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Trochanter complication

A H Abdelazeem, F K Beder, M M Abdel Karim, H Abdelazeem, H Abdel-Ghani
AIMS: This study analysed the clinical and radiological outcome of anatomical reduction of a moderate or severe stable slipped capital femoral epiphysis (SCFE) treated by subcapital osteotomy (a modified Dunn osteotomy) through the surgical approach described by Ganz. PATIENTS AND METHODS: We prospectively studied 31 patients (32 hips; 16 females and five males; mean age 14.3 years) with SCFE. On the Southwick classification, ten were of moderate severity (head-shaft angle > 30° to 60°) and 22 were severe (head-shaft angle > 60°)...
September 2016: Bone & Joint Journal
Weverley Rubele Valenza, Jamil Faissal Soni, Christiano Saliba Uliana, Fernando Ferraz Faria, Gisele Cristine Schelle, Daniel Sakamoto Sugisawa
OBJECTIVE: To present our experience and preliminary results from using controlled hip dislocation to treat cam-like femoroacetabular impingement, in teenagers and young adults with sequelae of slipped capital femoral epiphysis. METHODS: This was a retrospective analysis on 15 patients who were treated in a tertiary-level hospital between 2011 and 2013. The following data were collected for analysis from these patients' files: demographic data, surgical procedure reports, joint mobility evaluations, patients' perceptions regarding clinical improvement and whether they would choose to undergo the operation again, previous hip surgery and complications...
July 2016: Revista Brasileira de Ortopedia
Stijn G M Ghijselings, Ronald Driesen, Jean-Pierre Simon, Kristoff Corten
BACKGROUND: The direct anterior approach (DAA) is becoming more popular as the standard surgical approach for primary total hip arthroplasty. However, femoral complications of up to 2.8% have been reported. Therefore, it is important for surgeons to understand the periarticular neurovascular anatomy in order to safely deal with intraoperative complications. METHODS: Anatomic dissections were performed on 20 cadaveric hips. The neurovascular structures anterior to the femur and distal to the intertrochanteric line were dissected and its position was described in relation to anatomic landmarks easily identified through the DAA: anterior superior iliac spine (ASIS), the insertion of the gluteus minimus (GM), and the lesser trochanter (LT)...
July 15, 2016: Journal of Arthroplasty
D D Baksi, A K Pal, D P Baksi
BACKGROUND: Ununited femoral neck fracture is seen commonly in developing countries due to delayed presentation or failure of primary internal fixation. Such fractures, commonly present with partial or total absorption of femoral neck, osteonecrosis of femoral head in 8-30% cases with upward migration of trochanter posing problem for osteosynthesis, especially in younger individuals. Several techniques for treatment of such conditions are described like osteotomies or nonvascularied cortical or cancellous bone grafting provided varying degrees of success in terms of fracture union but unsatisfactory long term results occurred due to varying incidence of avascular necrosis (AVN) of femoral head...
July 2016: Indian Journal of Orthopaedics
A Gänsslen, S Grechenig, M Nerlich, M Müller
Historically, standard approaches for surgical treatment of displaced acetabular fractures were the KocherLangenbeck approach, the ilioinguinal approach and the extended iliofemoral approach (12). Presently, several modifications of these approaches are accepted alternatives, especially anterior modifications based on the intrapelvic approach described by Hirvensalo (8). Single access approaches allowing visualization of one acetabular column are the posterior Kocher-Langenbeck approach and the anterior ilioinguinal approach (12) and the use of a single approach is favoured (9, 24)...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Do-Hyeong Kim, Duck Mi Yoon, Kyung Bong Yoon
BACKGROUND: The quadratus femoris (QF) muscle is a possible source of lower buttock pain as evidenced by what is known about the pathophysiology of ischiofemoral impingement syndrome. However, there are few reports about the interventional management of the QF muscle as a pain generator. OBJECTIVE: To describe an ultrasound-guided QF muscle injection technique in patients with lower buttock pain suspected of QF muscle pathology and to report the result of treatment...
July 2016: Pain Physician
Scott A Christopher, Stanley E Kim, Simon Roe, Antonio Pozzi
Periprosthetic femoral fractures are a common complication associated with cementless press-fit total hip arthroplasty. The use of prophylactic cerclage wire fixation has been advocated to reduce this complication. The objective of this study was to evaluate whether a double loop cerclage wire, used as adjunctive fixation, increased the peak torsional load to failure in femora implanted with press-fit cementless stems. Peak torsional load to failure was compared between femora without adjunctive fixation and femora receiving a 1 mm double loop cerclage wire placed proximally to the lesser trochanter...
August 2016: Veterinary Journal
Olivier Herisson, Arnaud Felden, Moussa Hamadouche, Philippe Anract, David J Biau
BACKGROUND: Leg length discrepancy after total hip arthroplasty is a frequent complication. The aim of this study was to assess the validity (correlation) and reproducibility (inter-rater agreement) of various intraoperative hip radiographs measures to estimate leg length. METHODS: Patients were included if they were aged 15 years or older; were eligible for a total hip arthroplasty, and were operated in lateral recumbent. An intraoperative hip radiograph was performed with the definitive implants in place...
May 11, 2016: Journal of Arthroplasty
Najmul Huda, Julfiqar, Ajay Pant, M Aslam
INTRODUCTION: Perioperative complications are well known during partial and total hip arthroplasty. One of the common categories of these complications is an intraoperative fractures of the proximal femur. Here we discuss a case of perforation of posteromedial cortex of the proximal femur, while doing a press fit modular bipolar hemiarthroplasty, in a young adult with secondary nonunion of the femoral neck fracture. The cause of this proximal femur perforation was residual fibular strut graft that, redirected the femoral stem into undesirable direction...
July 2015: Journal of Orthopaedic Case Reports
Vito Potenza, Ubaldo Saputo, Francesco Catellani, Pasquale Farsetti, Roberto Caterini
INTRODUCTION: Injury of femoral vessels is an extremely rare complication in intertrochanteric femoral fractures. In most cases reported, the vascular lesion involves the superficial femoral artery, whereas in very few cases does it involve the profunda femoris artery. PRESENTATION OF CASE: We report a case of acute bleeding due to laceration of a perforating branch of the profunda femoris artery caused by a sharp fragment of the displaced lesser trochanter in an intertrochanteric femoral fracture; the lesion was treated by transcatheter embolization...
2016: International Journal of Surgery Case Reports
Walla Atchi, Abalo Anani, Dellanh Yannick, Ayouba Gamal, Dossim Assang
Anterior traumatic dislocations of the hip are much less common than posterior dislocations. To date, 14 cases of open anterior dislocation of the hip associated with such injuries, acetabular and femoral head fractures and femoral vascular and nerve damage have been reported. We present a case of a 23-year-old male who sustained open anterior dislocation of the hip with ipsilateral fracture of the greater trochanter after an accident on the public highway. Additional lesions included an iliac wing fracture and a perineal wound...
June 2016: Clinics in Orthopedic Surgery
Yinwen Liu, Yuxin Zheng, Ziliang Shen, Shuqiang Wang, Xiaoen Wei, Xinfeng Gu, Hongsheng Zhan, Yong Kuang
PURPOSE: The purpose of this study was to describe and evaluate the clinical application of the technique of interlocking intramedullary (IM) nailing via an entry point at the tip of greater trochanter using a specially designed femoral hollow trephine to stabilize diaphyseal fractures of the femur. METHODS: From February 2010 to April 2014, 35 consecutive patients with femoral shaft fractures were treated by the therapy of bone grafting from trochanter region with interlocking IM nail...
May 28, 2016: International Orthopaedics
Balasubramanian Balakumar, Sanjeev Madan
PURPOSE: Contemporary methods for the management of neck deformity following a healed severe slipped capital femoral epiphysis (SCFE) include subcapital neck osteotomy. METHODS: 18 patients with chronic severe SCFE in the oblique plane (mean slip angle = 70°) constituted the study group. 6 patients with an open physis underwent modified Dunn capital realignment and 12 patients with a closed physis underwent surgical dislocation with a corrective neck osteotomy...
July 25, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
George N Guild, Robert P Runner, Tracy D Rickels, Ryan Oldja, Ahmad Faizan
BACKGROUND: The incidence of revision hip arthroplasty is increasing with nearly 100,000 annual procedures expected in the near future. Many surgeons use straight modular tapered stems in revisions; however, complications of periprosthetic fracture and cortical perforation occur, resulting in poor outcomes. Our objective was to identify patient demographics and femoral characteristics that predispose patients to cortical perforation when using the straight modular stems. METHODS: We used a computed tomography database and modeling software to identify patient demographics and morphologic femoral characteristics that predispose patients to cortical perforation during revision hip arthroplasty...
April 13, 2016: Journal of Arthroplasty
Mohammed M Ahmed, Thomas J Otto, Berton R Moed
BACKGROUND: Limited-incision total hip arthroplasty (THA) preserves hip abductors, posterior capsule, and external rotators potentially diminishing dislocation risk. However, potential complications also exist, such as component malposition. Specific implants have been manufactured that enhance compatibility with this technique, while preserving metaphyseal bone; however, little data exists documenting early complications and component position. The purpose was to evaluate primary THA using a curved, bone-sparing stem inserted through the anterior approach with respect to component alignment and early complications...
2016: Journal of Orthopaedic Surgery and Research
Morad Chughtai, Jaydev B Mistry, Aloise M Diedrich, Julio J Jauregui, Randa K Elmallah, Peter M Bonutti, Steven F Harwin, Arthur L Malkani, Frank R Kolisek, Michael A Mont
BACKGROUND: Dislocation complicates 1% to 5% of primary total hip arthroplasties (THAs). As a result, some surgeons consider dual-mobility articulations, which are usually used in the revision setting to decrease the likelihood of dislocation, as an option for primary THA. However, few studies have evaluated their use in this setting. QUESTIONS/PURPOSES: (1) What is the cup survivorship when the dual-mobility articulation is used in the setting of primary THA? (2) What are the clinical outcomes with this approach? (3) What are the radiographic outcomes? (4) What are the complications of dual-mobility articulations in primary THA? METHODS: Between 2011 and 2013, the five participating surgeons performed 495 cementless primary THAs...
October 2016: Clinical Orthopaedics and related Research
S Molière, J-C Dosch, G Bierry
Pelvic ring fractures when caused by trauma, either violent or in demineralized bone, generally consist of injuries in both the anterior (pubic symphysis and rami) and posterior (iliac wing, sacrum, sacroiliac joint) portions. Injury classifications are based on injury mechanism and pelvic stability, and are used to determine treatment. Acetabular fractures, associated or not to pelvic ring disruption, are classified on the basis of fracture line, into elementary fractures of the acetabular walls, columns and roof, and into complex fractures...
July 2016: Diagnostic and Interventional Imaging
Long Qin, Zexing Zhu, Diyu Song, Jianqiang Xu, Hao Yu, Shuming Zhang
OBJECTIVE: To investigate the effectiveness of the modified Urbaniak operation to treat avascularnecrosis of the femoral head (ANFH). METHODS: A retrospective analysis was made on the clinical data of 38 patients (41hips) with ANFH treated between February 2010 and October 2012 with the modified Urbaniak operation (to add lateralfemoral incision based on femoral greater trochanter incision, to preserve the original fibula flap drilling, decompressionand filling through trochanteric outer cortex, and to select the descending branch of lateral circumflex femoral artery asthe supply vessel)...
January 2016: Chinese Journal of Reparative and Reconstructive Surgery
Zhen Liu, Yong Qiu, Huang Yan, Zong-shan Hu, Feng Zhu, Jun Qiao, Lei-lei Xu, Bin Wang, Yang Yu, Bang-ping Qian, Ze-zhang Zhu
The purpose of this study was to introduce a powerful technique for the treatment of kyphoscoliosis. There are currently multiple techniques for sacropelvic fixation, including trans-iliac bars and iliac and iliosacral screws. Several studies have documented the use of these instrumentation techniques; however, a ubiquitous problematic issue concerns the need for separate incisions for the use of offset connectors, which add to surgical time and morbidity. Any additional dissection of the skin, subcutaneous tissue or muscle in this area is believed to increase the incidence of complications of wound healing...
February 2016: Orthopaedic Surgery
Yanfeng Tang, Youwen Liu, Yingjie Zhu, Jianming Li, Wuyin Li, Qiyi Li, Yudong Jia
OBJECTIVE: To discuss the value of surgical hip dislocation approach in the treatment of femoral head fracture. METHODS: A retrospectively analysis was made on the clinical data of 15 patients with femoral head fractures treated through surgical hip dislocation approach between January 2010 and February 2013. There were 11 men and 4 women with an average age of 30.8 years (range, 15-63 years). The causes included traffic accident injury in 9 cases, falling injury from height in 5 cases, and sports injury in 1 case...
November 2015: Chinese Journal of Reparative and Reconstructive Surgery
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