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Register a new userArthroplasty for Acute Hip Fractures, Early Results
تبديل مفصل الورك في كسور عنق الفخذ الحادّة نتائج قريبة المدى
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Damascus University ورقة بحثية
Publication date
2000
fields
Medicine
and research's language is
العربية
Authors
هيثم غنام( باحث )
Created by
Shamra Editor
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تبديل مفصل الورك البدئي في كسور عنق الفخذ الحادة، يجب أن يكون لمرضى مختارين آخذين بالحسبان عمر المريض، و الحالة العامة، و مدى الحياة المتوقعة، و بنية العظم و التغييرات المرضية الموجودة في المفصل قبل الرض، و نمط الإصابة... يتم الحصول على نتائج جيدة في المدى القريب بعد تبديل مفصل الورك البدئي عند الغالبية العظمى من المرضى مع عودتهم إلى النشاط و الفعالية بشكل جيد شرط توافر الظروف المناسبة لإجراء هذه العمليات مع توافر إمكانية التأهيل الجيد.
THA as a primary management for acute fractures around the hip should generally be reserved to a very selected few patients where the general condition, life expectancy, age, bone quality, pathological changes, type of injury... Primary THA for acute fractures around the hip done with proper patient selection under the proper condition, and requirements can result in good clinical results with excellent short-term survival of the prosthesis.
References used
Bochner RM, Pellicci PM, Lyden JP: Bipolar hemiarthroplasty fracture of the femoral neck., J Bone Joint Surg 70- A: 1001, 1988
Carnesale PG, Anderson LD: Primary prosthetic replacement for femoral neck fractures, Arch Surg 110: 27, 1975
Delamarter R, Moreland JR: Treatment of acute femoral neck fractures with total hip arthroplasty, Clin O rthop 218: 68, 1987
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This study includes ٨٠ cases of total knee Arthroplasty, They
were treated in Al-Moassat Hospital during the years ٢٠٠٠-
٢٠٠١.
Idiopathic primary osteoarthrihis was the main reason for total
knee Arthroplasly. Some cases of Rheumatoid arthritis w
ere
observed too.
The short term chinicaln gools of total arthoplasty include
restoration of the normal activity of the limb and pain relief ,
which can be obtained under the proper surgical condition,
and requirements, supported by better understanding of the
biomechanics of the knee joint and good rehabilitation there
after.
Background& Objective: The acetabular bone deficiency secondary to acetabular fractures presents a
complex clinical problem and a big challenge to the orthopedic surgeons due to the technical difficulties
related to this deficiency, considering tha
t significant number of patients treated either surgically or
without surgery will require T.H.A in the future.
The purpose of our study was to determine the outcome of T.H.R performed in patients with a history of
acetabular fracture.
Materials & Methods: We performed T.H.R in 21 patients with previous acetabular fractures in Al-Assad
Hospital between2004-2009prespectively, these cases were divided into 3 groups:
-first group formed of 7 patients were treated conservatively. Second group formed of 9 patients did an
open reduction and internal fixation by screws and plates.
-Third group formed of 5 elderly patients with fresh acetabular fractures and were treated primarily by a
total prosthesis with use a reinforcement Muller ring .
For the clinical evaluation of our cases we used the modified Harris Hip Score Scale and for the
radiological evaluation we used the Delee and Charnley scale system .
Results: Our overage Harris Hip Score was 83.(80 for the first group, 86 for the second group, and 83 for
the third group).
-No complications were encountered intraoperative, in the early postoperative period one case developed
superficial wound infection and treated by repeated dressing and antibiotic, there was one case of D.V.T
on the 4th day treated by rest and anticoagulant, and one case developed loosening of acetabular
component 8 months after T.H.A and underwent to revision.
Conclusion: T.H.R in acetabular fractures despite the difficulties faced during the procedure is a safe and
effective way to salvage the hip when secondary osteoarthritis develops, open reduction and internal
fixation of acetabular fractures may have benefits even if it fails to prevent posttraumatic arthritis
.Furthermore the clinical results of T.H.R after surgical treatment of acetabular fractures are better than
it after conservative treatment of these fractures.
Reinforcement ring is an ideal solution when the decision of T.H.R is taken as a primary treatment of
acetabular fractures depending on the indications described by Joly.
The study included 25 patients were followed up for two years joined together. The number of females ranged from 18 patients percentage of 72%, the number of males ranged 7 patients by 28%. The incidence of these fractures in women more than men by 3
/1, especially in the seventh and eighth decades where we note in this Study, a good results in females. Muscular weakness occur after surgery due to lack of use, and muscular weakness continue for a period of two years after the surgery, which suggests the use of exercise for a long time . There is a noticeable improvement in two years after the surgery for intracapsul femoral neck fractures within the portfolio in terms of clinical and functional findings, in addition to the improvement in activities of daily routine (functional) for the patient compared to the same segment of the patients one year after surgery. The early treatment and movement as possible to strengthen the muscles of the lower limbs and improve the adjacent joint movement, the absence of lesions associated , the period of hospitalization least for so, technique of surgery, medical care and physical activities encourage are the most important facturs that have helped to warning and predictable, then we get agood results as we wont.
The rate of venous thromboembolism is unacceptable without prophylaxis.
Venographic studies of patients without prophylaxis show that the deep vein-thrombosis rates range from
40-84% after total knee replacement, and rates of pulmonary embolism ran
ge from 1.5-10%.
Surgeons must balance the need for thromboprophylaxis with the need to avoid bleeding complications.
The purpose of this study is to evaluate the status of thrombo prophylaxis after primary total knee
replacement in ALMouassat university hospital, and to improve our outcome in future, to get better
results and fewer complications.
This research aims to convert CT data of hip bone that sufferining cancer to 3D
model, and designing metal implant of the infected area on the mechanical analysis
programs, to study operability and convenience in terms of distribution of stresses a
nd
forces just as in patient’s body after installation and under the guidance of the bone
surgeon.By depending on Mimics software to read the CT image and 3MATIC to convert
the image to 3D digital model after generation the surface and the volume of the implant,
the analysis process of stresess and forces in COMSOL software. Where after design and
analysis the metal implant was appropriate mechanicaly and do not contain dangerousareas
after the application of the expected forces.
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