Consideration of technical developments, a review of the literature and of our own experience with 535 patients compared with nearly 20,000 patients of an ASIF population treated during the same period show that the indications for treatment of extra- and intracapsular fractures of the proximal femur have become much simpler. (1) Extracapsular fractures of the proximal femur fall into two groups: pertrochanteric fractures are fixed by means of the dynamic hip screw and intratrochanteric unstable fractures by means of either the dynamic hip screw (valgus type) or a 95 degrees condylar plate. (2) Intracapsular fractures are treated according to the patient's age group. In patients younger than 70 years femoral head preservation is achieved by compressing screw osteosyntheses, while in patients over 70 years head resection is performed an a total endoprothesis inserted. In patients with life expectation shorter than 3-5 years a femoral head prothesis is inserted.
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Bone Joint J
January 2025
Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Kadoorie Centre, University of Oxford, Oxford, UK.
Aims: There is compelling evidence for the use of cemented hip hemiarthroplasty for displaced intracapsular hip fractures; however, the risks of cement are well reported and in rare cases may be associated with haemodynamic collapse. It is therefore important to improve our understanding of haemodynamic instability, intraoperative monitoring, and strategies to reduce the risk to patients.
Methods: We measured arterial blood pressure using the LiDCO Continuous Non-invasive Arterial Pressure (CNAP) finger cuff during surgery in patients enrolled in the WHiTE 5 trial randomized to cemented or modern uncemented hip hemiarthroplasty at a single recruiting site.
Oral Dis
December 2024
Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Background: The treatment procedure for intracapsular condylar fractures (ICF) is still being debated. The temporomandibular joint (TMJ) disc is a key factor for treating ICF. The study aims to investigate the changes in TMJ disc status and condylar cartilage regeneration following ICF in a rabbit model, to assist in planning treatment.
View Article and Find Full Text PDFBMJ Case Rep
December 2024
Trauma and Orthopaedics, Lewisham and Greenwich NHS Trust, London, UK.
J Bone Joint Surg Am
December 2024
Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, Scotland.
Background: There is a paucity of longer-term outcome data in younger adult patients who undergo fixation for an intracapsular hip fracture. The aims of this study were to evaluate the outcomes for young adult patients undergoing intracapsular hip fracture fixation and to assess factors associated with failure and patient-reported outcome measures (PROMs).
Methods: From 2008 to 2018, 112 consecutive patients ≤60 years of age (mean age, 48 years [range, 20 to 60 years]; 54% male) were retrospectively identified as having undergone fixation of an intracapsular hip fracture.
Orthop Traumatol Surg Res
December 2024
Société Française de Chirurgie Orthopédique et Traumatologique, 56 rue Boissonade, 75014 Paris Cedex, France.
Introduction: Lower limb length discrepancy (LLD) following hip arthroplasty after proximal femoral fracture (PFFA) is little studied. The aim of this work was to answer the following questions: 1) What are the incidence and mean values of LLD after PFFA? 2) What are the clinical consequences (tolerance) of LLD after PFFA? 3) Can we identify risk factors for LLD after PFFA? 4) Is there a significant difference in terms of LLD after PFFA to treat intra- versus extra-capsular fractures?
Hypothesis: LLD after proximal femoral fracture arthroplasty is rare but has good clinical tolerance, given the low functional demands of the patients.
Patients And Methods: This is a multicenter prospective observational cohort study (15 centers), including 590 patients, operated on for hip arthroplasty for proximal femur fracture between May 2022 and June 2023.
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