Subtrochanteric Fracture of the Femur in the Elderly Osteoporotic Bone: Long Proximal Femoral Nail is the best Treatment Option: In Rural Population - Case Series
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 10
Abstract
Sub-trochanteric fractures involve the upper part of femur between the lesser trochanter and the isthmic region. Fractures in this area are complex and treatment is bothersome to both the patient and the orthopaedic surgeon. These fractures are common among elderly adults with coexisting low bone mineral density due to osteoporosis. Plates, dynamic hip screw, dynamic condylar screw, proximal femoral locking compression plate, intramedullary nail, cephalo medullary nail, proximal short and long femoral nail (PLFN) are the transformational procedures available in which the PLFN is being preferred due to stable fixation.1 10 patients were enrolled in the study.2 The patients were assessed using modified Harris hip scoring postoperatively at one, three, six month and one year from the date of surgery. Descriptive statistics was done in the MS office excel 2010. The encountered complications are non union (n=1), postoperative delirium (n=0) and a case of varus deformity (n=1). The biomechanical properties and minimally invasive fixation technique inspite of good of reduction the LPFN takes lower mean duration of surgery, lower rate of reoperation has the least complications among the other fixation techniques. Background: Long proximal femoral nail has been the standard treatment for subtrochanteric fractures. However there are many fixation implants in the field of traumatology.1 Especially in elderly osteoporotic bone fractures long proximal femoral nail achieved good functional outcome with least complications compared to other implants which leaded to high failure rates. Methods: A Series of eleven cases of osteoporotic subtrochanteric fractures are operated with long proximal femoral nail. One patient lost follow up. The patients are followed (at one, three, six month and one year) at regular intervals. Results were assessed using modified harris hip scoring system. Results: Total ten patients were taken for study were followed by minimum six months and maximum of one year. Clinical outcome was rated as per modified harris hip score. Excellent – 60 %, Good – 20 %, Fair – www.jmscr.igmpublication.org Impact Factor (SJIF): 6.379 Index Copernicus Value: 79.54 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v6i10.174 Neelakrishnan R et al JMSCR Volume 06 Issue 10 October 2018 Page 1047 JMSCR Vol||06||Issue||10||Page 1046-1055||October 2018 10%, Poor – 10%. Conclusion: The surgical management of subtrochanteric fracture with long proximal femoral nail provides stable fixation with moderate pain free early mobilization and good outcome in osteoporotic patients with limited complications.
Authors and Affiliations
Dr R. Neelakrishnan
Keywords
Related Articles
- EP ID EP513332
- DOI -
- Views 61
- Downloads 0
Platelet Indices and Special Cytochemical Stains (Intensity) Concomitant Effect–Now A Ancillary Technique and Survival Index for Leukemia Patients
Aims & Objective: Our study aims to evaluate the survival index of leukemia patients on the basic of cytochemical staining intensity and platelet count for hematological neoplasm. Concomtant effect of both ancillary tech...
Comparison of Open Colorectal Surgeries versus Laparoscopic and Lap Assisted Colorectal Surgeries for Short Term Outcomes in Colorectal Malignancy
Introduction: Laparoscopy has increasing been used in treatment of colorectal cancers. Its benefits and adequacy as compared to open procedures continue to be investigated. The short term outcomes of laparoscopic and lap...
Quantitative Assessment of Pubertal Development among Rural and Urban Adolescents in Osun State, Nigeria: A Comparison of Two Standard Instruments
Introduction: Pubertal development is a critical element in adolescents’ life and is affected by several factors. Studies with quantitative assessment of pubertal development of Nigerian adolescents are rare. Concerns ab...
Recanalisation of Multiple Vitellointestinal Duct after Small Bowel Obstruction in Adult- A Rare Case Presentation
Patent vitello-intestinal duct is an unusual congenital disease, occurs in about 2% of the population1 , which may lead to small intestinal obstruction and other complications, like abdominal pain, intestinal haemorrhage...
Study of Incidence of Melioidosis for a period of two years in a Tertiary care Hospital in North Kerala, South India
Burkholderia pseudomallei is a saprophytic organism found in soil and water predominant in Southeast Asian countries, India and North Australia. In India many cases have been reported in recent years. This study was unde...