Problematic osteosynthesis in osteoporosis

Moh awad,M.D Al-Helal hospital

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Is it challenging..?

The treatment of osteoporotic fractures is

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Is it challenging..?
* The major technical problem that surgeons face, is the difficulty to obtain a stable fixation of an implant due to osteoporotic bone. * The load transmitted at the bone-implant interface can often exceed the reduced strain tolerance of osteoporotic bone.
J Bone Joint Surg. 2006

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Is it challenging..?
Osteoporosis makes internal fixation problematic and frequently contributes to failed fixation and poor clinical results .
J Shoulder Elbow Surg. 2003

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When,,,,,,,,,,,,,,,?
All of us are confronted by the same problem but the date of meeting makes a very big difference..!!!!!!!!!!!!

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Patient .
65 year. Weight100 kg. No immediate post op view.!!!

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History..
Angry wound Serous discharge for a week post operative

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Associated problems.!

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Decision
Is to redo + bone grafting + no wieght bearing

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So it is real
Osteoporosis makes internal fixation problematic and frequently contributes to failed fixation and poor clinical result .

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Case 2

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Yes it is still challenging

In spite of approved methods of osteosynthesis of proximal femoral fractures, using modern implants stabilization still may fail especially in unstable osteoporotic fracture which is a cause of revision surgeries and unsatisfactory results.
J Bone Joint Surg Br 2010 vol. 92

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Interrupt the circle

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Teamwork

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.. Prevention (survey high risk)

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Healing in osteoporosis

Fracture healing in osteoporotic fractures: is it really different? A basic science perspective. Giannoudis P, Tzioupis C, Almalki T, Buckley R.
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.. Healing in osteoporosis. (researches)

The

biological
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Improving tech. in osteosynthesis

Adapted anchoring implants, Improved load distribution, Augmentation techniques.

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Thanks For Your Attention

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