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acetabular fractures

Nicholas C Arpey, Andrew J Holte, Josef N Tofte, Michael C Willey
CASE: A 23-year-old woman with injury-induced acetabular dysplasia developed subacute recurrent dislocation of the right hip following closed reduction of a traumatic dislocation. The initial dislocation had been associated with small posterior wall and femoral head fractures. The recurrent dislocation was addressed with an acute periacetabular osteotomy (PAO) for hip stabilization and femoral head fragment excision. CONCLUSION: An acute PAO is an unusual yet viable treatment strategy for addressing recurrent dislocation following traumatic fracture-dislocation in patients with posterior wall deficiency and injury-induced hip dysplasia...
June 13, 2018: JBJS Case Connector
Alexander Arzeno, Tim Wang, James I Huddleston
Revision hip arthroplasty in the setting of periacetabular bone loss presents a significant challenge, as options for restoring bone loss are limited. Recombinant human bone morphogenetic protein-2 may offer a solution by promoting bone growth to restore bone stock before implant reimplantation. Here we present a case of a patient with a periprosthetic acetabulum fracture, resulting in pelvic discontinuity as the result of significant periacetabular bone loss. Using a staged approach, periacetabular bone stock was nearly entirely reconstituted using recombinant BMPs and allograft, which resulted in stable fixation, but with abundant heterotopic bone formation...
June 2018: Arthroplasty Today
Hyeon Jun Kim, Sung Soo Kim, Young Hun Jung, Kyung Ho Lee
Purpose: This study is performed to evaluate the usefulness of arthroscopic surgery prior to open reduction and fixation surgery to treat acetabular fractures and hip fractures-dislocation. Materials and Methods: From January 2010 to March 2014, a total of 54 patients with acetabular fractures or hip fractures with dislocation were treated arthroscopically via fracture surface before open reduction and fixation (group 1, n=11), and without hip arthroscopy prior to open reduction and fixation (group 2; n=43)...
June 2018: Hip & Pelvis
José Luis Ramirez-Garcialuna, Fernando Dominguez-Paulin, Jesús Ramirez-Martinez, Luis Fernando Sanmiguel-Delgadillo
Introduction: The Modified Merle d'Aubigne-Postel Score and the Harris Hip Score are commonly used to assess the functional outcomes after acetabular fractures. A previous report showed that correlation between scores is good, that there is poor concordance among functional classes, and that the distribution of the scores is highly asymmetrical. Several issues were not addressed in this report, mainly that the data set was treated as transversal data without comparison of scores through time; therefore the objective of this article is to assess the degree of correlation and concordance between the Modified Merle d'Aubigne-Postel Score and the Harris Hip Score during the first 9 months after acetabular fracture treatment...
April 2018: Journal of Clinical Orthopaedics and Trauma
Yeong J Lau, Shashank Sarmah, Johan D Witt
INTRODUCTION: 3rd generation ceramic bearings were introduced in total hip arthroplasty (THA) with the potential to have better mechanical strength and wear properties than their predecessors. At present, there are few studies looking at the long-term results of this latest generation of ceramic bearings. The purpose of our study was to investigate the long-term clinical and radiographic results of 3rd generation ceramic-on-ceramic THA and the incidence of ceramic specific complications such as squeaking and bearing surface fracture...
March 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Steffan Tabori-Jensen, Christina Frølich, Torben B Hansen, Søren Bøvling, Morten Homilius, Maiken Stilling
INTRODUCTION: Dual mobility (DM) total hip arthroplasty (THA) may reduce dislocation risk, but might increase the risk of high polyethylene (PE) wear due to double wearing surfaces. METHODS: 127 patients (97 female) with 129 hips operated with THA after displaced femoral neck fracture FNF between 2005 and 2011, were seen for a cross-sectional clinical follow-up. Acetabular components were Saturne® DM cups with 28mm chrome-cobalt heads in UHMWPE. Cementless cups (n = 73) were hydroxyapatite coated...
March 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Yi-Long Dong, Yue-Nan Qian, Liang-le Liu, Xiang-Xiang Huang, Lin-Zhi Lin, Chun-Yuan Cai
OBJECTIVE: To investigate the biomechanical stability of the acetabular fracture with three different internal fixation methods. METHODS: Sixteen both-column acetabular fracture models were randomly divided into three groups:The specimens of 16 hip joints were randomly divided into 4 groups. Among them, 1 group of complete acetabulum were used as normal control group, and the other 3 groups simulated two column fracture models and were fixed in the following methods, respectively: anterior wall with screw and posterior with plate(SP), anterior wall with plate and posterior wall with screw(PS) and both wall with plate (PP)...
May 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
A Nicholas Kurup, Grant D Schmit, Thomas D Atwell, Erik B Sviggum, Wilfrido R Castaneda, Peter S Rose, Matthew R Callstrom
PURPOSE: To characterize the response of patients with acetabular metastases following combined cryoablation and cementoplasty (CCC) for pain palliation and fracture risk reduction, based on completeness of ablation and the presence of pre-existing pathologic fracture. MATERIALS AND METHODS: Thirty-nine consecutive acetabular CCC procedures were performed in 37 patients (24 M:13F, age 66 ± 8 years). Pain was assessed using a 0-10 numeric rating scale. Development of new or progression of pre-existing fractures and local tumor progression (LTP) were determined on follow-up imaging...
June 7, 2018: Cardiovascular and Interventional Radiology
Diederik O Verbeek, Jelle P van der List, Camden M Tissue, David L Helfet
BACKGROUND: Historically, the greatest residual (gap or step) displacement is used to predict clinical outcome following acetabular fracture surgery. Gap and step displacement may, however, impact the outcome to different degrees. We assessed the individual relationship between gap or step displacement and hip survivorship and determined their independent association with conversion to total hip arthroplasty. METHODS: Patients who had acetabular fracture fixation (from 1992 through 2014), follow-up of ≥2 years (or early conversion to total hip arthroplasty), and postoperative computed tomography (CT) scans were included...
June 6, 2018: Journal of Bone and Joint Surgery. American Volume
Soshi Uchida, Yuki Shimizu, Yohei Yukizawa, Hitoshi Suzuki, Cecilia Pascual-Garrido, Akinori Sakai
Intra-articular lesions are common in patients with acetabular hip dysplasia. Rim stress fractures (RSFs) have also been described in patients with acetabular hip dysplasia. This lesion is believed to be a result of an unfused secondary ossification center or a stress fracture that could be caused by repetitive impingement of an abnormal-shaped femoral head-neck junction. In addition, osteochondritis dissecans of the acetabulum is a rare condition that can also result from impingement and has been described in patients with hip dysplasia...
May 2018: Arthroscopy Techniques
S E S E McMahon, L A Cusick
No abstract text is available yet for this article.
May 2018: Ulster Medical Journal
Hidetatsu Tanaka, Go Yamako, Hiroaki Kurishima, Shutaro Yamashita, Yu Mori, Daisuke Chiba, Etsuo Chosa, Eiji Itoi
BACKGROUND: Supra-acetabular insufficiency fractures (SAIFs) occur in the upper acetabulum and are rare compared with insufficiency sacral, femoral head, or ischial fractures. However, SAIFs are known to occur in low grade trauma, and the underlying mechanism is still remained unclear. METHODS: We performed biomechanical analysis using finite element analysis to clarify the mechanisms underlying the development of SAIFs. Patient-specific models and bone mineral density (BMD) were derived from pelvic computed tomography data from two patients with SAIF (unaffected side) and two healthy young adults...
June 1, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Taylor J Reif, Patrick K Strotman, Stephanie A Kliethermes, Benjamin J Miller, Lukas M Nystrom
Objectives: Metastatic disease involving the femoral head and neck is often treated with a hemiarthroplasty or total hip arthroplasty (THA) to prevent pathologic fracture but there are no outcome studies demonstrating superiority of one option over the other. Methods: This investigation was designed as a survey of the current members of the Musculoskeletal Tumor Society (MSTS). The survey contained seven clinical vignettes with identical imaging of a pathologic lesion of the femoral head and neck...
September 2018: Journal of Bone Oncology
Faizan Iqbal, Asmat Ullah, Sajid Younus, Akram Aliuddin, Osama Bin Zia, Naveed Khan
PURPOSE: To assess the functional outcome of acute primary total hip replacement in the management of complex acetabular fractures. MATERIALS AND METHODS: This prospective observational study was conducted in orthopedic department of Liaquat National Hospital and Medical College, Karachi. The study was approved by the Ethics review committee of hospital (0190-2016). Patients who encountered between January 2010 to January 2016 were entered. Fifty-four patients with acetabular fractures with certain indications (marginal impaction or significant comminution (> 3 fragments) of the articular surface of the acetabulum, full-thickness articular injury to the femoral head, an associated femur neck fracture, or preexisting symptomatic osteoarthritis) were treated with primary total hip replacement...
May 29, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Mahmoud Fahmy, Mahmoud Abdel Karim, Sherif A Khaled, Ahmed Hazem Abdelazeem, Walid A Elnahal, Ashraf Elnahal
INTRODUCTION: Biomechanical studies have compared fixation methods in transverse acetabular fractures, yet there is not enough clinical data to suggest an optimal fixation method. The aim of this randomized controlled trail was to compare fracture stability in posterior plating alone versus posterior plating and anterior column lag-screw fixation in treatment of transverse and transverse with posterior wall acetabular fractures. METHODS: Thirty patients were randomized to one of two groups, either posterior fixation alone (single column group), or posterior plating and anterior fixation with percutaneous anterior column screw (double column group)...
May 24, 2018: Injury
Xi Zhou, Qiang Zhang, Wenhao Song, Dongsheng Zhou, Yu He
BACKGROUND: Delayed reconstruction of acetabular fractures remains a challenging task for orthopedists because of malunion, fracture line absorption, and scar formation. Accurate osteotomy, interfragmentary release, and proper adaptation of plates are keys to successful surgery. Prevention of superior gluteal artery (SGA) injury induced by cleaning of the osteotylus and reduction of the sciatic notch is also important. Therefore, sufficient preoperative planning is essential. However, traditional planning methods do not readily provide direct visual and tactile feedback to surgeons...
May 29, 2018: BMC Surgery
Gautham Prabhakar, Nicholas Kusnezov, Nicholas Rensing, Amr Abdelgawad
Despite timely and appropriate management, displaced femoral neck fractures are often devastating injuries for the young patient. The risk of negative sequelae is further amplified with increasing displacement and vertical fracture patterns. Open anatomic reduction with rigid internal fixation is essential to maximize the healing potential in displaced fractures of the femoral neck. Successful primary osteosynthesis of significantly displaced femoral neck fractures in the young patient has been reported in the literature...
2018: Case Reports in Orthopedics
F Chana Rodríguez, R Pérez Mañanes, F J Narbona Cárceles, P Gil Martínez
INTRODUCTION: Preoperative 3D modelling enables more effective diagnosis and simulates the surgical procedure. MATERIAL AND METHODS: We report twenty cases of acetabular fractures with preoperative planning performed by pre-contouring synthesis plates on a 3D printed mould obtained from a computarized tomography (CT) scan. The mould impression was made with the DaVinci 1.0 printer model (XYZ Printing). After obtaining the printed hemipelvis, we proceeded to select the implant size (pelvic Matta system, Stryker® ) that matched the characteristics of the fracture and the approach to be used...
May 25, 2018: Revista Española de Cirugía Ortopédica y Traumatología
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