Fractures in patients with poliomyelitis: Past or current challenge?

Injury. 2020 Apr:51 Suppl 1:S48-S54. doi: 10.1016/j.injury.2020.02.029. Epub 2020 Feb 19.

Abstract

Fractures in poliomyelitic limbs are a challenge to surgeons, due to polio's sequelae and morphological disorders, which make conventional osteosynthesis difficult. We present a retrospective study of 62 patients and 73 non-simultaneous fractures in their lower limbs. Average age was 61,7 years and 53,2% were females. We analyzed the preinjury functional level, etiology of the fracture, fracture pattern, treatment used (be conservative or surgical), and implant used in surgical cases. We treated 85,1% of them surgically and 37,9% of them maintained the same functional situation as before the fracture. 55,4% of them experienced the need to add some mechanical aids after the lesion and 6,8% lost the ability to walk. Most of the surgical treatments employed were similar as the ones used in non-poliomyelitic patients, although some cases required atypical implants, such as a Multiloc (® DePuy Synthes) humeral nail for a tibial shaft fracture, due to narrow bone. Mortality along the 1st year was 2.7%. We found similar functional and radiological results as those described in non-poliomyelitic limbs.

Keywords: Dysplasic limbs; Lower limb fractures; Neurologic conditions; Polio; Polio fractures; Poliomyelitis; Surgery in dysplasic limbs.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Databases, Factual
  • Female
  • Fracture Fixation, Intramedullary
  • Fractures, Bone / mortality
  • Fractures, Bone / surgery*
  • Humans
  • Humeral Fractures / surgery
  • Male
  • Middle Aged
  • Poliomyelitis / complications*
  • Radiography
  • Retrospective Studies
  • Spain
  • Tibial Fractures / surgery