RESUMO
BACKGROUND AND AIM: Number of hip prosthesis implants in arthritis, number of patients treated with bisphosphonates to prevent fragility fractures and, together, number of atypical femoral fracture's cases are increasing. CASE SERIES: This article describes two cases of hip arthritis, treated with hip replacement, in patients using bisphosphonates for a long time; in both cases an incomplete atypical femoral fracture was misdiagnosed before the surgery. Authors describe the importance to carry out a complete osteometabolic and radiographic pre-operative examination of patients in treatment with bisphosphonates going to hip replacement, to check the possible presence of incomplete atypical femoral fracture and to optimize surgical and pharmacological treatment. CONCLUSIONS: In hip prosthesis surgery, prior diagnosis of incomplete atypical femoral fractures can indicate the choice of a different kind of prosthesis stem to optimize surgical results. This can also positively impact to rehabilitation in term of duration and daily activities recovery.
Assuntos
Artrite , Artroplastia de Quadril , Fraturas do Fêmur , Fraturas do Quadril , Prótese de Quadril , Artrite/induzido quimicamente , Artrite/tratamento farmacológico , Artrite/cirurgia , Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/métodos , Difosfonatos/efeitos adversos , Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/etiologia , Fraturas do Fêmur/cirurgia , Fraturas do Quadril/cirurgia , Prótese de Quadril/efeitos adversos , Humanos , Estudos RetrospectivosRESUMO
The results of treatment of wrist fractures with percutaneous pin fixation in 106 patients are reported. Functional and radiological evaluation was made for all patients. All fractures healed; loss of reduction occurred in only two cases. The best results were obtained in metaphyseal fractures of the radius, while good results were obtained in intra-articular fractures; the worst results were noted in cases with an associated fracture of the ulnar styloid, in elderly patients, or in cases with associated fractures in other parts of the skeleton. When the volar tilt has been restored to more than 10 degrees higher than normal, loss of wrist motion may occur. No vascular, nervous or tendinous lesion was noted. A nerve entrapment syndrome at the wrist occurred in a fairly high percentage of cases (14.1%).
