The objective of this study was to evaluate the outcome in early treatment of subtrochanteric fractures with proximal femur locking compression plate (PF-LCP).The patients included in this study were those with subtrochanteric fractures (AO type 32A-C) treated with PF-LCP (Synthes) between Jan 2009 and Jun 2011. The patient characteristics and details of clinical conditions were obtained from records. Clinical and radiographic follow-ups were done at one, two, four and 6 months intervals, and at one year. The primary outcome studied included fracture union and functional ambulatory status. Twenty-six patients were included in the study, 19 of whom were male with a mean age of 42.4 years. Fourteen patients (53.9%) had sustained AO type 32B fractures, the majority in motor vehicle accidents. Twenty-two fractures (84.6%) achieved union, while sixpatients (23.1%) had complications such as broken plate, varus collapse, and broken screw. Four patients (15.4%) underwent a second operation. At the end of the follow-ups, 25 patients (96.2%) were community ambulators. We conclude that PF-LCP is an effective alternative treatment for subtrochanteric fractures when properly performed.
Femoral artery injury after femoral fracture fixation is a rare complication. Previous literature studies focused mostly on proximal femur fracture. We described a case of superficial femoral artery entrapment after internal fixation augmented with cerclage wire. An 80-year-old female underwent fixation with distal femur locking compression plate augmented with cerclage wire. Six hours after the operation, she developed pulseless limb and computed tomography angiogram showed femoral artery entrapped by cerclage wire. After vascular exploration and cerclage wire removal, the femoral artery returned to normal flow without further complication. We review available literature studies on vascular injury after cerclage wiring especially in the distal part of the femur, the so-called safe zone, for the great care needed before cerclage wiring and the importance of immediate diagnosis and treatment.
Background: The anterior half of the peroneus longus tendon (AHPLT) has recently gained popularity to become the alternate graft choice for anterior cruciate ligament reconstruction due to its acceptable biomechanical properties, easy and safe to harvest. Methods: A retrospective study was conducted to compare the results of anterior cruciate ligament (ACL) reconstruction with AHPLT and hamstring graft at the minimum of 3 years follow-up. Knee stability, International Knee Documentation Committee (IKDC) subjective score and Tegner activity level were collected. Results: There was no clinical significance regarding physical examination. Postoperative IKDC score was higher in the hamstring group compared with AHPLT group. Multiple regression analysis was done. The parsimonious model revealed graft types and gender were the most optimal variables explained postoperative IKDC score. Conclusion: AHPLT graft can be an alternative choice to conventional graft for single anatomic ACL reconstruction with less donor site morbidity, however there must be concern for smaller graft in short and thin female patients.
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