fracture neck femur-comedy of errors
DESCRIPTION
learning curve, fracture neck femur, common mistake in orthopaedics, fracture managementTRANSCRIPT
Vinod NaneriaConsultant, Orthopaedics
Choithram Hospital & Research CentreIndore, MP, India
Comedy of Errors
Case Summary A 75 years old female Occasional pain right hip X-ray Hip showing incomplete trans-
cervical fracture neck of femur.
Plain X-ray
Incomplete fracture neck of femur
Normal serum chemistry
Three Knowles pins for prophylactic fixation
Mobilization with walker started
Developed sub-trochanteric extension following loss of balance
Fixation by DHS after reduction and stabilization by one inter-fragmentary screws
Plate bending started
Pain persisted
Ambulation continued
Pain persisted
Ambulation continued
Hoping union
Plate failed
Severe pain
Difficulty in ambulation
Reconstruction nailing
Moral of the story & lessons learned Never leave an empty hole in cortical
bone. Avoid making entry point below the level of
lesser trochanter for multiple pinning. Do not rely on inter-fragmentary screws in
sub-trochanteric fracture. Do not wait for plate to brake once failure is
evident.
DISCLAIMER• Information contained and transmitted by this presentation is based on personal experience and collection of cases at Choithram Hospital & Research centre, Indore, India, during last 25 years.
• It is intended for use only by the students of orthopaedic surgery. Many GIF files are taken from Internet.
• Views and opinion expressed in this presentation are personal opinion.
• Depending upon the x-rays and clinical presentations viewers can make their own opinion.
• For any confusion please contact the sole author for clarification. Every body is allowed to copy or download and use the material best suited to him. I am not responsible for any controversies arise out of this presentation.• For any correction or suggestion please contact [email protected]