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Conservative Management of Stable, Minimally Displaced Pertrochanteric Fractures: A Case Series
BACKGROUND: Hip fractures are common, and account for significant morbidity and mortality. While surgical intervention remains the gold standard, nonoperative treatment protocols are seldom analysed and may be of value in select settings. OBJECTIVES: We sought to review our conservatively treated pe...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010580/ https://www.ncbi.nlm.nih.gov/pubmed/36923814 http://dx.doi.org/10.4103/jwas.jwas_223_22 |
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author | Mercouris, Matthew Klopper, Schalk Swanepoel, Stefan Maqungo, Sithombo Laubscher, Maritz Roche, Stephan Kauta, Ntambue |
author_facet | Mercouris, Matthew Klopper, Schalk Swanepoel, Stefan Maqungo, Sithombo Laubscher, Maritz Roche, Stephan Kauta, Ntambue |
author_sort | Mercouris, Matthew |
collection | PubMed |
description | BACKGROUND: Hip fractures are common, and account for significant morbidity and mortality. While surgical intervention remains the gold standard, nonoperative treatment protocols are seldom analysed and may be of value in select settings. OBJECTIVES: We sought to review our conservatively treated pertrochanteric fractures and present a case series that outlined indications, treatment protocol and early outcomes. MATERIALS AND METHODS: A retrospective review of medical records and radiographic imaging of all patients who presented with stable pertrochanteric fractures and were treated nonoperatively, from September 2017 to February 2021, at a Level 2 District Hospital in South Africa. RESULTS: Of the 242 patients who were admitted with pertrochanteric fractures, 12 (4.9%) fractures were radiographically classified as AO 31A1.2 (stable, minimally displaced) and eligible for active nonoperative management. Within 6 weeks of injury, 10 (84%) of the patients who received active nonoperative treatment achieved union. Two patients (16%) failed the treatment protocol and required surgery, with one failing during the hospital phase of the treatment protocol and the other on follow up. In the group of united fractures, the neck shaft angle was on average within 3 degrees of the contralateral hip with a range of 0 to 5 degrees. At follow-up, two (16%) patients had a measurable shortening of 5 mm at union. There was no medical morbidity associated with this protocol. CONCLUSIONS: In our case series, the active nonoperative management protocol, involving early mobilisation and serial radiographs, in select cases of stable pertrochanteric fractures yielded acceptable outcomes. This is of relevance in low-middle income countries with limited surgical capacity. |
format | Online Article Text |
id | pubmed-10010580 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-100105802023-03-14 Conservative Management of Stable, Minimally Displaced Pertrochanteric Fractures: A Case Series Mercouris, Matthew Klopper, Schalk Swanepoel, Stefan Maqungo, Sithombo Laubscher, Maritz Roche, Stephan Kauta, Ntambue J West Afr Coll Surg Original Article BACKGROUND: Hip fractures are common, and account for significant morbidity and mortality. While surgical intervention remains the gold standard, nonoperative treatment protocols are seldom analysed and may be of value in select settings. OBJECTIVES: We sought to review our conservatively treated pertrochanteric fractures and present a case series that outlined indications, treatment protocol and early outcomes. MATERIALS AND METHODS: A retrospective review of medical records and radiographic imaging of all patients who presented with stable pertrochanteric fractures and were treated nonoperatively, from September 2017 to February 2021, at a Level 2 District Hospital in South Africa. RESULTS: Of the 242 patients who were admitted with pertrochanteric fractures, 12 (4.9%) fractures were radiographically classified as AO 31A1.2 (stable, minimally displaced) and eligible for active nonoperative management. Within 6 weeks of injury, 10 (84%) of the patients who received active nonoperative treatment achieved union. Two patients (16%) failed the treatment protocol and required surgery, with one failing during the hospital phase of the treatment protocol and the other on follow up. In the group of united fractures, the neck shaft angle was on average within 3 degrees of the contralateral hip with a range of 0 to 5 degrees. At follow-up, two (16%) patients had a measurable shortening of 5 mm at union. There was no medical morbidity associated with this protocol. CONCLUSIONS: In our case series, the active nonoperative management protocol, involving early mobilisation and serial radiographs, in select cases of stable pertrochanteric fractures yielded acceptable outcomes. This is of relevance in low-middle income countries with limited surgical capacity. Wolters Kluwer - Medknow 2023 2023-01-18 /pmc/articles/PMC10010580/ /pubmed/36923814 http://dx.doi.org/10.4103/jwas.jwas_223_22 Text en Copyright: © 2023 Journal of West African College of Surgeons https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Mercouris, Matthew Klopper, Schalk Swanepoel, Stefan Maqungo, Sithombo Laubscher, Maritz Roche, Stephan Kauta, Ntambue Conservative Management of Stable, Minimally Displaced Pertrochanteric Fractures: A Case Series |
title | Conservative Management of Stable, Minimally Displaced Pertrochanteric Fractures: A Case Series |
title_full | Conservative Management of Stable, Minimally Displaced Pertrochanteric Fractures: A Case Series |
title_fullStr | Conservative Management of Stable, Minimally Displaced Pertrochanteric Fractures: A Case Series |
title_full_unstemmed | Conservative Management of Stable, Minimally Displaced Pertrochanteric Fractures: A Case Series |
title_short | Conservative Management of Stable, Minimally Displaced Pertrochanteric Fractures: A Case Series |
title_sort | conservative management of stable, minimally displaced pertrochanteric fractures: a case series |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010580/ https://www.ncbi.nlm.nih.gov/pubmed/36923814 http://dx.doi.org/10.4103/jwas.jwas_223_22 |
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