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Results for “FEMORAL FRACTURES”

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At least 595 records · Page 33Linked to original sources
PubMed2001

Extending fixation beyond the working length of an intramedullary nail with a linked intramedullary and extramedullary fixation in complex femoral fractures; a brief series.

We report the use of a fixed-angle side-plate device linked to an intramedullary nail in the femur with the interlocking screws applied through the plate. The 95 degrees device extends the effective length of the nail and increases the stability of the fixation. This technique is one of various adaptations that can be recommended to stabilise a complex combination of femoral fractures. This is a report of four such patients.

Adult↗
PubMed1995

[Classification, therapy and complications of pediatric femoral neck fractures].

Femoral neck fractures in children are rare injuries (less than 1 percent). The fracture pattern consists of transepiphyseal, transcervical, cervicotrochanteric and intertrochanteric fractures. Main problems with this type of injury are avascular necrosis, varus deformity, nonunion and premature epiphyseal closure. Varus and nonunion are affected by the treatment, vascular compromise with necrosis or growth problems are not related to therapy and hardly to control. Primary dislocated fractures are emergencies and need immediate operative management. Stabilization is achieved with K-wires or cancellous screws dependent on the child's age. In children below 3 years a pelvis cast is necessary post-operatively. Partial weight bearing is started 6 weeks post trauma and is rapidly increased to full weight bearing. One year post-operation the metal is removed, K-wires directly after bony healing.

Adolescent↗
PubMed2000

Distal femoral fracture through the screw hole of a ligament augmentation device fixation.

SUMMARY: Complications associated with fixation of artificial ligaments in augmented repair of the anterior cruciate ligament (ACL) have been reported throughout the literature. However, fractures following ligament augmentation device (LAD) fixation appear to be rare. We report the case of a 43-year-old woman, injured in a road accident, who sustained a depressed fracture of the tibial plateau and knee instability. The fracture was reduced and the medial collateral ligament and the menisci were sutured. The torn ACL was repaired using the Marshall technique and augmented with an LAD in an over-the-top technique. Twenty-five months postoperatively, the patient sustained a distal femoral fracture through the screw hole of the former LAD fixation after a simple fall on the street.

Accidental Falls↗
PubMed1990

Intertrochanteric femoral fractures. Mechanical failure after internal fixation.

In a prospective study we assessed the causes of mechanical failure in a series of 230 intertrochanteric femoral fractures which had been internally fixed with either a sliding hip screw or a Küntscher Y-nail. The overall rate of mechanical failure was 16.5%; cutting-out of the implant from the femoral head was the cause in three-quarters of the instances. Implants placed posteriorly in the femoral head cut out more often (27%) than those placed centrally (7%). The cut-out rate was also determined by the quality of the fracture reduction, but age, walking ability and bone density (assessed by the Singh grade and metacarpal indices) had no significant influence. We conclude that these fractures should be reduced as accurately as possible and it is imperative that the implant is placed centrally within the femoral head.

Aged↗
PubMed2001

[Surgical treatment of distal femoral fractures using extra-medullary osteosynthesis].

Forty seven fractures of the distal femur treated by internal fixation using a supracondylar compression screw or blade plate were retrospectively evaluated regarding their radiological and functional results. Blade plates were used for all types of distal femoral fractures until 1992; their indications were subsequently restricted to simple supracondylar fractures whereas a compression screw was preferred for other types of fractures. Taking into account the condition of the patients before fracture, 85% good and very good results were achieved with both techniques. Malunions resulted in poor functional outcomes (50% good and very good results). Malunions were mainly observed in patients with complex fractures (90% of cases with malunion), which confirms the poor prognosis of comminuted fractures. Nonunions (65%) and infection (3%) resulted in poor functional results. The presence of a bony defect in the medial femoral cortex increases the risk of nonunion; bone grafting should be used in such cases. The recent use of a long femoro-femoral external distractor in a few patients has proved of value as it allowed to achieve accurate reduction and considerably eased fracture reduction and fixation.

Activities of Daily Living↗
PubMed2000

[Treatment of per- and subtrochanteric femoral fractures by gamma nails and modular hip prostheses. Differential indications and results].

From January 1997 to August 1998 all stable and nonstable trochanteric femoral fractures (n = 72) were treated routinely by gamma nail using the correct operative technique. Patients showing additional osteoarthritis of the hip in radiographs hip replacement was performed by a cementless modular femoral hip prostheses from January 1996 to August 1998 (n = 28). Follow up period was 6 to 18 months. Operation time and blood loss were higher using the prostheses. However complications and lethality (< 5%) were not different during postoperative course. In each group three operative technical complications occurred. Using a modified Harris Hip Score (without range of motion, contractions) the score was decreased non significant comparing both groups first of all in unstable fractures until follow up. In each group one revision (loosening of prostheses, excessive shortening of femoral neck) was necessary. Using the correct operative technique, the gamma nail proved to be a save device with good outcome. Outcome using modular prostheses is comparable to gamma nail. Therefore the use of modular prostheses is justified in case of osteoarthrosis and in some cases of very unstable fracture.

Adult↗
PubMed1985

The longest delay between femoral neck fracture and femoral head collapse?

Osteonecrosis and acute collapse of the femoral head occurred in a 79-year-old woman with a history of femoral neck fracture sustained 28 years previously. The occurrence of radiographic signs and clinical symptoms was associated with new functional demands on the hip because of a recent contralateral hip fracture. The femoral head collapse necessitated total hip arthroplasty. Determination of femoral head vitality at the time of arthroplasty implicated partial avascularity of the head as a cause of the collapse. With high probability, this partial avascularity was induced by the femoral neck fracture sustained 28 years earlier.

Aged↗
PubMed2005

Treatment of distal femoral fractures in the elderly using a less-invasive plating technique.

We treated 16 patients having fractures of the distal femur with the less-invasive stabilization system (LISS). Patients' mean age was 75 (62-101) years. Fifteen patients had low-energy trauma. Eight fractures were type A (AO classification), three were type B and five were type C. In two cases, loosening of the proximal fixation was seen and surgical revision performed. Union time averaged 30 (16-68) weeks. There was no non-union. Average Oxford knee score was 46 (22-60). No loosening of the distal fixation was found. LISS appears to be an effective device in treating osteoporotic distal femoral fractures.

Aged↗
PubMed2000

Proximal femoral fracture. Range of hip motion as a predictor of fracture type.

A cadaveric study has shown that the femoral neck impinges on the posterior part of the acetabulum at an average of 54.5 degrees external rotation and that an intracapsular fracture can be reproduced by an impact load onto the greater trochanter with the hip in external rotation. A clinical study of hip rotation of the contralateral uninjured hip in 100 patients after proximal femoral fracture was done to compare the degree of external rotation between extracapsular and intracapsular fracture. The mean value for intracapsular fracture was 62.1 degrees and for extracapsular fracture was 48.9 degrees. A retrieval study of the femoral head and neck from patients undergoing hip hemiarthroplasty for intracapsular fracture showed a consistent pattern of fracture with posterior comminution suggesting neck impingement. Previous work has suggested that an intracapsular fracture occurs during a fall when external hip rotation thrusts the femoral neck against the posterior margin of the acetabulum. The current investigation would support this hypothesis and suggests that the natural degree of external hip rotation is a predictor of fracture type.

Aged↗