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CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD

Objective: We developed this study with the aim of evaluating the results from treating patients with proximal femoral fractures, in a series of cases. We sought to observe the influence of the most prevalent complications on the final results after a minimum follow-up of two years. We especially co...

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Autores principales: Astur, Diego da Costa, Arliani, Gustavo Gonçalves, Nascimento, Carolina Lins e Silva, Blumetti, Francesco Camara, Fonseca, Marcio José Alher, Dobashi, Eiffel Tsuyoshi, Pinto, José Antonio, Ishida, Akira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4799117/
https://www.ncbi.nlm.nih.gov/pubmed/27022575
http://dx.doi.org/10.1016/S2255-4971(15)30392-X
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author Astur, Diego da Costa
Arliani, Gustavo Gonçalves
Nascimento, Carolina Lins e Silva
Blumetti, Francesco Camara
Fonseca, Marcio José Alher
Dobashi, Eiffel Tsuyoshi
Pinto, José Antonio
Ishida, Akira
author_facet Astur, Diego da Costa
Arliani, Gustavo Gonçalves
Nascimento, Carolina Lins e Silva
Blumetti, Francesco Camara
Fonseca, Marcio José Alher
Dobashi, Eiffel Tsuyoshi
Pinto, José Antonio
Ishida, Akira
author_sort Astur, Diego da Costa
collection PubMed
description Objective: We developed this study with the aim of evaluating the results from treating patients with proximal femoral fractures, in a series of cases. We sought to observe the influence of the most prevalent complications on the final results after a minimum follow-up of two years. We especially considered the relationship between establishment of avascular necrosis and the time between the accident and the therapeutic intervention. Method: We retrospectively studied proximal extremity fractures of the femur in 29 patients under 14 years of age between 1988 and 2007. We analyzed the following variables: sex, age, mechanism of injury, fracture classification (Delbet), treatment administered, complications (pseudarthrosis, varus deformity, leg length discrepancy and avascular necrosis), duration of surgery and results (Ratliff). We carried out individual descriptive analysis on each variable. The tests were used in accordance with the premise that normality applied. For the evaluation, we used Fisher's exact test. Results: Five patients (17.2%) had avascular necrosis, and three of them (60.0%) were over 10 years of age. 73.3% of the patients treated within the first 24 hours showed good results. The most common cause of fractures was traffic accidents (44.8%). The best results were observed among patients who were treated surgically. 41.4% developed some type of complication. Conclusions: Among the 29 patients treated, 58.6% had good, 27.6% had regular and 13.8% had poor results, according to the Ratliff criteria. When conservative treatment was applied, only 17.0% had good results, while 69.3% had good results from surgical intervention. Likewise, 73.3% of the results were good results when surgery was performed within the first 24 hours and only 42.8% of the results were good among patients who underwent surgery after this period. Patients operated within the first 24 hours developed necrosis of the femoral head in 13.3% of cases, while 21.4% of those operated after this period developed this complication.
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spelling pubmed-47991172016-03-28 CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD Astur, Diego da Costa Arliani, Gustavo Gonçalves Nascimento, Carolina Lins e Silva Blumetti, Francesco Camara Fonseca, Marcio José Alher Dobashi, Eiffel Tsuyoshi Pinto, José Antonio Ishida, Akira Rev Bras Ortop Original Article Objective: We developed this study with the aim of evaluating the results from treating patients with proximal femoral fractures, in a series of cases. We sought to observe the influence of the most prevalent complications on the final results after a minimum follow-up of two years. We especially considered the relationship between establishment of avascular necrosis and the time between the accident and the therapeutic intervention. Method: We retrospectively studied proximal extremity fractures of the femur in 29 patients under 14 years of age between 1988 and 2007. We analyzed the following variables: sex, age, mechanism of injury, fracture classification (Delbet), treatment administered, complications (pseudarthrosis, varus deformity, leg length discrepancy and avascular necrosis), duration of surgery and results (Ratliff). We carried out individual descriptive analysis on each variable. The tests were used in accordance with the premise that normality applied. For the evaluation, we used Fisher's exact test. Results: Five patients (17.2%) had avascular necrosis, and three of them (60.0%) were over 10 years of age. 73.3% of the patients treated within the first 24 hours showed good results. The most common cause of fractures was traffic accidents (44.8%). The best results were observed among patients who were treated surgically. 41.4% developed some type of complication. Conclusions: Among the 29 patients treated, 58.6% had good, 27.6% had regular and 13.8% had poor results, according to the Ratliff criteria. When conservative treatment was applied, only 17.0% had good results, while 69.3% had good results from surgical intervention. Likewise, 73.3% of the results were good results when surgery was performed within the first 24 hours and only 42.8% of the results were good among patients who underwent surgery after this period. Patients operated within the first 24 hours developed necrosis of the femoral head in 13.3% of cases, while 21.4% of those operated after this period developed this complication. Elsevier 2015-11-17 /pmc/articles/PMC4799117/ /pubmed/27022575 http://dx.doi.org/10.1016/S2255-4971(15)30392-X Text en © 2010 Sociedade Brasileira de Ortopedia e Traumatologia http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Astur, Diego da Costa
Arliani, Gustavo Gonçalves
Nascimento, Carolina Lins e Silva
Blumetti, Francesco Camara
Fonseca, Marcio José Alher
Dobashi, Eiffel Tsuyoshi
Pinto, José Antonio
Ishida, Akira
CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD
title CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD
title_full CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD
title_fullStr CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD
title_full_unstemmed CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD
title_short CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD
title_sort correlation between avascular necrosis and early stabilization of proximal femoral fractures in childhood
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4799117/
https://www.ncbi.nlm.nih.gov/pubmed/27022575
http://dx.doi.org/10.1016/S2255-4971(15)30392-X
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