Saratov JOURNAL of Medical and Scientific Research

femoral neck

Efficacy and safety of hydroxyapatite-coated spokes in patients with femoral neck fractures in a multiple trauma

Summary:

Purpose: to evaluate the efficacy and safety of hydroxyapatite coated spokes for osteosynthesis in patients with femoral neck fractures in a multiple trauma. Material and Methods. We studied 26 patients of both sexes with severe injuries (on the ISS scale, the severity of the injury corresponded to 22-27 points). All revealed a fracture of the femoral neck, which was combined: with bruises of the brain (N=6) or kidney (N=12), fractures of the pelvis (N=18), ribs (N=8) or shin bones (N=4), rupture of the lung (N=4). All underwent treatment aimed at stabilizing the function of internal organs and systems, osteosynthesis of the femoral neck with a bundle of spokes with their fixation in the llizarov apparatus. Patients were randomized into 2 groups: main (N=11) — for osteosynthesis spokes with hydroxyapatite coating were used; control (N=15) — spokes without coating were used. To assess the effectiveness and safety of the use of spokes with hydroxyapatite coating, clinical and laboratory methods were used. Results. In the main group, positive results of treatment were observed in 10 patients (90.9%; Cl: 67.9-99.9%), in the control group-11 (73.3%; Cl: 48.9-91.8%). The patients of the main group have an average fracture consolidation time of 1.2 times less. After surgery, the activity of alkaline phosphatase is higher (P=0.04). The frequency of deviation of laboratory blood parameters from the norm in these patients is comparable with the frequency noted in the control group. Conclusion. The use of spokes with hydroxyapatite coating in the treatment of patients with femoral neck fractures in conditions of multiple trauma reduces the duration of fixation of bone fragments and increases the number of positive results of treatment by reducing the number of complications.

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The use of original device for positioning tools during the installation of femoral component of hip joint

Year: 2019, volume 15 Issue: №1 Pages: 57-61
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Varfolomeev D.l., Samoday V.G.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

Objective: to assess the accuracy of the femoral neck resection using the developed "Device for positioning tools for the installation of the femoral component of the hip prosthesis". Material and Methods. On the basis of the Department of traumatology and orthopedics of Voronezh state medical University n.a. N.N. Burdenko conducted experimental studies on 40 models of plastic bones. In the comparison group resection was performed using the proposed device, in the control group — using a standard guide. Results. Experimental studies have demonstrated higher accuracy of femoral neck osteotomy in the comparison group. The average value of the neck filing angle in the frontal plane in the comparison group was 3.2° higher than in the control group (p<0.05), and in the sagittal difference was 3.1°. The average distance from the line of the osteotomy to the apex of the greater trochanter in both groups was not significantly different (p=0.62). Conclusion. The use of the developed device allows to perform osteotomy of the femoral neck with high accuracy, as well as to control the position of the leg endoprosthesis, which helps to reduce the number of complications and improve the quality of life of patients.

Comparative analysis of treatment outcomes in patients with femoral neck fracture using monolateral wire and half-pin fixator of the authors' design and transosseous fixation wires

Year: 2014, volume 10 Issue: №4 Pages: 627-635
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Allakhverdiev A.S., Soldatov Y.P.
Organization: Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics»
Summary:

Objective. The purpose of the study is to analyze the errors, complications and outcomes of the operative treatment of patients with femoral neck fracture in the 1st group with application of wires bundle and fixation in the llizarov frame (64 cases) and in the 2nd group with application of developed monolateral wire- and half-pin device (23 cases). Material and Methods. The observation of 87 patients with fractures of the femoral neck. Operations performed using spokes kit for transosseous osteosynthesis by GA llizarov and develop devices for the treatment of patients with
fractures of the proximal femur. Two groups of patients were studied: duration of surgery, duration of osteosynthesis, complications, and outcomes (in terms of one year after the dismantling clips) using the modified scale Luboshyce — Mattis — Schwartzberg. Results. Fracture repair was achieved in 40 patients (62,5%) of the 1st group. The following complications were observed in this group: non-union and pseudarthrosis — in 21 (32,8%) case; aseptic necrosis of the femoral head in 3 (4,7%) cases; hip ankyloses — in one (1,6%) case, breakage and migration of wires into the joint cavity and smaller pelvis — 3 (4,7%) patients and cutting out of wires from the femoral head was observed in 3 (4,7%) cases. Totally 61 complication were revealed. In the second group of the patients non-union was found in one patient (64 years old). Complications were observed in 6 patients of this group — pint-tract infection, moderate secondary displacement of the fragments (the patient fell down on the operated limb) and wire breakage. Conclusion. The efficiency of the femoral neck osteosynthesis with application of elaborated monolateral wire- and half-pin fixator made up 95,7% of the positive outcomes (in osteosynthesis using bunch of wires with llizarov frame fixation the same 60,9% of the positive outcomes).

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