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Subtrochanteric Fracture

Shicheng Zhou, Seungyun Jung, Jihyo Hwang
BACKGROUND: A stress-riser fracture develops when stress in an object is higher than that in the surrounding material. The aim of this retrospective study was to evaluate all consecutive femoral stress-riser fractures during a period of >10 years and to verify high-risk factors by using mechanical analysis. METHODS: Forty clinical fractures caused by local stress concentration in the femoral cortical bone were included. Risk factors were analyzed, and Sawbones models were used to verify their effect...
February 14, 2019: Clinical Biomechanics
A Memeo, E Panuccio, R D D'Amato, M Colombo, S Boero, A Andreacchio, C Origo, L Pedretti
INTRODUCTION: Femoral shaft fractures are the commonest major pediatric fractures. For generations, traction and casting were the standard method of treatment for children. However, over the past two decades there has been growing recognition of the advantages of fixation and rapid mobilization. METHODS: A prospective multicenter study was conducted at four Italian centers of reference for pediatric fractures (January 2005 to December 2014). The study involved 62 patients of both sexes, between 6 and 14 years of age, with closed femoral shaft fractures...
February 7, 2019: Injury
Libor Necas, Maros Hrubina, Marian Melisik, Zoltan Cibula, Michal Chmurny, Matej Daniel, Boris Steno
INTRODUCTION: The aim of this study has been to present outcomes after cementless arthroplasty for developmental dysplasia Crowe type IV of the hip, with transverse subtrochanteric shortening osteotomy and using the S-ROM stem. METHODS: We evaluated radiographs, functional scores and complications in a consecutive series of 23 patients (28 hips) with high dislocation of the hip. The average age of patients at surgery was 49.9 (range 22-68) years. The operations were performed between 2007 and 2013...
February 13, 2019: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Huanguang Xie, Linzhen Xie, Jinwu Wang, Chunhui Chen, Chuanxu Zhang, Wenhao Zheng
PURPOSE: This meta-analysis was performed to investigate the outcomes of intramedullary fixation versus extramedullary fixation in the treatment of subtrochanteric fracture from the current literature. METHODS: The electronic literature database of PubMed, Embase, Cochrane library, CNKI and Wanfang were searched in December 2018. The data operation time, intraoperative blood loss, length of incision, length of stay, union time, rate of infection, rate of fixation failure, rate of refracture, rate of reoperation, rate of nonunion and rate of excellent and good results were extracted...
February 6, 2019: International Journal of Surgery
Armin Arshi, Kevin Rezzadeh, Alexandra I Stavrakis, Susan V Bukata, Erik N Zeegen
OBJECTIVE: To determine relative complication rates and outcome measures in patients treated under a standardized hip fracture program (SHFP). METHODS: The American College of Surgeons National Surgical Quality Improvement Program was queried to identify patients who underwent operative fixation of femoral neck, intertrochanteric, and subtrochanteric hip fractures in 2016. Cohorts of patients who were and were not treated under a documented SHFP were identified...
January 22, 2019: Journal of Orthopaedic Trauma
T Jennison, M Brinsden
INTRODUCTION: Fractures are a common reason for admission to hospital around the world. Varying incidences have been reported but these are mainly based on small studies from individual centres. The aim of our study was to analyse fracture admissions in England over a ten-year period. METHODS: Data were collated from the Hospital Episodes Statistics database. Since 2004, data have been collected for all admitted patients in England using the International Classification of Diseases codes for the primary diagnosis...
January 30, 2019: Annals of the Royal College of Surgeons of England
C Hirschfeld, J Jung, A Wicher, M Mousavi
BACKGROUND: The γ‑nailing system is a widespread intramedullary therapeutic option that has been used for intertrochanteric and subtrochanteric fractures since the late 1980s; however, some reports from the 1990s describing femoral shaft fractures questioned the indications for this system in simple fracture types. Due to increasing numbers of patients treated with this system, the complication rate is continuously falling as confirmed by many recent studies. OBJECTIVE: Between 2008 and 2013 a total of 1500 operations using the γ‑nailing system were performed at this traumatology department...
January 24, 2019: Der Unfallchirurg
D Andrew Hulet, Casey S Whale, Michael J Beebe, David L Rothberg, Jeremy M Gililland, Chong Zhang, Angela P Presson, Ami R Stuart, Erik N Kubiak
The purpose of this study was to compare failure and complication rates associated with short cephalomedullary nail vs long cephalomedullary nail fixation for stable vs unstable intertrochanteric femur fractures. This study included 201 adult patients with nonpathologic intertrochanteric femur fractures without subtrochanteric extension (OTA 31-A1.1-3, 31-A2.1-3, 31-A3.1-3) who were treated with a short cephalomedullary nail (n=70) or a long cephalomedullary nail (n=131) and had at least 6 months of follow-up...
January 22, 2019: Orthopedics
Eveline Lefever, Peter Witters, Evelien Gielen, Annick Vanclooster, Wouter Meersseman, Eva Morava, David Cassiman, Michaël R Laurent
BACKGROUND: Hypophosphatasia (HPP) is a rare metabolic bone disorder caused by mutations in the alkaline phosphatase (ALPL) gene, and characterized by low circulating alkaline phosphatase (ALP) levels and bone, muscle, dental and systemic manifestations. In this case series we investigate the clinical spectrum, genetic and biochemical profile of adult HPP patients from the University Hospitals Leuven, Belgium. METHODOLOGY: Adults with HPP were identified through medical record review...
December 21, 2018: Journal of Clinical Densitometry
T Gösling, C Krettek
Femoral shaft fractures after completion of growth predominantly affect young people with healthy bones. The causes are mostly high-velocity traffic accidents, crushing or running over mechanisms and falls from a great height. Gunshot wounds are relatively rare in Germany but have a certain importance internationally and in military medicine. Accompanying injuries in local or other regions are frequent. The predominant fracture types are transverse, wedge, segment and comminuted fractures. Spiral fractures are a sign of indirect force and are therefore frequently found in older patients with osteoporosis...
January 7, 2019: Der Unfallchirurg
Paul Karayiannis, Andrew James
PURPOSE: To assess the potential impact of using cerclage cables or wires when undertaking fixation of unstable intertrochanteric and subtrochanteric fractures. METHODS: Patients were identified from a validated hospital database which included patients from all trauma units within Northern Ireland from 2008 to 2015. The primary outcome measure was return to theatre for any reason. Secondary outcome measures included quality of reduction, tip-apex distance, length of stay, mortality at 3 and 12 months and functional outcomes assessed by Barthel Index and mobility...
January 5, 2019: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
James M Rizkalla, Scott J B Nimmons, Alan L Jones
No abstract text is available yet for this article.
January 2019: Clinical Orthopaedics and related Research
J K Giriraj Harshavardhan, Bharghava Ram Uppalapati, P Gopinath Menon
Introduction: Fibrous dysplasia is a rare benign disorder of the skeletal system characterized by fibro-osseous proliferation with intervening areas of normal or immature bone in the intramedullary region. It can either be a monostotic (involves one bone) or a polyostotic (involves more than one bone) presentation and usually occurs equally in males and females. Deformities such as scoliosis and shepherd's crook deformity are frequently encountered in the polyostotic form. We report the management of a rare managed case of bilateral shepherd's crook deformity of the proximal femur with impending neck of femur fracture...
May 2018: Journal of Orthopaedic Case Reports
Sanjit R Konda, Hesham Saleh, Ariana Lott, Kenneth A Egol
Patterns of discharge location may be evident based on the "sickness" profile of the patient. This study sought to evaluate the ability of the STTGMA tool, a validated mortality risk index for middle-aged and geriatric trauma patients, to predict discharge location in a cohort of low-energy elderly hip fracture patients, with successful discharge planning measured by readmission rates. Low-energy hip fracture patients aged 55 years and older were prospectively followed throughout their hospitalization...
2018: Advances in Orthopedics
Sebastian Lotzien, Valentin Rausch, Thomas Armin Schildhauer, Jan Gessmann
BACKGROUND: Nonunions of the subtrochanteric region of the femur after previous intramedullary nailing can be difficult to address. Implant failure and bone defects around the implant significantly complicate the therapy, and complex surgical procedures with implant removal, extensive debridement of the nonunion site, bone grafting and reosteosynthesis usually become necessary. The purpose of this study was to evaluate the records of a series of patients with subtrochanteric femoral nonunions who were treated with dynamic condylar screws (DCS) regarding their healing rate, subsequent revision surgeries and implant-related complications...
December 21, 2018: BMC Musculoskeletal Disorders
A Elhakeem, A Hartley, Y Luo, A L Goertzen, K Hannam, E M Clark, W D Leslie, J H Tobias
In a population-based sample of British women aged over 70 years old, lean mass and peak lower limb muscle force were both independently associated with hip strength and fracture risk indices, thereby suggesting a potential benefit of promoting leg muscle strengthening exercise for the prevention of hip fractures in postmenopausal women. INTRODUCTION: To investigate cross-sectional associations of lean mass and physical performance, including lower limb muscle function, with hip strength, geometry and fracture risk indices (FRIs) in postmenopausal women...
December 14, 2018: Osteoporosis International
E J Corona-Juárez, O Catalán-Arizmendi, I Alvarado-Ortega, E García-Cano, A Montiel-Jarquín
BACKGROUND: fibrous dysplasia is characterized by the formation of fibrous tissue that generates immature malformed trabeculae. Their involvement may be monostotic or poliostotic. CASE REPORT: Thirty years old female with fibrous dysplasia of the left hip. At age 15 suffered hip fracture without apparent trauma, she was managed conservatively and significant shortening of the same limb was observed. At 30 years old, is pregnant, it had left hip pain, deformity and shortening is exacerbated...
July 2018: Acta Ortopédica Mexicana
Kyung-Jae Lee, Byung-Woo Min
Atypical femoral fractures differ from ordinary femoral diaphyseal or subtrochanteric fractures in several aspects. Although several authors have reported the results of surgical treatment for atypical femoral fractures, the rate of complications (e.g., delayed union, nonunion, fixation failure, and reoperation) is still high. Therefore, we reviewed principles of surgical treatment and describe useful methods for overcoming femoral bowing in these high-risk patients.
December 2018: Hip & Pelvis
Pietro De Biase, Edy Biancalani, Daniela Martinelli, Andrea Cambiganu, Stefano Bianco, Roberto Buzzi
Proximal femoral fractures are a very common disease which affect elderly patients after low energy trauma, but can also affect the young population as a consequence of high energy trauma. Classification of sub trochanteric fractures has not yet been clearly defined representing a major issue in comparing different treatment techniques among the scientific literature.These fractures are well known by orthopaedic surgeons for intraoperative difficulties in reduction and post-operative high rate of non-unions and malunions...
December 2018: Injury
R Pascarella, S Cerbasi, A Maresca, P Sangiovanni, R Fantasia
This case report describes the management and therapeutic solution for the treatment of subtrochanteric non-union in a patient with hip arthrodesis. Two techniques can be used in the treatment of these non-unions: a closed intramedullary nailing or an open technique with plate, preferably carried out together with cortical bone graft. The surgical technique varies depending on the fixation method used for the initial treatment of the fracture and on the characteristics of the non-union. We report an unusual case of a patient who started her long clinical history more than 40 years ago with a septic arthritis of the hip healed in arthrodesis...
December 2018: Injury
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