Modern Technique for Proximal Femur Osteosynthesis at Reconstructive Operations on Hip Joint in Children

2010 ◽  
Vol 17 (1) ◽  
pp. 54-59
Author(s):  
S P Mironov ◽  
O V Kozhevnikov ◽  
A V Ivanov ◽  
N S Gavryushenko ◽  
D B Zatona ◽  
...  
Keyword(s):  
Hip Joint ◽  
Proximal Femur ◽  
Surgical Intervention ◽  
Operative Trauma ◽  
Joint Pathology ◽  
Reconstructive Operations ◽  
Strength Tests ◽  
Bone Fragments ◽  
Proper Setting

Set of instruments and metal fixatives for osteosynthesis in corrective operations on proximal femur in patients aged 1-15 years was elaborated at CITO. Comparative experimental strength tests showed the advantages of suggested metallic fixatives over existed analogs (fixatives from DON set and Blount plate). Cannulated system for angular metal fixatives application provided for proper setting of the construction, shortened the duration of surgical intervention and decreased operative trauma. That set was used for the treatment of 169 children with various types of hip joint pathology. Average duration of surgical intervention made up 45 min. (versus 95 min. at routine surgical technique). Bone fragments displacement, loss of correction, instabi-lity of osteosynthesis and other complications were not observed at follow up less than 1 year.

Surgical Treatment of Distal Femur Fractures using LISS System

2003 ◽  
Vol 10 (3) ◽  
pp. 36-42
Author(s):  
D Cherkes-Zade ◽  
M Monesi ◽  
A Causero ◽  
M Marcolini ◽  
D Cherkes-Zade ◽  
...  
Keyword(s):  
New Technology ◽  
Weight Bearing ◽  
Long Bone ◽  
Operative Trauma ◽  
Early Weight Bearing ◽  
Femur Fractures ◽  
Bone Fragments ◽  
Total Knee ◽  
Using Data

Osteosynthesis with LISS system (less invasive stabilization system) is a new technology and this conception of stabilization of long bone fragments is a new step in the development of AO philosophy. Indications to application of this system are distal metaepiphysis and diaphysis femur fractures, supra- and transcondylar fractures in polytrauma, fractures in osteoporosis as well as fractures after total knee replacement. During the last 3 years 35 patients were operated on by that technique. The follow-up period ranged from 6 months to 3 years. Assessment of outcomes was performed using data of clinical examination and evaluation of radiograms with modified Neer-Grantham-Shelton scale. In patients who were operated on I year ago the total score varied from 70 to 80 (maximum - 100). Advantages of this technology as compared to the traditional methods of osteosynthesis are the following: limited operative trauma, less blood loss, shortening of surgery duration, preservation of tissue physiology as well as absence of the necessity to use cement and bone auto- and allografts. Disadvantages include the difficulty for reposition prior to fixation and impossibility of correction in postoperative period as well as early weight-bearing load.

Reconstructive Operations in Malunited Fractures of Distal Radius Epimetaphysis

2011 ◽  
Vol 18 (1) ◽  
pp. 43-47
Author(s):  
Viktor Sergeevich Mel'nikov ◽  
V F Korshunov ◽  
V S Mel'nikov ◽  
V F Korshunov
Keyword(s):  
Distal Radius ◽  
Surgical Intervention ◽  
Wrist Joint ◽  
Hand Function ◽  
Long Term Results ◽  
Joint Deformity ◽  
Distraction Device ◽  
Reconstructive Operations ◽  
Bone Fragments

Experience in surgical treatment of 112 patients with malunited fractures of distal radius epimetaphysis is presented. Indication to surgical intervention was fragments consolidation with displacement that was accompanied by marked wrist joint deformity and hand function disturbance. In all patients osteotomy and bone plasty were performed followed by application of distraction device. In the postoperative period dosed distraction of bone fragments up to their complete reposition and rehabilitation treatment was performed. Long term results were assessed for all 87 patients: good result was achieved in 67 (77%), satisfactory - in 17 (19.5%) and poor - in 3 (3.5%) patients.

Reconstructive Operations on Hip Joint in Children with Epiphyseal Dysplasias

2012 ◽  
Vol 19 (1) ◽  
pp. 53-60
Author(s):  
M M Kamosko ◽  
Evgeniy Viktorovich Mel'chenko ◽  
M M Kamosko ◽  
E V Mel'nichenko
Keyword(s):  
Hip Joint ◽  
Pelvic Osteotomy ◽  
Age Group ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Joint Deformity ◽  
Younger Age ◽  
Reconstructive Operations ◽  
Positive Effect

Retrospective analysis of examination and treatment results for 100 patients with epiphyseal dysplasias (ED), aged 3 months - 18 years, was performed. In 22 patients conventional palliative surgical interventions for the elimination of defected limb position were performed. Authors have treated 78 patients: in 25 patients corrective shortening femur osteotomy (CSFO) and in 31 - pelvic osteotomy in combination CSFO was performed. Follow up period was from 3 years to 8 years. By the results of clinical and roentgenologic dynamics of hip joint deformity development in children with ED 3 clinic-roentgenologic-anatomic manifestations of the disease were determined: initial changes (from birth to 6 years), marked changes (7 - 11 years) and severe changes (from 12 years). It was shown that reconstructive operations on pelvic and femoral joint components possessed positive effect especially pronounced in children of the younger age group.

scholarly journals Draft Recommendations. Pharmacotherapy for the Prevention of Repeated Fractures in Patients with Osteoporosis after Surgical Treatment of Pathologic Proximal Femur Fracture

2017 ◽  
pp. 47-57
Author(s):  
S. P. Mironov ◽  
S. S. Rodionova ◽  
A. N. Torgashin
Keyword(s):  
Proximal Femur ◽  
Surgical Intervention ◽  
Life Quality ◽  
Pathologic Fracture ◽  
Proximal Femur Fracture ◽  
Operative Trauma ◽  
Femur Fractures ◽  
Pathologic Fractures ◽  
Fracture Localization ◽  
Pharmacologic Correction

Treatment of pathologic proximal femur fractures complicating the course of systemic osteoporosis is most often limited by surgical intervention as until now trauma and orthopaedic surgeons have no concrete recommendations on pharmacologic correction of metabolism disorders typical to the pathology, that aggravate in the postoperative period due to operative trauma. Proposed draft recommendations are a part of National clinical recommendations “Treatment for pathologic fractures of skeleton bones complicating the course of osteoporosis”. This issue of recommendations is only applicable to pharmacotherapy directed to the correction of bone tissue remodeling with regard for the fracture localization and volume of surgical intervention. Present recommendations are intended for the improvement of patients’ life quality, reduction of present and future losses from pathologic fracture as well as the prevention of repeated fractures.

scholarly journals Proximal Femur Versus Acetabular Extra-articular Resection of the Hip Joint for Primary Malignant Bone Tumors : A Retrospective Comparative Review of 33 Cases

2021 ◽  
Author(s):  
Victor Housset ◽  
Philippe Anract ◽  
Antoine Babinet ◽  
Guillaume Auberger ◽  
David Biau
Keyword(s):  
Hip Joint ◽  
Proximal Femur ◽  
Bone Tumors ◽  
Malignant Bone Tumors ◽  
Primary Bone Tumors ◽  
Comparative Review ◽  
Primary Bone ◽  
The Mean ◽  
Cumulative Probabilities

Abstract Introduction Extra-articular resection (EAR) of the hip joint is prone to significant complications and morbidity. Thus, this study evaluates the cumulative incidences and main reasons of reoperation following EAR of primary bone tumors of the hip to determine whether the outcomes are different between EAR of the pelvis and that of the proximal femur. Patients and methods Thirty-three patients presented with a PMBT of the proximal femur or pelvis were included in this study. Among all PMBTs, 58% originated from the pelvis and 42% were from the proximal femur. Twenty patients had chondrosarcomas (61%), 10 had osteosarcomas (30%), and 3 had sarcomas of another histological subtype (9%). Results The mean follow-up was of 76 months (range: 24–220 months). The cumulative probabilities of revision for any reason was 52% (95% confidence interval [CI]: 30%–70%) five years after surgery. The five-year cumulative probabilities of revision were 13% (95% CI: 4%–27%), 24% (95% CI: 10%–42%) and 34% (95% CI: 14%–56%) for mechanical, infectious and tumoral reasons, respectively. The five-year cumulative probabilities of revision for any reason were 78% (95% CI: 37%–94%) and 14% (95% CI: 2%–38%) for the pelvis and proximal femur, respectively ( p = 0.004). Posterior column preservation was significantly associated with more mechanical complications even after adjusting for the resection site ( p = 0.043). Conclusion Half of patients undergoing EAR of the hip joint for PMBT of the proximal femur or acetabulum will require another operation. EAR of the pelvis is associated with significantly worse outcome than EAR of the proximal femur.

scholarly journals Interlocking reconstruction-mode stem-sideplates preserve at-risk hips with short residual proximal femora

2021 ◽  
Vol 103-B (2) ◽  
pp. 398-404
Author(s):  
Alexander B. Christ ◽  
Tomohiro Fujiwara ◽  
Mohamed A. Yakoub ◽  
John H. Healey
Keyword(s):  
At Risk ◽  
Hip Joint ◽  
Proximal Femur ◽  
Collaborative Study ◽  
Endoprosthetic Reconstruction ◽  
Musculoskeletal Tumor Society ◽  
Msts Score ◽  
And Function ◽  
Reconstruction Mode

Aims We have evaluated the survivorship, outcomes, and failures of an interlocking, reconstruction-mode stem-sideplate implant used to preserve the native hip joint and achieve proximal fixation when there is little residual femur during large endoprosthetic reconstruction of the distal femur. Methods A total of 14 patients underwent primary or revision reconstruction of a large femoral defect with a short remaining proximal femur using an interlocking, reconstruction-mode stem-sideplate for fixation after oncological distal femoral and diaphyseal resections. The implant was attached to a standard endoprosthetic reconstruction system. The implant was attached to a standard endoprosthetic reconstruction system. None of the femoral revisions were amenable to standard cemented or uncemented stem fixation. Patient and disease characteristics, surgical history, final ambulatory status, and Musculoskeletal Tumor Society (MSTS) score were recorded. The percentage of proximal femur remaining was calculated from follow-up radiographs. Results All 14 at-risk native hip joints were preserved at a mean final follow-up of 6.0 years (SD 3.7), despite a short residual femur, often after proximal osteotomies through the lesser trochanter. Overall, 13 of 14 stems had long-term successful fixation. Eight patients required no reoperation. Three patients required reoperation due to implant-related issues, and three patients required reoperation for wound healing problems or infection. There were no dislocations or fractures. At final follow-up the mean MSTS score was 24.9 (SD 4.1). Nine patients required no ambulation aids, and only one had a Trendelenburg gait. Conclusion This interlocking, reconstruction-mode stem-sideplate reliably preserves native hip joint anatomy and function after large femoral resection with a short remaining proximal femur, both in the primary and revision setting. This is particularly important for preventing or delaying total femoral arthroplasty in young patients after oncological reconstruction. Hip abductor strength and function could be maintained by this method, and the risk of dislocation eliminated. The success of this technique in this modest series should be verified in a larger collaborative study and will be of interest to revision surgeons and oncologists. Cite this article: Bone Joint J 2021;103-B(2):398–404.

scholarly journals Rationale for Time of Reconstructive Operations on the Proximal Femur in Hip Joint Traumatic Injuries

TRAUMA ◽  
2016 ◽  
Vol 17 (2) ◽  
pp. 49
Author(s):  
А.I. Каnziuba ◽  
V.H. Klimovitskyi ◽  
M.A. Каnziuba ◽  
L.I. Donchenko ◽  
L.D. Honcharova ◽  
...  
Keyword(s):  
Hip Joint ◽  
Proximal Femur ◽  
Traumatic Injuries ◽  
Reconstructive Operations

scholarly journals Draft Recommendations. Pharmacotherapy for the Prevention of Repeated Fractures in Patients with Osteoporosis after Surgical Treatment of Pathologic Proximal Femur Fracture

2017 ◽  
Vol 24 (1) ◽  
pp. 47-57
Author(s):  
S. P Mironov ◽  
S. S Rodionova ◽  
A. N Torgashin
Keyword(s):  
Proximal Femur ◽  
Surgical Intervention ◽  
Life Quality ◽  
Pathologic Fracture ◽  
Proximal Femur Fracture ◽  
Operative Trauma ◽  
Femur Fractures ◽  
Pathologic Fractures ◽  
Fracture Localization ◽  
Pharmacologic Correction

Treatment of pathologic proximal femur fractures complicating the course of systemic osteoporosis is most often limited by surgical intervention as until now trauma and orthopaedic surgeons have no concrete recommendations on pharmacologic correction of metabolism disorders typical to the pathology, that aggravate in the postoperative period due to operative trauma. Proposed draft recommendations are a part of National clinical recommendations “Treatment for pathologic fractures of skeleton bones complicating the course of osteoporosis”. This issue of recommendations is only applicable to pharmacotherapy directed to the correction of bone tissue remodeling with regard for the fracture localization and volume of surgical intervention. Present recommendations are intended for the improvement of patients’ life quality, reduction of present and future losses from pathologic fracture as well as the prevention of repeated fractures.

scholarly journals Surgical treatment of secondary hip osteoarthritis using cementless total hip endoprosthesis with Fitmore® Hip Stem: A case report

2017 ◽  
Vol 74 (8) ◽  
pp. 791-794
Author(s):  
Ivan Golubovic ◽  
Zoran Bascarevic ◽  
Predrag Stojiljkovic ◽  
Zoran Radovanovic ◽  
Ivana Golubovic ◽  
...  
Keyword(s):  
Case Report ◽  
Hip Joint ◽  
Proximal Femur ◽  
Young Patients ◽  
Hip Osteoarthritis ◽  
Good Choice ◽  
X Ray ◽  
Total Endoprosthesis ◽  
Long Stem

Introduction. Hip dysplasia with subluxation represents insufficient coverage of the femur's head placed in the dysplastic acetabulum. This lack of coverage ranges from barely noticeable to condition where half of femur head is uncovered by acetabulum. The caput-collum-diaphyseal angle of the proximal femur and anteversion angle of collum are increased, Wiberg?s angle is less than 15? and M?nard-Shenton line is interrupted. Hip joint degeneration occurs very early. When radiological signs of hip joint degenerative changes are discovered in elderly they are associated with pain, limited movements and leg shortening. Case report. We present a 53-year old female treated conservatively in childhood because of hip diyplasia with subluxation. After pregnancy, right hip pain emerged. Clinical and radiological examinations revealed hip subluxation with the signs of degenerative osteoarthritis. Initial treatment was conservative and included drugs and balneophysical procedures. Since pain and movement impairment progressed and became constant, a hip replacement using cementless total endoprosthesis with Fitmore? Hip Stem was done. In the pre-operative preparation, anteroposterior x-ray of the hip(with third of the proximal femur) was made. This X-ray enabled precise planning of implantation endoprosthesis component. The early postoperative course was uneventful with very good therapeutic effect. Following successful physical rehabilitation, the patient returned to work and full life activity. Conclusion. Implantation of the cementless endoprosthesis with Fitmore? Hip Stem in the treatment of secondary hip osteoarthritis is a good choice in the treatment of young patients with good bone quality. Future clinical and radiological follow-up and comparative studies are needed to show the advantages of this type of stem compared to the classical cementless long stem.

Bone and Bone Marrow Blood Flow in Blastic Crisis of Chronic Granulocytic Leukaemia

1979 ◽  
Vol 18 (06) ◽  
pp. 290-292 ◽  
Author(s):  
R. Lahtinen ◽  
T. Lahtinen
Keyword(s):  
Bone Marrow ◽  
Cell Proliferation ◽  
Blood Flow ◽  
Proximal Femur ◽  
Blastic Crisis ◽  
Normal Bone ◽  
Chronic Granulocytic Leukaemia ◽  
Washout Curves ◽  
Bone Marrow Blood

SummaryA l33Xe washout method has been used for measuring changes of blood flow in the proximal femur of a patient with the blastic crisis of chronic granulocytic leukaemia. In the hyperplastic phase the blood flow was highly increased and over three times greater than in the hypoplastic phase of the disease and over thirteen times greater than the value in normal bone. The bone circulation and especially the first component of the two-exponential bone washout curves appeared to reflect cell proliferation and neoplastic activity of the whole bone marrow. The method may provide clinically important information in the follow-up of selected haematological diseases.

Sign in / Sign up

Export Citation Format

Share Document