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91 Yaşındaki Aktif Hastada Unstabil Pertorakhanterik Kırık Nedeniyle Uygulanan Proksimal Femoral Çivinin (PFN) Proksimalden İki Kez Kırılması

Year 2023, Volume: 10 Issue: 2, 134 - 137, 21.08.2023

Murat Saylık

https://doi.org/10.47572/muskutd.1126875

Abstract

Toplumda yaşam süresinin uzamasıyla beraber, ileri yaş hasta popülasyonunun artışına bağlı pertorakhanterik kalça kırıkları daha sık görülür hale gelmiştir. Özellikle unstabil pertorakhanterik kalça kırıklarında kırığın internal rijid fiksayonu ve hastanın erken mobilizasyonu için Proksimal Femoral Nail (PFN) sıklıkla tercih edilir. PFN sonrası proksimal kayıcı vidanın geri gelmesi veya kırılması, distal vidanın kırılması, PFN’ nin proksimal veya distalden kırılması gibi implant yetmezlik bulguları nadir olarak görülür. Bizim vakamızda unstabil pertorakhanterik kalça kırıklı ileri yaş aktif kadın hastamızın, PFN sonrası iki kez proksimal PFN kırığı gelişimi ve iki kez PFN+ grefle revizyonu sunuldu. Literatürde 91 yaşında, düşme veya yüksek enerjili travma olmadan iki kez proksimal PFN kırığı gelişen ve PFN ile revizyon uygulanan başka vakaya rastlamadığımız için bu olguyu sunduk.

Keywords

Femur Kalça Pertorakhanterik PFN

Supporting Institution

yok

Project Number

yok

References

  • 1. Bhandari M, Swiontkowski M. Management of acute hip fracture. N Engl J Med. 2017;377(21):2053–62.
  • 2. Roberts KC, Brox WT. AAOS clinical practice guideline: management of hip fractures in the elderly. J Am Acad Orthop Surg. 2015;23:138–40. 3. Hoffman MF, Khoriaty JD, Sietsema DL, et al. Outcome of intramedullary nailing treatment for intertrochanteric femoral fractures. J Orthop Surg. 2019;14:360.
  • 4. Koyuncu S, Altay T, Kayalı C, et al. Mechanical failures after fixation with proximal femoral nail and risk factors. Clin Interv Agin. 2015;10:1959–65.
  • 5. Pengfei L, Zhishan Z, Fang Z, et al. Characteristics of intramedullary nail breakage in pertrochanteric femur fractures: a summary of 70 cases. J Orthop Surg Res. 2021;16(1):676.
  • 6. Lambers A, Rieger B, Kop A, et al. Implant fracture analysis of the TFNA proximal femoral nail. J Bone Joint Surg Am. 2019;101:804–11.
  • 7. Rollo G, Rinonapoli G, Pichierri P, et al. Breakage in two points of a short and undersized "affixus" cephalomedullary nail in a very active elderly female: a case report and review of the literature. Case Rep Orthop. 2018;2018:9580190.
  • 8. Tomas-Hernandez J, Nunez-Camarena J, Teixidor-Serra J, et al. Salvage for intramedullary nailing breakage after operative treatment of trochanteric fractures. Injury. 2018;49(Suppl 2):S44–50.
  • 9. Von Ruden C, Hungerer S, Augat P, et al. Breakage of cephalomedullary nailing in operative treatment of trochanteric and subtrochanteric femoral fractures. Arch Orthop Trauma Surg. 2015;135:179–85.
  • 10. Giannoudis PV, Ahmad MA, Mineo GV, et al. Subtrochanteric fracture non-unions with implant failure managed with the "Diamond" concept. Injury. 2013;44(Suppl 1):S76–81.
  • 11. Johnson NA, Uzoigwe C, Venkatesan M, et al. Risk factors for intramedullary nail breakage in proximal femoral fractures: a 10-year retrospective review. Ann R Coll Surg Engl. 2017;99:145–50.

91 Year Old Active Patient, Two Proksimal Fractures of The Proksimal Femoral Nail (PFN) Applied Due to Unstable Perthorachanteric Fracture

Year 2023, Volume: 10 Issue: 2, 134 - 137, 21.08.2023

Murat Saylık

https://doi.org/10.47572/muskutd.1126875

Abstract

With prolonged life expectancy in society and an increasing elderly patient population, pertrochanterıc hip fractures have become more common. Particularly in unstable pertrochanteric hip fractures, Proximal Femoral Nail (PFN) is often preferred for internal rigid fixation of the fracture and early mobilization of the patient. Implant failure findings such as relapse or fracture of the proximal sliding screw after PFN, fracture of the distal screw, and fracture of the PFN from the proximal or distal area are rare. We present the case of an advanced-age active female patient with an unstable pertrochanteric hip fracture who developed two proximal PFN fractures after PFN, and we document the two revisions with PFN+ graft we introduced for her. We present this case because in the literature we had not encountered any 91-year-old patient who developed proximal PFN fractures twice without falling or high-energy trauma and who achieved union of the fracture with through revisions performed twice with PFN and graft.

Keywords

Femur Hip Pertrochanteric PFN

Project Number

yok

References

  • 1. Bhandari M, Swiontkowski M. Management of acute hip fracture. N Engl J Med. 2017;377(21):2053–62.
  • 2. Roberts KC, Brox WT. AAOS clinical practice guideline: management of hip fractures in the elderly. J Am Acad Orthop Surg. 2015;23:138–40. 3. Hoffman MF, Khoriaty JD, Sietsema DL, et al. Outcome of intramedullary nailing treatment for intertrochanteric femoral fractures. J Orthop Surg. 2019;14:360.
  • 4. Koyuncu S, Altay T, Kayalı C, et al. Mechanical failures after fixation with proximal femoral nail and risk factors. Clin Interv Agin. 2015;10:1959–65.
  • 5. Pengfei L, Zhishan Z, Fang Z, et al. Characteristics of intramedullary nail breakage in pertrochanteric femur fractures: a summary of 70 cases. J Orthop Surg Res. 2021;16(1):676.
  • 6. Lambers A, Rieger B, Kop A, et al. Implant fracture analysis of the TFNA proximal femoral nail. J Bone Joint Surg Am. 2019;101:804–11.
  • 7. Rollo G, Rinonapoli G, Pichierri P, et al. Breakage in two points of a short and undersized "affixus" cephalomedullary nail in a very active elderly female: a case report and review of the literature. Case Rep Orthop. 2018;2018:9580190.
  • 8. Tomas-Hernandez J, Nunez-Camarena J, Teixidor-Serra J, et al. Salvage for intramedullary nailing breakage after operative treatment of trochanteric fractures. Injury. 2018;49(Suppl 2):S44–50.
  • 9. Von Ruden C, Hungerer S, Augat P, et al. Breakage of cephalomedullary nailing in operative treatment of trochanteric and subtrochanteric femoral fractures. Arch Orthop Trauma Surg. 2015;135:179–85.
  • 10. Giannoudis PV, Ahmad MA, Mineo GV, et al. Subtrochanteric fracture non-unions with implant failure managed with the "Diamond" concept. Injury. 2013;44(Suppl 1):S76–81.
  • 11. Johnson NA, Uzoigwe C, Venkatesan M, et al. Risk factors for intramedullary nail breakage in proximal femoral fractures: a 10-year retrospective review. Ann R Coll Surg Engl. 2017;99:145–50.
There are 10 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Case Report
Authors

Murat Saylık 0000-0002-1023-4164

Project Number yok
Publication Date August 21, 2023
Submission Date June 6, 2022
Published in Issue Year 2023 Volume: 10 Issue: 2

Cite

APA Saylık, M. (2023). 91 Year Old Active Patient, Two Proksimal Fractures of The Proksimal Femoral Nail (PFN) Applied Due to Unstable Perthorachanteric Fracture. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 10(2), 134-137. https://doi.org/10.47572/muskutd.1126875
AMA Saylık M. 91 Year Old Active Patient, Two Proksimal Fractures of The Proksimal Femoral Nail (PFN) Applied Due to Unstable Perthorachanteric Fracture. MMJ. August 2023;10(2):134-137. doi:10.47572/muskutd.1126875
Chicago Saylık, Murat. “91 Year Old Active Patient, Two Proksimal Fractures of The Proksimal Femoral Nail (PFN) Applied Due to Unstable Perthorachanteric Fracture”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10, no. 2 (August 2023): 134-37. https://doi.org/10.47572/muskutd.1126875.
EndNote Saylık M (August 1, 2023) 91 Year Old Active Patient, Two Proksimal Fractures of The Proksimal Femoral Nail (PFN) Applied Due to Unstable Perthorachanteric Fracture. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10 2 134–137.
IEEE M. Saylık, “91 Year Old Active Patient, Two Proksimal Fractures of The Proksimal Femoral Nail (PFN) Applied Due to Unstable Perthorachanteric Fracture”, MMJ, vol. 10, no. 2, pp. 134–137, 2023, doi: 10.47572/muskutd.1126875.
ISNAD Saylık, Murat. “91 Year Old Active Patient, Two Proksimal Fractures of The Proksimal Femoral Nail (PFN) Applied Due to Unstable Perthorachanteric Fracture”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10/2 (August 2023), 134-137. https://doi.org/10.47572/muskutd.1126875.
JAMA Saylık M. 91 Year Old Active Patient, Two Proksimal Fractures of The Proksimal Femoral Nail (PFN) Applied Due to Unstable Perthorachanteric Fracture. MMJ. 2023;10:134–137.
MLA Saylık, Murat. “91 Year Old Active Patient, Two Proksimal Fractures of The Proksimal Femoral Nail (PFN) Applied Due to Unstable Perthorachanteric Fracture”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, vol. 10, no. 2, 2023, pp. 134-7, doi:10.47572/muskutd.1126875.
Vancouver Saylık M. 91 Year Old Active Patient, Two Proksimal Fractures of The Proksimal Femoral Nail (PFN) Applied Due to Unstable Perthorachanteric Fracture. MMJ. 2023;10(2):134-7.
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