ABSTRACT
INTRODUCTION: There is always confusion regarding preoperative stabilization modality for proximal femur fractures to achieve pain relief. Objectives: The aim of this study was to study the effects of skeletal traction and pillow support on pain in patients with proximal femur fractures. Patients and Methods: A total of 50 patients contributed in this randomized clinical trial. Patients were randomly allotted into two equal groups: the skeletal traction and pillow support groups. The severity of pain was recorded at admission and 30 minutes, 24, 48 hours after traction/pillow support application using Visual Analogue Scale (VAS). Results: The severity of pain was significantly decreased in skeletal traction group and pillow support group only at the end of the first day after traction application. The number of pain complaints which needs analgesics was the same between the two groups. Conclusions: even though skeletal traction and pillow support had no effect on analgesic consumption, both have significantly decreased the pain at the end of the first day. The application of skeletal traction and pillow support both are recommended in patients with proximal femur fractures.
ABSTRACT
@#The diagnosis of pathological fractures is on the rise. Themorbidity involved does not only burden the patient and theirfamilies but it has a great toll on the healthcare system aswell. Early identification of the patient at risk is aninvaluable tool to cut cost and improve the patient’s qualityof life. Multiple renal pathologies have been highlighted inrelation to the risk of pathological fractures; however,complications in renal tubular acidosis have been rarelydocumented. Nevertheless, prompt action with adequate andrelevant patient education ultimately can reduce theassociated morbidity. We present a case of poor control ofthe disease and its debilitating pathological fracturecomplications.
ABSTRACT
OBJETIVO: O presente estudo visa analisar prospectivamente dois tipos de osteossíntese (Dynamic Hip Screw (DHS), Orlando Pinto Souza (OPS)), utilizados para o tratamento de fraturas do fêmur proximal, quanto à ocorrência de "cut out". MATERIAIS E MÉTODOS: Foram realizadas no período de julho a dezembro de 2003, 52 cirurgias para tratamento de fraturas transtrocanterianas, 38 destas foram alvo do presente estudo. A técnica a ser utilizada foi escolhida por sorteio no ato operatório. RESULTADOS: No grupo onde fora implantado OPS não observamos a presença de "cut out" e no grupo do DHS obtivemos duas falências da síntese, uma em um paciente de sexo feminino portadora de fratura tipo Tronzo IV e outra em paciente do sexo masculino, portador de fratura Tronzo III, ambas classificadas como instáveis após a redução em mesa ortopédica. A média do TAD obtida foi de 31 mm para o grupo do DHS e de 56,63 mm para o OPS. CONCLUSÃO: Concluímos que quando Comparamos ambas as osteossínteses quanto à incidência de "cut out" e sua relação com o índice TAD preconizado por Baumgartner, no OPS o "cut out" não esteve dependente desta medida e que outros fatores como valgização e redução foram prioritários enquanto no DHS o índice TAD deve ser buscado.
OBJECTIVE: This prospective study compared the occurrence of cut out in two types of osteosyntheses (Dynamic Hip Screw (DHS), Orlando Pinto Souza (OPS)), used for treating proximal femur fractures. Materials and METHODS: From July to December of 2003, we operated 52 hip fractures, but only 38 cases were included in this study consistently with the inclusion criteria. The surgical technique was randomly determined at the moment of the procedure. RESULTS: In the OPS group, we didn't observe the occurrence of cut out, and, in the DHS group, we found 10 percent of synthesis failure: one in a female with a Tronzo IV fracture and other in a male patient with a Tronzo III fracture, both regarded as unstable after reduction on orthopaedic table. The mean Tip Apex Distance to OPS pin was 56.63 mm, and to DHS, 31 mm. CONCLUSION: We concluded that when we compared both osteosynthesis the incidence of cut out and its correlation with TAD as recommended by Baumgartner, in OPS the cut out wasn't dependent of TAD and other factors like valgusing reduction were most important, in DHS the TAD recommended by Baumgartner must be followed.