Synthesis of Controlateral Hip Fracture in Osteoporotic Patients – Prophylactic Treatment

Article Preview

Abstract:

the study tried to evaluate the advantages of mini-invasive prophylactic synthesis of controlateral hip fractures in osteoporotic patients. Material and method: 4 patients have been operated between 2009-2010 with hip fractures in osteoporotic patients. Neck fractures Garden IV in 2 patients and pertrochanteric fractures Kyle III and IV in two others patients. The fracture site was operated in dorsal decubitus under spinal anesthesia, we took adventage of this operation and anesthesia to performe a minimal invasive percutaneous synthesis for the nonfracture controlateral side. We used a simple implant, a quickly method during the same surgery time and anesthesia. The K wires with injected cement were percutaneously inserted. Through a 5 mm skin incision, a channel is created in the proximal femur bone and the implant, made of a fabric pouch hosting Titanium rods, is built percutaneously within the femur. A small amount of bone cement is then added, and interdigitates to the osteoporotic bone to further fixate the implant. Results: Rehabilitation was obtained and full weight bearing was allowed immediately. The potential benefits expected with the use of this minimally invasive method are: Quick procedure 15 min, No soft tissue or bone damage, No bleeding, short rehabilitation period, reduced morbidity and mortality, Low cost, same drape, single anesthesia. Conclusions: The method is simple, reproductible and economically. It can be made in emergency by the resident surgeon. The patient will be operated during the same anesthesia after the operation of fractured hip.

You might also be interested in these eBooks

Info:

Periodical:

Pages:

391-396

Citation:

Online since:

November 2013

Export:

Price:

Permissions CCC:

Permissions PLS:

Сopyright:

© 2014 Trans Tech Publications Ltd. All Rights Reserved

Share:

Citation:

[1] Barrett-Connor, E., 1995. The economic and human costs of osteoporotic fracture. Am. J. Med. A 2, 3S–8.

Google Scholar

[2] Melton III LJ. How many women have osteoporosis now? J Bone Miner Res 1995; 10: 175–7.

DOI: 10.1002/jbmr.5650100202

Google Scholar

[3] Ira P. Scott DL, O'neill TW, Pritchard C, Woolf AD, Davis MJ. Quality of life, morbidity, and mortality after low trauma hip fractures in men. Ann Rheum Dis (2005).

Google Scholar

[4] White B. L, Fisher W.D., Laurin C.A. Rate of mortality for elderly patients after fracture of the hip in the 1980's. J of Bone and Joint Surgery. VOL 69-A, NO. 9, (1987).

Google Scholar

[5] Steen Jensen,J. Mortality after Hip Fractures. ActaOrthop. Scandinavica, 50: 161-167, (1979).

Google Scholar

[6] Gordon P.C. The probability of death following a fracture of the hip. Canadian Med. Asson. J., 105: 47-62, (1971).

Google Scholar

[7] Keene GS, Parker MJ, Pryor GA. Mortality and morbidity after hip fractures. BMJ 1993; 307: 1248–50.

DOI: 10.1136/bmj.307.6914.1248

Google Scholar

[8] Resch H, Gollob E, Kudlacek S, Pietschmann P. Osteoporosis in the man. Wien Med Wochenschr 2001; 151: 457–63.

Google Scholar

[9] Cummings SR, Rubin SM, Black D. The future of hip fractures in the United States. Numbers, costs, and potential effects of postmenopausal estrogen. ClinOrthopRelat Res 1990: 163–6.

DOI: 10.1097/00003086-199003000-00024

Google Scholar

[10] Elffors L. Are osteoporotic fractures due to osteoporosis? Impacts of a frailty pandemic in an aging world. Aging (Milano) 1998; 10: 191– 204.

DOI: 10.1007/bf03339653

Google Scholar

[11] Ray WA, Taylor JA, Meador KG, et al. Arandomized trial of a consultation service to reduce falls in nursing homes. JAMA 1997; 278: 557–62.

DOI: 10.1001/jama.1997.03550070049037

Google Scholar

[12] Johnell O. The socioeconomic burden of fractures: today and in the 21st century. Am J Med 1997; 103: 20S–5S.

Google Scholar

[13] Stevens JA, Olson S. Reducing falls and resulting hip fractures among older women. Centers for Disease Control and Prevention. MMWR, Medical and Mortality Weekly Report. Ref Type: Report. 49 (RR02), 1-12. 31-3-(2000).

DOI: 10.1067/mhc.2000.109232

Google Scholar

[14] Wehren LE, Magaziner J. Hip fracture: risk factors and outcomes. CurrOsteoporos Rep 2003; 1: 78–85.

DOI: 10.1007/s11914-003-0013-8

Google Scholar

[15] T. Nymark. Short Time-Frame from the first to the Second Hip Fractures in the Funen Country Hip Fracture Study. Osteoporos. Int 17: 1353-1357.

DOI: 10.1007/s00198-006-0125-y

Google Scholar

[16] Melton L.J. Hip Fracture Recurrence a Population Based Study. Clinical Orthopedics and Related Research. 167: 131-8 July (1981).

Google Scholar

[17] Klotzbuecher M.C. Patients with Prior Fractures Have an Increased Risk of Future Fractures: A Summary of the Literature and Statistical Synthesis. J Of Bone & Mineral Research. Vol 15, N 4, (2000).

DOI: 10.1359/jbmr.2000.15.4.721

Google Scholar

[18] Schroder, Henrik M, Occurrence and Incidence of the Second Hip Fracture. Clinical Orthopedics and Related Research. 289: 166-169 April, (1993).

Google Scholar

[19] Wolinsky FD, Fitzgerald JF, Stump TE. The effect of hip fracture on mortality, hospitalization, and functional status: a prospect study. Am J Public Health. 1997; 87: 398-403.

DOI: 10.2105/ajph.87.3.398

Google Scholar

[20] Johnell O, Nilsson BE. Hip fracture and accident disposition. ActaOrthop Scand. 1985; 56: 302-304.

DOI: 10.3109/17453678508993019

Google Scholar

[21] Bonar SK, Tinetti ME, Speechley M, Cooney LM. Factors associated with short-versus long-term skilled nursing facility placement among community-living hip fracture patients. J Am Geriatr Soc. 1990; 38: 1139-1144.

DOI: 10.1111/j.1532-5415.1990.tb01378.x

Google Scholar

[22] Parker J. M. Cost Benefit Analysis of Hip Fracture Treatment. J Bone Joint Surg (Br) 1992; 74-B : 261-4.

Google Scholar

[23] Beckmanna J., Ferguson S.J. , Gebauer M., Luering C.,. Gasser B, Heini P. E Femoroplasty – augmentation of the proximal femur with composite bone cement - feasibility, biomechanical properties and osteosynthesis potential. Medical Engineering & Physics 29 (2007).

DOI: 10.1016/j.medengphy.2006.08.006

Google Scholar

[24] Heini P. F., Torsten F., Fankhauser C., Gasser B., Ganz R. Femoroplasty-augmentation of mechanical properties in the osteoporotic proximal femur: a biomechanical investigation of PMMA reinforcement in cadaver bones. Clinical biomechanics. 19 (2004).

DOI: 10.1016/j.clinbiomech.2004.01.014

Google Scholar

[25] M Zlowodzki, O Ayieni, BA Petrisor, M Bhandari, Femoral Neck Shortening After Fracture Fixation with Multiple Cancellous Screws: Incidence and Effect on Function, J Trauma 2008; 64: 163-169.

DOI: 10.1097/01.ta.0000241143.71274.63

Google Scholar