scholarly journals Avascular necrosis of the femoral head in the patients with posterior wall acetabular fractures associated with dislocations of the hip

2013 ◽  
Vol 60 (2) ◽  
pp. 65-69 ◽  
Author(s):  
Sasa Milenkovic ◽  
Milorad Mitkovic ◽  
Jordan Saveski ◽  
Ivan Micic ◽  
Predrag Stojiljkovic ◽  
...  
Keyword(s):  
Femoral Head ◽  
Young Patients ◽  
Hip Dislocation ◽  
Posterior Wall ◽  
Acetabular Fractures ◽  
Type I ◽  
Severe Injuries ◽  
Stable Osteosynthesis ◽  
Posterior Hip Dislocation

Introduction: Acetabular fractures are severe injuries, mostly occured in young patients after traffic accident or fall from heights. Of the all acetabular fractures, posterior wall acetabular fractures are the most often observed. Regarding to mechanism of the injury, about 30% of these fractures are associated with posterior hip dislocation. Material and methods: The incidence of AVN in 18 patients with posterior wall acetabular fractures associated with dislocations of the hip is presented. Thompson-Epstein Scale (type I-V) was used as the classification of the injury. Kocher-Langenbeck surgical approach was achieved in all patients. Results: Average following time after surgery was 22,66 months (8-36 months). After that period the incidence of femoral head AVN was observed in 33,3%6. Femoral head AVN was observed in 5,55%1 of patient who was treated by the reduction of hip dislocation in first 24 hours after injury, while in patients with later reduction, femoral head AVN were observed in 27,77%5. Conclusion: Posterior wall acetabular fractures associated with hip dislocation are severe injuries. Urgent, closed reduction of the hip, early definitive stable osteosynthesis of acetabulum and the experience of surgical team are factors that greatly decrease the possibility for AVN occurrence. Later reduction, comminution of posterior wall of the acetabulum (Thompson-Epstein III et IV), impaction, chondral lesion of the femoral head and associated fractures of femoral head, increase the possibility for AVN occurrence.

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 Treatment of fracture dislocation of the femoral head using safe surgical hip dislocation: a case report.

2021 ◽  
Author(s):  
Paa BAIDOO ◽  
Kwasi Twumasi-Baah Jnr ◽  
Kwadwo Anning ◽  
Alex Assim ◽  
Emmanuel Ayodeji ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Hip Dislocation ◽  
Fracture Dislocation ◽  
Type I ◽  
Femoral Head Fracture ◽  
Surgical Hip Dislocation ◽  
Posterior Hip Dislocation

We report the clinical and radiological outcomes of a 30-year-old female with femoral head fracture following a posterior hip dislocation. The patient was managed using safe surgical hip dislocation and reviewed the literature on Pipkin type I 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.

Pelvic Fractures

1994 ◽  
Vol 35 (5) ◽  
pp. 420-425 ◽  
Author(s):  
J. Albrechtsen ◽  
J. Hede ◽  
A. G. Jurik
Keyword(s):  
Femoral Head ◽  
Pelvic Ring ◽  
Posterior Part ◽  
Conventional Radiography ◽  
Pelvic Fractures ◽  
Acetabular Fractures ◽  
Pelvic Ring Fractures

Sixty-two patients with pelvic fractures were evaluated by conventional radiography and CT. A correct pathoanatomic classification of the fractures was most often obtained by conventional radiography, but CT added information regarding acetabular fractures and involvement of the posterior part of the pelvic ring. Besides, CT was essential in the detection of intraarticular fragments and lesions of the femoral head. Classification of pelvic ring fractures by the pattern of traumatic forces was easily obtainable by conventional radiography, but often difficult to achieve by CT.

scholarly journals “Acute Primary Total Hip Arthroplasty for Combined Posterior Acetabulum Fracture with Ipsilateral Associated Posteriorly Dislocated Femoral Head with Femoral Neck Fracture. Using of Femoral Head as an Autograft Would be an Advantage”

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Babaji Thorat ◽  
Avtar Singh ◽  
Mohammad Arshad ◽  
Sharad Salokhe ◽  
Ravi Mavani
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
High Energy ◽  
Acetabular Reconstruction ◽  
Total Hip ◽  
Neck Fracture ◽  
Posterior Hip Dislocation

Introduction: Traumatic posterior hip dislocation with comminuted fracture of the ipsilateral acetabulum and femoral neck is a rare fracture pattern. These injuries are associated with high energy trauma and pose challenges during management. Controversy exists between hip preservation and replacement surgeries in middle-age patients. Open reduction and internal fixation (ORIF) have a high risk of non-union, avascular necrosis, and post-traumatic osteoarthritis of hip requiring total hip arthroplasty hip replacement (THA) as a secondary procedure later. Case Report: A 56-year-old male presented with posterior hip dislocation and comminuted fracture of ipsilateral wall and column of the acetabulum, and femoral neck following a high energy trauma. He was managed by acetabular reconstruction using femoral head structural autograft combined with acute primary uncemented THA. At 2-year follow-up, the patient had good functional outcome with a satisfactory range of motion without any difficulty in weight-bearing and doing his daily activities. Conclusion: Although uncommon, acetabular reconstruction using femoral head structural autograft and acute primary uncemented THA is a viable alternative treatment option compared to ORIF in middle-age patients with fracture of ipsilateral neck and acetabulum. This facilitates post-operative rehabilitation and avoids further operations for possible developing AVN or secondary arthritis. Keywords: Hip dislocation, acetabulum fracture, femur neck fracture, acute total hip arthroplasty, acetabular reconstruction, femoral head structural autograft.

scholarly journals A Rare Case of a Traumatic Posterior Hip Dislocation in a 3-Year-Old Boy: A Case Report and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jan-Dierk Clausen ◽  
Marcel Winkelmann ◽  
Christian Macke ◽  
Philipp Mommsen ◽  
Christian Krettek ◽  
...  
Keyword(s):  
Femoral Head ◽  
Rare Case ◽  
Weight Bearing ◽  
Hip Dislocation ◽  
Early Mobilization ◽  
Minor Trauma ◽  
Review Of The Literature ◽  
Early Osteoarthritis ◽  
Traumatic Hip Dislocation ◽  
Posterior Hip Dislocation

We present a rare case of neglected hip dislocation in a 3-year-old boy. Hip dislocations in childhood represent less than 6% of all injuries. The boy presented to the ED with ongoing hip pain after his leg got stuck in a carousel. The physical and radiologic examination revealed a posterior right hip dislocation. The closed reduction failed, so open reduction during surgery was performed. The postoperative protocol included 3 days of immobilization with early mobilization and pain-adapted weight bearing. No signs of femoral head malperfusion occurred 2 months after the injury. The patient did not complain of any limitations such as weight bearing problems or loss of range of motion. In comparison to adults, there are several specialties such as the fact that minor trauma can lead to hip dislocations due to the laxity of the ligaments, and due to the limited direct anamnestic options, neglected hip dislocations can occur. The treatment should focus on immediate proper reduction. The main complications after traumatic hip dislocation are avascular necrosis of the femoral head, redislocation, and early osteoarthritis.

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