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Results for “FEMORAL FRACTURES”

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At least 883 records · Page 49Linked to original sources
PubMed1994

[Gamma nail osteosynthesis of per- and subtrochanteric femoral fractures. 4 years experiences and their consequences for further implant development].

The Gamma nail can be used in all types of per- and subtrochanteric fractures because of its biomechanical characteristics. In this prospective evaluation of our 330 patients treated between November 1989 and November 1993 the usefulness of the Gamma nail for the osteosynthesis of all types of fracture was evaluated. The rate of intraoperative and postoperative complications but also gait function, postoperative weight bearing, general complications, and survival were analysed. We compared the results of four therapy periods to evaluate the importance of the expertise of the surgeon and the 'learning curve'. The Gamma nail osteosynthesis was performed in 72-98% in unstable per- and subtrochanteric fractures. The nail diameters used shifted to the 12 mm nail (99%) and the 130 degrees angle (93%) in the fourth examination period. The intraoperative complication rate is highly dependent from the expertise of the surgeon and the experience with the system. The rate decreased from 42.2% in the first to 17.2% in the fourth examination period. The most important complications were: additional fractures (1.7%), distal locking screw problems (7%), femoral head rotation (2,4%), and not sufficient fracture reduction (4.1%). Whereas in general these did not influence the postoperative management the use of a too short femoral neck screw lead to instability. Postoperative local complications were: rotation of the femoral head and neck (0.6-5.5%), related to the gliding of the neck screw (0.6-4%), fracture at the end of the nail (1.8-4%), fatigue break of the nail (1 case) and hematoma (1.2-8.3%). In all these cases reoperation was needed. To reduce the rate of intra- and postoperative complications a new gliding nail (GN) is presented. Due to the double T-profile of the femoral neck blade the implant is stable for neck rotation. The blade has a collar which makes it impossible to implant the blade to deep in the femoral neck. The larger nail profile at the femoral neck perforation reduces the risk of implant failure. The implant can be used as dynamic compression as well as static implant both in the direction of femoral neck and shaft.

Aged↗
PubMed1990

The Brooker-Wills interlocking nail in the treatment of femoral fractures.

Interlocking nails have expanded the indication for intramedullary fixation to almost any type of fracture of the shaft of the femur. Distal locking with the Brooker-Wills femoral nail is obtained by a wing fixator. This simplifies the operative technique and diminishes exposure to radiation. Adequate control of angulation, shortening and rotation could be achieved in a first series of 25 patients, thus leading to firm bone healing and to early functional recovery.

Adult↗
PubMed1991

[Stabilization of hip para-articular femoral fractures. A report of experiences with 1,698 patients].

Between 1973 and 1987 a total of 1698 patients with fractures of the proximal femur were operatively treated at the surgical accident and emergency department of the Städtische Krankenanstalten Krefeld. The most commonly observed fracture in the high age group (mean: 81.4 years) was that of the subcapital femoral neck (n = 901). A total hip replacement (n = 648) was commonly indicated - followed by a hemiarthroplasty (n = 114) and 130 AO plate (n = 70). Fractures of the femoral neck in young patients were treated with a cancellous screw in order to preserve the femoral head (n = 69). The majority of pertrochanteric fractures (n = 603) were stabilized with 130 degrees AO plates (n = 520) and most of the subtrochanteric fractures (n = 194) were treated either with an angle plate (n = 130) or with a 95 degrees AO plate (n = 64). In principle early internal fixation followed by immediate mobilization was the aim in all patients (68% of patients were operated on within three days of admission). Sufficient stability was achieved using internal fixation to allow full weight bearing in 76% of the injuries, or partial weight bearing in 21% postoperatively. The paper shows that the patients need spend less time in the hospital (60% stayed less than three weeks on the ward, 80% were discharged within four weeks) and that the mortality in this study was reduced to 10.1%. Complications such as fracture of the implant (0.5%) and dislocation (0.9%) were described. The rate of bone infection amounted to 0.9% of all operations.

Adolescent↗
PubMed1992

Unrecognized femoral fractures during cementless total hip arthroplasty in the dog and their effect on bone ingrowth.

Uncemented straight-stemmed proximally porous-coated femoral components were press fitted into the femoral canals of seven dogs using a rasp 0.5 mm smaller than the components (press-fit group). In seven other dogs the components were fit precisely into the femoral canals using a rasp that was the same size as the components (control group). Using this technique, all of the dogs in the press-fit group developed longitudinal fractures in the femoral cortex, while none of the dogs in the control group developed fractures. None of the fractures were recognized at operation. Two of the dogs in the press-fit group displaced the fractures at 1 week and were sacrificed. The other five dogs were bearing weight on their limbs and completed the 3-week experimental period. Follow-up radiographs of these femurs showed marked periosteal new bone formation, but did not reveal any fractures. Serial sections of these femurs showed longitudinal healing fractures in the anterior cortex. The fractures had an adverse effect on the bone ingrowth into the porous surface of the press-fit group compared to the control group without fractures, and the porous surface adjacent to the fractures was ingrown with fibrous tissue. The amount of bone ingrowth expressed as a percentage of the porous coating area measured, on average, only 3.9% in the press-fit group at 3 weeks compared to 5.6% in the control group--a statistically significant difference at P < .025. This experience in the dog illustrates the inherent risk of driving a larger femoral component into a smaller cavity prepared in the femur.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2004

[Pitfalls and complications of elastic stable intramedullary nailing (ESIN) of femoral fractures in infancy].

BACKGROUND: The aim of this prospective study was to evaluate the intra- and postoperative problems as well as the complications of elastic stable intramedullary nailing (ESIN) of femur fractures in children. PATIENTS AND METHODS: 47 consecutive children, mean age 6 years, were reviewed clinically and radiologically until hardware removal and after this annually. Mean time of follow up was 37 months. RESULTS: Intraoperatively one cortex perforation and one displacement of a third fragment occurred. Two correction operations were necessary: In one case due to an implant displacement and in another case due to an unacceptable loss of reduction. There were no infections, non union, implant breakage, refracture or disturbance of growth. CONCLUSIONS: ESIN is a safe procedure in femoral shaft fractures of children. Most of the problems and complications can be avoided by a careful consideration of the indication and a correct operation technique.

Bone Nails↗