Pathological fracture of the femoral neck as the first manifestation of osteonecrosis of the femoral head

2000 ◽  
Vol 5 (6) ◽  
pp. 605-609 ◽  
Author(s):  
Young-Min Kim ◽  
Hee Joong Kim
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Pathological Fracture

scholarly journals Capital femoral physeal dysplasia in cats submited to ostectomy of the femoral head and neck

2021 ◽  
Vol 51 (7) ◽  
Author(s):  
Tryssia Scalon Magalhães Moi ◽  
Marco Aurélio Molina Pires ◽  
Kelly Cristiane Ito Yamauchi ◽  
Luís Gustavo Gosuen Gonçalves Dias ◽  
Bruno Watanabe Minto
Keyword(s):  
Femoral Head ◽  
Connective Tissue ◽  
Femoral Neck ◽  
Head And Neck ◽  
Pathological Fracture ◽  
Good Alternative ◽  
Fibrous Connective Tissue ◽  
Limb Function ◽  
Mixed Breed

ABSTRACT: This report described pathological fracture of the femoral head (physeal dysplasia) in four male cats (three mixed breed and one Bengal), with an average age of 16 months, treated by an ostectomy of the femoral head and neck. Three cats were neutered and one entire. All presented with mild intermittent lameness in the pelvic limbs. Displacement of the femoral epiphysis and resorption of the femoral neck were present and excision of the femoral head and remaining neck was performed in all cases. Hstological examination showed mild foci of compaction and trabecular fibrosis with deposition of fibrous connective tissue, permeated by granulation tissues, consistent with the original diagosis. Limb function improved in all patients from 2 to 4 weeks postoperatively. Diagnosis of physeal dysplasia is challenging and treatment is different from acute traumatic fractures. Femoral head and neck excision was considered a good alternative in these patients.

scholarly journals Pathological Fracture of Femoral Neck Associated to Femoral Head Osteonecrosis: Case Report

2019 ◽  
pp. 1-4
Author(s):  
Victoria Eugenia Restrepo Noriega ◽  
Mejía Luz A ◽  
Montoya Beatriz E ◽  
Victoria Eugenia Restrepo Noriega
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Pathological Fracture ◽  
Middle Age ◽  
Traumatic Event ◽  
Femoral Neck Fractures ◽  
Necrotic Bone ◽  
Femoral Head Osteonecrosis ◽  
Nucleus Plus ◽  
Fracture Complication

Introduction: The osteonecrosis of femoral head is a progressive and devastating condition for the prognosis of the coxofemoral joint, with an increase in its prevalence and an etiology of multifactorial nature, and with compromise specially in young or middle age (20 to 40 years of age) patients [1-3]. The fractures associated to femoral head osteonecrosis are very rare, being the subchondral portion the site with a higher compromise, and the junction between the necrotic bone and the bone under remodeling process another site of potential fracture [4-7]. The management of this condition can vary from a conservative management to a surgical management with total hip arthroplasty, depending on patient’s clinic and the extension of his necrotic lesion. Discussion: This patient presents a sub-capital fracture of his femoral neck, associated to osteonecrosis of the femoral head. This patient was managed with decompression of the osteonecrosis nucleus plus bone graft and osteosynthesis with cannulate screws, in order to decrease bone hypertension and avoid femoral collapse. Conclusion: Although femoral neck fractures, as a complication from femoral head osteonecrosis are rare, in our patient such association can be found due to the worsening of his painful clinical features and the absence of a previous traumatic event, which allows discarding femoral osteonecrosis as a fracture complication.

The association between femoral neck shaft angle and degenerative disease of the hip in a cadaveric model

2021 ◽  
pp. 112070002110130
Author(s):  
Leigh-Anne Tu ◽  
Douglas S Weinberg ◽  
Raymond W Liu
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Hip Osteoarthritis ◽  
Volume Ratio ◽  
Femoral Head Coverage ◽  
Neck Shaft Angle ◽  
Hip Arthritis ◽  
Femoral Version ◽  
Shaft Angle ◽  
The Impact

Background: While the influences of acetabular dysplasia and overcoverage on hip arthritis have been studied, the impact of femoral neck-shaft angle on hip arthritis is much more poorly understood. The purpose of this study is to determine if a relationship exists between neck shaft angle and the development of osteoarthritis, a better understanding of which would be useful to surgeons planning osteotomies about the hip. Methods: 533 cadaveric femora and acetabulae (1066 total) from the Hamann-Todd Osteological Collection (Cleveland, OH) were acquired. We measured true neck shaft angle using an AP photograph with the femoral neck parallel to the table. Femoral head volume to acetabular volume ratio, representing femoral head coverage, as well as femoral version were utilised. Correlation between neck shaft angle, femoral version, femoral head coverage and osteoarthritis were evaluated with multiple regression analysis. Results: The mean age and standard deviation was 56 ± 10 years. There were 64 females (12%) and 469 males. There were 380 Caucasians (71%) and 153 African-Americans. Mean femoral version was 11° ± 12° and mean true neck shaft angle was 127.7° ± 5.9° There was a strong correlation between age and arthritis (standardised beta 0.488, p < 0.001). There was a significant correlation between increasing true neck shaft angle and decreasing hip arthritis (standardised beta -0.024, p = 0.038). In the femoral head overcoverage subset, increasing true neck shaft angle was still significantly associated with decreasing hip arthritis (standardised beta −0.088, p = 0.018), although this relationship was not significant with femoral head undercoverage subset. Conclusions: With sufficient acetabular coverage, a relative increase in femoral neck shaft angle within the physiologic range is associated with decreased hip osteoarthritis. Clinical relevance: An understanding of the relationship between femoral neck shaft angle and hip osteoarthritis could be useful for surgeons planning pelvic or proximal femur osteotomies in children.

Recent Methods of Neck Femur Fixation A Systematic review and meta-analysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Salem Eid ◽  
Ahmed Mohamed Mohasseb ◽  
Ramy Mohamed Mohamed El-Bahnasy
Keyword(s):  
Systematic Review ◽  
Femoral Head ◽  
Femoral Neck ◽  
High Energy ◽  
Femoral Neck Fractures ◽  
Final Outcome ◽  
Cannulated Screws ◽  
Fixed Angle ◽  
Femur Fractures ◽  
Femoral Head Osteonecrosis

Abstract Background Femoral neck fractures in adults younger than age 50 years are uncommon and often the result of high energy trauma. They account for only 2-3% of all femoral neck fractures. Femoral neck fractures are associated with aging and osteoporosis and can occur after relatively trivial trauma in elderly patients. femoral neck fractures are associated with higher incidences of femoral head osteonecrosis and nonunion. Fixation options include cannulated screws, non parallel cannulated screws, medial augmentation plate, and fixed angle femoral neck fixation implants. A systematic review of literature done to evaluate which technique is better. Methods After literature search thirteen articles were found and were reviewed to evaluate final outcome of fixation of neck femur fractures by cannulated screws, non parallel cannulated screws, medial augmentation plate, and fixed angle femoral neck fixation implants. Results After evaluation of all studies the incidence of nonunion, osteonecrosis of femoral head, implant failure & revesion surgery is lower in comparing Targon plate with multiple cannulated screws while we need further studies for application of non parallel screws and medial plate. Conclusion Targon plate recorded low incidence of complications in the final outcome in comparison with multiple cannulated screw while we need further studies for application of Non parallel screws and medial plate.

Instability and Femoral Head Vitality in Fractures of the Femoral Neck

1993 ◽  
Vol &NA; (287) ◽  
pp. 30???40 ◽  
Author(s):  
J??N INGVAR RAGNARSSON ◽  
LENNART BOQUIST ◽  
LEIF EKELUND ◽  
JOHAN K??RRHOLM
Keyword(s):  
Femoral Head ◽  
Femoral Neck

Use of computed tomography to compare two femoral head and neck excision ostectomy techniques as performed by two novice veterinarians

2015 ◽  
Vol 28 (05) ◽  
pp. 295-300 ◽  
Author(s):  
M. D. O’Donnell ◽  
G. Bobe ◽  
R. P. Scholz ◽  
J. E. Wiest ◽  
S. Nemanic ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Femoral Head ◽  
Femoral Neck ◽  
Head And Neck ◽  
Clinical Setting ◽  
Ex Vivo ◽  
Bone Volume ◽  
Bone Trauma ◽  
Before And After ◽  
Bone Fragments

Summary Objectives: To compare the results of femoral head and neck excision (FHNE) ostectomy performed by two novice veterinarians using an osteotome and mallet or microsagittal saw. Methods: In this ex vivo cadaveric study, hindlimbs of eight canine cadavers were randomized to FHNE with osteotome or micro sagittal saw as performed by two recently graduated veterinarians. The hindimbs were imaged by computed tomography (CT) before and after the osteotomy. Post FHNE CT images were evaluated by a board certified radiologist blinded to the ostectomy technique for assessment of the number of bone fragments, fissures, smoothness of osteotomy margination, and volume of residual fe-moral neck. Results: Femoral head and neck excision performed with the osteotome produced more peri-ostectomy bone fragments, cortical fissures, irregular margins, and residual femoral neck volume, compared with osteotomy using a saw. Clinical relevance: Compared to FHNE performed with a sagittal saw, osteotome FHNE resulted in a greater bone trauma and residual neck bone volume, which would require post-ostectomy modification in a clinical setting.

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