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Extra Articular Distal Femoral Fractures in the Elderly Treated with Retrograde Nailing Using a Spiral-Locking Blade System
BACKGROUND: The number of elderly patients sustaining long bone fractures is increasing with the rise of elderly population in the western world. Management of distal femur fractures is particularly difficult due to osteoporosis and other associated comorbidities. The key to management would be by s...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415554/ https://www.ncbi.nlm.nih.gov/pubmed/30967690 http://dx.doi.org/10.4103/ortho.IJOrtho_590_17 |
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author | D'sa, Prashanth Karuppiah, Saravana Vail |
author_facet | D'sa, Prashanth Karuppiah, Saravana Vail |
author_sort | D'sa, Prashanth |
collection | PubMed |
description | BACKGROUND: The number of elderly patients sustaining long bone fractures is increasing with the rise of elderly population in the western world. Management of distal femur fractures is particularly difficult due to osteoporosis and other associated comorbidities. The key to management would be by surgical stabilization, which allows early mobilization. This study was devised to look into the radiological outcome and complication rate in a series of elderly patients who were treated with retrograde nail using spiral locking blade system for extra articular distal femur fractures. MATERIALS AND METHODS: This is a retrospective study of patients who have undergone retrograde nailing with spiral-locking blade for distal femoral fractures (extra articular) above the age of 70 years in a major trauma center from 2001 to 2015. Notes were assessed for postoperative complications; time to union and final postoperative followup radiographs were assessed for alignment using a scoring system. RESULTS: Forty one patients with an average age of 80 years and an average followup period of 9 months were included. The mean radiological score at final followup was 10.34 (range 8–12), with no significant shortening in any of the patients. Thirty patients had excellent radiological score (>10) and 11 patients scored good (8–9). The difference in time to union between Group 1 – simple fracture pattern (3.42 months) and Group 2 – complex comminuted fracture pattern (4.74 months) was not statistically significant (P = 0.072). There were five delayed unions but no cutout or metal work failure. CONCLUSION: The retrograde femoral nail with distal spiral-locking blade system can be a good surgical option for the treatment of extra articular distal femoral fractures in the elderly with the possibility of early weightbearing. |
format | Online Article Text |
id | pubmed-6415554 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-64155542019-04-09 Extra Articular Distal Femoral Fractures in the Elderly Treated with Retrograde Nailing Using a Spiral-Locking Blade System D'sa, Prashanth Karuppiah, Saravana Vail Indian J Orthop Original Article BACKGROUND: The number of elderly patients sustaining long bone fractures is increasing with the rise of elderly population in the western world. Management of distal femur fractures is particularly difficult due to osteoporosis and other associated comorbidities. The key to management would be by surgical stabilization, which allows early mobilization. This study was devised to look into the radiological outcome and complication rate in a series of elderly patients who were treated with retrograde nail using spiral locking blade system for extra articular distal femur fractures. MATERIALS AND METHODS: This is a retrospective study of patients who have undergone retrograde nailing with spiral-locking blade for distal femoral fractures (extra articular) above the age of 70 years in a major trauma center from 2001 to 2015. Notes were assessed for postoperative complications; time to union and final postoperative followup radiographs were assessed for alignment using a scoring system. RESULTS: Forty one patients with an average age of 80 years and an average followup period of 9 months were included. The mean radiological score at final followup was 10.34 (range 8–12), with no significant shortening in any of the patients. Thirty patients had excellent radiological score (>10) and 11 patients scored good (8–9). The difference in time to union between Group 1 – simple fracture pattern (3.42 months) and Group 2 – complex comminuted fracture pattern (4.74 months) was not statistically significant (P = 0.072). There were five delayed unions but no cutout or metal work failure. CONCLUSION: The retrograde femoral nail with distal spiral-locking blade system can be a good surgical option for the treatment of extra articular distal femoral fractures in the elderly with the possibility of early weightbearing. Medknow Publications & Media Pvt Ltd 2019 /pmc/articles/PMC6415554/ /pubmed/30967690 http://dx.doi.org/10.4103/ortho.IJOrtho_590_17 Text en Copyright: © 2019 Indian Journal of Orthopaedics http://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 D'sa, Prashanth Karuppiah, Saravana Vail Extra Articular Distal Femoral Fractures in the Elderly Treated with Retrograde Nailing Using a Spiral-Locking Blade System |
title | Extra Articular Distal Femoral Fractures in the Elderly Treated with Retrograde Nailing Using a Spiral-Locking Blade System |
title_full | Extra Articular Distal Femoral Fractures in the Elderly Treated with Retrograde Nailing Using a Spiral-Locking Blade System |
title_fullStr | Extra Articular Distal Femoral Fractures in the Elderly Treated with Retrograde Nailing Using a Spiral-Locking Blade System |
title_full_unstemmed | Extra Articular Distal Femoral Fractures in the Elderly Treated with Retrograde Nailing Using a Spiral-Locking Blade System |
title_short | Extra Articular Distal Femoral Fractures in the Elderly Treated with Retrograde Nailing Using a Spiral-Locking Blade System |
title_sort | extra articular distal femoral fractures in the elderly treated with retrograde nailing using a spiral-locking blade system |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415554/ https://www.ncbi.nlm.nih.gov/pubmed/30967690 http://dx.doi.org/10.4103/ortho.IJOrtho_590_17 |
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