Management of Femoral Fractures in Aging Adult Polio Population: A Retrospective Review of 13 Cases

Abstract

INTRODUCTION[|]Polio survivors have common sequelae of lower extremity paralysis characterized by flaccid muscle tone, limited ambulation, asymmetric involvement, retarded growth, and disuse osteoporosis. Such patients at risk of disuse osteoporosis are also at risk of sustaining osteoporotic fractures. This study aims to evaluate the effectiveness of extramedullary internal fixation devices in achieving better results in osteoporotic polio-related femoral fractures. [¤]METHODS[|]Retrospective evaluation was made of a total of 13 adult polio patients treated with extramedullary internal fixation devices for unilateral proximal and diaphyseal femoral fractures. The functional status of all patients was evaluated with the Vignos grade of disability.[¤]RESULTS[|]All patients (mean age 62 years; range 47–88 years) were treated with extramedullary internal fixation devices (locked plate in eight diaphyseal fractures; dynamic condylar screw (DCS) and plate in three, and dynamic hip screw (DHS) and plate in two proximal femoral fractures). The mean follow-up period was 48.6 months (range 26–62 months). Bony union was confirmed at a mean of 3.7 months (range, 3–5 months) in all patients. Massive pulmonary embolism was seen in one patient. No cases of non-union, implant cutout or any other complications developed.[¤]DISCUSSION AND CONCLUSION[|]Post-polio patients are at high risk of fractures. Extramedullary internal fixation devices provide effective stability for bony union and good functional results in polio-related femoral fractures.[¤]

Keywords

• femur fracture
• disuse osteoporosis; polio.