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Results for “FEMORAL FRACTURES”

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PubMed2002

[Intensive physical therapy after trochanteric femoral fracture. A randomized clinical trial].

INTRODUCTION: This randomised study evaluates the effect of intensive physical therapy on the duration of rehabilitation after hip fracture. MATERIALS AND METHODS: The study comprised 88 patients transferred for rehabilitation after operative treatment for hip fracture. After randomisation, 44 patients received physical therapy 3.6 hours (median) a week, whereas the 44 control patients received physical therapy 1.9 hours a week. The outcome was defined as the duration of physical rehabilitation until the patient was able to 1) walk 50 metres in less than two minutes; 2) manage to climb stairs to the first floor; 3) manage the sit-to-stand transfer; 4) get in and out of bed; 5) manage bathing, dressing, and lavatory visits. RESULTS: In the group randomised to intensive physical therapy, 24 patients dropped out after 15 days (median) whereas 13 patients dropped out of the control group after 22 days. Drop outs were caused by orthopaedic complications, general weakness, and poor co-operation. No difference was found in the duration of physical rehabilitation by analysis per protocol of the patients who completed the trial. DISCUSSION: The considerable number of drop outs suggests that intensive physical therapy may be of limited value in the attempt to reduce the duration of rehabilitation after hip fracture. An altered objective, including enhanced outpatient rehabilitation, may be necessary in order to reduce the length of hospital stay after hip fracture.

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PubMed2006

Spontaneous rapid osteolysis in Paget's disease after internal fixation of subtrochanteric femoral fracture.

Rapidly-progressive spontaneous progression of the osteolysis following internal fixation of pathological fracture in patients with Paget's disease has not been previously reported. We describe two patients, aged 59 and 65 years, respectively, who had pathological subtrochanteric fractures in Pagetic femora fixed internally using an interlocked intramedullary nail, and who developed spontaneous rapid osteolysis. Both patients responded favourably to long-term treatment with alendronate, with resultant fracture union and resolution of osteolysis.

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PubMed1999

Biomechanical analysis of supracondylar femoral fractures fixed with modern retrograde intramedullary nails.

OBJECTIVES: Several new retrograde supracondylar intramedullary nails have been developed to specifically address fractures of the distal femur. The nails appear clinically effective, but there are few biomechanical data documenting the stability of the fixation or the mechanical stiffness of the different designs. The goal of this study was to assess the torsional and bending stiffness of four designs of intramedullary nails developed for this application. METHODS: Four nail designs were tested in torsion and bending to determine system stiffness: Ace supracondylar, Richards "five hole" and "multi-hole" supracondylar, and Biomet retrograde. The nails were inserted into cadaveric femurs in which a one-centimeter distraction osteotomy had been created seven centimeters proximal to the condyles. The constructs were then tested on an Instron biaxial testing system. RESULTS: There were no statistically significant differences in bending stiffness among the groups of nails (range 0.79 to 1.18 newtons/meter; p > 0.1). However, the Ace nails (1.10 newtonmeters/degree) did exhibit a statistically lower torsional stiffness compared with the other nails (2.20 to 2.21 newton-meters/ degree; p < 0. 1). No differences were noted as a function of the number of locking holes. CONCLUSIONS: The bending stiffness of four currently available designs of retrograde intramedullary nails does not appear to be dependent on design variations. The torsional stiffness did vary among the four designs, but this was not determined by the number of fixation holes provided. It appears that a well-placed retrograde supracondylar nail of modern design should have sufficient stiffness to support the femur and provide stability during fracture healing.

Biomechanical Phenomena↗
PubMed1992

[Experimental study of external fixation of femoral fractures. Mechanical properties of different kinds of fixation. Clinical implications].

An in vitro assessment of the mechanical performance of 10 types of external femoral stabilization allowed the amplitudes of fracture site displacements during the initial loading phase of a comminuted fracture treated by external fixation to be established. The largest displacement to load ratios were observed in the sagittal plane for all tested configurations. The highest fixator stiffnesses were obtained by using large diameter tubes and pins. The most rigid fixators have a derigidification system which creates the problem of choosing the ideal time to change the rigidity.

External Fixators↗