M Abolghasemian, MDA th l tArthroplasty surgeonShafa hospital, IUMS

Case 1

78 y old female

Falling down

Medically fit

What would you do?What would you do?

Dynamic hip screw (DHS)

Blade plate

D i   d l    (DCS) Dynamic condylar screw (DCS)

Cephalomedullary nail Cephalomedullary nail

Arthroplastyp y

AO / OTA

Case 2

80y old female Diabetic CVA 3 years ago Left hemiparesis AF, under Warfarin ththerapy

What would you do? Dynamic hip screw (DHS)

Bl d   l Blade plate

Dynamic condylar screw  Dynamic condylar screw (DCS)

Cephalomedullary nail

Arthroplasty

Unsuccessful closed d ireduction

O   d ti    d   Open reduction 2 days later

3 days later

Dislocation

Followed by infection

What would you do next?

2 months in skeletal traction and IV AB !!traction and IV AB !!

Final result

What would be your nextWhat would be your next question?

64y old woman

Lt hip pain following f lli  dfalling down

Hi t   f  History of bisphosphonate intake for 7 years7 y

Treatment options?

Conventional IM nail?

Cephalomedullary nail

Fixed angle plate

LCP

12 days latery

What would you do?What would you do?

6 weeks later

Case 4

72y old lady

Intertrochanteric Fx one  year ago

Wh ld d ?What would you do?

Refixation

Valgus osteotomy

Arthroplasty

Case 5

76 y old female

Falling down

Medically fit

What would you do?What would you do?

Dynamic hip screw (DHS)

Blade plate

D i   d l    (DCS) Dynamic condylar screw (DCS)

Cephalomedullary nail Cephalomedullary nail

Arthroplastyp y