seok Baik ◽  
Keon Rok Kim ◽  
Byung Ha Park ◽  
Suc Hyun Kweon
Keyword(s):  
Elderly Patients ◽  
Intertrochanteric Fractures ◽  
Lag Screw

The Character of Reverse Obliquity Intertrochanteric Fractures in Elderly Patients

2013 ◽  
Vol 26 (3) ◽  
pp. 173 ◽  
Author(s):  
Ji Wan Kim ◽  
Jae-Suk Chang ◽  
Jung Hwan Sung ◽  
Jung Jae Kim
Keyword(s):  
Elderly Patients ◽  
Intertrochanteric Fractures

scholarly journals Lag screw cutout in intertrochanteric fractures fixed with DHS.

2020 ◽  
Vol 27 (09) ◽  
pp. 1862-1866
Author(s):  
Muhammad Nasir Ali ◽  
Muhammad Khalid Chishti ◽  
Kashif Siddiq ◽  
Muhammad Hamayun Hameed ◽  
Muhammad Tayyab Waheed ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Intertrochanteric Fractures ◽  
Cross Sectional ◽  
Middle Position ◽  
Lag Screw ◽  
Screw Position ◽  
Hip Screw ◽  
The Mean ◽  
Study Setting

Objectives: To determine the failure of DHS (dynamic hip screw) in terms of lag screw cutout. Study Design: Hospital Based Cross Sectional study. Setting: BVH and Civil Hospital Bahawalpur. Period: From 2013 to 2018. Material & Methods: 273 patients of both genders with age more than 50 years having stable intertrochanteric fractures were included in this study. With the help of C arm, the best possible anatomical reduction and rigid internal fixation was done with 135 degree DHS. Lag screw position and TAD determined on first postoperative day on radiographs (Anteroposterior & Lateral). Failure of fixation was determined on the radiographs during follow up. Lag screw cut-out was the projection of the screw from the femoral head by more than 1mm. Results: The mean age of the patients was 68.6 years (50-88). There were 132 (51.1 %) males and 126 (48.8%) females. Overall lag screw cutout rate was 11.2%. 21(30.8%) had screw cutout while 47 (69.1%) healed successfully among 68 patients with TAD ≥ 25mm. On the other hand 8(4.2%) had screw cutout while 182 (95.7%) healed successfully among 190 patients with TAD < 25mm. Middle middle and inferior middle position had highest success rate (˃ 92%) while inferior posterior position had highest cutout rate (36.2%). Among different age categories high failure rate (17.8%) seen in patients more than 70 years. Conclusion: The incidence of lag screw cutout is 11.2 % and risk of cutout can be minimized by placing lag screw in middle middle or inferior middle position and keeping the TAD < 25mm. More attention during follow up should be paid to patients with age ˃ 70 years.

scholarly journals Critical analysis of factors determining mechanical failures in proximal femoral nailing

2019 ◽  
Vol 5 (2) ◽  
pp. 275 ◽  
Author(s):  
Karthik Ramachandran ◽  
K. K. Arvind Manoj ◽  
A. Vishnu Sankar
Keyword(s):  
Failure Rate ◽  
Mechanical Failure ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Intertrochanteric Fractures ◽  
Excellent Outcome ◽  
Lag Screw ◽  
Femoral Nailing ◽  
Femoral Nail ◽  
Proximal Femoral Nailing

<p class="abstract"><strong>Background:</strong> Intertrochanteric fractures are one of the commonest fractures encountered in elderly population. Though there are various implants, proximal femoral nail has been the standard choice for management of unstable fractures. Inspite of its biomechanical advantages, various complications like screw cut out, Z effect, reverse Z effect does occur in proximal femoral nailing. The aim of the study is to analyse various factors determining the mechanical failures in patients operated with proximal femoral nail.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study conducted in our institution from June 2014 to May 2018. The study included 72 patients with unstable intertrochanteric fractures treated with proximal femoral nail. All patients were followed for average period of 2 years. Functional outcome was assessed using Harris Hip score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among the patients<strong> </strong>33%<strong> </strong>had excellent outcome. 42% had good and 14% had fair outcome. 11% of cases ended with poor outcome. Mechanical failure rate was less in patients with positive medial cortical support (PMCS) and in patients with tip apex distance difference between antirotation screw and lag screw (TAD<sub>AR </sub>-TAD<sub>LS</sub>) more than 15 mm. Whereas the difference in the position of lag screw centre had no significant influence in the mechanical failure rate in our study.</p><p class="abstract"><strong>Conclusions:</strong> From our study we like to conclude that the<strong> </strong>fracture reduction with positive medial cortical support and the TAD difference play a major role in determining the incidence of mechanical failure in proximal femoral nailing.</p>

scholarly journals Primary cemented bipolar hemiarthroplasty by transtrochanteric approach in unstable intertrochanteric fractures

2021 ◽  
Author(s):  
Thomas Angelo Skariah ◽  
Koshy George ◽  
Deny Mathew ◽  
James C. George ◽  
Samuel Chittaranjan
Keyword(s):  
Elderly Patients ◽  
Successful Treatment ◽  
Tertiary Care ◽  
Postoperative Outcome ◽  
Early Mobilization ◽  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures ◽  
Tertiary Care Centre ◽  
Duration Of Surgery ◽  
One Year

<p><strong>Background:</strong> The successful treatment of unstable intertrochanteric fractures of the femur in elderly patients is a challenge. Due to complications associated with internal fixation, primary hemiarthroplasty is increasingly becoming an alternative treatment to achieve early mobilisation. A transtrochanteric approach could potentially decrease the complications associated with primary hemiarthroplasty. Aim of the study is to document the postoperative outcome and complications associated with this treatment.</p><p><strong>Methods:</strong> In this retrospective study, all elderly patients with unstable trochanteric fractures, treated by primary hemiarthroplasty through a transtrochanteric approach, in a tertiary care centre, from September 2017 to December 2019, were enrolled. Their data from hospital records were analysed and results compared to literature.</p><p><strong>Results:</strong> 48 patients underwent the procedure. Average age was 85 years. One year mortality was 31.25%. Average duration of surgery is 85 min. 58.3% were ambulant at one year. One case of dislocation secondary to surgical site infection was present.</p><p><strong>Conclusions:</strong> Primary hemiarthroplasty as a primary treatment in this group of patients enables early mobilization and prevents complications associated with prolonged immobilization. Transtrochanteric approach reduces the duration of surgery. Achieving early ambulation is the key to successful treatment.</p>

scholarly journals Admission deep venous thrombosis of lower extremity after intertrochanteric fracture in the elderly: a retrospective cohort study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Jinzeng Zuo ◽  
Yongcheng Hu
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Intertrochanteric Fracture ◽  
Lower Extremities ◽  
The Elderly ◽  
Intertrochanteric Fractures ◽  
Targeted Interventions ◽  
Laboratory Test Results

Abstract Objective The purpose of this study was to investigate the incidence, location, and related factors of deep venous thrombosis (DVT) of the bilateral lower extremities after intertrochanteric fractures in the elderly. Methods Retrospective analysis was performed on the elderly patients with intertrochanteric fracture who were admitted from January 2017 to December 2019. At admission, patients receive routine ultrasound Doppler scanning of bilateral lower extremities to detect DVT; those with DVT were assigned to the case group and those without DVT to the control group. Patient data on demographics, comorbidities, injury-related data, and laboratory test results at admission were extracted. Logistic regression analyses were conducted to identify the independent risk factors associated with DVT. Results Five hundred seventy-eight patients were included, among whom 116 (20.1%) had DVT. Among those with DV, 70.7% (82/116) had DVT of the distal type, 24 (29.6%) had DVT of the proximal type, and 10 (10.4%) had mixed DVT. In 76.7% (89/116) of patients, DVT occurred in the fractured extremity, 9.5% (11/116) in the bilateral and 13.8% (16/116) in the non-fractured extremity. Multivariate analyses identified obesity, delay to admission, increased D-dimer level (> 1.44 mg/L) and reduced albumin (< 31.7 g/L) as independent factors. Conclusions Admission incidence of DVT was high in elderly patients with intertrochanteric fractures, especially the proximal DVT. Identification of associated risk factors is useful for individualized assessment risk of DVT and early targeted interventions.

Mid-term survivals of cemented calcar-replacement bipolar hemiarthroplasty for unstable intertrochanteric fractures in elderly patients

Injury ◽  
2019 ◽  
Vol 50 (12) ◽  
pp. 2277-2281
Author(s):  
Adem Cobden ◽  
Yalkin Camurcu ◽  
Serda Duman ◽  
Ahmet Kocabiyik ◽  
Mehmet Kıs ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures
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