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Effectiveness of circular external fixator in periprosthetic fractures around the knee.
Nozaka, Koji; Miyakoshi, Naohisa; Hongo, Michio; Kasukawa, Yuji; Saito, Hidetomo; Kijima, Hiroaki; Tsuchie, Hiroyuki; Mita, Motoki; Shimada, Yoichi.
Afiliação
  • Nozaka K; Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. kk-nozaka@mue.biglobe.ne.jp.
  • Miyakoshi N; Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
  • Hongo M; Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
  • Kasukawa Y; Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
  • Saito H; Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
  • Kijima H; Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
  • Tsuchie H; Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
  • Mita M; Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
  • Shimada Y; Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
BMC Musculoskelet Disord ; 21(1): 317, 2020 May 21.
Article em En | MEDLINE | ID: mdl-32438922
BACKGROUND: The incidence of periprosthetic fractures after total joint arthroplasty (TJA) is rising due to an increasing number of TJAs performed annually and the growing elderly population. In many elderly patients with periprosthetic fractures, the bone strength is lowered due to the deterioration of bone quality and a decrease in bone quantity; rigid fixation of the fracture is difficult. It is a challenging operation for orthopedic surgeons. The usefulness of circular external fixation for periprosthetic fractures has been reported in several case studies. The aim of this study was to investigate the rate of union and complications associated with circular external fixation in periprosthetic fractures around the knee. METHODS: We included 19 patients with periprosthetic femur and tibial fractures who underwent osteosynthesis using a circular external fixator and had at least 2 years of follow-up. All patients had comorbidities and high risks associated with anesthesia. Tourniquets were not used in any of the patients. There were no cases in which the skin incision was placed, and the closed reduction technique was used in all cases. RESULTS: A 100% union rate was achieved with no serious complications. All fractures healed after a mean time of 14.3 ± 5.2 weeks (range, 8-38 weeks). The walking ability was the same level as before the injury in 13 cases. DISCUSSION: There are many comorbidities associated with periprosthetic fractures in elderly patients. Double-plate or revision surgery were largely invasive and had high risks associated with anesthesia. Circular external fixation is a feasible and effective treatment option because it provides stable fixation, prompt postoperative mobilization, and has no major complications, especially in elderly patients who are treated for periprosthetic fractures. CONCLUSION: Circular external fixation is a safe and reliable method for periprosthetic fractures around the knee in elderly patients. LEVEL OF EVIDENCE: Level IV, retrospective case series.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fraturas da Tíbia / Fixadores Externos / Artroplastia do Joelho / Fraturas Periprotéticas / Fixação Interna de Fraturas Tipo de estudo: Diagnostic_studies / Observational_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Musculoskelet Disord Assunto da revista: FISIOLOGIA / ORTOPEDIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Japão

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fraturas da Tíbia / Fixadores Externos / Artroplastia do Joelho / Fraturas Periprotéticas / Fixação Interna de Fraturas Tipo de estudo: Diagnostic_studies / Observational_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Musculoskelet Disord Assunto da revista: FISIOLOGIA / ORTOPEDIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Japão