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1.
Sigurdur Ragnarsson Johan Sjögren Martin Stagmo Per Wierup Shahab Nozohoor 《General thoracic and cardiovascular surgery》2018,66(7):398-404
Objectives
The aim of the study was to evaluate the right ventricular (RV) performance during exercise in patients who underwent mitral valve repair for chronic mitral valve insufficiency relative to healthy individuals and to assess exercise capacity using a semisupine ergometer.Methods
We studied 56 patients who underwent mitral valve repair for degenerative posterior mitral leaflet prolapse between 2005 and 2014 and a control group of 13 healthy individuals. Clinical data were collected prospectively, and echocardiographic measurements of RV function were obtained at rest and at peak exercise.Results
One-third of the study patients had RV systolic dysfunction as indicated by tricuspid annular plane excursion (TAPSE) at rest. Resting TAPSE was lower in the study group (16.7?±?3.3 mm) than in the control group (24.4?±?4.3 mm), p?<?0.001. TAPSE increased in both groups during exercise and exercise was shown to have a significant main effect on TAPSE F(1, 52)?=?80, p?<?0.001. TAPSE increased more in the control group and an interaction was detected between the participant groups (study group vs. control group) and exercise, F(1, 52)?=?24, p?<?0.001. In the study group, Poor postoperative RV function was associated with preoperative left ventricular dilatation but was not correlated with impaired maximum exercise capacity.Conclusions
Despite the excellent clinical outcome during rest and exercise after mitral valve repair, our results suggest patients that have undergone mitral valve repair due to posterior leaflet prolapse have significantly reduced RV function at rest and during exercise compared to healthy controls at long-term follow-up, as measured by TAPSE.2.
Miyako Okada Toshiaki Akita Fumito Mizuno Asami Nakayama Kouichi Morioka 《Surgery today》2016,46(5):621-630
Purpose
Posterior myocardial infarction (MI) can induce LV remodeling and ischemic mitral regurgitation (IMR). The protective effects of a cardiac support device (CSD) against LV remodeling and IMR after posterior MI have been poorly documented.Methods
Posterior MI was induced by ligation of the left circumflex coronary artery in beagle dogs. After 7 days, the dogs were randomized to a CSD placement (CSD group, n = 8) or no treatment (CTL group, n = 8).Results
At 3 months after MI, the LV remodeling was less marked and the LV and RV systolic functions were better in the CSD group than in the CTL group. Neither the RV nor LV diastolic function (min dP/dt, Tau and EDPVR) was disturbed by the CSD. IMR was consistently prevented in our canine model.Conclusion
Early application of a CSD after posterior MI can attenuate LV remodeling without causing any deterioration of the biventricular diastolic function.3.
Toru Niwa Katsuhisa Waseda Tomofumi Mizuno Yusuke Nakano Kentaro Mukai Hirokazu Wakabayashi Atsushi Watanabe Hirohiko Ando Hiroaki Takashima Tetsuya Amano 《Journal of Echocardiography》2017,15(3):118-126
Background
There is no echocardiographic predictor of the effectiveness of tolvaptan in patients with heart failure (HF). The aim of this study was to investigate the echocardiographic predictor of responders to tolvaptan in patients with HF.Methods
This observational study consisted of 62 consecutive in-hospital patients with HF who received tolvaptan with volume overload despite standard therapies. The echocardiography data were obtained within 1 week before the administration of tolvaptan. Tolvaptan responders were defined as those having a body weight decrease from baseline >1 kg on the morning of day 8.Results
The mean age of the 62 patients was 75.1 ± 13.9 years, and 45 patients (72.6%) were considered to be responders. Tricuspid annular plane systolic excursion (TAPSE) was significantly higher (17.1 ± 3.8 vs. 13.0 ± 3.9 mm; p = 0.0004) and the tricuspid valve regurgitation pressure gradient (33.3 ± 14.6 vs. 44.9 ± 12.2 mmHg; p = 0.007) and estimated right atrium pressure (7.8 ± 4.2 vs. 10.3 ± 4.5 mmHg; p = 0.043) were significantly lower in the Responder group than in the Non-responder group. In a multivariate logistic regression analysis, TAPSE was found to be an independent predictor of response (odds ratio 1.28; 95% confidence interval 1.03–1.60). According to the receiver operating characteristics analysis, the area under the curve of TAPSE was the largest among the parameters measured by echocardiography. The cut-off value for TAPSE to predict responders was determined to be 17.0 mm (sensitivity = 56.8%, specificity = 94.1%).Conclusions
TAPSE is a simple predictor of the effectiveness of tolvaptan in patients with HF.4.
Malini Govindan Anatoli Kiotsekoglou Samir K. Saha A. John Camm 《Journal of Echocardiography》2017,15(4):166-175
Background
Atrial fibrillation (AF) is a bi-atrial disease yet little attention has been given to right heart function in AF. We propose that the assessment of right atrial (RA) and right ventricular function (RV) using two-dimensional speckle tracking echocardiography (2D-STE) could be valuable in predicting AF recurrence in patients with paroxysmal AF (PAF).Methods
Thirty patients with PAF were prospectively recruited from a dedicated AF clinic. Right atrial size, volume, and area and RV dimensions were analyzed along with RA and RV strain derived from 2D-STE at baseline and at 3 and 12 months.Results
Higher RA booster strain independently predicted sinus rhythm (SR) maintenance for up to 1 year (P = 0.001). RV strain was impaired in patients with recurrent AF compared to those in SR (P < 0.05) but did not predict AF recurrence. Two-dimensional STE for RA and RV function was simple to perform with excellent reproducibility (adjusted R 2 0.92–0.99).Conclusions
Two-dimensional STE is useful and highly reproducible in assessing right heart function in AF patients. RA booster strain function was predictive of sinus rhythm maintenance for up to 1 year.5.
Alessandro Gandini David Melodelima Francesco Schenone Apoutou William N’Djin Jean Yves Chapelon Michel Rivoire 《Annals of surgical oncology》2012,19(3):447-454
Background
Bleeding is the main cause of postoperative complications of hepatic surgery. To minimize intraoperative bleeding during hepatectomy, resections are generally carried out under hepatic vascular control despite the risk of liver dysfunction in patients with chronic liver disease. This study evaluates the feasibility and safety of high-intensity focused ultrasound (HIFU)-assisted hepatic resection during an open procedure in an animal model.Methods
Three groups of 12–14-week-old Landrace pigs (n = 7/group) were used to evaluate HIFU-assisted liver resection (group A) vs liver resection with or without portal triad clamping (groups B and C). In each pig, liver resection was performed on the right and left paramedian lobes. The following were evaluated and compared in the 3 groups: total blood loss, blood loss/cm2 of resection area, clip density, procedure duration, morbidity, and mortality.Results
Median blood loss was significantly lower in group A than in group B (P = .02), and group C (P = .007). Median blood loss/cm2 of resection area was 4.77 mL/cm² in group A, 11.35 mL/cm² in group B, 12.22 mL/cm² in Group C. Precoagulation resulted in sealing blood vessels <5 mm; therefore, median clip density during liver transection was 0.78 clip/cm² in group A, 1.61 clip/cm2 in group B, and 1.57 clip/cm2 in group C. Median duration of the surgical procedure was 12 min in group A, 21 min in group B, and 19 min in group C.Conclusions
HIFU-assisted hepatic resection during an open procedure in an animal model is safe, reduces bleeding, and allows real-time ultrasound guidance.6.
Purpose
The HyperEye Medical System (HEMS) uses indocyanine green (ICG) to visualize blood vessels in coronary artery bypass grafting (CABG). We performed quantitative HEMS assessment to detect grafts at risk of occlusion.Methods
We assessed the HEMS angiograms of 177 grafts from 69 patients who underwent CABG and compared the results with those of fluoroscopic coronary angiography, by measuring the increasing rate of ICG intensity, average acceleration value, and time to peak luminance intensity.Results
Grafts in the patent and failed groups showed significant differences in their increasing rate of intensity and average acceleration value. The average accelerations value of ICG intensity of internal thoracic artery (ITA) and saphenous vein (SV) grafts were 112.3 and 144.9 intensity/s2 in the patent group, and 71.0 and 91.8 intensity/s2 in the failed group. The time to peak luminance intensity was 1.7 and 1.4 s in the patent group and 2.3 and 1.9 s in the failed group; these values were not significantly different.Conclusion
Significant reductions in the ICG intensity rate and average acceleration value can occur in failed grafts. Therefore, quantifiable changes in ICG intensity may help detect minute changes in blood flow.7.
Mohammed Al-Biltagi Osama A. Tolba Maher Ahmed Abd ElHafez Ahmed Abd ElBasset Abo-Elezz Eman Kamel EL Kady Sahar Mohey El-din Hazza 《Pediatric nephrology (Berlin, Germany)》2016,31(8):1329-1339
Objective
The objective of this study was to evaluate cardiac function in children with end-stage renal disease (ESRD) on regular hemodialysis using speckle tracking echocardiography (STE) and correlate results with plasma glutathione level as a marker of oxidative stress.Methods
The study involved 30 children with ESRD and 30 healthy controls. The plasma glutathione and C-reactive protein (CRP) levels were measured, and cardiac function was evaluated using conventional echocardiography and STE.Results
Plasma glutathione levels were significantly lower and CRP significantly higher in patients than in controls. Children with ESRD had significant systolic and diastolic cardiac dysfunctions detected by STE compared with controls. Conventional echocardiography failed to detect these dysfunctions. There was significant increase in left-ventricular relative wall thickness (LV-RWT) in patients, especially those with hypertension, compared with the control group. There was also significant impairment of LV and right-ventricular (RV) global longitudinal strain (GLS) and torsion; however, LV-GLS was significantly better in hypertensive than in normotensive patients. The degree of impairment in GLS and cardiac torsion negatively correlated with plasma glutathione levels.Conclusion
Significant oxidative stress was present in children with ESRD and was correlated with the degree of cardiac dysfunction detected early using the new cardiac imaging modality, STE.8.
J. E. Gschwend P. Albers M. Bögemann P. Goebell A. Heidenreich J. Klier F. König S. Machtens K. Pantel C. Thomas 《Der Urologe. Ausg. A》2018,57(1):34-39
Background
At the 2016 ASCO annual meeting, new data from two randomized phase III studies concerning taxane-based chemotherapy as a treatment option for patients with metastatic castration-resistant prostate cancer (mCRPC) were presented.Objectives
The focus is on the clinical impact of these data.Materials and methods
A group of German experts in the field of urogenital–oncologic expertise discussed the clinical impact with respect to the current data.Results
The study results support the current clinical data. They confirm the efficacy and safety of cabazitaxel beyond first-line therapy with docetaxel for patients with mCRPC.Conclusions
Cabazitaxel is an important treatment option after docetaxel progression. With respect to the performance status of a patient, it is adequate to reduce the dosage to 20?mg/m2 cabazitaxel.9.
Objective
To clarify the contribution of the subcutaneous area during breast approach endoscopic thyroidectomy (BAET), with regard to invasiveness-related outcomes.Methods
Seventy-two patients were randomly assigned to two groups: standard dissection and limited dissection. Postoperative pain and inflammatory response were compared between groups.Results
The groups were well matched except for subcutaneous dissection area (137.11 ± 21.10 vs. 83.69 ± 12.10 cm2, p < 0.0001). No significant difference was found with regard to VAS score and postoperative inflammatory response.Conclusion
Our RCT indicated that the subcutaneous area plays a less important role with regard to BAET-related postoperative pain.10.
Johannes B. Erhardt G. Roderer K. Grob T. N. Forster K. Stoffel M. S. Kuster 《Archives of orthopaedic and trauma surgery》2009,129(10):1367-1374
Objectives
We report early results using a second generation locking plate, non-contact bridging plate (NCB PH®, Zimmer Inc. Warsaw, IN, USA), for the treatment of proximal humeral fractures. The NCB PH® combines conventional plating technique with polyaxial screw placement and angular stability.Design
Prospective case series.Setting
A single level-1 trauma center.Patients
A total of 50 patients with proximal humeral fractures were treated from May 2004 to December 2005.Intervention
Surgery was performed in open technique in all cases.Main outcome measures
Implant-related complications, clinical parameters (duration of surgery, range of motion, Constant–Murley Score, subjective patient satisfaction, complications) and radiographic evaluation [union, implant loosening, implant-related complications and avascular necrosis (AVN) of the humeral head] at 6, 12 and 24 weeks.Results
All fractures available to follow-up (48 of 50) went to union within the follow-up period of 6 months. One patient was lost to follow-up, one patient died of a cause unrelated to the trauma, four patients developed AVN with cutout, one patient had implant loosening, three patients experienced cutout and one patient had an axillary nerve lesion (onset unknown). The average age- and gender-related Constant Score (n = 35) was 76.Conclusions
The NCB PH® combines conventional plating technique with polyaxial screw placement and angular stability. Although the complication rate was 19%, with a reoperation rate of 12%, the early results show that the NCB PH® is a safe implant for the treatment of proximal humeral fractures.11.
Purpose
Sevoflurane preconditioning (SevoPreC) has been proved to prevent organ ischemia/reperfusion (I/R) injury in various animal models and preclinical studies. Clinical trials on cardioprotection by SevoPreC for adult patients undergoing coronary artery bypass graft (CABG) revealed mixed results. The aim of this meta-analysis was to evaluate the cardiac effect of SevoPreC in on-pump CABG.Methods
Randomized controlled trials (RCT) comparing the cardiac effect of SevoPreC (compared with control) in adult patients undergoing CABG were searched from PubMed, Embase, and the Cochrane Library (up to November 2015). The primary endpoints were postoperative troponin levels. Additional endpoints were CK-MB levels, mechanic ventilation (MV) duration, intensive care unit (ICU) stay, and hospital length of stay (LOS).Results
Six trials with eight comparisons enrolling a total of 384 study patients reporting postoperative troponin levels were identified. Compared with controls, SevoPreC decreased postoperative myocardial troponin levels [standardized mean difference (SMD) = ?0.38; 95 % CI, ?0.74 to ?0.03; P = 0.04; I 2 = 63.9 %]. However, no significant differences were observed in postoperative CK-MB levels [weighted mean difference (WMD) = ?1.71; P = 0.37; I 2 = 37.7 %], MV duration (WMD = ?0.53; P = 0.47; I 2 = 0.0 %), ICU stay (WMD = ?0.91; P = 0.39; I 2 = 0.9 %), and hospital LOS (WMD = 0.08; P = 0.86; I 2 = 8.0 %).Conclusion
Available evidence from the present systematic review and meta-analysis suggests that sevoflurane preconditioning may reduce troponin levels in on-pump CABG. Future high-quality, large-scale clinical trials should focus on the early and long-term clinical effect of SevoPreC in on-pump CABG.12.
Faisal G. Bakaeen Zade Akras Lars G. Svensson 《Indian Journal of Thoracic and Cardiovascular Surgery》2018,34(3):272-278
Purpose
Redo coronary artery bypass grafting (CABG) can be one of the most technically challenging operations in cardiac surgery. The coronary disease is more advanced, and the coronary targets may be suboptimal. In addition, the patients are typically older and sicker compared to those undergoing primary CABG.Methods
A literature review focused on the epidemiology, operative techniques, and outcomes associated with redo CABG.Results
The frequency of redo CABG relative to total CABG procedures has been decreasing over time. From 2000 to 2009, redo CABG decreased from 6.0 to 3.4% of all CABG procedures reported to the STS Adult Cardiac Surgery Database (STS ACSD) and currently stands at 2%. Risks associated with reoperations include diabetes and renal dialysis. Perioperative mortality for redo CABG is reported to be as high as three times that of primary CABG, but this risk is reduced with experience. Careful preoperative planning including quality imaging and precise surgical technique coupled with meticulous myocardial protection contributes to good outcomes. Experience is important in optimizing outcomes.Conclusions
Redo CABG is a complicated operation and surgical experience, and appropriate perioperative strategies are essential for achieving optimal outcomes.13.
Aya Saito Norimichi Hirahara Noboru Motomura Hiroaki Miyata Shinichi Takamoto 《General thoracic and cardiovascular surgery》2018,66(1):8-12
Objective and methods
Data on isolated coronary artery bypass grafting (CABG) performed in 2013 and 2014, and registered in the Japan Cardiovascular Surgery Database were reviewed for preoperative characteristics, postoperative outcomes, and choice of graft material for the left anterior descending artery (LAD).Results
Isolated CABG was performed off-pump in 54.7% of cases, and graft material for the LAD was left internal thoracic artery in 74.3% and right internal thoracic artery in 15.6%. Operative mortality was 2.0% in elective cases, 8.2% in emergency cases, and 3.0% overall. In elective cases, operative mortality was 1.1% for off-pump CABG compared with 3.0% for on-pump CABG.Conclusions
Clinical results of our isolated CABG were reasonable and acceptable.14.
Erhardt JB Grob K Roderer G Hoffmann A Forster TN Kuster MS 《Archives of orthopaedic and trauma surgery》2008,128(4):409-416
Objectives
We report the application of a new fixed angle plate (NCB DF®, Zimmer inc. USA, Warsaw, IN) in the treatment of periprosthetic femur fractures. The NCB DF® combines conventional plating technique with polyaxial screw placement and angular stability.Design
Prospective cohort study.Setting
A single level-1 trauma center.Patients
From May 2003 to December 2005, a total of 24 patients with periprosthetic femur fractures were treated. The NCB DF® femur plate was used in all cases. The average follow-up period was 12 months (3–31 months). Twelve patients had a periprosthetic fracture after total knee replacement (TKA) and 12 patients after total hip replacement (THA). The mean period from primary joint replacement to periprosthetic fracture was 8.2 years for the THA group and 7.2 years for the TKA group.Intervention
A combined conventional/locking surgical technique was performed in all the cases.Main outcome measures
Union, non-union, mal-union, duration of surgery, range of motion, postoperative mobility, subjective patient satisfaction and complications.Results
The union rate was 90%, the mal-union rate 5% and the re-operation rate 15%. Postoperative mobility reached the preoperative level in all but for two patients. Three complications occurred relating to the implant or the procedure: one fatigue failure of the plate (non-union), one screw breakage, and one wound infection.Conclusions
The NCB DF® combines conventional plating technique with polyaxial screw placement and angular stability. This combination technique shows promising results regarding union and mal-union rates in periprosthetic fractures in elderly and osteoporotic patients.15.
Naykky M. Singh Ospina Rene Rodriguez-Gutierrez Spyridoula Maraka Ana E. Espinosa de Ycaza Sina Jasim Ana Castaneda-Guarderas Michael R. Gionfriddo Alaa Al Nofal Juan P. Brito Patricia Erwin Melanie Richards Robert Wermers Victor M. Montori 《World journal of surgery》2016,40(10):2359-2377
Background
Parathyroidectomy is a definitive treatment for primary hyperparathyroidism. Patients contemplating this intervention will benefit from knowledge regarding the expected outcomes and potential risks of the currently available surgical options.Purpose
To appraise and summarize the available evidence regarding benefits and harms of minimally invasive parathyroidectomy (MIP) and bilateral neck exploration (BNE).Data sources
A comprehensive search of multiple databases (MEDLINE, EMBASE, and Scopus) from each database’s inception to September 2014 was performed.Study selection
Eligible studies evaluated patients with primary hyperparathyroidism undergoing MIP or BNE.Data extraction
Reviewers working independently and in duplicate extracted data and assessed the risk of bias.Data synthesis
We identified 82 observational studies and 6 randomized trials at moderate risk of bias. Most of them reported outcomes after MIP (n = 71). Using random-effects models to pool results across studies, the cure rate was 98 % (95 % CI 97–98 %, I 2 = 10 %) with BNE and 97 % (95 % CI 96–98 %, I 2 = 86 %) with MIP. Hypocalcemia occurred in 14 % (95 % CI 10–17 % I 2 = 93 %) of the BNE cases and in 2.3 % (95 % CI 1.6–3.1 %, I 2 = 87 %) with MIP (P < 0.001). There was a statistically significant lower risk of laryngeal nerve injury with MIP (0.3 %) than with BNE (0.9 %), but similar risk of infection (0.5 vs. 0.5 %) and mortality (0.1 vs. 0.5 %).Limitations
The available evidence, mostly observational, is at moderate risk of bias, and limited by indirect comparisons and inconsistency for some outcomes (cure rate, hypocalcemia).Conclusion
MIP and BNE are both effective surgical techniques for the treatment of primary hyperparathyroidism. The safety profile of MIP appears superior to BNE (lower rate of hypocalcemia and recurrent laryngeal nerve injury).16.
Krischak GD Augat P Blakytny R Claes L Kinzl L Beck A 《Archives of orthopaedic and trauma surgery》2007,127(6):453-458
Introduction
Non-steroidal anti-inflammatory drug (NSAID) is well known to significantly delay fracture healing. Results from in vitro studies implicate an impairment of osteoblast proliferation due to NSAIDs during the initial stages of healing. We studied whether diclofenac, a non-selective NSAID, also impairs appearance of osteoblasts in vivo during the early phase of healing (at 10 days).Materials and methods
Two defects (Ø 1.1 mm) were drilled within distal femurs of 20 male Wistar rats. Ten rats received diclofenac continuously; the other obtained a placebo until sacrificing at 10 days. Osteoblast proliferation was assessed by cell counting using light microscopy, and bone mineral density (BMD) was measured using pQCT.Results
Osteoblast counts from the centre of bone defect were significantly reduced in the diclofenac group (median 73.5 ± 8.4 cells/grid) compared to animals fed with placebo (median 171.5 ± 13.9 cells/grid). BMD within the defect showed a significant reduction after diclofenac administration (median 111.5 ± 9.3 mg/cm³) compared to the placebo group (median 177 ± 45.4 mg/cm³).Conclusion
The reduced appearance of osteoblasts in vivo implicates an inhibiting effect of diclofenac on osteoblasts at a very early level of bone healing. The inhibition of proliferation and migration of osteoblasts, or differentiation from progenitor cells, is implicated in the delay of fracture healing after NSAID application.17.
Katrin Müller 《Journal ?sthetische Chirurgie》2018,11(4):208-211
Background
New patients come more and more often over the internet; therefore internet marketing plays an increasingly important role.Question
How can physicians build an effective internet marketing strategy and avoid complications?Method
Selection and authorization of a reputable agency.Results
New customer acquisition through high visibility in the internet, at the same time increasing the image and awareness.Conclusions
In the overall “marketing mix” internet marketing has become indispensable to physicians who want to be successful. Those who are well positioned in Google are well known by their target audience and thus receive a higher response.18.
Maryam Nabati Safora Salehi Babak Bagheri Mahmoud Nouraei 《Journal of Echocardiography》2016,14(3):113-119
Objectives
The purpose of our study was to assess the echocardiographic and angiographic parameters in patients with symptomatic heart failure (HF) and mild diastolic dysfunction (grade I).Background
It remains uncertain why some patients with mild diastolic dysfunction exhibit HF symptoms and others are asymptomatic.Methods
The study enrolled 80 hospitalized patients with impaired left ventricular (LV) relaxation. Patients were divided into two groups; one group had chronic functional class II to III dyspnea and the other group had no symptoms of HF. After admission, echocardiography and coronary angiography were performed for all patients and LV systolic and diastolic parameters were compared between the two groups.Results
More patients in the asymptomatic group were hypertensive (p-value: 0.012). However, coronary artery disease was more prevalent in symptomatic patients (p-value: 0.022). The LV ejection fraction (EF) was significantly lower in symptomatic patients [median 54.33 %, 95 % confidence interval (53.76–54.87 %) in asymptomatic patients and median 49.43, 95 % confidence interval (47.23–50.91 %) in symptomatic patients, p-value <0.001]. Furthermore, the systolic LV internal dimension was significantly larger in this group (p-value: 0.037). The results of logistic regression identified that only the absolute level of the LVEF was the negative determinant of the occurrence of HF in patients with impaired LV relaxation.Conclusion
Our study showed that LV systolic performance has an important role in occurrence of HF symptoms in patients with grade I diastolic dysfunction.19.
C. Neuerburg S. Mehaffey M. Gosch W. Böcker M. Blauth C. Kammerlander 《Operative Orthopadie und Traumatologie》2016,28(3):164-176
Objective
Use of standardized cement augmentation of the proximal femur nail antirotation (PFNA) for the treatment of trochanteric fragility fractures, which are associated with high morbidity and mortality, to achieve safer conditions for immediate full weight-bearing and mobilization, thus, improving preservation of function and independency of orthogeriatric patients.Indications
Trochanteric fragility fractures (type 31-A1–3).Contraindications
Ipsilateral arthritis of the hip, leakage of contrast agent into the hip joint, femoral neck fractures.Surgical technique
Reduction of the fracture on a fracture table if possible, or minimally invasive open reduction of the proximal femur, i.?e., using collinear forceps if necessary. Positioning of guidewires for adjustment of the PFNA and the spiral blade, respectively. Exclusion of leakage of contrast agent and subsequent injection of TRAUMACEM? V+ into the femoral head–neck fragment via a trauma needle kit introduced into the spiral blade. Dynamic or static locking of the PFNA at the diaphyseal level.Postoperative management
Immediate mobilization of the patients with full weight-bearing and secondary prevention, such as osteoporosis management is necessary to avoid further fractures in the treatment of these patients.Results
A total of 110 patients older than 65 years underwent the procedure. Of the 72 patients available for follow-up (average age 85.3 years), all fractures healed after an average of 15.3 months. No complications related with cement augmentation were observed. Approximately 60?% of patients achieved the mobility level prior to trauma.20.