scholarly journals Avoiding malalignment in proximal femur fractures treated with newer generation cephalomedullary nails: Some technical tips

2019 ◽  
Vol 10 ◽  
pp. S242-S246
Author(s):  
Arvind Kumar ◽  
Samarth Mittal ◽  
Aditya Jain ◽  
Vivek Trikha
Keyword(s):  
Proximal Femur ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Cephalomedullary Nails

scholarly journals Role of cephalomedullary nail in proximal femur fractures

2017 ◽  
Vol 3 (5) ◽  
pp. 929
Author(s):  
Nishant Kumar ◽  
Dhruv Sharma ◽  
Kuljit Kumar
Keyword(s):  
Hip Fractures ◽  
Proximal Femur ◽  
Femoral Fractures ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Cephalomedullary Nail ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Bending Loads ◽  
Cephalomedullary Nails

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Hip fractures are recognized to be a major public health problem. Key determinants of hip fractures include age, osteoporosis, and falls. In these determinants socioeconomic status, have not been well explored. Under eccentric loading, high bending loads occur, leading to failure of the osteosynthetis anchorage at the center of the femoral head.The introduction of the reconstruction nail has broadened the indications for the intramedullary fixation of difficult femoral fractures. The operative technique is however complicated. Some technical difficulties encountered during its use are presented together with guidance to allow these problems to be avoided.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This Study had included 47 cases which were operated by single surgeon and use of different implant (cephalomedullary nail) was randomized irrespective of fracture types and pattern. This study was done over a period of 12 months (October 2013 to October 2014) with 1 month, 3 months, 6 months, 12 months follow up. At every visit patient were assessed as per Oxford hip score. Type of implant used was<strong> </strong>PFNA<strong>,</strong> Intertan<strong>, </strong>Sirus Nail</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The mean age of the patients was 65.68 (±13.55) years. Severe pain was observed among majority of the patients at one month (70.2%) which became mild (40.4%) and moderate (34%) at 3 months. Very mild pain was found in 36.2% patients at 6 months and in 61.7% at 12 months. The limping was all the time among all the patients at one month. However, the limping was found often in 46.8% at 3 months and sometimes in 57.4% at 6 months and 53.2% at 12 months. The hip score was found to be severe among all the patients at one month. However, moderate to severe hip was in 46.8% patients at 3 months, mild to moderate was in 57.4% at 6 months and satisfactory joint function was in 68.1% at 12 months. The comparison of Hip score according to long or short nail at one 3, 6 and 12 months showed no difference. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Cephalomedullary nails with adequate technique so that the lag screws by purchase in the centre-centre or posterior-inferior quadrant combines the benefit of sliding hip screw as well as intramedullary implants. So we recommend the use of cephalomedullary nails in proximal femur fractures especially the unstable fractures.</span></p>

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

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.

Durability of Hemiarthroplasty for Pathologic Proximal Femur Fractures

2017 ◽  
Vol 32 (12) ◽  
pp. 3607-3610 ◽  
Author(s):  
Matthew T. Houdek ◽  
Cody C. Wyles ◽  
Joshua R. Labott ◽  
Peter S. Rose ◽  
Michael J. Taunton ◽  
...  
Keyword(s):  
Proximal Femur ◽  
Proximal Femur Fractures ◽  
Femur Fractures

scholarly journals Treatment of Proximal Femur Fractures on the Background of Osteoporosis

2004 ◽  
Vol 11 (1) ◽  
pp. 27-31 ◽  
Author(s):  
A F Lazarev ◽  
E I Solod ◽  
A O Ragozin ◽  
M G Kakabadze ◽  
A F Lazarev ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Femoral Neck Fractures ◽  
Mineral Density ◽  
Stable Fixation ◽  
Fracture Characteristics ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Choice Of Treatment ◽  
Density Evaluation

Analysis of treatment of 526 patients with proximal femur fractures (362 patients with femoral neck fractures and 164 patients with trochanteric zone fractures) was performed. Patients' age ranged from 34 to 92 (mean 67). Algorithm of differentiated choice of operative tactics depending on fracture characteristics and injury term was presented. Low invasive osteosynthesis of femoral neck with bundle of stressed V-shaped pins was suggested. Theoretical and practical ground of that technique was given. Stress within fixative-bone system created after osteosynthesis by V-shaped pins, provided stable fixation even in marked osteoporosis. The importance of bone mineral density evaluation for the choice of treatment tactics as well as the necessity of medicamental correction of the disturbed bone remodeling after surgical treatment was noted.

scholarly journals Mortality and morbidity of proximal femur fractures in elderly population – A three year follow-up study

2020 ◽  
Vol 6 (2) ◽  
pp. 69-72
Author(s):  
Sandeep Krishna Avulapati ◽  
◽  
Avinash Bajjuri ◽  
Sunil Boddu ◽  
Anudeep Peddineni ◽  
...  
Keyword(s):  
Proximal Femur ◽  
Elderly Population ◽  
Mortality And Morbidity ◽  
Proximal Femur Fractures ◽  
Follow Up Study ◽  
Femur Fractures

scholarly journals Bone remodeling features in elderly and senile patients with the proximal femur fractures after hip replacement

2020 ◽  
Vol 73 (2) ◽  
pp. 259-265
Author(s):  
Oleksandr M. Khvysyuk ◽  
Volodymyr O. Babalian ◽  
Serge B. Pavlov ◽  
Galina B. Pavlova
Keyword(s):  
Treatment Outcome ◽  
Proximal Femur ◽  
Enzyme Linked Immunosorbent Assay ◽  
Regulatory Pathways ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Results Of Treatment ◽  
Group 2 ◽  
Tgf Β1 ◽  
Group 1

The aim of this study is to identify the dependence of the result of surgical treatment of patients of elderly and senile age with fractures of the proximal femur on the characteristics of the response cytokine-mediated regulatory response to trauma and surgery. Materials and methods: In 74 patients after hip arthroplasty, serum levels of bone metabolism markers were determined using enzyme-linked immunosorbent assay. Patients were divided into 2 groups depending on the results of treatment. Results: It was found that compared with group 2 (treatment outcome is worse) in group 1 (treatment outcome is better) there was a greater number of correlations. In group 1, correlations were found between OPG and RANKL (r = 0.88; p = 0.000), OPG and OPG/RANKL (r = 0.44; p = 0.006), TGF-β1 and OPG/RANKL (r = 0.66; p = 0.000) , IL-6 and OPG (r = 0.67; p = 0.000), IL-6 and RANKL (r = 0.53; p = 0.001), IL-6 and OPG/RANKL (r = 0.39; p = 0.016). In group 2, only between OPG and OPG/RANKL (r = 0.72; p = 0.000), RANKL and OPG/RANKL (r = −0.53; p = 0.0007). In patients of group 2, there was a decrease in the level of OPG relative to the control and a less significant increase in TGF-β1 and IL-6 relative to group 1. Conclusion: The prognosis of the results of treatment of patients with proximal femur fractures is largely determined by the nature of the adaptive response to injury and the implant, the synchronism of the mechanism of stress remodeling of the bone. A less favorable prognosis after arthroplasty is associated with exacerbation of the initial metabolic disorders in the bone tissue due to severe cytokine-mediated dysfunction of the regulatory pathways.

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