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Navarre, Pierre, Belinda J. Gabbe, Xavier L. Griffin, Matthias K. Russ, Andrew T. Bucknill, Elton Edwards, and Max P. Esser. "Outcomes following operatively managed acetabular fractures in patients aged 60 years and older." Bone & Joint Journal 102-B, no. 12 (December 1, 2020): 1735–42. http://dx.doi.org/10.1302/0301-620x.102b12.bjj-2020-0728.r1.
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Aims Acetabular fractures in older adults lead to a high risk of mortality and morbidity. However, only limited data have been published documenting functional outcomes in such patients. The aims of this study were to describe outcomes in patients aged 60 years and older with operatively managed acetabular fractures, and to establish predictors of conversion to total hip arthroplasty (THA). Methods We conducted a retrospective, registry-based study of 80 patients aged 60 years and older with acetabular fractures treated surgically at The Alfred and Royal Melbourne Hospital. We reviewed charts and radiological investigations and performed patient interviews/examinations and functional outcome scoring. Data were provided by the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR). Survival analysis was used to describe conversion to THA in the group of patients who initially underwent open reduction and internal fixation (ORIF). Multivariate regression analyses were performed to identify factors associated with conversion to THA. Results Seven patients (8.8%) had died at a median follow-up of 18 months (interquartile range (IQR) 12 to 25), of whom four were in the acute THA group. Eight patients (10%) underwent acute THA. Of the patients who underwent ORIF, 17/72 (23.6%) required conversion to THA at a median of 10.5 months (IQR 4.0 to 32.0) . After controlling for other factors, transport-related cases had an 88% lower rate of conversion to THA (hazard ratio (HR) 0.12, 95% confidence interval (CI) 0.02 to 0.91). Mean standardized Physical Component Summary Score (PCS-12) of the 12-Item Short Form Health Survey (SF-12) was comparable with the general population (age-/sex-matched) by 12 to 24 months. Over half of patients working prior to injury (14/26) returned to work by six months and two-thirds of patients (19/27) by 12 months. Conclusion Patients over 60 years of age managed operatively for displaced acetabular fractures had a relatively high mortality rate and a high conversion rate to THA in the ORIF group but, overall, patients who survived had mean PCS-12 scores that improved over two years and were comparable with controls. Cite this article: Bone Joint J 2020;102-B(12):1735–1742.
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Watters, Carol L., and William P. Moran. "Hip Fractures???A Joint Effort." Orthopaedic Nursing 25, no. 3 (May 2006): 157???165. http://dx.doi.org/10.1097/00006416-200605000-00003.
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&NA;. "Hip Fractures???A Joint Effort." Orthopaedic Nursing 25, no. 3 (May 2006): 166???167. http://dx.doi.org/10.1097/00006416-200605000-00004.
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Holloway, Kara L., Muhammad A. Sajjad, Mohammadreza Mohebbi, Mark A. Kotowicz, Patricia M. Livingston, Mustafa Khasraw, Sharon Hakkennes, et al. "The epidemiology of hip fractures across western Victoria, Australia." Bone 108 (March 2018): 1–9. http://dx.doi.org/10.1016/j.bone.2017.12.007.
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Ekegren, Christina L., Richard de Steiger, Elton R. Edwards, Richard S. Page, Raphael Hau, Susan Liew, Andrew Oppy, and Belinda J. Gabbe. "Using Patient-Reported Outcomes to Predict Revision Arthroplasty Following Femoral Neck Fracture: Enhancing the Value of Clinical Registries through Data Linkage." International Journal of Environmental Research and Public Health 16, no. 8 (April 12, 2019): 1325. http://dx.doi.org/10.3390/ijerph16081325.
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The aim of this study was to determine the association between patient-reported outcome measures (PROMs) six months following femoral neck fracture after a low fall and future arthroplasty, and the factors associated with this. Six-month post-fracture PROMs were collected from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) for patients aged >55 years who were admitted for a femoral neck fracture after a low fall between March 2007 and June 2015. These cases were linked with those registered by Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) up to October 2016. Multivariable analysis was performed using a Cox proportional hazards model to determine factors associated with future arthroplasty, including six-month PROMs. Of the 7077 hip fracture patients registered by VOTOR during the study period, 2325 met the inclusion criteria. Internal fixation being used for the initial hip fracture surgery, being younger and having no pre-injury disability were all independently associated with future revision or conversion to arthroplasty. Out of all PROMs, reporting pain and discomfort six months post-fracture was associated with a 9.5-fold increase in the risk of future arthroplasty (95% CI: 3.81, 23.67). The value of clinical registries can be enhanced via data linkage, in this case by using PROMs to predict arthroplasty following femoral neck fracture.
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Buachidze, O. Sh. "Hip joint implanting." N.N. Priorov Journal of Traumatology and Orthopedics 1, no. 4 (March 21, 2022): 14–17. http://dx.doi.org/10.17816/vto105147.
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The paper provides some experience with hip joint endoprosthesis with Poldi and Beznoska implants, Czechia, used in 210 patients (235 operations). Total and cervicocapital endoprostheses were implanted in 193 and 42 cases, respectively. The indications for total and unipolar joint replacement were severe Stage III coxarthrosis, aseptic necrosis of the head of the femur, pseudoarthrosis of its neck, subcapital fractures with severe limb dysfunctions and persistent pains. Positive results (complete recovery of joint movements and limb load) were noted in 93% of patients in the follow-up periods of 6 months to 18 years. The complications were seen as follows: wound suppuration in 4 patients, aseptic instability in 4 (they all were reoperated), relaxation of a total implant and partial protrusion of the head of a unipolar implant in 6 patients.
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Nambiar, Dr Sudeep Madhukar, Dr Naeem S. Jagani, Dr Lokesh Sharoff, and Dr Jonathan James Dsouza. "Total hip replacement the ideal joint for failed osteosynthesis of hip fractures." International Journal of Orthopaedics Sciences 3, no. 3j (July 1, 2017): 667–72. http://dx.doi.org/10.22271/ortho.2017.v3.i3j.102.
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Vikmanis, Andris, and Andris Jumtins. "The Treatment of Acetabular Fracture Complications in a Combination of Post-traumatic Hip Joint Osteoarthritis and Femoral Fracture for Polytrauma Patient." Acta Chirurgica Latviensis 11, no. 1 (January 1, 2011): 164–66. http://dx.doi.org/10.2478/v10163-012-0035-3.
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The Treatment of Acetabular Fracture Complications in a Combination of Post-traumatic Hip Joint Osteoarthritis and Femoral Fracture for Polytrauma PatientPelvic bone fractures are related to a high energy injury. Therefore with an increase of the traffic intensity simultaneously grows the number of polytrauma patients, who have pelvic bone fractures of various severity levels. In the case of acetabular fractures, as the most frequent complication is the hip joint post-traumatic degeneratively destructive osteoarthritis, in whose treatment very often the hip joint arthroplasty is necessary. The frequency of this complication is affected by the precision of repositioning and the strength of fixation of an acetabular fracture.
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Bonnaire, F., D. J. Schaefer, and E. H. Kuner. "Hemarthrosis and Hip Joint Pressure in Femoral Neck Fractures." Clinical Orthopaedics and Related Research 353 (August 1998): 148–55. http://dx.doi.org/10.1097/00003086-199808000-00017.
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Park, Sang Won, Soon Hyuck Lee, Jung Ho Park, and Hong Kun Lee. "Ipsilateral Fractures of the Hip Joint and Femoral Shaft." Journal of the Korean Society of Fractures 3, no. 1 (1990): 88. http://dx.doi.org/10.12671/jksf.1990.3.1.88.
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Klyuchevskiy, V. V., Sergey Il'suverovich Gil'fanov, V. V. Danilyak, M. V. Belov, M. A. Khudaybergenov, I. V. Klyuchevskiy, V. V. Klyuchevskiy, et al. "Joint Replacement in Femoral Neck Fractures." N.N. Priorov Journal of Traumatology and Orthopedics 16, no. 3 (September 15, 2009): 21–25. http://dx.doi.org/10.17816/vto200916321-25.
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Results of joint replacement in femoral neck fractures have been analyzed. During the period from 1994 to 2003 total hip replacement was performed to 399 patients with subcapital fractures including 372 patients in whom the operation was performed as a primary intervention. From 2002 to 2004 the total number of 290 hemiarthroplasty operations with use of module native implant was performed in 286 patients aged 76-101 years. In total joint replacement group intrahospital lethality made up 2% due to the following causes: pulmonary thrombembolia - 3 cases, acute cardiac insufficiency - 1 case, deep decubitus ulcers resulting in sepsis - 2 cases, polyorganic insufficiency on the background of severe concomitant pathology - 1 case. In the early postoperative period the following complications were noted: implant dislocation (5.2% of cases), intraoperative femoral fracture (3.5%). Infectious complications developed in 2 patients and in both cases removal of the implant was required. With mean-term follow-up native implants showed mean-term survival of 92-94% in 272 patients. Mean evaluation by Harris was the following: biometric «Sinko» and «ESI» implants - 83.1 points, PF «Sinko» implants - 89.3 points, combination of «Mathys» friction pair with native femoral component - 91.2 points. «Mathys» implants showed 94.6 points. Results of ЯРТЕЗ joint replacement were evaluated during the period from 1 to 3 years in 183 patients. Intrahospital lethality made up 1.8%. Excellent and good results were achieved in 53.7% of patients. Revision was required in 1.5% of cases. As concluded total hip replacement in femoral neck fracture was the effective treatment technique. It was reasonable both cement and cementless fixation with various implants for the optimum choice of implant in every specific patient. Use of modern module implants enabled to expand the indications for application of arthroplasty in elderly patients.
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Li, Dongzhe, Yue Fang, and Zhou Xiang. "Homolateral Hip Dislocation, Floating Hip Injury, and Floating Knee Injury: A Unique Presentation of a Rare Injury." International Surgery 103, no. 9-10 (September 1, 2019): 489–92. http://dx.doi.org/10.9738/intsurg-d-16-00227.1.
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Introduction: Floating joint injury is an unusual injury pattern that is hard to deal with and often caused by high-energy trauma. In this report, a patient had a homolateral floating hip injury (FHI), floating knee injury (FKI), and hip dislocation at our hospital, and there was no case reported before. Case Presentation: A 48-year-old driver who encountered a traffic accident was seen. Radiologic examination revealed acetabulum comminuted fractures and hip joint posterior dislocation with some fracture pieces in the joint space on the left side. The femur, tibia, and fibula were simultaneously disrupted with open trauma of the left calf. Open reduction and screw-plate fixation of the acetabulum fracture, intramedullary nail fixation of the femoral fracture, and external fixator for his tibia and fibula fracture were carried out. Conclusion: The treatment of multiple fractures should focus on life-threatening injuries above all, and then deal with the fractures according to the situation of the patient. Open reduction and internal fixation are priority choices except in some special cases like where soft tissue is in poor condition. Individual therapy and early rehabilitation are effective for homolateral FHI and FKI.
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Abdulhabirov, M. "KONSTANTIN SIVASH - CONSTRUCTOR OF UNIQUE ENDOPROTHESIS." East European Scientific Journal 2, no. 3(67) (April 15, 2021): 12–15. http://dx.doi.org/10.31618/essa.2782-1994.2021.2.67.2.
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The author briefly describes the history of the creation of the hip joint endoprotheses, as well as the biography of Professor Konstantin Sivash, the implementator of a unique one-piece hip joint endoprosthesis, original knee and elbow joint endoprostheses, compression apparatus for the knee joint, plates and pins for osteosynthesis of fractures.
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S. Kawade, Manish, and Harnam S. Madan. "Salvage total hip arthroplasty (THA) for failed internal fixations of proximal hip fractures." International Journal of Research in Medical Sciences 6, no. 1 (December 23, 2017): 167. http://dx.doi.org/10.18203/2320-6012.ijrms20175714.
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Background: Failed proximal femoral fractures like operated transcervical neck fractures, intertrochanteric fractures and subtrochanteric fractures poses a great challenge to surgeon with limited options. Revision of failed internal fixation with hip arthroplasty, also known as Salvage THA (Total Hip Arthroplasty) is a promising surgical option in elderly patients providing early mobility and preventing age related complications.Methods: 45 patients with failed proximal hip fractures were treated over a period of 2 year with THA with modular cemented prosthesis by southern approach.Results: Fourty five patients were followed up for atleast 16 months with no radiological evidence of loosening and heterotrophic ossification and analyzed for pain, difficulty in walking, muscle power, range of motion of joint and functional status. The overall results were expressed in terms of Salvati-Wilson hip grading system.Conclusions: Revision of failed internal fixation with hip arthroplasty, also known as Salvage THA (Total Hip Arthroplasty) is a promising surgical option in elderly patients providing early mobility and preventing age related complications.
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MAKEDONSKAYA, Marina V., Dmitry P. Semikin, Sergey A. Mordovin, and Sergey A. Petrukhin. "LONG-TERM EFFECTS OF TRAUMA AND OPERATIONAL INTERVENTIONS FOR PROXIMAL FEMORAL FRACTURES." Medicine and Physical Education: Science and Practice, no. 8 (2020): 14–19. http://dx.doi.org/10.20310/2658-7688-2020-2-4(8)-14-19.
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After surgery for proximal hip fractures, patient treatment takes long months. Given the features of the fracture, the age of the patient, the duration of treatment, the psychological state, as well as the presence of comorbidities, there is a problem of restoring limb function in the distant period after the injury. Aim : to analyze the long-term effects of osteosynthesis of proximal hip fractures in terms of limb function. Material and methods : we carried out assessment of presence of restriction of lower extremity function by analysis of expression of limitation of motion amplitude in hip joint of operated extremity and expression of post-traumatic hypotrophy of hip muscles. Results : we detected pronounced hypotrophy of the hip muscles in 19.7 % of cases, pronounced decrease in the amplitude of movements in the hip joint in 21 % of cases, in 3 % of cases hip ankylosis was formed. Conclusion . Based on the analysis, we can conclude that there is insufficient activation of patients after surgical treatment of proximal hip fractures, which can be associated with both objective and subjective causes.
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Yao, Wuping, Yuji Li, Zhi Liu, Liuyi Yao, Rui Liang, Jinqiu Wu, and Lingwei Yuan. "Autologous Oxygen-Releasing Nano-Biomimetic Scaffold with Chondrocytes Promotes Joint Repair After Trauma." Journal of Biomaterials and Tissue Engineering 12, no. 3 (March 1, 2022): 602–8. http://dx.doi.org/10.1166/jbt.2022.2930.
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Our study assesses the role of a scaffold constructed by co-culture of autologous oxygen-releasing biomimetic scaffold (AONS) and chondrocytes in joint repair after trauma. A composite scaffold structure was used and a scaffold constructed of AONS and chondrocytes was transplanted into SD rats to create models of patellar cartilage fracture and hip osteochondral fracture, respectively followed by analysis of cell proliferation by immunofluorescence method, osteogenesis-related gene expression by RT-PCR, chondrocytes apoptosis by TUNEL staining. The blank control group and AONS composite chondrocytes have significant differences in apoptosis and cell proliferation of two fracture types (P <0.05). The autologous oxygen-releasing nanometers at 4 and 8 weeks showed a significant difference in the number of PCNA and TUNEL cells between biomimetic scaffold and chondrocytes in two groups (P < 0.05). The AONS and chondrocytes were effective for two types of fractures at 1, 4 and 8 weeks. The expression of various markers of intrachondral osteogenesis was decreased and the markers of hip osteochondral fracture were increased significantly (P < 0.05). Joint recovery was better than patellar cartilage fractures. The AONS composite chondrocyte scaffold promotes repair of patellar cartilage fractures and hip osteochondral fractures with a better effect on hip osteochondral fractures.
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Montavon, P. M., and H. F. L’Eplattenier. "Avulsion Fractures of the Femoral Head: Internal Fixation Using a Ventral Approach to the Hip Joint." Veterinary and Comparative Orthopaedics and Traumatology 10, no. 01 (January 1997): 23–26. http://dx.doi.org/10.1055/s-0038-1632564.
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SummaryAvulsion fractures of the femoral head are encountered in conjunction with craniodorsal luxations of the hip joint and cannot be treated conservatively without risking either reluxation of the joint or considerable cartilage damage resulting in degenerative joint disease. Fixation of the fragment is possible by inserting a Kirschner wire and a lag screw from the articular surface, making sure the implants are well countersunk. A ventromedial approach to the hip joint allows good visibility of the joint surface and easy reduction of the fracture without severing the round ligament. The surgical technique described was used on three cases and combines a ventromedial approach to the hip joint with fixation of the fracture with a Kirschner wire and a lag screw inserted from the joint surface, and has the advantages of enabling good reconstruction of the joint surface as well as maintaining postoperative joint stability. Both these factors considerably reduce the development of degenerative joint disease and improve the prognosis for recovery of full limb function.A surgical technique for treatment of avulsion fractures of the femoral head is described. It combines a ventromedial approach to the hip joint with fixation of the fracture with a Kirschner wire and a lag screw inserted from the joint surface.
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Slobodskoy, Aleksandr Borisovich, E. Yu Osintsev, A. G. Lezhnev, A. B. Slobodskoi, E. Yu Osintsev, and A. G. Lezhnev. "Complications in Hip Arthroplasty." N.N. Priorov Journal of Traumatology and Orthopedics 18, no. 3 (September 15, 2011): 59–63. http://dx.doi.org/10.17816/vto201118359-63.
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Experience in follow up of 1399 patients after 1603 hip joint arthroplasties is presented. Bilateral operations were performed in 102 patients. In 111 patients revision total hip replacement was performed. Age of patients ranged from 18 to 94 years. Different complications were present in 4,3% of cases: pyo-inflammatory - in 1,37%, implant head dislocation - 1,93%, periprosthetic fractures - 0,19%, postoperative neuritis - 0,49% and pulmonary thrombosis - in 0,31% of cases. Elderly and senile patients, severe concomitant pathology (diabetes mellitus, rheumatoid arthritis and other systemic diseases), acute proximal femur injury, earlier operated dysplastic coxarthrosis, revision and complicated total hip replacement, history of pyo-inflammatory processes in the zone of hip joint are to be considered as risk factors to complication development. Scale for complications prognosis in hip joint arthroplasty is presented.
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Berezin, P. A., S. V. Bragina, and A. L. Petrushin. "Traumatic Hip Dislocation: Lecture." Traumatology and Orthopedics of Russia 27, no. 2 (July 13, 2021): 156–69. http://dx.doi.org/10.21823/2311-2905-2021-27-2-156-169.
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Traumatic hip dislocations occupy the fourth place among dislocations of various localizations and, as a rule, are the result of exposure to a high-energy traumatic agent. Such injuries are more often observed in young and middle-aged males. The main cause of hip dislocations is road accidents. The femoral head is more often dislocated posteriorly, but anterior dislocations are not casuistic and account for approximately 10%. Hip dislocations are often combined with acetabular fractures, while their fairly clear clinical picture in the presence of fractures can be leveled. Traumatic hip dislocations require urgent diagnosis and treatment. After the clinical examination of the patient, an x-ray of the pelvis and hip joints are performed. Radiographic diagnosis of hip dislocation remains relevant, but modern imaging methods allows to study the hip joint in more detail and identify concomitant injuries. The main treatment for hip dislocation is closed reduction. Early dislocation reduction and the absence of damage to the structures forming the hip joint are important for the treatment results prognosis. The further patient management tactics after the dislocation reduction is determined by the results of stress tests and the CT data. When confirming the instability and associated injuries of the hip joint anatomical structures, surgical treatment is indicated. Among the complications of hip dislocation: sciatic nerve damage, post-traumatic coxarthrosis, the femoral head avascular necrosis, heterotopic ossification. Current literature data indicates the importance of early diagnosis of dislocation-associated injuries of the hip joint and periarticular tissues. Early and comprehensive repair of all existing injuries is crucial for favorable outcomes. A number of therapeutic and diagnostic methods, primarily arthroscopy, show optimistic results, but need further study.
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Rashid, Fatima, Aatif Mahmood, David H. Hawkes, and William J. Harrison. "Coronavirus in hip fractures (CHIP) 4." Bone & Joint Journal 104-B, no. 12 (December 1, 2022): 1362–68. http://dx.doi.org/10.1302/0301-620x.104b12.bjj-2022-0843.r1.
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Aims Prior to the availability of vaccines, mortality for hip fracture patients with concomitant COVID-19 infection was three times higher than pre-pandemic rates. The primary aim of this study was to determine the 30-day mortality rate of hip fracture patients in the post-vaccine era. Methods A multicentre observational study was carried out at 19 NHS Trusts in England. The study period for the data collection was 1 February 2021 until 28 February 2022, with mortality tracing until 28 March 2022. Data collection included demographic details, data points to calculate the Nottingham Hip Fracture Score, COVID-19 status, 30-day mortality, and vaccination status. Results A total of 337 patients tested positive for COVID-19. The overall 30-day mortality in these patients was 7.7%: 5.5% in vaccinated patients and 21.7% in unvaccinated patients. There was no significant difference between post-vaccine mortality compared with pre-pandemic 2019 controls (7.7% vs 5.0%; p = 0.068). Independent risk factors for mortality included unvaccinated status, Abbreviated Mental Test Score ≤ 6, male sex, age > 80 years, and time to theatre > 36 hours, in decreasing order of effect size. Conclusion The vaccination programme has reduced 30-day mortality rates in hip fracture patients with concomitant COVID-19 infection to a level similar to pre-pandemic. Mortality for unvaccinated patients remained high. Cite this article: Bone Joint J 2022;104-B(12):1362–1368.
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Stołtny, Tomasz, Jarosław Pasek, Dominika Rokicka, Marta Wróbel, Michał Dobrakowski, Paweł Kamiński, Rafał Domagalski, Szymon Czech, Krzysztof Strojek, and Bogdan Koczy. "Are there really specific risk factors for heterotopic ossifications? A case report of ‘non-risk factor’ after total hip replacement." Journal of International Medical Research 50, no. 6 (June 2022): 030006052210952. http://dx.doi.org/10.1177/03000605221095225.
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Femoral neck fractures are one of the most common fractures in the elderly population. Due to frequent complications of the fixation of these fractures, patients are more and more often eligible for hip replacement surgery. One of the most frequently mentioned postoperative complication is the formation of heterotopic ossification. This case report describes as a 70-year-old male patient that presented with an old hip fracture accompanied by a mild craniocerebral trauma. The patient underwent total cementless hip arthroplasty followed by rehabilitation. At 8 months after surgery, the patient was diagnosed with Brooker IV° heterotopic ossification in the area of the operated hip joint. Due to the persistent pain and complete loss of mobility in the operated joint, computed tomography imaging was performed and the patient was recommended for a revision surgery. The procedure was performed 14 months after the original surgical treatment, resulting in a significant improvement in the range of motion and reduction of pain.
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Jabbar, Faisal Abdul, and Rehana Ali Shah. "OSTEOARTHRITIS OF THE HIP JOINT;." Professional Medical Journal 24, no. 11 (November 3, 2017): 1669–74. http://dx.doi.org/10.29309/tpmj/2017.24.11.647.
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Objectives: The aim of our study is to determine the surgical outcome andrates of complication in patients undergoing surgical treatment for osteoarthritis of the hip jointwith total hip arthroplasty and compare it with hip resurfacing procedures. Study Design: Aprospective cohort study. Period: Five years duration from January 2011 to December 2016.Setting: Tertiary Care Centre in Karachi, Pakistan. Materials and methods: The study populationconsisted of n= 170 patients (n= 110 patients undergoing cementless THA and n=60 patientsundergoing hip resurfacing procedures). The inclusion criteria was all the patients who came toour outpatient clinic, with unilateral or bilateral osteoarthritis (grade 3,4) of the hip joint requiringsurgical treatment, were fit for surgery and gave informed consent to participate in the study.All the procedures were done by the same team of surgeons at the same institute in seriesunder general anesthesia. Data was collected in a pre-designed proforma. Postoperatively thepatients were restricted to a reduction of weight bearing by half for the first six weeks, andwere involved in physiotherapy till discharge from the hospital. The patients from both groupsreceived the same thromboembolic and infection prophylaxis. Data was analyzed using IBMSPSS version 22. Results: In our study we found that the rates of reoperation had statisticallysignificant differences, being n= 5 in THA group and n=9 in resurfacing group having a pvalue of 0.019. In the resurfacing group n= 4 patients had fractures of the femoral neck. All therevision surgeries were undertaken utilizing the posterolateral approach, n= 2 patients wererevised utilizing cementless femoral stems while n=2 were revised utilizing cemented femoralstem, n= 5 patients were revised to total hip arthroplasty procedure on account of asepticloosening. No dislocations were observed after the revision surgical procedures. There wasno statistically significant difference in the total rates of complications among the two groups,having a p value of 0.44. The pre-operative Harris hip scores were similar in the two groupshaving a p value of 0.2. Conclusion: According to the results of our study the outcome in theboth the cementless total hip arthroplasty and hip resurfacing procedure are similar in termsof implant survival and clinical results however rate of complication is higher in the patientsundergoing hip resurfacing technique and needed revision surgeries. The patients undergoinghip resurfacing had better mobility post operatively, and hence this consideration is to be madeduring patient selection, as hip resurfacing is preferred by younger patients due to its higherfunctional outcomes.
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Ishimaru, Daichi, Satoshi Nozawa, Masato Maeda, and Katsuji Shimizu. "Intertrochanteric Fracture of the Ankylosed Hip Joint Treated by a Gamma Nail: A Case Report." Case Reports in Orthopedics 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/278156.
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We herein report a rare case of an intertrochanteric fracture complicated with an ankylosed hip joint in a 76-year-old man. Generally, operative treatment is performed for elderly people with intertrochanteric fractures to prevent general complications, maintain mobility, and release pain. However, intertrochanteric fractures of ankylosed hip joints are rare, and the optimal surgery for this condition is unknown. In addition, surgical fracture repair is challenging because unusual instability of the fracture site is suspected owing to the long lever arm of the lower extremity. Nevertheless, we successfully treated this rare fracture using a gamma nail, which may be a useful implant with which to treat this type of fracture if the status of the arthrodesed hip joint allows.
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Vyrva, Oleg, and Dmytro Vatamanitsa. "Acetabulum fractures. Analysis of treatment results." ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS, no. 1-2 (November 15, 2022): 77–84. http://dx.doi.org/10.15674/0030-598720221-277-84.
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Treatment of patients with acetabulum fractures (AF) remains a big challenge for orthopaedists and traumatologists. Suchfractures are known for their complications that lead to disability. Objective. To analyze the results of treatment of patientswith AF and complications that arise depending on the of the injury mechanism and the method of treatment, to evaluate the effectiveness available methods of preventing the development of these complications. Methods. A retrospective study wasdone on the basis of 89 AF patients analysis (age 17‒75 years, 22 women and 67 men) with different terms after the fracture.The majority of patients got primary care in other clinics. Diagnostic measures: clinical examination; X-ray examinationof the pelvis, that under conditions of acute injuries were supplemented with CT scan; ultrasound of abdominal cavity,chest X-ray, brain MRI, electroneuromyography of the lower limbs. Results. Most AF occurred as a result of traffic accidents.The most common types are A1 and B1 according to the classification of AO/ASIF. The system of skeletal traction has beenapplied often at the stage of primary treatment. During surgical treatment the Kocher-Langenbeck approach and osteosynthesis was mainly used to stabilize the posterior wall and acetabulum column. The typical complications of AF are coxarthrosis, femoral head aseptic necrosis despite the chosen treatment tactics. Their clinical manifestation with the hip impaired function occurred within a year after the trauma. Defined complications led to the need for total hip replacement in 67 (75.3 %) cases out of 89. In 8 patients, total hip replacement was performed in the acute period of injury and it was possible to restore the joint function with better early functional results compared to the rest of the patients. Conclusions. Primary total hip replacement in the case of AF is an effective treatment measure that gives the posibility restore the function of the hip joint in the shortest time and prevent the development of typical complications.
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Vyrva, Oleg, and Dmytro Vatamanitsa. "Current trends in the treatment of acetabular fractures (literature review)." ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS, no. 2 (October 12, 2021): 83–91. http://dx.doi.org/10.15674/0030-59872021283-91.
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Acetabular fractures are known for their disabling outcomes, so the search for optimal treatment tactics is an actual problem for modern orthopedics and traumatology. Materials and methods. Randomized trials that reflect the results of acetabular fractures treatment depending on the method of treatment were analyzed. The literature was searched in the PubMed Central database. Hip joint is a complex two-component articulated system. Traumatic lesion of all elements of the joint creates the conditions for the development of a wide range of complications and secondary changes that must be taken into account at preoperative treatment. Acetabular fracture is an intra-articular injury, where the visualization methods have the prominent significance. Nowadays the treatment can be conservative and surgical. Surgical treatment can be divided into two areas: osteosynthesis and arthroplasty. Anatomical reposition and stable fixation of fragments, in the most of cases, is the key to a satisfactory functional result, but the development of post-traumatic changes in the joint nullifies the results of even perfect osteosynthesis, encourages repeated surgery and, finally, hip replacement. In recent years, primary arthroplasty has been successfully used to treat acetabular fractures, reducing inpatient and rehabilitation period, compared with osteosynthesis, preventing the possible development of secondary degenerative changes in the joint. Conclusions. Acute hip replacement is an effective treatment, however, the technical aspects of reliable fixation of the acetabular component of the implant are insufficiently substantiated and highlighted in actual literature and constitute significant research interest.
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Lazarev, A. F., A. O. Ragozin, E. I. Solod, M. G. Kakabadze, A. F. Lazarev, A. O. Ragozin, E. I. Solod, and M. G. Kakabadze. "Peculiarities of Total Hip Replacement in Femur Neck Fractures." N.N. Priorov Journal of Traumatology and Orthopedics 10, no. 2 (June 15, 2003): 3–8. http://dx.doi.org/10.17816/vto20031023-8.
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Biomechanic conception of implant choice for primary total hip replacement in osteoporotic femur neck fractures is presented. Criterion for the choice is a localization of load-bearing surface of dense structure in acetabulum roof zone, i.e. sursile. Absolute indications to total hip replacement, use of bipolar and unipolar hemiprostheses are determined depending on the direction and deviation degree of sursile from horizontal axis of pelvis. Based on suggested conception the retrospective analysis of joint replacement results in 58 patients has been performed. The causes of protrusion and loosing of implants were studied.
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BOROVOY, I. S. "Surgical treatment of transacetabular fractures." Practical medicine 19, no. 3 (2021): 92–94. http://dx.doi.org/10.32000/2072-1757-2021-3-92-94.
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The article presents an analysis of the treatment results of patients with transverse acetabulum fractures of type B1.1 according to the AO classification using various surgical tactics/ the most optimistic results were obtained when using the hip joint osteosynthesis with an external fixation device (EFD) «pelvis-hip» in urgent cases. Besides the obvious antishock action, it allows removing the femoral head from the central displacement and in many cases achieving the reposition of the acetabulum, due to ligamentotaxis. After x-ray control in the case of a further incomplete reposition in the EFD, it significantly simplifies the open stage of surgical treatment after the stabilization of the vital functions of the body, which has a positive effect on the long-term results of treatment of this complex category of patients.
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Bednarski(, Piotr, and Karolina Piekarska. "Traumatic Hip Joint and Thigh Injuries – an Analysis of NHF Reporting Data from 2016-2019 Using the NHF Statistics API." Ortopedia Traumatologia Rehabilitacja 23, no. 5 (October 31, 2021): 349–60. http://dx.doi.org/10.5604/01.3001.0015.4353.
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Background. The hip joint is one of the most important joints in the human body. Although its multiaxial movements account for many benefits, they also render the hip one of the most hard-working joints. Injuries to the hip joint and thigh often occur as a result of a fall. According to epidemiologic data, such falls are most frequent in the elderly, particularly in osteoporosis sufferers. Material and methods. The “Services” component of the Statistics API version 1.0 provided by the National Health Fund (NHF) was used in order to evaluate the number of hospitalizations due to hip joint and thigh injuries. Information on the number of patients was obtained in a number of stages. The first stage involved determination of hip and thigh injuries as the main diagnosis. Then, the billing products which made possible settlement for hospitalization of patients with the selected diagnoses were chosen. The last stage consisted in the extraction of relevant medical data sets from the “Services” component of the NHF Statistics API, which made possible this analysis. Results. According to the NHF reporting data, over the four-year period of interest there were approx. 42,000 hospitalizations per year. The most frequent causes of hospitalization were fractures of the neck of the femur (S72.0) and trochanteric fractures (S72.1), accounting for approx. 48% and 36% of all hospital stays, respectively. Conclusions. 1. Hip injuries constitute a significant health problem in Poland (approx. 42,000 hospitalizations per year). 2. The most frequent causes of hospitalization are injuries in the form of fractures of the neck of the femur or trochanteric fractures (corresponding to the ICD-10 codes S72.0 and S72.1, respectively). 3. It appears advisable to develop a tool to enable medical service providers to adjust their services to patients’ changing needs. This tool could employ open-access data on injuries published in the NHF Statistics API.
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Konan, S., S. Alazzawi, B.-H. Yoon, Y.-H. Cha, and K.-H. Koo. "A focused update on preventing ceramic fractures in hip arthroplasty." Bone & Joint Journal 101-B, no. 8 (August 2019): 897–901. http://dx.doi.org/10.1302/0301-620x.101b8.bjj-2019-0309.r1.
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Ceramic bearings have several desirable properties, such as resistance to wear, hardness, and biocompatibility, that favour it as an articulating surface in hip arthroplasty. However, ceramic fracture remains a concern. We have reviewed the contemporary literature, addressing the factors that can influence the incidence of ceramic bearing surface fracture. Cite this article: Bone Joint J 2019;101-B:897–901.
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Peel, T. N., A. C. Cheng, P. F. M. Choong, and K. L. Buising. "Early onset prosthetic hip and knee joint infection: treatment and outcomes in Victoria, Australia." Journal of Hospital Infection 82, no. 4 (December 2012): 248–53. http://dx.doi.org/10.1016/j.jhin.2012.09.005.
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Kurniawan, Yosalfa Adhista, Muhammad Hasan, and Rena Normasari. "Effect of Leg Length Discrepancy to the Hip Function on Post Hemiarthroplasty Patients in Jember." Journal of Agromedicine and Medical Sciences 3, no. 2 (July 20, 2017): 35. http://dx.doi.org/10.19184/ams.v3i2.5068.
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Hip fractures in elderly patient are often treated with hemiarthroplasty. Hemiarthroplasty can cause various complications, one of which is leg legth descrepancy (LLD). The function of the hip joint is reduced due to these complications. Previous studies have shown contradictive results regarding the relationship of LLD to the function of the hip joint in post-arthroplasty patient's. This type of research is observational with retrospective study. The population in this study came from 2 hospitals in Jember was 53 patients and the sample was 30 people. LLD is measured by true leg length and apparent leg length, whereas hip joint function is measured by Oxford Hip Score (OHS). The data were tested by using Spearman correlation test. In conclusion, there was a moderate relationship between LLD true leg length to the function of the hip joint. This study does not support the implications of the LLD to the hip function because of weak relationship between LLD true leg to the hip function and moderate relasionship between LLD apparent leg length to the hip function.
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Menger, Maximilian M., Benedikt J. Braun, Steven C. Herath, Markus A. Küper, Mika F. Rollmann, and Tina Histing. "Fractures of the femoral head: a narrative review." EFORT Open Reviews 6, no. 11 (November 2021): 1122–31. http://dx.doi.org/10.1302/2058-5241.6.210034.
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Fractures of the femoral head are rare injuries, which typically occur after posterior hip dislocation. The Pipkin classification, developed in 1957, is the most commonly used classification scheme to date. The injury is mostly caused by high-energy trauma, such as motor vehicle accidents or falls from a significant height. Emergency treatment consists of urgent closed reduction of the hip joint, followed by non-operative or operative treatment of the femoral head fracture and any associated injuries. There is an ongoing controversy about the suitable surgical approach (anterior vs. posterior) for addressing fractures of the femoral head. Fracture location, degree of displacement, joint congruity and the presence of loose fragments, as well as concomitant injuries are crucial factors in choosing the adequate surgical approach. Long-term complications such as osteonecrosis of the femoral head, posttraumatic osteoarthritis and heterotopic ossification can lead to a relatively poor functional outcome. Cite this article: EFORT Open Rev 2021;6:1122-1131. DOI: 10.1302/2058-5241.6.210034
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Malik, Azeem Tariq, Safdar N. Khan, Thuan V. Ly, Laura Phieffer, and Carmen E. Quatman. "The “Hip Fracture” Bundle—Experiences, Challenges, and Opportunities." Geriatric Orthopaedic Surgery & Rehabilitation 11 (January 1, 2020): 215145932091084. http://dx.doi.org/10.1177/2151459320910846.
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Introduction: With growing popularity and success of alternative-payment models (APMs) in elective total joint arthroplasties, there has been recent discussion on the probability of implementing APMs for geriatric hip fractures as well. Significance: Despite the growing interest, little is known about the drawbacks and challenges that will be faced in a stipulated “hip fracture” bundle. Results: Given the varying intricacies and complexities of hip fractures, a “one-size-fits-all” bundled payment may not be an amenable way of ensuring equitable reimbursement for participating physicians and hospitals. Conclusions: Health-policy makers need to advocate for better risk-adjustment methods to prevent the creation of financial disincentives for hospitals taking care of complex, sicker patients. Hospitals participating in bundled care also need to voice concerns regarding the grouping of hip fractures undergoing total hip arthroplasty to ensure that trauma centers are not unfairly penalized due to higher readmission rates associated with hip fractures skewing quality metrics. Physicians also need to consider the launch of better risk-stratification protocols and promote geriatric comanagement of these patients to prevent occurrences of costly adverse events.
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Khominets, V. V., P. A. Metlenko, A. L. Kudyashev, A. L. Dresvyannikov, V. V. Chernyshev, and D. R. Fakhrutdinov. "Features of treatment of patients with periprosthetic fractures after replacement hip joint." Journal of Emergency Surgery named after I.I. Dzhanelidze, no. 2 (2022): 40–47. http://dx.doi.org/10.54866/27129632_2022_2_40.
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Mahmood, Aatif, Fatima Rashid, Richard Limb, Thomas Cash, Mathias Thomas Nagy, Nasri Zreik, Gautam Reddy, et al. "Coronavirus infection in hip fractures (CHIP) study." Bone & Joint Journal 103-B, no. 4 (April 1, 2021): 782–87. http://dx.doi.org/10.1302/0301-620x.103b.bjj-2020-1862.r1.
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Aims Despite the COVID-19 pandemic, incidence of hip fracture has not changed. Evidence has shown increased mortality rates associated with COVID-19 infection. However, little is known about the outcomes of COVID-19 negative patients in a pandemic environment. In addition, the impact of vitamin D levels on mortality in COVID-19 hip fracture patients has yet to be determined. Methods This multicentre observational study included 1,633 patients who sustained a hip fracture across nine hospital trusts in North West England. Data were collected for three months from March 2020 and for the same period in 2019. Patients were matched by Nottingham Hip Fracture Score (NHFS), hospital, and fracture type. We looked at the mortality outcomes of COVID-19 positive and COVID-19 negative patients sustaining a hip fracture. We also looked to see if vitamin D levels had an impact on mortality. Results The demographics of the 2019 and 2020 groups were similar, with a slight increase in proportion of male patients in the 2020 group. The 30-day mortality was 35.6% in COVID-19 positive patients and 7.8% in the COVID-19 negative patients. There was a potential association of decreasing vitamin D levels and increasing mortality rates for COVID-19 positive patients although our findings did not reach statistical significance. Conclusion In 2020 there was a significant increase in 30-day mortality rates of patients who were COVID-19 positive but not of patients who were COVID-19 negative. Low levels of vitamin D may be associated with high mortality rates in COVID-19 positive patients. Cite this article: Bone Joint J 2021;103-B(4):782–787.
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Belinov, Nikolay V. "Long-term results of internal-and-transosseous osteosynthesis of intraarticular fractures of the proximal femur." Medicine and Physical Education: Science and Practice, no. 11 (2021): 7–11. http://dx.doi.org/10.20310/2658-7688-2021-3-3(11)-7-11.
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We analyze the condition of 28 patients who underwent internal-and-transosseous metal osteosynthesis of the femoral neck. We use clinical, radiological and functional research methods for the examination. In clinical research methods, the main attention was paid to the patient's gait, pain syndrome, which was evaluated both during physical exertion and at rest. The radiological methods of the study assessed the signs of consolidation of bone fragments, the presence of bone trabeculae, which, without interruption, pass from the neck to the femoral head. In case of pain in the hip joint, a computed tomography was performed with the measurement of the length of the hip neck, which was compared with the length of the hip neck of the healthy side. The congruence of the articular surfaces and the articular gap of the hip joint were studied. Functional studies were carried out using the systems for assessing the state of the hip joint of Luboshitz–Mattis–Schwarzberg and W.H. Harris. The follow-up period ranged from 1 to 7 years. The obtained studies allowed an objective assessment of the long-term results of metal osteosynthesis of femoral neck fractures with an original fixator. A positive assessment of the long-term results of osteosynthesis of the femoral neck allows us to recommend using this fixator in clinical practice.
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Mellema, Jos J., Stein Janssen, Tundi Schouten, Daniël Haverkamp, Michel P. J. van den Bekerom, David Ring, and Job N. Doornberg. "Intramedullary nailing versus sliding hip screw for A1 and A2 trochanteric hip fractures." Bone & Joint Journal 103-B, no. 4 (April 1, 2021): 775–81. http://dx.doi.org/10.1302/0301-620x.103b.bjj-2020-1490.r1.
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Aims This study evaluated variation in the surgical treatment of stable (A1) and unstable (A2) trochanteric hip fractures among an international group of orthopaedic surgeons, and determined the influence of patient, fracture, and surgeon characteristics on choice of implant (intramedullary nailing (IMN) versus sliding hip screw (SHS)). Methods A total of 128 orthopaedic surgeons in the Science of Variation Group evaluated radiographs of 30 patients with Type A1 and A2 trochanteric hip fractures and indicated their preferred treatment: IMN or SHS. The management of Type A3 (reverse obliquity) trochanteric fractures was not evaluated. Agreement between surgeons was calculated using multirater kappa. Multivariate logistic regression models were used to assess whether patient, fracture, and surgeon characteristics were independently associated with choice of implant. Results The overall agreement between surgeons on implant choice was fair (kappa = 0.27 (95% confidence interval (CI) 0.25 to 0.28)). Factors associated with preference for IMN included USA compared to Europe or the UK (Europe odds ratio (OR) 0.56 (95% CI 0.47 to 0.67); UK OR 0.16 (95% CI 0.12 to 0.22); p < 0.001); exposure to IMN only during training compared to surgeons that were exposed to both (only IMN during training OR 2.6 (95% CI 2.0 to 3.4); p < 0.001); and A2 compared to A1 fractures (Type A2 OR 10 (95% CI 8.4 to 12); p < 0.001). Conclusion In an international cohort of orthopaedic surgeons, there was a large variation in implant preference for patients with A1 and A2 trochanteric fractures. This is due to surgeon bias (country of practice and aspects of training). The observation that surgeons favoured the more expensive implant (IMN) in the absence of convincing evidence of its superiority suggests that surgeon de-biasing strategies may be a useful focus for optimizing patient outcomes and promoting value-based healthcare. Cite this article: Bone Joint J 2021;103-B(4):775–781.
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Zacharias, Anthony J., Brian T. Muffly, David A. Zuelzer, Cale A. Jacobs, Raymond D. Wright, and Stephen T. Duncan. "Development of Cam Impingement following Operative Fixation of Acetabular Fractures." Journal of Hip Surgery 06, no. 02 (June 2022): 076–79. http://dx.doi.org/10.1055/s-0042-1749439.
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AbstractThe development of femoroacetabular impingement following acetabular fracture fixation is under-recognized. This study assessed radiographic changes of the hip joint after acetabular fracture fixation, and the clinical implications of associated radiographic changes. Institutional review of patients under age 40 who underwent acetabular fracture fixation from 2010 to 2016 with minimum 1-year radiographic follow-up was performed. Two independent evaluators compared immediate postoperative radiographs and those at final follow-up for basic radiographic parameters. Chi-squared test, Fisher's exact test, and two-tailed t-tests were used to compare those with and without cam lesion development. Two-hundred twenty-four hips were reviewed, with 55 hips (53 patients) meeting inclusion criteria (age = 29.2 years, 60% male, average follow-up = 2.1 years). Average α angle increased from 53.8 to 75.5 degrees postfixation (p < 0.001). Average immediate postoperative joint space was unchanged from that at follow-up (3.6 versus 3.6 mm, p = 0.90), and there was no association between joint space narrowing and cam lesion development. Forty-four hips had postoperative α angles of less than 65 degrees. At final follow-up, 26/44 hips (59.1%) had α angles of greater than 65 degrees. Lower body mass index was an independent risk factor for increase in α-angle (p < 0.05). Hip dislocation, acetabular fracture pattern, age, and joint space narrowing were not risk factors for the development of cam deformity. Two patients had undergone hip preservation procedures at the last follow-up. Our findings identify the development of primarily femoral-sided femoroacetabular impingement following acetabular fracture fixation and highlight the importance of prolonged postoperative follow-up for these patients. Providers should scrutinize radiographs in those with new-onset pain or poor satisfaction following acetabular fixation.
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Park, Jinhee, and Yun Ja Nam. "Finite element modeling and simulation of hip joints in elderly women: for development of protective clothing against fracture." International Journal of Clothing Science and Technology 32, no. 5 (April 28, 2020): 661–75. http://dx.doi.org/10.1108/ijcst-09-2019-0140.
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PurposeFracture experiments on real human bodies to examine the protected positions and protective devices for the development of protective clothing to manage fractures is exceedingly difficult. Thus, the experimental design will have limitations, more of which are imposed if subjects are elderly people. To circumvent these limitations, this study proposes a finite element model of the hip joint in elderly women with virtual impact simulations that can replace actual fall and impact tests, and examine the positions and characteristics of fractures resulting from taking a fall.Design/methodology/approachThe hip joints were modeled after the average horizontal surface size and cross-sectional shapes of the lower extremities (waist to knee) in 439 elderly Korean women in that age group. The model was composed of bones, cartilages, and soft tissue.FindingsThe fracture was examined by comparing the maximum stress on the hip joint by applying a point force to its adjacent surface. The vulnerable part in the hip joint neck with a high risk of fracture risk on an impact could be determined and used to set the protective device attachment position.Originality/valueIt is significant that this study has developed a partial model of the human body that can be used for a relatively simple simulation by minimizing the highly complex human body as much as possible. Furthermore, the model is easily applicable to the designing of protected positions and protective devices for the development of special clothing, for hip joint fracture prevention.
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Johnson, Justine, Connie Austin, and Gert Breur. "Incidence of Canine Appendicular Musculoskeletal Disorders in 16 Veterinary Teaching Hospitals from 1980 through 1989." Veterinary and Comparative Orthopaedics and Traumatology 07, no. 02 (1994): 56–69. http://dx.doi.org/10.1055/s-0038-1633097.
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SummaryThe goal of this study was to determine the incidence of musculoskeletal disorders in a large canine population. Patient information was obtained from clinical cases contributed to the Veterinary Medical Data Base (VMDB) by 16 veterinary teaching hospitals during the ten year period of 1980 through 1989. The relative contribution of bone diseases, joint diseases, and muscle-tendon-unit diseases was determined, and the incidence of each musculoskeletal disease reported.Nearly 24% of all patients in the source population had been affected by a disorder of the musculoskeletal system, and over 70% of those diagnoses involved appendicular structures. Diseases of joints, ligaments, and related structures contributed more cases (47%) to this study than diseases of bones (39%) or muscle-tendon-units (14%). Fractures made up the largest disease category, with pelvic fractures most common, followed by femoral fractures, and fractures of the radius and/or ulna. Joint instability and degenerative joint dis-ease were also common diagnosis categories, affecting primarily the hip and stifle joints. Common specific dis-ease entities included hip dysplasia, cruciate ligament rupture, traumatic hip luxation and patellar luxation.In this study we provided a comprehensive analysis of the canine musculoskeletal system. The relative importance of joint disorders compared to those of bones and muscle-tendon-units was illustrated. The incidence of most of the disorders described in this report had not been well documented previously.Patient information was obtained from the clinical cases of 16 veterinary teaching hospitals during a 10-year period. The number of dogs with musculoskeletal disorders was determined. The absolute and relative contribution of bone diseases, joint diseases, and muscle-tendon-unit diseases is reported as well as the incidence of the specific disease entities affecting the canine appendicular musculoskeletal system.
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Ahsan, Pervez, and Rafi Ahmed. "Periprosthetic Femur Fracture in a 73-Year-Old Female: A Case Report." Annals of International Medical and Dental Research 8, no. 3 (May 15, 2022): 72–81. http://dx.doi.org/10.53339/aimdr.2022.8.3.10.
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Increasing use of joint replacement for various conditions has led to a new group of fractures- the periprosthetic fractures. Periprosthetic fractures are considered which are associated with an orthopaedic implant. Worldwide incidence of Periprosthetic fractures is increasing due to increased number of primary joint arthroplasties and other revision surgeries. Periprosthetic femoral fracture can be classified as intraoperative & post-operative. The intraoperative periprosthetic fractures usually occur during the insertion of the femoral stem, often preceded by an area of increased cortical thickness. The management of these fractures are complex and usually needs application of basic principles to fit an individual situation rather than having a fixed set of rules. Standard treatment protocol includes use of locking plate with encirclage wires. In this study, we provide a case of periprosthetic femur fracture pain. A 75-year-old woman presented to us with pain in her right hip and thigh. The patient was a homemaker who had cemented total hip replacement surgery due to a femoral neck fracture 27 days back. After the primary replacement surgery, the patient appeared to be doing well and adhering to the hip precautions. While getting out of bed, she tripped and fell carelessly in the morning & complained of severe pain in her right hip. After assessment of all her medical conditions and physical examination, she was advised for revision surgery. An open reduction and internal fixation of the fracture with revision of the femoral component was planned. Risks, benefits, and alternatives were discussed at length with her and her family. The patient and her family agreed to the operative plan.
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Kjærvik, Cato, Eva Stensland, Hanne Sigrun Byhring, Jan-Erik Gjertsen, Eva Dybvik, and Odd Søreide. "Hip fracture treatment in Norway." Bone & Joint Open 1, no. 10 (October 1, 2020): 644–53. http://dx.doi.org/10.1302/2633-1462.110.bjo-2020-0124.r1.
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Aims The aim of this study was to describe variation in hip fracture treatment in Norway expressed as adherence to international and national evidence-based treatment guidelines, to study factors influencing deviation from guidelines, and to analyze consequences of non-adherence. Methods International and national guidelines were identified and treatment recommendations extracted. All 43 hospitals routinely treating hip fractures in Norway were characterized. From the Norwegian Hip Fracture Register (NHFR), hip fracture patients aged > 65 years and operated in the period January 2014 to December 2018 for fractures with conclusive treatment guidelines were included (n = 29,613: femoral neck fractures (n = 21,325), stable trochanteric fractures (n = 5,546), inter- and subtrochanteric fractures (n = 2,742)). Adherence to treatment recommendations and a composite indicator of best practice were analyzed. Patient survival and reoperations were evaluated for each recommendation. Results Median age of the patients was 84 (IQR 77 to 89) years and 69% (20,427/29,613) were women. Overall, 79% (23,390/29,613) were treated within 48 hours, and 80% (23,635/29,613) by a surgeon with more than three years’ experience. Adherence to guidelines varied substantially but was markedly better in 2018 than in 2014. Having a dedicated hip fracture unit (OR 1.06, 95%CI 1.01 to 1.11) and a hospital hip fracture programme (OR 1.16, 95% CI 1.06 to 1.27) increased the probability of treatment according to best practice. Surgery after 48 hours increased one-year mortality significantly (OR 1.13, 95% CI 1.05 to 1.22; p = 0.001). Alternative treatment to arthroplasty for displaced femoral neck fractures (FNFs) increased mortality after 30 days (OR 1.29, 95% CI 1.03 to 1.62)) and one year (OR 1.45, 95% CI 1.22 to 1.72), and also increased the number of reoperations (OR 4.61, 95% CI 3.73 to 5.71). An uncemented stem increased the risk of reoperation significantly (OR 1.23, 95% CI 1.02 to 1.48; p = 0.030). Conclusion Our study demonstrates a substantial variation between hospitals in adherence to evidence-based guidelines for treatment of hip fractures in Norway. Non-adherence can be ascribed to in-hospital factors. Poor adherence has significant negative consequences for patients in the form of increased mortality rates at 30 and 365 days post-treatment and in reoperation rates. Cite this article: Bone Joint Open 2020;1-10:644–653.
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Wallace, Robert B., Jo Ellen Ross, Jeffrey C. Huston, Carolyn Kundel, and George Woodworth. "Iowa FICSIT Trial: The Feasibility of Elderly Wearing a Hip Joint Protective Garment to Reduce Hip Fractures." Journal of the American Geriatrics Society 41, no. 3 (March 1993): 338–40. http://dx.doi.org/10.1111/j.1532-5415.1993.tb06715.x.
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Nakamura, Takuya, Toru Yamakawa, Junji Hori, Hisataka Goto, Akihiko Nakagawa, Tetsuro Takatsu, Naoki Osamura, Atsushi Saito, Keisuke Hagio, and Kanto Mouri. "Conjoined tendon preserving posterior approach in hemiarthroplasty for femoral neck fractures: A prospective multicenter clinical study of 322 patients." Journal of Orthopaedic Surgery 29, no. 3 (September 2021): 230949902110639. http://dx.doi.org/10.1177/23094990211063963.
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Purpose The posterior approach is widely used in femoral hemiarthroplasty. The major problem with this approach is the high risk of postoperative dislocation. A modified posterior approach, the conjoined tendon preserving posterior approach (CPP), was developed to reduce postoperative dislocations. The objective of this multicenter study was to evaluate the efficacy and safety of hemiarthroplasty performed using the CPP approach for femoral neck fractures. Methods A total of 322 patients with femoral neck fracture, from 10 facilities, were prospectively studied. Bipolar hemiarthroplasty using the CPP approach was performed, using the same type of implants. Hip joint movement was not restricted following surgery, regardless of a patient’s cognitive status. Final follow-up was performed 9.1 ± 1.5 months after surgery. Results Hemiarthroplasty was undertaken in 320 patients using the CPP approach. The mean age, operative time, and intraoperative blood loss were 83.3 ± 7.4 years, 70.0 ± 22.7 min, and 134.8 ± 107.9 mL, respectively. No postoperative dislocations were observed during the study period. Intraoperative adverse events related to the hip joint included femoral fractures in five patients (1.6%) and trochanteric fractures in four patients (1.3%). Postoperative hip joint adverse events included a periprosthetic fracture in one patient (0.3%), deep infection in two patients (0.6%), and stem subsidence in one patient (0.3%). Postoperative deaths occurred in 23 patients (7.2%). One patient (0.3%) had a severe non-hip adverse event unrelated to surgery that prevented independent living, while five patients (1.6%) had a moderate non-hip adverse event that required treatment. Conclusion The CPP approach prevented postoperative dislocation following femoral hemiarthroplasty in elderly patients, with no CPP-associated specific adverse events.
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Borg, T., B. Hernefalk, and N. P. Hailer. "Acute total hip arthroplasty combined with internal fixation for displaced acetabular fractures in the elderly." Bone & Joint Journal 101-B, no. 4 (April 2019): 478–83. http://dx.doi.org/10.1302/0301-620x.101b4.bjj-2018-1027.r2.
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Aims Displaced, comminuted acetabular fractures in the elderly are increasingly common, but there is no consensus on whether they should be treated non-surgically, surgically with open reduction and internal fixation (ORIF), or with acute total hip arthroplasty (THA). A combination of ORIF and acute THA, an approach called ’combined hip procedure’ (CHP), has been advocated and our aim was to compare the outcome after CHP or ORIF alone. Patients and Methods A total of 27 patients with similar acetabular fractures (severe acetabular impaction with or without concomitant femoral head injury) with a mean age of 72.2 years (50 to 89) were prospectively followed for a minimum of two years. In all, 14 were treated with ORIF alone and 13 were treated with a CHP. Hip joint and patient survival were estimated. Operating times, blood loss, radiological outcomes, and patient-reported outcomes were assessed. Results No patient in the CHP group required further hip surgery, giving THA a survival rate of 100% (95% confidence interval (CI) 100 to 100) after three years, compared with 28.6% hip joint survival in the ORIF group (95% CI 12.5 to 65.4; p = 0.001). No dislocations or deep infections occurred in the CHP group. No patient died within the first year after index surgery, but patient survival was lower in the CHP group after three years. There were no relevant differences in patient-reported outcomes. Conclusion The CHP confers a considerably reduced need of further surgery when compared with ORIF alone in elderly patients with complex acetabular fractures. These findings encourage both further use of, and larger prospective studies on, the CHP. Cite this article: Bone Joint J 2019;101-B:478–483.
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Nishino, Tomofumi, Fumi Ochiai, Tomohiro Yoshizawa, Hajime Mishima, and Masashi Yamazaki. "Isolated Distal Fibular Stress Fracture after Total Hip Arthroplasty in a Patient with Developmental Dysplasia of the Hip." Case Reports in Orthopedics 2020 (January 20, 2020): 1–6. http://dx.doi.org/10.1155/2020/4218719.
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Stress fractures following total hip arthroplasty in the lower limbs away from the surgical area are very rare. We report a case of stress fracture in the isolated distal fibula that presented five months after total hip arthroplasty in a patient with developmental dysplasia of the hip. A 67-year-old woman diagnosed with coxarthrosis of the right hip joint, classified as Crowe’s group 3, underwent total hip arthroplasty with acetabular reconstruction using a bulk bone graft. The surgery successfully treated the preoperative leg length discrepancy and flexion and external rotation contractures. The alignment of the right lower limbs changed from slight varus to valgus knee following surgery. The postoperative process went well; however, she experienced lateral ankle pain on the affected side five months after surgery. No obvious fracture was observed via radiograph; however, she received a subsequent diagnosis of isolated distal fibula stress fracture. Additionally, she was diagnosed with vitamin D deficiency. Valgus alignment change of the knee joint and vitamin D deficiency were considered the main causes of the stress fracture. Stress fractures should be suspected in patients complaining of unexpected pain following total hip arthroplasty, even in distant areas of the affected limb, especially in osteoporotic patients.
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Wietecki, Paweł, Łukasz Pawik, Felicja Fink-Lwow, Artur Leśkow, Radosław Górski, Malwina Pawik, Jarosław Olech, et al. "Kinematic Parameters Following Pilon Fracture Treatment with the Ilizarov Method." Journal of Clinical Medicine 11, no. 10 (May 13, 2022): 2763. http://dx.doi.org/10.3390/jcm11102763.
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Background: The purpose of our study was to analyze kinematic parameters following pilon fracture treatment with the Ilizarov method. Methods: Our study assessed kinematic parameters of gait in 23 patients with pilon fractures treated with the Ilizarov method. Patients had completed their treatment 24–48 months prior to measurements. The range-of-motion values in the non-operated limb (NOL) and operated limb (OL) were compared. Kinematic parameters were measured using the Noraxon MyoMOTION System. Results: We observed no significant differences in hip flexion, hip abduction, or knee flection between the OLs and NOLs in patients after treatment with the Ilizarov method. We observed significant differences in the ranges of ankle dorsiflexion, inversion, and abduction (p < 0.001; p < 0.001; p < 0.003, respectively) between the OLs and the NOLs. Conclusion: Following pilon fracture treatment with the Ilizarov method, we observed no differences in terms of knee or hip joint mobility between the OL and the NOL, whereas the range of motion in the ankle joint of the OL was significantly limited. The treatment of pilon fractures with the Ilizarov method does not ensure the complete normalization of ankle joint kinematic parameters. Therefore, intense personalized rehabilitation of the ankle joint is recommended.
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Madejczyk, Jakub, and Ireneusz Urbaniak. "Periprosthetic fractures in the hip joint – own study by the Department of Orthopedics and Traumatology in Kalisz." Chirurgia Narządów Ruchu i Ortopedia Polska 86, no. 1 (April 1, 2021): 18–29. http://dx.doi.org/10.31139/chnriop.2021.86.1.4.
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Every year, the number of total hip replacement treatments increases and along with it, so does the number of local and systemic complications, including periprosthetic fractures. These fractures usually occur among elderly people with deteriorated bone quality and other general and neurological disorders. Treatment of periprosthetic femoral fractures imposes a difficult and complex medical problem, which requires adequate experience and a rational combination of traumatological and orthopedical knowledge from the surgeon. In this article we review management of periprosthetic femoral fractures in the Department of Orthopedics and Traumatology in Kalisz.
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Davut, Serkan, and Aydıner Kalacı. "Does a relationship between type of hip fracture and osteoarthritis exist?" Journal of Surgery and Medicine 6, no. 10 (October 24, 2022): 863–67. http://dx.doi.org/10.28982/josam.7514.
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Background/Aim: Many factors have been associated with the etiology of falls and hip fractures in the elderly. However, only a few studies have examined the relationship between osteoarthritis and hip fractures, which are common in this age group. The aim of this study was to determine the relationship between the knee and hip osteoarthritis (OA) and the type of hip fracture. Methods: Patients who underwent surgery in the Orthopedics and Traumatology Department between January 2017 and December 2021 were eligible to participate in this retrospective cohort study. Patients who were 60 years and older with a hip fracture and adequate medical records and radiographs of bilateral hip and knee joints met the inclusion criteria. Data concerning patient co-morbidities, type of hip fracture, whether they had OA in their hip and knee joints, and the severity of their OA were assessed. The severity of the osteoarthritis presence was categorized with using the Kellgren–Lawrence (KL) classification. To categorize the patients, three groups were identified: (1) femoral neck, (2) trochanteric, and (3) subtrochanteric fracture groups. The presence and severity status of OA in the hip and knee joints and co-morbidity data were compared between the groups. Results: Three-hundred forty-one patients with a M/F ratio of 148/193 are included in this study. Femoral neck fractures occurred in 142 (41.6%), trochanteric fractures in 147 (43.1%), and subtrochanteric fractures in 52 (15.2%) patients. The mean age of the cohort was 76.72 (10.165); The mean age of the patients in the trochanteric group was higher than in the subtrochanteric group (P = 0.001). No effect of any existing co-morbidities on fracture type was observed. The overall prevalence of OA in the cohort that was observed in the hip joint was 34.3% with 33.7% in males and 35.3% in females. These rates were 66.6%, 53.4%, and 76.7% in the knee joint, respectively. No difference could be observed between hip OA presence and any type of hip fracture group (P = 0.833 for right hip, P = 0.865 for left hip). Similar rates of moderate and severe hip OA were found in the femoral neck and trochanteric fracture groups. However, the frequency of moderate hip OA was lower and the frequency of severe hip OA was higher in subtrochanteric fracture group compared to other groups (P = 0.164 for right hip, P = 0.241 for left hip. Knee OA was observed to be more common in the trochanteric fracture group (P = 0.003 for the right knee, P = 0.002 for left knee) and also, the rate of severe OA was higher in the trochanteric fracture group compared to other groups (P = 0.013 for right knee, P = 0.006 for the left knee). Conclusion: In contrast to OA presence in the hip, knee OA presence and severity can be significant risk factors for occurrence of trochanteric type fractures in the elderly.
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Putra, DP, AS Pradana, KY Phatama, E. Mustamsir, and M. Hidayat. "Functional Outcome of Traumatic Acetabulum Fractures : A 6 Months Comprehensive Follow Up Following Open Reduction Internal Fixation Surgery at Saiful Anwar General Hospital Malang." Orthopaedic Journal of Sports Medicine 8, no. 5_suppl5 (May 1, 2020): 2325967120S0003. http://dx.doi.org/10.1177/2325967120s00031.
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Acetabular fractures commonly occurred in young adult patient who suffered from high impact trauma which often associated with life threatening injuries. Displaced acetabular fractures lead to abnormal distribution on joint cartilage pressures. It produces early cartilage disruption and development of premature osteoarthritis at the hip. Anatomical reduction and fixation operation in acetabulum fractures still a major challenges due to its complications such as poor functional outcome after surgery. Despite its difficulty to predict the outcomes of acetabular fractures surgeries, functional outcomes scoring such as Oxford Hip Score (OHS) and Harris score may help surgeon to measure long term outcome following acetabular fractures. A total of 13 patients were treated over period of January 2018 until March 2019 in Saiful Anwar General Hospital Malang. The mean age of patients in this serial case is 37 years old and were operated within 2 weeks of injury. All the patients undergone an ORIF (Open Reduction Internal Fixation) operation and observed for the OHS and also Harris score 6 months following surgeries to measure functional outcome of the patients. The mean score of OHS in this serial case is 41 (satisfactory joint function) and the mean score of harris hip score is 91 (excellent). Some patients experience pain during activities, tingling sensation after standing in some periods of time, and heaviness when taking stairs 6 months after operation. This results conclude that the preoperative, operative and post operative management of patient with acetabular fracture in Saiful Anwar Hospital has satisfactory results.