Our work is a retrospective study of 17 cases of distal femur fracture colligated in the department of orthopaedic surgery and traumatology ii, mohamed v military hospital. Management of subtrochanteric proximal femur fractures. Osteochondroma fracture at the distal medial femur journal. Both periprosthetic femoral shaft and distal femur fractures are associated with relatively high mortality rates, approaching that of patients with hip fractures. Pdf antegrade reamed femoral nailing via the piriformis entry point is the technique of choice in treating femoral shaft fractures, with. Numerous reports suggest a 1year mortality rate of 20% to 30% after traditional proximal.
Evans and others published fractures of the proximal femur find, read and cite all the research you need on researchgate. Fractures commonly happen because of car accidents, falls, or sports injuries. This article appeared in a journal published by elsevier. The trial of acute femoral fracture fixation traffix is a randomised, parallelgroup feasibility study. Femur, proximal end segment, femoral head fracture 31c. Intramedullary nailing for femoral shaft fractures in adults ncbi. Timely and accurate diagnosis and appropriate therapy are critical in order to avoid permanent morbidity and. Total hip arthroplasty or hemiarthroplasty for hip fracture.
As part of primary survey patients chest and pelvis xrays done at trauma bay shows no abnormality. Concomitant injuries associated with femoral shaft fractures. Management of fractures of distal femur journal of medical. Fracture and dislocation compendium orthopaedic trauma. Case reports fractures of the neck of the femur in children dimitrios g. Prehospital care in isolated neck of femur fracture. Fractures of the neck of the femur in children sciencedirect. These findings are consistent with a nondisplaced incomplete stress fracture.
Timing of fracture stabilization is depended on the overall medical condition of the patient, but definite fracture fixation can often be implemented in the early total care. Development of operative treatment of femoral shaft fractures. Isolated condylar femur fractures are extremely rare, particularly those of the medial condyle. Given the traumatic mechanism of injury, worsening symptoms, and the presence of a painful, firm mass in the left distal medial thigh region, the physical therapist ordered radiographs of the left femur, which demonstrated a fracture at the base of an 8. Overuse can cause stress fractures, which are very. For displaced femoral neck fractures, there remains uncertainty regarding the effect of a total hip. The bone marrow edema associated with the femoral neck stress fracture produces the highintensity signal seen in this image. Missed femur fracture in pediatric trauma patient medcrave. Zuckerman jd, skovron ml, koval kj, aharonoff g, frankel vh.
Due to their high complication rate and negative impact of those complications upon the knee and the whole lower limb, distal femoral fractures require optimal. Pdf temporizing management of pediatric femur fractures. If the broken bone punctures the skin, it is called an open or compound fracture. Distal femur fractures are uncommon, but an important cause of patient morbidity. Pdf diaphyseal femoral fractures are common and can present as isolated injuries. Injuries associated with femoral shaft fractures with special.
Current concepts in fractures of the distal femur soucasny pohled na zlomeniny dolniho konce stehenni kosti b. The international journal of fracture is an outlet for original analytical, numerical and experimental contributions which provide improved understanding of the mechanisms of micro and macro fracture in all materials, and their engineering implications. Stabilization of the femur fractures were performed before arterial repair in 10 of the femurs. Divergent patterns in the proximal femur, acetabulum, and pelvis. These figures indicate that there is room for considerable improvement in the treatment of this type of fracture. Recovery is impaired by malnutrition and oxidative stress, which is affected by antioxidants such as ascorbic acid aa. Fractures in femur bone are divided according to anatomic regions.
Distal femur fracture, elderly, retrograde nail, spirallocking blade. Around 65 000 people experience a fractured neck of femur nof each year in the uk. Babst department of trauma surgery, cantonal hospital lucerne, lucerne, switzerland summary this paper describes current treatment strategies of distal femoral fractures as well as their evidence based rationale. Intramedullary nailing for pertrochanteric fractures of. The epidemiology of adult distal femoral shaft fractures in a. Get a printable copy pdf file of the complete article 2. Jan 24, 2015 concurrent ipsilateral fractures of the proximal and shaft of the femur are rare complex fracture combinations. Chapter 53 fractures of the distal femur china quad diaries. The proximal femoral intramedullary nail provides more stability and allows for earlier weight bearing than the locking plate when used for the treatment of unstable intertrochanteric fractures of. Pattern and outcome of femoral fractures treated in a regional. Postoperative complications and mortality associated with operative delay in older patients who have a fracture of the hip. Diaphyseal femur fractures in children clinmed international. It is estimated that the lifetime risk of hip fracture was 23. Femur, proximal end segment, femoral head, split fracture 31c1.
Fractures of the neck of the femur are rare among children when one considers the frequency with which they occur among adults. In this prospective cohort study, we evaluated clinical and radiological longterm results after operative treatment using several surgical strategies. Epidemiology and social burden of the femoral neck fractures orlin filipov department of geriathic orthopedics, vitosha hospital sofia, bulgaria journal of imab annual proceeding scientific papers 2014, vol. The femoral neck fracture continues to be unsolved fractures and the guidelines for management are still evolving. Surgical treatment of ipsilateral multilevel femoral. This study monitored aa levels during hospitalization of patients with a proximal femur to investigate the influence of aa.
Any pathological fracture except due to osteoporosis method of study every patient was evaluated after history, clinical examination and radiological investigation and fracture pattern was classified according to ao classification. It is a common skeletal injury, occurring with minor trauma in the osteoporotic bone of elderly patients. Brownbill and ilich 20038 described several components of the geometry of proximal femur which are possible risk factors for fracture. Femoral neck fractures are a commonly encountered injury in orthopaedic practice and result in significant morbidity and mortality. Distinguishing injuries due to accidents from those due to child abuse in young children can be difficult because of the inability of the young child to provide a history. According to more recent research, half of the proximal femur fractures are intraarticular fractures of the femoral neck 6, 7. Lippincott journals subscribers, use your username or email along with your password to log in. Optimal indications for surgical repair versus revision arthroplasty and optimal postoperative weightbearing protocols remain uncertain. Insufficiency fractures of the pelvis and proximal femur are usually found in elderly subjects and are the result of normal stress placed on abnormal bone that may be a complication of osteoporosis or previous radiation therapy but can also be the result of rheumatoid arthritis, prolonged corticosteroid therapy, renal failure, and mechanical changes after hip surgery 15. Subtrochanteric femur fractures are an uncommon injury in orthopedics, but when they are encountered they may present difficulties in management. Femur, proximal end segment, femoral head, depression fracture 31c2. Children, elastic nailing, femur, fractures, hip spica, submuscular plating. Neonatal physeal fracture of the distal femur is often difficult to diagnose.
Interventions for treating fractures of the distal femur in. Fracture occurs in femur bone only when the bone is affected with great force due to bending and twisting actions. Jul 31, 2018 the femur, your thigh bone, is the largest and strongest bone in your body. Depending on how close to the hip the break is, it may be called a hip fracture instead of a femur fracture. These will assist the physician to determine the optimal treatment strategy and avoid. The journal presents papers from engineers and scientists working in various aspects of. Characteristics of femur fractures in ambulatory young.
Current concepts 598 journal of the american academy of orthopaedic. The mean duration of bisphosphonate treatment was 9. Until very recently it has been generally thought that the outcome of treatment of a fracture at the neck of the femur depended solely on the degree of interruption of the. International journal of contemporary medical research. Abstract background globally, hip fractures are among the top 10 causes of disability in adults. It is essential that surgeons are able to recognize specific fracture patterns and patient characteristics that indicate the use of particular implants and methods to effectively manage these injuries. Open reduction and internal fixation was a poor prognostic factor of nonunion in these fractures. Prevention was the initial indication in 68% of the subjects. Ota open fracture classification otaofc ao pediatric comprehensive classification of long bone fractures pccf to view the otaao fracture and dislocation classification compendium as a pdf, please click here. Nonunion of the distal femur can be very challenging to treat and often has a devastating impact on patient function and quality of life.
Analysis of the outcome of fracture femur surgeries. Hence management of femoral shaft fractures is often directed by comorbidities, additional injuries and the medical condition of the patient. The treatment of intertrochanteric fractures of the femur. A patients guide to femur fractures advanced physical therapy. Three parameters of the proximal femur geometry are most important for fracture risk assessment. Distal femur fractures are most commonly seen as a fallrelated injury in older adults but can also stem from highenergy impacts in younger people, and in people who have previously undergone total knee replacement elsoe, ceccotti. The jsplint is a reliable, simple, and rapidly applied splint that prevents many of the complications and pitfalls of other described temporizing measures, such as skeletal traction, skin traction, traction splinting, and posterior splinting. Preoperative ascorbic acid levels in proximal femur fracture. The purpose of this paper is to examine the recent literature on the epidemiology, classification, initial evaluation, and definitely treatment for these injuries. Mri and ct of insufficiency fractures of the pelvis and the. Surgical treatment of osteopetrosisrelated femoral fractures.
Selected articles from this journal and other medical research on novel coronavirus 2019ncov and related viruses are now available for free on sciencedirect start exploring directly or visit the elsevier novel coronavirus information center. Two of the patients 15% sustained segmental two levels arterial injuries. Dec 18, 2019 according to the literature, the cutout of the lag screw is the most frequent complication of the nail for proximal femur fracture 11, 23, 27,28,29,30,31 with an occurrence rate between 1 and 5% of surgeries 11, 23,24,25,26 causing the 84% of failures and revision surgery of these devices. Fractures of the proximal femur are a substantial problem in the elderly. Extra articular distal femoral fractures in the elderly treated with. Distal femur fractures in adults orthopaedics and trauma. Pdf femoral shaft fractures in adults researchgate. The effect of hip fracture on mortality, hospitalization, and functional status. Traumatic knee injuries, femoral fractures, epidemiology, distal femur, adult, trauma. Reported outcomes for patients with periprosthetic. Treatment options for distal femoral fractures ncbi. Surgical treatment of pediatric femur fractures is indicated in the 614 years age group, as the. Proximal femur fractures show a high prevalence in elderly patients and are associated with an elevated risk of multimorbidity and early mortality.
This article describes a novel splinting technique for the temporizing management of pediatric femur fractures. Femur fractures with femoral or popliteal artery injuries. May, 2003 we report a case of an intrauterine fracture of the femur detected at routine mid. The best suitable fda approved implant for a particular fracture pattern of distal femur was used. Ununited fractures of the neck of the femur cleveland. Femur fractures have been documented in 12%29% of physically abused children. Factors that affect mortality rates in elderly hip fracture patients arc journal of orthopedic page 3 patients were operated in 2 days while 49. Other causes are low bone density and osteoporosis, which cause weakening of the bones. The bill for nof fracture, excluding substantial social care costs, is. In our study, the first case had a positive family history, mild anemia, bilateral loss of vision, diffuse sclerosis, and an osteopetrotic fracture of the right femur. The femur bone is the second largest and strongest bone in our body as shown in figure 1 1. At birth, callus formation was palpable and confirmed by radiography.