Unstable intertrochanteric fractures: How to prevent uncontrolled impaction and shortening of the femur

Bogosavljević, Miodrag; Stokic, D.; Friscic, Z.; Ristić, Branko

doi:10.2298/vsp1105399b

Cited by 2 publications

(2 citation statements)

References 15 publications

(20 reference statements)

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“…However, additional studies including dose of radiation analysis are being desirable in checking of this statement. Dynamisation in the femoral neck axis is important in trochanteric fractures with a pertrochanteric component, providing significant interfragmentary transfer of the load 19 . This dynamisation doesn't have to be blocked at the first postoperative time due to a lot of cancellous bone in the fracture area.…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of operation time and intraoperative fluoroscopy time in intramedullary and extramedullary fixation of trochanteric fractures

et al. 2022

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Background/Aim. Cephalomedullary and extramedullary methods are used for the internal fixation of trochanteric fractures. The usage of the third generation Gamma Nail (GN) is a gold standard in this kind of treatments. Self-dynamisable Internal Fixator (SIF) is an extramedullary implant for trochanteric fractures? treatment. The aim of this study was to compare these two methods regarding operation time and intraoperative fluoroscopy time. Methods. A total of 89 patients with a surgical treatment of a trochanteric fracture were included in this study. There were two groups of patients ? GN group (43 patients) and SIF group (46 patients). Results. Average operation times were 67.5 min (GN group) and 56.0 min (SIF group). Average intraoperative fluoroscopy times were 84.8 s (GN group) and 36.7 s (SIF group). The difference between the groups was statistically significant for both of the given parameters (p < 0.05). The correlation between operation time and intraoperative fluoroscopy time was confirmed in the SIF group (p < 0.05; r = 0.405), while it was not confirmed in the GN group (p > 0.05). There was a higher variability in the GN method than in the SIF method regarding the duration and type of repeated surgical maneuvers followed by X-ray checks. Conclusion. The number of planned surgical interventions per day could depend on the type of trochanteric fracture internal fixation (intramedullary or extramedullary). Certain additional analyses including radiation dose assessment are desirable to clarify if shorter intraoperative fluoroscopy time in the SIF method can have the influence regarding intraoperative X-ray protection clothing. If there is the need to activate dynamization in long femoral axis after initial static fixation in that axis, the SIF method provides its spontaneous activation several weeks after the surgery without the need neither for additional surgery nor for additional intraoperative fluoroscopy

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Section: Discussionmentioning

confidence: 99%

Comparative analysis of operation time and intraoperative fluoroscopy time in intramedullary and extramedullary fixation of trochanteric fractures

et al. 2022

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“…A lot of variables affecting the treatment outcomes in the patients with fracture were described and include: age, gender 11 , interval between admission and the surgery, the level of surgery risk, functional and mental status before the fracture 12,13 , cognitive impairment 14 , presence of multiple diseases before the fracture, American Society of Anesthesiologists (АSА) score 15 , hemodynamic disorders 16 , type of treatment (surgical or non-surgical) and type of surgical technique 17 .…”

Section: Introductionmentioning

confidence: 99%

The impact of gender differences on mortality in elderly patients after hip fracture

et al. 2018

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Background/Aim. Hip fracture is one of the leading causes of death in elderly population. We evaluated the impact of gender differences on mortality rate in elderly patients with hip fracture. Methods. The study included all hospitalized elderly patients (aged over 65 years) with hip fracture during 2013. The patients were classified into four risk groups in accordance with institutional ?i?li Etfal risk factor assessment scale ISERFAS to estimate postoperative mortality. Clinical, laboratory and risk score results were gender matched between survived and deceased patients. Hospital mortality was monitored as well as mortality at intervals of three and six months. The prediction effect of gender and overall risk variables on mortality rate were determined by univariate and multivariate logistic regression analyses. Results. The complete sample included 434 female and 163 male patients. Average age of men was 77.95 years and 79.18 years for women. Femoral neck fracture was more often seen in women (44.5%), but with no statistically significant difference (p = 0.57). Significant difference between the genders in relation to the risk score values was determined (p = 0.024). It was observed that the values of risk score was lower in the female patients and higher in the male patients. Cumulative mortality was 6% during hospital stay, 17.8% after three months and 25% after six months, respectively. In-hospital and six months after the hip fracture, the mortality rates were similar in both genders. The mortality rate was significantly higher in male patients (p = 0.035) three months after the hip fracture. The overall risk observed at all mortality intervals was a significant predictor by itself (p = 0.000). Independent gender prediction effect disappeared in joint effects of patients? overall risk. Conclusion. Gender can be defined as a significant mortality predictor in patients with hip fracture. A risk assessment system to estimate postoperative mortality for hip fractures would be helpful in planning treatment for each patient. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175007]

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Unstable intertrochanteric fractures: How to prevent uncontrolled impaction and shortening of the femur

Cited by 2 publications

References 15 publications

Comparative analysis of operation time and intraoperative fluoroscopy time in intramedullary and extramedullary fixation of trochanteric fractures

Comparative analysis of operation time and intraoperative fluoroscopy time in intramedullary and extramedullary fixation of trochanteric fractures

The impact of gender differences on mortality in elderly patients after hip fracture

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