Letter regarding “Popere et al. A cross sectional study of outcomes of muscle pedicle grafting in neck of femur fractures and avascular necrosis of femoral head. Injury.2020. Doi.org/10.1016/j.injury.2020.04.026

Injury ◽  
2020 ◽  
Vol 51 (8) ◽  
pp. 1943
Author(s):  
Tomonori Shigemura
2015 ◽  
Vol 22 (07) ◽  
pp. 949-953
Author(s):  
Hanif Ullah Khan ◽  
Abdul Waheed Jan ◽  
Abdus Samad Khan

Fracture neck of femur is a devastating injury. One of its main complicationsis avascular necrosis (AVN) of the femoral head. For the fixation of femoral neck fractures,cannulated screws are now universally used. The aim of the study was to determine thefrequency of avascular necrosis in fracture neck of femur fixed with cannulated screws.Study Design: Descriptive cross sectional study. Setting: Orthopedic unit of Ayub TeachingHospital Abbottabad. Period: 7th March, 2011 to 6th September, 2011. Material and Methods:Recruiting 113 patients of either gender between 15 to 60 years of age with fracture neck offemur who were fixed with cannulated screws. The data was entered and analyzed with thehelp of SPSS 10.Results: There were 113 patients with an overall mean age of 43.51 years+ 11.94SD. Maximum number of patients was 56 (49.50%) from the age group of 46 to 60years. Avascular necrosis was noted in 23 (20.35%) cases. The maximum number of patientswith avascular necrosis was 13 (56.52%) belonging to the age group of 15 to 25. Conclusion:Avascular necrosis was high in younger ages in displaced fractures of neck of femur treatedwith cannulated screws.


2020 ◽  
Vol 3 (2) ◽  
pp. 8-12
Author(s):  
Bishnu Pokharel ◽  
Ashok Raj Pant ◽  
Pashupati Chaudhary ◽  
Guru Prasad Khanal

Background: Most of the proximal femur fractures are managed surgically by internal fiation with a variety of implants. Improperly designed or ill-fited implant may lead to a failure of fiation, breakage of implant and nonunion, thus increasing the morbidity and the cost of treatment. This study was conducted to evaluate the radiographic morphometry of the proximal femur which may be helpful in designing the implants for the Nepalese population. Methods: In this cross-sectional study, 84 patients aged 18 years and above with traumatic unilateral hip fracture were enrolled. Anthropometric measurements were recorded. The postoperative check X-ray in the antero-posterior view of the pelvis and bilateral hip were assessed. Various morphometric parameters of the proximal femur were measured and recorded in the radiograph of the unaffcted limb using a digital caliper. Results: Out of 84 patients, 47 were male. The mean ± SD femoral neck width, femoral neck length, femoral axis length, cervico-diaphyseal angle, acetabular tear-drop distance, and great trochanter-pubic symphysis distance were 36.10 ± 5.67 mm, 28.29 ± 4.18 mm, 104.51 ± 9.56 mm, 130.35 ± 8.67°, 32.56 ± 11.05 mm, and 163.07 ± 10.71 mm respectively. The femoral neck width was found to be signifiantly larger in males (39.08 ± 3.06 mm) than in females (32.32 ± 5.99 mm, p < 0.001). Conclusion: This study determined the radiographic measurement of the proximal femur and found that the femoral neck width of the males was larger than that of the females.


BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023216 ◽  
Author(s):  
Amy GL Nuttall ◽  
Katie M Paton ◽  
Alison M Kemp

ObjectiveTo evaluate utility and equivalence of Glasgow Coma Scale (GCS) and the Alert, Voice, Pain, Unresponsive (AVPU) scale in children with head injury.DesignCross sectional study.SettingUK hospital admissions: September 2009–February 2010.Patients<15 years with head injury.InterventionsGCS and/or AVPU at injury scene and in emergency departments (ED).Main outcomeMeasures used, the equivalence of AVPU to GCS, GCS at the scene predicting GCS in ED, CT results by age, hospital type.ResultsLevel of consciousness was recorded in 91% (5168/5700) in ED (43%: GCS/30.5%: GCS+AVPU/17.3%: AVPU) and 66.1% (1190/1801) prehospital (33%: GCS/26%GCS+AVPU/7%: AVPU). Failure to record level of consciousness and the use of AVPU were greatest for infants. Correlation between AVPU and median GCS in 1147 children <5 years: A=15, V=14, P=8, U=3, for 1163 children ≥5 years: A=15, V=13, P=11, U=3. There was no significant difference in the proportion of infants who had a CT whether AVPU=V/P/U or GCS<15. However diagnostic yield of intracranial injury or depressed fracture was significantly greater for V/P/U than GCS<15 :7/7: 100% (95% CI 64.6% to 100%) versus 5/17: 29.4% (95% CI 13.3% to 53.1%). For children >1 year significantly more had a CT scan when GCS<14 was recorded than ‘V/P/U only’ and the diagnostic yield was greater. Prehospital GCS and GCS in the ED were the same for 77.4% (705/911).ConclusionThere was a clear correlation between Alert and GCS=15 and between Unresponsive and GCS=3 but a wider range of GCS scores for responsive to Pain or Voice that varied with age. AVPU was valuable at initial assessment of infants and did not adversely affect the proportion of infants who had head CT or the diagnostic yield.


2021 ◽  
pp. 56-57
Author(s):  
Jakra Priyanka ◽  
Mishra Meenu ◽  
Soni Kamini

Introduction:Avascular necrosis is also known as aseptic, osteonecrosis and ischaemic necrosis of bone. There are a multitude of risk factors but over 80% of cases are attributed to glucocorticoid treatment or alcohol excess. Avascular Necrosis of femoral head is the most common type of necrosis, because the artery supplying to neck of femur is very narrow which easily gets injured. In modern medicine there is no specic treatment rather than surgery. In Ayurveda avascular necrosis can be correlated with Asthimajjagatvata. Aim: To assess the efcacy of Dashmooladi Majja Sneha in the management of avascular necrosis. The objective of the treatment includes the preservation of structure and function of hip joint with symptomatic relief. Materials & Methods:The present case study is upon a 32 year old, diagnosed case of avascular necrosis of femoral head with complaints of pain in bilateral sacroiliac joint since one and half years which was associated with difculty in doing normal daily activities such as walking, sitting, squatting along with change in the gait, at the Panchakarma OPD of Govt. Ayurvedic hospital Bhopal. The patient of idiopathic AVN of femoral head was treated with Dashmooladi Majja Sneha, Brihatvata Chintamani Rasa, Amritaristha, Panchtikta Ghrita Guggulu and Shastik Shali Pind Swedan have done as per the classical method for 30 days. Assessment was done after treatment and follow up after 15 days for 2months. Observations: The Ayurvedic therapies and oral medicines yielded complete symptomatic relief from pain, general debility and improvement in the gait. Conclusion: On the basis of the results obtained it can be concluded that Dashmooladi Majja Sneha, Shastik Shali Pind Swedan and some oral medicines can be used as an effective treatment in the management of Avascular Necrosis.


2020 ◽  
Vol 12 (6) ◽  
pp. 1776-1783
Author(s):  
Ze‐qing Huang ◽  
Fan‐yu Fu ◽  
Wen‐long Li ◽  
Biao Tan ◽  
Hai‐jun He ◽  
...  

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Benjamin G. Domb ◽  
Lyall Ashberg ◽  
Parth Lodhia ◽  
Chengcheng Gui ◽  
Timothy J Martin ◽  
...  

2015 ◽  
Vol 100 (11) ◽  
pp. 1032-1037 ◽  
Author(s):  
P Burrows ◽  
L Trefan ◽  
R Houston ◽  
J Hughes ◽  
G Pearson ◽  
...  

The risk of serious head injury (HI) from a fall in a young child is ill defined. The relationship between the object fallen from and prevalence of intracranial injury (ICI) or skull fracture is described.MethodCross-sectional study of HIs from falls in children (<6 years) admitted to UK hospitals, analysed according to the object fallen from and associated Glasgow Coma Score (GCS) or alert, voice, pain, unresponsive (AVPU) and CT scan results.ResultsOf 1775 cases ascertained (median age 18 months, 54.7% boys), 87% (1552) had a GCS=15/AVPU=alert. 19.3% (342) had a CT scan: 32% (110/342) were abnormal; equivalent to 5.9% of the overall population, 16.9% (58) had isolated skull fractures and 13.7% (47) had ICI (49% (23/47) had an associated skull fracture). The prevalence of ICI increased with neurological compromise; however, 12% of children with a GCS=15/AVPU=alert had ICI. When compared to falls from standing, falls from a person's arms (233 children (mean age 1 year)) had a significant relative OR for a skull fracture/ICI of 6.94 (95% CI 3.54 to 13.6), falls from a building (eg, window or attic) (mean age 3 years) OR 6.84 (95% CI 2.65 to 17.6) and from an infant or child product (mean age 21 months) OR 2.75 (95% CI 1.36 to 5.65).ConclusionsMost HIs from a fall in these children admitted to hospital were minor. Infants, dropped from a carer's arms, those who fell from infant products, a window, wall or from an attic had the greatest chance of ICI or skull fracture. These data inform prevention and the assessment of the likelihood of serious injury when the object fallen from is known.


2015 ◽  
Vol 6 (1) ◽  
pp. 1-15 ◽  
Author(s):  
Olalekan Akanji Akinwunmi ◽  
Adeyanju Akinola Rachael ◽  
Olawale Balogun Babajide ◽  
Olabanji Akano Aliu ◽  
Mojisola Atalabi Omolola ◽  
...  

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