ABSTRACT
We assessed the bone mineral density (BMD), the body mass index (BMI), and the hip axis length (HAL) in 78 postmenopausal women with 38 cervical and 40 trochanteric hip fractures. The results were compared with those of age-matched, control postmenopausal women. No statistically significant difference was found in the values of BMD, BMI, and HAL between the groups of patients with cervical and those with trochanteric fractures, but lower BMD and BMI were found in fracture patients compared with the corresponding values of the control subjects. Contrary to the existing data, HAL was found to be shorter in the fracture patients compared with the controls. Thus, the type of hip fracture was found to be independent of the value of BMD, BMI, and the length of the patient's hip axis. The fact that a shorter hip axis was found in the group of fracture patients compared with that found in the control subjects raises questions about the significance of this parameter as an independent risk factor for hip fracture.
Subject(s)
Body Mass Index , Bone Density , Cervix Uteri/injuries , Femur/injuries , Hip Fractures/physiopathology , Hip Joint/pathology , Postmenopause , Aged , Aged, 80 and over , Cervix Uteri/physiopathology , Female , Femur/physiopathology , Greece , Hip Fractures/etiology , Humans , Middle AgedABSTRACT
We studied endogenic factors for the occurrence of cervical hip fractures in 256 patients. 230 underwent hemiarthroplasty, and 26 were treated with internal fixation or without surgery. The condition of the fractured hip and of the ipsilateral knee, as well as the mobility of the patient before the fracture, were studied in all 256 patients. The removed femoral heads were examined, photographed and radiographs were taken with sensitive film. The acetabulum and the femoral head were macroscopically normal in all 230 cases and there was no radiographic evidence of arthrosis. 64% of the patients were fully mobile before the fracture, 34% were mobile with the aid of a cane and 2% were dependent. In 88%, the ipsilateral knee was normal both clinically and radiographically, and in 12%, there was moderate arthrosis. When comparing the mobility before the fracture and the condition of the ipsilateral hip and knee in 100 patients having a cervical fracture with 100 patients having a trochanteric fracture matched for age and sex, we found that a normal hip joint was sine qua non while a normal ipsilateral knee and a fully mobile individual were important additional conditions for the occurrence of a cervical hip fracture, instead of a trochanteric one, after a fall in an elderly person.
Subject(s)
Femoral Neck Fractures/etiology , Hip Fractures/etiology , Osteoarthritis, Hip/complications , Accidental Falls , Aged , Arthroplasty, Replacement, Hip , Chi-Square Distribution , Female , Femoral Neck Fractures/therapy , Hip Fractures/therapy , Humans , Incidence , Male , Osteoarthritis, Hip/diagnostic imaging , Osteoarthritis, Hip/physiopathology , Radiography , Range of Motion, Articular , Risk FactorsABSTRACT
In 11 patients with a Rolando's fracture of the first metacarpal, the mini-Hoffman external fixation was used to maintain closed reduction of the fracture, with two pins placed distally in the first metacarpal and one pin proximally in the trapezium. The results were excellent in 7 patients; in 3 patients mild arthritis was noted radiographically, and one patient had a poor result because of severe postraumatic arthritis 1-5 years (mean 30 months) after the injury. This method of treatment is proposed for patients with Rolando's fracture as it is very easily performed and provides good results.
Subject(s)
Fracture Fixation/methods , Fractures, Bone/therapy , Metacarpus/injuries , Adult , Aged , External Fixators , Female , Fracture Fixation/instrumentation , Fractures, Bone/diagnostic imaging , Humans , Male , Metacarpus/diagnostic imaging , Middle Aged , RadiographyABSTRACT
An H-shaped device was invented to facilitate placement of the distal interlocking screws during closed femoral nailing. Eleven sound cadaveric femurs were experimentally nailed before the application of the device in 15 patients with a femoral shaft fracture. In all experimental cases the insertion of the distal screws proved to be easy. In 11 of 15 patients with a femoral fracture, distal locking was achieved using the H-device. These primary results should stimulate further clinical application of the device.
Subject(s)
Bone Nails , Bone Screws , Femoral Fractures/surgery , Fracture Fixation, Intramedullary/instrumentation , Fracture Fixation, Intramedullary/methods , HumansABSTRACT
Shoulder dislocation associated with ipsilateral humeral shaft fracture is an uncommon combination. Two cases treated, one by open and the other by closed methods, are presented. The mechanism of this complex injury is detailed and the treatment modalities are discussed. The relevant literature is reviewed.
Subject(s)
Humeral Fractures/complications , Shoulder Dislocation/complications , Adult , Humans , Humeral Fractures/diagnostic imaging , Humeral Fractures/surgery , Male , Middle Aged , Radiography , Shoulder Dislocation/diagnostic imaging , Shoulder Dislocation/surgeryABSTRACT
This is a prospective study of 106 patients with 37 stable and 69 unstable trochanteric fractures treated with 2 different implants: a sliding screw-plate and a triflanged nail-plate. The fractures were classified according to Jensen's modification of Evans classification. The parameter migration was compared between the 2 implants and for the various areas of placement of the screw or nail within the femoral head. For stable fractures, the migration observed was independent of the area of implant placement or the type of implant used. For unstable fractures, central placement of the sliding screw resulted in a decreased mean value of migration. When the nail was used, the mean values of migration observed were independent of the areas of placement within the femoral head. In cases of central placement, the sliding screw appeared to be superior to the triflanged nail.
