Intertrochanteric Fracture of the Femur in an Ankylosed Hip: A Case Report / Fratura intertrocantérica do fêmur em um quadril anquilosado: Relato de caso

Abstract Intertrochanteric fractures of the femur in ankylosed hips are extremely rare. The aims of the operative management for elderly patients with intertrochanteric fractures are to prevent general complications, to maintain mobility, and to relieve pain. The optimal management to achieve these goals is not clear. The authors present a case of a 74-year-old man with an intertrochanteric fracture of the femur in an ankylosed hip. The fracture was managed surgically with dynamic hip screws and cannulated screws. Two years after the surgery, good union was observed at the fracture, and the patient was ambulating independently.

Resumo A fratura intertrocantérica do fêmur em um quadril anquilosado é extremamente rara. O objetivo do manejo operatório em idosos com fraturas intertrocantéricas é prevenir complicações gerais, manter a mobilidade, e aliviar a dor. O manejo ideal para atingir tal objetivo não é claro. Os autores apresentam o caso de um paciente do sexo masculino de 74 anos com fratura intertrocantérica do fêmur em um quadril anquilosado. A fratura foi tratada cirurgicamente com parafuso de quadril dinâmico e parafuso canulado. Dois anos após a cirurgia, observou-se boa união na fratura, e o paciente deambula de forma independente.

Normative reference database for bone mineral density in Indian men and women using digital X-ray radiogrammetry.

Osteoporosis is a major healthcare problem around the world and its importance lies in the fractures that result. A variety of devices are available in India and other Asian countries for bone mineral density (BMD) assessment, but their clinical utility is limited because of non-availability of local normative database. The purpose of this study was to establish the normative reference database for BMD in Indian women and men using digital x-ray radiogrammetry (DXR). Radiographs of the non-dominant hand were obtained on 262 women and 178 men between 20 and 79 years of age following strict inclusion and exclusion criteria. The radiographs were analysed by DXR using pronosco x-posure system V.2 to estimate the BMD (DXR-BMD). The peak value for DXR-BMD in women was 0.588 g/cm2 at age 35 years and 0.602 g/cm2 in men at age 42 years. There were statistically significant differences in BMD in women and men across all age ranges. An age dependent decline in BMD was seen in both women and men over the age of 50 years. The use of DXR should broaden the availability of fracture risk assessments in places where DXA is not available.

The role of bed rest in acute low back pain.

Acute low back pain is a common problem and clinicians from a number of different disciplines are involved in its management. Advice on daily activities constitutes an important part in the management of low back pain. In spite of evidence against its efficacy, bed rest continues to be a cornerstone of treatment. The purpose of this review is to present evidence from literature to determine the effectiveness of bed rest for patients with acute low back pain together with comparison of bed rest versus advice to stay active, bed rest versus other treatment modalities and shorter periods of bed rest (2 to 4 days) versus longer periods (more than 4 days) of bed rest. There is strong evidence to suggest that bed rest is not effective in the management of acute low back pain.

Prevalence of low bone mass in healthy Indian population.

Osteoporosis is a major problem of health care delivery services, both in the developed and developing countries. The first normative reference database of bone mineral density in the Indian women and men was established using digital x-ray radiogrammetry. Further analysis of this database revealed that 29.9% of women and 24.3% of men between the age of 20 and 79 years had low bone mass. About 50% women and 36% of men over 50 years of age were noted to have low bone mass. The observations of this study suggest that there is higher prevalence of low bone man in the Indian population compared to the western population.