To see the other types of publications on this topic, follow the link: Femoral fracture fixation.
Journal articles on the topic 'Femoral fracture fixation'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Femoral fracture fixation.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Milenkovic, Sasa, Milos Stanojlovic, Milorad Mitkovic, and Mile Radenkovic. "Dynamic internal fixation of the periprosthetic femoral fractures after total hip arthroplasty." Acta chirurgica Iugoslavica 51, no. 3 (2004): 93–96. http://dx.doi.org/10.2298/aci0403093m.
Full textAbstract:
Periprosthetic fractures of the femur after total hip arthroplasty are a big orthopaedic problem, particularly in elderly patients and quite a challenge for orthopaedic surgeons. There is no universal method in treating these fractures. Rigid plates fixation can be limited and aggravated especially in the proximal part of the femur where the endoprosthesis stem does not allow for an undisturbed fixation of both femur cortexes by means of screws. Mitkovic?s dynamic internal fixator is an original implant allowing for an undisturbed fixation of both femur cortexes regardless of the presence of the endoprosthesis stem. Fixation is made possible by means of movable clamps and a convergent possibility to place screws. A dynamic internal fixator can fix all types of periprosthetic femoral fractures. The paper shows the early experience in fixating periprosthetic femoral fractures after total hip arthroplasty in 14 patients, average age 69,7. According to Vancouver classification, 3 patients had the type A fracture, 9 patients had the type B fracture, and 2 patients had the type C fracture. All fractures were fixed by Mitkovic?s dynamic internal fixator. The fracture occurred 2-12 years after primary total hip arthroplasty. The follow- up of the operated patients was 12 months. The method is less invasive than the methods described in books. Mechanical complications are not likely to appear due to the fracture dynamics along the femoral shaft axis, which is made possible by this implant. Our initial experience in femur fracture fixation after hip arthroplasty ahows that it is modern and effective dynamic implant which will contribute significantly to the improving of the treatment of these often very complicated fractures.
2
Stojiljkovic, Predrag, Zoran Golubovic, Desimir Mladenovic, Ivan Micic, Sasa Karalejic, and Danilo Stojiljkovic. "External skeletal fixation of femoral shaft fractures in polytrauma patients." Medical review 61, no. 9-10 (2008): 497–502. http://dx.doi.org/10.2298/mpns0810497s.
Full textAbstract:
Introduction. Polytrauma remains a major social, economic and medicine affliction. A successful surgical treatment of polytrauma patients requires an approach predicated on prioritizing injuries. An isolated femur fractures rarely poses any threat but in association with multiple injuries, this fracture assumes greater significance. The proper management of femur fractures in polytrauma can greatly reduce the mortality and morbidity. Material and methods. We present our results in the treatment of 24 femur shaft fracture in 22 polytrauma patients treated by Mitkovic external fixator in 5 year period (2000-2004) on Orthopeadic and Traumatology Clinic - Clinical Center Nis. The average of patients age was 32.8 years (ranging from 17 to 62). There were 11 (46%) closed and 13 (54%) open fractures. Results. Eighteen fractures were treated by external fixation until union. The remaining six fractures were treated by conversion of the external fixation to internal fixation. Sixteen fractures (88.88%), in which the external fixation was the definitive method of treatment, healed completely. The average healing time was 6.29 (4-9) months. There were three pin-track infections (16.66%), one nonunion (5.55%) and only one deep infection (5.55%). Conclusion. The external fixation by the use of Mitkovic external fixator in the treatment of femur fractures is a safe procedure to achieve temporary rigid stabilisation in polytrauma patients before the subsequent internal fixation (damage control orthopaedics). The external fixation using Mitkovic external fixator can be definitive method of choice in treatment of open and comminutiwe femur fractures in polytrauma patients until union.
3
Knobe, Matthias, and Hans-Christoph Pape. "Anchorage strategies in geriatric hip fracture management." Innovative Surgical Sciences 1, no. 2 (December 1, 2016): 73–78. http://dx.doi.org/10.1515/iss-2016-0034.
Full textAbstract:
AbstractThere is an enormous humanitarian and socioeconomic need to improve the quality and effectiveness of care for patients with hip fracture. To reduce mechanical complications in the osteosynthesis of proximal femoral fractures, improved fixation techniques have been developed including blade or screw-anchor devices, locked minimally invasive or cement augmentation strategies. However, despite numerous innovations and advances regarding implant design and surgical techniques, systemic and mechanical complication rates remain high. Treatment success depends on secure implant fixation in often-osteoporotic bone as well as on patient-specific factors (fracture stability, bone quality, comorbidity, and gender) and surgeon-related factors (experience, correct reduction, and optimal screw placement in the head/neck fragment). For fracture fixation, the anchorage of the lag screw within the femoral head plays a crucial role depending on the implant’s design. Meta-analyses and randomized controlled studies demonstrate that there is a strong trend towards arthroplasty treating geriatric femoral neck fractures. However, for young adults as well as older patients with less compromised bone quality, or in undisplaced fractures, head-preserving therapy is preferred as it is less invasive and associated with good functional results. This review summarizes the evidence for the internal fixation of femoral neck fractures and trochanteric femoral fractures in elderly patients. In addition, biomechanical considerations regarding implant anchorage in the femoral head including rotation, migration, and femoral neck shortening are made. Finally, cement augmentation strategies for hip fracture implants are evaluated critically.
4
Kostic, Igor, Milan Mitkovic, and Milorad Mitkovic. "Results of the application of a new method of internal fixation of femoral neck fractures - self-tapping antirotation cannulated screws (SAF)." Acta chirurgica Iugoslavica 60, no. 2 (2013): 71–79. http://dx.doi.org/10.2298/aci1302071k.
Full textAbstract:
Introduction: Femoral neck fractures are one of the most common fractures primarily the elderly, coupled with a high degree of morbidity and mortality. The treatment is applied a number of methods of internal fixation (multiple cannulated screws available, DHS system, cefalomedullary). At the Department of Orthopedics and Traumatology of Nis developed a new method of fixation of femoral neck fracture, which allows stable fixation of dislocated and nondislocated femoral neck fracture. Self-tapping antirotation fixation (SAF) using two cannulated screws to initial compression fractures intraoperative and postoperative dynamic linear compression of the fracture with early full support to the patient. Matherial and methods: In the period between 2008 to 2012, 53 patients treated for femoral neck fracture in the Clinic for orthopedic and traumatology, Clinical center in Nis, Serbia, by SAF (the self-tapping cannulated screws antirotation; ORTOKON doo Nis). All patients were followed up after surgery in a minimum period of 13 weeks (13-106 weeks). The outcome was evaluated on the basis of clinical and radiological signs of fracture healing and the Harris hip score of functional recovery of the patient. Results: Of the total number of patients (53) treated with this method of fixation, 31 of them were females and 22 males, mean age 52.7 years (28-75 years). The average time of surgery was 36.4 minutes (19-70 minutes). During the postoperative follow-up of all patients (53) operated by this method, six patients were lost in the further postoperative monitoring, so that 47 patients remained for final evaluation. The total incidence of nonunion of femoral neck fracture after surgery this method was 6.4% (three patients). Shortening of the femoral neck after fixation by this method was recorded in 27 cases, and what amounted to an average of 2.8 mm (1, 2 mm in nondislocated to 4.55 with dislocated fracture) and did not affect the functional outcome. During radiographic follow-up was not detected fracture implants. Conclusion: Self-tapping screws cannulated antirotacioni (SAF method) represent a reliable method of fixation of dislocated and nondislocated femoral neck fracture. The main prerequisite for the proper healing of femoral neck fractures with this method is that anatomical fracture reduction is achieved by a closed or open method. This way of fixation allows the early full weight bearing patient operated limb and faster postoperative functional recovery of the fracture healing in optimal time.
5
Messner, Mitchell, Alexander Chong, and Bruce Piatt. "Impact of Cigarette Smoking on Re-operation and Revision Surgery after Femoral Neck Fracture Treatment." Kansas Journal of Medicine 13 (August 17, 2020): 195–201. http://dx.doi.org/10.17161/kjm.v13i.14563.
Full textAbstract:
Introduction. Smokers and nicotine users have a higher risk of femoral neck fracture non-union and prolonged time to fracture union. The impact of smoking resulting in revision surgery after fixation of femoral neck fractures, however, rarely has been studied. The aim of this retrospective study was to review if cigarette smoking had an influence on re-operation and revision after femoral neck fracture treatment.
Methods. Three groups of patients (Group 1: active smokers; Group 2: former smokers; and Group 3: non-smokers) who sustained a femoral neck fracture from January 2012 through August 2018 were included. Outcomes investigated included femoral neck fracture type, operative fixation type, fixation failure, and time interval between initial fixation and revision.
Results. A total of 1,452 subjects were identified (Group 1: 165 subjects; Group 2: 507 subjects; and Group 3: 780 subjects). In the male population, Groups 1 and 2 had higher rates of femoral neck fracture than Group 3. Twelve cases required revisions (Group 1: three cases (6%); Group 2: two cases (2%); Group 3: seven cases (4%)), with all but one revision within the first year following initial fixation. Group 1 patients tended to be younger than the other two groups.
Conclusion. Smoking has a positive association with the risk of femoral neck fracture amongst active and former male smokers. This study concluded that active smokers have a higher risk of non-union compared with non-smokers or former smokers. Smoking history, especially heavy or long-term, should play a role in deciding which fixation construct type to use for femoral neck fractures.
6
Samsami, Shabnam, Peter Augat, and Gholamreza Rouhi. "Stability of femoral neck fracture fixation: A finite element analysis." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 233, no. 9 (June 15, 2019): 892–900. http://dx.doi.org/10.1177/0954411919856138.
Full textAbstract:
Femoral neck fractures represent a relatively uncommon injury in the non-elderly population often resulting from high-energy trauma. Clinical outcome in these patients can be improved by optimizing surgical procedures and selecting appropriate fixation methods. The aim of this study was to develop a numerical fracture model to investigate the influence of critical mechanical factors on the stability of fixation methods for femoral neck fractures. The mechanical stability of fracture fixation was assessed through employing finite element models and simulating progressive consolidation of the fracture for a vertical femoral neck fracture (i.e. Pauwels type III in which the angle between the fracture line and the horizontal plane is greater than 70°). Mechanical performance was compared among three different fixation methods (cannulated screws, dynamic hip screw with de-rotational screw, and proximal femoral locking plate). Axial femoral head displacement varied from 2.3 mm for cannulated screws to 1.12 mm for proximal femoral locking plate, although dynamic hip screw with de-rotational screw indicated a value of 0.94 mm. Considering a consolidated fracture and full weight-bearing load case, average displacements of fracture fragments were obtained of about 1.5, 3 and 70 µm for dynamic hip screw with de-rotational screw, proximal femoral locking plate and cannulated screws methods, respectively. In terms of interfragmentary movements at the fracture site, outcomes of this study demonstrated that, in agreement with our previous experimental research, the dynamic hip screw with de-rotational screw implant is a more effective choice than cannulated screws and proximal femoral locking plate techniques for vertical femoral neck fractures in young patients. Thus, one may conclude that the use of dynamic hip screw with de-rotational screw, particularly during the early stages of bone healing, could provide suitable mechanical environments that facilitate direct bone formation and shorter healing times.
7
Zivanovic, Dragoljub, Zoran Radovanovic, Andjelka Slavkovic, and Zoran Marjanovic. "Internal fixator "Mitkovic" in the treatment of fractures of femoral shaft: A possible solution for fractures in heavier children and adolescents." Acta chirurgica Iugoslavica 62, no. 1 (2015): 45–47. http://dx.doi.org/10.2298/aci1501045z.
Full textAbstract:
Background: Management of femoral shaft fractures in older and heavier children and adolescents is still challenging and controversial and includes several modalities of fixation. Aim of this study was to analyze single center experience in application of selfdynamisable internal fixator Mitkovic (SIF) for the treatment of fractures of femoral shaft in children and adolescents. Methods: Retrospective analysis of data of pediatric and adolescent patients treated for diaphyseal fracture in single center has been conducted. Results: Eleven patients, with 12 femoral shaft fractures were treated in ten-year-period with internal fixator ?Mitkovic?. Time to fracture healing ranged from 4-12 weeks (average 8.9 weeks). All fractures healed without complications. No rotational or angular mall-alignment was noticed. No external cast immobilization was applied in any patient. Conclusion: Selfdynamisable internal fixator Mitkovic may be considered as viable option for treatment of femoral fractures in older/heavier children and adolescents particularly with unstable fracture patterns.
8
Erwin, Erwin, Deni Noviana, Dany Umbu, and Tri Isyani Tungga Dewi. "Management Femoral Fracture in Cats using Intramedullary Pin and Wires Fixation." International Journal of Tropical Veterinary and Biomedical Research 3, no. 2 (November 17, 2018): 32–35. http://dx.doi.org/10.21157/ijtvbr.v3i2.12333.
Full textAbstract:
On April 2016, Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Bogor Agricultural University (VTH FKH IPB) received 4 cases of femoral fractures in cats caused by trauma. Two cats suffered oblique diaphysis fracture femoral, one cat suffered comminuted diaphysis fracture femoral, and one cat suffered epiphyseal fracture femoral (column femoral and trochanter major). All cats were treated by open surgery using intramedullary pins (Steinmann) and cerclage wires (Kirschner). Fracture recovery went without complication and all cats were able to move their feet one week after surgery.
9
Nuñez, Jorge H., Jordi Teixidor, Felipe Borim, Vicente Molero, and Jordi Tomas. "Outcomes of Subcapital Femoral Fracture after a Fixation of an Intertrochanteric Fracture with a Proximal Femoral Nail: Case Report." Case Reports in Orthopedic Research 4, no. 1 (April 8, 2021): 56–61. http://dx.doi.org/10.1159/000512075.
Full textAbstract:
Proximal femoral fractures are a common injury that represents an important cause of hospitalization, morbidity, and mortality in elderly patients. Subcapital femoral neck fracture after fixation of an intertrochanteric fracture with a proximal femoral nail is an extremely rare complication. However, because of the large and steadily increase in the number of patients undergoing to proximal femoral nail fixation in recent years, we believe that the number of these cases could increase over time. We present a 78-year-old woman with a subcapital femoral fracture 11 months after a fixation of intertrochanteric fracture with a proximal femoral nail in the same hip. Five years of follow-up was presented. Also through our case report a review of literature of these rare cases was done, trying to evaluate the associated risk factors, the difficulties in their treatment and the final follow-up of these patients.
10
Petrie, J., A. Sassoon, and G. J. Haidukewych. "When femoral fracture fixation fails." Bone & Joint Journal 95-B, no. 11_Supple_A (November 2013): 7–10. http://dx.doi.org/10.1302/0301-620x.95b11.32896.
Full text
11
Prabhakar, Gautham, Nicholas Kusnezov, Nicholas Rensing, and Amr Abdelgawad. "Threading the Needle: Intrapelvic Displacement of a Femoral Neck Fracture through the Obturator Foramen." Case Reports in Orthopedics 2018 (2018): 1–5. http://dx.doi.org/10.1155/2018/2506187.
Full textAbstract:
Despite timely and appropriate management, displaced femoral neck fractures are often devastating injuries for the young patient. The risk of negative sequelae is further amplified with increasing displacement and vertical fracture patterns. Open anatomic reduction with rigid internal fixation is essential to maximize the healing potential in displaced fractures of the femoral neck. Successful primary osteosynthesis of significantly displaced femoral neck fractures in the young patient has been reported in the literature. We present a unique case of open reduction and internal fixation of a high-energy femoral neck fracture with extrusion of the head through the obturator foramen into the pelvis without associated acetabular or pelvic injury.
12
Anup, Khare, and M. M. Mehra. "Retrograde Femoral Interlocking Nail in Complex Fractures." Journal of Orthopaedic Surgery 10, no. 1 (June 2002): 17–21. http://dx.doi.org/10.1177/230949900201000104.
Full textAbstract:
Retrograde interlocking nail was used as the method of fixation in 35 different cases of combination of complex femoral fractures. We performed this procedure in fractures of femoral shaft associated with fracture neck femur, pathological fractures of proximal third of femur with trochanteric pathology, ipsilateral fracture of femur and tibia in polytrauma cases with multiple other injuries, in highly obese patients with fracture shaft femur. This technique was also used in cases of pregnancy with fracture shaft femur and in unstable pelvic fracture or dislocation hip associated with fracture shaft femur. Operative technique involved with retrograde insertion of un-reamed, non-cannulated custom made nail through entrance portal in intercondylar notch was applied for fixation of the shaft femur fracture. The other associated fracture around hip was stabilized separately using suitable implant according to type of fracture. In cases of ipsilateral fracture of femur and tibia, femur was stabilized by retrograde interlocking nail and tibia was stabilized by antigrade interlocking nail through same incision at the same sitting. The case was followed up for three years; the average union time was 12 to 18 weeks. Out of 35 cases, 31 cases regained full knee movement. Out of the remaining 4 cases, 2 cases could regain up to 90° of movement, these were old fractures and noncooperative patients. In one case, patellofemoral arthritis was developed because of an operative error where a nail was not put inside the articular surface. Mal-union was observed in an early case of the series and implant failure was nil. Retrograde interlocking nail was used as the method of fixation in complex fracture problems. Multiple fractures of long bones can be stabilized in one stage, preventing multiple operations at different stages in polytraumatized patients. This resulted in early recovery, lesser hospital stay, and early rehabilitation of patient with good results and is economical also.
13
González-López, J. L., J. Soleto-Martín, and R. López-Casero Quirós. "Proximal Femoral Epiphysiolysis Secondary to a Femoral Neck Fracture." HIP International 13, no. 1 (January 2003): 45–48. http://dx.doi.org/10.1177/112070000301300110.
Full textAbstract:
Fractures of femoral neck in children present serious problems related to the fracture itself, or secondary to delayed and inadequate treatment. Urgent and appropriate treatment is therefore required. We present one case in which late diagnosis and inadequate treatment resulted in a varus union of a cervicotrochanteric fracture that seriously increased the shear forces, thus causing a chronic proximal femoral epiphysiolysis with an evolution similar to that seen in adolescents. This requires early surgical treatment and stable internal fixation with a functionally good medium-term result.
14
MANSUR, HENRIQUE, RAFAEL ALVAREZ, ANDERSON FREITAS, CESAR BARBOSA GONÇALVES, and MAX ROGERIO FREITAS RAMOS. "BIOMECHANICAL ANALYSIS OF FEMORAL NECK FRACTURE FIXATION IN SYNTHETIC BONE." Acta Ortopédica Brasileira 26, no. 3 (June 2018): 162–65. http://dx.doi.org/10.1590/1413-785220182603182288.
Full textAbstract:
ABSTRACT Objectives To analyze the results of biomechanical assays of the fixation of Pauwels type II femoral neck fractures in synthetic bones, using two parallel cannulated screws or three cannulated screws in an inverted pyramid formation. Methods Ten Brazilian-made synthetic bones were divided into 2 groups. Groups A and B utilized three and two cannulated screws, respectively, after osteotomy in the middle third of the femur, perpendicular to the axis of the femoral neck, simulating a Pauwels type II femoral neck fracture. The resistance of these fixations was analyzed by compression on the axis of the force resulting from hip compression, simulated with a manual hydraulic press. The T-test and post hoc analysis were used to compare the groups, and the significance criterion adopted was p < 0.05. Results In group A, which used fixation with three screws, synthesis failure was seen at a mean force of 526 N. In group B, which used two screws, the mean force was 466 N. The results presented a statistically significant difference (p = 0.02). Conclusion The osteosynthesis of femoral neck fractures in synthetic bone fixated with two screws presented inferior results to fixation with three screws. Level of Evidence III; Case-control study.
15
Testa, Gianluca, Domenico Aloj, Alessandro Ghirri, Eraclite Petruccelli, Vito Pavone, and Alessandro Massé. "Treatment of femoral shaft fractures with monoaxial external fixation in polytrauma patients." F1000Research 6 (August 7, 2017): 1333. http://dx.doi.org/10.12688/f1000research.11893.1.
Full textAbstract:
Background: Femoral shaft fractures, typical in younger people, are often associated with polytrauma followed by traumatic shock. In these situations, despite intramedullary nailing being the treatment of choice, external fixation could be used as the definitive treatment. The aim of this study is to report evidence regarding definitive treatment of femoral shaft fractures with monoaxial external fixation. Methods: Between January 2006 and December 2015, 83 patients with 87 fractures were treated at the Department of Orthopaedics and Traumatology CTO of Turin, with a monoaxial external fixation device. Mean age at surgery, type of fracture, mean follow-up, time and modalities of treatment, non-weight bearing period, average healing, external fixation removal time, and complications were reported. Results: The average patient age was 31.43±15.19 years. In 37 cases (42.53%) the right femur was involved. 73 (83.91%) fractures were closed, and 14 (16.09%) were open. The average follow-up time was 61.07±21.86 weeks. In 68 (78.16%) fractures the fixation was carried out in the first 24 hours, using a monoaxial external fixator. In the remaining 19 cases, the average delay was 6.80±4.54 days. Mean non-weight bearing time was 25.82±27.66 days (ranging from 0 to 120). The 87 fractures united at an average of 23.60±11.37 weeks (ranging from 13 to 102). The external fixator was removed after an average of 33.99±14.33 weeks (ranging from 20 to 120). Reported complications included 9.19% of delayed union, 1.15% of septic non-union, 5.75% of malunion, and 8.05% cases of loss of reduction. Conclusions: External fixation of femoral shaft fractures in polytrauma is an ideal method for definitive fracture stabilization, with minimal additional operative trauma and an acceptable complication rate.
16
Kumara, Hendra C., Ariya M. Nasution, Bayu S. Jiwandono, Anung B. Satriadi, and Pamudji Utomo. "Open femoral neck fracture of 14 years old boy treated by emergency internal fixation with additional osteomuscular pedicle graft: case report." International Journal of Research in Orthopaedics 6, no. 6 (October 22, 2020): 1303. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20204601.
Full textAbstract:
<p>The incidence of femoral neck fractures in pediatric patients is rare, including <1% in all cases of fractures in children. The mechanism of injury is a high-energy injury that can cause a fracture in the femoral neck, open fracture cases are rare. Avascular necrosis is the most common complication. We report a fourteen year old boy who was in a road-traffic accident and had a Gustillo Anderson grade IIIA open femoral neck fracture. On the X-ray findings, we classified the type of fracture into Delbet type II. We decided to do the debridement and ORIF accompanied by an osteomuscular pedicle graft using a quadratus femoris muscle tendon fixed with 3 interfragmentary screws. Short-term evaluation shows a clinical union picture and is still well reduced without any signs of infection. Long-term evaluation of the bone healing process is needed and recognizes complications in the form of avascular necrosis of the femoral head.</p>
17
Kanchanomai, Chaosuan, Panurungsit Muanjan, and Vajara Phiphobmongkol. "Stiffness and Endurance of a Locking Compression Plate Fixed on Fractured Femur." Journal of Applied Biomechanics 26, no. 1 (February 2010): 10–16. http://dx.doi.org/10.1123/jab.26.1.10.
Full textAbstract:
The effects of locking screw position (long column fixation—long distance between the nearest screws to the fracture—and short column fixation—short distance between the nearest screws to the fracture) and fracture gap size (1-mm and 8-mm transverse fracture gap) on stiffness and fatigue of fractured femur fixed with a locking compression plate (LCP) were biomechanically evaluated. The stiffness of 1-mm fracture gap models and that of intact femoral model were in the range of 270–284 N/mm, while those of 8-mm fracture gap models were significantly lower (155–170 N/mm). After 1,000,000 cycles of loading, no fracture of LCP of 1-mm fracture gap models fixed in either long column or short column fashions occurred. On the other hand, the complete fractures of LCPs of 8-mm fracture gap models fixed in long column and short column fashions occurred after 51,500 and 42,000 cycles of loading, respectively. These results suggest that the full weight loading may be allowed for the patient with 1-mm transverse femoral fracture fixed with an LCP. On the other hand, the full load of walking should be avoided for the patient with 8-mm transverse femoral fracture fixed with an LCP before adequate healing.
18
Manoj, K. K. Arvind, R. Karthik, and A. Vishnu Sankar. "Calcar buttressed screw fixation for femoral neck fracture." International Journal of Research in Orthopaedics 5, no. 1 (December 25, 2018): 145. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20185337.
Full textAbstract:
<p class="abstract"><strong>Background:</strong> The incidence of neck of femur fracture among elderly population is increasing day by day. Femoral neck fracture has always been an unsolved fracture<strong> </strong>as far as treatment and results are concerned. There are different views regarding the optimal method of internal fixation in femoral neck fractures. Biomechanical data from literature suggest that calcar fixation is superior to central screws placement. This study aims to analyse the functional and radiological outcome of femoral neck fractures treated by calcar buttressed screw fixation described by Filipov as biplane double supported screw fixation.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study conducted in our institution from May 2015 to May 2018.The study included 43 patients (31 male, 12 female) with femoral neck fracture. Three 6.5-mm cannulated screws were laid in two medially diverging oblique planes. The distal and the middle screws were supported on the calcar. The distal screw had additional support on the posterior neck cortex. Patients were followed up for average period of 2 years. Functional outcome was evaluated using Harris Hip score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Bone union occurred in 40 patients (93%) with average period of 3-4 months.<strong> </strong>51.2% of cases had<strong> </strong>excellent outcome. 23.2% of cases had good and 16.3% of cases had fair outcome. 9.3% of cases ended with poor outcome. Non union was reported in 3 patients (7%) and AVN in one patient. Various factors like age, Garden and Pauwel fracture types, time of presentation and time of surgery were statistically significant to the final functional outcome in our study.</p><p><strong>Conclusions:</strong> By providing additional calcar buttress compared to conventional method, this technique of screw fixation enhances femoral neck fracture fixation strength and reduces the fixation failure. </p>
19
Wang, Gang, Yong Tang, Bin Wang, and Huilin Yang. "Minimally invasive open reduction combined with proximal femoral hollow locking plate in the treatment of Pauwels type III femoral neck fracture." Journal of International Medical Research 47, no. 7 (May 30, 2019): 3050–60. http://dx.doi.org/10.1177/0300060519850962.
Full textAbstract:
ObjectiveThis study was performed to investigate the clinical effects of minimally invasive open reduction and internal fixation with a proximal femoral hollow locking plate on Pauwels type III femoral neck fractures.MethodsThe clinical data of 45 patients aged 32.0 ± 8.1 years (range, 19–45 years) with Pauwels type III femoral neck fractures treated from March 2012 to August 2016 were retrospectively analyzed. All patients underwent anterolateral minimally invasive open reduction and proximal femoral hollow locking plate fixation of the hip joint. Garden’s index was used to evaluate the quality of fracture reduction. Complications and fracture healing were recorded in all patients. At the last follow-up, the functional outcome was recorded using the Harris hip score.ResultsNo complications such as femoral neck shortening, internal fixation loosening, or refracture occurred. However, three patients required reoperation (one with nonunion and two with femoral head necrosis). At the last follow-up, the mean Harris hip score was 92.1 ± 4.5 (range, 76–98). The rate of excellent and good Harris hip scores was 93.3%.ConclusionThe herein-described strategy for Pauwels type III femoral neck fractures is advantageous in terms of high reduction quality, firm fixation, and prevention of neck shortening.
20
Zhang, Yuelei, Chao Yan, Lecheng Zhang, Wei Zhang, and Gang Wang. "Comparison of Ordinary Cannulated Compression Screw and Double-Head Cannulated Compression Screw Fixation in Vertical Femoral Neck Fractures." BioMed Research International 2020 (December 30, 2020): 1–9. http://dx.doi.org/10.1155/2020/2814548.
Full textAbstract:
Background. The treatment of vertical femoral neck fractures in young patients remains a challenge. This study is aimed at comparing ordinary cannulated compression screw (OCCS) and double-head cannulated compression screw (DhCCS) fixation in vertical femoral neck fractures both clinically and biomechanically. Materials and Methods. Clinically, the radiographs of 81 patients with Pauwel’s III femoral neck fractures, including 54 fractures fixed with three parallel OCCSs and 27 fractures fixed with three parallel DhCCSs, were reviewed retrospectively. Complications consisting of fixation failure (screw loosening, obvious fracture displacement, varus deformity, or femoral neck shortening), bony nonunion, and avascular necrosis (AVN) were determined. Biomechanically, twenty synthetic femur models of vertical femoral fractures with an 80° Pauwel’s angle were divided into two groups and subsequently fixed with three parallel OCCSs or DhCCSs. All specimens were tested for axial stiffness, load to 5 mm displacement, and a maximum load to failure with a loading rate of 2 mm/min. Results. Clinically, 22 fractures in the OCCS group experienced fixation failure, including 19 screw loosening, 18 femoral neck shortening, 14 varus deformities, and 8 obvious fracture displacements, whereas only 4 fractures experienced fixation failure in the DhCCS group, including 3 screw loosening, 3 femoral neck shortening, 3 varus deformities, and 1 obvious fracture displacement. Additionally, 11 fractures in the OCCS group exhibited nonunion, whereas only 3 in the DhCCS group exhibited nonunion. Nine fractures with AVN were noted in the OCCS group, whereas only 1 was observed in the DhCCS group. Biomechanically, the axial stiffness of the DhCCS group was greater than that of the OCCS group ( 154.9 ± 6.81 vs. 128.1 ± 7.41 N/mm), and the load to 5 mm displacement was also significantly greater in the DhCCS group ( 646.1 ± 25.87 vs. 475.8 ± 21.46 N). Moreover, the maximum load to failure in the DhCCS group exhibited significant advantages compared with that of the OCCS group ( 1148 ± 39.47 vs. 795.9 ± 51.39 N). Conclusion. Our results suggested that using three DhCCSs improved the outcome of vertical femoral neck fractures compared to three OCCSs, offering a new choice for the treatment of femoral neck fracture.
21
Walia, Palak, and Amna Diwan. "Lateral Tibial Plateau with Peroneal Nerve Entrapment is Unique Fracture in Diagnosis and Management." Orthopedics Research and Traumatology – Open Journal 5, no. 1 (December 19, 2020): 17–20. http://dx.doi.org/10.17140/ortoj-5-119.
Full textAbstract:
A majority of tibial plateau fractures involve the lateral plateau. Posterolateral tibial plateau fractures are caused by a valgus force that impacts the posterolateral plateau against the lateral femoral condyle. We describe a unique case of a patient who sustained a lateral plateau fracture with posterior displacement behind a fractured fibular head, with entrapment of the peroneal nerve. This unusual fracture pattern required dual anterolateral and lateral approach for reduction and fixation.
22
Asakawa, Shunsuke, Takeo Mammoto, and Atsushi Hirano. "Proximal Femoral Fracture in Hip Arthrodesis Treated with Double Reconstruction Plates." Case Reports in Orthopedics 2017 (2017): 1–5. http://dx.doi.org/10.1155/2017/5246080.
Full textAbstract:
We present a rare clinical case of a 90-year-old female who sustained a proximal femoral neck fracture following long-standing hip arthrodesis. Since the fracture occurred relatively proximally and involved the pelvis, double-plate fixation was chosen to achieve rigid fixation. The reconstruction plate was placed at the posterior and anterior columns individually through single vertical incision. She was treated successfully, and she attained preinjury activity level. Proximal femoral fractures in arthrodesed hips need to be recognized as a fracture between the pelvis and femur. Rotational stress from the trunk and lower extremity requires rigid fixation to minimize the increase of displacement and the risk for nonunion.
23
MacDonald, David RW, and Iain Stevenson. "Intramedullary femoral nail fixation for A pathological fracture distal to A resurfacing arthroplasty." Journal of Orthopaedics, Trauma and Rehabilitation 28 (January 2021): 221049172110395. http://dx.doi.org/10.1177/22104917211039519.
Full textAbstract:
Traumatic femoral shaft fractures distal to a hip resurfacing arthroplasty (HRA) are rare. Only four cases have been described in which an intramedullary nail was used to treat the fracture. We present the first case in the literature of a pathological femoral shaft fracture distal to a HRA, and describe its treatment with an anterograde intramedullary femoral nail with proximal locking screws placed into the femoral head overlapping the HRA stem. This demonstrates that the presence of a hip resurfacing arthroplasty does not preclude from utilising an intramedullary nail with recon screws to stabilise a pathological fracture.
24
Dharmarajan, R., R. Vadivelu, and T. Lawrence. "An Unusual Neurological Complication following Internal Fixation of Pertrochanteric Fracture Neck of the Femur." HIP International 12, no. 4 (October 2002): 400–402. http://dx.doi.org/10.1177/112070000201200410.
Full textAbstract:
Fracture of the femoral neck is a common injury in the elderly population and may be associated with significant morbidity. More than 25,000 patients per year in the UK receive treatment for femoral neck fractures. Neurological injury associated with pertrochanteric fracture of the neck of the femur is rare. Sciatic nerve injury following isolated pertrochanteric femoral neck fractures is very rare and has not previously been reported in the literature. We describe a case of foot drop secondary to sciatic nerve injury following fracture of neck of the femur, with recovery after surgical exploration and nerve release.
25
Zazirnyi, I. M., and O. O. Kostrub. "Current Management of Femoral Neck Fractures (Literature Review)." Visnyk Ortopedii Travmatologii Protezuvannia, no. 1(108) (June 1, 2021): 68–75. http://dx.doi.org/10.37647/0132-2486-2021-108-1-68-75.
Full textAbstract:
Summary. Femoral neck fractures are a commonly encountered injury in orthopedic practice and result in significant morbidity and mortality. It is essential that surgeons are able to recognize specific fracture patterns and patient characteristics that indicate the use of particular implants and methods to effectively manage these injuries. The use of the Garden and Pauwels classification systems has remained the practical mainstay of femoral neck fracture characterization that help choosing appropriate treatment. Operative options include in situ fixation, closed or open reduction and internal fixation, hemiarthroplasty, and total hip arthroplasty. Recent reports demonstrate diversity among orthopedic surgeons in regard to the optimal treatment of femoral neck fractures and changing trends in their management.
26
Zha, Guo-Chun, Jun-Ying Sun, Sheng-Jie Dong, Wen Zhang, and Zong-Ping Luo. "A Novel Fixation System for Acetabular Quadrilateral Plate Fracture: A Comparative Biomechanical Study." BioMed Research International 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/391032.
Full textAbstract:
This study aims to assess the biomechanical properties of a novel fixation system (named AFRIF) and to compare it with other five different fixation techniques for quadrilateral plate fractures. This in vitro biomechanical experiment has shown that the multidirectional titanium fixation (MTF) and pelvic brim long screws fixation (PBSF) provided the strongest fixation for quadrilateral plate fracture; the better biomechanical performance of the AFRIF compared with the T-shaped plate fixation (TPF), L-shaped plate fixation (LPF), and H-shaped plate fixation (HPF); AFRIF gives reasonable stability of treatment for quadrilateral plate fracture and may offer a better solution for comminuted quadrilateral plate fractures or free floating medial wall fracture and be reliable in preventing protrusion of femoral head.
27
Egund, Niels, Lars T. Nilsson, Björn Strömqvist, Hans Wlngstrand, and Nils Malmgren. "Hemarthrosis after femoral neck fracture fixation." Acta Orthopaedica Scandinavica 59, no. 5 (January 1988): 526–29. http://dx.doi.org/10.3109/17453678809148777.
Full text
28
DeAngelis, Joseph P. "Biomechanics of Femoral Neck Fracture Fixation." Techniques in Orthopaedics 25, no. 3 (September 2010): 160–63. http://dx.doi.org/10.1097/bto.0b013e3181eb3514.
Full text
29
Zlowodzki, Michael, Anders Jönsson, Ritva Paulke, Philip J. Kregor, and Mohit Bhandari. "Shortening after Femoral Neck Fracture Fixation." Clinical Orthopaedics and Related Research 461 (August 2007): 213–18. http://dx.doi.org/10.1097/blo.0b013e31805b7ec4.
Full text
30
Hoffmeister, Ellen. "Femoral Fracture Fixation in Trauma Patients." Lippincott's Bone and Joint Newsletter 14, no. 4 (April 2008): 37. http://dx.doi.org/10.1097/01.bonej.0000314134.12934.2f.
Full text
31
Wu, Yipeng, Yi Wang, Yang Li, Xiaoqing He, Mingjie Wei, Yancunxin Li, Xiaoyan Zhang, and Yongqing Xu. "Treatment of Femoral Traumatic Fractures with a Custom Bridge Combined Fixation System." Journal of Biomaterials and Tissue Engineering 9, no. 7 (July 1, 2019): 914–21. http://dx.doi.org/10.1166/jbt.2019.2076.
Full textAbstract:
Background: With the development of transportation in modern China, the incidence of traumatic fracture and the global degree of fracture complexity are increasing. This study explored the use and curative effect of a novel custom-manufactured bridge combined fixation system for traumatic fractures of the femur. The bridge combined fixation system can be tailored to the specific patient's requirements by bending the rods and sliding the attachment modules. Methods: From May 2013 to August 2017, 14 patients with traumatic femur fractures were managed with the bridge combined fixation system. The operation was conducted according to the routine incision approach of femur fracture. The patients were given early postoperative functional rehabilitation exercise. The curative effect was evaluated according to clinical manifestations, postoperative imaging, and a self-developed standard for bone healing. Results: All patients were followed for 12–24 (median: 12.5) months. Fracture healing was assessed based on clinical symptoms and postoperative X-ray. After 3 months, complete weight-bearing on the affected leg was painless. X-ray showed that the fracture line had disappeared by 6–9 months postoperatively and showed bone healing. According to the self-developed standard for bone healing, 13/14 (92.8%) patients achieved excellent/good clinical outcomes. Bone union was achieved in all patients within 2 years. Conclusion: The custommanufactured bridge combined fixation system is simple and can effectively achieve tailored reduction of the fracture. The fixation was stable, with few complications after surgery and with good treatment effect for traumatic fractures.
32
Pelet, Leyvraz, Garofalo, Borens, and Mouhsine. "Sub- or Intertrochanteric Fracture Following Screw Fixation of an Intracapsular Proximal Femoral Fracture: True Complication or Technical Error?" Swiss Surgery 9, no. 2 (April 1, 2003): 82–86. http://dx.doi.org/10.1024/1023-9332.9.2.82.
Full textAbstract:
Purpose: To review, retrospectively, the possible causes of sub- or intertrochanteric fractures after screw fixation of intracapsular fractures of the proximal femur. Methods: Eighty-four patients with an intracapsular fracture of proximal femur were operated between 1995 and 1998 by using three cannulated 6.25mm screws. The screws were inserted in a triangular configuration, one screw in the upper part of the femoral neck and two screws in the inferior part. Between 1999 and 2001, we use two screws proximally and one screw distally. Results: In the first series, two patients died within one week after operation. Sixty-four fractures healed without problems. Four patients developed an atrophic non-union; avascular necrosis of the femoral head was found in 11 patients. Three patients (3.6%) suffered a sub- and/or intertrochanteric fracture after a mean postoperative time of 30 days, in one case without obvious trauma. In all three cases surgical revision was necessary. Between 1999 and 2001 we did not observe any fracture after screwing. Conclusion: Two screws in the inferior part of the femoral neck create a stress riser in the subtrochanteric region, potentially inducing a fracture in the weakened bone. For internal fixation for proximal intracapsular femoral fracture only one screw must be inserted in the inferior part of neck.
33
Gok, Arif, Sermet Inal, Ferruh Taspinar, Eyyup Gulbandilar, and Kadir Gok. "Comparison of parallel or convergent proximal schanz screw placement of pertrochanteric fixator in intertrochanteric fracture model." Mechanical Sciences 8, no. 2 (August 15, 2017): 259–66. http://dx.doi.org/10.5194/ms-8-259-2017.
Full textAbstract:
Abstract. Intertrochanteric femoral fractures are serious traumas among elderly patients. In these patients, external fixator is a preferable method for the fixation of fractures. Therefore, this study was planned to compare the parallel and convergent proximal schanz screw placement of pertrochanteric fixator in the intertrochanteric femoral fractures with respect to biomechanical forces that stabilize the fracture line and to present their clinical importance. A commercial finite element based program, AnsysWorkbench was used to investigate the biomechanical parameters of the femoral intertrochanteric fractures and different placement of implants. The von Mises stress, von Mises strain and shear stress on the proximal and distal surface of the fracture line were lower in the convergent pertrochanteric fixator. Proximal schanz screws in convergent configuration pertrochanteric fixator had greater stress and strain values than proximal schanz screws in parallel configuration pertrochanteric fixator. The distance between the proximal schanz screws on the fracture line was measured as 12 mm in convergent configuration pertrochanteric fixator, and as 3.5 mm in parallel configuration pertrochanteric fixator. The angle between the proximal schanz screws in the convergent configuration was measured as 12.88°. The effect of convergent and parallel configuration pertrochanteric fixators on axial loading demonstrated that convergent configuration pertrochanteric fixator was safer in this respect.
34
Mitkovic, Milorad, Marko Bumbasirevic, Z. Golubovic, D. Mladenovic, Sasa Milenkovic, Ivan Micic, Aleksandar Lesic, et al. "New biological method of internal fixation of the femur." Acta chirurgica Iugoslavica 52, no. 2 (2005): 113–16. http://dx.doi.org/10.2298/aci0502113m.
Full textAbstract:
One of the main goals in fracture treatment is preservation of both intramedular and periosteal vascularisation. The aim of this paper is to show a new method of internal fixation which accomplishes these goals. The paper presents the results of clinical application of Mitkovic Internal Fixator, new self-dynamisable device, which provides fixation of the femur using minimally invasive technique. This device has been investigated experimentally on 60 animals. It has been applied to 267 patients. Here is presented a series of 92 fixations of femoral diaphyses after fresh fractures and after unsuccessful treatment using other methods. Follow-up was 3.1 years (2 to 7 years). Bone healing was achieved in all patients within 3.5 months (2.7-9 months) with big amount of periosteal callus formation. There were no complications in all patients seen. It can be concluded that this method and device meet biological and biomechanical requirements for safe fracture treatment.
35
Bogosavljevic, M., B. Ristic, D. Stranojlovic, Z. Pavlov, D. Stokic, S. Ilic, J. Kostic, et al. "Intracapsular fractures of the femoral neck: Internal fixation or arthroplasty." Acta chirurgica Iugoslavica 62, no. 1 (2015): 65–68. http://dx.doi.org/10.2298/aci1501065b.
Full textAbstract:
Objective: Significant advances in the surgical treatment of intracapsular fractures of the femoral neck began in the mid-twentieth century, because of the better understanding of the characteristics and biomechanics of the fractures. The aim of this study is to precisely identify the characteristics of the fractures, that will be taken into account in the individualization of treatment of intracapsular fractures of the femur. Materials and Methods: We analyzed, in a retrospective study, 148 patients with intraarticular fractures of the femoral neck from the registry of the Orthopaedic Department in Pozarevac, in the period from 2009 to 2014. Fractures were classified by the modified Garden?s classification. Garden type III fractures were divided into two sub-types. Garden type IIIa included fractures in which the distance between the fragments of the medial cortex was less than ? the diameter of the femoral neck. Garden type III b included fractures in which the distance of the medial cortex of the fracture fragments was larger than ? the diameter of the femoral neck. Patients with the Garden type I fracture (6 cases), Garden type II ( 22 cases), Garden type IIIa (35 cases) and Garden type IV (5 cases) were treated by closed reduction and internal fixation. Patients with Garden type IIIb (28 cases) and Garden type IV (52 cases) were treated by primary total hip replacement. Results : All fractures in patients with the fracture Garden type I (6 cases) and Garden type II (22 cases) have healed and avascular necrosis did not occur. In the group of patients with the Garden type III b fracture, 3 patients with non-union were treated with total hip arthroplasty. In the same group in two patients avascular necrosis occurred. In the group of patients with the Garden type IV fracture who were treated by closed reduction and inter- nal fixation (5 cases), two patients with non-union were treated with total hip arthroplasty. In patients with Garden sub-type III b, in the time of monitoring we found 4 dislocations after primary total hip arthroplasty. One patient underwent acetabular revision in the same group. In the group of patients with Garden type IV fracture, we found 7 dislocations after total hip arthroplasty and two patients underwent acetabular revision surgery. Conclusion: Our results indicate that fractures Garden type I, II and Garden type III a can be successfully treated with internal fixation. Fractures Garden type III b and IV should be treated by primary hip arthroplasty, because of internal fixation of these fractures lead to unsatisfactory results.
36
Teguh Wisesa, I. Komang Indra, and I. Wayan Suryanto Dusak. "Comparison outcome in management of femoral neck fracture using multiple cancellous screws with and without fibular graft." International Journal of Research in Medical Sciences 8, no. 9 (August 26, 2020): 3333. http://dx.doi.org/10.18203/2320-6012.ijrms20203688.
Full textAbstract:
Multiple cancellous cannulated screw is preferred method in fresh cases of fracture neck of femur in young patients. Fibular strut graft is sometimes used along with multiple cancellous cannulated screws to enhance union and early restoration of function. We conducted a retrospective study to patients aged between 20-50 years old with femoral neck fracture treated with multiple cancellous screws either with or without fibular graft between the period of January 2016 to January 2018. We obtained total of six patients (five males and one female) with femoral neck fracture treated with multiple cancellous screws either with or without fibular graft. All fractures were garden type II-IV fresh femoral neck fractures. The functional outcome based on Harris hip score was excellent for all patients. The mean time of full weight bearing was 16±8 weeks in both multiple cancellous screws without fibular group and multiple cancellous screws with fibular group. The mean time of union was also 16±8 weeks in both groups. There is no complication such as non-union, avascular necrosis of femoral head and/or broken fibular graft in both the groups occurrences. Fixation with cancellous screws and fibular strut grafts for femoral neck fractures is cost effective and technically less demanding and associated with good outcomes. There is no added advantage of non-vascularized fibular grafting with multiple hip screw fixation in fresh femoral neck fractures in young adults over multiple hip screw fixation alone.
37
Baral, Pramod, Pashupati Chaudhary, Amit Bikram Shah, Deepak Banjade, and Subash Chandra Jha. "Outcome of Proximal Femoral Nail Antirotation II fixation of Peritrochanteric Fracture of Femur." Journal of Nepal Health Research Council 18, no. 2 (September 8, 2020): 301–6. http://dx.doi.org/10.33314/jnhrc.v18i2.2956.
Full textAbstract:
Background: Intramedullary fixation is biomechanically superior to extramedullary fixation for fracture of peritrochanteric region of femur in elderly which is often complicated due to associated osteoporosis. Helical blade of proximal femoral nail antirotation II has stronger purchase in the head of femur preventing rotation and cutout. This study was done to evaluate the outcome of Proximal Femoral Nail Antirotation II fixation in B.P. Koirala Institute of Health Sciences.Methods: Retrospective review of the data of 100 traumatic peritrochanteric fracture cases operated between March 2017 and March 2018 was done for study. Cases lost to follow-up, deaths and incomplete functional outcome (VAS, HHS), intraoperative and postoperative data were excluded. Total of 71 cases were included in the study. Results: Mean age of patients was 65 (+14) (range:19 to 86) years and were operated for intertrochanteric (54), subtrochanteric (16) and neck of femur (1) fractures. Trivial fall on ground was the commonest mechanism of injury (43 of 71). Mean injury to surgery time was 7 (+7) days and mean duration of hospital stay was 5.92 (+4) days. Mean blood loss during surgery was 132.61 (+21) ml and mean surgical time was 56 (+8) minutes. Mean visual analogue scale (VAS) Score was 7 at 2 weeks, 3 at 6 weeks and 1 at 12 weeks. Mean harris hip score was 80 (+10) at 6 months.Conclusions: Proximal femoral nail antirotation II is a reliable implant system to use for fixation of proximal femoral fractures with a good functional outcome and low complication rates.Keywords: Harris hip Score; helical blade; intramedullary fixation; peritrochanteric fracture; proximal femoral nail antirotation
38
Oda, Taiga, Akira Maeyama, Tetsuro Ishimatsu, and Takuaki Yamamoto. "Distal femoral osteotomy for genu valgum deformity caused by malunited Hoffa fracture." BMJ Case Reports 14, no. 2 (February 2021): e238615. http://dx.doi.org/10.1136/bcr-2020-238615.
Full textAbstract:
Hoffa fractures are unstable intra-articular fractures of the femoral condyle that occur in the coronal plane.Insufficient anatomical reduction and internal fixation may lead to non-union or malunion. A 39-year-old man was involved in a traffic accident while riding a motorcycle and was diagnosed with left Hoffa fracture and avulsion fracture of the femoral attachment of the medial collateral ligament. Open reduction and internal fixation were performed 5 days after injury. The patient experienced intermittent knee pain, joint contracture and deformity, and attended our hospital for further treatment 18 months after surgery. CT revealed depression and malunion of the posterior aspect of the lateral femoral condyle, and weight-bearing X-ray showed valgus deformity due to malunion. Distal femoral osteotomy (DFO) was performed and good functional and radiographic results were obtained. This report suggests that DFO is a reasonable treatment for young patients suffering from malalignment due to malunited Hoffa fracture.
39
Metwaly, Radwan G., and Zeiad M. Zakaria. "Single-Incision Double-Plating Approach in the Management of Isolated, Closed Osteoporotic Distal Femoral Fractures." Geriatric Orthopaedic Surgery & Rehabilitation 9 (January 1, 2018): 215145931879985. http://dx.doi.org/10.1177/2151459318799856.
Full textAbstract:
Introduction: Distal femoral fractures in elderly population had recorded an increase in incidence in the last 2 decades. Lateral distal femoral locking plating is considered one of the best options especially when dealing with comminuted fractures but varus collapse of the medial femoral condyle occurs frequently in patients with osteoporosis. Anatomical reduction of the fracture with stable rigid fixation using double-plating approach allows early mobilization of geriatric population and prevents varus collapse minimizing the comorbidities in such fractures. Patients and Methods: Between September 2014 and January 2017, a prospective study on 23 patients with comminuted osteoporotic distal femoral fractures managed through the double-plating approach through a single parapatellar approach has been conducted. Only osteoporotic geriatric patients with isolated distal femoral fractures were included. Polytraumatized, open fractures, and fracture type 33-A1, 33-A2, and 33-B were excluded. The mean age was 69.6 years (61-80). All patients have been evaluated as regard duration of procedure, time to union, EQ-5D-5L score, the need of autologous bone grafts, range of knee motion, and presence of complications. Results: The average follow-up was 14.1 months. The majority of fractures were type 33-C2 (13 patients). Average procedure time was 148 minutes (117-193 minutes). Mean EQ-5D-5 L score was 83.8 (72-82). Average time to union was 9 months (3-12 months). Four (17.4%) cases needed autologous bone graft after 6 months. No loss of reduction in any of the cases was evident, although 6 (26%) cases had screw breakage or cutout in one of the plate fixation. Two (8.7%) patient developed superficial wound infection and 1 (4.3%) developed DVT. Discussion: This study aimed at evaluation of the success of double plating of distal femoral fractures in geriatric population. different fixation methods were studied for reduction and fixation of such a fracture such as external fixation, intramedullary nails and lateral plating. the quality of fracture reduction, functional and radiological outcomes, time to union, the need for bone grafting and complication are the main debatable issues. Conclusion: Single-incision double-plating approach for distal femoral osteoporotic fractures is effective and provides stable construct without reduction loss allowing early rehabilitation. Delayed union and the need for bone graft are the major drawbacks for this technique.
40
Samy, Tarek M., Tarek M. Khalil, Maged Abouelsoud, Amr Abdelrahman, and Mohamed B. Elghonimy. "Fracture Cascade in Patients with End-Stage Renal Disease: Complications and Outcome." Case Reports in Orthopedic Research 1, no. 1-3 (December 5, 2018): 55–61. http://dx.doi.org/10.1159/000495148.
Full textAbstract:
We report a 68-year-old end-stage renal disease female patient on dialysis for 15 years. She sustained consecutive fractures starting with left-sided femoral neck fracture, followed 16 months later by a right-sided one. On her recovery from her right hip injury she sustained a stress type subtrochanteric fracture at the entry site of the fixation implants and an ipsilateral humeral shaft fracture. Cementless total hip replacement was done for the left femoral neck, and osteosynthesis was done for her undisplaced right femoral neck fracture. Revision fixation was done for her right subtrochanteric fracture with a long Gamma nail that was statically locked. The humeral fracture was fixed with an interlocking nail in a closed manner. This case highlights the fact that sequential hip fractures is an ominous event which is likely to be followed by a quick cascade of bone injuries with trivial trauma and a high rate of unexpected complications. Our treatment approach is explained here, stressing the unexpected complications and challenges met.
41
Mesa, A. Ceballos, R. Balmaseda Manent, R. Puente Rodriguez, and M. Pedroso Canto. "Intrapelvic Dislocation of the Femoral Head after Central Acetabular and Femoral Neck Fracture." HIP International 7, no. 2 (January 1997): 75–77. http://dx.doi.org/10.1177/112070009700700203.
Full textAbstract:
Central fracture-dislocation of the hip associated with fracture of the femoral neck and intrapelvic intrusion of the femoral head is a very rare condition. The treatment of choice consists of open reduction of the dislocation and internal fixation of both fractures, but this is often not possible in delayed cases. In our patient, a young female, operated on six months after the trauma by partial resection of the femoral head and a cementless total hip arthroplasty, a good clinical result was achieved.
42
Kern, D. A., S. A. Johnston, and T. L. Dew. "Treatment of Complicated Femoral Fractures With External Skeletal Fixation Utilizing Bone Screws and Polymethylmethacrylate." Veterinary and Comparative Orthopaedics and Traumatology 05, no. 04 (1992): 170–75. http://dx.doi.org/10.1055/s-0038-1633105.
Full textAbstract:
Two femoral fractures initially treated using ASIF methods failed to proceed to union prior to implant loosening. The Inoue method of external skeletal fixation (ESF) employing AO/ASIF screws for fracture fragment fixation, a polymethylmethacrylate (PMMA) side bar and cancellous bone grafting was used. The dogs retained good limb function while the external fixators were in place. In case # 1 the fracture proceeded to union without further complications. The dog in case # 2 maintained good limb function, however fixation screw failure occurred prior to complete fracture healing.
43
Salokhiddinov, F. B. "Outcomes of the proximal femur fractures repaired with half-pin devices as compared with various types of osteosynthesis." Genij Ortopedii 27, no. 2 (April 2021): 175–81. http://dx.doi.org/10.18019/1028-4427-2021-27-2-175-181.
Full textAbstract:
Objective To review outcomes of the proximal femur fractures repaired with half-pin apparatus in comparison with various types of osteosynthesis. Material and methods The study enrolled 86 patients with proximal femur fractures treated at the general hospital of the Tashkent Medical Academy. Of these, 52 were females and 34 were males. The mean age of the participants was 54.1 ± 1.1 years (range, 22 to 92 years). The effectiveness of the treatment was evaluated depending on the treatment method used. The patients were divided into 3 groups: group I included 39 patients who underwent closed percutaneous osteosynthesis with Ilizarov wires; group II consisted of 29 patients who underwent osteosynthesis with bone plates; group III included 18 patients who underwent surgical treatment using the external half-pin fixator we developed. Results Outcomes were evaluated in 58 patients at one to two years. In group I, good results were rated as good obtained in 45.8% (n = 11), as fair in 33.3% (n = 8) and poor in 20.9 % (n = 5) of patients due to nonunited fracture, avascular necrosis of the femoral head and hip joint ankylosis. Group II showed 68.4 % (n = 12) good, 4 (21 % (n = 4) fair and 10.5 % (n = 2) poor results. The latter occurred due to patient noncompliance and unauthorized early removal of the plaster cast. Group III demonstrated 73.4 % (n = 11) good, 13.3% (n = 2) fair and 13.3 % (n = 2) poor outcomes. Patients with poor outcomes developed lesion of the femoral neck following a subcapital femoral neck fracture at 2 months of frame removal that healed with a 2.0 cm limb length discrepancy. Conclusion The external half-pin fixator offered could facilitate stable bone fixation after reduction and gradual dynamic compression for successful bone healing. The bone fixation period with external half-pin fixation device was dependent on the fracture type and averaged to 4 ± 1 months in type A fracture and 5 ± 1 months in type B fractures. Fixation of the proximal femur fractures with half-pin fixation device allows stabilization of the general state of patients, easier postoperative care, prevention of secondary complications and early exercises for the adjacent joints. The technique offered can be a method of choice among the current technologies.
44
Pitjamit, Siwasit, Wasawat Nakkiew, Kriangkrai Thongkorn, Warinthorn Thanakulwattana, and Kittiya Thunsiri. "Finite Element Analysis of Traditional and New Fixation Techniques of the 3D-Printed Composite Interlocking Nail in Canine Femoral Shaft Fractures." Applied Sciences 10, no. 10 (May 15, 2020): 3424. http://dx.doi.org/10.3390/app10103424.
Full textAbstract:
Since the removal of a metallic interlocking nail system leaves a blank cavity inside a healed bone, bioactive and biodegradation materials have been used instead to induce bone formation and eliminate complications of the material removal procedure. The previous study presented the possibility of an interlocking nail fabrication from polylactic acid (PLA), polycaprolactone (PCL), and hydroxyapatite (HA) using 3D printing, namely fused filament fabrication (FFF), for canine diaphyseal fractures. Therefore, a finite element analysis (FEA) was used to predict the maximum principal stress of this 3D-printed composite interlocking nail to stabilize a canine femoral fracture, and the biomechanical performance was evaluated for the treatment of canine femoral shaft fractures using both traditional and new fixation techniques. Three-dimensional FEA models were created, and the composite interlocking nail was tested for implant strength and stability. Three types of canine femoral shaft fracture (proximal shaft fracture, middle shaft fracture, and distal shaft fracture) fixed by traditional and new fixation techniques, consisting of two, four, and six locking screws, were analyzed with a multilevel factorial design technique. The maximum principal stresses of the composite interlocking nail were compared with each fixation technique. According to the multilevel factorial design, gap type, fracture gap, and fixation techniques are factors that affect the maximum principal stress of the composite interlocking nail for two and four locking screws. For six locking screws, all factors, including gap type, fracture gap, nail length, and fixation techniques, significantly affect the maximum principal stress. The use of a 3D-printed composite interlocking nail system with new fixation techniques demonstrated lower maximum principal stresses than the interlocking nail system that used a traditional fixation technique. The results of this study could help orthopedic veterinary surgeons to understand the biomechanical performances of traditional and new fixation techniques. Furthermore, surgeons may use the numerical results of this analysis to choose a fixation technique based on a patient’s condition.
45
Gao, Ya Lei, Li Min Dong, and Wei Chen. "Finite Element Analysis of Femoral Fracture System." Advanced Materials Research 941-944 (June 2014): 1192–95. http://dx.doi.org/10.4028/www.scientific.net/amr.941-944.1192.
Full textAbstract:
Plates are most commonly used fixation devices on treatment of femoral fracture, Hwoever, due to the unique mechanical properties and the strong bearing capacity of the femur, the cases of plate broken are at the top of the body skeleton. With the femur’s healing, the stress on the femur and plate is in the process of dynamic transfer. Therefor, healing factors of femur should be considered to more fully describe the stress conditions, on femoral fracture fixation study. This paper study on titanium plate fixation of femoral fracture, analyzed the stress of the femur and plate in different healing period of the femur under different loads.
46
Soeharno, Henry, Amila Nirmal Silva, Adriel Tay, and Wong Merng Koon. "Failure of femoral neck fracture fixation in younger patients." International Journal of Research in Orthopaedics 5, no. 6 (October 22, 2019): 1015. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20194808.
Full textAbstract:
<p class="abstract"><strong>Background:</strong> Failure of femoral neck fracture fixation in younger patients frequently lead to significant morbidity. This study aims to evaluate the associated risk factors, to help achieve better outcomes.</p><p class="abstract"><strong>Methods:</strong> Records of 25 men and 6 women aged 23 to 50 (mean, 39.8) years who underwent fixation for femoral neck fractures using cancellous screws (n=29), a dynamic hip screw (n=1), or a locking plate (n=1) were reviewed. Patients with or without fixation failure were compared.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean follow-up period was 28.4 (range, 24–38) months. Of the 31 patients, 24 had bone union and 7 had fixation failure secondary to non-union (n=1), screw cut-out (n=4), and avascular necrosis (n=2). The Revised Trauma Score on admission was 4 in one patient with fixation failure and >6 in all other patients. Comparing patients with or without fixation failure, excess alcohol consumption (5/7 vs. 6/24, p=0.024), smoking (6/7 vs. 9/24, p=0.025), and operative time in minutes (57±16 vs 108±58, p=0.00004), fracture type of OTA 31 B2 or 31 B3 (7/7 vs. 14/24, p=0.027) were significant risk factors.</p><p class="abstract"><strong>Conclusions:</strong> Excess alcohol consumption, smoking, operative time <strong>></strong>85 minutes, and displaced fractures were risk factors for femoral neck fixation failure.</p>
47
Guo, Jialiang, Weichong Dong, Lin Jin, Yingchao Yin, Ruipeng Zhang, Zhiyong Hou, and Yingze Zhang. "Treatment of basicervical femoral neck fractures with proximal femoral nail antirotation." Journal of International Medical Research 47, no. 9 (July 21, 2019): 4333–43. http://dx.doi.org/10.1177/0300060519862957.
Full textAbstract:
Objective A basicervical femoral neck fracture, which is located at the junction between the femoral neck and intertrochanteric region, is a rare type of fracture. The treatment effects for this type of fracture vary. The present retrospective study was performed to evaluate the clinical and radiological outcomes of proximal femoral nail antirotation and illustrate its effect on improving the clinical prognosis of basicervical femoral neck fractures. Methods Fourteen patients with two-part basicervical fractures underwent treatment with proximal femoral nail antirotation. Results The treatment exhibited a good effect on decreasing complications such as femoral neck shortening and screw protrusion. Improvements were also noted in the Harris hip score and other clinical prognostic factors. The patients were satisfied with the prognosis, although not all of them returned to their preinjury level of occupation or daily activities. Conclusion This research provides clinical data to support the treatment of basicervical femoral neck fractures with proximal femoral nail antirotation and contributes to our understanding of treatment selection in the clinical setting. Selection of the optimal fixation method and subsequent conservative rehabilitation plan will benefit patients with basicervical femoral neck fractures.
48
Gok, Kadir, Ferruh Taspinar, Sermet Inal, and Eyyup Gulbandilar. "IMPORTANCE OF SIDEBAR-BONE SPACING DURING THE APPLICATION OF PERTROCHANTERIC FIXATOR ON FEMORAL INTERTROCHANTERIC FRACTURE MODEL; COMPARISON OF THE BIOMECHANICAL EFFECTS USING FINITE ELEMENT METHOD." Biomedical Engineering: Applications, Basis and Communications 27, no. 03 (May 28, 2015): 1550030. http://dx.doi.org/10.4015/s1016237215500301.
Full textAbstract:
Many unwanted traumas occur in daily life, the result of which may be intertrochanteric fractures in the musculoskeletal system. An intertrochanteric femoral fracture is a serious trauma which can lead to pneumonia, pulmonary embolism or death. Therefore, accurate and stable fixation of these fractures is necessary. Schanz screws with a pertrochanteric fixator body are used for the stabilization of intertrochanteric fractures. The stability of fractures created by external fixators is dependent on the frame and bone interaction. The distance between the fixator body and the bone, called "sidebar-bone spacing", is one of the most important aspects of fracture stability. The primary objective in the treatment of these fractures is to maintain the stability of the fracture in the reduction position to allow early mobilization. In this study, an intertrochanteric femoral fracture was fixed with a pertrochanteric fixator, then the effect of sidebar-bone spacing on the fracture line under axial loading was analyzed using AnsysWorkbench software. Stress and strain values on the fracture line and schanz screws were calculated to understand this effect according to the von-Mises criteria. The sidebar-bone spacing was selected as 8, 6 and 4 cm. The von-Mises stress value on the fracture line decreased as the distance between the fixator body and the bone decreased, although strain values increased. In conclusion, decreasing the sidebar-bone spacing in the pertrochanteric fixator used on hip fractures provides stronger stabilization, and demonstrates safer axial loading.
49
Monotti, Isobel C., Christopher A. Preston, and Scott W. Kidd. "Treatment Outcomes for Periprosthetic Femoral Fractures in Cementless Press-Fit Total Hip Replacement." Veterinary and Comparative Orthopaedics and Traumatology 33, no. 05 (April 30, 2020): 370–76. http://dx.doi.org/10.1055/s-0040-1709486.
Full textAbstract:
Abstract Objective The aim of this study was to report outcomes in dogs with periprosthetic femoral fractures associated with a press-fit cementless femoral total hip replacement implant. Materials and Methods Electronic medical records and digital radiographs were used to identify dogs with periprosthetic femoral fractures associated with press-fit cementless total hip replacement. Data collected included signalment, weight, time of fracture, cause of fracture, presence of intra-operative fissure, fracture type, repair technique, and clinical and radiographic outcomes. Long-term patient outcome was assessed by communication with owners or referring veterinarians. Results Twenty-eight dogs with femoral fracture repair associated with cementless press-fit total hip replacement were identified. Eight of the fractures occurred intraoperatively and 20 occurred at a median of 2 days postoperatively. An oblique or spiral configuration was noted in 19 cases and 15 occurred at the distal end of the femoral stem (type B), with thirteen type B1, one type B2 and one type B3 fractures. Fractures were repaired with non-locking (18/28) or locking-plate fixation (10/28). Cerclage wire was applied around the plate and proximal bone segment in 17/28 dogs. Major complications occurred in 7/28 cases (five deep infection, two mechanical failures). Bone healing was noted in 21/23 cases, for which follow-up radiographic interpretation was available. Return to function was complete in 17 cases, acceptable in 8 cases and unacceptable in 3 cases. Conclusions While cementless total hip replacement periprosthetic femoral fractures can be successfully repaired with lateral plate fixation, the risk of infection appears to be high.
50
Lin, SH, CW Lo, SC Cheng, MY Kuo, and LS Chin. "Use of Reconstruction Nails to Manage Ipsilateral Displaced Femoral Neck-Shaft Fractures: Assessment of a New Approach." Journal of Orthopaedic Surgery 10, no. 2 (December 2002): 185–93. http://dx.doi.org/10.1177/230949900201000214.
Full textAbstract:
Purpose. Owing to unpredictable femoral neck reduction, reconstruction nails are not suitable for fixation of group 3 ipsilateral femoral neck-shaft fractures. We developed a new one-step fixation technique to overcome this problem. This study aims to assess this new technique at the Orthopaedic Department, Chi-Mei Foundation Medical Center, Tainan. Methods. Of 31 consecutive patients with femoral fractures treated by reconstruction nails, five patients had group 3 ipsilateral femoral neck-shaft fractures, 4 of whom were treated by a new surgical technique. Two 5.0-mm drills were firstly inserted to tether the trochanter fragment, and distal locking screws were secondly applied to immobilise the shaft fracture. The neck-shaft angle was then restored in a closed fashion and proximal cephalomedullary screws were attached. Patients were followed up by post-operative radiography. Results. All 5 cases of group 3 ipsilateral femoral -neck-shaft fracture obtained radiographic union without significant surgical sequelae. Three of the patients had implants removed. No patients presented with osteonecrosis at the 3-year follow-up. Conclusion. The new approach to manage ipsilateral femoral neck-shaft fractures by using reconstruction nails obtains relatively good clinical results.