| Autor: |
Garceau SP; Division of Orthopaedics, Joseph and Wolf Lebovic Health Complex, Mount Sinai Hospital, Toronto, Ontario, Canada., Igbokwe EN; University of Toronto Faculty of Medicine, Toronto, Ontario, Canada., Warschawski Y; Division of Orthopaedics, Joseph and Wolf Lebovic Health Complex, Mount Sinai Hospital, Toronto, Ontario, Canada., Neufeld ME; Division of Orthopaedics, Department of Adult Joint Reconstruction, Western University, London, Ontario, Canada., Safir OA; Division of Orthopaedics, Joseph and Wolf Lebovic Health Complex, Mount Sinai Hospital, Toronto, Ontario, Canada., Wade JP; Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada., Guy P; Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada., Wolfstadt JI; Division of Orthopaedics, Joseph and Wolf Lebovic Health Complex, Mount Sinai Hospital, Toronto, Ontario, Canada. |
| Abstrakt: |
Post-polio syndrome is characterized by a late functional deterioration (usually after >=15 years from the initial infection) in patients with a history of paralytic poliomyelitis infection, and it is defined by the March of Dimes criteria. Patients with post-polio syndrome are at increased risk for falls and associated hip and femoral fractures as a result of lower bone mineral density, decreased lean muscle mass, and musculoskeletal deformities. Current evidence suggests that treatment modalities for femoral fractures should emphasize fixation that allows early progressive weight-bearing and ambulation to optimize functional outcomes. Good results after hip arthroplasty have been described with both cemented and uncemented implants in patients who have been treated for osteoarthritis, but there has been little evidence guiding hip fracture management. Anatomic challenges that are encountered are osteoporotic bone, a valgus neck-shaft angle, increased femoral anteversion, and a small femoral canal diameter. Intramedullary nailing of hip and femoral fractures can be challenging due to the small femoral canal diameter that frequently is encountered. Alternative methods of fixation have shown promising results. These include the use of sliding hip screws for hip fracture management and fixed-angle locking plates for hip and femoral fracture management. |
