Kyle's Criteria Research Articles

EVALUATION OF CLINICAL AND RADIOLOGICAL OUTCOME OF INTERTROCHANTERIC FRACTURES OF FEMUR TREATED WITH PROXIMAL FEMORAL NAIL : A PROSPECTIVE STUDY

Background: With purpose to evaluate the outcome of proximal femur nail procedure ,we carried out a prospective observational study in which 40 patients, underwent Proximal Femoral nailing for intertrochanteric fracture femur at Govt. R.D.B.P Jaipuria Hospital, Jaipur, Rajasthan. Materials and Methods: Patients were included as per the inclusion and exclusion criteria in the study. All patients were followed up at 4 weeks, 6 weeks, 8 weeks, 12 weeks, 16weeks and 24 weeks and later depending on the fracture healing status. X ray of the operated hip with femur –anteroposterior and lateral views were taken during follow up. Kyle's criteria and Harris hip score was measured at 6 months follow up. Results:The Kyle's criteria was Excellent in 22 patients (55%), Good in 13 patients (32.5%), Fair in 4 patients (10%) and poor in 1 patient (2.5%) Conclusion: proximal femoral nail (PFN) is a good minimally invasive implant for stable and unstable proximal femoral fractures. It's particularly benecial in elderly and osteoporotic population. Adequate fracture reduction is critical in management of the intertrochanteric fractures. Achieving good anatomical reduction and maintaining the tip apex distance less than 25mm will avoid the implant related complications

Dynamic Hip Screw Technique in the Management of Trochanteric Fracture

Background: To study was conducted to find the results of dynamic hip screw in the management of trochanteric fracture
 Methods: 50 Individuals >18 years, both genders who were diagnosed having a trochanteric type I and II Boyd and Griffin Stable fractures were included in the study. 
 Results: As per the Kyle's criteria, 40.00% showed excellent response, followed by good by 48.00% members, fair by 8.00% members. Poor results were shown by 4.00% members.
 Conclusions: Dynamic hip screw is the operative treatment of choice for stable trochanteric fractures. However, studies on large sample for long time are recommended.
 Keywords: Femur, Fracture, Operative

Dynamic hip screw technique in the management of trochanteric fracture

<p class="abstract"><strong>Background:</strong> Study was conducted to find the results of dynamic hip screw in the management of trochanteric fracture by analyzing the factors which influence post-operative mobility.</p><p class="abstract"><strong>Methods:</strong> Study was conducted in the department of orthopedics, GSL Medical College. Individuals >18 years, both genders who were diagnosed having trochanteric type I and II Boyd and Griffin stable fractures were included in the study. All surgeries were performed under spinal anesthesia, internal fixation with dynamic hip screw and 135o angled blade plate. Injectable third generation cephalosporins were used 24 hours preoperatively, intra- operatively and 5 days post-operatively, and oral antibiotics till suture removal. Patients allowed to sit on bed on 2nd and 3rd day and static quadriceps exercises were started from 2nd day onwards, hip and knee flexion exercises from 6 or 7th day and weight bearing walking form 10th day.<strong></strong></p><p class="abstract"><strong>Results:</strong> The average age was of the participants was 61.53 years, ranged between 41 to 80 years; 65% were female participants and 35% were male patients. In the study, 20 (50%) patients had right side fracture and left sided affection of trochanteric fracture to the remaining 50%. Most of the patients (67.5%) in this study were classified as type II Boyd and Griffin criteria, and 32.5% were type I. The clinical and functional outcome was calculated using the Kyle's criteria; 25% (10) showed excellent response, followed by good (50%), fair (15%) and poor (10%) results.</p><p class="abstract"><strong>Conclusions:</strong> Dynamic hip screw is the operative treatment of choice for stable trochanteric fractures. However, studies on large sample for long time are recommended.</p>

FUNCTIONAL OUTCOME AND ASSOCIATED COMPLICATIONS OF INTERTROCHANTERIC FRACTURE TREATED WITH TROCHANTERIC FEMORAL NAIL: A PROSPECTIVE OBSERVATIONAL STUDY

Introduction: As age increases, fall becomes more often so as intertrochanteric fracture of femur. Because of early mobilization, The Trochanteric Femoral Nail (TFN) is found effective and suitable in Indian population as it is smaller in size than Proximal Femoral Nail (PFN). AIM: To clinically evaluate the functional outcome and associated complications of intertrochanteric fracture treated with trochanteric femoral nail. Methodology: Study was done in 30 patients with intertrochanteric fractures treated with trochanteric femoral nail. Patients were followed up at 6 wks, 3months, and 6 months. The intraoperative blood loss, duration of surgery, intra operative complications, post-operative complication, duration of hospital stay were studied. Functional outcome was assessed based on Kyle criteria. Results: In our series of 30 cases there were 22 male and 8 female, maximum age of 90 yrs and minimum age of 20 yrs, most of the patients were between 60 to 70 yrs. Mean age of 58 yrs. 63.3% of cases were admitted due to Domestic fall and 36.7% due to road traffic accidents with common predominance of both sides.AO Type 31A2 fracture accounted for 40 % of cases. Mean duration of hospital stay is 14 days and mean time of full weight bearing is 6 wks. Good to excellent results are seen in 81% cases, Fair in 16%, 3% case with poor results according to kyle's criteria. Conclusion: Trochanteric femoral nail can be considered the most judicious and rational method of treating intertrochanteric fractures, especially the unstable and reverse oblique type.

Outcome of intertrochanteric fractures treated with proximal femoral nail: A prospective study

Introduction: Intertrochanteric fractures are common in the elderly especially with the increase in the incidence of osteoporosis. Various studies have shown good results when treated with intramedullary devices such as the proximal femoral nail (PFN) while other studies have shown high rates of complications. Aim: To study the outcome of intertrochanteric fractures treated with proximal femoral nailing by using Kyle's criteria. Materials and Methods: The study involved fifty cases of intertrochanteric fractures of femur that were treated with PFN. Fractures were classified using Orthopaedic Trauma Association classification. Patients were followed up at 4 weeks, 3 months, and 6 months and results were evaluated using Kyle's criteria. Results: The study included fifty patients, 32 males and 18 females of age 38-94 years with an average of 57 years. Excellent and good results were found in 44 patients (88%). Intra- and post-operative complications were found in 12 patients (24%). Conclusion: Good fracture reduction is critical in the management intertrochanteric fractures with PFN. Proximal femoral nailing is an excellent treatment option for unstable intertrochanteric fractures.

Plasma cell leukemia: a rare condition

Plasma cell leukemia (PCL) is a rare lymphoproliferative disorder characterized by a malignant proliferation of plasma cells in the bone marrow and peripheral blood. PCL is also characterized by a fulminant course and poor prognosis. Diagnosis of PCL is established based on Kyle's criteria which include an absolute plasma cell number comprising greater than 20% of peripheral blood cells. PCL has two variants: the primary form presents de novo in patients with no previous history of multiple myeloma (MM) and the secondary form consists of a leukemic transformation in a previously recognized MM. In this paper, we report ten cases of PCL occurring since 1994 to 2005 in a Mexican health institution. Median age at presentation in our study was 58 years, most of them were female (70%). Primary PCL (PPCL) represented 80% and secondary PCL (SPCL) 20%. We describe clinical characteristics, stage, and response to treatment. Interestingly, we report a patient who presented a secondary PCL and acquired activated protein C resistance (APC-R). Additionally, we found an incidence of 20% of venous thrombosis events in two patients with PPCL. Mean survival was 5.9 months (range 2-17) for both PPCL and SPCL. Mean survival for PPCL was 6.75 months and for SPCL 2.0 months, similar to previous literature reports.

Role of Russell - Taylor delta reconstruction nail in the management of complex proximal femoral fractures

Background: Complex proximal femoral fractures are challenging problem. Methods: Forty-one patients had Russell- Taylor Delta reconstruction nailing done during the period from March 1992 to December 1996. 38 patients could be followed both clinically and radiologically either up to the fracture union or death. Clinical outcome was assessed by Kyle's criteria. Out of 13 patients with high-energy comminuted fractures, 12 were rated excellent or good. There was one death due to poly trauma. Results: Out of six elderly subtrochanteric fractures, 4 had excellent or good results. There was one poor result and one death. Out of 11 elderly interochanteric fractures with subtrochanteric extension, 8 had excellent or good results. There was 1 fair, 1 poor result and 1 death. In the elderly groups, the poor results were due to poor pre- existing medical conditions of the patients. In all the seven cases of pathological lesions, excellent or good results were achieved either till fracture union or death because of their malignant pathology. Conclusion: Russell- Taylor Delta reconstruction nail is a very useful device in high-energy comminuted proximal femoral fractures, in elderly low energy proximal femoral fractures and also in pathological lesions. The implant provides bio-mechanically stable fixation. The relatively high complication rate in elderly patients is because of their poor medical condition. In cases of pathological lesions, it is always preferable to fix the bone at the stage of impending fracture.

Neuropatías paraproteinémicas: bases para un tratamiento específico con relación a la calidad de vida de los pacientes

Monoclonal gammopathy (MG) is reported in 1% of subjects above 50 years of age and in 3% of those above the age of 70. Of all patients with MG, 3% present polyneuropathy (PNP). The abbreviation MGUS (monoclonal gammopathy of undetermined significance) is used to describe a benign proliferation of M component (monoclonal) according to Kyle's criteria, with a potential to be malignant that is indicated by clinical, biochemical and haematological parameters. Aims. The aim of this study was to evaluate the effect of the clinical exacerbation of MGUS associated neuropathy, by referring to the existing literature and to our own experience in order to set out a number of proposals for treatment based on the deterioration of the patient's quality of life. Case 1: a 53 year old female with predominantly sensory sensory motor demyelinating polyradiculoneuropathy, associated to IgG lambda MGUS. Case 2: a 65 year old female with demyelinating sensory motor polyradiculoneuropathy associated to IgM kappa MGUS. In both cases there was a rapidly progressing neurological deterioration and no other data exist to suggest malign lymphoproliferation. In addition to the treatments established for MG linked PNP, which are based on the modulation of the immune response, it has also been proved that when malign proliferation of plasmacytes exists specific treatment of the gammopathy can significantly stabilise or improve the neuropathic symptoms. We propose gammopathy specific haematological treatment in patients who still meet Kyle's criteria for MGUS with a torpid neurological course and scarce response to therapy with immunomodulators, prior to an important deterioration in the quality of life. We also suggest establishing this rapidly progressing clinical course as a criterion that indicates the process of becoming malign as put forward by Eurelings et al.

Envejecimiento poblacional e incidencia de hemopatias primarias adquiridas en un area de la Comunidad Autonoma de Aragon

Aging probably comprises one of the major factors contributing to the onset of acquired primary blood diseases (APBD's) most of which are of a chronic type. The purpose of this study is to analyze the rate of occurrence (RO) of HPA in a population of 522,621 inhabitants (Males: 252,721; Females: 269,900) showing a negative vegetative growth (-1.4/10(5) inhabitants/year), said occurrence being dealt with separately for the population under age 60 and the population over age 60. In January-December, 1994, a estimate was made of the HPA rate of occurrence and rate of analyses among the patients from the area in question, dealing separately with those under age 60 and over age 60. The diagnostic criteria applied were Monoclonal Gammopathies of Undetermined Significance (MGUS's) in keeping with Kyle's criteria. Multiple Myeloma (MM) and Chronic Lymphatic Leukemia (CLL) in keeping with the Myeloma Task Force criteria. Non-Hodgkin's Lymphoma (NHL) and Hodgkin's Disease (HD) in keeping with the REAL classification, Myelodisplasic Syndromes (MS's) and Acute Leukemia (AL) in keeping with the FAB classification, Chronic Myeloproliferative Syndromes (CMS's) in keeping with the PVSG. For calculating the rates of occurrence, descriptive epidemiological methods were used. The highest rates of blood analyses as the result of suspected APH's fell within the over 60 age group (p < 0.0001). During the length of time analyzed, a total of 302 APH's (< 60/> or = years: 100/202, p < 0.0001) were diagnosis, being worthy of special mention: 84 MGUS's; 21 MM's; 57 NHL's; 26 CLL's; 33 CMS's; 11 AL's and 14 HD's. The spread by gender was: Males: 177; Females 125. Average age: 63.54 years (age range 19-92). The rates of occurrence (cases/10(5) inhabitants/year) were (< age 60/> or = age 60): overall: 31.31/178.86; MGUS: 7.37/52.87; MM: 1.84/13.21; NHL: 5.53/34.36; CLL: 1.53/18.50; MS: 0.62/27.31; CMS: 5.52/16.74; AL: 1.53/5.29; HD: 3.68/1.76. The highest rate of analyses as the result of suspected APH was found among those over 60 years of age. The overall occurrence of APH is significantly higher in those over age 60, as well as for each type of APH taken into account, except for AL and HD. The highest rate of occurrence is that of MGUS, NHL and MS's, especially in males.