The Experts below are selected from a list of 1308 Experts worldwide ranked by ideXlab platform
Mario Ronga - One of the best experts on this subject based on the ideXlab platform.
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blood loss in trochanteric fractures multivariate analysis comparing Dynamic Hip Screw and gamma nail
Injury-international Journal of The Care of The Injured, 2017Co-Authors: Mario Ronga, Daniele Bonzini, Marco Valoroso, Giuseppe La Barbera, Jacopo Tamini, Mario Cherubino, Paolo CherubinoAbstract:Abstract Introduction Anaemia in patients with trochanteric fracture is associated with increased morbidity and mortality and it is an independent risk factor for functional mobility of patients. Several authors have reported the blood loss following operative treatment comparing different fixation systems but few authors have evaluated many associated variables that could influence the perioperative blood loss. Purpose To evaluate the blood loss in patients that had their trochanteric fracture stabilized with Dynamic Hip Screw (DHS) or Gamma nail. Multivariate analysis of different variables that can influence blood loss was carried out (type of fracture, antiaggregant or anticoagulant therapy, time to surgery). The hypothesis was that there is no difference in terms of blood loss in patients with trochanteric fracture treated with DHS or Gamma nail considering all these variables. Materials & Methods Perioperative blood loss was evaluated in 417 consecutive patients treated for trochanteric fracture with DHS or Gamma nail between January 2010 and March 2013. The perioperative blood loss was calculated using the Lisander formula modified by Foss-Kehlet based on pre- and post-operative haemoglobin values and transfusion rates. Univariate and multivariate analysis were performed integrating the following variables: type of fracture (A1 vs A2), antiaggregant/anticoagulant therapy vs no therapy, time to surgery ( 24 hours from trauma), type of implant (DHS vs Gamma nail). Results A significant blood loss (p 24 hours from trauma (1584.4 ml vs 1323.9 ml), DHS and Gamma nail (894.7 ml vs 1720.6 ml). At multivariate analysis, in the A1 fracture groups the DHS showed a significant lower blood loss compared to Gamma nail (p Conclusions According to the perioperative blood loss, DHS should be used in A1 fractures while Gamma nail can be taking in account for the unstable A2 fractures.
Rahul Agarwal - One of the best experts on this subject based on the ideXlab platform.
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role of valgus osteotomy and fixation with Dynamic Hip Screw and 120 double angle barrel plate in the management of neglected and ununited femoral neck fracture in young patients
Journal of Orthopaedics and Traumatology, 2009Co-Authors: Abdul Qayyum Khan, Mohammad Shahnawaz Khan, Mohammed Khalid Anwar Sherwani, Rahul AgarwalAbstract:Head preservation is the mainstay of management in younger patients with neglected or ununited intracapsular fracture neck of femur. Very few reports have dealt with the results of valgus intertrochanteric osteotomy and fixation with Dynamic Hip Screw in such cases. In this prospective study, we have tried to evaluate the role of valgus osteotomy and fixation with Dynamic Hip Screw and 120° double angle barrel plate in neglected or ununited intracapsular fracture neck of femur in patients below 60 years of age and whose time since injury is equal to or more than 3 weeks. We treated 16 such cases with valgus intertrochanteric osteotomy and fixation achieved with Dynamic Hip Screw and 120° double angle barrel plate, with mean age of 36.4 years. The cases were evaluated radiologically and clinically at a mean of 19 months. In 14 of the 16 patients, the fracture went on to satisfactory union after an average of 14.7 weeks (10–26.7 weeks). The average Harris Hip score increased from 66.6 points (range 55–75 points) before surgery to 88 points (range 75–95 points). All the patients with united fractures were able to sit cross-legged, squat and do one-leg stance. Pain and limitation of motion improved remarkably. Two patients had unfavourable outcome; both had cut-through of the implant, out of the head. Valgus intertrochanteric osteotomy is a very cheap and effective procedure to achieve union in neglected and ununited fracture neck femur in young patients. We propose fixation with Dynamic Hip Screw and 120° double angle barrel plate as it provides additional compression and, with valgus osteotomy, improved stability of internal fixation, with few complications.
Mohammad Javad Zehtab - One of the best experts on this subject based on the ideXlab platform.
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a comparative study between multiple cannulated Screws and Dynamic Hip Screw for fixation of femoral neck fracture in adults
International Orthopaedics, 2015Co-Authors: Babak Siavashi, Arash Aalirezaei, Mersad Moosavi, Mohammad Reza Golbakhsh, Dariush Savadkoohi, Mohammad Javad ZehtabAbstract:Purpose In younger adults with fractures of the femoral neck, anatomic reduction is compulsory and maintaining the reduction is crucial. Both cannulated Screws and Dynamic Hip Screw (DHS) have the capacity of compression in the fracture site but the strength for keeping reduction is not the same. The aim of this study was to compare the results with fixations of the femoral neck fractures with cannulated Screws versus Dynamic Hip Screw.
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a comparative study between multiple cannulated Screws and Dynamic Hip Screw for fixation of femoral neck fracture in adults
International Orthopaedics, 2015Co-Authors: Babak Siavashi, Arash Aalirezaei, Mersad Moosavi, Mohammad Reza Golbakhsh, Dariush Savadkoohi, Mohammad Javad ZehtabAbstract:In younger adults with fractures of the femoral neck, anatomic reduction is compulsory and maintaining the reduction is crucial. Both cannulated Screws and Dynamic Hip Screw (DHS) have the capacity of compression in the fracture site but the strength for keeping reduction is not the same. The aim of this study was to compare the results with fixations of the femoral neck fractures with cannulated Screws versus Dynamic Hip Screw. This is a randomized clinical trial study on 58 cases with a minimum of one year follow-up. Leg length discrepancy, Harris Hip Score, infection, avascular necrosis of femoral head, and union of the fracture site were evaluated. There were two failures in the first trimester in the cannulated Screw group and three more failures in the second and third trimesters in this group. In the DHS group, there was no reduction and fixation failure in the follow-up period. There was no fixation failure (0 %) in Group B (DHS) but there were five fixation failures (18 %) in Group A (Screw), and there is significant difference between the groups (p < 0.001). The rate of avascular necrosis was the same in both groups. It seems to us that in our practice the fixation of femoral neck fracture in young adults with the DHS is a better option compared with the osteosynthsis with multiple cannulated Screws.
B J J Houben - One of the best experts on this subject based on the ideXlab platform.
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percutaneous compression plating pccp versus the Dynamic Hip Screw for pertrochanteric Hip fractures preliminary results
Injury-international Journal of The Care of The Injured, 2002Co-Authors: S E Brandt, S Lefever, H M J Janzing, P L O Broos, P Pilot, B J J HoubenAbstract:Abstract The percutaneous compression plate (PCCP) is a new implant for the minimally invasive treatment of pertrochanteric Hip fractures that might reduce blood loss, wound problems and prevent devascularization of bone fragments. A quicker operation with minimal blood loss is better in the older patients. We performed a prospective, randomized clinical trial to compare the PCCP with the well-known Dynamic Hip Screw (DHS). A total of 71 patients with an Evans type 1A–D pertrochanteric Hip fractures were included. We measured the operation duration, blood loss, wound healing, complications, fracture healing and functional outcome. In total, 33 PCCP and 38 DHS were implanted. The mean operation times were 69.2 and 46.6 min for DHS and PCCP, respectively ( P =0.000). Blood transfusions were given in 24 DHS patients compared with six PCCP patients ( P =0.000). There were 27 haematomas in the DHS group and eight in the PCCP group ( P =0.000). There were no differences in fracture healing and the functional outcome between the two implants ( P =0.767, ns). Although this is a preliminary study with a relatively small number of patients and short follow-up, the PCCP seems similar to the DHS in relation to bone healing and stability, but with significant advantages for blood loss, soft tissue healing and operation time.
Paolo Cherubino - One of the best experts on this subject based on the ideXlab platform.
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blood loss in trochanteric fractures multivariate analysis comparing Dynamic Hip Screw and gamma nail
Injury-international Journal of The Care of The Injured, 2017Co-Authors: Mario Ronga, Daniele Bonzini, Marco Valoroso, Giuseppe La Barbera, Jacopo Tamini, Mario Cherubino, Paolo CherubinoAbstract:Abstract Introduction Anaemia in patients with trochanteric fracture is associated with increased morbidity and mortality and it is an independent risk factor for functional mobility of patients. Several authors have reported the blood loss following operative treatment comparing different fixation systems but few authors have evaluated many associated variables that could influence the perioperative blood loss. Purpose To evaluate the blood loss in patients that had their trochanteric fracture stabilized with Dynamic Hip Screw (DHS) or Gamma nail. Multivariate analysis of different variables that can influence blood loss was carried out (type of fracture, antiaggregant or anticoagulant therapy, time to surgery). The hypothesis was that there is no difference in terms of blood loss in patients with trochanteric fracture treated with DHS or Gamma nail considering all these variables. Materials & Methods Perioperative blood loss was evaluated in 417 consecutive patients treated for trochanteric fracture with DHS or Gamma nail between January 2010 and March 2013. The perioperative blood loss was calculated using the Lisander formula modified by Foss-Kehlet based on pre- and post-operative haemoglobin values and transfusion rates. Univariate and multivariate analysis were performed integrating the following variables: type of fracture (A1 vs A2), antiaggregant/anticoagulant therapy vs no therapy, time to surgery ( 24 hours from trauma), type of implant (DHS vs Gamma nail). Results A significant blood loss (p 24 hours from trauma (1584.4 ml vs 1323.9 ml), DHS and Gamma nail (894.7 ml vs 1720.6 ml). At multivariate analysis, in the A1 fracture groups the DHS showed a significant lower blood loss compared to Gamma nail (p Conclusions According to the perioperative blood loss, DHS should be used in A1 fractures while Gamma nail can be taking in account for the unstable A2 fractures.
