J Mingo-Robinet1, J A Alonso2, M Moreno-Barrero3, L González-García4, V Garcia-Virto5, H J Aguado5. 1. Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial Universitario de Palencia, Palencia, España. Electronic address: mingojuan@gmail.com. 2. FRCS (Tr & Orth), Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial de Segovia, Segovia, España. 3. Servicio de Radiología, Complejo Asistencial Universitario de Palencia, Palencia, España. 4. Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial Universitario de Palencia, Palencia, España. 5. Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
Abstract
OBJECTIVE: Post-polio patients present problems such as small and deformed bones, with narrow intramedullary canal and osteoporosis, affecting surgical treatment. The aim of this article is to describe the main preoperative and intraoperative complications of the surgical treatment of fractures in this population. MATERIAL AND METHODS: A retrospective analysis was conducted between 1995 and 2014. Data obtained from the medical records included patient age, fracture pattern (AO/OTA), device used, technical aspects of the surgery that changed compared to a standard procedure, and the presence of intraoperative skeletal complications. RESULTS: Sixty-four patients with 78 fractures were included in the study. Forty-seven percent of the fractures were at the proximal femur. The main complications of hip arthroplasty (14 patients) were absent hip abductors and intraoperative instability (3), bad cup fixation (3) and intraoperative periprosthetic fracture (2). The main problems of intramedullary nailing were due to a narrow canal and previous bone deformity. Main problems reported when plating included difficulty to fit a precontoured plate, and oversized hardware. CONCLUSION: Given the large number of intraoperative complications, in preoperative planning we must include nails of small diameter and length, locking plates and external fixators, and, in the case of hip arthroplasty, long and thin stems and restrictive or dual mobility acetabular systems.
OBJECTIVE: Post-polio patients present problems such as small and deformed bones, with narrow intramedullary canal and osteoporosis, affecting surgical treatment. The aim of this article is to describe the main preoperative and intraoperative complications of the surgical treatment of fractures in this population. MATERIAL AND METHODS: A retrospective analysis was conducted between 1995 and 2014. Data obtained from the medical records included patient age, fracture pattern (AO/OTA), device used, technical aspects of the surgery that changed compared to a standard procedure, and the presence of intraoperative skeletal complications. RESULTS: Sixty-four patients with 78 fractures were included in the study. Forty-seven percent of the fractures were at the proximal femur. The main complications of hip arthroplasty (14 patients) were absent hip abductors and intraoperative instability (3), bad cup fixation (3) and intraoperative periprosthetic fracture (2). The main problems of intramedullary nailing were due to a narrow canal and previous bone deformity. Main problems reported when plating included difficulty to fit a precontoured plate, and oversized hardware. CONCLUSION: Given the large number of intraoperative complications, in preoperative planning we must include nails of small diameter and length, locking plates and external fixators, and, in the case of hip arthroplasty, long and thin stems and restrictive or dual mobility acetabular systems.