The Percentage of Migration as Indicator of Femoral Head Position

1988 ◽  
Vol 29 (3) ◽  
pp. 363-366 ◽  
Author(s):  
O. Eklöf ◽  
H. Ringertz ◽  
L. Samuelsson
Keyword(s):  
Femoral Head ◽  
Head Position ◽  
Pediatric Age ◽  
Reliable Technique ◽  
Early Stages

In childhood subluxation of one or both hips may develop rather insidiously. For lack of generally accepted objective methods of assessment, ambiguous interpretations of findings in serial examinations are common. Many subluxations are overlooked during the early stages. In order to overcome such disadvantages, determination of the percentage of migration seems to be a reasonably easy and reliable technique facilitating evaluation of impending dislocation. This investigation was carried out in order to establish norms applicable to patients in the pediatric age interval. The 98th percentile of migration increases with age from 16 per cent in patients <4 years of age to 24 per cent in patients ≥12 years. Higher figures represent subluxation. If the migration exceeds 80 per cent a manifest luxation is present. A difference in migration between the two hips larger than 12 per cent indicates abnormality calling for clinical and radiologic follow-up.

scholarly journals Effect of Osteonecrosis Intervention Rod Versus Core Decompression Using Multiple Small Drill Holes on Early Stages of Necrosis of the Femoral Head: A Prospective Study on a Series of 60 Patients with a Minimum 1-Year-Follow-Up

2015 ◽  
Vol 9 (1) ◽  
pp. 179-184 ◽  
Author(s):  
Haixiong Miao ◽  
Dongping Ye ◽  
Weiguo Liang ◽  
Yicun Yao
Keyword(s):  
Femoral Head ◽  
Core Decompression ◽  
Alternative Methods ◽  
Early Stages ◽  
Significant Difference ◽  
Harris Score ◽  
The Mean ◽  
Drill Holes ◽  
Partial Weight

Introduction: The conventional CD used 10 mm drill holes associated with a lack of structural support. Thus, alternative methods such as a tantalum implant, small drill holes, and biological treatment were developed to prevent deterioration of the joint. The treatment of CD by multiple 3.2 mm drill holes could reduce the femoral neck fracture and partial weight bearing was allowed. This study was aimed to evaluate the effect of osteonecrosis intervention rod versus core decompression using multiple small drill holes on early stages of necrosis of the femoral head. Method: From January 2011 to January 2012, 60 patients undergoing surgery for osteonecrosis with core decompression were randomly assigned into 2 groups based on the type of core decompression used: (1) a total of 30 osteonecrosis patients (with 16 hips on Steinburg stageⅠ,20 hips on Steinburg stageⅡ) were treated with a porous tantalum rod insertion. The diameter of the drill hole for the intervention rod was 10mm.(2) a total of 30 osteonecrosis patients (with 14 hips on Steinburg stageⅠ,20 hips on Steinburg stageⅡ) were treated with core decompression using five drill holes on the lateral femur, the diameter of the hole was 3.2 mm. The average age of the patient was 32.6 years (20-45 years) and the average time of follow-up was 25.6 months (12- 28 months) in the rod implanted group. The average age of the patient was 35.2 years (22- 43 years) and the average time of follow-up was 26.3 months (12-28 months) in the small drill holes group. Results: The average of surgical time was 40 min, and the mean volume of blood loss was 30 ml in both surgical groups. The average of Harris score was improved from 56.2 ± 7.1 preoperative to 80.2 ± 11.4 at the last follow-up in the rod implanted group (p < 0.05). The mean Harris score was improved from 53.8 ± 6.6 preoperative to 79.7 ± 13.2 at the last follow-up in the small drill holes group (p<0. 05). No significant difference was observed in Harris score between the two groups. At the last follow-up, 28 of 36 hips were at the same radiographic stages as pre-operation, and 8 deteriorated in the rod implanted group. 26 of 34 hips were at the same radiographic stage as pre-operation, and 8 deteriorated in the small drill holes group. No significant difference was observed in radiographic stage between the two groups. There was no favourable result on the outcome of a tantalum intervention implant compared to multiple small drill holes. Discussion: CD via multiple small drill holes would allow similar postoperative load-bearing and seems to result in similar or even better clinical outcome without the prolonged implantation of an expensive tantalum implant. A tantalum rod intervention and core decompression using multiple small drill holes were effective on the stage I hips rather than stage II hips.

scholarly journals Use of Perfotran at Conservative Treatment of Early Stages of Femoral Head Avascular Necrosis

2015 ◽  
Vol 22 (4) ◽  
pp. 26-31
Author(s):  
V. M Prokhorenko ◽  
A. G Shusharin ◽  
M. P Polovinka
Keyword(s):  
Femoral Head ◽  
Conservative Treatment ◽  
Avascular Necrosis ◽  
Pain Syndrome ◽  
Harris Hip Score ◽  
Treatment Results ◽  
Early Stages ◽  
Reduction Of Pain ◽  
Group 2

Conservative treatment results are presented for 328 patients with I-II stages of femoral head avascular necrosis (FHAN) at 3 years follow up term. Uni- or bilateral coxarthrosis was observed in 157 patients. Patients were on intraarticular injections of perfotran (1st group; n=102) or perfotran+dimexide mixture (2nd group; n=226). Clinical and functional hip joint condition was evaluated by Harris Hip Score. Positive dynamics was noted in all patients however in group 2 it was more marked: absence of negative dynamics was recorded in 204 (90.2%) patients; restorative process, by MRI examination results, was noted in 105 (46.5%) patients; significant reduction of pain syndrome was achieved. Algorithm for the management of patients with early stages of FHAN was proposed.

scholarly journals What is the role of core decompression in the early stages of osteonecrosis of the femoral head? Evaluation of the surgical result by functional score and radiological follow-up

2018 ◽  
Vol 53 (5) ◽  
pp. 537-542 ◽  
Author(s):  
Helder de Souza Miyahara ◽  
Bruno Berbert Rosa ◽  
Fabio Yuiti Hirata ◽  
Henrique de Melo Campos Gurgel ◽  
Leandro Ejnisman ◽  
...  
Keyword(s):  
Femoral Head ◽  
Core Decompression ◽  
Functional Score ◽  
Surgical Result ◽  
Early Stages

Determination of Structural Femoral Head Allograft Viability and Integrity with a Novel Diagnostic Tool: SPECT/CT. A Preliminary Study

2017 ◽  
Vol 27 (6) ◽  
pp. 558-563 ◽  
Author(s):  
Kasım Kilicarslan ◽  
Nadir Yalcin ◽  
Vedat Bicici ◽  
Elif Ozdemir ◽  
Izzet Bingol ◽  
...  
Keyword(s):  
Femoral Head ◽  
Clinical Symptoms ◽  
Visual Analogue Score ◽  
Harris Hip Score ◽  
Osteoblastic Activity ◽  
Fresh Frozen ◽  
Vas Scores ◽  
Acetabular Defects

Objective To evaluate the viability and integrity of fresh frozen bulk femoral head allografts obtained from the institutional bone bank that were used to reconstruct severe acetabular defects and to validate the SPECT/CT method which gives both anatomical and functional data for this purpose. Methods We retrospectively reviewed 9 patients (6 female, 3 male; mean age 63.6 years). Preoperative and postoperative leg lengths, existence of the Trendelenburg sign, range of motion of the hip, visual analogue score (VAS), Harris Hip Score (HHS) and any complication were assesed at each follow-up. Radiographically, position of the cup, signs of loosening or migration, and union of the graft were all determined. At the latest follow-up, patients were evaluated with hybrid SPECT/CT. Results The average duration of follow-up was 38.1 months (24-50 months). The overall mean HHS and VAS scores were significantly improved (p<0.05). When hybrid SPECT/CT results were evaluated, the vascular phase of scintigraphy showed hyperaemia of the graft and the bone phase of scintigraphy showed normal or increased radiotracer uptake in the graft site in 7 patients. SPECT/CT images were used to determine the exact localisation of osteoblastic activity. 1 patient with minor resorption of the graft without clinical symptoms revealed mild osteoblastic activity. The patient who had no activity in the graft site was rerevised because of infection. Conclusions Institutional bank allografts are still excellent options for treating large acetabular defects in revision total hip arthroplasty where trabecular metals are not available or in common use. The Hybrid SPECT/CT method is a reliable, noninvasive method for evaluating both the integrity and viability of a bulk graft in 3-D.

scholarly journals Transinguinal sonographic determination of the position of the femoral head after reposition and follow-up in a spica cast

2010 ◽  
Vol 40 (11) ◽  
pp. 1794-1799 ◽  
Author(s):  
Frederik J. A. Beek ◽  
Rutger-Jan Nievelstein ◽  
Hans E. Pruijs ◽  
Pim A. de Jong ◽  
Ralph J. B. Sakkers
Keyword(s):  
Femoral Head ◽  
Spica Cast

The percentage of migration as indicator of femoral head position

1988 ◽  
Vol 29 (3) ◽  
pp. 363-366 ◽  
Author(s):  
O. Eklof ◽  
H. Ringertz ◽  
L. Samuelsson
Keyword(s):  
Femoral Head ◽  
Head Position

EVALUASI KESESUAIAN PELAKSANAAN PROBITY AUDIT PADA BPKP PUSAT DENGAN PEDOMAN PROBITY AUDIT PENGADAAN BARANG/JASA PEMERINTAH

INFO ARTHA ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. 17-34
Author(s):  
Fadlil Usman
Keyword(s):  
Public Sector ◽  
Real Time ◽  
Procurement Process ◽  
Assessment Activity

Probity audit is an independence assessment activity to ensure the goods/services procurement processes have been implemented consistently appropriate with the principle of upholding integrity, uprightness, honesty and fulfill certain occur legislation aimed for improving the accountability for the use of public sector fund. Probity audit is done in real time simultaneously with the goods/services procurement process. This study aims to evaluate the suitability of the implementation of probity audit conducted by BPKP Headquarter as agency that initiated the implementation of probity audit in Indonesia compared with the Probity audit Guidelines for Procurement of Goods/Services as criteria. The results of this study indicate that the implementation of probity audit conducted by BPKP Headquarter has been implemented adequately, but there are activities that do not fit the criteria, especially in the activities of the determination of the scope of the audit, the preparation of working papers and the follow-up monitoring of the audit results. Probity audit merupakan kegiatan penilaian (independen) untuk memastikan bahwa proses pengadaan barang/jasa telah dilaksanakan secara konsisten sesuai dengan prinsip penegakan integritas, kebenaran, kejujuran dan memenuhi ketentuan perundangan yang berlaku yang bertujuan meningkatkan akuntabilitas penggunaan dana sektor publik. Probity audit dilakukan secara real time yaitu bersamaan dengan pelaksanaan pengadaan barang/jasa. Penelitian ini bertujuan untuk melakukan evaluasi kesesuaian pelaksanaan probity audit yang dilakukan oleh BPKP Pusat selaku instansi yang menginisiasi pelaksanaan probity audit di Indonesia dibandingkan dengan kriteria berupa Pedoman Probity audit Pengadaan Barang/Jasa Pemerintah. Hasil dari penelitian ini menunjukkan bahwa pelaksanaan probity audit yang dilakukan oleh BPKP Pusat sudah dilaksanakan secara memadai, namun masih terdapat hal yang belum sesuai dengan kriteria terutama dalam kegiatan penentuan ruang lingkup audit, penyusunan kertas kerja dan pemantauan terhadap tindak lanjut hasil audit.

Necrosis avascular

2020 ◽  
Vol 63 (2) ◽  
pp. 18-23
Author(s):  
Alejandro Jardón Gómez ◽  
Ana Cristina King ◽  
Carlos Pacheco Díaz
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Femoral Fracture ◽  
Open Fracture ◽  
Clinical Presentation ◽  
Femoral Fractures ◽  
Proximal Femoral Fracture ◽  
Young Population ◽  
Steroid Use

The clinical presentation of a proximal femoral fracture is completely different between young and adult patients. Unlike closed proximal femoral fractures, the incidence of exposed fractures is found in the young population between 15 and 30 years of age. Osteonecrosis of the femoral head is one the complications we can find in this type of fractures. Avascular necrosis (AVN or osteonecrosis) is defined as the interruption of blood supply to the femoral head due to trauma, infectionalcohol or steroid use, resulting in bone necrosis, joint collapse and osteoarthrosis. The treatment will depend on the clinical presentation, age of the patient and when the diagnosis is made. This is a case report of a 16-year-old patient with a gunshot wound on the hip. Surgical cleansing and closed reduction plus internal fixation with a nail in the center of the spine were performed. A 3-year clinical and radiographic follow up was made, observing the evolution of the fracture and the subsequent avascular necrosis that the patient presented. Key words: Proximal femoral fracture; hip; avascular necrosis (AVN, osteonecrosis); open fracture; osteoarthritis.

scholarly journals Dental implant placement with inferior alveolar nerve repositioning in severely resorbed mandibles: a retrospective multicenter study of implant success and survival rates, and lower lip sensory disturbances

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
George Deryabin ◽  
Simonas Grybauskas
Keyword(s):  
Dental Implants ◽  
Dental Implant ◽  
Healing Process ◽  
Survival Rates ◽  
Inferior Alveolar Nerve ◽  
Reliable Technique ◽  
Lower Lip ◽  
Neurosensory Disturbances ◽  
Sensory Disturbances

Abstract Background The purpose of this study was to analyze medium-to-long-term implant success and survival rates, and lower lip sensory disturbance after placement of dental implants with simultaneous inferior alveolar nerve (IAN) repositioning. Methods Fifteen patients (3 men, 12 women) treated in two centers were included in this retrospective study. The ages of the participants ranged from 19 to 68. A total of 48 dental implants were placed in 23 posterior mandibular segments simultaneously with IAN transposition or lateralization. The residual bone above the IAN ranged from 0.5 to 7.0 mm. Crestal bone changes were measured using cone beam computed tomography (CBCT) images. Disturbance of the IAN was evaluated subjectively using a modified questionnaire. Results The healing process was uneventful in fourteen patients. In one patient, spontaneous fracture of the operated mandible occurred on tenth day after the surgery. The implant in the fracture line was removed at the time of open reduction and fixation. One more implant was lost after 5 years of loading. Therefore, the overall dental implant survival rate was 95.8%, whereas all implants in function were judged as successful after a follow-up period of 1 to 10 years. Transient neurosensory disturbances (ND) were observed in all patients who underwent IAN lateralization and IAN transposition. At follow-up times of 3 years, 5 years, and 10 years, weak hypoesthesia remained in two subjects treated with IAN transposition. None of the patients developed neuropathic pain after the procedure. Conclusions Within the limitations of this study, we conclude that reconstruction of severely resorbed mandibles with dental implants in conjunction with IAN repositioning is an effective and reliable technique. Although neurosensory disturbances are the most common complication after surgery, they tend to resolve over time. Advanced surgical skills are required to perform this technique.

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