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Bipolar Hemiarthroplasty by Using Cemented Calcar Replacement Stem for Unstable Inter-trochanteric Fractures in Old Age

January 10, 2020/in Jan. - Jun 2020 | Volume 6 | Issue 1

Vol 6 | Issue 1 | Jan-Jun 2020 | page:6-11 – Shriniwas R Yemul, Rushikesh Lonikar Author: Shriniwas R Yemul [1], Rushikesh Lonikar [1] [1] Department of Orthopaedics, Ashwini Rural Medical College, Kumbhari, Solapur, Maharashtra, India. Address of CorrespondenceDr. Rushikesh Lonikar,Associate Professor, Ashwini Rural Medical College, Kumbhari, Solapur, Maharashtra, IndiaE-mail: rushikeshlonikar1@gmail.com Abstract Background: Internal fixation […]

Fat Embolism in Long Bone Fracture Patients and its Complications: A Prospective Study

January 10, 2020/in Jan. - Jun 2020 | Volume 6 | Issue 1

Vol 6 | Issue 1 | Jan-Jun 2020 | page:2-5 – Dheeraj Attarde, Atul Patil, Chetan Pradhan, Chetan Puram, Adarsh Kota, Parag Sancheti, Ashok Shyam Author: Dheeraj Attarde [1], Atul Patil [1], Chetan Pradhan [1], Chetan Puram [1], Adarsh Kota [1], Parag Sancheti [1], Ashok Shyam [1,2] [1] Sancheti Institute of Orthopaedics and Rehabilitation, Pune, […]

Bipolar Hemiarthroplasty by Using Cemented Calcar Replacement Stem for Unstable Inter-trochanteric Fractures in Old Age

January 10, 2020/in Jan. - Jun 2020 | Volume 6 | Issue 1

Fat Embolism in Long Bone Fracture Patients and its Complications: A Prospective Study

January 10, 2020/in Jan. - Jun 2020 | Volume 6 | Issue 1

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Bipolar Hemiarthroplasty by Using Cemented Calcar Replacement Stem for Unstable Inter-trochanteric Fractures in Old Age

January 10, 2020/in Jan. - Jun 2020 | Volume 6 | Issue 1

Vol 6 | Issue 1 | Jan-Jun 2020 | page:6-11 – Shriniwas R Yemul, Rushikesh Lonikar

Author: Shriniwas R Yemul [1], Rushikesh Lonikar [1]

[1] Department of Orthopaedics, Ashwini Rural Medical College, Kumbhari, Solapur, Maharashtra, India.

Address of Correspondence
Dr. Rushikesh Lonikar,
Associate Professor, Ashwini Rural Medical College, Kumbhari, Solapur, Maharashtra, India
E-mail: rushikeshlonikar1@gmail.com

Abstract

Background: Internal fixation of unstable inter-trochanteric is challenging and most of the morbidity is associated with prolonged immobilization and implant cut outs. Aim of this study is to evaluate clinical outcomes of bipolar hemiarthroplasty in old age patients with unstable inter-trochanteric fractures by using cemented calcar replacement stem.
Methods: 80 hips of inter-trochanteric fractures (AO/OTA type 31-A2.2 and 31-A2.3) in 80 patients, 49 females and 31 male patients from Aug 2016 to Sept 2019. All the patients were operated by posterolateral approach, and hemi-replacement done using cemented modular calcar replacement stem, greater trochanter also reconstructed in all the patients. Patients were followed at 6 wks, 3 months, 6 months and 1 year. Primary outcome included Harris hip score and secondary outcome includes functional walking ability (kovals), thigh pain, dislocation, trendelenberg test and infection, mortality.
Results: No dislocation, No e/o infection, only two patients complained of anterior thigh pain. One patient developed pulmonary embolism treated and recovered, limb length discrepancy seen in 4 patients (lengthening 4, no shortening) range 0-20 mm, Perioperative mortality during hospitalization is seen in two patients due to cardiac complications. 5 patients died from discharge to within one year. 3 patients lost to follow up. Fifty five patients (78.57%) regained preinjury ambulation status at final follow up. At final follow up, Average Harris hip score (HSS) was 80 (Range 70 to 95) , poor (<70)-3, fair(70-79)-12, Good (80-89)-50, Excellent (90-100)-5.
Conclusion: Hemiarthroplasty using calcar replacement stem in unstable inter-trochanteric fracture in old age patients helps in early mobilization of patients and early regaining of preinjury ambulation status.
keyword: Unstable inter-tochanteric fracture; Cemented bipolar; Calcar stem bipolar.
Level of evidence: Therapeutic level II.

References

1. Koval KJ, Zuckerman JD. Hip fractures are an increasingly important public health problem. Clin Orthop Relat Res 1998;348:2.
2. Miyamoto RG, Kaplan KM, Levine BR, Egol KA, Zuckerman JD. Sur-gical management of hip fractures: an evidence-based review of the lit-erature. I: femoral neck fractures. J Am Acad Orthop Surg 2008;16:596-607.
3. Davis TR, Sher JL, Horsman A, Simpson M, Porter BB, and Checketts RG. Intertrochanteric femoral fractures. Mechanical failure after internal fixation The Journal of Bone and Joint Surgery. British volume 1990 72-B:1, 26-31
4. Rosenfeld RT, Schwartz DR, Alter AH. Prosthetic replacements for trochantric fractures of the femur. J Bone Joint Surg Am 1973;55:420
5. KH Sancheti, PK Sancheti, AK Shyam, S Patil, Q Dhariwal, R Joshi. Primary hemiarthroplasty for unstable osteoporotic intertrochanteric fractures in the elderly: A retrospective case series Indian J Orthop | October 2010 | Vol. 44 | Issue 4 428-34
6. Chandrashekhar J thakkar, Savyasachi Thakkar, Rajshekhar T kathalgere, malhar N kumar. Calcar femorale grafting in the hemiarthroplasty of the hip for unstable intertrochanteric fractures. Indian journal of orthopaedics/ nov 2015/vol;49/issue 6 602-609
7. Sivabalan T., Thirunarayanan V., Senthil Kumar S., Ramprasath D. R., Basheer Ahmed S.1.Functional analysis of cemented bipolar hemiarthroplasty with medial calcar augmentation for unstable intertrochanteric fractures in elderly. International Journal of Research in Orthopaedics, 2018 Jan;4(1):141-145
7. Yeesuk Kim, Jun Ki Moon, Kyu-tae Hwang, II – Young CHOI, young-Ho Kim. Cementless bipolar hemiarthroplasty for unstable intertrochanteric fractures in octogenarians. Acta orthop Traumatol Turc 2014; 48 (4) 424-430
8. Gashi YN, Elhadi AS, Elbushra IM. Outcome of Primary Cemented Bipolar Hemiarthroplasty compared with Dynamic Hip Screw in Elderly Patients with Unstable Intertrochanteric Fracture. Malays Orthop J. 2018;12(1):36–41.
9. 10.Khaldoun Sinno, Mazen Sakr, Julien Girard, Hassan Khatib. The effectiveness of primary bipolararthroplasty in treatment of unstable intertrochanteric fracturesin elderly patients. North Am Med Sci 2010;2: 561-568
10. 11. Broos PL, Rommens PM, Deleyn PR, Geens VR, Stappaerts KH. Pertrochanteric fractures in the elderly: Are there indications for primary prosthetic replacement? J Orthop Trauma 1991;5:446-51.
12. Kiezo Wada, Hiroshi Mikami, Koichi oba, Hiroshi Yonezu and Koichi Sairya. Cementless calcar replacement stem with integrated greater trochanter plate for unstable intertrochanteric fracture in very elderly patients. Journal of orthopaedic surgery volume;25 (1) 1-8
13. Young-Kyun Lee, MD, Chan Ho Park, MD, Kyung-Hoi Koo, MD. Fixation of Trochanteric Fragments in Cementless Bipolar Hemiarthroplasty of Unstable Intertrochanteric Fracture:Cerclage Wiring. Hip Pelvis 29(4): 262-269, 2017
14. Sivabalan T., Thirunarayanan V., Senthil Kumar S., Ramprasath D. R., Basheer Ahmed S.1 Functional analysis of cemented bipolar hemiarthroplasty with medial calcar augmentation for unstable intertrochanteric fractures in elderly. International Journal of Research in Orthopaedics Sivabalan T et al. Int J Res Orthop. 2018 Jan;4(1):141-145
15. Osman Rodop • Ahmet Kiral • Haluk Kaplan Ibrahim Akmaz. Primary bipolar hemiprosthesis for unstable intertrochanteric fracturesInternational Orthopaedics (SICOT) (2002) 26:233–237
16. Kiran Kumar GN, Sanjay Meena, Vijaya Kumar N, Manjunath S, Vinaya Raj MK. Bipolar Hemiarthroplasty in Unstable Intertrochanteric Fractures in Elderly: A Prospective Study. Journal of Clinical and Diagnostic Research. 2013 Aug, Vol-7(8): 1669-1671
17. ThakurA, LalM. Cemented hemiarthroplasty in elderly osteoprotic unstable trochanteric fractures using fracture window. Malaysian Orthopaedic Journa vol 10 no 1, 1-6
18. Skender Ukaj, Bahri Gjyshinca, Vlora Podvorica, Fatime Ukaj, Granit Molliquaj, Arben BBoshnjaku, Axel Gamulin. Primary hemiarthroplasty for treatment of unstable pertrochanteric femoral fractures (AO/OTA Type 31 A2.3) in elderly osteoporotic patients. SICOT J 2017, 3, 31-36
19. Deniz Çankaya, M.D., Bülent Özkurt, M.D., Abdullah Yalçın Tabak, M.D. Cemented calcar replacement versus cementlesshemiarthroplasty for unstable intertrochantericfemur fractures in the elderly. Ulus Travma Acil Cerr Derg, November 2013, Vol. 19, No. 6, 548-553
20. Jun-Il Yoo, MD, Yong-Han Cha, MD, Kap-Jung Kim, MD, Ha-Yong Kim, MD, Won-Sik Choy, MD, Sun-Chul Hwang, MD. Comparison between Cementless and Cemented Bipolar Hemiarthroplasty for Treatment ofUnstable Intertrochanteric Fractures:Systematic Review and Meta-analysis. Hip Pelvis 30(4): 241-253, 2018.

How to Cite this article: Yemul SR, Lonikar R | Bipolar Hemiarthroplasty by Using Cemented Calcar Replacement Stem for Unstable Inter-trochanteric Fractures in Old Age | Trauma International | January-June 2020; 6(1):6-11.

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Fat Embolism in Long Bone Fracture Patients and its Complications: A Prospective Study

January 10, 2020/in Jan. - Jun 2020 | Volume 6 | Issue 1

Vol 6 | Issue 1 | Jan-Jun 2020 | page:2-5 – Dheeraj Attarde, Atul Patil, Chetan Pradhan, Chetan Puram, Adarsh Kota, Parag Sancheti, Ashok Shyam

Author: Dheeraj Attarde [1], Atul Patil [1], Chetan Pradhan [1], Chetan Puram [1], Adarsh Kota [1], Parag Sancheti [1], Ashok Shyam [1,2]

[1] Sancheti Institute of Orthopaedics and Rehabilitation, Pune, India.
[2] Indian Orthopaedic research group, Thane, India.

Address of Correspondence
Dr. Dheeraj Attarde,
Sancheti Institute of Orthopaedics and Rehabilitation, Pune, India.
E-mail: dheerajattarde@yahoo.in

Abstract

Background: Incidence of fat embolism after long bone fracture in Indian scenario is not studied much. In our study we try to analyse data over 2 years to find incidence and its complications.
Materials and Methods: Two hundred FES (fat embolism syndrome ) suspected patients secondary to long bone fractures admitted over a 1 year period included. Patients satisfying the clinical criteria proposed by Gurd and Wilson, and Schonfeld were included in the study. Clinical features, risk factors, complications and any sequelae were noted.
Results: Out of 200 patient’s majority were male patients. Maximum (85.5%) cases were used immobilizers to stabilize case. Isolated fractures (97%) were more compare to multiple fracture (3%). Associated features included features of altered sensoriam (n = 14, 7%), petechial rash (6%), tachycardia (16.5%) and fever (14.5%). Hypoxemia was demonstrable in 25.5% (51patients) cases. Fat embolism was found in 2% (4 cases) study population. Hypoxia @ 72 hours more in multiple fractures (50%) compare to isolated fractures (4.6%). This association was statistically significant. (P<0.05) No long-term sequelae were observed.
Conclusion: We conclude that in our representative population the incidence of fat embolism is slightly higher compared to other population. This amounts to 2% of people with long bone fractures of lower limb. Fat embolism was more in femur fractures compared to tibia fractures and the chance of fat embolism was more in multiple fractures when compared to isolated fractures. The incidence of fat embolism was more in closed fractures as compared to open fractures. Other salient features of the study were the increased incidence of fat embolism noted in fractures which were not immobilized.
Key Words: Accidents; ARDS; Fat embolism syndrome; Fracture.

References

1. Saigal R, Mittal M, Kansal A, Singh Y, Kolar P, Jain S. Fat embolism syndrome. JAPI. 2008 Apr;56.
2. Akhtar S. Fat embolism. Anesthesiology clinics. 2009 Sep 1;27(3):533-50.
3. Maitre S. Causes, clinical manifestations, and treatment of fat embolism. Virtual Mentor. 2006 Sep 1;8(9):590-2.
4. Stein PD, Yaekoub AY, Matta F, Kleerekoper M. Fat embolism syndrome. The American journal of the medical sciences. 2008 Dec 1;336(6):472-7.
5. Bulger EM, Smith DG, Maier RV, Jurkovich GJ. Fat embolism syndrome: a 10-year review. Archives of surgery. 1997 Apr 1;132(4):435-9.
6. Peltier L.F.: Fat embolism: A perspective. Clin Orthop 1988;232:263-270.
7. Allgower M., Durig M., Wolff G.: Infection and trauma. Surg Clin North Am 1980;60:133-144.
8. Beck J.P., Collins J.A.: Theoretical and clinical aspects of post-traumatic fat embolism syndrome. Instr Course Lect 1973;23:38-87..

How to Cite this article: Attarde D, Patil A, Pradhan C, Puram C, Kota A, Sancheti P, Shyam A | Fat Embolism in Long Bone Fracture Patients and its Complications- A Prospective Study | Trauma International | January-June 2020; 6(1):2-5.

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Bipolar Hemiarthroplasty by Using Cemented Calcar Replacement Stem for Unstable Inter-trochanteric Fractures in Old Age

Fat Embolism in Long Bone Fracture Patients and its Complications: A Prospective Study

Bipolar Hemiarthroplasty by Using Cemented Calcar Replacement Stem for Unstable Inter-trochanteric Fractures in Old Age

Fat Embolism in Long Bone Fracture Patients and its Complications: A Prospective Study

Full Sized Blog Element (Big Preview Pic)

Bipolar Hemiarthroplasty by Using Cemented Calcar Replacement Stem for Unstable Inter-trochanteric Fractures in Old Age

Author: Shriniwas R Yemul [1], Rushikesh Lonikar [1]

Abstract

References

(Abstract)(Full Text HTML) (Download PDF)

Fat Embolism in Long Bone Fracture Patients and its Complications: A Prospective Study

Author: Dheeraj Attarde [1], Atul Patil [1], Chetan Pradhan [1], Chetan Puram [1], Adarsh Kota [1], Parag Sancheti [1], Ashok Shyam [1,2]

Abstract

References

(Abstract Text HTML) (Download PDF)

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