Blog Elements – Page 33 – Trauma International

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

A Neglected Case of Bilateral Hip Fractures and Other Fractures with Delayed Diagnosis of Hyperparathyroidism as Cause

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page: 38-41 | Sanjay Chhawra, Arun Kumar N Kambar, Ravi Gupta doi-10.13107/ti.2018.v04i01.065 Author: Sanjay Chhawra [1], Arun Kumar N Kambar [1], Ravi Gupta [1]. [1] Department of Orthopaedics, Jaipur Golden Hospital , 2 Institutional Area ,Sec 3 Rohini Delhi 110085. Address of Correspondence Dr. Sanjay […]

The Management of the Displaced Fracture Neck Femur by Dynamic Compression Hip Screw with Derotation Screw

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page: 29-33 | Wasudeo mahadeo Gadegone, Bhaskaran Shivashankar, Rajendra Chandak, Piyush Gadegone. doi-10.13107/ti.2018.v04i01.063 Author: Wasudeo mahadeo Gadegone [1], Bhaskaran Shivashankar [2], Rajendra Chandak [3], Piyush Gadegone [4]. [1] GMC Chandrapur, Maharashtra, India. [2] Iyer Orthopaedic Hospital, Solapur, India [3] Chandak Nursing Home Nagpur Maharashtra India. […]

A Neglected Case of Bilateral Hip Fractures and Other Fractures with Delayed Diagnosis of Hyperparathyroidism as Cause

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

The Management of the Displaced Fracture Neck Femur by Dynamic Compression Hip Screw with Derotation Screw

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Full Sized Blog Element (Big Preview Pic)

A Neglected Case of Bilateral Hip Fractures and Other Fractures with Delayed Diagnosis of Hyperparathyroidism as Cause

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page: 38-41 | Sanjay Chhawra, Arun Kumar N Kambar, Ravi Gupta

doi-10.13107/ti.2018.v04i01.065

Author: Sanjay Chhawra [1], Arun Kumar N Kambar [1], Ravi Gupta [1].

[1] Department of Orthopaedics, Jaipur Golden Hospital , 2 Institutional Area ,Sec 3 Rohini Delhi 110085.

Address of Correspondence
Dr. Sanjay Chhawra
A-144 Gaytri Vihar Bagh Mughaliya, Bhopal. MP. India.
E-mail: sanjaychhawra@yahoo.com

Abstract

Introduction: Primary hyperparathyroidism is a disease characterized by hypercalcemia attributable to autonomous overproduction of PTH ParaThyroid Hormone.Primary hyperparathyroidism PHPT is prevalent in approximately 1% of adult population with F;M 3;1. The disease affects multiple systems –Musculosketal, CVS, G.Urinary, Abdomen and Endocrine. Primary hyperparathyroidism present with classic signs and symptoms of hypercalcaemia. Non-specific symptoms may include muscle weakness, thirst, polyuria, anorexia and weight loss along with pathological fractures.The treatment of choice is parathroidectomy after proper investigation.
Case Report: A 40 yrs Male presented with Pain, Swelling and Deformity over Bilateral Hip, Right Shoulder, Right Hand and Right Clavicular Region. Unable to bear weight since 1 year. Along with its General Complaint of Weakness, Joint Pain, Abdominal Pain with clinical syptoms and operated right sided hip after proper investigation patient was diagnosed Hyperparathyridism with B/L Hip fracture {unusual presentation }multiple fractures with implant failure .After Parathyroidectomy and regular follow fracture fixation was done later with calcium supplementation the outcome was satisfactory.
Conclusions: Repeatedly multiple fractures must be investigated with appropriate and precise routine serum biochemical along with PTH Vitamin D Thyroid profile to diagnose endocrine disorder as in this case diagnosed as Hyperparathyroidism.With Clinical examination of neck as specific site with extremities, deformities and systemic examination is essential. USG Neck as routine investigation for this disease. After parathyroidectomy and regular follow up is done. Afterwards fracture fixation is done as secondary procedure with adequate calcium and vitamin D correction give good prognosis better union with best possible outcome. This is rare presentation of PHPT with B/L Hip fracture and other fractures deformities is an excellent example of an endocrine disease that is best managed by a multidisciplinary approach and long term patient follow up.
Keywords: Primary Hyperparathroidism PHPT, Pathological fracture, PTH Parathyroid Hormone.

References

1. Goode A. W. The parathyroid and adrenal glands. In: Russel R. C.G, Williams N. S and Bulstrode C. J. K (eds). Short textbook of surgery. Arnold, London. 2000; 734-748.
2. Mungadi IA, Amole *AO, Pindiga UH. Primary hyperparathyroidismpresenting with multiple pathological fractures and normocalcaemia.Ann Afr Med 2004;3(1):42e4.
3. Grégoire C, Soussan M, Dumuis ML, Martin A, et al. (2012) Contribution of multimodality imaging for positive and aetiological diagnosis of multiple brown tumours. Ann Endocrinol (Paris) 73: 43-50.
4. Morgan G, Ganapathi M, Afzal S, Grant A.J (2002) Pathological fractures in primary hyperparathyroidism: a case report highlighting diagnostic difficulties. Injury 33: 288-289.
5. Callender GG, Udelsman R. Surgery for pri-mary hyperparathyroidism. Cancer 2014; 120: 3602-3616.
6. John P, Bilezikian MD, Shonni J, Silverberg MD. Asymptomaticprimary hyperparathyroidism. N Engl JMed 2004;350:1746e51.
7. K. A˘gbaht, A. Aytac¸, and S. G¨ull¨u, “Catastrophic bone deformities associated with primary hyperparathyroidism in a middleaged man,” The Journal of Clinical Endocrinology &Metabolism, vol. 98, no. 9, pp. 3529–3531, 2013
8. Henry,J.Mankin.: An instruction course lecture- Metabolic bone disease. The American Academy of orthopaedic surgeons. Journal of Bone & Joint Surgery; 1994;Vol- 76A, No.5; 760-788
9. Albright F, Aub JC, Bauer W (1934) Hyperparathyroidism, a commonand polymorphic condition as illustrated by seventeen proved casesfrom one clinic. JAMA 102:1276-1287.
10. Nussbaum,S.R., & Polt,J.T., Jr.: Immunoassays for parathyroid hormone 1-84 in the diagnosis of hyperparathyroidism. J Bone and Min. Res., 6 (supplement 2); s43- s50, 1991.
11. Lancourt JE, Hochberg F. Delayed fracture healing in primary hyperparathyroidism Clin OrthoP 1977; 124: 214-218
12. A.Khan and J. P. Bilezikian, “Primary hyperparathyroidism: pathophysiology and impact on bone,” Canadian Medical Association Journal, vol. 163, no. 2, pp. 184–187, 2000.
13. Winzelberg G.G ;Parathyroid imaging. Ann.Intern.Med. 1987;vol -107;64-70
14. Lorberboym M, Ezri T, Schachter PP. Preoperative technetium Tc 99m sestamibi SPECT imaging in the management of primary hyperparathyroidism in patients with concomitant multinodular goiter. Arch Surg 2005 Jul;140(7):656e60.
15. Lars Rolighed, MD,1 Lars Rejnmark, PhD, DMSci2 and Peer Christiansen, DMSci Bone Involvement in Primary Hyperparathyroidism and Changes After Parathyroidectomy US Endocrinology 2013;9(2):181–4 3
16. Cristina Stefan1,2, Amalia Arhire1, Luminita Cima1,3 & Carmen Barbu1,3 Long standing primary hyperparathyroidism consequences after parathyroid surgery: fast recovery not only for bone mass Endocrine Abstracts (2017) 49 Ep262 .

How to Cite this article: Chhawra S, Kambar AN, Gupta R. A Neglected Case of Bilateral Hip Fractures and Other Fractures with Delayed Diagnosis of Hyperparathyroidism as Cause. Trauma International May – Aug 2018;5(1):38-41.

(Abstract Text HTML) (Download PDF)

The Management of the Displaced Fracture Neck Femur by Dynamic Compression Hip Screw with Derotation Screw

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page: 29-33 | Wasudeo mahadeo Gadegone, Bhaskaran Shivashankar, Rajendra Chandak, Piyush Gadegone.

doi-10.13107/ti.2018.v04i01.063

Author: Wasudeo mahadeo Gadegone [1], Bhaskaran Shivashankar [2], Rajendra Chandak [3], Piyush Gadegone [4].

[1] GMC Chandrapur, Maharashtra, India.
[2] Iyer Orthopaedic Hospital, Solapur, India
[3] Chandak Nursing Home Nagpur Maharashtra India.
[4] Sion Hospital, Mumbai, India

Address of Correspondence
Dr. W.M. Gadegone,
Vivek Nagar Mul-Road Chandrapur 442402, Maharashtra, India.
Email: gadegone123@yahoo.co.in

Abstract

Introduction: The aim of the present study was to evaluate the outcomes of displaced intracapsuar fracture neck femur managed by dynamic hip screw (DHS) with derotation screw treated within ten days of injury in patients younger than 60 years.
Materials and methods: This was a prospective study, carried out between December 2010 to December 2016. A total of 42 patients younger than 60 yrs of age with displaced intracapsular fracture neck femur (Garden III and IV, Pauwels III, with the comminution) presenting to the hospital within 2-10 days were included in the study. Data analysis and statistical analysis was done by using SPSS using appropriate tests.
Results: There were 27 males and 15 females, age ranging from 21 to 60 years (mean42.4±10.2 years). There were twenty seven Garden III while fifteen fractures were Garden IV. In forty fractures (95.2 %) average time to union was 3.7 months [3-5 months]. Radiographic evidence of avascular necrosis was seen in four cases(9.5%) and two patients(4.7%) developed non-union of the fracture .There were no cut-outs and breakage of implant .Two patients developed isolated coxa vara ( 120-124°) with backing of screws. Mean shortening of the injured limb was 2 -4 mm in twenty four patients without any functional impairment. Functional results were evaluated by Harris Hip Score. Excellent results were achieved in thirty four (81%), good/fair in six (14.2%) and poor in two (4.8%)patients.
Conclusion: Dynamic Hip Screw (DHS) with derotation screw is a good implant for the fixation of the displaced fracture neck femur with excellent to good radiological and functional outcome.
Keywords: Fracture neck femur, transcervical/ subcapital fracture, cannulated cancellous screw, dynamic hip screw, avascular necrosis, nonunion.

References

1. Yang JJ, Lin LC, Chao KH, Chuang SY, Wu CC, Yeh TT, Lian YT. Risk factors for nonunion in patients with intracapsular femoral neck fractures treated with three cannulated screws placed in either a triangle or an inverted triangle configuration. J Bone Joint Surg Am. 2013;95:61-69
2. Deneka DA, Simonian PT, Stankewich CJ, et al ;Biomechanical comparison of internal fixation techniques for the treatment of unstable basicervical femoral neck fractures. J Orthop Trauma. 1997;11:337–343.
3. Wei J, Mao YJ, Jia ZZ (Treatment of 212 cases of fresh femoral neck fracture with compressed hollow screws. Chin J Traumatol 2000 16: 142-144 4
4. Makki D, Mohamed AM, Gadiyar R, Patterson M ;Addition of an anti-rotation screw to the dynamic hip screw for femoral neck fractures. Orthopedics. 2013;36:865–868.
5. Bonnaire FA, Weber AT. Analysis of fracture gap changes, dynamic and static stability of different osteosynthetic procedures in the femoral neck. Injury. 2002;33 Suppl 3:C24–C32.
6. W.-C. Chen, S.-W. Yu, I.-C. Tseng, J.-Y. Su, Y.-K. Tu, and W.-J. Chen, “Treatment of undisplaced femoral neck fractures in the elderly,” Journal of Trauma, 2005 vol. 58, no. 5, pp. 1035–1039
7. Gurusamy K, Parker MJ, Rowlands TK. ;The complications of displaced intracapsular fractures of the hip: The effect of screw positioning and angulation on fracture healing. J Bone Joint Surg [Br] ;2005 87-B:632–634
8. Baumgaertner MB, Solberg BD .Awareness of tip-apex distance reduces failure of fixation of trochanteric fractures of the hips. J Bone Joint Surg [Br] 1997;79-B:969–971.
9. Ly, T. V., &Swiontkowski, M. F. Treatment of femoral neck fractures in young adults. Journal of Bone and Joint Surgery. American Volume,2008 90, 2254–2266
10. Haidukewych, G. J., Rothwell, W. S., Jacofsky, D. J., Torchia, M. E., & Berry, D. J. Operative treatment of femoral neck fractures in patients between the ages of fifteen and fifty years. The Journal of Bone & Joint Surgery, 2004 86, 1711–1716.
11. Garden RS. Reduction and fixation of subcapital fractures of the femur. Orthop Clin North Am. 1974;5:683-712.
12. Liporace, F., Gaines, R., Collinge, C., &Haidukewych, G. J. Results of internal fixation of pauwels type-3 vertical femoral neck fractures. The Journal of Bone & Joint Surgery, 2008. 90: 1654–1659.
13. Shabnam Samsami,Sadegh Saberi,Sanambar Sadighi,Gholamreza Rouh; Comparison of Three Fixation Methods for Femoral Neck Fracture in Young Adults: Experimental and Numerical Investigations .Journal of Medical and Biological Engineering. 2015 October, Volume 35, Issue5, pp 566–579
14. Bosch U, Schreiber T, Krettek C. Reduction and fixation of displaced intracapsular fractures of the proximal femur. ClinOrthop RelatRes.2002 ;59-71.
15. Karaeminogullari O, Demirors H, Atabek M, Tuncay C, Tandogan R, Ozalay M. Avascular necrosis and nonunion after osteosynthesis of femoral neck fractures: effect of fracture displacement and time to surgery. Adv Ther.2004 ;21:335-342. Andreas Panagiotopoulos
16. AndreaPiccioli,Peter V. Giannoudis;Timing of internal fixation of femoral neck fractures. A systematic review and meta-analysis of the final outcome;Injury 2015 March Volume 46, Issue 3, Pages 459–466
17. Razik F, Alexopoulos AS, El-Osta B, Connolly MJ, Brown A, Hassan S, Ravikumar K. Time to internal fixation of femoral neck fractures in patients under sixty years–does this matter in the development of osteonecrosis of femoral head? International orthopaedics ;2012;36:2127-2132.Slobogean GP
18. 1, Sprague SA2, Scott T3, Bhandari M2; Complications following young femoral neck fractures. Injury.2015. Mar;46(3):484-91.
19. Stiasny J., Dragan S., Kulej M., Martynkiewicz J., Płochowski J., Dragan S.ŁComparison analysis of the operative treatment results of the femoral neck fractures using side-plate and compression screw and cannulated AO screws. OrtopTraumatolRehabil.2008 ;10(4):350–361.
20. Upadhyay A, Jain P, Mishra P, Maini L, Gautum VK, Dhaon BK;Delayed internal fixation of fractures of the neck of the femur in young adults. A prospective, randomised study comparing closed and open reduction. J Bone Joint SurgBr. 2004;86:1035–1040.
21. Lee CH, Huang GS, Chao KH, Jean JL, Wu SS.Surgical treatment of displaced stress fractures of the femoral neck in military recruits: a report of 42 cases. Arch Orthop Trauma Surg.;2003.123:527-33 Lu-Yao GL
22. 1, Keller RB, Littenberg B, Wennberg JE. Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports.J Bone Joint Surg Am. 1994. Jan;76(1):15-25.
23. Blomfeldt R, Tornkvist H, Ponzer S, Soderqvist A, Tidermark J. Comparison of internal fixation with total hip replacement for displaced femoral neck fractures. Randomized, controlled trial performed at four years. J Bone Joint Surg Am. Aug. 2005.87(8):1680-8. Barnes R
24. Brown JT, Garden RS, Nicoll EASubcapital fractures of the femur. A prospective review. J Bone Joint Surg Br.1976 Feb;58(1):2-24.

How to Cite this article: Gadegone WM, Shivashankar B, Chandak R, Gadegone P. The Management of the Displaced Fracture Neck Femur by Dynamic Compression Hip Screw with Derotation Screw. Trauma International JMay-Aug 2018;4(1):29-33.

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

A Neglected Case of Bilateral Hip Fractures and Other Fractures with Delayed Diagnosis of Hyperparathyroidism as Cause

The Management of the Displaced Fracture Neck Femur by Dynamic Compression Hip Screw with Derotation Screw

A Neglected Case of Bilateral Hip Fractures and Other Fractures with Delayed Diagnosis of Hyperparathyroidism as Cause

The Management of the Displaced Fracture Neck Femur by Dynamic Compression Hip Screw with Derotation Screw

Full Sized Blog Element (Big Preview Pic)

A Neglected Case of Bilateral Hip Fractures and Other Fractures with Delayed Diagnosis of Hyperparathyroidism as Cause

Author: Sanjay Chhawra [1], Arun Kumar N Kambar [1], Ravi Gupta [1].

Abstract

References

(Abstract Text HTML) (Download PDF)

The Management of the Displaced Fracture Neck Femur by Dynamic Compression Hip Screw with Derotation Screw

Author: Wasudeo mahadeo Gadegone [1], Bhaskaran Shivashankar [2], Rajendra Chandak [3], Piyush Gadegone [4].

Abstract

References

(Abstract Text HTML) (Download PDF)

Contact

Important Links

LICENSE