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Results for “FEMORAL FRACTURES”

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PubMed1980

Anaesthesia for surgical correction of fractured femoral neck. A comparison of three techniques.

Sixty patients with fractured neck of femur and scheduled for surgical correction were randomly allocated to receive one of three anaesthetic techniques: general anaesthesia; spinal analgesia; psoas compartment block. The patients in the local anaesthetic groups also received a light general anaesthetic. There was little difference in the pre-, intra- and postoperative events, and no difference in postoperative mortality.

Aged↗
PubMed2005

Unstable pertrochanteric femoral fractures.

BACKGROUND: Fractures in the trochanteric region of the femur are classified as AO/OTA 31-A, as they are extracapsular. This report analyzes the relatively rare 31-A3 fracture, which has also been referred to as an "intertrochanteric femur fracture with subtrochanteric extension," "reverse obliquity intertrochanteric femur fracture," "unstable intertrochanteric femur fracture," or a "subtrochanteric femur fracture." The A3 fracture is characterized by having a fracture line exiting the lateral femoral cortex distal to the vastus ridge. Possible fixation constructs include compression hip screws, intramedullary hip screws, trochanteric intramedullary nails, cephalomedullary antegrade intramedullary nails, and 95 degrees plates. Most reports investigating 31-A fractures do not describe the 31-A3 fracture. For this analysis, only reports clearly indicating that the fracture treated was a 31-A3 were included. It should be understood that this approach therefore excludes reports on generic "subtrochanteric fractures" or "intertrochanteric fractures," some of which may have been 31-A3 fractures. OBJECTIVE: To determine the effect of fixation technique for the AO/OTA 31-A3 fracture on rates of union, infection, risk of reoperation, and functional outcomes.

Fracture Fixation, Internal↗
PubMed2003

Strut allografts for failed treatment of periprosthetic femoral fractures: good outcome in 13 patients.

Strut allografts are not recommended after a femoral shaft exposure, because they may endanger the femoral blood supply. Up till now, we have seen no clinical reports on this problem. We treated 13 consecutive patients with very large anteromedial and anterolateral femoral strut allografts to restabilize periprosthetic fractures which had become loose after a previous attempt at surgical fixation (Vancouver type B fractures with severe bone loss). In 8 cases, the stem was revised in conjunction with the use of strut allografts and in 5 cases, strut allografts alone were used. All refractures and nonunions healed without further treatment. At a mean follow-up of 3 (1.2-7) years, the mean Harris Hip Score was 78 (65-92). All strut grafts showed ingrowth with augmentation of periprosthetic bone on the radiographs. There were 3 complications, 1 nonprogressive subsidence of a revision stem (fibrous stable), 1 deep hematoma and 1 partial lesion of the sciatic nerve. In this series, strut grafts gave reliable healing with augmentation of the host bone stock despite previous femoral exposure, severe bone loss, adverse type of fracture, and persistent instability at the index operation.

Aged↗
PubMed1993

[Differentiated therapy of proximal femoral fractures].

The operative therapy of 95 proximal femur fractures is reported, which were treated in the Kreiskrankenhaus St. Ingbert/Saar in the time from January 1st 1990 to June 30th 1991. Femoral neck fractures mainly were treated operatively by endoprosthetic replacement with hemiarthroplasty or hip total endoprosthesis. For per- to subtrochanteric femur fractures the use of the dynamic hip screw (DHS) was the treatment of choice, partly with screwing up the trochanter minor, cerclage of the trochanter major and/or with stabilization by bone cement in addition. Despite of a very high average age of the patients and a high rate of mostly severe basic illness for 80% of the fractures a sufficient stability was achieved to allow full weight bearing. 76.8% of the patients could be discharged directly from the surgical treatment. The therapeutic procedure is compared with the recommendations found in the literature. Different conceptions are discussed.

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