scholarly journals Traumatic obturator–anterior type dislocation of the hip with an ipsilateral ischial tuberosity and greater trochanter fractures: Case report

2020 ◽  
pp. 221049172097898
Author(s):  
Juan Manuel Concha ◽  
Humberto Gonzalez ◽  
Andrea C Montero ◽  
Nelsy B Mueses ◽  
Heydy Y Muñoz ◽  
...  
Keyword(s):  
Hip Dislocation ◽  
Femoral Fractures ◽  
High Energy ◽  
Ischial Tuberosity ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Functional Evaluation ◽  
Greater Trochanter ◽  
Anterior Hip Dislocation ◽  
Trochanter Fracture

Anterior hip dislocation is a rare orthopedic emergency, usually following high-energy trauma. This injury is occasionally associated with acetabular fractures, femoral head fractures, or diaphyseal femoral fractures. However, the combination between the anterior hip dislocation and the ipsilateral ischial tuberosity and greater trochanter fractures is extremely rare, and very sparsely reported in the literature. This paper reports a case of an obturator type of anterior hip dislocation associated with a concomitant ipsilateral ischial tuberosity and greater trochanter fracture. The hip dislocation was reduced by closed means under general anesthesia, and the greater trochanter fracture was reduced and internally fixed with tension band in a second stage. Radiological and functional evaluation at 12 months after surgery, using the Harris Hip Score (HHS), was good.

scholarly journals Capsular arthroplasty for neglected developmental dysplasia of hip

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901877788 ◽  
Author(s):  
Saeed Ahmad ◽  
Irfan Qadir ◽  
Atiq uz Zaman ◽  
Chiragh Muhammad Khan ◽  
Shahzad Javed ◽  
...  
Keyword(s):  
Hip Dislocation ◽  
Developmental Dysplasia ◽  
Harris Hip Score ◽  
Functional Evaluation ◽  
Short Term ◽  
Scoring Method ◽  
Developmental Dysplasia Of Hip ◽  
Femoral Shortening ◽  
Shelf Procedure

Introduction: Treatment of developmental dysplasia of hip (DDH) diagnosed after 10 years of age is extremely difficult because of the soft tissue and bone deformities. In this study, we evaluated short-term results of a single-stage procedure performed with surgical hip dislocation, femoral shortening and capsular arthroplasty. Patients and Methods: A retrospective review of charts of five patients with DDH, older than 10 years, who underwent capsular arthroplasty at Ghurki Trust Teaching Hospital between 2013 and 2015 was performed. Post-operative functional evaluation was performed using modified McKay’s scoring system and radiographic assessment using Severin’s scoring method at a minimum of 2-year follow-up. Results: We present results of five patients (six hips) with a mean age of 18.16 years. All patients had limping gait and International Hip dysplasia Institute classification (IHDI) class 4 hip dislocation. Harris hip score showed a significant improvement (53.13 vs 84.16; p = 0.0001). Femoral shortening of 2–2.5 cm was done. Additional shelf procedure was required in one patient. This patient persistently has post-operative hip subluxation. All patients had good to excellent outcomes according to McKay classification. Post-operative Severin classification was 1A in all patients. No case of avascular necrosis of the femoral head was noted during the follow-up. Conclusion: Capsular arthroplasty with subtrochanteric shortening is a useful procedure for neglected cases of DDH in patients older than 10 years.

Ipsilateral open anterior hip dislocation and avulsion fracture of the greater trochanter: An unusual case report

2019 ◽  
Vol 26 (7) ◽  
pp. 422-425
Author(s):  
M.A. Khalifa ◽  
Z. Alaya ◽  
L. Hassini ◽  
K. Bouattour ◽  
W. Osman ◽  
...  
Keyword(s):  
Case Report ◽  
Unusual Case ◽  
Avulsion Fracture ◽  
Hip Dislocation ◽  
Greater Trochanter ◽  
Anterior Hip Dislocation ◽  
Unusual Case Report

scholarly journals Fractures of the trochanteric region in children and young adolescents—a treatment algorithm for a rare injury

2020 ◽  
Author(s):  
Stephan Payr ◽  
Ellen Payr ◽  
Britta Chocholka ◽  
Manuela Jaindl ◽  
Monika Luxl ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Femoral Fractures ◽  
Trochanteric Fracture ◽  
High Energy ◽  
Fracture Reduction ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Trochanteric Fractures ◽  
Fractures In Children ◽  
Trochanteric Region

Abstract For femoral fractures of the trochanteric region in children and adolescents, only two mechanisms have been identified to cause a fracture of the proximal femur: high-energy trauma or predisposing bone pathologies with inadequate trauma (e.g., simple fall, movement). We identified 20 patients between 1993 and 2018 with a trochanteric fracture under the age of 18 (12 males; 8 females; mean age, 12 years; range, 4–17 years) who were treated operatively at our department. The mean follow-up of all patients was 50.06 months. All 20 patients were treated operatively. Complications occurred after a mean time of 6.27 months (range, 0.47 to 12.07 months) in two patients. Harris Hip Score was evaluated in all patients with a mean score of 94.16 (range 11 to 100). Eighty-five percent of the patients reached an excellent clinical outcome after treatment. Trochanteric femoral fractures in children and adolescents are very rare accounting for only 1% of all trochanteric fractures. Excellent long-term results can be achieved with an adequate fracture reduction. Conclusion: Physicians treating pediatric trauma have to be aware of other predisponding diseases when low-energy trauma leads to a trochanteric fracture as in this study, 50% of the trochanteric fractures were associated with bone pathologies. What is Known:• Trochanteric femoral fractures in children and adolescents are very rare• In all patients with trochanteric femoral fractures, malignancies have to be ruled outWhat is New:• Awareness of an underlying bone pathology in a high number of cases• Awareness for necessity of a good fracture reduction leading to highly satisfactory results

scholarly journals Is the Any Clinical Importance for Separation Congenitally Dislocated Hip in Adults into Types C1 and C2 by Hartofilakidis?

2019 ◽  
Vol 25 (3) ◽  
pp. 9-24 ◽  
Author(s):  
R. M. Tikhilov ◽  
I. I. Shubnyakov ◽  
A. O. Denisov ◽  
D. G. Pliev ◽  
M. I. Shubnyakov ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Femoral Nerve ◽  
Revision Arthroplasty ◽  
Hip Dislocation ◽  
Clinical Importance ◽  
Harris Hip Score ◽  
Greater Trochanter ◽  
Non Union ◽  
Nerve Paresis ◽  
Surgical Tactics

The main questions of the study: 1) is there any difference in anatomical features between subtypes C1 and C2 of high hip dislocation by Hartofolakidis classification; 2) are the conditions for performing the THA different and what are the surgical decisions; 3) what are the THA results in different groups? Materials and Methods. In a single center study the authors retrospectively evaluated the outcomes of 561 THAs performed in 349 patients with a high hip dislocation including 32 men (9.2%) and 317 women (90.8%) with the follow up from 12 to 188 months (average 69,4 months). In 326 cases (58.1%) the dislocation was assessed as type C1, and in 235 cases (41.9%) — as type C2. The average age of the patients at the time of surgery was 47.6 (19 to 74) years, for men — 39.1 years and 48.1 years for women. Results. Paavilainen shortening osteotomy was performed in 100% of patients with type C2 and only in 50.6% of patients with type C1, p<0.001. The cup was implanted into the true acetabulum cavity in 99.1% of cases with type C2, and for type C1 only in 69.0% of cases, p<0.001. Lateral under-coverage of the cup in patients with type C2 required supplementing by femoral head autograft only in three cases, and for type C1 — in 18 patients, p = 0.009. In the group of C2, the mean length of the osteotomized fragment of the proximal femur was 78.6 mm compared to 62.5 mm in patients with type C1. This provided a better contact area between the greater trochanter and the femur and in 92.8% of cases fixation was done by cerclage wires and two screws. In the group of patients with type C1, this option was feasible only in 60.0% of cases. Odds ratio (OR) for fixation of the greater trochanter by a special plate for primary indications in patients with type C1 were 10 367, p = 0.008. Harris Hip score improved averaged from 39.5 points to 83.6, without statistically significant differences between groups of C1 and C2. Early complications included 9 dislocations (1.6%), 8 cases of femoral nerve neuropathy (1.4%) and 3 early infections (0.5%). No cases of sciatic nerve paresis were observed. Non-union of the greater trochanter was observed with almost equal frequency in patients with C1 and C2 types, and revision fixation was needed in 27 patients (6.8%). Revision arthroplasty was performed in 22 cases (3.9%) due to 4 infections, 2 aseptic loosening of the stem, 11 aseptic loosening of the acetabular component and 5 recurrent dislocations. Conclusion. The group of patients with high hip dislocation is very heterogenic in terms of severity of anatomical changes and demands different surgical tactics. Hartofolakidis classification helps the surgeon to select the best type of the surgical procedure, minimize the mistakes and predict treatment outcomes.

scholarly journals Concomitant ipsilateral acetabular and femoral fractures – an appraisal of outcomes and complications in 34 patients

2021 ◽  
Vol 87 (3) ◽  
pp. 401-410
Author(s):  
Umesh Kumar Meena ◽  
Mahesh Chand Bansal ◽  
Prateek Behera ◽  
Divyanshu Goyal ◽  
Rakesh Kumar
Keyword(s):  
Road Traffic ◽  
Tertiary Care ◽  
Femoral Fractures ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Common Mechanism ◽  
Type B ◽  
Young Males ◽  
Hip Injuries

Concomitant ipsilateral femoral and acetabular fractures are complex injuries which result from high-velocity trauma. Surgical treatment is the accepted management of such injuries. The objectives of this study were to evaluate the outcomes and study the complications in patients treated for concomitant ipsilateral acetabular and femoral fractures (type ‘B’ floating hip injuries). This retrospective study was conducted at a tertiary care teaching hospital on patients operated for type B floating hip injuries, who had completed a minimum of one-year follow-up after the surgery and whose complete records were available. Those with floating hip injuries with pelvic fractures were excluded. All patients were operated on the femoral side first, followed by the acetabular side. 34 patients were included ; most of them were young males. A road traffic accident was the most common mode, with a dashboard injury being the most common mechanism of injury. No association between the type of acetabular and femoral fractures was found. The clinical (measured with Harris hip score) and radiological (Matta’s method) outcomes at the latest follow-up were excellent or good in >60% cases and had a significant association with the quality of reduction on the post-operative radiographs. Com- plications were seen in 12 out of the 34 patients. Type B floating hips injuries can be managed well with acceptable short-term results by following a femur first strategy. However, patients must be informed of the possible complications and the probabilities of poorer outcomes when compared to isolated acetabular or femoral fractures.

Midterm results of trochanteric flip osteotomy technique for management of fractures around the hip

2017 ◽  
Vol 28 (2) ◽  
pp. 148-155 ◽  
Author(s):  
Vivek Trikha ◽  
Saubhik Das ◽  
Arkesh Madegowda ◽  
Prabhat Agrawal
Keyword(s):  
Femoral Head ◽  
Excellent Result ◽  
Hip Dislocation ◽  
Posterior Wall ◽  
Acetabular Fractures ◽  
Functional Evaluation ◽  
Midterm Results ◽  
Surgical Hip Dislocation ◽  
Surgical Dislocation ◽  
Trochanteric Flip Osteotomy

Introduction: In this study, we aimed to investigate safety and efficacy of the trochanteric flip osteotomy with surgical hip dislocation technique in selected displaced acetabular and femoral head fractures with clinico-radiological outcome and potential complications. Materials and methods: We retrospectively reviewed 32 patients from January 2009 to June 2014. Selected displaced acetabular fractures with comminution and/or cranial extension of posterior wall, marginal impaction, intraarticular fragment, femoral head fractures and hip fracture-dislocations were operated by this modified approach of trochanteric flip osteotomy and surgical hip dislocation. Patients were evaluated for fracture reduction, femoral head viability, trochanteric union, abduction power, and functional evaluation was done by Merle d’Aubigné-Postel scoring system. Minimum follow-up was 24 months. Results: Reduction was judged to be anatomical in 84.38% of cases, and within 1-3 millimetres in 9.38% of cases. All osteotomies healed in an anatomical position. Heterotopic ossification was found in 2 patients limited to Brooker class I. Osteonecrosis developed in 1 patient. 2 patients developed arthritis of the hip as sequelae of poor reduction. Abduction power was MRC 5/5 in all except in 1 patient (4/5). Mean Merle d’Aubigné-Postel score was 16.18; overall good to excellent result was achieved in 87.5% of cases. Conclusions: Trochanteric flip osteotomy with surgical dislocation allows better intraarticular assessment, control of intraarticular fragments, assists accurate reduction and the fixation of complex acetabular and femoral head fractures, without compromising femoral head vascularity and abductor strength. This technique has provided excellent midterm results in the management of complex injuries around the hip.

scholarly journals Management of type B2 and B3 post-operative proximal periprosthetic femoral fractures, Oghara experience

2021 ◽  
Vol 9 (1) ◽  
pp. 52-60
Author(s):  
R.E.T. Enemudo ◽  
E.O. Edomwonyi ◽  
D.O. Odatuwa-Omagbemi ◽  
A.T. Obumse ◽  
M.M. Awa
Keyword(s):  
Femoral Fracture ◽  
Hip Prosthesis ◽  
Hip Dislocation ◽  
Femoral Fractures ◽  
University Teaching ◽  
Harris Hip Score ◽  
Periprosthetic Femoral Fracture ◽  
Vancouver Classification ◽  
Duration Of Surgery

Objective: To report the outcome of treatment of Types B2 and B3 Post- operative Periprosthetic proximal femoral fracture (PPFF) in four patients treated in Delta State University Teaching Hospital, Oghara, Delta State, using Vancouver classification of Duncan and Masri. Methodology: A retrospective study of four cases managed in this hospital. Information retrieved from case notes were sex, age, duration of prosthesis, treatment given, complications and outcome of treatment. Result: Atotal of 4 patients were reviewed in the study, 2 males and 2 females with a M: F of 1: 1. Duration of the implant before treatment was 5-12 years (mean of 8.3years). Age range was 60-83years (mean of 67.5 years). Two patients had Type B2 and two had Type B3. Average intraoperative blood loss was 1 litre. Duration of surgery was 3-4 hours. Duration of hospital stay was between 3 weeks and 5 months. The complications seen were primary haemorrhage, wound infection, hip dislocation and pulmonaryembolism. The outcome was good for 3 patients and fair in 1, using Harris Hip Score. Conclusion:Vancouver classification of Duncan and Masri is effective in the treatment of PPFF. Key words; Periprosthetic femoral fracture, Long stem hip prosthesis, Vancouver classification, osteolysis.

Medium-term outcome and classification of traumatic anterior hip dislocations

2020 ◽  
pp. 112070002091886
Author(s):  
Lee S Yaari ◽  
Assaf Kadar ◽  
Shai Shemesh ◽  
Barak Haviv ◽  
Michael P Leslie
Keyword(s):  
Femoral Head ◽  
Range Of Motion ◽  
Clinical Outcomes ◽  
Weight Bearing ◽  
Hip Dislocation ◽  
Anterior Dislocation ◽  
Harris Hip Score ◽  
Surgical Data ◽  
Anterior Hip Dislocation

Introduction: Traumatic anterior hip dislocations are subdivided to obturator (inferior) and pubic (superior) dislocations by Epstein’s descriptive classification. This rare injury is thought to have favourable clinical outcomes. The incidence of associated femoral head and acetabular injuries has been low in past case series. We sought to revisit this injury and classification in the era of advanced imaging and contemporary surgical techniques. Materials and methods: A retrospective study of 15 patients treated for anterior hip dislocation was performed. Medical records were reviewed for demographic and surgical data. Imaging studies were revisited to determine direction of dislocation and associated fractures. Patients were assessed for pain, hip function using the modified Harris Hip Score (mHHS), hip range of motion and radiographic changes. Mean follow-up time was 3 years. Results: Anterior dislocation occurred in an obturator (inferior), pubic (superior) or central direction. 9 patients had concomitant femoral head impaction and 7 patients suffered from acetabular fractures. 8 patients with an anterior hip dislocation underwent surgical treatment. This therapy, along with early range of motion and weight bearing, produced favourable clinical outcomes with 9 patients reporting no pain and an average mHHS of 83.8. 6 patients had heterotopic ossification at latest follow-up. Conclusions: Traumatic anterior hip dislocation is commonly associated with femoral head impaction and acetabular injuries which should be addressed operatively when appropriate to produce favourable results. In this paper, we propose a revision to the commonly used descriptive classification system.

scholarly journals Proximal femur locking compression plate in Subtrochanteric Fractures : a prospective analysis

2019 ◽  
pp. 66-68
Author(s):  
Kailasnath M.S ◽  
K. Subramanian ◽  
G. Pugazhendhi
Keyword(s):  
Femoral Fractures ◽  
Early Mobilization ◽  
The Elderly ◽  
Bimodal Distribution ◽  
High Energy ◽  
Locking Compression Plate ◽  
Harris Hip Score ◽  
Osteoporotic Bone ◽  
Compression Plate ◽  
Mobility Score

Introduction:Sub-trochanteric femoral fractures are injuries that mostly affect the elderly population.Ithasa bimodal distribution. In young and healthy individuals, the injury results from high energy trauma, where as in the elder age group, most of the fractures are in osteoporotic bone resulting from a trivial fall. The aim of the surgery is to achieve initial stability and early mobilization of the patients and to avoid complications. The aim of our study is to analyze the outcomes of proximal femoral locking compression plate (PF-LCP) in these fractures. Materials and Methods:We prospectively analyzed30sub-trochantericfemoral fractures treated with PF-LCP from January 2015 to December 2018. There were 20 females (66.6%) and 10 males (33.4%) with an average age of 61.2 years (range, 36 to 75 years). The sub-trochanteric fractures are classified by Seinshemier's classification. The functional outcome was evaluated by Harris Hip Score and the Parker Palmer Mobility Score at 12 months follow-up. Results:Among 30 patients, 27 patients (90%) obtained fracture union without further intervention; 3 patients required additional bone grafting at the end of 3 months. There were no cases of hip screw cutting the femoral head. There was no post-operative mortality in our study. The average Harris Hip Score was 87 (80-93). The assessment by Parker and Palmar Mobility Score was 7.8(range 5-9). Conclusions:The PF-LCP is a good stable alternative in the treatment of sub-trochanteric femoral fractures. It providesgood to excellent bone healing with limited complications.

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