Transtrochanteric fractures: evaluation of data between hospital admission and discharge

Uliana, Christiano Saliba; Abagge, Marcelo; Malafaia, Osvaldo; Filho, Faruk Abrão Kalil; Cunha, Luiz Antônio Munhoz da

doi:10.1016/j.rboe.2014.03.003

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…Hip fractures are common in the elderly. The number of cases increases every year due to the lengthening period of physical activity and lifespan [ 1 , 2 ]. Pertrochanteric fractures represent those that extend from the base of the femoral neck to a point located below the lesser trochanter.…”

Section: Introductionmentioning

confidence: 99%

In Silico Finite Element Modeling of Stress Distribution in Osteosynthesis after Pertrochanteric Fractures

Lorkowski

Pokorski

2022

JCM

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A stabilization method of pertrochanteric femur fractures is a contentious issue. Here, we assess the feasibility of rapid in silico 2D finite element modeling (FEM) to predict the distribution of stresses arising during the two most often used stabilization methods: gamma nail fixation (GNF) and dynamic hip screw (DHS). The modeling was based on standard pre-surgery radiographs of hip joints of 15 patients with pertrochanteric fractures of type A1, A2, and A3 according to the AO/OTA classification. The FEM showed that the stresses were similar for both GNF and DHS, with the medians ranging between 53–60 MPa and consistently lower for A1 than A3 fractures. Stresses also appeared in the fixation materials being about two-fold higher for GNF. Given similar bone stresses caused by both GNF and DHS but shorter surgery time, less extensive dissection, and faster patient mobilization, we submit that the GNF stabilization appears to be the most optimal system for pertrochanteric fractures. In silico FEM appears a viable perioperative method that helps predict the distribution of compressive stresses after osteosynthesis of pertrochanteric fractures. The promptness of modeling fits well into the rigid time framework of hip fracture surgery and may help optimize the fixation procedure for the best outcome. The study extends the use of FEM in complex orthopedic management. However, further datasets are required to firmly position the FEM in the treatment of pertrochanteric fractures.

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Section: Introductionmentioning

confidence: 99%

In Silico Finite Element Modeling of Stress Distribution in Osteosynthesis after Pertrochanteric Fractures

Lorkowski

Pokorski

2022

JCM

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“…Their incidence is expected to double in the next 25 years. 1 , 2 Currently, there is a consensus that pertrochanteric fractures of the femur should be treated surgically. 3 , 4 The techniques for fixation of these fractures with cephalomedullary nails are best conducted with a traction table.…”

Section: Introductionmentioning

confidence: 99%

Comparative study between lateral decubitus and traction table for treatment of pertrochanteric fractures with cephalomedullary nails

Souza

Hungria

Rezende

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo perform a retrospective radiographic assessment of the reduction and implant position in the femoral head in patients with pertrochanteric fractures treated with cephalomedullary nailing in the lateral position versus traction table.MethodsRadiographs of patients with pertrochanteric fracture of the femur treated with cephalomedullary nailing in the lateral position and traction table were retrospectively evaluated. For the evaluation we used the anteroposterior radiographic view of the pelvis and the lateral view of the affected side. The cervicodiaphyseal angle, the tip-apex distance (TAD), and the spatial position of the cephalic component in the head were measured. Two patient groups were created, one group operated on the traction table and another group operated in the lateral position.ResultsRegarding the cervicodiaphyseal angle observed in the traction table group, the results of 11 patients (61.1%) were outside the acceptable parameters proposed in the present study. Both groups were equivalent regarding TAD and the position of the cephalic component in the head.ConclusionA difference in the cervicodiaphyseal angle was observed; the group operated on the traction table had 11 patients (61.1%) whose measurements were outside the acceptable parameters.

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“…Their incidence has increased significantly because of greater life expectancy among the population, with the estimate that this may double over the next 25 years. 1 Every year, one in every 1000 inhabitants of developed countries is affected by these fractures and it has been estimated that by 2050, the annual cost of treatment (currently US$ 8 billion) may have doubled. Thus, this is considered to be one of the world's most important public health problems.…”

Section: Introductionmentioning

confidence: 99%

Lateral decubitus for treating pertrochanteric fractures using cephalomedullary nails

Oliveira

Hungria

Bellan

et al. 2015

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo perform a retrospective radiographic evaluation on the fracture reduction and implant position in the femoral head among patients with pertrochanteric fractures who had been treated using a cephalomedullary nail in lateral decubitus; and to assess factors that might interfere with the quality of the fracture reduction and with the implant position in using this technique.MethodsNineteen patients with a diagnosis of pertrochanteric fractures of the femur who had been treated using cephalomedullary nails in lateral decubitus were evaluated. For outpatient radiographic evaluations, we used the anteroposterior view of the pelvis and lateral view of the side affected. We measured the cervicodiaphyseal angle, tip-apex distance (TAD), spatial position of the cephalic element in relation to the head, and the bispinal diameter. To make an anthropometric assessment, we used the body mass index. Two groups of patients were created: one in which all the criteria were normal (TAD ≤25 mm, cervicodiaphyseal angle between 130° and 135° and cephalic implant position in the femoral head in the central–central quadrant); and another group presenting alterations in some of the criteria for best prognosis.ResultsFemale patients predominated (57.9%) and the mean age was 60 years. Seven patients presented a central–central cephalic implant position. One patient present a cervicodiaphyseal angle >135° and the maximum TAD was 32 mm; consequently, 12 patients presented some altered criteria (63.2%). None of the characteristics evaluated differed between the patients with all their criteria normal and those with some altered criteria, or showed any statistically significant association among them (p > 0.05).ConclusionThe technique described here enabled good reduction and good positioning of the implant, independent of the anthropometric indices and type of fracture.

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Transtrochanteric fractures: evaluation of data between hospital admission and discharge

Cited by 5 publications

References 21 publications

In Silico Finite Element Modeling of Stress Distribution in Osteosynthesis after Pertrochanteric Fractures

In Silico Finite Element Modeling of Stress Distribution in Osteosynthesis after Pertrochanteric Fractures

Comparative study between lateral decubitus and traction table for treatment of pertrochanteric fractures with cephalomedullary nails

Lateral decubitus for treating pertrochanteric fractures using cephalomedullary nails

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