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Tom J Crijns, Stein J Janssen, Jacob T Davis, David Ring, Hugo B Sanchez
BACKGROUND: Radiographic fracture classification helps with research on prognosis and treatment. AO/OTA classification into fracture type has shown to be reliable, but further classification of fractures into subgroups reduces the interobserver agreement and takes a considerable amount of practice and experience in order to master. QUESTIONS/PURPOSES: We assessed: (1) differences between more and less experienced trauma surgeons based on hip fractures treated per year, years of experience, and the percentage of their time dedicated to trauma, (2) differences in the interobserver agreement between classification into fracture type, group, and subgroup, and (3) differences in the interobserver agreement when assessing fracture stability compared to classifying fractures into type, group and subgroup...
March 14, 2018: Injury
Agraharam Devendra, M Avinash, Dinesh Chidambaram, Jayaramaraju Dheenadhayalan, S Rajasekaran
PURPOSE: The cerclage passer instrument was introduced for aiding percutaneous reduction in spiral femur fractures, thereby overcoming the risk of devascularization of the fracture ends commonly associated with traditional open cerclage wiring techniques. This may, however, predispose to iatrogenic vascular injuries owing to the proximity of the vessels and several other factors. We report four cases with femoral artery (superficial and deep) injuries caused by the cerclage passer in proximal femur and distal femur shaft fractures and incidence of these injuries in our institution...
January 2018: Journal of Orthopaedic Surgery
Wen-Lin Hu, Zhan-Feng Zhang, Li-Hua Shi
OBJECTIVE: To study the effect of greater trochanteric slide osteotomy(GTSO) in total hip arthroplasty (THA) for the treatment of stiff hip, as well as the potential complications. METHODS: There were 12 cases enrolled in the study from April 2010 to December 2014, including 9 males and 3 females. The mean age was 49.9 years old (ranged, 37 to 62 years old). The clinical result was evaluated according to the Harris evaluation system, and the radiological evaluations included the healing of the osteotomy, the stability of the prosthesis, and occurrence of heterotopic ossification (HA)...
August 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Ashok S Gavaskar, Naveen C Tummala, Parthasarathy Srinivasan, Hitesh Gopalan, Bhupesh Karthik, S Santhosh
OBJECTIVES: To compare the radiological and clinical results with PFNA - II and InterTan in the treatment of unstable trochanteric fractures in the elderly DESIGN:: Retrospective, multi-center, matched pair SETTING:: 3 tertiary level trauma centres PATIENTS:: 100 elderly patients who underwent intramedullary stabilisation with either the PFNA - II or the InterTan for osteoporotic unstable trochanteric fractures. INTERVENTIONS: 50 matched pairs consisting of AO - A2 and A3 fractures were created from a cohort of 290 patients who underwent internal fixation for unstable trochanteric fractures with the PFNA - II or InterTan nails...
February 9, 2018: Journal of Orthopaedic Trauma
A R Díaz, P Z Navas
INTRODUCTION AND OBJECTIVES: The differences between the two main types of fracture of proximal end of the femur, trochanteric and cervical fractures, are still a subject of study, and could be the key to a better understanding of its pathophysiology and prevention. The aim of this study is to determine whether epidemiological differences in the distribution of risk factors associated with hip fracture exist between these two entities. PATIENTS AND METHOD: A descriptive cross-sectional study of 428 patients over the age of 65 admitted for trochanteric or cervical fractures in 2015, in which gender, age, previous diagnosis, external causes associated with fracture and place of the event were recorded...
February 8, 2018: Revista Española de Cirugía Ortopédica y Traumatología
Yin-Qiao Du, Yong-Gang Zhou, Li-Bo Hao, Wen-Ming Wu, Hai-Yang Ma, Chong Zheng, Shang Piao, Zhi-Sen Gao, Jing-Yang Sun, Sen Wang
OBJECTIVE: To study the complications and efficacy of self-made, antibiotic-loaded cement articulating spacers in the treatment of the infected hip replacement. METHODS: Between January 2006 and July 2016, 265 patients (266 hips) received a self-made, antibiotic-loaded cement articulating spacer as part of a two-stage protocol. Among those patients, there were 143 males(144 hips) and 122 females(122 hips). The cement articulating spacers with vancomycin and two Steinman pins were made by a self-made mold system...
May 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Alicja J Bojan, Anders Jönsson, Hans Granhed, Carl Ekholm, Johan Kärrholm
Cut-out complication remains a major unsolved problem in the treatment of trochanteric hip fractures. A better understanding of the three-dimensional fracture-implant motions is needed to enable further development of clinical strategies and countermeasures. The aim of this clinical study was to characterise and quantify three-dimensional motions between the implant and the bone and between the lag screw and nail of the Gamma nail. Radiostereometry Analysis (RSA) analysis was applied in 20 patients with trochanteric hip fractures treated with an intramedullary nail...
January 12, 2018: Injury
Alexander R Vap, Justin J Mitchell, Karen K Briggs, Shannen C McNamara, Marc J Philippon
PURPOSE: To determine the prevalence of chronic trochanteric bursitis (TB) in patient being treated for femoroacetabular impingement (FAI) and determine the effectiveness of arthroscopic bursectomy and iliotibial band lengthening (AB-ITB-L) at the time of hip arthroscopy for FAI. METHODS: Patients diagnosed with primary FAI and chronic TB were included in the study. Patients were included if they underwent hip arthroscopy with labral repair, femoral and/or acetabular osteoplasty, and AB-ITB-L...
January 27, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Aristeidis H Zibis, Vasileios D Mitrousias, Michail E Klontzas, Theofilos Karachalios, Sokratis E Varitimidis, Apostolos H Karantanas, Dimitrios L Arvanitis
PURPOSE: The purpose of this study is to point out the difficulty of differentiating great trochanter bursitis (GTB) from sciatica and estimating the prevalence of GTΒ, in patients poorly diagnosed with sciatica in their first visit to the general practitioner and referred to a spine infirmary. METHODS: The diagnosis of GTΒ was made based on history and physical examination, and was confirmed by ultrasonography and/or response to an anesthetic plus corticosteroid injection to the trochanteric bursa...
February 1, 2018: European Spine Journal
Bogdan Deleanu, Radu Prejbeanu, Dinu Vermesan, Horia Haragus, Lucian Honcea, Mihail-Lazar Mioc, Eleftherios Tsiridis, Vlad Predescu
Even if the intertrochanteric fracture under an arthrodesis hip is rare and the optimal surgical treatment is controversial, we consider that treating this kind of fracture with a locked plate was a success.
January 2018: Clinical Case Reports
Xavier L Griffin, Juul Achten, William Sones, Jonathan Cook, Matthew L Costa
INTRODUCTION: Sliding hip screw fixation is well established in the treatment of trochanteric fractures of the hip. The X-Bolt Dynamic Hip Plating System builds on the successful design features of the sliding hip screw but differs in the nature of the fixation in the femoral head. A randomised pilot study suggested that the X-bolt Dynamic Hip Plating System might provide similar health-related quality of life while reducing the risk of revision surgery when compared with the sliding hip screw...
January 26, 2018: BMJ Open
Anaïs Huwart, Florent Garrigues, Sandrine Jousse-Joulin, Thierry Marhadour, Dewi Guellec, Divi Cornec, Maelenn Gouillou, Alain Saraux, Valérie Devauchelle-Pensec
BACKGROUND: This study assessed inflammatory changes using ultrasound (US) and magnetic resonance imaging (MRI) in patients taking tocilizumab for polymyalgia rheumatica (PMR). METHODS: Eighteen patients were included in the prospective open-label TENOR study and received three tocilizumab infusions, without corticosteroids. B-mode and power Doppler US and MRI (T1 and T2-short time inversion recuperation weighted sequences) of the hips and shoulders were performed at weeks 0, 2, and 12...
January 25, 2018: Arthritis Research & Therapy
C T Griffin
Understanding ontogenetic patterns is important in vertebrate paleontology because the assessed skeletal maturity of an individual often has implications for paleobiogeography, species synonymy, paleobiology, and body size evolution of major clades. Further, for many groups the only means of confidently determining ontogenetic status of an organism is through the destructive process of histological sampling. Although the ontogenetic patterns of Late Jurassic and Cretaceous dinosaurs are better understood, knowledge of the ontogeny of the earliest dinosaurs is relatively poor because most species-level growth series known from these groups are small (usually, maximum of n ~ 5) and incomplete...
January 23, 2018: Journal of Anatomy
Takuya Otani, Yasuhiko Kawaguchi, Keishi Marumo
Slipped capital femoral epiphysis (SCFE) is not frequently encountered during routine practice and diagnosis and treatment are often delayed. It is important to understand symptoms and imaging features to avoid delayed diagnosis. After the diagnosis is made correct classification of the disease is required. The classification should be based on the physeal stability in order to choose safe and effective treatment. However, surgeons should bear in mind that the assessment is challenging and actual physeal stability is not always consistent with the stability predicted by a clinical classification method...
January 17, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
William G Mitchell, Sharon C Kettwich, Wilmer L Sibbitt, Randy R Sibbitt, Maheswari Muruganandam, Noelle A Rolle, William A Hayward, Roderick A Fields, Luis P Roldan, N Suzanne Emil, Monthida Fangtham, Arthur D Bankhurst
We hypothesized that ultrasound (US) guidance improves outcomes of corticosteroid injection of trochanteric bursitis. 40 patients with greater trochanteric pain syndrome defined by pain to palpation over the trochanteric bursa were randomized to injection with 5 ml of 1% lidocaine and 80 mg of methylprednisolone using (1) conventional anatomic landmark palpation guidance or (2) US guidance. Procedural pain (Visual Analogue Pain Scale), pain at outcome (2 weeks and 6 months), therapeutic duration, time-to-next intervention, and costs were determined...
March 2018: Rheumatology International
Shane Tipton, Ian Alkhafaji, Rebecca Senehi, Allston Stubbs
Therapeutic extra-articular hip endoscopy is an effective treatment of greater trochanteric sciatic nerve impingement. We describe in detail technical pearls of the procedure including positioning, portal placement, and steps to obtaining adequate decompression while avoiding iatrogenic nerve injury.
December 2017: Arthroscopy Techniques
Ali Abdulkarim, Cathy Keegan, Raazi Bajwa, Eoin Sheehan
INTRODUCTION: Lateral trochanteric pain (LTP) complicates up to 17% of cases of total hip arthroplasty (THA). Studies have refuted underlying trochanteric bursitis. Restoration of the femoral offset and reproduction of the natural femoral centre of rotation are important in successful arthroplasty. LTP is believed to be associated with their alteration. AIM: The aim of our study was to evaluate the effect of femoral offset and centre of rotation on the incidence of LTP post-THA...
January 15, 2018: Irish Journal of Medical Science
Jacob C Mandell, Michael J Weaver, Bharti Khurana
PURPOSE: The purpose of this study was to evaluate the diagnostic performance of CT for assessment of occult fractures of the proximal femur, pelvis, and sacrum. MATERIALS AND METHODS: A retrospective review was performed on patients who received a CT of the hip or pelvis for suspected occult fracture after negative or equivocal radiographs performed within 24 h. The official radiology report was utilized for the determination of CT findings and calculation of sensitivity and specificity...
January 11, 2018: Emergency Radiology
J H Schröder, M Geßlein, M Schütz, C Perka, D Krüger
BACKGROUND: Operative refixation is a new therapeutic option in cases of failed conservative treatment for trochanteric pain syndrome (TPS) and lesions of the hip abductors in magnetic resonance imaging (MRI). OBJECTIVE: Evaluation of the clinical and radiological results after open gluteus medius and minimus tendon reconstruction with a double-row technique was carried out. MATERIAL AND METHODS: Patients with failed conservative treatment for TPS and confirmed lesions of the hip abductors in MRI were treated by open hip abductor tendon reconstruction with a double-row technique...
January 11, 2018: Der Orthopäde
M Kumar, V Akshat, A Kanwariya, M Gandhi
Introduction: Sub-trochanteric fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. This study was done to analyse the management and complications of sub-trochanteric fractures using long proximal femoral nail (PFN). Materials and Methods: This was a prospective study of 50 patients with sub-trochanteric fractures of femur who were treated with long PFN at a tertiary care center from July 2012 to June 2016. The fractures were classified according to Seinsheimer classification...
November 2017: Malaysian Orthopaedic Journal
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