SIMULTANEOUS INSUFFICIENCY FRACTURE OF BILATERAL NECK OF FEMUR WITH COXA VARA

Simultaneous insufficiency fracture of bilateral neck of femur with displacement and coxa vara is very uncommon , and very challenging. Osteomalacia is a known cause of insufficiency fracture. We present a case of a young female with non traumatic simultaneous bilateral femur neck fracture. On radiological and laboratory investigation fracture was diagnosed as insufficiency fracture due to osteomalacia with coxa vara. Treatment was done by intertrochanteric valgus osteotomy and fixation by dynamic condylar screw with a prebend plate along with oral and parentral vitamin D therapy. On six month follow up both side fractures were well united and patient was able to walk without pain with full weight bearing and with normal gait .Her lab investigations also returned to normal during follow up.

Download Full-text

Slipped capital femoral epiphysis after treatment of femoral neck fracture

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.icon-suppl.1725 ◽

2019 ◽

Vol 36 (ICON-Suppl) ◽

Author(s):

Muhammad Amin Chinoy ◽

Sateesh Pal ◽

Mansoor Ali Khan

Keyword(s):

Femoral Neck ◽

Internal Fixation ◽

Femoral Neck Fracture ◽

Weight Bearing ◽

Slipped Capital Femoral Epiphysis ◽

Coxa Vara ◽

Femur Neck Fracture ◽

Anatomic Reduction ◽

Neck Fracture ◽

Stable Internal Fixation

Slipped capital femoral epiphysis (SCFE) in children after treatment of femoral neck fracture is a very rare condition. This complication should be recognized promptly and treated urgently. The risk of development of this complication can be minimized by anatomical reduction of the fracture and stable internal fixation of the fracture. Five years old male child sustained right sided femur neck fracture and was treated with closed reduction and Hip spica cast application. The fracture healed with a varus deformity. After 7 months, he developed slip of femoral epiphysis with a coxa vara deformity of proximal femur, which was treated with in situ fixation with Cannulated screws. His subsequent course remained uneventful up to five months.Slipped capital femoral epiphysis (SCFE) after treatment of femoral neck fracture in children is a rare complication that should be recognized and treated promptly. The onset of SCFE may show inadequate reduction or fixation of the fracture. Anatomic reduction and stable internal ﬁxation for femoral neck fracture in children provides best outcomes. Postoperative care and delayed weight bearing are also equally important to avoid complications. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1725 How to cite this:Chinoy MA, Pal S, Khan MA. Slipped capital femoral epiphysis after treatment of femoral neck fracture. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S94-S97. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1725 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download Full-text

A Larger Sized Cup Accelerates Cartilage Erosion of Acetabulum after Bipolar Hemiarthroplasty in Elderly with Femur Neck Fracture

10.21203/rs.3.rs-242724/v1 ◽

2021 ◽

Author(s):

Sang Min Kim ◽

Saumil Ashvin Shah ◽

Jae Young Kim ◽

Hyun Woo Cho ◽

Won Yong Shon

Keyword(s):

Head Size ◽

Bipolar Hemiarthroplasty ◽

Femur Neck ◽

Femur Neck Fracture ◽

Neck Fracture ◽

Group A ◽

Cartilage Erosion ◽

Group B ◽

Acetabular Erosion

Abstract Purpose: Bipolar Hemiarthroplasty (BHA) is one of the common procedures done for the treatment of femur neck fracture. One of the frequently encountered complication with this surgery is erosion of the acetabular cartilage. This study was conducted to investigate acetabular erosion after BHA according to the difference in diameter between femoral head and implanted cup at minimum 10-year follow-up.Patients and Methods: We retrospectively reviewed 117 patients (117 hips) undergoing BHA with fracture of neck of the femur. Their mean age was 77.8 years (range, 65-96 years) and male: female ratio was 32:85. Patients were divided into 3 groups; Group A- bipolar cup size > actual head size, Group B- cup size < head size, Group C- cup size = head size. The degree of both superior and medial acetabular cartilage erosion was identified and calculated on postoperative radiographs using line of acetabular margin and Kohler’s line.Results: The mean superior and medial acetabular erosion were 1.62 ± 1.6 mm (range, 0 – 4.4) and 4.15 ± 2.7 mm (range, 0 – 8.2) in Group A, 1.30 ± 1.3 mm (range, 0 – 3.8) and 4.11 ± 2.7 mm (range, 0 – 7.8) in Group B, and 0.90 ± 1.1 mm (range, 0 – 2.6) and 3.16 ± 2.9 mm (range, 0 – 7.9) in Group C (p=0.039 and p=0.187, respectively). The superior acetabular erosion showed significant difference between the three groups. During mean follow-up period of 12.3 years, five patients (5/117, 4.3%) underwent conversion to THA due to superior acetabular erosion. All of three patient underwent BHA with a larger bipolar cup than the actual femoral head.Conclusion: A lager sized cup accelerated superior cartilage erosion of acetabulum after bipolar hemiarthroplasty. An optimal cup size should be considered when undergoing BHA in elderly patients.

Download Full-text

Functional outcome of Austin Moore Hemire Placement Arthroplasty in Fracture Neck of Femur in elderly

Journal of Manmohan Memorial Institute of Health Sciences ◽

10.3126/jmmihs.v3i1.19174 ◽

2018 ◽

Vol 3 (1) ◽

pp. 6-15

Author(s):

Tej P. Dawadi ◽

TR Bhatta ◽

B Gyawali ◽

BR Adhikari ◽

SK Giri

Keyword(s):

Weight Bearing ◽

Randomized Study ◽

Functional Results ◽

Harris Hip Score ◽

Full Weight Bearing ◽

Neck Of Femur ◽

Fracture Neck Of Femur ◽

Neck Fracture ◽

Displaced Fracture ◽

Austin Moore

Objective: To study the outcome of Austin Moore Hemireplacement Arthroplasty in terms of Harris Hip Score and Mobility and Aid Score in fracture neck of femur in elderly.Design: A prospective randomized study carried out between September 2011 to August 2012 AD.Methods: We performed 30 Austin Moore hemiarthroplasties in patients aged 65 and above that sustained a displaced femoral neck fracture and evaluated the outcome in terms of Harris Hip Score and Mobility and Aid Score.Results: Mean HHS at 2 week was 63.93 which increased to 73.83, 80.53 and 86.48 at 6 weeks, 12 weeks and 6 months respectively with overall excellent to good result of 60%. The mean MASM at 6 months was 4.0 whereas the pre-injury MASM was 4.53.Conclusion: Hemiarthroplasty with Austin Moore Prosthesis is safe and effective method of treatment for displaced fracture neck of femur in elderly. There was early post-operative full weight bearing mobilization with reduction in major complications. The operative duration, post-operative complicationsare comparable to other similar studies done elsewhere. The end functional results also depend on the associated comorbidities and optimum post op rehabilitation.Journal of Manmohan Memorial Institute of Health SciencesVol. 3, No. 1, 2017, page: 6-15

Download Full-text

Differences in femoral component subsidence rate after THA using an uncemented collarless femoral stem: full weight-bearing with an enhanced recovery rehabilitation versus partial weight-bearing

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03913-0 ◽

2021 ◽

Author(s):

Franziska Leiss ◽

Julia Sabrina Götz ◽

Matthias Meyer ◽

Günther Maderbacher ◽

Jan Reinhard ◽

...

Keyword(s):

Risk Factors ◽

Enhanced Recovery ◽

Weight Bearing ◽

Femoral Stem ◽

Full Weight Bearing ◽

Partial Weight Bearing ◽

Fill Ratio ◽

Stem Subsidence ◽

Partial Weight

Abstract Background Femoral component subsidence is a known risk factor for early failure of total hip arthroplasty (THA) using cementless stems. The aim of the study was to compare an enhanced recovery concept with early full weight-bearing rehabilitation and partial weight-bearing on stem subsidence. In addition, the influence of patient-related and anatomical risk factors on subsidence shall be assessed. Methods One hundred and fourteen patients underwent primary cementless THA and were retrospectively analyzed. Sixty-three patients had an enhanced recovery rehabilitation with early full weight-bearing and 51 patients had rehabilitation with partial weight-bearing (20 kg) for 6 weeks. Postoperative subsidence was analyzed on standing pelvic anterior–posterior radiographs after 4 weeks and 1 year. Subsidence was measured in mm. Anatomical and prosthetic risk factors (stem size, canal flare index, canal fill ratio as well as BMI and demographic data) were correlated. Results Femoral stem subsidence rate was significantly higher for the group with an enhanced recovery concept compared to the group with partial weight-bearing at the first radiological follow up after 4 weeks [2.54 mm (SD ± 1.86) vs. 1.55 mm (SD ± 1.80)] and the second radiological follow up after 1 year [3.43 mm (SD ± 2.24) vs. 1.94 (SD ± 2.16)] (p < 0.001, respectively). Stem angulation > 3° had a significant influence on subsidence. Canal flare index and canal fill ratio showed no significant correlation with subsidence as well as BMI and age. Conclusion In the present study, cementless stem subsidence was significantly higher in the group with enhanced recovery rehabilitation compared to partial weight-bearing. Small absolute values and differences were demonstrated and therefore possibly below clinical relevance. Anatomical radiological parameters and anthropometric data did not appear to be risk factors for stem subsidence.

Download Full-text

Femur neck fracture in young adults, is it really an urgent surgery indication: retrospective clinical study

Pan African Medical Journal ◽

10.11604/pamj.2018.30.112.13643 ◽

2018 ◽

Vol 30 ◽

Cited By ~ 6

Author(s):

Seyitali Gumustas ◽

Haci Bayram Tosun ◽

Mehmet Isyar ◽

Sancar Serbest ◽

Kadir Oznam ◽

...

Keyword(s):

Young Adults ◽

Clinical Study ◽

Femur Neck ◽

Urgent Surgery ◽

Femur Neck Fracture ◽

Retrospective Clinical Study ◽

Neck Fracture

Download Full-text

Hip dislocation following the treatment of femoral neck fracture: Case report

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1004248v ◽

2010 ◽

Vol 138 (3-4) ◽

pp. 248-251

Author(s):

Zoran Vukasinovic ◽

Igor Seslija ◽

Borislav Dulic

Keyword(s):

Femoral Neck ◽

Femoral Neck Fracture ◽

Open Reduction ◽

Weight Bearing ◽

Young Patients ◽

Hip Dislocation ◽

Full Weight Bearing ◽

Limited Range Of Motion ◽

Femoral Head Osteonecrosis ◽

Neck Fracture

Introduction. Femoral neck fractures are very rare in young patients and are frequently complicated by femoral head osteonecrosis and femoral neck nonunion. Case Outline. A 19-year-old girl with hip dislocation following the treatment of the femoral neck fracture is presented. The femoral neck fracture was initially treated by open reduction and three-screw fixation. After detecting the nonunion of femoral neck, valgus osteotomy was done. Secondary, iatrogenic, hip dislocation appeared. The patient had pains, and in clinical findings a shorter leg and limited range of motion in the hip - altogether 40 degrees. She was then successfully treated by open reduction, together with Chiari pelvic osteotomy and joint transfixation. Transfixation pin was removed three weeks following the operation. After that, the patient was put into the abduction device and physical therapy was started. The mentioned regimen lasted four months after the surgery, then the abduction device was removed and walking started. Full weight bearing was allowed eight months after surgery. Conclusion. As we have not found the literature data concerning the above mentioned problem, we solved it in the way that we usually do for the treatment of developmental dislocation of the hip in adolescence.

Download Full-text

Left Femur Neck Fracture and Left Eye Esotropia as Initial Clinical Presentations of Gastric Cancer in a 54-Year-Old Female Patient: A Case Report and Review of Literature

Cureus ◽

10.7759/cureus.20645 ◽

2021 ◽

Author(s):

Mohammed S Almasri ◽

Omar N Alfehaid ◽

Ayman Z Azzam ◽

Tarek Amin

Keyword(s):

Gastric Cancer ◽

Case Report ◽

Female Patient ◽

Review Of Literature ◽

Left Femur ◽

Femur Neck ◽

Clinical Presentations ◽

Femur Neck Fracture ◽

Neck Fracture

Download Full-text

Intercalary reconstruction of femur after tumour resection: is a vascularized fibular autograft plus allograft a long-lasting solution?

The Bone & Joint Journal ◽

10.1302/0301-620x.100b3.bjj-2017-0283.r2 ◽

2018 ◽

Vol 100-B (3) ◽

pp. 378-386 ◽

Cited By ~ 10

Author(s):

D. A. Campanacci ◽

F. Totti ◽

S. Puccini ◽

G. Beltrami ◽

G. Scoccianti ◽

...

Keyword(s):

Weight Bearing ◽

Young Patients ◽

Bone Tumour ◽

Full Weight Bearing ◽

Tumour Resection ◽

Fibular Graft ◽

Musculoskeletal Tumor Society ◽

Long Term Outcome ◽

The Mean

Aims After intercalary resection of a bone tumour from the femur, reconstruction with a vascularized fibular graft (VFG) and massive allograft is considered a reliable method of treatment. However, little is known about the long-term outcome of this procedure. The aims of this study were to determine whether the morbidity of this procedure was comparable to that of other reconstructive techniques, if it was possible to achieve a satisfactory functional result, and whether biological reconstruction with a VFG and massive allograft could achieve a durable, long-lasting reconstruction. Patients and Methods A total of 23 patients with a mean age of 16 years (five to 40) who had undergone resection of an intercalary bone tumour of the femur and reconstruction with a VFG and allograft were reviewed clinically and radiologically. The mean follow-up was 141 months (24 to 313). The mean length of the fibular graft was 18 cm (12 to 29). Full weight-bearing without a brace was allowed after a mean of 13 months (seven to 26). Results At final follow-up, the mean Musculoskeletal Tumor Society Score of 22 evaluable patients was 94% (73 to 100). Eight major complications, five fractures (21.7%), and three nonunions (13%) were seen in seven patients (30.4%). Revision-free survival was 72.3% at five, ten, and 15 years, with fracture and nonunion needing surgery as failure endpoints. Overall survival, with removal of allograft or amputation as failure endpoints, was 94.4% at five, ten, and 15 years. Discussion There were no complications needing surgical revision after five years had elapsed from surgery, suggesting that the mechanical strength of the implant improves with time, thereby decreasing the risk of complications. In young patients with an intercalary bone tumour of the femur, combining a VFG and massive allograft may result in a reconstruction that lasts a lifetime. Cite this article: Bone Joint J 2018;100-B:378–86.

Download Full-text