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Trochanter damage

M Leunig, H M Manner, L Turchetto, R Ganz
NEW PATHOPHYSIOLOGICAL INSIGHTS: Based on improved knowledge of the vascular supply of the proximal femur, a safe surgical dislocation of the hip joint was established allowing direct insights to the pathomorphological malfunctioning of the joint. One insight was that slipped capital femoral epiphysis (SCFE) impingement leads to substantial damage of the chondrolabral rim area, even in the presence of minor slips. A further surgical development was the extended retinacular flap allowing for correction of the deformity with calculable risk for iatrogenic necrosis...
April 2017: Journal of Children's Orthopaedics
Ahmed I Hammouda, Julio J Jauregui, Martin G Gesheff, Shawn C Standard, John E Herzenberg
BACKGROUND: Antegrade intramedullary (IM) nailing for skeletally immature femur fractures can damage the capital femoral epiphysis blood supply, leading to avascular necrosis (AVN) of the femoral head. Reported AVN rates are 2% for piriformis entry and 1.4% for trochanteric entry. None of previous reports described IM lengthening nails for limb lengthening procedures. We have used self-lengthening telescopic nails with a proximal Herzog bend and standard trochanteric entry for femoral lengthening in children...
June 2017: Journal of Pediatric Orthopedics
J Tang, M Lv, Y X Zhou, J Zhang
OBJECTIVE: To analyze the operation technique and the methods to avoid early complications on the learning curve for bilateral direct anterior approach (DAA) total hip arthroplasty (THA). METHODS: We retrospectively studied a series of continued cases with bilateral avascular necrosis of the femoral head (AVN) or degenerative dysplastic hip and rheumatoid arthritis that were treated by DAA THA in Beijing Jishuitan Hospital. A total of 22 patients with 44 hips were analyzed from June 2014 to August 2016 in this study...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Jakub Sikora-Klak, James D Bomar, Christina N Paik, Dennis R Wenger, Vidyadhar Upasani
BACKGROUND: Recent studies have demonstrated the intra-articular cartilage and labral damage that can occur from the proximal femoral cam-like deformity of a moderate to severe slipped capital femoral epiphysis (SCFE). The approach to treating this deformity in a symptomatic Loder stable hip is controversial. The purpose of this study was to compare radiographic outcomes, complication rates, and revision rates between Imhauser type triplane proximal femoral osteotomy (TPFO) and the modified Dunn procedure (MDP)...
March 10, 2017: Journal of Pediatric Orthopedics
Michael M Nogler, Martin R Thaler
BACKGROUND: The direct anterior approach (DAA) to the hip has been criticized as an approach that is limited to primary arthroplasty only. Our study objective was to demonstrate, in a cadaveric setting, that an alternate extension of the DAA can be used to reach the femur at the posterior border of the lateral vastus muscle without endangering the nerve supply. METHODS: The iliotibial tract is split anteriorly and pulled laterally, thereby opening the interval to the lateral-posterior aspect of the vastus muscle...
February 2017: Journal of Arthroplasty
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
B Heimkes
BACKGROUND: The structure of apophyses and apophyseal growth plates is not substantially different from those of epiphyses and epiphyseal growth plates. In contrast to epiphyseal growth plates, apophyses and apophyseal growth plates do not contribute to the longitudinal growth of the extremity. They are associated with their adjacent joints, triggering the lengths of their lever arms and influencing their external shape and internal architecture. The formative stimulus on apophyses is given by muscles and tendons inserting at the apophysis or canopying the apophsis...
March 2016: Der Orthopäde
Dongmin Xiao, Ming Ye, Xiong Li, Hong Wu, Chi Zhong
OBJECTIVE: This work aims to perform a biomechanical test to evaluate the effect of interior supporting system and tantalum rod in simulating the treatment of ischemic necrosis of the femoral head. METHOD: Three models were established: control group (group A), interior supporting system group (group B), and tantalum rod group (group C). Step-by-step loading was applied on the top of the femoral head until femoral head damage occurs by using the testing machine of the material test system...
2015: International Journal of Clinical and Experimental Medicine
Phonthakorn Panichkul, Kevin B Fricka, Robert H Hopper, C Anderson Engh
Adverse reaction to metal debris (ARMD) involving the hip joint has emerged as an important reason for failure and revision among patients with metal-on-metal (MOM) hip arthroplasty. To the authors' knowledge, there are no reports of adverse radiographic sequelae in the greater trochanter subsequent to revision for ARMD. The authors describe clinical and radiographic findings in 2 patients who developed greater trochanteric fragmentation 1 to 2 years after conversion of their failed MOM hips to polyethylene bearings...
May 2015: Orthopedics
Masaki Fujioka, Aya Yakabe, Kana Masuda, Yosinobu Imamura
 Pressure ulcers commonly occur on the sacrum, ischium, lateral trochanter, and heel where pressure or shearing forces continuously affect bony prominences. The following describes three cases of unusual pressure ulcers of the cheek and upper extremity. Patients developed the wounds as a result of lying face downward on the hand for a prolonged period. All facial wounds were treated conservatively and eventually healed, but the damage to the hands was irreversible due to severe complications related to muscle contraction...
May 2010: Wounds: a Compendium of Clinical Research and Practice
Yutaka Kuroda, Haruhiko Akiyama, Manabu Nankaku, Kazutaka So, Shuichi Matsuda
BACKGROUND: A lateral approach is common in total hip arthroplasty because of the good exposure it provides and its low complication rates. However, a drawback of the procedure is that the abductor mechanism is damaged when the tendinous insertion of the abductor muscle is split. Here, we describe a wafer technique using ultra-high-molecular-weight polyethylene tape for promising reattachment of the abductor mechanism. METHODS: We retrospectively evaluated 120 consecutive primary total hip arthroplasties performed using a modified Mostardi approach, which involved reattaching the trochanter using either a braided polyester suture (polyester suture group, n = 60) or ultra-high-molecular-weight polyethylene tape (UHMWPE tape group, n = 60)...
July 2015: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Binhua Li, Bin Zhang, Zhihui Ding, Yuan Liu, Min Dai
This cadaveric study was designed to clarify the anatomic basis of using an anterolateral intermuscular approach to repair type A2 intertrochanteric fractures (ITF). The conventional lateral approach to surgery that is used for ITF has several disadvantages that can result in both intraoperative and postoperative complications, especially for type A2 ITF. Previous studies have suggested using minimally-invasive total hip arthroplasty (THA) with an anterolateral approach. The legs of 10 formalin-fixed Asian cadavers were dissected, simulating an anterolateral surgical approach...
February 2015: International Surgery
Elizabeth A Howse, Sandeep Mannava, Cüneyt Tamam, Hal D Martin, Miriam A Bredella, Allston J Stubbs
Ischiofemoral space impingement has become an increasingly recognized extracapsular cause of atypical hip, deep gluteal, and groin pain that can be treated endoscopically. We present a minimally invasive posterolateral technique that preserves the attachment of the iliopsoas tendon and quadratus femoris insertion while decompressing the ischiofemoral space by resecting the lesser trochanter. Furthermore, we present tips to perform this technique in a manner that minimizes the potential for damage to the sciatic nerve...
December 2014: Arthroscopy Techniques
Fumihiro Mizokami, Yoshiko Takahashi, Tetsuya Nemoto, Yayoi Nagai, Makiko Tanaka, Atsushi Utani, Katsunori Furuta, Zenzo Isogai
A pressure ulcer is defined as damage to skin and other tissues over a bony prominence caused by excess pressure. Deep pressure ulcers that develop over specific bony prominences often exhibit wound deformity, defined as a change in the 3-dimensional shape of the wound. Subsequently, the wound deformity can result in undermining formation, which is a characteristic of deep pressure ulcers. However, to date, a concept with respect to alleviating wound deformity has yet to be defined and described. To clarify the issue, we propose a new concept called "wound fixation" based on the physical properties of deep pressure ulcers with wound deformity...
February 2015: Journal of Tissue Viability
Tsuyoshi Nakai, Naxin Liu, Kazumasa Fudo, Toshikazu Mohri, Masaaki Kakiuchi
BACKGROUND: For total hip arthroplasty (THA), minimally invasive surgery (MIS) has been developed to reduce incision length, muscle damage, and a shorter hospital stay. However, reduced exposure of anatomical landmarks may result in technical errors and inferior implant survivorships. The aim of this study was to report the short-term results and clinical complications of primary MIS THA in the supine position. METHODS: A consecutive series of 103 patients who underwent MIS cementless THA with a modified Watson-Jones anterolateral approach (AL) were enrolled...
December 2014: Journal of Orthopaedics
S Raux, K Abelin-Genevois, I Canterino, F Chotel, R Kohler
INTRODUCTION: Osteoid osteoma is a benign osteogenic tumor that is mainly located in the lower limbs. According to Campanacci the proximal femur is involved in 25% of cases. We present a series of 44 cases of osteoid osteoma located in the neck of the femur or the lesser trochanter treated by the minimally invasive method, CT-guided percutaneous bone resection and drilling (PBRD). MATERIALS AND METHODS: This series included 44 patients, 20 girls and 24 boys, treated between 1987 and 2012...
October 2014: Orthopaedics & Traumatology, Surgery & Research: OTSR
J R Rether, D Höntzsch
OBJECTIVE: Antegrade femoral nailing through a greater trochanteric entry portal avoids damage to the proximal external rotators and to the ramus profundus of the medial femoral circumflex artery, furthermore eases insertion in adipose subjects. However a helical nail shape is necessary for this pathway because bending in two perpendicular planes has to be passed by the nail. INDICATIONS: All femoral shaft fractures suitable for antegrade nailing (type 32-A/B/C)...
October 2014: Operative Orthopädie und Traumatologie
Jian Xu, Xiang Geng, Hassan Muhammad, Xu Wang, Jia-Zhang Huang, Chao Zhang, Xin Ma
Gluteal muscle contracture is not very common, but cases are still seen in China. Open surgical treatment is considered as an efficient method to treat this disease. However, the type of incision that can provide best results is yet to be determined. The authors therefore compared various incisions to determine the better one. In this retrospective study, patients who underwent surgery with a traverse straight incision, a curved incision, a longitudinal straight incision, or an 'S'-shaped incision above the greater trochanter were enrolled and divided into four groups: A, B, C, and D...
September 2014: Journal of Pediatric Orthopedics. Part B
T Repantis, T Bouras, P Korovessis
BACKGROUND: It is a general belief among hip surgeons that minimally invasive surgical (MIS) approach for implantation of a total hip arthroplasty (THA) allows an improved and faster postoperative rehabilitation because of reduced muscle and soft-tissue damage, less postoperative pain and blood loss, and shorter hospital stay compared with conventional approaches. In the published relative literature though, there are controversial reports and debates on this matter. To our knowledge, there is no study on the medium-term functional results comparing MIS and traditional approaches for total hip replacement...
January 2015: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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