scholarly journals A Evaluation of Initial Treatment of Trochanteric Fractures using Gamma Nails

10.3823/2619 ◽  
2020 ◽  
Vol 13 ◽  
Author(s):  
Quang-Tri LE ◽  
Minh-Hoang Nguyen
Keyword(s):  
Range Of Motion ◽  
Initial Treatment ◽  
Treatment Effectiveness ◽  
Trochanteric Fracture ◽  
The Elderly ◽  
Bone Union ◽  
Military Hospital ◽  
Trochanteric Fractures ◽  
Functional Rehabilitation ◽  
Neck Shaft Angle

Background: Trochanteric fractures are extra-joint fractures, account for 55% of femoral proximal fractures. They often happen in the elderly with increased frequency due to age. Treatment experiences at 7A Military Hospital showed increased trochanteric fracture cases. To properly assess treatment effectiveness and select proper treatment methods, the study of “Evaluation of initial treatment of trochanteric fractures using gamma nails at 7A Military Hospital and made the conclusions of indications and applied techniques” was carried out. The study objectives are evaluating the initial treatment of trochanteric fractures using gamma nails at 7A Military Hospital and made the conclusions of indications and applied techniques. Methods and findings: nineteen patients diagnosed with traumatic trochanteric fractures and surgically treated with Gamma nails were monitored and evaluated for bone fusion, bone union, range of motion, limb shortening, and functional rehabilitation according to Merle D'Aubigné scale. Fourteen patients (82.35%) achieved proper bone union with the femoral neck-shaft angle of 1250 - 1300, three patients (17.65%) got slightly deviated bone union. Amongst patients aged under 60, 14/17 cases (82.35%) achieved “good” and “very good” functional rehabilitation, scored over 15 points according to Merle D΄aubigne Index; 3/17 cases (17.65%) got “average” recovery. Hip range of motion in 14 cases (82.35%) achieved “very good” (normal movement) or “good” (over 10% movement limitation) outcome, 3 cases had “average” movement (17.65%). Limb shortening of below 1cm took place in 10 patients (58.82%), 1 – 2 cm in 4 patients (23,53%) and over 3 cm in 3 patients (17.65%). Conclusions: The surgical treatment of trochanteric fractures using gamma nails yielded positive outcomes. Keywords: Gamma nails, trochanteric fractures, elderly, extra-joint.

scholarly journals Breakage of a Third Generation Gamma Nail: A Case Report and Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Takashi Iwakura ◽  
Takahiro Niikura ◽  
Sang Yang Lee ◽  
Yoshitada Sakai ◽  
Kotaro Nishida ◽  
...  
Keyword(s):  
Rare Complication ◽  
Trochanteric Fracture ◽  
High Strength ◽  
The Elderly ◽  
Gamma Nail ◽  
Bipolar Hemiarthroplasty ◽  
Third Generation ◽  
Trochanteric Fractures ◽  
Cemented Bipolar Hemiarthroplasty ◽  
Fractures Of The Femur

The use of intramedullary nails to treat trochanteric fractures of the femur has increased with the increasing size of the elderly population. The third generation Gamma nail is currently one of the most popular devices for the treatment of trochanteric fractures. Nail breakage is a rare complication, possibly resulting from fatigue fracture of the implant. We present the first reported case of breakage of a third generation Gamma nail that was not used to treat a pathological fracture. An 83-year-old woman with an unstable trochanteric fracture of the femur was treated using a third generation Gamma nail. She was referred to our hospital 14 months postoperatively with nail breakage at the opening for the lag screw. The breakage was secondary to nonunion, which was thought to be mainly due to insufficient reduction of the fracture. The broken nail was removed, and the patient underwent cemented bipolar hemiarthroplasty. At followup 18 months later, she was mobile with a walker and asymptomatic with no complications. This case shows that inadequate operation such as insufficient reduction of the trochanteric fracture may result in nonunion and implant breakage, even when using a high-strength, well-designed implant.

scholarly journals Interest of Surgical Treatment of Per-Trochanteric Fractures by Gamma Nail: About 100 Cases

2018 ◽  
Vol 25 (4) ◽  
Author(s):  
Omar Mourafiq ◽  
Youssef Benyias ◽  
Hicham Benomar ◽  
Valery Kamenan ◽  
Jalal Boukhriss ◽  
...  
Keyword(s):  
Trochanteric Fracture ◽  
Functional Results ◽  
The Elderly ◽  
Gamma Nail ◽  
Infectious Complications ◽  
Trochanteric Fractures ◽  
Male Predominance ◽  
Trochanteric Region ◽  
The Military ◽  
Consolidation Time

Gamma nail closed osteosynthesis has surpassed several methods previously used in the treatment of fractures in the trochanteric region.          The objective of the research was to carry out an epidemiological study and to assess the evolutionary profile of patients with per-trochanteric fracture treated with gamma nail.          Materials and methods. In this retrospective study, we report the experience of the Traumatology-Orthopedics Service II of the Military Teaching Hospital Mohamed V-Rabat, in the treatment of per-trochanteric fractures by gamma nail in 100 cases, collected between January 2011 and March 2016.          Results. The average age of our patients was 68 years, with a male predominance of 67%. The most reported etiology (92% of cases) was simple drop. Stable fractures were the most common (81%), with a predominance of simple per-trochanteric fractures. The average response time was 24 hours, the average duration of the surgical procedure was 45 minutes. The rate of infectious complications was 1%; the rate of mechanical complications was 1%. The functional results were excellent and good in 95% of cases. The average consolidation time was 8 weeks.          Conclusions. Trochanteric fracture is a delayed emergency which is seen primarily in the elderly. The gamma nail represents one of the latest improvements in implants for the treatment of these fractures. We report a series of 100 cases of trochanteric fractures treated surgically by gamma nail. The functional results were very encouraging compared to those reported in the literature.  

scholarly journals Banding with lesser trochanter fragment using nonabsorbable tape in trochanteric femoral fractures

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 33
Author(s):  
Takuya Usami ◽  
Naoya Takada ◽  
Kazuki Nishida ◽  
Hiroaki Sakai ◽  
Hidetoshi Iwata ◽  
...  
Keyword(s):  
Femoral Fracture ◽  
Poor Prognosis ◽  
Femoral Fractures ◽  
The Elderly ◽  
Bone Union ◽  
Trochanteric Fractures ◽  
Lesser Trochanter ◽  
Computed Tomography Images ◽  
Trochanteric Femoral Fracture ◽  
Group B

Introduction: Trochanteric femoral fracture is one of the most common fractures in the elderly. Trochanteric femoral fracture with involvement of the lesser trochanter is considered unstable and recognized as having a poor prognosis. However, fixation of lesser trochanter fragment is scarce because of technical difficulties. In this study, we reported the simple surgical procedure and the effect of using nonabsorbable tape in lesser trochanter fixation. Methods: From January 2014 to December 2017, 114 patients treated with proximal intramedullary nailing for trochanteric fractures with the lesser trochanter fragment were reviewed. Among patients enrolled in this study, 73 were followed up until radiographic bone union, of which 26 were treated with lesser trochanter fragment banding (group B) and 47 without banding (group N). Radiographs and/or computed tomography images were used to evaluate bone union of the lesser trochanter fragment at three months postoperatively. Results: The bone union of the lesser trochanter fragment was achieved in 24 cases (92%) in group B and 30 cases (64%) in group N. Compared with group N, group B showed a significantly increased number of mild and moderate deformities but decreased number of severe deformity and nonunion (P < 0.001). Postoperative complications were not observed in both groups. Conclusions: From the viewpoint of increasing lesser trochanteric bone union ratio, fixation of the lesser trochanter fragment using nonabsorbable tape in the treatment of trochanteric fractures could be an effective procedure.

PENGARUH LATIHAN RANGE OF MOTION (ROM) AKTIF ASSITIF TERHADAP RENTANG GERAK SENDI PADA LANSIA YANG MENGALAMI IMMOBILISASI FISIK

2019 ◽  
Vol 13 (2) ◽  
Author(s):  
Andri Setyorini ◽  
Niken Setyaningrum
Keyword(s):  
Range Of Motion ◽  
Human Life ◽  
The Elderly ◽  
General Purpose ◽  
Test Statistic ◽  
Physical Mobility ◽  
Motion Exercise ◽  
The One ◽  
The Individual ◽  
Active Training

Background: Elderly is the final stage of the human life cycle, that is part of the inevitable life process and will be experienced by every individual. At this stage the individual undergoes many changes both physically and mentally, especially setbacks in various functions and abilities he once had. Preliminary study in Social House Tresna Wreda Yogyakarta Budhi Luhur Units there are 16 elderly who experience physical immobilization. In the social house has done various activities for the elderly are still active, but the elderly who experienced muscle weakness is not able to follow the exercise, so it needs to do ROM (Range Of Motion) exercise.   Objective: The general purpose of this research is to know the effect of Range Of Motion (ROM) Active Assitif training to increase the range of motion of joints in elderly who experience physical immobility at Social House of Tresna Werdha Yogyakarta unit Budhi Luhur.   Methode: This study was included in the type of pre-experiment, using the One Group Pretest Posttest design in which the range of motion of the joints before (pretest) and posttest (ROM) was performed  ROM. Subjects in this study were all elderly with impaired physical mobility in Social House Tresna Wreda Yogyakarta Unit Budhi Luhur a number of 14 elderly people. Data analysis in this research use paired sample t-test statistic  Result: The result of this research shows that there is influence of ROM (Range of Motion) Active training to increase of range of motion of joints in elderly who experience physical immobility at Social House Tresna Wredha Yogyakarta Unit Budhi Luhur.  Conclusion: There is influence of ROM (Range of Motion) Active training to increase of range of motion of joints in elderly who experience physical immobility at Social House Tresna Wredha Yogyakarta Unit Budhi Luhur.

scholarly journals Hip fractures among the elderly in Kyoto, Japan: a 10-year study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Maki Asada ◽  
Motoyuki Horii ◽  
Kazuya Ikoma ◽  
Tsuyoshi Goto ◽  
Naoki Okubo ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Incidence Rate ◽  
Acute Care ◽  
Hip Fractures ◽  
Age Groups ◽  
The Elderly ◽  
Femoral Neck Fractures ◽  
Age Group ◽  
Trochanteric Fractures

Abstract Summary In Kyoto Prefecture, Japan, the number of hip fractures increased during 2013–2017 compared to 2008–2012. However, the estimated overall incidence rate increased only in femoral neck fractures in men aged ≥75 and women aged ≥85. Purpose The incidence rate of hip fractures in Japan has plateaued or decreased. We investigated the annual hip fracture occurrences in Kyoto Prefecture, Japan, from 2008 to 2017. Methods Patients aged 65 years and above who sustained hip fractures between 2008 and 2017 and were treated at one of the participating 11 hospitals were included. The total number of beds in these institutions was 3701, accounting for 21.5% of the 17,242 acute-care beds in Kyoto Prefecture. The change in incidence rate was estimated utilizing the population according to the national census conducted in 2010 and 2015. Results The total number of hip fractures was 10,060, with 47.5% femoral neck fractures and 52.5% trochanteric fractures. A decrease in number was seen only in trochanteric fractures in the group of 75- to 84-year-old women. The population-adjusted numbers of femoral neck fractures showed a significant increase in all age groups in men, whereas in women, there was an increase in femoral neck fractures in the ≥85 group and trochanteric fractures in the age group 65–74, and a decrease in trochanteric fractures in the age group 75–84. The estimated change in incidence rate showed an increase in femoral neck fractures in men aged ≥75 and women aged ≥85. Conclusion In Kyoto Prefecture, the number of hip fractures increased in the second half of the study period (2013–2017) compared to the first half (2008–2012). However, the incidence rate had not increased, except in femoral neck fractures in men aged ≥75 and women aged ≥85.

Morbidity and Mortality of the Elderly after Early Operation for Trochanteric Fractures

2013 ◽  
Vol 26 (3) ◽  
pp. 199 ◽  
Author(s):  
Se-Ang Jang ◽  
Young-Ho Cho ◽  
Young-Soo Byun ◽  
Ki-Hong Park ◽  
Hyun-Seong Yoo ◽  
...  
Keyword(s):  
The Elderly ◽  
Morbidity And Mortality ◽  
Early Operation ◽  
Trochanteric Fractures

scholarly journals Prevalence of Non-Communicable Diseases among Retired Military Personnel

2021 ◽  
Vol 16 (2) ◽  
pp. 35-39
Author(s):  
Md Mazharul Islam Khan ◽  
Ariful Haque ◽  
- Md Shamimuzzaman ◽  
Chyochyo Nancy ◽  
Farzana Zafreen
Keyword(s):  
Diabetes Mellitus ◽  
Military Personnel ◽  
The Elderly ◽  
Communicable Diseases ◽  
Ischemic Heart ◽  
Military Hospital ◽  
Epidemiologic Transition ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Mortality And Morbidity

Introduction: Non-communicable diseases (NCDs) have become burning issues worldwide, especially among the elderly individuals. Bangladeshi elderly is also susceptible cohort to NCDs for its recent epidemiologic transition and the NCDs is casting as prominent risk for major mortality and morbidity related issues. Objectives: To find out the prevalence of common NCDs and its risk factors among the Bangladeshi retired military personnel. Methods: This cross-sectional study was conducted among the retired military personnel admitted in Combined Military Hospital (CMH), Savar from January 2019 to July 2019. A face-to-face interview was carried out among the respondents using a semi-structured questionnaire. Results: Among 153 retired military personnel; most common NCDs were hypertension (80.4%), diabetes mellitus 66.7%, ischemic heart disease37.3% and only 3.9 % had low back pain. Most of them accessed their health in CMH (66.7%), where 17.6% reported to Govt. hospital and only a minor portion (15.7%) to private hospital. Moreover, 70.6% of them were not willing to regular health check-up. Conclusions: The most common NCDs were hypertension, diabetes mellitus and ischemic heart disease. This study concluded with a few intervention strategies and community-based health promotion programs to reduce the burden of NCDs among the retired military personnel. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 35-39

scholarly journals Health Problems of Elderly Patients attending Combined Military Hospital, Dhaka

2017 ◽  
Vol 13 (1) ◽  
pp. 8-12
Author(s):  
SM Humayun Kabir ◽  
Md Ziaul Islam ◽  
Masuda Begum ◽  
Masud Ahmed ◽  
Mohammad Mohsin ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Health Care Providers ◽  
Family Income ◽  
Sampling Technique ◽  
Armed Forces ◽  
The Elderly ◽  
Health Problems ◽  
Military Hospital ◽  
Care Providers ◽  
Cross Sectional

Introduction: Health problems of elderly are an emerging health burden throughout the world. Bangladesh is currently undergoing a demographic transition and the proportion of the population of 60 years and older is increasing rapidly. Health care providers and policymakers are highly concerned with this burning issue. Objective: To know the disease pattern among the elderly patients in Combined Military Hospital, Dhaka. Materials and Methods: This cross-sectional study was carried out from July 2015 to June 2016 among 152 elderly patients above 60 years of age admitted in Combined Military Hospital (CMH), Dhaka Cantonment. Data were collected by face-to-face interview with semi-structured questionnaire and checklist following purposive sampling technique. Analysis of data was done by Statistical Package for Social Science (SPSS, version 20.0). Results: Mean age of the elderly was 72.06±4.56 years with the range of 60-80 years and majority (90.8%) of the elderly was male. Out of total 152 elderly patients, by occupation majority (31.6%) were in the business group followed by 30.3% in the retired group and 9.2 % in the housewife group. Average monthly family income was BDT 17927.63±7360.75 with the range of BDT 6000-35000. With initial complaints elderly patients reported to doctors in private chamber (38.2%), private hospital (25.6%) and Govt hospital (5.9%). Among all of the elderly patients, majority (21.1%) had Diabetes Mellitus followed by Rheumatoid Arthritis (17.6%), Asthma (12.5%), Cataract (11.2%), ENT problem (6.6%), Malignancy (5.9%) and Benign Enlargement of Prostate 8(5.3%). Conclusion: The number of elderly people is expanding rapidly; it also presents multifaceted health problems and thus creates unique challenges for the national healthcareservices. Early identification of problem and ensuring the availability of health with economic and social support can have a control over the elderly health problems. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 8-12

scholarly journals Short versus standard PFN outcome analysis in unstable intertrochantric fracture

2018 ◽  
Vol 4 (5) ◽  
pp. 747
Author(s):  
Pravin Kumar Jangde ◽  
Anant Kumar Singh
Keyword(s):  
Hip Fractures ◽  
Trochanteric Fracture ◽  
The Elderly ◽  
Outcome Analysis ◽  
Femoral Canal ◽  
Femoral Nail ◽  
Group 2 ◽  
One Year ◽  
Group B ◽  
Group 1

<p class="abstract"><strong>Background:</strong> Hip fractures in the elderly are frequent. Intertrochanteric hip fractures account for approximately half of all hip fractures in the elderly; of these, from 50% to 60% are classified as unstable. In our study we tried to compare outcome of unstable trochantric fracture in terms length of PFN (180 vs 240 mm).</p><p class="abstract"><strong>Methods:</strong> 80 patients of unstable trochanteric fracture were randomly allotted to 2 groups who were treated with closed reduction and internal fixation with proximal femoral nail of size 180 mm(group A) and 240mm (group B). Patients in both the group were compared right from the fracture configuration till the one year post-operative period.<strong></strong></p><p class="abstract"><strong>Results:</strong> In the study of 80 patients there were 18 males (45%) and 22 females (55%) in group 1, and 23 male (57%) and 17 female (42.5%) in group 2. Group 1 patient had a better range of movements than group 2. Femoral canal impingement was present in 6 (15%) of patients of group 1 and 28(70%) patients of group 2 showed femoral canal impingement.</p><p class="abstract"><strong>Conclusions:</strong> There are very few studies which compare the length of PFN to the outcome. The standard PFN group presented with complications like femoral nail impingement and hence more thighs pain and less range of movements even after one year of follow up. We conclude that for Indian group of population who have a relatively short femora gives a better result with a shorter length implant.</p>

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