Dynamic Condylar Screw as a Solution to Operative Dilemma in Early Sub-Trochanteric Fracture Following Cannulated Screw Fixation for Slipped Capital Femoral Epiphysis: A Case Report

Sidaginamale, R; Fadero, P; Apostolopoulos, Alexandros P; Zolcze, L

doi:10.1615/jlongtermeffmedimplants.v22.i1.30

Cited by 2 publications

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“…Most cases are caused by severe injury violence and often require surgical reduction and internal fixation to minimize the incidence of fracture malunion, nonunion, and coxa varus deformity [7,8]. The anatomical structure of the subtrochanteric region of the femur is in the region with the most concentrated stress conduction, in which the medial and posterior medial cortical bones bear high compressive stress, while the lateral cortex bears high tension stress [9,10].…”

Section: Introductionmentioning

confidence: 99%

Case series and finite element analysis of PFNA combined with cerclage wire for treatment of subtrochanteric fracture of femur

Huang

Zhang

2021

J Orthop Surg Res

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Objective To retrospectively analyze the clinical efficacy of PFNA combined with a cerclage wire in the treatment of 52 patients with unstable subtrochanteric fracture of the femur and to analyze the biomechanical effect of ligature on a fracture model. Methods In this study, 52 patients with unstable subtrochanteric fractures were treated in our orthopedic trauma center from June 2013 to July 2018. The Seinsheimer type IV fracture model was established using the patient’s CT data, and the joint surface of the distal femoral condyle and the external condyle were restrained. The femoral head was used as the loading point, and a force of 500 N was applied vertically along the long axis of the femoral shaft. Results All 52 patients were followed up for 12 to 37 months, with an average of 18.07 ± 4.38 months. According to the Sanders hip function score, 28 cases were excellent (55–60 points), 22 cases were good (45–54 points), and 2 cases were poor (35–44 points), with an excellent and good rate of 96.15%. Postoperative deep vein thrombosis occurred in 3 cases, and fracture nonunion occurred in 1 case. No infection, loose fracture of internal fixation or hip varus deformity occurred. The finite element analysis indicated that the displacement of the whole model decreased slightly and the relative sliding of the fracture block decreased, but the maximum stress of the femur increased after the addition of the cerclage wire. Conclusion The treatment of unstable subtrochanteric fracture of the femur with PFNA combined with cerclage wire has the advantages of simple operation, satisfactory reduction of fracture, stable fixation, and good recovery of limb function. The finite element analysis suggested that the biomechanical strength fixation was enhanced after the addition of cerclage wire. However, the local stress concentration of the tie may increase the risk of failure.

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Section: Introductionmentioning

confidence: 99%

Case series and finite element analysis of PFNA combined with cerclage wire for treatment of subtrochanteric fracture of femur

Huang

Zhang

2021

J Orthop Surg Res

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“…The most important factors affecting these fractures include age, sex, smoking, dementia, psychological disorders, underlying diseases, and osteoporosis (6). The overall incidence of proximal femoral fractures is about 230 per 100000 population, of which approximately 5 to 10% are in the ST region.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Proximal Femur Locking Compression Plate and Intramedullary Nailing in the Treatment of Sub-Trochanteric Fractures

et al. 2019

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Background: The sub-trochanteric (ST) fracture is relatively common. It does not have a single treatment but it can be repaired in a variety of ways. Objectives: The aim of this study was to compare the proximal femur locking compression plate (PFLCP) and intramedullary nailing in the treatment of ST fracture. Methods: This cross-sectional study was performed on 56 patients with ST fracture who referred to Firoozgar Hospital, Tehran, Iran, between January 2014 and December 2018. The patients were equally divided into two groups, PFLCP group and nailing group. The recovery and postoperative complications were evaluated by the Harris hip score (HHS). Results: Of the 56 eligible patients examined, 49 (87.5%) were male. The overall mean age was 42.7 ± 16.2 years. The status of the union was significantly better in the PFLCP group than in the nailing group (P = 0.038). The total mean HHS was 88.9 ± 14.1 with no significant difference between the two groups. The results of the logistic regression model showed that sex and age could significantly decrease the HHS. Thus, the HHS was influenced by female sex (OR = 0.851) and age of more than 60 (OR = 0.829). Conclusions: PFLCP provides an appropriate union, expedites the operation, and yields a very good HHS. Therefore, it can work even better than intramedullary nailing in some parameters, such as pain after the operation.

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Dynamic Condylar Screw as a Solution to Operative Dilemma in Early Sub-Trochanteric Fracture Following Cannulated Screw Fixation for Slipped Capital Femoral Epiphysis: A Case Report

Cited by 2 publications

References 0 publications

Case series and finite element analysis of PFNA combined with cerclage wire for treatment of subtrochanteric fracture of femur

Case series and finite element analysis of PFNA combined with cerclage wire for treatment of subtrochanteric fracture of femur

Comparison of Proximal Femur Locking Compression Plate and Intramedullary Nailing in the Treatment of Sub-Trochanteric Fractures

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