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Femoral neck non union

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https://www.readbyqxmd.com/read/28511967/a-sliding-hip-screw-augmented-with-2-screws-is-biomechanically-similar-to-an-inverted-triad-of-cannulated-screws-in-repair-of-a-pauwels-type-iii-fracture
#1
B Kemker, K Magone, J Owen, P Atkinson, S Martin, T Atkinson
OBJECTIVE: Pauwels III femoral neck fractures are highly unstable. These fractures are commonly treated with three cannulated screws or sliding hip screw (SHS) implants, however high rates of non-union persist. A hybrid SHS construct has recently been proposed. The objective of the study was to compare this construct to the familiar inverted triad of cannulated screws and to a single SHS. METHODS: Fourth generation biomechanical femur analogs were used to create a highly repeatable injury model...
May 8, 2017: Injury
https://www.readbyqxmd.com/read/28439306/fibular-strut-graft-for-nonunited-femoral-neck-fractures-in-children
#2
A Elgeidi, A El-Negery
PURPOSE: To evaluate the clinical and radiological outcomes of using fibular strut grafts as a fixation device for non-united femoral neck fractures in children with or without subtrochanteric valgus osteotomy. METHODS: A total of 12 children with non-united femoral neck fractures (nine males and three females) with an average age of 8.2 years (5 to 12) were managed, and functional results evaluated, between July 2013 and July 2015. The mechanisms of injury were fall from a height in ten patients and road traffic accident in two cases...
2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28431804/prognostic-value-of-dynamic-mri-positive-enhancement-integral-color-mapping-in-osteosynthesis-of-undisplaced-femoral-neck-fractures
#3
Masatoshi Morimoto, Yoshinori Takahashi, Takahiro Kubo, Kosuke Sugiura, Yasuaki Tamaki, Shunichi Toki, Katsuyoshi Suganuma, Kazumasa Inoue, Keisuke Adachi, Takashi Chikawa, Koichi Sairyo, Akihiro Nagamachi
AIMS: The common treatment for an undisplaced femoral neck fracture is osteosynthesis. Two major complications of osteosynthesis are non-union and late collapse of the femoral head. We speculated that femoral head perfusion is one of the most important factors that affect the outcome of osteosynthesis after femoral neck fracture. We have preoperatively estimated femoral head perfusion by dynamic MRI positive enhancement integral color mapping (PEICM). The purpose of this study was to evaluate the outcomes of undisplaced femoral neck fractures based on PEICM...
April 18, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28430719/intertrochanteric-osteotomy-for-femoral-neck-non-union-does-undercorrection-result-in-an-acceptable-rate-of-femoral-neck-union
#4
Brandon J Yuan, David W Shearer, David P Barei, Sean E Nork
OBJECTIVES: To analyze the radiographic outcomes of intertrochanteric osteotomy for the treatment of femoral neck non-union with "undercorrection" of the Pauwels' angle and relative preservation of the proximal femoral anatomy. DESIGN: Retrospective cohort study SETTING:: Level-1 trauma center PATIENTS:: Thirty-two patients with established femoral neck non-unions that had been treated with intertrochanteric osteotomy were retrospectively identified through Current Procedural Terminology (CPT) codes...
April 18, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28361017/lower-limb-stress-fractures-in-sport-optimising-their-management-and-outcome
#5
REVIEW
Greg A J Robertson, Alexander M Wood
Stress fractures in sport are becoming increasing more common, comprising up to 10% of all of sporting injuries. Around 90% of such injuries are located in the lower limb. This articles aims to define the optimal management of lower limb stress fractures in the athlete, with a view to maximise return rates and minimise return times to sport. Treatment planning of this condition is specific to the location of the injury. However, there remains a clear division of stress fractures by "high" and "low" risk. "Low risk" stress fractures are those with a low probability of fracture propagation, delayed union, or non-union, and so can be managed reliably with rest and exercise limitation...
March 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28228129/prognostic-value-of-the-sliding-length-of-cephalocervical-screws-to-predict-the-risk-of-non-union-after-osteosynthesis-a-retrospective-analysis-of-86-patients-with-intracapsular-femoral-neck-fractures
#6
Yohei Hirakawa, Hidehiro Nakamura, Kazuhito Minamitani, Ryuki Hashida, Masafumi Gotoh, Naoto Shiba
BACKGROUND: Here, we assessed the prognostic value of the early sliding length (ESL) for predicting the risk of non-union after internal fixation of femoral neck fractures (FNFs) by Dual SC Screws (DSCS). METHODS: A retrospective analysis of 86 patients with intra-capsular FNFs was performed. They underwent osteosynthesis by DSCS at our institution between 2008 and 2013 with a minimum follow-up duration of 6 months. Preoperative displacement, fracture reduction quality, ESL of screws at 2 weeks postoperatively, and correlation of non-union with the ESL of screws were evaluated...
February 22, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28116505/total-hip-arthroplasty-after-failed-treatment-of-proximal-femur-fracture
#7
Tomonori Tetsunaga, Kazuo Fujiwara, Hirosuke Endo, Tomoyuki Noda, Tomoko Tetsunaga, Toru Sato, Naofumi Shiota, Toshifumi Ozaki
INTRODUCTION: Total hip arthroplasty (THA) is a good option as a salvage procedure after failed treatment of proximal femur fracture. The anatomy of the proximal femur, however, makes this surgery complicated and challenging. The purpose of this study was to evaluate the radiographic and clinical outcomes of THA after failed treatment of proximal femur fractures. MATERIALS AND METHODS: We retrospectively analysed 50 consecutive THAs (42 women, 8 men; mean age 77 years) after failed treatment of a proximal femur fracture...
March 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28018062/non-union-fracture-neck-femur-in-a-toddler-reconstructed-by-valgus-osteotomy-a-minimally-invasive-approach
#8
Amit Sharma, Anurag Tiwari, Tarun Verma, Lalit Maini
BACKGROUND: Non-union is one of the devastating complications of fracture neck of femur. Though a very rarely encountered entity in a toddler (1-3 years paediatric age group), non-united femoral neck fractures are reported in developing countries because of mismanagement by quacks and delay in referrals. For operative treatment, many different procedures have been described, including close/open reduction and internal fixation using K-wires, cannulated screws, fibula or nails. There is no evidence in the literature that one or other implant influences the rate of postoperative complications, such as avascular femoral head necrosis or coxa vara...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27955672/an-update-on-the-pauwels-classification
#9
REVIEW
Min Shen, Chen Wang, Hui Chen, Yun-Feng Rui, Song Zhao
BACKGROUND: Femoral neck fractures typically occur as a result of high-energy mechanisms among non-geriatric patients. Complications, including femoral neck shortening, non-union, and avascular necrosis, are relatively common after the internal fixation of this fracture pattern. These complications have serious effects on young patients. The Pauwels classification, which is the first biomechanical classification for femoral neck fractures, is still frequently used to determine and prescribe the appropriate treatment for femoral neck fractures...
December 12, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27837321/hemiarthroplasty-versus-internal-fixation-in-super-aged-patients-with-undisplaced-femoral-neck-fractures-a-5-year-follow-up-of-randomized-controlled-trial
#10
RANDOMIZED CONTROLLED TRIAL
Qifeng Lu, Genling Tang, Xijiang Zhao, Shuguang Guo, Bin Cai, Qingsong Li
INTRODUCTION: There were higher rates of revision, complication, non-union, delayed union, and poorer functional outcomes reported in super-aged patients of undisplaced femoral neck fractures treated with internal fixation. Therefore, we designed this randomized comparative study aiming to compare the effectiveness and long-term follow-up results of hemiarthroplasty (HA) with that of multiple cannulated screws (MCS). MATERIALS AND METHODS: Eligible participants were randomly assigned into two groups for different methods of operation (hemiarthroplasty group and internal fixation group)...
January 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27797839/young-man-with-sudden-severe-hip-pain-secondary-to-femoral-neck-stress-fracture
#11
Ziva Petrin, Anupam Sinha, Sunny Gupta, Mitesh K Patel
Femoral neck stress fractures have been described in military recruits and athletes. Early recognition and aggressive treatment are important, as femoral neck stress fractures have a high potential for complications and even uncomplicated fractures require an extensive course of rehabilitation. Tension-side (superolateral) stress fractures of the femoral neck are at high risk for complications such as displacement, non-union and avascular necrosis, and need to be treated surgically, while compression-side (inferomedial) fractures can be treated conservatively...
October 26, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27649760/conservative-management-of-a-femoral-neck-stress-fracture-in-a-female-athlete-a-case-report-and-review-of-the-literature
#12
Ilias Katsougrakis, Alexandros P Apostolopoulos, Samantha Z Tross
UNLABELLED: Femoral-neck stress fractures are relatively rare and may present as sports-related injuries. The presentation is variable, and prompt diagnosis facilitates the earliest return to pre-morbid functional activity levels. Delayed detection may precipitate femoral non-union or avascular necrosis, resulting in long-term functional deficit. AIMS: We describe the clinical, diagnostic and therapeutic approach of a femoral-neck stress fracture that occurred in a 28-year-old female recreational runner...
2016: Journal of Long-term Effects of Medical Implants
https://www.readbyqxmd.com/read/27637999/three-year-outcomes-of-intracapsular-femoral-neck-fractures-fixed-with-sliding-hip-screws-in-adults-aged-under-sixty-five-years
#13
D P Dargan, F Callachand, O J Diamond, C K Connolly
INTRODUCTION: Intracapsular femoral neck fractures remain associated with high rates of post-traumatic femoral head necrosis, non-union, and revision surgery. AIM: Our aim was to identify factors associated with revision surgery in intracapsular femoral neck fractures treated with sliding hip screws (SHS) in adults aged <65 years. PATIENTS AND METHODS: Consecutive admissions were identified retrospectively from the Royal Victoria Hospital, Belfast, which was the largest volume hospital on the National Hip Fracture Database...
November 2016: Injury
https://www.readbyqxmd.com/read/27536620/surgical-treatment-of-undisplaced-femur-neck-fractures-in-dementia-patients-using-proximal-femoral-nail-antirotation
#14
Bong-Ju Park, Hong-Man Cho, Woong-Bae Min
PURPOSE: People with dementia have poor mobility and discharge outcomes following hip fractures. The purpose of this study was to evaluate the clinical and radiological results of internal fixation of undisplaced femur neck fractures (Garden types 1 and 2) by proximal femoral nail antirotation (PFNA) in dementia patients. MATERIALS AND METHODS: We studied retrospectively 19 patients with undisplaced femur neck fracture. All patients were over 70 years of age, walked independently with a cane or crutches and suffered moderate-to-severe dementia...
September 2015: Hip & Pelvis
https://www.readbyqxmd.com/read/27084541/low-failure-rate-by-means-of-dlbp-fixation-of-undisplaced-femoral-neck-fractures
#15
A D P van Walsum, J Vroemen, H M J Janzing, T Winkelhorst, J Kalsbeek, W H Roerdink
BACKGROUND: This study evaluated the clinical results of a new implant in the internal fixation of undisplaced femoral neck fractures. METHOD: Irrespective of their age, 149 patients with undisplaced (Garden I and II) femoral neck fractures were included in a prospective multicentre clinical cohort study and were treated by internal fixation by means of the Dynamic Locking Blade Plate (DLBP). The mean age was 69 years and the follow-up at least one year. RESULTS: The DLBP fixation resulted in 6 out of 149 failures caused by AVN (2x), non-union (2x), loss of fixation (3x) or combination of these...
March 19, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27057146/femoral-neck-non-union-treatment-by-valgus-intertrochanteric-osteotomy
#16
Carlos Roberto Schwartsmann, Leandro de Freitas Spinelli, Anthony Kerbes Yépez, Leonardo Carbonera Boschin, Marcelo Faria Silva
OBJECTIVE: : The purpose of this study was to evaluate the performance of valgus intertrochanteric osteotomy in femoral neck non-union. METHODS: : Forty-two patients with femoral neck fractures with non-union treated using Pauwels' intertrochanteric osteotomy were reviewed. Demographics, time elapsed between fracture and surgery, follow--up, osteosynthesis used, Garden's classification, limb shortening, and x-rays were evaluated. RESULTS: : Twenty-two men and 20 women were reviewed...
November 2015: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/27055409/serum-albumin-and-fixation-failure-with-cannulated-hip-screws-in-undisplaced-intracapsular-femoral-neck-fracture
#17
O Riaz, R Arshad, S Nisar, R Vanker
Introduction Internal fixation of undisplaced intracapsular femoral neck fractures with cannulated hip screws is a widely accepted surgical technique, despite reported failure rates of 12%-19%. This study determined whether preoperative serum albumin levels are linked to fixation failure. Methods We retrospectively reviewed 251 consecutive undisplaced intracapsular femoral neck fracture patients treated with cannulated hip screws in a district general hospital. Preoperative albumin levels were measured, and the fixation technique, classification and posterior tilt on radiography assessed...
July 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27019832/valgusing-intertrochanteric-osteotomy-for-the-treatment-of-femoral-neck-non-unions-report-of-32-cases
#18
Carlos Roberto Schwartsmann, Marco Aurélio Telöken, Leonardo Carbonera Boschin, Ivo Schmiedt, Ricardo Falavinha, Marcus Vinicius Crestani
UNLABELLED: The purpose of the present study was to review the results of femoral neck non-unions treatment with valgusing intertrochanteric osteotomy. METHODS: Between 1988 and 2003 we treaded thirty two femoral neck non-unions with valgusing osteotomy and fixation. The mean follow-up time was 9.8 years and the mean age was 41.7 years. RESULTS: Twenty eight (87.4%) of the thirty two valgusing osteotomies evolved to femoral neck union, while four cases (12...
January 2009: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/27011838/femoral-head-neck-junction-reconstruction-after-iatrogenic-bone-resection
#19
Alberto Guevara-Alvarez, Nicholas Lash, Martin Beck
Arthroscopic over-resection of the head-neck junction during the treatment of a cam deformity can be a devastating complication and is difficult to treat. Large defects of the femoral head-neck junction (FHNJ) increase the risk of femoral neck fracture and can also affect hip biomechanics. We describe a case of an iatrogenic defect of the FHNJ due to excessive bone resection, and a previously non-described treatment using iliac crest autograft to restore femoral head-neck sphericity and hip joint stability...
July 2015: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/26942332/treatment-of-ununited-femoral-neck-fractures-in-young-adults-using-low-intensity-pulsed-ultrasound-report-of-2-cases
#20
Sang Yang Lee, Takahiro Niikura, Takashi Iwakura, Ryosuke Kuroda, Masahiro Kurosaka
INTRODUCTION: Delayed union and non-union of displaced femoral neck fractures remains a difficult clinical problem for orthopaedic surgeons. In the physiologically young patient, every effort should be made to preserve the native hip joint. We present two cases of ununited femoral neck fractures in young adults who were successfully treated with low-intensity pulsed ultrasound (LIPUS) and showed satisfactory results. PRESENTATION OF CASE 1: A 41-year-old woman was involved in a motor vehicle crash and was diagnosed with displaced femoral neck fracture...
2016: International Journal of Surgery Case Reports
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