Background: Intertrochanteric fractures is the most commonly treated fractures by orthopaedic surgeon. Many techniques are described in literature but internal fixation with Dynamic Hip screw is most efficient method.
Aim: The present study is conducted compare the results of conservative methods and internal fixation with dynamic hip screw in management of intertrochanteric fractures of the femur.
Materials and methods: This study includes 40 patients of intertrochanteric fractures of the femur, out of which 30 patients were treated by conservative methods considered as Group I and 10 patients were treated by internal fixation with Dynamic hip Screw (DHS) considered as Group II. All the results were evaluated by using Kyle’s criteria.
Results:
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Patients who were non ambulatory prior to fracture.
2. Patients with severe anaemia.
3. Poor cardiovascular and pulmonary status.
4. Osteoporotic patients.
For internal fixation with Dynamic Hip Screw.
1. Patients who were ambulatory prior to fracture.
2. Patients who were in stable medical condition to tolerate the stress of surgery and anaesthesia.
All patients were subjected to take detailed clinical history, examination of the injured hip, assessment of neuro vascular status of limb associated with injury, radiological examination of hip.
Implants used: DHS lag screw, Compression Screw, 1350 DHS Barral Plate, 4.5mm cortical screws.
Evaluation of the results: The results will be evaluated and graded as excellent, good and poor as per criteria of Kyle (1979).
(a) Excellent : No pain, minimum limp, normal range of motion, can walk without support, can squat and sit cross legged, no shortening
(b) Good: occasional mild pain, noticeable limp, acceptable range of motion, can walk with the help of cane. Can squat and sit cross-legged shortening less than two cm.
(c) Poor: moderate pain, marked limp, limited range of motion, can’t walk, can’t squat and sit cross-legged, shortening more than two
The pain that patients report is out of proportion to the severity of the injury. The pain gets worse, rather than better, over time. Eventually the joints become
Each year duchenne muscular dystrophy affects around 1 in 3500 male births worldwide(1). Duchenne affects patient's whole life since it attacks skeletal system, respiratory system, and in progress stages it may attack the heart(2).The phases of duchenne muscular dystrophy help scientists understand the disease because each phase has its own symptoms. Moreover, each phase attacks specific systems and organs in the patient's body. Duchenne muscular dystrophy develops relentlessly over time, and can be divided into three phases, early phase , transitional phase, and teenager and adult phase(1). The Early phase of duchenne muscular dystrophy begins from the day is diagnosed until the patient is 6 years old(1).Duchenne can by diagnosed through a muscle biopsy, taking a sample
DOI: 01/31/2006. Patient is a 39-year-old male plumber who sustained a work-related injury to his back and elbow when he slipped and fell while going down the stairs. Per OMNI, he is status post lumbar fusion at L5-S1 on 7/19/10. The patient was declared permanent and stationary as of 8/15/11 with future medical care including physician visits, medications, possible surgery, bone growth stimulator, lumbar brace, and vocational retraining. On 12/18/12, he underwent removal of hardware and inspection of fusion.
Total Hip Resurfacing With the evolution in advancement in the medical field, the old practiced of hip resurfacing is no longer active. The process is lined in such manner that the hip bone is capped and reframed through metal prosthesis. This surgery has an advantage over traditional means as the hip socket is secured by means of metal cup. It also helps in lasting longer and little discharge of metal ions during surface rubbing.
The manifestations of a fractured hip include all or some of the following: severe pain in hip or groin, inability to put weight on leg on the side of injured hip, stiffness, bruising and swelling
How does weight-bearing influence the bone repair process you described above? (i.e. what effect does weight-bearing have on the orientation of the Haversian systems?) ( 3
With the increase in age, it is normal to find older people with reduced range in motion of the joints (Kruse). But again, candidates for the anterior approach must have flexible joints. Even if patients were younger, many would still be rejected because of their weight. In the United States, “68.8% of adults are either obese or overweight” (Overweight and Obesity Statistics). The current society demands a procedure to fulfil their needs, and the anterior approach hip replacement is just not the
Patient has had progressive pain, numbness, and weakness in both lower extremities. He has had an epidural, physical therapy, and medications. It was reiterated that the patient has lost over 30 pounds. He has clear-cut instability as documented by the pars fracture and the spondylolisthesis, which is mobile on flexion/extension films.
My name is Katarzyna Budkiewicz and I am a chiropractor from the Great Chiropractic Clinic in La Habra. I am writing to refer Dane Danes for a physical therapy evaluation and co-management. The patient presented to my office with low back pain that radiates from his back down to the lateral thigh and down to the front of the knee over the past 4 weeks. His pain increases with standing. Ice, ibuprofen and stretching do not alleviate his condition.
The patient is in good overall health, and prior to injury remained active, participating in water aerobics and outdoor activities such as yard work. The patient currently wears splints to protect and support the wrists. In addition to the initial OT evaluation, the self-administered assessment The DASH was used. DASH stands for "Disabilities of the Arm, Shoulder and Hand."
MODALITIES OF FEMORAL FIXATION The goals of femoral component revision are to achieve implant stability while restoring hip biomechanics. Multiple fixation options exist for proximal femoral reconstruction including cemented components with or without associated bone restoration techniques, uncemented components, and patient specific implants such as modular or custom components. As previously mentioned, the Paprosky classification is most commonly used to describe proximal femur deficiency [31-33, 52]. This classification scheme allows effective communication between surgeons and is a good predictor of surgical complexity.
The implementation of ICD-10 brought with it 264 new codes, 143 deleted, and 134 revised codes that apply to coding for an orthopedic practice. This is in addition to new rules related to modifier 59 and the introduction of the applicable modifiers XU, XE, XP, and XS. There are also changes with regard to the way that injuries and diseases are classified, a new focus on laterality, and revisions to relevant terminology. Noted required documentation specifics: Laterality, site specificity, encounter type (initial, subsequent, consulting, operative, post-op), combination codes (there are only a few combination codes utilized in orthopedic procedures, i.e. M54.4 lumbago with sciatica), and place of occurrence
There were no significant differences in the mean stay in the hospital or in the ICU. The fractures that were most often missed were those of the cuboid or the metarsalia. The highest risk factor for a delayed diagnosis was a fracture already diagnosed on the same foot. In 52.4% of the delayed diagnosed fractures, an operative therapy was necessary. There were no significant differences between the two groups in the clinical results.”
Mrs Jones physical shows she had a hip operation thereby causing her pain, reducing her mobility and access to her occupation and engagement. Additionally she has difficulty in weight bearing on her right leg due to her operation and experiencing muscle weakness causing her limited endurance and strength when walking and transferring. Cognition: It was documented the patient experienced post-operative confusion, memory loss, difficulty following and understanding post hip surgery caution. Affective (mood): Patient experienced low mood and lacks confidence walking due to her illness, this has impacted on her emotion.
However, each of these methods come with some advantages and some disadvantages that are discussed in this paragraph. X-ray, one of the commonly used method can be used only in a static manner to analyze residual femoral movement within transfemoral sockets and also residual tibial movement within transtibial sockets. The contact between the residual limb and prosthetic socket can also be studied using X-ray imaging. However, X-ray images cannot be used for volumetric and three dimensional\thinspace(3D) measurements. Using CT, the 3D shape of the residual limb can be reconstructed from a number of two dimensional\thinspace(2D) slices that are taken transversely to the limb's long axis.