Ipsilateral Intracapsular Hip Fracture 2 Years after Fixation of Extracapsular Fracture by Dynamic Hip Screw (original) (raw)
Related papers
The complications of displaced intracapsular fractures of the hip
The Journal of Bone and Joint Surgery. British volume, 2005
We have studied the placement of three screws within the femoral head and the degree of angulation of the screws in 395 patients with displaced intracapsular fracture of the hip to see if either was related to the risk of failure of the fracture to unite. No relationship between nonunion of the fracture was found regarding the position of the screws on the anteroposterior radiograph. However, we found that a reduced spread of the screws on the lateral view was associated with an increased risk of nonunion of the fracture.
Dynamic Hip Screw Fixation versus Multiple Screw Fixation for Intracapsular Hip Fracture
Journal of Orthopaedic Surgery, 2016
Purpose To compare dynamic hip screw (DHS) fixation with multiple screw fixation for intracapsular hip fractures in terms of complications and conversion to hemiarthroplasty or total hip arthroplasty (THA). Methods Records of 52 884 patients aged ≥50 years who underwent internal fixation using a dynamic hip screw (n=18 014, 34.1%) or multiple screws (n=34 870, 65.9%) for intracapsular femoral neck fracture from September 2007 to September 2013 were extracted from the hospital admission database that covers all admissions to the National Health Service hospitals in England using the ICD-10 and OPCS-4 codes. Gender, age, and Charlson comorbidity score of each patient were recorded, as were complications at specific time intervals and revision to hemiarthroplasty or THA at one and 4 years. Results Compared with DHS fixation, multiple screw fixation resulted in shorter hospital stay (15 vs. 13 days, p<0.001) and lower rates of 30-day myocardial infarction (2% vs. 1.5%, p=0.022), 30-d...
Internal Fixation of Nondisplaced Intracapsular Hip Fractures in Older Patients
Techniques in Orthopaedics, 2018
For the treatment of, nondisplaced intracapsular hip fractures, the choice of the implant type might be relevant to the postoperative response. A comparison was, therefore, initiated between the use of the cannulated screws and that of the Targon femoral neck nail. A retrospective survey included 110 patients who were subjected to an internal fixation surgery for nondisplaced intracapsular hip fracture and were 50 years old or older. This study was based on the computerized databases of the Orthopedic Outpatient Clinic. In 73 (66%) of the patients, internal fixation utilized cannulated screws, and, in 37 (34%), the Targon femoral neck nail was used. The rate of revision surgery during the 5-year follow-up was similar for the 2 subsets (16.4% vs. 10.8%, P = 0.429). Secondary outcomes such as avascular necrosis, nonunion, infection, and mechanical sequels did not differ significantly in the 2 groups. The 2 types of internal fixation did not differ significantly in their outcome when used for nondisplaced intracapsular hip fractures. No variance was shown in the propensity to undergo a revision surgery, following the 2 implant types with this indication. Moreover, the other complications explored did not differ either.
2019
Background: One of the leading causes of death and disability among the elderly are hip fractures. Approximately half of these injuries are intertrochanteric fractures and the incidence is continuously increasing. Different types of implants were tried at different times for internal fixation of these fractures, of which dynamic hip screw has remained the most popular one. But with the advent of some newer implants, the efficacy of dynamic hip screw is being questioned. Aim: To determine the failure after DHS fixation of intertrochanteric fracture and identify causes (instability, increased tip apex distance and high angle side plate) leading to failure after DHS fixation. Methods: This was a descriptive interventional case study. Forty five cases fulfilling the inclusion criteria were included after taking informed consent. There were 32 males and13 females with male to female ratio of 2.5:1. They were operated under standard surgical protocol for DHS by senior residents. Pre, per ...
The open orthopaedics journal, 2017
Currently, approximately half of all hip fractures are extracapsular, with an incidence as high as 50 in 100,000 in some countries. The common classification systems fail to explain the logistics of fracture classification and whether they all behave in the same manner. The Muller AO classification system is a useful platform to delineate stable and unstable fractures. The Dynamic hip screw (DHS) however, has remained the 'gold standard' implant of choice for application in all extracapsular fractures. The DHS relies on the integrity and strength of the lateral femoral wall as well as the postero-medial fragment. An analysis of several studies indicates significant improvements in design and techniques to ensure a better outcome with intramedullary nails. This article reviews the historical trends that helped to evolve the DHS implant as well as discussing if the surgeon should remain content with this implant. We suggest that the gold standard surgical management of extraca...
Archives of Orthopaedic and Trauma Surgery, 2011
Introduction The osteosynthesis of intracapsular hip fractures results in a 19-48% failure rate. Only when the anatomical reduction is secured by stable fixation, revascularisation of the femoral head can take place and the fracture can heal by primary osteonal reconstruction. The common implants lack rotational and/or angular stability. Also the relative large volume of the implants within the femoral head compromises the (re)vascularisation. The combination of an anatomical reduction and a low volume, dynamic implant, providing angular and rotational stability seem to be crucial factors in the treatment of intracapsular hip fractures. This assumption formed the starting point for the development of the dynamic locking blade plate (DLBP), a new implant for the internal fixation of intracapsular hip fractures. This report describes the first clinical results of the new implant. Patients and methods Internal fixation with the DLBP was performed in 25 consecutive patients with an intracapsular hip fracture within 24 h from admission. Failure of fixation, due to non-union, avascular necrosis, implant failure or secondary displacement of the fracture, was the primary outcome measurer. Functional outcome was assessed by the Harris Hip Score. Results Following internal fixation of intracapsular hip fractures with the DLBP, a failure rate of 2 out of 25 patients and excellent functional results were seen after a follow-up of more than 2 years. Conclusion The initial clinical results of the DLBP are promising and justify the start of a randomised controlled trial.
Journal of Orthopaedics
There is no consensus regarding the optimal device for displaced intracapsular hip fractures. This retrospective study compared two techniques (1) cannulated cancellous screw (CCS), and (2) Targon Femoral Neck (TFN) plate. Materials and methods: Data regarding gender, operational data, complications, pain, Quality of life and function scores were retrieved. Results: 103 patients were included, 42 were treated using CCS, compared to 61 treated using TFN. Operative time shorter for CCS (p = 0.019). Complication rates were not different (p > 0.05). Conclusion: As CCS method take shorter operating time and reduced costs, CCS should be used for the treatment of displaced ICHF.