Outcome of femoral fractures in poliomyelitis patients

Yechiel N. Gellman*, Amal Khoury, Meir Liebergall, Rami Mosheiff, Yoram A. Weil

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background and purpose: As patients who were afflicted with poliomyelitis during the outbreaks in the past are aging, lower extremity osteoporotic fractures are becoming more frequent. Fixation in deformed, porotic bone, coupled with muscle weakness and imbalance creates a unique challenge when treating these fractures as does their reduced rehabilitation potential. The aim of this study was to investigate the outcome of femoral fractures in surviving poliomyelitis patients. Patients and methods: Sixty-five patients with 74 femoral fractures were treated between 1990 and 2014. Clinical outcome was assessed using the Parkland and Palmer mobility score, and quality-of-life was assessed using the SF-12® score. Results: Some 84% of the fractures were a result of low-energy mechanisms and occurred in the polio-affected limbs, but nonaffected limbs were also injured owing to low-energy mechanisms in all cases. Fifty-seven fractures were treated operatively. There were nine re-operations (16%), including implant removals, nonunion, peri-implant fractures, and malunion. Some 60% of the patients did not regain their previous ambulatory capacity. Post-operative weight-bearing status did not correlate with the final functional outcome. Conclusions: Polio patients with femoral fractures have a guarded prognosis for regaining their pre-injury ambulatory capacity. A higher re-operation rate than that with “normal” osteoporotic fractures is expected.

Original languageEnglish
Pages (from-to)2607-2612
Number of pages6
JournalInternational Orthopaedics
Volume43
Issue number11
DOIs
StatePublished - 1 Nov 2019
Externally publishedYes

Keywords

  • Femoral fractures
  • Osteoporotic fractures
  • Poliomyelitis

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