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Avascular necrosis

Yashwant Singh Tanwar, Yatinder Kharbanda, Atin Jaiswal, Vikas Birla, Ramsagar Pandit
INTRODUCTION: Coronal plane distal humeral injuries are relatively rare. Numerous classification systems have been proposed as the complexity of these fractures has been realized. We in the present series of ten patients describe the surgical technique of Open Reduction and Internal Fixation of Coronal plane fractures of the distal humerus with headless compression screws performed using the anterolateral approach. MATERIAL AND METHOD: It was a retrospective study, the data collected from March 2010 to 2015 was analysed and the final outcome was assessed using the DASH score...
2018: SICOT-J
Hammad Parwaiz, Sherif Elnikety
Kienböck's disease is characterised by avascular necrosis of the lunate bone, and over the years it has been a challenging disease to manage, with differing opinions on the best intervention. We present an interesting case of a metallic unconstrained lunate replacement that is still functioning well in a patient 40 years after surgery. This case report represents the longest follow-up of any such prosthesis.
March 15, 2018: BMJ Case Reports
Joseph Tracey, Danny Arora, Christopher E Gross, Selene G Parekh
BACKGROUND: Third generation total talar prostheses (TTPs) are viable options for talar avascular necrosis (AVN) in the absence of neighboring joint pathology. The use of modern three-dimensional (3D) printing allows the production of custom implants that exactly mimic the patient's anatomy. The aim of this study is to determine the accuracy of 3D printing in reproducing a synthetic talus and, in doing so, restoring more normal anatomical relationships. We hypothesize that this mode of replication will restore and maintain normal radiographic alignment of the ankle, subtalar, and forefoot joints in the setting of talar AVN...
March 1, 2018: Foot & Ankle Specialist
Ying-Zhou Li, Feng Ye, Lei Wan, Yong-Bo Yang, Yuan-Sheng Chen, Xiao Wang
OBJECTIVE: To investigate the preliminary effects of modified percutaneous compression plate in treating femoral neck fractures of Pauwels type III. METHODS: From March 2012 to March 2016, 35 patients with femoral neck fracture were treated by closed reduction and internal fixation with a modified percutaneous compression plate, including 21 males and 14 females with an average age of 45 years old ranging from 23 to 62 years old. The anatomical position of fracture was divided into 8 cases of lower head type, 27 cases of head and neck...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Hao-Shan Guo, Yi-Jun Tian, Gang Liu, Long An, Zhan-Guo Zhou, Huan-Zhen Liu
OBJECTIVE: To observe the clinical effects of arthroscopy-guided core decompression and bone grafting combined with selective arterial infusion for early stage avascular necrosis of femoral head. METHODS: From January 2010 to December 2014, 76 patients(76 hips) diagnosed as Ficat II stage avascular necrosis of femoral head were randomly divided into experimental group and control group. In the experimental group, there were 27 males and 8 females aged from 24 to 55 years old with an average of (43...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Takumi Matsumoto, Christopher E Gross, Selene G Parekh
Distal Chevron osteotomy is a well-established surgical procedure for mild to moderate hallux valgus deformity. Many methods have been described for fixation of osteotomy site; secure fixation, enabling large displacement of the metatarsal head, is one of the essentials of this procedure. The purpose of the present study was to evaluate the short-term radiographic outcome of a distal Chevron osteotomy using an intramedullary plate for the correction of hallux valgus deformity. The present study evaluated 37 patients (40 feet) who underwent distal Chevron osteotomy using an intramedullary plate by periodic radiographs obtained preoperatively and at 4 weeks, 8 weeks, 3 months, and 6 months postoperatively...
March 1, 2018: Foot & Ankle Specialist
Siddharth A Mahure, Joseph A Bosco, James D Slover, Jonathan Vigdorchik, Richard Iorio, Ran Schwarzkopf
BACKGROUND: Individuals coinfected with both hepatitis C virus (HCV) and HIV represent a unique and growing population of patients undergoing orthopaedic surgical procedures. Data regarding complications for HCV monoinfection or HIV monoinfection are robust, but there are no data available, to our knowledge, on patients who have both HCV and HIV infections. QUESTIONS/PURPOSES: We sought to determine whether patients with coinfection differed in terms of baseline demographics and comorbidity burden as compared with patients without coinfection and whether these potential differences were translated into varying levels of postoperative complications, mortality, and hospital readmission risk...
February 2018: Clinical Orthopaedics and related Research
Benjamin Zielonka, Alan R Cohen, Kim Smith-Whitley, Bhavya S Doshi
Although musculoskeletal pain in patients with sickle cell disease (SCD) is most frequently the result of vaso-occlusive episodes, clinicians often consider other etiologies including osteomyelitis, avascular necrosis, and trauma. In this study, we report the case of a young female with SCD with hip and back pain secondary to a nontraumatic iliopsoas periosteal hematoma with evidence of adjacent bone infarction. The pathophysiology, diagnostic considerations, and management of periosteal hematomas in SCD are reviewed...
March 12, 2018: Pediatric Blood & Cancer
Niv Marom, Joseph J Ruzbarsky, Naomi Roselaar, Robert G Marx
The multiple ligament injured knee presents a challenge with regard to management and treatment. Immediate management of the acute injury requires special attention and thorough examination because knee dislocations have been associated with significant complications. Treatment options range from closed reduction and immobilization to surgical repair and/or reconstruction of the injured ligaments. This article focuses on complications that may result from surgical treatments of the multiple ligament injured knee and ways of prevention...
April 2018: Clinics in Sports Medicine
C Z Esenyel, I Kalkar, M Adaş, S S Dedeoğlu, C D Büyükkurt, H Cabuk, A E Esenyel
Objective: To evaluate the functional and radiological results of patients with and without medial calcar continuity in plate osteosynthesis applied for a proximal humerus fracture retrospectively. Methods: The study included 27 patients to whom plate osteosynthesis was applied because of a proximal humerus fracture between January 2, 2010, and December 30, 2013, at Okmeydanı Research and Training Hospital. Patients were separated into Group A with medial calcar continuity and Group B without medial calcar continuity...
March 2018: Nigerian Journal of Clinical Practice
Andreas Panagopoulos, Irini Tatani, Seferlis Yannis, Bavelou Aikaterini, Antonis Kouzelis, Minos Tyllianakis, Panayotis Dimakopoulos
Background: The valgus-impacted (VI) 4-part fractures are a subset of fractures of the proximal humerus with a unique anatomic configuration characterized by a relatively lower incidence of avascular necrosis after operative intervention. Objectives: The present study reports the midterm clinical and radiological results of a large series of consecutive patients with 4-part VI fractures treated with a minimal invasive technique of internal fixation. Methods: Over a ten-year period (2004-2014), we treated 56 patients with a true 4-part valgus impacted fracture of the proximal part of the humerus...
2018: Open Orthopaedics Journal
Qian Wen, Shimeng Zhang, Xialin Du, Ruining Wang, Yanfen Li, Honglin Liu, Shengfeng Hu, Chaoying Zhou, Xinying Zhou, Li Ma
Absence of effective therapeutic methods for avascular necrosis of femoral head (ANFH) is still perplexing the world's medical community. Bone marrow mesenchymal stem cells (BMSCs) adoptive cell therapy combined with core decompression is a promising modality, which is highly dependent on the cellular activities of BMSCs. Hepatocyte growth factor (HGF) is a survival factor for BMSCs, yet the underlying mechanism is not fully elucidated. In this study, the effects of multiplicity of infections (MOIs) of recombinant adenovirus carrying HGF gene (rAd-HGF) on human BMSC proliferation and osteogenic differentiation were systemically examined...
March 5, 2018: International Journal of Molecular Sciences
S Guner, S I Guner, M A Gokalp, M F Ceylan, S S Unsal, H Demir
OBJECTIVE: In view of the high occurrence of avascular necrosis of the femoral head (ANFH) after femoral neck fracture and the difficulties in the treatment, our work aimed to explore the effects of platelet-rich plasma (PRP) combined with tri-calcium phosphate (TCP) on the repair of ANFH after femoral neck fracture and to provide reference for clinical treatment. MATERIALS AND METHODS: Thirty New Zealand white rabbits were randomly divided into control group, TCP group, and PRP+TCP group...
February 2018: European Review for Medical and Pharmacological Sciences
X-L Zhang, Y-M Wang, K Chu, Z-H Wang, Y-H Liu, L-H Jiang, X Chen, Z-Y Zhou, G Yin
OBJECTIVE: In view of the high occurrence of avascular necrosis of the femoral head (ANFH) after femoral neck fracture and the difficulties in the treatment, our work aimed to explore the effects of platelet-rich plasma (PRP) combined with tri-calcium phosphate (TCP) on the repair of ANFH after femoral neck fracture and to provide reference for clinical treatment. MATERIALS AND METHODS: Thirty New Zealand white rabbits were randomly divided into control group, TCP group, and PRP+TCP group...
February 2018: European Review for Medical and Pharmacological Sciences
Christiane Kruppa, Tyler Snoap, Debra L Sietsema, Thomas A Schildhauer, Marcel Dudda, Clifford B Jones
The outcomes of pediatric talus fractures have been minimally reported in published studies. The purpose of the present retrospective study was to determine the clinical and radiographic outcomes after talus fractures in pediatric and adolescent patients and to define the differences among the different age groups in this population. A total of 52 children and adolescents (54 fractures) with 24 type 1 (44.44%), 13 type 2 (24.07%), 8 type 3 (14.81%), and 9 type 4 (16.67%) Marti-Weber fractures were considered...
March 2, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Peter J Simm, Andrew Biggin, Margaret R Zacharin, Christine P Rodda, Elaine Tham, Aris Siafarikas, Craig Jefferies, Paul L Hofman, Diane E Jensen, Helen Woodhead, Justin Brown, Benjamin J Wheeler, Denise Brookes, Antony Lafferty, Craig F Munns
Bisphosphonate therapy is the mainstay of pharmacological intervention in young people with skeletal fragility. The evidence of its use in a variety of conditions remains limited despite over three decades of clinical experience. On behalf of the Australasian Paediatric Endocrine Group, this evidence-based consensus guideline presents recommendations and discusses the graded evidence (using the GRADE system) for these recommendations. Primary bone fragility disorders such as osteogenesis imperfecta are considered separately from osteoporosis secondary to other clinical conditions (such as cerebral palsy, Duchenne muscular dystrophy)...
March 2018: Journal of Paediatrics and Child Health
Xiangnan Ren, Wu Fan, Zixing Shao, Kaiyun Chen, Xuefeng Yu, Qionglin Liang
The early and accurate diagnosis of steroid-induced avascular necrosis of the femoral head (SANFH) is appealing considering its irreversible progression and serious consequence for the patients. The purpose of this study was to investigate the metabolic change of SANFH for its early detection. Two stages were designed in this study, namely discovery and verification. Except the biochemical index anomaly and the accidental death, 30 adult healthy adult Japanese white rabbits were used for screening out the potential metabolites in discovery experiment and 13 rabbits were used in verification experiment...
January 30, 2018: Oncotarget
Jing Luo, Felix S Chew, Alice S Ha
Ankle cheilectomy as surgical treatment for anterior ankle impingement has high rates of procedural success and low rates of complications when performed before the onset of significant osteoarthritis. We present 3 patients who developed insufficiency fractures of the talar neck following cheilectomy for anterior ankle impingement. Due to the high risk of avascular necrosis associated with displaced talar neck fractures, the recognition of talar insufficiency fractures by the radiologist can aid in the timely diagnosis and initiation of intervention...
February 2018: Radiology Case Reports
William J Sanders
Background: Sickle cell trait is usually an asymptomatic presentation of a patient with slightly different hemoglobin molecule makeup than normal. It is similar to a more serious disease, sickle cell disease, in which a person's hemoglobin is mutated in such a way that causes their red blood cells to easily change shape in certain environmental and internal states; this causes red blood cells to adhere to the walls and occlude the lumen of the arteries in which they travel, leading to downstream effects secondary to ischemia...
2018: BMC Hematology
J Randolph Clements, François Dijour, Wesley Leong
The tarsal navicular is a critical component of the foot's medial longitudinal arch. Injuries to the navicular have significant long-term functional consequences. In addition to stress fractures, acute injuries to the navicular include acute avulsion, tuberosity, and body fractures. Nonoperative treatment is the mainstay for avulsion injuries and nondisplaced body fractures. Open reduction and internal fixation is performed to achieve anatomic reduction in the other situations. Common complications following operative intervention include pain, stiffness, post-traumatic arthritis, avascular necrosis, nonunion, and hindfoot deformity...
April 2018: Clinics in Podiatric Medicine and Surgery
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