ObjectivesTo compare the body mass index (BMI) of patients with fractures in the proximal extremity of the femur with the BMI of patients without any previous history of fractures.MethodsWe investigated patients of both sexes, aged 65 years or over, who were admitted to Hospital Independência, Hospital Beneficência Portuguesa or ULBRA University Hospital, between December 2007 and December 2010, with histories of low-energy trauma such as falling from a standing position. These individuals were compared with patients of the same age but without any history of fracturing of the proximal extremity of the femur (n = 89), who were attended at the geriatrics outpatient clinic of the Sociedade Porto-Alegrense de Auxílio aos Necessitados (SPAAN).ResultsThe age group of the patients with fractures in the proximal extremity of the femur ranged from 65 to 96 years (mean: 77.58). The main type of fracture was trochanteric (47; 62.2%), followed by femoral neck fractures (27; 36%). Among the patients who presented on fracturing the proximal extremity of the femur, 12% had low weight, 62.7% normal weight, 24% overweight, and 1.3% obesity. Among the patients without any history of fractures, 5.6% presented low weight, 43.8% normal weight, 33.7% overweight, and 9.8% obesity. It was observed that the patients with fractures in the proximal extremity of the femur (n = 75) presented a mean BMI of 22.6, while the patients without fractures presented a mean BMI of 25.5.ConclusionThe patients in the group with fractures were significantly taller than those in the group without fractures and presented significantly lower BMI than those in the group without fractures.

ObjectiveTo radiographically evaluate the quality of cementation and implantation technique using a polished, triple-tapered femoral stem in total hip arthroplasty (THA).MethodRetrospective study with radiographic evaluation of 86 hips in 83 patients who underwent to primary THA with the triple-tapered cemented femoral stem C-Stem (DePuy Orthopedics, Warsaw, Indiana). Cases with at least one-year of follow-up were included, and data related to preoperative, immediate postoperative, and late postoperative radiographic evolution were recorded. This study analyzed, among others, the proximal femoral anatomy, the quality of cementation as described by Barrack, and the implant positioning. Cementation was also evaluated and quantified in the Gruen zones with one-year of follow-up.ResultsThe mean age was 62.85 years. Proximal femoral anatomical conformation was Dorr type A in 34 (39.53%) cases, type B in 52 (60.46%), and no type C cases were found. Five (5.81%) cases were defined as type A by Barrack's cementation classification system, 46 (56.49%) type B, 27 (31.40%) type C, and eight (9.30%) type D. The greatest cement mantle thickness was observed in zones four (15.53 mm) and 11 (15.64 mm), and the smallest in zone nine (3.51 mm). Positioning in varus was observed in eight (9.3%) cases, valgus in 25 (29%), forward deviation in two (5%), and backward deviation in 55 (63.95%).ConclusionsThe C-Stem femoral system presented satisfactory results related to cementation pattern, positioning, osteolysis, and stress shielding with regard to literature referring to double-tapered or triple-tapered models, demonstrating to be a safe method, with a predictable and reliable cementing pattern.

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r e v b r a s o r t o p . 2 0 1 4;4 9(5):461-467 w w w . r b o . o r g . b r Artigo OriginalÍndice de massa corporal como fator prognóstico para fratura da extremidade proximal do fêmur: um estudo de caso-controle ଝ

A transverse plantar incisional approach was used on 35 patients who underwent heel spur surgery from 1982 through 1990. Ten bilateral procedures were performed on a total of 45 feet. A medial approach was used for five of the bilateral surgeries. The average age of the patient was 47 years, and the average follow-up period was 49 months. Of the 34 plantar approach cases in which complete data were obtained, 94% showed either good or excellent results. The authors illustrate a technique using a transverse plantar incision as an alternative to the medial approach for heel spur surgery.