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Outcome of femoral fractures in poliomyelitis patients

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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.

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Authors and Affiliations

  1. Orthopedic Trauma Service, Hadassah Hebrew University Hospital, Jerusalem, Israel

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

  2. Department of Orthopedics, Hadassah Medical Center, POB 12000, 91120, Jerusalem, Israel

    Yechiel N. Gellman

Authors
  1. Yechiel N. Gellman
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  2. Amal Khoury
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  3. Meir Liebergall
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  4. Rami Mosheiff
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  5. Yoram A. Weil
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Contributions

YNG and YAW designed the study, supported data collection, performed data analyses, and wrote and revised the manuscript. AK, ML, and RM designed the study, operated the patients, and critically reviewed the manuscript.

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Correspondence to Yechiel N. Gellman.

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The authors declare that they have no conflict of interest.

Ethical approval

An IRB (institutional Review Board) approval was obtained for this study according to the 1964 Helsinki Declaration.

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Gellman, Y.N., Khoury, A., Liebergall, M. et al. Outcome of femoral fractures in poliomyelitis patients. International Orthopaedics (SICOT) 43, 2607–2612 (2019). https://doi.org/10.1007/s00264-019-04285-2

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  • DOI: https://doi.org/10.1007/s00264-019-04285-2

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