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Orthopaedics
Published in Kelvin Yan, Surgical and Anaesthetic Instruments for OSCEs, 2021
The dynamic hip screw is intended for compressible and reducible fractures. Fractures that are irreducible or incompressible are therefore contraindicated. Fractures with a high risk of avascular necrosis of the femoral head should contraindicate the use of dynamic hip screws. In these cases, a hip replacement is likely more beneficial.
Osteotomy to correct unstable intertrochanteric fractures
Published in K. Mohan Iyer, Hip Preservation Techniques, 2019
In fractures with severe commination, the operating surgeon can place the calcar spike (proximal fragment) into the medially displaced distal fragment without osteotomy. It helps to convert the unstable fracture configuration into the stable fracture pattern, and excellent results can be achieved with fixation of the fracture with a dynamic hip screw (Figure 32.6).
Single Best Answer Questions
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
A 35-year-old woman is hit by a car. The plain X-ray shows an intracapsular fracture of the right femoral neck. Select the operation you would recommend.TractionDynamic hip screwCannulated screwsIntramedullary hip screwHemiarthroplasty
Digital Assessment of the Implantation Angle of Proximal Femoral Nail Antirotation Helical Blade Using CT Three-dimensional Reconstruction
Published in Journal of Investigative Surgery, 2019
Feiyu Luan, Wenbo Wang, Ning Liu, Yanan Zhang, Jinyi Liu
Trochanteric fracture of the femur is one of the most common injuries in the elderly and carries a high morbidity and mortality rate.1,2 Treatment of these fractures aims at restoring early ambulation and minimization of future functional impairment and disability.3 Surgery remains the preferred approach for treatment of trochanteric fractures. A number of implants have been developed for extramedullary or intramedullary fixation;4 among them, the dynamic hip screw, an extramedullary device, has been widely accepted as the best device for treating stable intertrochanteric fractures,5,6 while the intramedullary device, proximal femoral nail antirotation (PFNA), has been widely used for almost all types of trochanteric fractures.3, 7
The Barthel Index and the Cumulated Ambulation Score are superior to the de Morton Mobility Index for the early assessment of outcome in patients with a hip fracture admitted to an acute geriatric ward
Published in Disability and Rehabilitation, 2019
Signe Hulsbæk, Rikke Faebo Larsen, Susanne Rosthøj, Morten Tange Kristensen
Known group’s validity was investigated by comparison of medians using quantile regression. Confidence intervals were obtained using bootstrap resampling based on 10,000 bootstrap samples. Discharge scores were investigated for patients discharged to own home compared to patients discharged back to nursing home or temporary rehabilitation facilities. Baseline scores were investigated for differences in scores of patients using a walking aid prefracture compared with patients not using a walking aid, and for patients operated with two screws/hemiarthroplasty [cervical femoral fractures] compared with scores of patients operated with dynamic hip screw (DHS) or intra-medullar hip screw (IMHS) [trochanteric fractures].
Numerical investigation of mechanical behavior of human femoral diaphysis in normal and defective geometry: experimental evaluation
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Moeinoddin Mahmoudi, Hossein Mahbadi
Many studies have used constant bone shapes and screws for simplifying their simulations. For example, in a FEA, Fouad (2010) numerically studied effects of mechanical properties of internal fixations (IF) and presence of a gap between the fractured bone and plate; the materials were considered to be titanium alloys, stainless steel, and a functionally graded material; although, human bone has a complex shape, the study has used a uniform cylindrical geometry. In another research, Sanderson et al. (2011, 2013) performed a FEA on tibia diaphysis with oblique osteotomy in cortical and isotropic material properties; a pressure load was applied to the proximal face, and the distal face was fixed. While the study considered complex periosteal shape, constant cross-sectional area was considered in central cavity or endosteal area. In fact, geometry or moment of inertia has an extensive effect on mechanical response of the bone. Threaded screws modeling in FEA presented by Gok et al. (2017, 2019). Chang et al. (2015) numerically studied effect of compression screws on femur bone in dynamic hip-screw system. But the biomedical screws were modeled by cylindrical geometries; researchers have claimed that simplifying the screws had not a distinctive different behavior compared with threaded screws in FEA. Application of artificial bones has been examined in several experimental investigations (e.g. Yánez et al. 2010); these researches has been conducted torsional and bending tests on artificial bones (e.g. cylindrical polyurethane bars known as osteoporotic generic bones) with LCP and DCP. While, variation of geometry through the length of bones has not been considered in most of these researches, optimizing methods in these studies were presented based on uniform geometry.