Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “FEMORAL FRACTURES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources
PubMed2007

Fractured neck of femur in a child after femoral fracture fixation by intramedullary flexible nails: a case report.

Since the introduction of flexible intramedullary nails, the treatment of femoral shaft fractures in adolescents has been revolutionized and this has become the routine treatment in most units, with minimal complications. We report a rare complication of an ipsilateral fractured neck of femur in a fit and healthy 12-year-old girl 6 months after treatment of a traumatic fractured femoral shaft; this was treated effectively with cannulated screws and the patient was successfully discharged without any further complication.

Bone Nails↗
PubMed1999

Organ injuries associated with femoral fractures: implications for severity of injury in motor vehicle collisions.

OBJECTIVE: To determine if motor vehicle collisions (MVCs) resulting in femoral fractures were associated with a different injury severity and pattern of injury compared with crashes in which victims did not sustain femoral fractures. METHODS: Retrospective review of seriously injured motor vehicle occupants admitted to a regional trauma unit (Hamilton General Hospital) during a 69-month period (April 1991 to December 1996) for whom detailed crash details were known. RESULTS: Data for 733 motor vehicle occupants with Injury Severity Scores greater than 12 were available; 112 occupants (15.3%) sustained femoral fractures, and 621 occupants (84.7%) did not sustain femoral fractures. Victims with femoral fractures had a significantly higher mean Injury Severity Score (29.4 compared with 25.3 for non-femoral fracture group; p<0.001). The femoral fracture group had a higher incidence of bowel (p<0.012) and hemopneumothorax (p<0.02) injuries as well as an increased incidence of upper and lower extremity (p<0.001) and pelvic (p<0.05) fractures. CONCLUSION: The presence of a femoral fracture is strongly associated with the pattern and severity of injuries sustained by occupants in MVCs. A high index of suspicion is warranted in identifying associated organ injuries in MVC victims with concomitant femoral fractures.

Accidents, Traffic↗
PubMed2004

Minimally invasive percutaneous plating of distal femoral fractures using the dynamic condylar screw.

BACKGROUND: In distal femoral fractures, conventional open reduction and internal fixation causes complications because of excessive soft-tissue stripping. To prevent this, minimally invasive percutaneous plating was performed in distal femoral fractures. METHODS: Sixteen supracondylar or intercondylar femoral fractures were treated by minimally invasive percutaneous plating with the dynamic condylar screw without bone graft. Five (31%) were open fractures. RESULTS: All fractures healed except one. The average time for fracture healing was 17 weeks (range, 14-22 weeks). Complications included one nonunion related to early full weight bearing. No patient showed malunion or deep infection. Results were evaluated by modified Neer rating, and all patients had excellent or good results. Intra-articular fractures showed less favorable range of motion and clinical scores than extra-articular fractures. CONCLUSION: Minimally invasive percutaneous plating with the dynamic condylar screw can provide favorable results in the treatment of distal femoral fractures.

Adult↗
PubMed1995

Children's femoral fractures: the Edinburgh experience.

Femoral fracture is a relatively common cause of trauma admission to the paediatric surgical services in Edinburgh. Our current policy is to use gallows traction for babies and infants under 2 years and external Liston splintage with straight leg balanced skin traction for older children followed by either early mobilization or the application of a hip spica or cast brace. We reviewed the use of this management protocol over a 10-year period (323 cases) in order to assess its value and complications. A prospective study was made of 143-patients between 5 and 10 years after their fracture to assess residual disability. We found our management protocol to be a simple, highly reliable method of treatment with a minimum of complications or long-term disability.

Adolescent↗
PubMed1993

External fixation in comminuted upper femoral fractures.

External fixation of comminuted upper femoral fractures has not been studied widely. The minority of such fractures which cannot be fixed internally due to clinical and anatomical problems are generally treated in traction. Early external fixators were not sufficiently robust to hold these fractures and pin site problems are more common in femoral fixation than in the tibia. A study was undertaken including all patients with comminuted upper femoral fractures who were too unwell or otherwise unsuitable for internal fixation. The long-term results were comparable, if not superior to traction, and patient comfort and mobilization were much improved.

External Fixators↗
PubMed1994

[Osteosynthesis of proximal femoral fractures with the modular interlocking system of unreamed AO femoral intramedullary nail. Initial clinical results].

The unreamed femoral nail system (UFN) features highly versatile proximal interlocking options for the treatment of a wide range of femoral fracture patterns and combinations. Besides standard interlocking modes for diaphyseal fractures, special interlocking options for subtrochanteric fractures and ipsilateral neck/shaft fractures are available. Two aiming arms can be attached to the insertion handle of the nail in a modular fashion. The standard aiming arm is designed for transverse static or dynamic locking. The special aiming arm permits spiral blade, 130 degrees, and miss-a-nail interlocking. From August 1992 to July 1994, in 10 out of 55 UFN implantations the special interlocking options were used. In 9 subtrochanteric fractures the spiral blade interlocking and in one ipsilateral neck/shaft fracture the miss-a-nail cancellous screw interlocking was applied. ASIF type A fractures with closed soft tissue damage prevailed. Fracture healing was uneventful and no implant complications or loss of reduction have been observed.

Adult↗
PubMed1989

[Extra-long plate osteosynthesis in femoral fractures].

Of 252 femoral shaft fractures seen within a 9-year period, 32 (13%) were treated by internal fixation with an extra long DC plate, mainly because of severe comminution or fractures at two or more levels. Depending on the localization of the fracture, extra long, straight or angled plates were used. Half of the 32 patients showed multiple other injuries (mean ISS 39). Delayed union was seen in 4 patients, necessitating repeat osteosynthesis in 2. Postoperative osteitis was seen in 1 patient. The average time for consolidation was 22 weeks (10-50 weeks). The mean duration of hospitalization was 31 days. Apart from specific complications resulting from other severe injuries in 2 patients, the overall functional results were good.

Adolescent↗
PubMed1993

High assembly strains and femoral fractures produced during insertion of uncemented femoral components. A cadaver study.

The assembly strains produced in cadaver femurs during uncemented femoral arthroplasty were measured using strain gages and photoelastic coatings. Resecting the femoral neck, reaming the canal with power drills, and rasping with an optimal size rasp, as determined by preoperative radiographic templating, produced small assembly strains, up to 300 microstrain. Insertion of an optimal-size prosthesis after preparing the femoral canal with instruments the same size as the prosthesis produced moderate assembly strains, up to 1,000 microstrain. Half a millimeter press-fit of optimal prostheses produced larger assembly strains, up to 2,000 microstrain. Half a millimeter press-fit of a prosthesis that was also one size (1.0 mm) larger than that determined to be optimum produced even larger assembly strains (2,000-6,000 microstrain) and longitudinal linear fractures in the femoral cortex. Insertion of prostheses that were smaller than the rasps produced minimal strains in the femoral cortex. The magnitude of peak strains produced by press-fitting the femoral components and the small amounts of disparity between the size of the recess and the prosthesis necessary to produce these strains show the narrow range of tolerances available to the surgeon. Cementless femoral arthroplasty requires great care in preparing the femoral canal to the appropriate size as determined from preoperative templating, using accurate and precisely toleranced instrumentation and prosthetic components in order to avoid femoral fractures, yet obtain a stable fit.

Adult↗
PubMedDate not supplied

Treatments for paediatric femoral fractures: a randomised trial.

BACKGROUND: Treatments for femoral fractures in children vary widely and have been investigated only in case series. We did a multicentre randomised trial to compare malunion rates after external fixation and after early application of a hip spica cast for paediatric femoral shaft fractures. METHODS: All children aged 4-10 years with femoral fractures, admitted to four paediatric hospitals, were randomly assigned early application of hip spica or external fixation. The primary outcome was malunion at 2 years after the fracture. Secondary outcomes were scores on the RAND physical function child health questionnaire and the post-hospitalisation behavioural questionnaire, and parents' and children's ratings of overall satisfaction with treatment. Analysis was by intention to treat based on children who reached the 2 year evaluation. FINDINGS: Of 60 children assigned to the hip-spica group, 56 reached the 2-year assessment; of them, six (11%) required other forms of treatment because of unacceptable loss of reduction. Of 48 children assigned external fixation, 45 reached the 2-year assessment; two (4%) had refractures and five (11%) required operative adjustment of the fixator. The rate of malunion was significantly higher in the hip-spica group than in the external-fixator group (25/56 [45%] vs 7/45 [16%]; 95% CI for difference 12-46%; p=0.002). The two groups had similar mean scores for the RAND physical function health questionnaire (0.34 vs 0.45; 95% CI for difference, -0.57 to 0.34; p=0.61), for the post-hospitalisation questionnaire (106.8 vs 106.3; -4.9 to 5.9; p=0.86), and for parents' satisfaction (4.3 vs 4.2; -0.3 to 0.6; p=0.5) and children's ratings of happiness with treatment (6.9 vs 7.7; -2.2 to 0.5; p=0.21). INTERPRETATION: Early application of hip spica has a small role in the treatment of paediatric femoral fractures. Future trials need to compare external fixation with flexible intramedullary nails.

Casts, Surgical↗
PubMed2001

Primary total knee arthroplasty for supracondylar/condylar femoral fracture in osteoarthritic knees.

Supracondylar or condylar femoral fractures require extended treatment and often result in loss of knee range of motion. We present 3 cases in which femoral fractures and preexisting painful knees secondary to osteoarthritis were treated using total knee arthroplasty with a stemmed femoral implant. The patients were all women aged 83, 84, and 87 years old. All fractures united within 3 months, and the patients could walk with 1 cane within 2 months. Primary total knee arthroplasty should be considered as a treatment for supracondylar/condylar femoral fractures in osteoarthritic knees.

Aged↗
PubMed1977

Effects of enviromental temperature and femoral fracture on wound healing in rats.

Femoral fracture, unilateral and bilateral, impaired the healing of dorsal skin incisions and formation of reparative granulation tissue in subcutaneously implanted polyvinyl alcohol sponges judged histologically and by breaking strengths and hydroxyproline contents, respectively, 1 week after injury in pair-fed rats kept at 22 degrees C. When rats were transferred to a room at 30 degrees C immediately after skin incision and sponge implants, with or without unilateral fracture, no differences in healing were observed between the two groups. Rats with skin incision, sponge implants, and either femoral fracture or sham-fracture excreted more urinary nitrogen than preoperatively when kept at 22 degrees. Counterpart groups transferred to a 30 degrees room right after operation excreted less urinary nitrogen than preoperatively, but because of lower food intakes postoperatively, the ratio of urinary nitrogen to food intake nitrogen was increased. With equivalent food intakes, pair-fed rats with fracture kept at 22 degrees postoperatively lost more weight and excreted more nitrogen than corresponding rats transfered to a 30 degrees room.

Animals↗
PubMed2002

The use of a carbon fiber plate for periprosthetic supracondylar femoral fractures.

Operative management of periprosthetic supracondylar femoral fractures in poor-quality bone presents a challenging task for the orthopaedic surgeon. We report our experience with the use of a semirigid carbon fiber-reinforced plate in the treatment of 5 patients, all of whom were elderly women with severe osteoporosis and highly restricted mobility. All 5 of the fractures were sustained after low-energy trauma at least 2 years after primary knee arthroplasty. Except for 1 patient who died of pulmonary embolism, all 4 surviving patients progressed uneventfully to fracture union with good mobility and no residual pain. The use of this method for the treatment of periprosthetic femoral fractures has not been reported previously, and we believe it provides a successful and technically undemanding solution to this difficult problem.

Aged↗
PubMed2001

Comparison study between reamed and unreamed nailing of closed femoral fractures.

Intramedullary nailing is an accepted procedures for femoral fractures gives uniformly good results. Various methods of intramedullary fixation have been practiced in the past. Recently intramedullary fixation without reaming has come into vogue. Preservation of the endosteal blood supply, less blood loss and quicker union have been the alleged benefits of not reaming the medullary canal. This study is a prospective randomised study conducted to compare intramedullary nail fixation of closed femoral fractures with and without a reaming procedure to assess the validity of the above assumptions. One hundred and two consecutive cases of skeletally mature patients with closed fracture of femoral shaft were randomised into two groups, i.e. Reamed (52) and Unreamed (50). The average follow-up was 36 weeks (range 28-86 weeks). Average time taken for various stages of the operation and total operating time were longer in the reamed group (109.9 min vs 78.6 min) and the blood loss was also increased (320 mls vs. 190 mls). Bridging and callus formation were seen to occur earlier in the reamed group compared to the unreamed enabling the patients in the reamed group to return to normal functions earlier. Limb length discrepancy and rotational alignment measured clinically and with CT scan did not however show any significant difference between the two methods. Nails used in this study group were notably of a smaller diameter and of shorter length when compared to those used in the western population highlighting the difference in the femur in the Asian population. Complications were notably more in the unreamed group where these were screw breakage (3/50) delayed unions (9/50) and non-unions (4/50). In the reamed group however there were only delayed union (2/50) and all fractures eventually united without any implant failure. We conclude that closed, reamed, antegrade insertion of an intramedullary nail is the treatment of choice in femoral shaft fractures, especially those involving the distal 1/3. The unreamed procedure should be reserved for certain exceptions, such as in polytrauma, where a shorter operative time and less blood loss is desired.

Adolescent↗
PubMed2006

Long-term outcome and risk factors of proximal femoral fracture in uncemented and cemented total hip arthroplasty in 2551 hips.

Proximal femoral fractures are relatively common during total hip arthroplasty. The purposes of this study were to identify risk factors associated with femoral fractures and determine their effect on femoral stem survivorship. A total of 2551 hips were examined with up to 16 years of follow-up (mean, 6.8 years). Seventy-five percent of the stems were cemented. The incidence of proximal femoral fracture was 2.3% (59 hips). Risk factors associated with fractures include anterolateral approach, uncemented femoral fixation, and female sex (P < .01). Cerclage wiring was the most common treatment. After a fracture, femoral component survivorship was 95.8% for uncemented stems and 91.7% for cemented stems. In the absence of fracture, stem survivorship was 98.6% for cemented stems and 100% for circumferentially coated tapered titanium uncemented stems.

Adolescent↗
PubMed1988

[Polytrauma and femoral fracture].

From 1976 to 1986 1.003 polytraumatized patients were treated at our institution. 88% had suffered fractures of spine, pelvis and limbs. Of particular relevance are the femoral fractures (36% of all cases) in the management of those patients. In not adequately immobilized femoral fractures the rate of general and local complications in this group is elevated. Impaired microcirculation and the required high doses of analgesics can lead to an increased risk of eventually lethal ARDS. From 1976 to 1983 we used the conventional approach and stabilized femoral fractures using plates and IM nails. Due to the time required for the operation, the eventual blood loss and the invasiveness of the operation, we could operate only on 44% of the femoral fractures within the first 24 hours. In 1984 we introduced the DAF device in our service and used it in compound femurs and unstable patients with femoral fractures. In the other cases the locking nail (GK Nail) was used. With this concept we managed to increase the rate of surgery of femoral fractures in polytrauma victims within the first 24 hours to 80%. Further assessment of the date showed a significant drop of 27.3% in mortality, mainly due to a decreased rate in late ARDS-related deaths. The advantage of the DAF concept in the stabilization of these fractures in polytrauma victims we see in the less time consuming fixation, the minimal blood loss, easier ICU care and fewer local complications. The DAF device is used as a definitive management tool and does not generally require a change to another method of fixation.

Bone Nails↗