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At least 433 records · Page 24Linked to original sources
PubMed1984

Treatment of femoral fractures with the cast brace.

The authors report a retrospective review of 82 patients with femoral fractures treated nonoperatively by skeletal traction and cast bracing at the University of Alberta Hospital between 1975 and 1979. Fractures were classified as stable or unstable and the position of the fracture was assessed at the time of application of the cast brace and at the time of removal, using angulation, shortening and healing time as criteria for classification of results. Satisfactory results were seen in 88% of patients. At the time of cast brace removal, average knee flexion was 97 degrees, thigh atrophy was 2.5 cm and shortening was 1.4 cm. The unsatisfactory results are analysed and a protocol for successful use of the cast brace is suggested.

Adolescent↗
PubMed1983

Use of the Hoffmann external fixator in the treatment of femoral fractures.

The Hoffmann external fixator has proved to be an effective means of stabilizing complex femoral fractures in patients in whom prolonged traction or internal fixation is not advisable. It provides for the prompt mobilization of multiple-trauma victims and assists in the evaluation of the "floating knee." Pin tract infections and lack of stability or adaptability of the frame are not major problems. Increased risks of delayed union or nonunion are often attributed to this mode of therapy. Within the limits of the present study these difficulties could not be directly related to the use of the fixator. In four patients nonunions were not unexpected and could have occurred with any form of therapy. Improved results may be achieved by earlier recognition of situations in which healing potential is compromised so that bone grafts may be applied at an early stage for prevention of nonunion.

Adolescent↗
PubMed1977

[Results and complications of operated femoral fractures (author's transl)].

On the basis of an analysis of results gained from 153 operated femoral fractures the therapeutic possibilities under usual conditions in the majority of surgical departments are demonstrated. For the most part, the intramedullary nailing is made by the open method without drilling, sometimes with circular wiring, rarely urgently but some days later in a planned programme, after preparing the patient in an aseptic but rarely superaseptic theatre. 73.2% of the patients were controlled, 81.4% of them showing very good or good results. Disorders of vascularisation (2.6%), nail dislocations (1.96%), nail bending (3.26%), nail fractures (1.96%) andosteitis (3.26%) were analysed, timely reoperation for avoiding complications is recommended.

Bone Nails↗
PubMed2002

Effect of dynamization in open interlocking nailing of femoral fractures. A prospective randomized comparative study of 50 cases with a 2-year follow-up.

This prospective randomized comparative study evaluated the role of dynamization of interlocking nails after open reduction and internal fixation of femoral shaft fractures. Fifty femoral shaft fractures were treated by open interlocking nailing and were statically locked. Twenty six of these 50 patients were randomly selected for dynamization and the other 24 were treated without dynamization. The patients were followed up for at least 2 years. The 26 cases which were dynamized went on to union between 13 and 28 weeks (average 19.2 weeks) with two poor results, including one nonunion. The cases that were not dynamized went on to union between 16 and 30 weeks (average 23.5 weeks) with two poor results, including one nail breakage. Though final results are comparable, the study suggests that dynamization after open interlocking nailing significantly shortens the mean time to union, though it does not significantly affect the union rate of the femoral shaft fractures.

Adolescent↗
PubMed1997

[5-year results of dia-/supracondylar femoral fractures, managed with the dynamic condylar screw].

In 118 patients with intra- and extraarticular distal femoral fractures we used open reduction and internal fixation with a dynamic condylar screw. We recorded general implant related complications in a very low percentage of patients. In evaluation of the long-term results in eighty one patients after follow-up of more than five years we found occasional pain in eighteen patients and frequent pain in two patients. 70% of the patients presented with free range of motion in knee joint. Only five patients had a clinically important malunion of greater than five degrees. We found malrotation of greater than ten degrees in four patients. 90% of patients were found to have a stable knee joint. The functional result according to Neer was excellent in more then 50 percent and satisfying in 40 percent of the patients. Only in 5 patients the result was determined as unsatisfying or as a failure. No arthrotic changes were found in the femoro-patellar and femoro-tibial joint in about 75 percent of the cases. Grade 2 changes were found in 15 percent in the femoro-patellar joint and in 18 percent in the femoro-tibial joint. Grade 3 arthrotic changes were seen even in less than 10 percent in both parts of the knee joint.

Adolescent↗
PubMed2005

The use of uncemented extensively porous-coated femoral components in the management of Vancouver B2 and B3 periprosthetic femoral fractures.

We assessed the outcome of patients with Vancouver type B2 and B3 periprosthetic fractures treated with femoral revision using an uncemented extensively porous-coated implant. A retrospective clinical and radiographic assessment of 22 patients with a mean follow-up of 33.7 months was performed. The mean time from the index procedure to fracture was 10.8 years. There were 17 patients with a satisfactory result. Complications in four patients included subsidence in two, deep sepsis in one, and delayed union in one. Concomitant acetabular revision was required in 19 patients. Uncemented extensively porous-coated femoral stems incorporate distally allowing stable fixation. We found good early survival rates and a low incidence of nonunion using this implant.

Aged, 80 and over↗
PubMed1982

Proximal femoral fractures following total hip arthroplasty.

Thirty-one postoperative fractures around the femoral component of previous total hip arthroplasties were reviewed retrospectively until healing occurred. This type of injury seemed to be associated with either high-velocity trauma or weakening of bony stock secondary to stress risers from prior surgery or loosening. These fractures were classified as Type A at the stem tip, Type B spiralling around the stem, and Type C comminuted around the stem. Type A fractures have a significant incidence of nonunion in the face of multiple previous proximal femoral surgeries, but, after healing, usually show no loosening. Type B fractures usually will heal without operative intervention but have a high incidence of associated eventual component loosening. Type C fractures need immediate surgery to allow mobilization of the elderly patient. When postfracture revision surgery with long-stem component or plating is required, the technical order of priority should be adequate bony apposition of fracture fragments, good cement technique at the proximal femur, bone grafting.

Adult↗
PubMed2001

Distal femoral fractures and LISS stabilization.

In recent years, the technique of surgical stabilization in the distal femur has changed. This change decreased the number of non unions and the need for bone grafting. Minimally invasive surgical techniques with a submuscular plate placement have replaced the emphasis on anatomical reduction in the shaft area. Reconstruction of complex articular injuries has been simplified by more direct visualization of the articular surface with the lateral peripatellar approach. Problems remaining are surgical technique and implant considerations. The Less Invasive Stabilization System (LISS) simplifies the surgical technique for percutaneous plate osteosynthesis. An insertion guide is used to insert monocortical, self-tapping screws through a stab incision. A thread in the plate provides the angular stability for the anchoring of these screws. In extra-articular fractures and simple intra-articular fractures, the distal femoral nail permits intramedullary stabilization. A spiral blade improves fixation of the distal femoral condylar block. Despite the enhanced surgical technique and implant possibilities, a great number of patients show a functional deficiency. These are particularly patients with complex intra-articular fractures. The 'fatigue failure' of the osteoporotic implant-bone construct is a problem in elderly patients. The LISS represents a good option to avoid the addition of bone cement to an osteosynthesis.

Adult↗