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A survey was undertaken to investigate the treatment of displaced intracapsular femoral neck fractures across the UK. The usual practice at 223 hospitals was recorded for two groups of patients, active and frail. Management of stereotyped fractures, in similar patients, varied between hospitals. There was also variation between specialists within some hospitals: two or more of the alternative methods...
This retrospective study evaluates the results obtained in five Italian departments of traumatology in the treatment of peritrochanteric (pertrochanteric and subtrochanteric) fractures by the intramedullary hip screw (IMHS; Smith & Nephew Richards, Memphis, TN, USA) nail. One thousand two hundred and seventy-three patients were treated with the IMHS nail between March 1992 and February 2000.The...
Purpose: To study the pathomechanism of shock wave injuries to the femoral artery, vein and nerve in dogs.Materials and methods: High-energy shock wave (0.47mJ/mm 2 energy flux density) were applied to the right femoral artery, vein and nerve in nine mongrels, and the left side was used as control. Macroscopic examinations including structure integrity, edema, discolouration and extravasation;...
The management of open fractures requires excision of all devitalised tissues, both bony and soft tissue, and failure to do so is likely to increase the risk of infection. This study evaluated the applicability of laser Doppler flowmetry for the objective evaluation of fracture fragment viability in an experimental open ballistic fracture over a period of 12h. The results indicate that this technique...
Trauma units all over the world are faced with an ever-increasing number of gunshot injuries. While the traditional view is that exploration is mandatory for all gunshot wounds to the neck, this issue is now often debated amongst trauma surgeons.The aim of this particular study was to assess the outcome of gunshot wounds to the neck using a selective conservative approach. Haemodynamically stable...
This study reports two cases of fracture of the femur with segmental bone loss that were treated by a new technique of bone transport. A minimally invasive plate osteosynthesis (MIPO) bridge from the proximal to distal femur served as a fixation system. A separate Wagner distraction apparatus was used for distraction osteogenesis.After the transport segment docked with the bone fragment, it was fixed...
The percutaneous compression plate (PCCP) is a new implant for the minimally invasive treatment of pertrochanteric hip fractures that might reduce blood loss, wound problems and prevent devascularization of bone fragments. A quicker operation with minimal blood loss is better in the older patients. We performed a prospective, randomized clinical trial to compare the PCCP with the well-known dynamic...
The most widely used implant in unstable proximal femoral fractures is the dynamic hip screw (DHS). Intramedullary implants include the intramedullary hip screw (IHMS), gamma nail and proximal femoral nail (PFN). There have not yet been any randomised trials comparing the PFN and DHS. We report our experience of stabilising 60 consecutive proximal femoral fractures with the PFN.Fifty fractures were...
In order to determine which technical aspects of the Austin Moore hemiarthroplasty procedure affect the outcome, we reviewed 243 patients with a non-pathological intracapsular femoral neck fracture who had, Austin Moore uncemented hemiarthroplasty. The immediate post-operative X-rays were assessed for alignment of the prosthetic stem, calcar seating, length of the neck remnant, leg length discrepancy...
The AO/ASIF proximal femoral nail (PFN) is a new device designed for the treatment of the unstable trochanteric femoral fracture. This study reports the outcome in such fractures treated using the PFN at a District General Hospital.All patients presenting to our department with unstable trochanteric femoral fractures were treated operatively using the PFN. A total of 76 patients were included in the...
An experimental study was performed on 20 cadaveric human proximal femurs to investigate both the reproducibility of their mechanical behavior under uniaxial compression and the correlation of mechanical properties with geometric dimensions and bone density. These variables were assessed by radiography, physical measurement, and dual-energy X-ray absorptiometry (DEXA). The specimens were immobilized,...
We studied the outcome of 100 uncemented Austin-Moore hemiarthroplasties used as a revision procedure for failed osteosynthesis of intracapsular femoral fractures. This group was compared with 730 patients in whom an uncemented Austin-Moore prosthesis had been used as the primary treatment for an intracapsular femoral fracture.The results indicate that the study group had more pain at 1-year post-fracture...
To assess outcome after hip fracture in older Irish women, 106 consecutive females aged over 50 years admitted to a general hospital with a hip fracture were compared to 89 age- and gender-matched controls from the same catchment area. Interview-based data were collected on socio-demographic factors, mobility and activities of daily living before recruitment and 2 years later. Information was also...
Osteoporotic hip fractures are an increasing cause of disability to elderly patients and expenditure to the NHS. The aim of this work was to determine whether the rate of sequential hip fractures in elderly patients has changed over the past 20 years. The design was to do a retrospective study of 186 patients admitted with a diagnosis of femoral neck fracture in order to determine how many had suffered...
The evolution of bone plate design has been with a view to reducing the interface contact between the plate and the underlying bone thereby limiting the perfusion deficiency that develops. Little consequence, however, has been attributed to the drilling of holes in the steps prior to bone plate application; the work present herein attempts to define the vascular response of bone to the trauma of drilling...
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