Feasibility and Value of Radiographic Union Score Hip Fracture after Treatment with Intramedullary Nail of Stable Hip Fractures

Maiettini, Daniele; Bisaccia, Michele; Caraffa, Auro; Rinonapoli, Giuseppe; Piscitelli, Luigi; Bisaccia, Olga; Rollo, Giuseppe; Meccariello, Luigi; Ceccarini, Paolo; Rebonato, Alberto

doi:10.5455/aim.2016.24.394-396

Cited by 14 publications

(16 citation statements)

References 12 publications

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“…A delay in union was found in three cases in group I and two cases in group II. When evaluated with RUSH scores, where reliability and validity studies have been carried out, 13 , 14 , 32 we found no significant difference between the groups.…”

Section: Discussionmentioning

confidence: 62%

“… 12 However, there are important variations in the evaluation of fracture healing in orthopaedic trauma studies. 32 When RUSH scores are used to evaluate union in femoral neck and intertrochanteric fractures, there was better agreement between radiologist and orthopaedist observers at the sixth months than at the third month. 14 In the present study, and for these reasons, delay in union was evaluated at the third month and RUSH scores obtained at the sixth month.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Effects of Zoledronic Acid Treatment on Fracture Healing, Morbidity and Mortality in Elderly Patients with Osteoporotic Hip Fractures

Sargın¹,

Konya²,

Gülcü³

et al. 2020

Strategies in Trauma and Limb Reconstruction

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Background In this study, the effects of zoledronic acid (ZolA) administered at different times to patients undergoing surgical treatment for hip fracture were investigated. Materials and methods Ninety patients who underwent surgical treatment for osteoporotic (OP) hip fractures between February 2013 and September 2016 in our hospital were included in the study. After surgical treatment, patients were allocated into three groups: group I—patients who had osteosynthesis using proximal femoral nail (PFN) for an intertrochanteric fracture of the femur were given ZolA within 1 week after fracture and before discharge; group II—patients who had osteosynthesis using the PFN for an intertrochanteric fracture of the femur were given ZolA within 1 month after fracture post-discharge; group III—patients in the same age group who had a hemiarthroplasty (HA) for an intertrochanteric fracture of the femur were administered ZolA before discharge. In addition, all patients were given daily oral calcium and vitamin D3. The Radiographic Union Score for Hip (RUSH), Harris Hip Score (HHS), and bone mineral density (BMD) were used at the follow-up as evaluation criteria, and complications were noted. Results There were no significant differences between groups in terms of demographic data and laboratory outcomes ( p > 0.05). Radiographic Union Score for Hip scores were similar between groups I and II ( p > 0.05). Fracture union occurred by the sixth month in all patients whose results were evaluated. No statistically significant difference was found between three groups ( p > 0.05). There was no difference between the three groups in the hip and vertebrae BMD and t scores ( p > 0.05). When t and BMD scores before treatment were compared with those at 1 year after treatment, a benefit from ZolA treatment was observed in all three groups ( p < 0.05). Conclusion This study shows that the timing of ZolA administration has no effect on fracture healing and complication incidence in elderly patients with hip fractures. In addition, ZolA was found to be beneficial in increasing BMD of both femur and vertebra in all groups, but there was no significant difference between the groups. Clinical significance The study demonstrated that ZolA may be used early in the treatment of osteoporotic hip fractures with PFN. How to cite this article Sargin S, Konya MN, Gulcu A, et al. Effects of Zoledronic Acid Treatment on Fracture Healing, Morbidity and Mortality in Elderly Patients with Osteoporotic Hip Fractures. Strategies Trauma Limb Reconstr 2019;14(3):126–131.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 97%

Effects of Zoledronic Acid Treatment on Fracture Healing, Morbidity and Mortality in Elderly Patients with Osteoporotic Hip Fractures

Sargın¹,

Konya²,

Gülcü³

et al. 2020

Strategies in Trauma and Limb Reconstruction

View full text Add to dashboard Cite

show abstract

“…Studies in the literature have reported that not locking the nail distally reduces pain and bleeding and therefore the days of hospitalization. In the present study, we also have not locked the nails during the PFN procedure [28,29]. When durations of hospitalization were compared according to the operation types, the mean duration of hospitalization was significantly shorter in cannulated screw and PFN operations than in the other types of surgical procedures.…”

Section: Discussionmentioning

confidence: 70%

Relationship between the AB0 Blood System and Proximal Femoral Fracture Patterns in the Turkish Population

Kuru

Olçar

2020

BioMed Research International

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Objective. AB0 blood groups have shown to be associated with increased risk of several orthopedic disorders such as Achilles tendon rupture and hip osteoarthritis. The objective of this study was to investigate relationships between the AB0 blood system and hip fracture patterns, duration of hospitalization, and amount of blood transfusion. Methods. Data of 308 patients treated due to hip fractures in our hospital between 2017 and 2019 were evaluated. Epicrisis reports and X-rays of the patients included in this study were retrospectively screened, and hip fractures were classified as intracapsular and extracapsular fractures. Patients were divided into A, B, 0, and AB groups according to blood groups. Results. The mean age of the patients was 75.54±13.5 years. Of all patients, 103 had an intracapsular fracture and 205 had an extracapsular fracture. No statistically significant correlation was found between blood groups and fracture patterns. No statistically significant difference was found between the amounts of transfusion according to the blood groups, and no significant difference between the durations of hospitalizations according to the blood groups. Conclusion. In our study population, we could not find a significant relationship between the AB0 blood system and fracture patterns. We think that these potential relationships could be explained with further comprehensive studies with larger populations.

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“…Multiple factors such as fracture type, patient comorbidities, surgical approach, and the type of IMN may affect the likelihood of nail breakage. [19][20][21][24][25][26] Subtrochanteric fractures, which occur in the area within 5 cm distal to the lesser trochanter, are prone to nonunion and malunion and require proper reduction before and during fixation to ensure favorable results. 6 Reasons for the breakage may also be attributed to excessive premature weight bearing or prolonged cyclical loading (eg, with nonunion).…”

Section: Discussionmentioning

confidence: 99%

Intramedullary Nail Breakage and Mechanical Displacement in Patients with Proximal Femoral Fractures: A Commercial and Medicare Supplemental Claims Database Analysis

Chitnis

Ray²,

Sparks³

et al. 2021

MDER

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Objective This study evaluated the rates and patterns of intramedullary nail (IMN) breakage and mechanical displacement for proximal femur fractures and the factors associated with their occurrence. Patients and Methods Patients with subtrochanteric, intertrochanteric, or basicervical femoral neck fractures treated with IMN from 2016 to 2019 were identified from commercial and Medicare supplemental claims databases and were followed for up to two years. Kaplan–Meier analysis estimated the cumulative incidence of and patterns of breakage/mechanical displacement. Multivariable Cox regression models evaluated the factors associated with breakage/mechanical displacement. Results A total of 11,128 patients had IMN fixation for subtrochanteric, intertrochanteric, or basicervical femoral neck fractures: (mean SD) age 75.6 (16.4) years, 66.2% female, 74.3% Medicare supplemental vs 26.7% commercial insurance. Comorbidities included hypertension (62.9%), osteoporosis (27.3%), cardiac arrhythmia (23.1%), diabetes (30.7%), and chronic pulmonary disease (16.3%). Most fractures were closed (97.2%), intertrochanteric or basicervical femoral neck (80.1%), and not pathological (91.0%). The cumulative incidence of nail breakage over two years was 0.66% overall, 1.44% for combination fractures, 1.16% for subtrochanteric fractures, and 0.49% for intertrochanteric or basicervical fractures. The cumulative incidence of mechanical displacement was 0.37% overall, 0.43% for subtrochanteric fractures, 0.42% for combination fractures, and 0.36% for intertrochanteric or basicervical femoral neck fractures. Half of the breakages occurred within five months after surgery and half of the mechanical displacements occurred within 75 days. Age 50–64 (vs 75+) and subtrochanteric or pathological fracture were more commonly associated with nail breakage. Complicated hypertension was more commonly associated with mechanical displacement. Conclusion The incidence of IMN breakage and mechanical displacement in US commercial and Medicare supplemental patients with proximal femur fractures from 2016 to 2019 was low (0.66% and 0.37%, respectively up to two years). Age 50–64 (vs 75+) and subtrochanteric or pathological fracture were more commonly associated with breakage. Complicated hypertension was associated with mechanical displacement.

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Feasibility and Value of Radiographic Union Score Hip Fracture after Treatment with Intramedullary Nail of Stable Hip Fractures

Cited by 14 publications

References 12 publications

Effects of Zoledronic Acid Treatment on Fracture Healing, Morbidity and Mortality in Elderly Patients with Osteoporotic Hip Fractures

Effects of Zoledronic Acid Treatment on Fracture Healing, Morbidity and Mortality in Elderly Patients with Osteoporotic Hip Fractures

Relationship between the AB0 Blood System and Proximal Femoral Fracture Patterns in the Turkish Population

Intramedullary Nail Breakage and Mechanical Displacement in Patients with Proximal Femoral Fractures: A Commercial and Medicare Supplemental Claims Database Analysis

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