Elderly patient's mortality and morbidity following trochanteric fracture. A hundred cases prospective study

Mnif, H.; Koubaa, M.; Zrig, M.; Trabelsi, R.; Abid, A.

doi:10.1016/j.otsr.2009.08.001

Cited by 48 publications

(44 citation statements)

References 20 publications

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“…In this study, fracture instability was found to be an independent risk factor for early death. Mnif et al, 19 in their review of 100 trochanteric fractures, also reported higher early mortality with greater instability. In their study, the fractures were not classified according to the AO/OTA classification; however, a point to note is that the relationship between fracture instability and mortality was maintained in a cohort treated by the same device, suggesting that the device or fixation type is likely to be less important.…”

Section: Discussionmentioning

confidence: 95%

Influence of Fracture Stability on Early Patient Mortality and Reoperation After Pertrochanteric and Intertrochanteric Hip Fractures

Chehade

Carbone²,

Awward

et al. 2015

Journal of Orthopaedic Trauma

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Section: Discussionmentioning

confidence: 95%

Influence of Fracture Stability on Early Patient Mortality and Reoperation After Pertrochanteric and Intertrochanteric Hip Fractures

Chehade

Carbone²,

Awward

et al. 2015

Journal of Orthopaedic Trauma

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“…Osteoporotic femoral fractures are a major clinical problem with high morbidity and mortality [1,2]. Improvement of fracture risk prediction is fundamental in order to improve the patients' quality of life and to reduce the costs associated to the ageing of our society.…”

Section: Introductionmentioning

confidence: 99%

Experimental validation of DXA-based finite element models for prediction of femoral strength

Dall’Ara

Eastell

Viceconti

et al. 2016

Journal of the Mechanical Behavior of Biomedical Materials

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Osteoporotic fractures are a major clinical problem and current diagnostic tools have an accuracy of only 50%. The aim of this study was to validate dual energy X-rays absorptiometry (DXA)-based finite element (FE) models to predict femoral strength in two loading configurations. Thirty-six pairs of fresh frozen human proximal femora were scanned with DXA and quantitative computed tomography (QCT). For each pair one femur was tested until failure in a one-legged standing configuration (STANCE) and one by replicating the position of the femur in a fall onto the greater trochanter (SIDE). Subject-specific 2D DXA-based linear FE models and 3D QCT-based nonlinear FE models were generated for each specimen and used to predict the measured femoral strength. The outcomes of the models were compared to standard DXA-based areal bone mineral density (aBMD) measurements. For the STANCE configuration the DXA-based FE models (R(2)=0.74, SEE=1473N) outperformed the best densitometric predictor (Neck_aBMD, R(2)=0.66, SEE=1687N) but not the QCT-based FE models (R(2)=0.80, SEE=1314N). For the SIDE configuration both QCT-based FE models (R(2)=0.85, SEE=455N) and DXA neck aBMD (R(2)=0.80, SEE=502N) outperformed DXA-based FE models (R(2)=0.77, SEE=529N). In both configurations the DXA-based FE model provided a good 1:1 agreement with the experimental data (CC=0.87 for SIDE and CC=0.86 for STANCE), with proper optimization of the failure criteria. In conclusion we found that the DXA-based FE models are a good predictor of femoral strength as compared with experimental data ex vivo. However, it remains to be investigated whether this novel approach can provide good predictions of the risk of fracture in vivo.

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“…Wraz z szyb ko ro sną cą po pu la cją osób star szych licz ba tych zła mań sta le się zwięk sza. Sza cu je się, że w USA przed 2050 ro kiem ich licz ba wy nie sie 0,5 mln in cy den tów rocz nie, pod czas gdy na świe cie do 2025 ro ku osią gnie po ziom 6,25 mln rocz nie [3,4]. Jed ną z po wa żniej szych, mo żli wych kom pli ka cji jest brak, mi mo sta bi li za cji zła ma nia, zro stu kost ne go i w dal szej ko lej no ści po wsta nie sta wu rze ko me go [5][6][7].…”

Section: Wstępunclassified

“…With the quickly growing elderly population, the incidence of these fractures is also increasing. It is estimated that, in the USA,, the number will reach 0.5m annually before 2050 while in the world, the figure will reach 6.25m a year before 2025 [3,4]. One of the most important possible complications is bone non-union despite previous fracture stabilisation, followed by the development of a pseudarthrosis [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Complication of a Femoral Fracture Treated by Intramedullary Nailing - Numerical Analysis of a Clinical Case

Słowiński

Kudłacik²

2016

Ortop Traumatol Rehabil

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Po wi kła nie zła ma nia ko ści udo wej sta bi li zo wa ne go gwoź dziem śród sz pi ko wym -nu me rycz na ana li za przy pad ku kli nicz ne go STRESZ CZE NIECe lem pra cy by ła nu me rycz na ana li za przy pad ku zła ma nia ko ści udo wej sta bi li zo wa ne go gwoź dziem śród sz pi kowym i po twier dze nie wa run ków, któ re do pro wa dzi ły do wy kształ ce nia sta wu rze ko me go w miej scu zła ma nia.Ni sko ener ge tycz ne zła ma nie ko ści udo wej sta bi li zo wa no za po mo cą śród sz pi ko we go gwoź dzia krę ta rzo we go ChFN Sys tem z pi nem de ro ta cyj nym. Z wy ko rzy sta niem me to dy ele men tów skoń czo nych opra co wa ny zo stał układ kość -im plant, któ ry umo żli wił ob ser wa cję po la prze miesz czeń oraz od kształ ceń w re jo nie szcze li ny zła ma nia. Ob licze nia prze pro wa dzo no na 3 wa rian tach mo de lu, z gwoź dziem ty ta no wym (10 mm i 12 mm) oraz sta lo wym (10 mm). Ana li za roz kła du od kształ ceń wska za ła, że naj więk sze ich war to ści lo ka li zu ją się w szcze li nie zła ma nia i są wy ższe w przy pad ku za sto so wa nia im plan tu ze sto pu ty ta nu (0-17% vs 0-11%). Ru chy mię dzy odła mo we po wo do wa ne przyło żo nym ob cią że niem by ły ta kże wy ższe w przy pad ku za sto so wa niu im plan tu ze sto pu ty ta nu. Ana li za od kształ ceń wska za ła, że od se tek ele men tów w ob sza rze szcze li ny, po ten cjal nie zdol nych do two rze nia tkan ki kost nej jest wyższy w przy pad ku za sto so wa nia im plan tu sta lo we go.Mo żli we jest wska za nie miejsc, w któ rych zaj dzie nie ko rzyst na od bu do wa szcze li ny zła ma nia, co mo że do prowa dzić do po wsta nia sta wu rze ko me go. Za sto so wa nie im plan tu sta lo we go pod no si praw do po do bień stwo uzy ska nia sta bil ne go zro stu kost ne go.Słowa kluczowe: MeSH, hip frac tu res, pseu dar th ro sis, com pu ter si mu la tion SUMMARYThe aim of this paper is to conduct a numerical analysis of a case of femoral fracture treated by intramedullary nailing and confirm the conditions which led to the formation of a pseudarthrosis at the fracture site.A low-energy femoral fracture was treated by placing a ChFN System intramedullary nail with a derotation pin. Using the finite element method, a bone-implant system was generated which made it possible to observe the dis placement area and strains in the region of the fracture gap. The calculations were conducted for 3 variants of the model, using a titanium nail (10 mm and 12 mm) and a steel one (10 mm). Analysis of strain distribution indicated that the highest strain values occur in the fracture gap and that they are higher when a titanium alloy is used (0-17% vs 0-11%). Interfragmentary movements caused by an imposed load were also higher when a titanium alloy implant was used. Strain analysis showed that the percentage of elements in the gap area which are potentially able to grow bone tissue is higher when a steel implant is used.It is possible to indicate sites where unfavourable fracture gap healing will take place, which may lead to the deve lopment of a pseud...

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Elderly patient's mortality and morbidity following trochanteric fracture. A hundred cases prospective study

Abstract: Level III: Prospective diagnostic study.

Cited by 48 publications

References 20 publications

Influence of Fracture Stability on Early Patient Mortality and Reoperation After Pertrochanteric and Intertrochanteric Hip Fractures

Influence of Fracture Stability on Early Patient Mortality and Reoperation After Pertrochanteric and Intertrochanteric Hip Fractures

Experimental validation of DXA-based finite element models for prediction of femoral strength

Complication of a Femoral Fracture Treated by Intramedullary Nailing - Numerical Analysis of a Clinical Case

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