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Surgery of the Hip
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Daud TS Chou, Jonathan Miles, John Skinner
A 15 cm skin incision is made with its midpoint lying over the posterior half of the greater trochanter (Figure 10.2). The proximal extent of the incision is curved posteriorly, to lie in the line of the fibres of the gluteus maximus. The distal portion lies along the line of the femoral shaft.
Extremity trauma
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Traction is often used in the treatment of femoral shaft fractures in adults as a temporary measure for comfort and to allow transfer of the patient, until definitive fixation can be undertaken. A Thomas splint is applied to the limb initially in a static fashion (Figure28.13a) and then, once in bed, balanced traction is applied to help pull the leg out to length and pull the splint off the ischial tuberosity (Figure28.13b).
Test Paper 5
Published in Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike, Get Through, 2017
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike
Femoral neck stress fractures are associated with the classic ‘female athlete triad’ of amenorrhoea, osteoporosis and eating disorders. Femoral neck stress fractures are often classified as tension side (superolateral or transverse) or compression side (inferolateral), with the contention that tension side fractures are associated with poorer prognosis and are potentially unstable. The femoral shaft is particularly susceptible to repetitive stresses on the medial compression side of the femur at the junction of the proximal and middle thirds.
A finite element analysis study based on valgus impacted femoral neck fracture under diverse stances
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Haowei Zhang, Xinsheng Xu, Shenghui Wu, Ying Liu, Jiong Mei
Chaudhry et al. (2020) analyzed the hip joint and focused on the fracture of the hip joint and found that: proximal hip joint fractures mostly occur in the elderly, and most occur in the femoral shaft under the same boundary conditions. With age, the possibility of hip fractures increases, and fractures tend to be more likely to be femoral heads. In the analysis of normal femoral gait, Gao et al. (2019) analyzed the force of the hip joint by anybody and found that the stress distribution is mainly distributed in the femur during the gait, and the stress peak value in the hip joint area is 1.2 MPa. Bai and Shang (2010) concluded that femoral fractures usually occur in the middle of the femoral shaft and at the femoral neck, which is basically same in this article. The stress is usually greater and the stress distribution is uneven, which will lead to a worse mechanical environment after the fracture, and secondary fractures may occur at these stress-concentrated parts (Xu 2014), especially the middle and lower part of the femoral neck. Future research will further study the relationship between implant-associated complications and the mechanical environment of the femoral neck fractures (Hrubina et al. 2013). Therefore, from the simulation results, the results are feasible
Cost utility analysis of intramedullary nailing and skeletal traction treatment for patients with femoral shaft fractures in Malawi
Published in Acta Orthopaedica, 2021
Linda Chokotho, Claire A Donnelley, Sven Young, Brian C Lau, Hao-Hua Wu, Nyengo Mkandawire, Jan-Erik Gjertsen, Geir Hallan, Kiran J Agarwal-Harding, David Shearer
The incidence of femoral shaft fractures in low- and middle-income countries (LMICs) is estimated to range from 16 to 46 per 100,000 people per year (Agarwal-Harding et al. 2015). In Malawi, which has 17.5 million inhabitants (National Statistical Office of Malawi 2019), a recent study estimated the prevalence of femoral shaft fractures at 1.4 per 100,000 people and incidence of 27 per 100,000 people per year (Agarwal-Harding et al. 2020), translating into approximately 4,700 fractures annually. For comparison, the annual incidence of femoral shaft fractures in Sweden is one third of that in Malawi (personal communication, Michael Möller, The Swedish Fracture Registry). The goal of treatment for these fractures is to achieve stability at the fracture site, thereby promoting union and painless weight-bearing, and allowing early patient rehabilitation. Treatment with intramedullary nailing (IMN) achieves this goal earlier and more consistently than skeletal traction (ST), and has become the gold standard for managing these fractures in high-income countries. In Malawi, however, treatment using ST, requiring patient immobilization in bed for at least 6 weeks, remains the mainstay treatment.
Interlocking Intramedullary Nailing Versus Locked Dual-Plating Fixation for Femoral Shaft Fractures in Patients with Multiple Injuries: A Retrospective Comparative Study
Published in Journal of Investigative Surgery, 2019
Tao Cheng, Rong-Gang Xia, Shi-Kui Dong, Xiao-Yu Yan, Cong-Feng Luo
Femur diaphysis is a common fracture site in trauma patients.1 An epidemiological study demonstrated that approximately 9.9 femoral shaft fractures (FSFs) occur in 100,000 adults per year, with higher age and gender-specific incidence among young males and elderly females.2 Intramedullary nailing (IMN) is now widely considered as the standard method in FSF treatment, with union rates of 99% and infection rates as low as 1% under stable biomechanical circumstances which provide sufficient torsional stability and bending stiffness.3–5 Despite satisfactory results, IMN presents potential complications in comminuted or length-unstable fractures, including nonunion, angular malalignment, malrotation, leg-length discrepancy, and femoral head necrosis.3,4,6,7 These complications may lead to prolonged patient morbidity, gait abnormality, inability to return to work, reoperation, and psychoemotional impairment. IMN use for surgical treatment of highly complex FSFs remains challenging in clinical practice.4,7