Posterior femoral head dislocation with ipsilateral posterior wall and anterior column acetabular fracture

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Wael Salama ◽  
Hossam Hosny
Keyword(s):  
Femoral Head ◽  
Acetabular Fracture ◽  
Posterior Wall ◽  
Anterior Column

scholarly journals Effects of the acetabular fracture index and other factors of posterior wall acetabular fracture on functional outcome

2017 ◽  
Vol 45 (4) ◽  
pp. 1394-1405 ◽  
Author(s):  
Hai-Tao Long ◽  
Zhen-Han Deng ◽  
Min Zou ◽  
Zhang-Yuan Lin ◽  
Jian-Xi Zhu ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Femoral Head ◽  
Functional Outcome ◽  
Avascular Necrosis ◽  
Lower Limb ◽  
Acetabular Fracture ◽  
Posterior Wall ◽  
Functional Score ◽  
Related Data ◽  
Limb Fracture

Objective To analyze the effects of the acetabular fracture index (AFI) and other factors on the functional outcome of patients with acetabular fractures involving the posterior wall. Methods Forty-eight patients who underwent surgery in our department were reviewed. According to the AFI, which indicates the percentage of remaining intact posterior acetabular arc, the patients were divided into Group A (AFI ≤ 25%, 11 patients), Group B (25% < AFI ≤ 50%, 23 patients), Group C (50% < AFI ≤ 75%, 7 patients), and Group D (75% < AFI ≤ 100%, 7 patients). The AFI was measured with a computed tomography picture archiving and communication system or calculated with the cosine theorem. A nonparametric test and ordinal regression were used to determine the role of the AFI and other factors on the functional outcome. Perioperative information, including demographic and fracture-related data, reduction quality, physical therapy duration, association with a lower limb fracture and avascular necrosis of the femoral head were prospectively gathered. Results The mean AFIs of A, B, C, and D groups were 14.3%, 35.9%, 59.5%, and 81.2%, respectively. No statistically significant differences were observed among the groups for demographic and fracture-related data. A better reduction quality (OR = 4.21, 95%CI 1.42 ∼ 12.43, χ2 = 6.781, P = 0.009) and a larger value of AFI (OR = 2.56, 95%CI 1.18 ∼ 5.55, χ2 = 5.648, P = 0.017) result in a higher functional score. The functional outcome of a physical therapy duration of more than 12 months (OR = 0.15, 95%CI 0.02 ∼ 0.90, χ2 = 4.324, P = 0.038) was better than that of less than 12 months. Lower limb fracture (OR = 0.13, 95%CI 0.02 ∼ 0.74, χ2 = 5.235, P = 0.022) and avascular necrosis of femoral head (OR = 0.02, 95%CI 0.00 ∼ 0.87, χ2 = 4.127, P = 0.042) were found to correlate with a lower functional score. Conclusion With a greater of AFI, the functional outcome score would be better. Other factors, including reduction quality, physical therapy duration, association with a lower limb fracture, and avascular necrosis of the femoral head, most likely also affect hip functional recovery.

Clamp Assisted Reduction of the Transverse Acetabular Fracture with Anterior Column Screw Fixation and Posterior Plating

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Phillip M Mitchell ◽  
M. Kareem Shaath ◽  
Milton “Chip” Routt
Keyword(s):  
Acetabular Fracture ◽  
Screw Fixation ◽  
Anterior Column

scholarly journals Discrimination of Low-Energy Acetabular Fractures from Controls Using Computed Tomography-Based Bone Characteristics

2020 ◽  
Vol 49 (1) ◽  
pp. 367-381
Author(s):  
Robel K. Gebre ◽  
Jukka Hirvasniemi ◽  
Iikka Lantto ◽  
Simo Saarakkala ◽  
Juhana Leppilahti ◽  
...  
Keyword(s):  
Machine Learning ◽  
Risk Factors ◽  
Computed Tomography ◽  
Femoral Head ◽  
Acetabular Fracture ◽  
Ct Images ◽  
Low Energy ◽  
Acetabular Fractures ◽  
Operating Characteristics ◽  
Femoral Neck Axis

AbstractThe incidence of low-energy acetabular fractures has increased. However, the structural factors for these fractures remain unclear. The objective of this study was to extract trabecular bone architecture and proximal femur geometry (PFG) measures from clinical computed tomography (CT) images to (1) identify possible structural risk factors of acetabular fractures, and (2) to discriminate fracture cases from controls using machine learning methods. CT images of 107 acetabular fracture subjects (25 females, 82 males) and 107 age-gender matched controls were examined. Three volumes of interest, one at the acetabulum and two at the femoral head, were extracted to calculate bone volume fraction (BV/TV), gray-level co-occurrence matrix and histogram of the gray values (GV). The PFG was defined by neck shaft angle and femoral neck axis length. Relationships between the variables were assessed by statistical mean comparisons and correlation analyses. Bayesian logistic regression and Elastic net machine learning models were implemented for classification. We found lower BV/TV at the femoral head (0.51 vs. 0.55, p = 0.012) and lower mean GV at both the acetabulum (98.81 vs. 115.33, p < 0.001) and femoral head (150.63 vs. 163.47, p = 0.005) of fracture subjects when compared to their matched controls. The trabeculae within the femoral heads of the acetabular fracture sides differed in structure, density and texture from the corresponding control sides of the fracture subjects. Moreover, the PFG and trabecular architectural variables, alone and in combination, were able to discriminate fracture cases from controls (area under the receiver operating characteristics curve 0.70 to 0.79). In conclusion, lower density in the acetabulum and femoral head with abnormal trabecular structure and texture at the femoral head, appear to be risk factors for low-energy acetabular fractures.

scholarly journals Partial resection of the posterior wall for hip dislocation in severe acetabular protrusio

2020 ◽  
Vol 1 (7) ◽  
pp. 431-437
Author(s):  
Hugo A. Rodriguez ◽  
Felipe Viña ◽  
Meilyn A. Muskus
Keyword(s):  
Femoral Head ◽  
Surgical Technique ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
Posterior Wall ◽  
Partial Resection ◽  
Hip Arthroplasties ◽  
Acetabular Protrusio

Aims In elderly patients with osteoarthritis and protrusio who require arthroplasty, dislocation of the hip is difficult due to migration of the femoral head. Traditionally, neck osteotomy is performed in situ, so this is not always achieved. Therefore, the purpose of this study is to describe a partial resection of the posterior wall in severe protrusio. Methods This is a descriptive observational study, which describes the surgical technique of the partial resection of the posterior wall during hip arthroplasty in patients with severe acetabular protrusio operated on between January 2007 and February 2017. Results In all, 49 hip arthroplasties were performed. The average age of patients was 60 years, and idiopathic was the most frequent aetiology of protrusio. All patients were treated with femoral head autograft and no intra- or postoperative complications were reported. No patients required revision surgery. Conclusion Partial resection of the posterior wall demonstrated to be a safe surgical technique with 100% survival in a follow-up to ten years in total hip arthroplasty due to severe acetabular protrusio. Cite this article: Bone Joint Open 2020;1-7:431–437.

scholarly journals An Effective and Feasible Method, “Hammering Technique,” for Percutaneous Fixation of Anterior Column Acetabular Fracture

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Lihai Zhang ◽  
Peng Yin ◽  
Wei Zhang ◽  
Tongtong Li ◽  
Jiantao Li ◽  
...  
Keyword(s):  
Acetabular Fracture ◽  
Guide Wire ◽  
Operation Time ◽  
Anterior Column ◽  
Percutaneous Fixation ◽  
Fluoroscopic Time ◽  
The Mean ◽  
Cortical Perforation ◽  
Mean Time ◽  
Time From Injury

Objective. The objective of this study was to evaluate the effectiveness and advantages of percutaneous fixation of anterior column acetabular fracture with “hammering technique.”Materials and Methods. We retrospectively reviewed 16 patients with percutaneous fixation of anterior column acetabular fracture with “hammering technique.” There were 11 males and 5 females with an average age of 38.88 years (range: 24–54 years) in our study. Our study included 7 nondisplaced fractures, 6 mild displaced fractures (<2 mm), and 5 displaced fractures (>2 mm). The mean time from injury to surgery was 4.5 days (range: 2–7 days).Results. The average of operation time was 27.56 minutes (range: 15–45 minutes), and the mean blood loss was 55.28 mL (range: 15–100 mL). The mean fluoroscopic time was 54.78 seconds (range: 40–77 seconds). The first pass of the guide wire was acceptable without cortical perforation or intra-articular perforation in 88.89% (16/18) of the procedures, and the second attempt was in 11.11% (2/18).Conclusion. Our study suggested that percutaneous fixation of anterior column acetabular fracture with “hammering technique” acquired satisfying surgical and clinical outcomes. It may be an alternative satisfying treatment for percutaneous fixation of anterior column acetabular fracture by 2D fluoroscopy using a C-arm with less fluoroscopic time.

Surgical results and factors influencing outcome in patients with posterior wall acetabular fracture

Injury ◽  
2017 ◽  
Vol 48 (8) ◽  
pp. 1819-1824 ◽  
Author(s):  
Raffaele Pascarella ◽  
Simone Cerbasi ◽  
Rocco Politano ◽  
Giovanni Balato ◽  
Rossana Fantasia ◽  
...  
Keyword(s):  
Acetabular Fracture ◽  
Posterior Wall ◽  
Surgical Results ◽  
Factors Influencing
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