Unexplained “massive osteolysis of femoral head” (MOFH) after acetabular fracture: occurrence and suggested patho-etiology

2016 ◽  
Vol 58 (6) ◽  
pp. 710-718 ◽  
Author(s):  
Gwy Suk Seo ◽  
Gregory Dieudonne ◽  
Scott A Mooney ◽  
Johnny UV Monu
Keyword(s):  
Femoral Head ◽  
Acetabular Fracture ◽  
Massive Osteolysis

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.

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 Ipsilateral Acetabular Fracture with Displaced Femoral Head and Femoral Shaft Fracture: A Complex Floating Hip Injury

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Raja Bhaskara Rajasekaran ◽  
Dheenadhayalan Jayaramaraju ◽  
Dhanasekara Raja Palanisami ◽  
Ramesh Perumal ◽  
Rajasekaran Shanmuganathan
Keyword(s):  
Femoral Head ◽  
Acetabular Fracture ◽  
Femoral Shaft Fracture ◽  
Road Traffic ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Complex Case ◽  
Acetabular Reconstruction ◽  
Rare Presentation ◽  
Hip Injury

Floating hip injuries involving the acetabulum, femoral head, and the femoral shaft are a very rare presentation. A complex floating hip injury comprising of an ipsilateral acetabular fracture associated with a displaced femoral head fracture and a femoral shaft fracture following a high-velocity road traffic accident presented to us where all the fractures were addressed with internal fixation during the primary surgery. Postoperatively, the patient suffered a dislocation of the femoral head which eventually went on to avascular necrosis at 5 months from the initial presentation. Then, the patient underwent a total hip replacement with an acetabular reconstruction following which he went on to have a good functional outcome. Our experience in dealing with such a complex case shows that it is difficult to set a protocol for such injuries and they need to be addressed on a case-to-case basis depending on the complexity of the injury.

The young arthritic hip

2011 ◽  
Author(s):  
Ahmad K. Malik ◽  
Aresh Hashemi-Nejad
Keyword(s):  
Rheumatoid Arthritis ◽  
Juvenile Idiopathic Arthritis ◽  
Femoral Head ◽  
Femoroacetabular Impingement ◽  
Acetabular Fracture ◽  
Developmental Dysplasia ◽  
Neck Fracture ◽  
Slipped Upper Femoral Epiphysis ◽  
Dysplasia Of The Hip ◽  
Head Neck

♦ Impingement:• Primary femoroacetabular impingement:▪ Cam type▪ Pincer type▪ Combined cam and pincer• Secondary femoroacetabular impingement:▪ Slipped upper femoral epiphysis (cam type)▪ Protusio (pincer type)▪ Retroverted acetabulum (pincer type)▪ Malunited femoral head/neck fracture (cam type)▪ Acetabular fracture (pincer type)▪ Perthes disease (cam type)♦ Instability:• Developmental dysplasia of the hip (treated/residual and untreated)• Dislocation• Subluxation• Dysplasia♦ Inflammatory:• Juvenile idiopathic arthritis• Rheumatoid arthritis.

Femoral head ostectomy for the treatment of acetabular fracture and coxofemoral joint luxation in a Potbelly pig

2016 ◽  
Vol 46 (2) ◽  
pp. 316-321 ◽  
Author(s):  
Joe S. Smith ◽  
Munashe Chigerwe ◽  
Carly Kanipe ◽  
Sarah Gray
Keyword(s):  
Femoral Head ◽  
Acetabular Fracture ◽  
Joint Luxation

Blood Flow Changes to the Femoral Head After Acetabular Fracture or Dislocation in the Acute Injury and Perioperative Periods

2001 ◽  
Vol 15 (3) ◽  
pp. 170-176 ◽  
Author(s):  
James J. Yue ◽  
John K. Sontich ◽  
Stefan D. Miron ◽  
Allan E. Peljovich ◽  
John H. Wilber ◽  
...  
Keyword(s):  
Blood Flow ◽  
Femoral Head ◽  
Acetabular Fracture ◽  
Acute Injury ◽  
Flow Changes

Femoral head subchondral impaction on CT: what does it mean in patients with acetabular fracture?

2018 ◽  
Vol 48 (6) ◽  
pp. 939-948 ◽  
Author(s):  
Pierre-Alexandre Poletti ◽  
Mehmet Sahin ◽  
Robin Peter ◽  
Sana Boudabbous ◽  
Guillaume Herpe ◽  
...  
Keyword(s):  
Femoral Head ◽  
Acetabular Fracture

scholarly journals Early Detection and Management of Massive Intraoperative Pulmonary Embolism in a Patient Undergoing Repair of a Traumatic Acetabular Fracture

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Tobechi E. Okoronkwo ◽  
XueWei Zhang ◽  
Jessica Dworet ◽  
Matthew Wecksell
Keyword(s):  
Pulmonary Embolism ◽  
Cardiac Arrest ◽  
Femoral Head ◽  
Cardiopulmonary Resuscitation ◽  
Early Detection ◽  
Acetabular Fracture ◽  
Preoperative Evaluation ◽  
Operative Repair ◽  
Surgical Positioning ◽  
History Of

A 73-year-old male with history of hyperlipidemia and osteoarthritis was transferred from an outside hospital after a fall from a ladder at home. He sustained a severe right sided acetabular fracture involving the femoral head, requiring operative repair. Preoperative evaluation was unremarkable except for oxygen saturation < 95 %. After induction of anesthesia and surgical positioning, the patient went into cardiac arrest. After intraoperative cardiopulmonary resuscitation (CPR) and placement on extracorporeal membrane oxygenation (ECMO), the patient stabilized. Cardiac catheterization revealed a large left pulmonary embolism. Here, we discuss the etiology and management of intraoperative pulmonary embolism.

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