Innovative technique of minimally invasive closed reduction for impacted femoral neck fractures (MICRIF)

Noda, Masaharu; Takahashi, M; Nukuto, Koji; Fujita, Masahiro; Shinohara, Issei; Suda, Yoshihito; Ohsawa, Shin

doi:10.1177/2309499019832418

Cited by 9 publications

(11 citation statements)

References 12 publications

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“…The treatment principle for an intertrochanteric fracture combined with an acetabular fracture is similar to that of an isolated intertrochanteric fracture. Intertrochanteric fractures are generally considered unstable; thus, surgical treatment is performed in all patients [3,25]. If a patient receives surgical treatment for an acetabular fracture, the intertrochanteric fracture can be treated by the same incision (or with an extension).…”

Section: Treatmentsmentioning

confidence: 99%

As an unusual traumatic presentation, acetabular fracture and concomitant ipsilateral intertrochanteric femur fracture: a retrospective case series of 18 patients

Liu

et al. 2020

J Orthop Surg Res

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Background Acetabular fracture and concomitant ipsilateral intertrochanteric femur fracture has been suggested as an unusual traumatic presentation and rarely reported in the literature. The aims of this study were (1) to identify the etiological characteristics, (2) to summarize the treatment strategy, and (3) to present the mid- to long-term results of patients with this rare traumatic presentation. Methods In this retrospective study, 18 patients (15 males, 3 females; mean age = 42.77 ± 17.74 years, range = 16 to 87 years) who were diagnosed and treated for simultaneous acetabular fracture and ipsilateral intertrochanteric fracture were included. Injury mechanisms, fracture classifications, and treatment strategies were noted. To assess functional status, the Harris score was used. To evaluate pain intensity, visual analogous scale (VAS) was used. The reduction quality of acetabular fractures was examined as per Matta’s standard. Postoperative complications were also recorded. Results The mean follow-up was 10.04 ± 3.38 (range = 6.2 to 16 years). The most common injury mechanism was traffic accident, followed by falling from a tall height. As per the Evans classification, intertrochanteric fractures were defined as type 3 in 13 patients, type 2 in one patient, and type 4 in 4 patients. In acetabular fracture site, the most common fractures were posterior wall fractures, followed by anterior column fractures. All patients received internal fixation for their intertrochanteric fractures. Ten out of 18 patients also received internal fixation for their acetabular fracture. However, for the remaining patients, acetabular fractures were treated conservatively or with fracture fragment resection. Bony healing was achieved in all but one patient who died postoperatively. Twelve patients achieved excellent and good results (Harris score ≥ 80 points) whereas five patients achieved fair and poor results (Harris score < 80 points). The proportion of patients who achieved an excellent-good Harris score was 70.6%. Dislocation of the hip was found to be an independent risk factor (HR = 9.194, 95% CI = 1.024-82.515) for the poor patient outcome. Conclusion To sum up, high-impact trauma is the main cause of acetabular fracture and concomitant ipsilateral intertrochanteric femur fracture. For patients who have undergone surgical treatment, fracture healing is usually achieved. However, the occurrence of complications, especially avascular necrosis, is the major cause of a poor prognosis. Dislocation of the hip joint at the time of injury is considered to be an important risk factor for a poor prognosis.

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Section: Treatmentsmentioning

confidence: 99%

As an unusual traumatic presentation, acetabular fracture and concomitant ipsilateral intertrochanteric femur fracture: a retrospective case series of 18 patients

Liu

et al. 2020

J Orthop Surg Res

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“…Our designed technique may be similar to Mahajan et al [14] and Noda et al [15] . Combined with femoral head and acetabular, a greater proximal fracture was formed to match distal fracture.…”

Section: Discussionmentioning

confidence: 99%

Reverse fracture displacement direction closed reduction technique (RCRT) for the treatment of valgus impacted femoral neck fracture

Zhu¹,

Yan

et al. 2020

Preprint

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Background Impacting locked in fracture site of valgus impacted femoral neck fracture may be the difficulty to achieve anatomical reduction. The aim of this article is to introduce a novel technique to successful complete anatomical reduction. Methods After identify the fracture classification and displace direction. Two 2.0 mm diameter kirschners wire were inserted crossing the femoral head and fixed into acetabular bone. under the continuous image guiding and monitoring, reversing fracture displacement direction with internal rotation and abduction of the hip to complete the closed reduction. results anatomical reduction was achieved in X-ray and CT data postoperative. conclusions This technique provides anatomical reduction, simple procedure, and few interference of internal environment of hip and fracture site in valgus impacted femoral neck fracture.

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“…The treatment principle for intertrochanteric fracture combined with an acetabular fracture is similar to an isolated intertrochanteric fracture. Intertrochanteric fractures are generally considered unstable [3,8]; thus, surgical treatment has been performed in all patients. If a patient received surgical treatment for an acetabular fracture, the intertrochanteric fracture could be treated by the same incision (or with some extension).…”

Section: Discussionmentioning

confidence: 99%

“…Based on the anatomy site of a proximal femoral fracture, these fractures could be divided into three subgroups: fractures involving the acetabulum and femoral head, femoral neck and femoral trochanter. The rst two kinds of fractures might be more common because there have been some reports about them [4][5][6][7][8]. Several reports [3,7] about intra-articular femoral head fracture associated with fracture-dislocation of the hip and acetabulum have been found.…”

Section: Introductionmentioning

confidence: 99%

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Rare injury - acetabular fracture combined with ipsilateral intertrochanteric fracture: treatment and outcome in patients with at least 6 years of follow-up

Liu

et al. 2020

Preprint

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Background Fractures involving both the acetabulum and the ipsilateral femoral trochanter are rarely reported. The aims of our study were to identify the etiological characteristics, summarize the treatment methods, and analyze the mid- to long-term prognosis for this kind of rare injury. Methods A total of 18 patients who were treated in our hospital for a combination of ipsilateral acetabular fracture and intertrochanteric fracture from 2003 to 2013 was retrospectively analyzed. The etiology, fracture classifications, treatment and prognosis of patients were identified. Results We followed up with patients for 6.2 years to 16 years. In this study, injuries occurred most commonly via traffic accidents, followed by falls from a tall height and crushing injury. Six patients had posterior dislocation of the hip joint. Evans type 3 fracture and Letournel type 1 fracture were the most common fractures among these patients. All patients received internal fixation for their intertrochanteric fracture. Some patients also received internal fixation for their acetabular fracture. However, for the other patients, acetabular fractures were treated conservatively or with fracture fragment resection. One elderly (87 years) female patient had pulmonary disease and died at 24 days postoperatively. In other patients, fractures all achieved bony healing. Twelve patients achieved excellent and good results (Harris score ≥ 80 points), and 5 patients achieved fair and poor results (Harris score < 80 points). The proportion of patients who achieved an excellent-good Harris score was 70.6%. Dislocation of the hip was found to be an independent risk factor (HR = 9.194, 95% CI = 1.024–82.515) for poor patient outcomes. Conclusion The detailed characteristics of patients with acetabular fracture and ipsilateral intertrochanteric fracture were identified in this study. For patients who undergo surgical treatment, fracture healing is usually achieved. However, the occurrence of complications, especially avascular necrosis, is the major cause of poor prognosis. Dislocation of the hip joint at the time of injury is considered to be an important risk factor for poor prognosis.

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Innovative technique of minimally invasive closed reduction for impacted femoral neck fractures (MICRIF)

Cited by 9 publications

References 12 publications

As an unusual traumatic presentation, acetabular fracture and concomitant ipsilateral intertrochanteric femur fracture: a retrospective case series of 18 patients

As an unusual traumatic presentation, acetabular fracture and concomitant ipsilateral intertrochanteric femur fracture: a retrospective case series of 18 patients

Reverse fracture displacement direction closed reduction technique (RCRT) for the treatment of valgus impacted femoral neck fracture

Rare injury - acetabular fracture combined with ipsilateral intertrochanteric fracture: treatment and outcome in patients with at least 6 years of follow-up

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