scholarly journals Intramedullary nail in the treatment of pertrochanteric fractures in elderly patients

2015 ◽  
Vol 62 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Gabriele Falzarano ◽  
Antonio Medici ◽  
Predrag Grubor ◽  
Milan Grubor ◽  
Elizabeth Barron ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Elderly Population ◽  
Femoral Fractures ◽  
Empty Space ◽  
Proximal Femoral Fractures ◽  
Risk Of Infection ◽  
Intramedullary Nails ◽  
Pertrochanteric Fractures ◽  
Femur Fractures ◽  
Pertrochanteric Femur Fractures

Introduction. Intramedullary nail is an important component of modern treatment of pertrochanteric femur fractures. Objective. In elderly population, pertrochanteric fractures treated with unreamed intramedullary nails cause less deep infections when compared to reamed intramedullary nails. Patients and Methods. From April, 2010 to May, 2012 at the Department of Orthopedics and Traumatology, Gaetano Rummo Hospital (Benevento, Italy), 156 patients with pertrochanteric fracture, average age 82.7 years (75-102 years), were treated. In the analyzed case, there were 90 females and 66 males with pertrochanteric fractures. The respondents were divided into two groups. The first group consisted of 78 respondents who were treated with reamed intramedullary nails and the second group of 78 respondents treated with unreamed intramedullary nails. Discussion. Infections are not the most common postoperative complications. The risk of infection is increased in patients with comorbidity and in cases when there is an empty space between the intramedullary nail fixation and bone. Proximal femoral fractures carry a high mortality, but its causes are unclear. Conclusion. Our research has shown that the application of unreamed intramedullary nails in the treatment of pertrochanteric femoral fractures reduces a mortality risk and risk of infection.

Clinical outcomes of proximal femoral fractures treated with a novel carbon fiber-reinforced polyetheretherketone intramedullary nail

Injury ◽  
2020 ◽  
Vol 51 (3) ◽  
pp. 678-682 ◽  
Author(s):  
Kazuma Takashima ◽  
Ichiro Nakahara ◽  
Keisuke Uemura ◽  
Hidetoshi Hamada ◽  
Wataru Ando ◽  
...  
Keyword(s):  
Carbon Fiber ◽  
Clinical Outcomes ◽  
Intramedullary Nail ◽  
Femoral Fractures ◽  
Proximal Femoral Fractures ◽  
Fiber Reinforced ◽  
Carbon Fiber Reinforced

scholarly journals Removal of locked intramedullary nails with the aid of bolts

2020 ◽  
Vol 8 (4) ◽  
pp. 1397
Author(s):  
Richard C. Echem ◽  
Phillip D. Eyimina
Keyword(s):  
Intramedullary Nail ◽  
Tibial Fracture ◽  
Femoral Fractures ◽  
Extraction System ◽  
Intramedullary Nails ◽  
Background Removal ◽  
Heterotopic Calcification ◽  
Port Harcourt ◽  
Duration Of Surgery ◽  
A Prospective Study

Background: Removal of an intramedullary nail would require the extraction system of the inserted nail to be available. Sometimes the system is not available, and an alternative system would have to be utilised. Aim of the study was to document the removal of interlocked nails using bolts in the absence of appropriate fitting extraction system.Methods: A prospective study of consecutive patients seen by the authors between September 2016 and September 2018 in private clinics in Port Harcourt where the authors were invited to remove intramedullary nails. Bolts fitted to the proximal tips of the nails were utilized. With the aid of plier applied to the bolts and mallet, the nails were extracted. The patients’ socio-demographic and information relevant to the injury were obtained. Data was analysed using SPSS version 23.Results: Fifteen patients were seen. Ages ranged from 29 to 72 years, consisting of 10 males and five females. The tibia was affected in six and the femur in nine. There were five united tibial fractures and one non-united tibial fracture, six united femoral fractures and three non-united femoral fractures. Indication for removal was mostly patients’ request. Duration of surgery ranged from 1 to 4 hours. All the nails were extracted. Complications included broken nail, heterotopic calcification, bony overgrowth/ ingrowth/ongrowth around the nail and interlocking screws. There was no mortality.Conclusions: In the absence of conventional intramedullary nail extraction system, appropriate size bolts can be applied to the threaded proximal tip of nails and used for nail extraction.

scholarly journals Characteristics of intramedullary nail breakage in pertrochanteric femur fractures: a summary of 70 cases

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Pengfei Li ◽  
Zhishan Zhang ◽  
Fang Zhou ◽  
Yang Lv ◽  
Yan Guo ◽  
...  
Keyword(s):  
Rare Complication ◽  
Delayed Union ◽  
Warning Sign ◽  
Pertrochanteric Fractures ◽  
Non Union ◽  
Femur Fractures ◽  
Initial Surgery ◽  
Pubmed Database ◽  
Secondary Failure ◽  
Pertrochanteric Femur Fractures

Abstract Objective To reveal noteworthy characteristics of intramedullary (IM) nail breakage in pertrochanteric femur fractures. Materials and methods The data from 6 patients with IM nail breakage in our hospital between August 2008 and May 2018 were reviewed retrospectively. With an additional 64 cases reported in articles in the PubMed database prior to October 2019, a total of 70 cases were reviewed and analysed; epidemiological patient data and data on the initial trauma, fracture type, nail selected for the original surgery, time from surgery to breakage, mechanism and location of breakage, status of fracture healing, salvage treatment and prognosis were assessed. Results Seventy patients with pertrochanteric fractures, including 2 stable fractures and 68 unstable fractures, experienced IM nail breakage at a mean of 9.4 months after the initial surgery. Among them, 9 (12.9%) occurred within 3 months, 23 (32.9%) between 3 and 6 months and 38 (54.3%) after 6 months. The mean age was 72.3 years, and 16 (22.9%) patients were younger than 65 years old. When nail breakage occurred, 66 fractures (94.3%) exhibited delayed union/non-union. Self-dynamisation was found in 12 cases (17.1%). The salvage procedures included 4 partial/total implant removal procedures, 17 hemi/total hip arthroplasty procedures, 3 conservative treatment procedures, and 46 revised osteosyntheses, of which 7 cases (15.2%) sustained secondary implant failure. No significant differences were found between the failure rates of IM nails and extramedullary(EM) devices (odds ratio [OR], 3.429; 95% confidence interval [CI], 0.632–18.877; p = 0.330). Conclusion IM nail breakage is a rare complication lack of time regularity and mostly occurs in unstable pertrochanteric fractures in the presence of delayed union/non-union. Osteosynthesis revision can be conduct by a new IM nail or EM device but considerable secondary failure rate is noteworthy. Self-dynamisation may be a warning sign of nail breakage.

scholarly journals The significance of malnutrition as a risk factor of proximal femoral fractures in the elderly population

Injury Extra ◽  
2007 ◽  
Vol 38 (4) ◽  
pp. 127-128
Author(s):  
A. Torbergsen ◽  
G. Sing ◽  
E. Rooyen ◽  
T. Bøhmer ◽  
K. Strømsøe
Keyword(s):  
Risk Factor ◽  
Elderly Population ◽  
Femoral Fractures ◽  
The Elderly ◽  
Proximal Femoral Fractures

scholarly journals Bipolar Hemiarthroplasty as Coxofemoral Bypass Technique in Treating Unstable Pertrochanteric Comminuted Fracture of Elderly Patients

2021 ◽  
Vol 10 (43) ◽  
pp. 3683-3688
Author(s):  
Neetin Pralhad Mahajan ◽  
Pramod K. Bagimani ◽  
Kartik Prashant Pande ◽  
Ravi Rameshbhai Dadhaniya
Keyword(s):  
Average Duration ◽  
Harris Hip Score ◽  
Common Mechanism ◽  
Bipolar Hemiarthroplasty ◽  
Pertrochanteric Fractures ◽  
Femur Fractures ◽  
Early Return ◽  
Study Results ◽  
Duration Of Surgery ◽  
Pertrochanteric Femur Fractures

BACKGROUND Pertrochanteric fractures in the elderly are highly unstable and osteoporotic. Comminution of fragments and distraction fragments make union difficult owing to forces acting on the proximal hip joint. The internal fixation in these cases leads to prolonged bed rest and immobilization to prevent implant failure. The purpose of this study was to analyse the role of bipolar hemiarthroplasty in cases of unstable pertrochanteric femur fractures as bypassing forces transmission through the proximal femur. METHODS 30 patients with pertrochanteric fractures were randomized and operated on as bipolar hemiarthroplasty using the indigenous bipolar prosthesis between July 2017 and July 2021. The inclusion criteria were patients more than 65 years of age, Type 4 intertrochanteric fracture (As per Evans classification) AO/ OTA type 31A2.3, 31A3.2, 31A3.3. Patients with polytrauma, compound injuries, pathological fractures and medically unfit patients were excluded from the study. RESULTS The mean age was 67 ± 5 years. The most common mechanism of injury was domestic fall comprising 80 %. The average duration of surgery from the time of injury was 3.5 ± 1.5 days. The average surgical duration was 85.5 mins. The average duration of stay in the hospital was 8.5 ± 1.5 days. Final results were calculated using the Harris Hip score with 33.3 % cases as excellent, 56.6 % cases as good and 10 % cases had fair results respectively. Follow-up was done at 6 weeks, 3, 6, 12 and 24 months. CONCLUSIONS Bipolar hemiarthroplasty in pertrochanteric femur fractures has the advantage of stable adequate fixation with early return to activities of daily living, thus preventing serious life-threatening complications. KEY WORDS Intertrochanteric Fractures, Hemiarthroplasty, Femur, Harris Hip Score

scholarly journals Tendências Epidemiológicas das Fraturas do Fémur Proximal na População Idosa em Portugal

2018 ◽  
Vol 31 (10) ◽  
pp. 562 ◽  
Author(s):  
João Silva ◽  
Daniela Linhares ◽  
Mariana Ferreira ◽  
Nélson Amorim ◽  
Nuno Neves ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Femoral Fractures ◽  
Public Health Problem ◽  
Older Individuals ◽  
Proximal Femoral Fractures ◽  
Important Public Health Problem ◽  
Femur Fractures ◽  
Epidemiological Trends

Introduction: Proximal femoral fractures are an important public health problem in industrialized societies. There are few studies that evaluate the incidence of this type of fracture in Portugal. The aim of this study was to analyze and interpret epidemiological trends of proximal femoral fractures in the elderly population in Portugal between 2005 and 2013.Material and Methods: Cross-sectional study including all patients aged 65 years and older admitted due to proximal femoral fractures in Portuguese hospitals belonging to the National Health Service using data from the national registry of the health system central administration.Results: 101,436 patients were included. There was a progressive increase in the number of hospitalizations per year over the period analyzed. The mean age at admission was 79.32 (± 12.33) years presenting a progressive and significant increase over the analyzed period (p < 0.001). 74.5% of the patients were female (p < 0.001). They had a significantly higher average age at admission, both globally and in each study year (p < 0.001). The age-adjusted incidence (≥ 65 years) was 597 fractures / year / 100,000 inhabitants. There was an increase in the incidence of proximal femoral fractures from 508.49 (2005) to 628.39 fractures per 100,000 person-years (2013). In the female sex the increase was from 616.78 to 762.88 and in the male sex from 339.95 to 419.06.Discussion: This is the first study to evaluate and interpret the epidemiological trends of proximal femur fractures in patients admitted to the National Health Service in Portugal including only individuals aged 65 years or over.Conclusion: The global number of proximal femoral fractures in Portugal showed a trend of increase between 2005 - 2013, affecting a significant percentage of the Portuguese population over 65 years of age, especially in females and progressively older individuals.

Impact of concomitant injuries in geriatric patients with proximal femur fracture

2021 ◽  
Vol 103-B (9) ◽  
pp. 1526-1533
Author(s):  
Carsten Schoeneberg ◽  
Bastian Pass ◽  
Ludwig Oberkircher ◽  
Katherine Rascher ◽  
Matthias Knobe ◽  
...  
Keyword(s):  
Upper Limb ◽  
Proximal Femur ◽  
Cohort Analysis ◽  
Femoral Fractures ◽  
Walking Ability ◽  
Proximal Femoral Fractures ◽  
Concomitant Injuries ◽  
Femur Fractures ◽  
Concomitant Injury ◽  
The Impact

Aims The impact of concomitant injuries in patients with proximal femoral fractures has rarely been studied. To date, the few studies published have been mostly single-centre research focusing on the influence of upper limb fractures. A retrospective cohort analysis was, therefore, conducted to identify the impact and distribution of concomitant injuries in patients with proximal femoral fractures. Methods A retrospective, multicentre registry-based study was undertaken. Between 1 January 2016 and 31 December 2019, data for 24,919 patients from 100 hospitals were collected in the Registry for Geriatric Trauma. This information was queried and patient groups with and without concomitant injury were compared using linear and logistic regression models. In addition, we analyzed the influence of the different types of additional injuries. Results A total of 22,602 patients met the inclusion criteria. The overall prevalence of a concomitant injury was 8.2% with a predominance of female patients (8.7% vs 6.9%; p < 0.001). Most common were fractures of the ipsilateral upper limb. Concomitant injuries resulted in prolonged time-to-surgery (by 3.4 hours (95 confidence interval (CI) 2.14 to 4.69)) and extended length of stay in hospital by 2.2 days (95% CI 1.74 to 2.61). Mortality during the admission was significantly higher in the concomitant injury group (7.4% vs 5.3%; p < 0.001). Additionally, walking ability and quality of life were reduced in these patients at discharge. More patients were discharged to a nursing home instead of their own home compared to patients without additional injuries (25.8% vs 30.3%; p < 0.001). Conclusion With a prevalence of 8.2%, the appearance of a concomitant injury is common in elderly patients with hip fracture. These patients are at a greater risk for death during the admission, longer hospital stays, and delayed surgery. This knowledge is clinically important for all who are involved in the treatment of proximal femur fractures. Cite this article: Bone Joint J 2021;103-B(9):1526–1533.

scholarly journals Complications after Dynamic Hip Screw Osteosynthesis of Proximal Femoral Fractures at Army Instructional Hospital-Libreville

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
F. M. Bombah ◽  
M. Diawara ◽  
B. Y. Ekani ◽  
T. Nana ◽  
A. Mikiela
Keyword(s):  
Postoperative Complications ◽  
Internal Fixation ◽  
Effective Means ◽  
Surgical Techniques ◽  
Femoral Fractures ◽  
Proximal Femoral Fractures ◽  
Femur Fractures ◽  
Hip Function ◽  
Hip Screw

The DHS system is an effective means of open reduction and internal fixation of proximal femur fractures. Postoperative complications are little described and deserve to be studied for better preventive and curative treatment. We report the observations of five (5) patients who presented postoperative complications specific to the DHS system at army instructional Hospital-Libreville. These described complications are related to deterioration of internal fixation leading to callus, nonunion, or infection. Those found are the cut out phenomenon, avascular necrosis of the femoral head, and the fracture of the DHS system. All these complications required surgical revision without functional repercussions at the last follow-up. Complications of internal fixation by the DHS system can be avoided by rigorous asepsis, adequate indications for surgery, and rigorous surgical techniques. Good management can restore hip function.

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