Trochanteric Femoral Fractures Research Articles

Simultaneous ipsilateral trochanteric and femoral shaft fracture

Thirteen cases of concomitant trochanteric and shaft fracture of the same femur are reported. The hip fracture was initially missed in two cases. Osteosynthesis of both fractures was performed in ten cases. Both fractures healed in the 12 cases followed for 6 months or more. Osteosynthesis of both fractures is recommended, preferably by fixation with angled or straight plates, and Ender nailing in selected cases.

Ender nailing of pertrochanteric fractures: Complications related to technical failures and bone quality

In a series of 127 consecutive patients with trochanteric femoral fractures treated with Ender nailing, bone quality and technical failures were analysed. Of the fractures, 35 per cent were stable and 65 per cent unstable according to the definitions of Evans. There were no implant failures. Technical failures occurred in 16 cases. These could be referred to unsuitable location of the nails in the femoral head and/or to an insufficient fixation of the nails in the medullary cavity, especially in patients with poor bone quality and unstable fractures. Technical failures should therefore be preventable. When a correct surgical technique is used with a sufficient number of nails in femurs with low bone quality and a wide medullary canal, the method seems to be a simple and safe treatment for most pertrochanteric fractures, with elimination of many of the problems often associated with this injury.

The influence of age on the morphology of trochanteric fracture.

A series of 127 trochanteric femoral fractures was analyzed with respect to fracture type, age, and bone quality (osteoporosis). There was a continuous decrease in bone quantity (measured as femoral score) with age and a direct relation between bone quality and the severity of the pattern of the trochanteric fracture. The skeletal ageing process starts earlier in women. However, after the age of 85 years the process is more rapid in men. Consequently, the risk of sustaining a trochanteric fracture is greater in men than in women above this age. The increasing age of the population and the longer survival of the oldest people results in more unstable and more comminuted fractures, which have increased by a factor of nearly 3 during the past three decades.

Treatment of comminuted trochanteric femoral fractures with Dimon Hughston displacement fixation and acrylic cement—a preliminary report of sixteen cases

A new method for the treatment of unstable intertrochanteric fracture of the femur is proposed. This consists of stabilizing the fracture with a Dimon and Hughston medial displacement osteotomy and then restoring the cortical defect at the fracture site with methylmethacrylate cement (Dimon and Hughston, 1967). A preliminary trial on sixteen patients showed the excellent stability of the fracture achievable by this method. No mechanical failure was encountered, even though patients were all starting to walk and bearing full weight within the first week. No infection or non-union occurred. Early walking by the elderly patient suffering from a comminuted trochanteric fracture is important to counter the ill effects of decubitus associated with this fracture.

Use of Ender's nails in unstable trochanteric femoral fractures.

Eighty consecutive patients with unstable trochanteric femoral fractures treated by the Ender technique have been studied. Early fixation failure was seen in 18% of patients. Leg shortening and external rotation deformities due to uncontrolled fragmentary collapse were found in almost 80% of the 57 surviving patients at 3 months, and caused severe disability. The continued use of the Ender technique in unstable fractures is questioned.

The Treatment of Trochanteric Fractures of the Femur in Old Age

In our clinic we have treated thirty-five patients over the age of sixty-five for trochanteric fracture of the femur since 1975. Eight of them were males and twenty-seven females with the average age of seventy-five and seventy-eight, respectively. Fracture was classified into stable and unstable as described by Evans. Except for one stable fracture thirty-four of them were treated operatively.Of the twenty-four fractures, treated by three cancellous screw fixation, fifteen were of the stable type and nine of the unstable type. Sixty percents of them were able to walk using crutches postoperatively, however coxa vara developed in five cases. Non-union did not occur in any of them. The remaining ten cases, most of which were unstable fractures, were treated by compression hip screw, plate and Ender nail techniques. Eighty percents of these showed good results.

Trochanteric femoral fractures treated with McLaughlin osteosynthesis.

Of 317 patients with trochanteric femoral fractures, 305 were treated with McLaughlin osteosynthesis. The mortality rate was 14.5 per cent. The postoperative complication rate (35.6 per cent) was dominated by cardiopulmonary (10.6 per cent) and thromboembolic (10.6 per cent) events. Wound infection was found in 3.8 per cent and osteitis in 0.9 per cent. In all, 106 patients had stable fractures according to the Evans classification. Of these, four had to be re-operated due to penetration or a loose bolt. Two hundred and eleven patients (66.6 per cent) had unstable fractures. Follow-up of 169 patients showed two-thirds to have healed in unchanged position. Only 14.8 per cent of the 169 patients had significant fracture complications, particularly varus dislocation of more than 20 degrees (nine patients) and penetration of the nail (eight patients). A total of 10 patients (5.9 per cent) had to be re-operated because of varus dislocation, broken plate or development of pseudarthrosis after removal of the osteosynthesis material. McLaughlin osteosynthesis is concluded to be a suitable method for the treatment of trochanteric femoral fractures--also of the unstable type.

Treatment of trochanteric fractures of femur.

Treatment of trochanteric fractures of femur.

Treatment of trochanteric femoral fractures with special reference to complications

Treatment of trochanteric femoral fractures with special reference to complications

Treatment of Trochanteric, Subtrochanteric and Transcervical Fractures of the Upper Femur by Fixation with Plastic Plates and Stainless Steel Screws

Treatment of Trochanteric, Subtrochanteric and Transcervical Fractures of the Upper Femur by Fixation with Plastic Plates and Stainless Steel Screws