Injury
-
Observational Study
Trochanteric femoral nonunion in patients aged over 60 years treated with dynamic condylar screw.
Nonunions of trochanteric femoral fractures are uncommon due to a good blood supply of the cancellous bone of the trochanteric region. Nevertheless, if a nonunion occurs, complex revision procedures usually become necessary. The purpose of this study was to evaluate a series of aseptic trochanteric nonunions in patients aged 60 years or older, looking at outcomes regarding healing rate, implant-related complications and secondary surgeries. ⋯ DCS treatment and preservation of the patient's femoral head can be successful for patients aged over 60 years with a well-preserved femoral head and acetabulum. However, preservation of the hip joint and revision plating might be associated with higher revision rates.
-
This study evaluated a series of geriatric femoral neck fracture treated with closed reduction percutaneous pinning (CRPP) at a single level-1 trauma center to determine if there are any simple, reliable, radiographic characteristics that can be used to predict increased risk of post-operative failure in nondisplaced and valgus impacted fracture patterns. ⋯ Varus femoral neck fractures fixed with CRPP have a high rate of failure (37.5%). Nondisplaced or valgus impacted fractures with the presence of a visible medial transcervical line on pre-operative radiographic imaging resulted in a fourfold increase in the risk of failure after CRPP. Identification of the MTL will help treating surgeons better council patients when making pre-operative decisions between arthroplasty and CRPP.
-
Comparative Study
Validation of the Fracture Mobility Score against the Parker Mobility Score in hip fracture patients.
The Parker Mobility Score has proven to be a valid and reliable measurement of hip fracture patient mobility. For hip fracture registries the Fracture Mobility Score is advised and used, although this score has never been validated. This study aims to validate the Fracture Mobility Score against the Parker Mobility Score. ⋯ The Fracture Mobility Score is overall strongly correlated with the Parker Mobility Score and can be considered as a valid score to measure hip fracture patient mobility. This may encourage other hip fracture audits to also use the Fracture Mobility Score, which would increase the uniformity of mobility score results among national hip fracture audits and decrease the overall registration load.
-
Posterior tilt of the femoral head in femoral neck fractures (FNF) may influence stability of the fracture and may therefore affect the treatment outcome. Posterior tilt can be measured with different methods. The Lateral Garden Angle (LGA) has been used for this purpose for decades and more recently the Posterior Tilt Measurement (PTM) was introduced. Despite the fact that both methods (LGA and PTM) are used in multiple studies, they have never been compared for reliability in a direct study. The aim of this study is to analyze the intra and inter observer reliability of the LGA described by Garden and the PTM according to Palm. ⋯ Based on our results we believe the LGA and the PTM are both reliable methods to measure posterior tilt. Yet the Posterior Tilt Measurement seems to have a better inter observer reliability and therefore has a slight preference over the Lateral Garden Angle.
-
The purpose of this study is to report the longterm radiological and clinical outcomes of the distal humeral epiphyseal separations (DHESs) treated by arthrogram-assisted closed pinning, retrospectively. ⋯ Level IV, Therapeutic.