Journal of the Southern Orthopaedic Association
-
J South Orthop Assoc · Jan 1998
Femur fractures in patients with hip arthroplasty: indications for revision arthroplasty.
The number of periprosthetic femur fractures has increased due to the increase in the number of patients having total hip arthroplasty. In this study, we define indications for operative treatment in patients with femur fractures after hip arthroplasty. Fifty-three patients with 56 periprosthetic fractures were available for retrospective review of charts, radiographs, and physical examination; 42 fractures were treated with open reduction and internal fixation, 8 had replacement of hip prosthesis, 4 were treated with a retrograde genucephalic nail, and 2 patients were treated conservatively. ⋯ We recommend treatment with plate fixation for fractures without signs of prosthetic loosening. In fractures with loose implants, revision arthroplasty is required. Distal femoral fractures should be stabilized with a plate or with genucephalic nailing.
-
Spinal injuries resulting from falls out of tree stands are often associated with concomitant neurologic deficit, prolonged hospitalization, and long-term disability. The purpose of this study was to review the types of spinal injuries that resulted from falls from hunting tree stands. We retrospectively reviewed 27 patients who came to our institution for treatment of spine injuries related to tree-stand accidents between 1981 and 1997. ⋯ The remaining patients were treated in rigid, molded, polypropylene thoracolumbar orthoses or lumbosacral corsets. Accidental falls from tree stands may result in significant spinal fractures often associated with concomitant neurologic injury, extended hospitalization, and permanent disability. Many of these injuries may be prevented through aggressive hunter safety education.
-
Shoulder arthroscopy can be a safe and effective tool to perform a variety of diagnostic and therapeutic procedures about the shoulder. Careful attention to positioning, fluid management, use of traction, and appreciation of shoulder anatomy to select portal placement will help decrease the common complications associated with shoulder arthroscopy. The awareness of uncommon complications, such as deep venous thrombosis, pneumothorax, and iatrogenic rotator cuff tears will help the orthopedic surgeon to promptly diagnose and treat these problems.
-
J South Orthop Assoc · Jan 1997
Comparative StudyComparison of compression hip screw and gamma nail for treatment of peritrochanteric fractures.
Twenty-seven peritrochanteric fractures in 27 patients were evaluated and treated prospectively. Ten fractures were internally fixed with compression hip screws (CHS) (Omega Howmedica, Rutherford, NJ) and 135 degrees, four-hole side plates. Internal fixation of the posteromedial fragment was not done. ⋯ Fractures of the femoral shaft were believed to be caused by two factors: a mismatch of the nail design and the normal geometry of the proximal femur and stress risers in the femoral shaft caused by repeatedly missing the screw hole with the drill bit. Although the Gamma nail is an excellent device for stabilizing and preventing collapse of unstable peritrochanteric fractures, the learning curve is high, and femoral shaft fractures can occur. We believe precautions outlined in this report are helpful in preventing these complications.