Hip Fractures Clinical Trial
Official title:
Sensitivity of CT-scan as a Predictor of Fixation Failure in Per-trochanteric Fractures
To assess the importance Of Ct scan in the prediction of fixation failure of per-trochanteric fractures
Recently, epidemiological studies had shown an increase in hip fractures with aging of the
population. Osteoporosis had been defined by a mean of -2.5 SD upon DEXA scan, which is not a
practical tool to use in patients with recent hip fractures until management of such
fractures either with fixation or replacement. Also it have been found that assessment of
osteoporosis using the Singh index is not a reliable method for osteoporosis diagnosis .
Osteoporosis may affect the decision making for dealing with per-trochanteric fractures as
some surgeons prefer to do hip replacement for fear of fixation failure, while others still
convinced that fixation with good reduction and appropriate placement of lag screw within a
TAD less than 25mm is the best even with unstable types specially after the progress in
proximal femoral nails .
CT scan can be used for osteoporosis measurement. Even it can detect stress fractures that
are not dRecently, epidemiological studies had shown an increase in hip fractures with aging
of the population . Osteoporosis had been defined by a mean of -2.5 SD upon DEXA scan , which
is not a practical tool to use in patients with recent hip fractures until management of such
fractures either with fixation or replacement. Also it have been found that assessment of
osteoporosis using the Singh index is not a reliable method for osteoporosis diagnosis .
Osteoporosis may affect the decision making for dealing with per-trochanteric fractures as
some surgeons prefer to do hip replacement for fear of fixation failure, while others still
convinced that fixation with good reduction and appropriate placement of lag screw within a
TAD less than 25mm is the best even with unstable types specially after the progress in
proximal femoral nails .
CT scan can be used for osteoporosis measurement. Even it can detect stress fractures that
are not diagnosed using DEXA scan. It can be used to assess BMD in specific regions like
spine or hip in a quantitative manner that can be compared to the T score used with DEXA scan
. Again It can assess the presence of comminution in the anterior and posterior cortices that
might not be easy with x-rays. The thickness of the lateral wall can be better measured
through CT scan which is a critical measure while deciding to fix trochanteric fractures
using whether DHS or PFN .
The purpose of this prospective clinical cohort study is to assess the sensitivity of CT scan
for localized osteoporosis detection that can be used in patients with hip fracture and
detection of comminution and thin trochanteric lateral wall that might not be accessible with
x-rays. And whether these independent factors could predict the fixation failure iagnosed
using DEXA scan. It can be used to assess BMD in specific regions like spine or hip in a
quantitative manner that can be compared to the T score used with DEXA scan . Again It can
assess the presence of comminution in the anterior and posterior cortices that might not be
easy with x-rays. The thickness of the lateral wall can be better measured through CT scan
which is a critical measure while deciding to fix trochanteric fractures using whether DHS or
PFN .
The purpose of this prospective clinical cohort study is to assess the sensitivity of CT scan
for localized osteoporosis detection that can be used in patients with hip fracture and
detection of comminution and thin trochanteric lateral wall that might not be accessible with
x-rays. And whether these independent factors could predict the fixation failure
;
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