scholarly journals Evaluation of proximal femoral locking plate in unstable extracapsular proximal femoral fractures: Surgical technique & mid term follow up results

2014 ◽  
Vol 5 (3) ◽  
pp. 137-145 ◽  
Author(s):  
Nishikant Kumar ◽  
Himanshu Kataria ◽  
Chandrashekhar Yadav ◽  
Bharath S. Gadagoli ◽  
Rishi Raj
2018 ◽  
Vol 9 ◽  
pp. 215145851775051 ◽  
Author(s):  
Franz Müller ◽  
Michael Galler ◽  
Christina Roll ◽  
Bernd Füchtmeier

Introduction: The surgical treatment of proximal femoral fractures predominantly involves geriatric patients and is associated with high morbidity and mortality. However, analyses on postoperative infections or hematoma are rare. Methods: Patients requiring surgical revision due to infection (n = 90) or hematoma (n = 77) in the postoperative phase were identified from an electronic database of 2000 consecutive patients surgically treated for proximal femoral fractures between 2006 and 2014. Demographic and clinical data were retrieved, including information on the pathogens in patients with infection. A follow-up on morbidity and mortality was conducted via telephone for at least 2 years postsurgery. Results: The follow-up rate was 100%, and the mean age was 81.9 years. The incidence rate of infection was 4.1% (90/2000), and women were commonly affected. Staphylococcus aureus and Staphylococcus epidermidis were the most commonly detected pathogens (35.5% and 25.5%, respectively). Mixed infections were observed in 15 patients, and Methicillin-resistant Staphylococcus aureus infections were observed in only 4 patients. A total of 77 (85.6%) infections occurred within 30 days postsurgery. The implant was preserved in 76 (84.4%) patients, and resection arthroplasty was required in 14 patients. Dementia and pertrochanteric fractures were significantly more common in the infection than in the hematoma group. Although infections were associated with high mortality rates for up to 2 years postsurgery, the rates did not significantly differ from those in the hematoma control group. Conclusion: One of every 2 patients who developed an infection following the surgical treatment of a proximal femoral fracture died within 2 years postsurgery. In addition, infections were significantly associated with dementia. Avoiding postoperative infection should be a high priority in the surgical treatment of proximal femoral fractures.


2017 ◽  
Vol 16 (04) ◽  
pp. 07-14
Author(s):  
Harindra Himanshu ◽  
Mani Bhushan Prasad ◽  
Ajay Kumar Verma ◽  
Lal Bahadur Manjhi

2020 ◽  
Author(s):  
Liangqi Kang ◽  
Hui Liu ◽  
Zhenqi Ding ◽  
Yiqiang Ding ◽  
Wei Hu ◽  
...  

Abstract Background: Although many treatments for ipsilateral proximal and shaft femoral fractures have been developed, controversy exists regarding their optimal management. The purpose of this retrospective study was to discuss the effectiveness of the Bridge-Link type combined fixation system (BCFS) and evaluate functional outcomes in treating patients with these complex fractures. Patients and Methods: We retrospectively reviewed 14 cases of ipsilateral proximal and shaft femoral fractures treated from January 2012 to December 2016. All cases were treated by BCFS combined with minimally invasive percutaneous plate osteosynthesis (MIPPO). Clinical and radiographic data were collected during regular post-operative follow-up visits. Functional outcomes were determined according to the Friedman and Wyman scoring system. Results: The proximal femoral fractures were emergency diagnoses in 11 cases and delayed diagnoses in 3 cases. The delay time was 5-6 days, with an average of 5.3 days. The mean operation time was 179.6 minutes (range 135-231 minutes) with a blood loss volume that ranged from 430 to 535 ml (average 483.6 ml). Follow up was conducted in 13 cases between 9 and 30 months post-operation, with an average follow-up time of 17.3 months. The proximal femoral fractures were united in 12 cases at the final follow-up. One case had nonunion 13 months after the operation, underwent valgus intertrochanteric osteotomy, and healed 6 months later. The femoral shaft fractures obtained rigid union at the latest follow-up in 12 cases. One case endured nonunion 12 months after the operation. After the revision surgery and iliac bone grafting, the fracture healed 6 months later. Eight of the cases had good functional results, 4 had fair results, and results were poor in 1 case at the final follow-up. Conclusions: The treatment of ipsilateral proximal femoral and shaft fractures with BCFS in combination with MIPPO demonstrated a high likelihood of union for both fractures and good functional results.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Liangqi Kang ◽  
Hui Liu ◽  
Zhenqi Ding ◽  
Yiqiang Ding ◽  
Wei Hu ◽  
...  

Abstract Background Although many treatments for ipsilateral proximal and shaft femoral fractures have been developed, controversy exists regarding their optimal management. The purpose of this retrospective study was to discuss the effectiveness of the bridge-link type combined fixation system (BCFS) and evaluate functional outcomes in treating patients with these complex fractures. Patients and methods We retrospectively reviewed 14 cases of ipsilateral proximal and shaft femoral fractures treated from January 2012 to December 2016. All cases were treated by BCFS combined with minimally invasive percutaneous plate osteosynthesis (MIPPO). Clinical and radiographic data were collected during regular post-operative follow-up visits. Functional outcomes were determined according to the Friedman and Wyman scoring system. Results The proximal femoral fractures were emergency diagnoses in 11 cases and delayed diagnoses in 3 cases. The delay time was 5–6 days, with an average of 5.3 days. The mean operation time was 179.6 min (range 135–231 min) with a blood loss volume that ranged from 430 to 535 ml (average 483.6 ml). Follow-up was conducted in 13 cases between 9 and 30 months post-operation, with an average follow-up time of 17.3 months. The proximal femoral fractures were united in 12 cases at the final follow-up. One case had nonunion 13 months after the operation, underwent valgus intertrochanteric osteotomy, and healed 6 months later. The femoral shaft fractures obtained rigid union at the latest follow-up in 12 cases. One case endured nonunion 12 months after the operation. After the revision surgery and iliac bone grafting, the fracture healed 6 months later. Eight of the cases had good functional results, 4 had fair results, and results were poor in 1 case at the final follow-up. Conclusions The treatment of ipsilateral proximal femoral and shaft fractures with BCFS in combination with MIPPO demonstrated a high likelihood of union for both fractures and good functional results.


2020 ◽  
Author(s):  
Liangqi Kang ◽  
Hui Liu ◽  
Zhenqi Ding ◽  
Yiqiang Ding ◽  
Wei Hu ◽  
...  

Abstract Background: Although many treatments for ipsilateral proximal and shaft femoral fractures have been developed, controversy exists regarding their optimal management. The purpose of this retrospective study was to discuss the effectiveness of the Bridge-Link type combined fixation system (BCFS) and evaluate functional outcomes in treating patients with these complex fractures. Patients and Methods: We retrospectively reviewed 14 cases of ipsilateral proximal and shaft femoral fractures treated from January 2012 to December 2016. All cases were treated by BCFS combined with minimally invasive percutaneous plate osteosynthesis (MIPPO). Clinical and radiographic data were collected during regular post-operative follow-up visits. Functional outcomes were determined according to the Friedman and Wyman scoring system. Results: The proximal femoral fractures were emergency diagnoses in 11 cases and delayed diagnoses in 3 cases. The delay time was 5-6 days, with an average of 5.3 days. The mean operation time was 179.6 minutes (range 135-231 minutes) with a blood loss volume that ranged from 430 to 535 ml (average 483.6 ml). Follow up was conducted in 13 cases between 9 and 30 months post-operation, with an average follow-up time of 17.3 months. The proximal femoral fractures were united in 12 cases at the final follow-up. One case had nonunion 13 months after the operation, underwent valgus intertrochanteric osteotomy, and healed 6 months later. The femoral shaft fractures obtained rigid union at the latest follow-up in 12 cases. One case endured nonunion 12 months after the operation. After the revision surgery and iliac bone grafting, the fracture healed 6 months later. Eight of the cases had good functional results, 4 had fair results, and results were poor in 1 case at the final follow-up. Conclusions: The treatment of ipsilateral proximal femoral and shaft fractures with BCFS in combination with MIPPO demonstrated a high likelihood of union for both fractures and good functional results.


2009 ◽  
Vol 19 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Ufuk Ozkaya ◽  
Fuat Bilgili ◽  
Ayhan Kilic ◽  
Atilla Sancar Parmaksizoglu ◽  
Yavuz Kabukcuoglu

The efficacy of the reverse Less Invasive Plating System in the management of unstable proximal femoral extracapsular fractures was retrospectively evaluated. Twenty-seven patients with complex proximal femoral fractures were identified. There were three open fractures. The mean age was 71 years (range; 65–79). The mean follow up was 24 months (range; 15–32). The main outcome measures were union, union time, requirement for secondary procedures, development of deep infection, pain, and functional impairment. Nonunion was observed in one patient. The average Harris hip score at the last assessment was 73 points (range 58–85). The outcome was adversely affected by concomitant medical problems, anatomical reduction and fixation of the plate. The use of this plate in the management of proximal femoral fractures of all types may be a safe and alternative method to other treatment options.


Author(s):  
Jaspreet Singh ◽  
Harpal Singh Selhi ◽  
Rahul Gupta ◽  
Gurleen Kaur

<p class="abstract"><strong>Background:</strong> The optimal management of unstable proximal femoral fractures is controversial. In this prospective study, the functional outcomes of reverse distal femoral locking plate for the treatment of comminuted unstable proximal femoral fractures were assessed. Objectives were<strong> </strong>to study the functional outcomes of reverse locking plate in extra-capsular fractures of the proximal femur, with respect to quality of reduction, time to bony union, mobility achieved, complications of the procedure, secondary procedures performed (if any) and delayed complications like implant breakage, delayed union, non-union.</p><p class="abstract"><strong>Methods:</strong> 17 patients with unstable proximal femoral fractures were assessed and managed with reverse distal femur plates, and evaluated with X-ray, physical examination, Palmer and Parker mobility score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Union was achieved in all the patients, with average time to union 6.43±1.18 months (range 3-12 months). There was one loosening of implant and wound breakdown, which was managed conservatively. One case of loosening of proximal screws was there, but the fracture united in 9 months with some varus angulation. Superficial infection occurred in one patient, which healed after debridement and IV antibiotics.</p><p class="abstract"><strong>Conclusions:</strong> Taking into consideration the simple surgical technique, good healing rate and minimum complications, it is strongly recommended to use reverse locked distal femoral plates for the management of proximal femoral fractures and further in lean patients, sum-muscular MIPPO should be attempted.</p>


2021 ◽  
Vol 15 (6) ◽  
pp. 2142-2144
Author(s):  
Muhammad Shoaib Zardad ◽  
Abdus S. Awan ◽  
Muhammad Younas ◽  
Shahkeel A. Shah ◽  
S. Sohail Akhtar ◽  
...  

Objective: The aim of this study is to determine the outcome of distal femoral fracture treated with locking plate. Study Design:Prospective study Place and Duration: Conducted at Orthopaedic Unit Ayub Medical Teaching Institute, Abbottabad for one year duration from 1stJanuary 2020 to 31st December 2020. Methods: Total 90 patients of both genders were presented in this study.Patients were aged between 18-80 years of age. Patients’ detailed demographics including age, sex and body mass index were recorded after taking informed written consent. All the patients had distal femoral fracture treated with locking plate. Radiological assessment was done. Mean union time and complications associated to procedure were examined.Functional outcomes were analyzed according to the Flyn’s criteria. Follow-up was taken at 6 months postoperatively. Complete data was analyzed by SPSS 24.0 version. Results:There were 58 (64.4%) patients were males and 32 (35.6%) were females. Mean age of the patients were 42.61±12.88 years with mean BMI 27.65±9.56 kg/m2. According AO/OTA classification 55 (61.1%) had A1, A2 fracture was among 18 (20%) cases and the rest were 17 (18.9%) had A3. 62 (68.9%) fractures were caused due road traffic accidents, falling from height were among 17 (18.9%) cases and 11 (12.2%) cases were due to sports. Right side fracture was the most common side of fracture among 54 (60%). Mean union time among patients was 5.16±1.27 months.According to Flyn’s criteria, 38 (42.2%) cases had excellent results, 32 (35.6%) patients had good, fair results were among 16 (17.8%) cases and poor results were among 4 (4.4%) cases. Complications were delayed union, stiffness, varus deformityand non union observed among all cases. Conclusion: We concluded in this study that the locking plate for the treatment of distal femoral fractures was effective in terms of good results with fewer complications. Keywords:Distal femoral fracture, Locking plate, RTA, Complications


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