scholarly journals A New Effective Approach to the Hip (for Old Unreduced Dislocation)

2020 ◽  
pp. 1-2
Author(s):  
Lê Phúc ◽  
Keyword(s):  
Femoral Head ◽  
Hip Dislocation ◽  
Femoral Shaft ◽  
Gluteus Medius ◽  
Skin Incision ◽  
Surrounding Tissue ◽  
Iliac Wing ◽  
Surrounding Structure ◽  
Bony Lesions ◽  
The Right

In Vietnam, Incidence of Old Unreduced Hip Dislocation may account for up to 20%. Old Dislocation is defined as older than 3 weeks not relocated. Inside the dislocated hip, develop many inflammatory tissues such as granulation, fibrous with injured a surrounding structure (capsule, ligaments, tendons, bony pieces etc...) which filled up the acetabulum, prevents the head to be relocated. Over effort to reduce closely an old hip dislocation risks fracture of neck or trochanteric femur. In this case, open reduction is almost mandatory. There are many approaches to access and relocate a dislocated hip, we propose a new one which enables surgeon to expose the acetabulum, to liberate the femoral head, reconstruct the defect of acetabulum and /or femoral head and relocate the hip. Skin incision in shape of S for the left hip, in shape of Z for the right hip, from iliac wing to trochanter, then along the femoral shaft. Figure1 Follow strictly on the bone of lateral iliac wing, go posteriorly will find out the acetabulum; determine the anterior border of Gluteus Medius, dissect the muscles toward greater trochanter, and get complete exposure of operative field. Femoral head is found out & liberated from surrounding tissue. Clear up the acetabulum, reconstruct the bony lesions. Relocate the femoral head in acetabulum, and stabilize with a K-wire. The hip is often immobilized with a Spica casting for > 3 weeks.

scholarly journals Simultaneous Ipsilateral “Floating Hip” with Hip Dislocation and Femoral Neck and Shaft Fractures Associated with “Floating Knee” Injuries with Patella Fracture and Traumatic Sciatic Nerve Injury

2021 ◽  
pp. 255-260
Author(s):  
Sasa S. Milenkovic ◽  
Milan M. Mitkovic
Keyword(s):  
Femoral Head ◽  
Sciatic Nerve ◽  
Nerve Injury ◽  
Knee Injuries ◽  
Hip Dislocation ◽  
Femoral Shaft ◽  
Sciatic Nerve Injury ◽  
Fracture Dislocation ◽  
Shaft Fractures ◽  
Posterior Wall Fracture

Simultaneous ipsilateral “floating-hip” and “floating-knee” injuries are very rare and severe, and they occur in high-velocity road traffic accidents. A 55-year-old man presented with posterior wall fracture – dislocation of the acetabulum, complete fracture – dislocation of the femoral head, ipsilateral femoral shaft fracture, open patellar fracture, Gustilo type II, tibial fracture, and traumatic sciatic nerve injury/peroneal division. Given the fact that hip dislocation is an orthopedic emergency, we first did closed external tibial fixation, femoral head reduction, osteosynthesis of the acetabular fracture, and partial patellectomy. After 2 days, the patient underwent a second surgery; fixation of the neck and femoral shaft fractures was done, with a self-dynamic internal fixator. After 14 months from the injuries, radiographs show complete healing of all fractures, the patient walks independently without crutches, and the peroneal nerve is partially recovered. Despite the seriousness of the presented injuries, we did not have any complications, and 14 months after the injury, the femoral head is still viable, with no signs of femoral head osteonecrosis.

Is a hip flip the right trick?

2019 ◽  
Vol 37 (1) ◽  
pp. 53-54
Author(s):  
Leonoor Neline Tess Oerlemans ◽  
Wierd P Zijlstra ◽  
Heleen Lameijer ◽  
Constant W Coolsma
Keyword(s):  
Femoral Head ◽  
Internal Rotation ◽  
Closed Reduction ◽  
Hip Dislocation ◽  
Anterior Dislocation ◽  
List Type ◽  
Reduction Procedure ◽  
X Ray ◽  
Sedation And Analgesia ◽  
The Right

Clinical introductionA 68-year-old man, with known spasticity and a total left hip arthroplasty (THA) performed 6 years ago, was brought to our ED after falling down the stairs. Laying on the stretcher, his left leg was internally rotated and in hyperflexion. An X-ray of the left hip was performed. The diagnosis of posterior hip dislocation was made (figure 1). The patient received sedation and analgesia with 75 mg propofol and 9 mg esketamine intravenously, and a closed reduction procedure was attempted using manual flexion, adduction, traction and internal rotation. Unfortunately, the reduction failed.Figure 1The patient’s X-ray.QuestionWhy is closed reduction not effective in this case?The femoral head is located more cranially expected, due to material failure. The whole THA should be replaced.This is an anterior dislocation. The closed reduction procedure should be performed by using extension, abduction, traction and internal rotation.The femoral head is not reduced centrally in the acetabulum and the closed reduction procedure should be repeated more forcefully.A dual-mobility cup is used and the liner is not in place anymore. Revision surgery is required.For answer see page 2

scholarly journals Traumatic Hip Dislocation with Associated Femoral Head Fracture

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
H. Dortaj ◽  
A. Emamifar
Keyword(s):  
Femoral Head ◽  
Full Range ◽  
Hip Dislocation ◽  
High Energy ◽  
Femoral Head Fracture ◽  
Hip Instability ◽  
The Right ◽  
Dislocation Of The Hip ◽  
Critical Injury

Dislocation of the hip is a critical injury that results from high-energy trauma. This paper describes a case of posterior dislocation of the right hip in a 35-year-old woman with associated ipsilateral femoral head fracture. Initial treatment included reduction of the right hip through posterior approach and fixation of the femoral head fracture with three absorbable screws. After 15-month follow-up, a full range of motion has been achieved and there are no signs of avascular necrosis, hip instability, or limping. The authors describe their method of surgery.

TO EVALUATE THE CHANGES IN HIP JOINT RELATED TO LOWER LIMB DOMINANCE AND ITS ASSOCIATION WITH HIP DISLOCATION

1969 ◽  
Vol 5 (1) ◽  
pp. 635-638
Author(s):  
NIAZ MOHAMMAD ◽  
MAQBOOL ILAHI ◽  
QAISAR ZAMAN
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Lower Limb ◽  
Weight Bearing ◽  
Hip Dislocation ◽  
Congenital Dislocation ◽  
Left Femur ◽  
Horizontal Diameter ◽  
The Mean ◽  
The Right

BACKGROUND: The stability of a joint depends on the arrangement of the articular surfaces. Thefailure of acetabulum to deepen along with associated relaxed capsule can be a causative factor leadingto congenital dislocation of hip in babies. The right traumatic hip dislocation is less uncommon ascompared to left side in adults.OBJECTIVE: To correlate the majority of right-footed population with the bony parameters of hipjoint bilaterally and to find out its association with left congenital and right acquired traumaticdislocation of hip.MATERIAL AND METHODS: As the right footed people are considerably more (90%) than the leftfooted and this study work was correlated with the bones collected from cadavers in Anatomydepartment of KGMC Peshawar from January 2014 to December 2014. We included 14 pairs of femurs,14 pairs of hip bones in this study to see the structural differences when dominant hip joint is comparedwith non-dominant hip joints. The measurements were performed with the help of vernier caliper.RESULTS: The mean horizontal diameter of right (dominant) and left acetabulum was 50.14±0.69 mmand 52.35±0.65mm. The mean horizontal depth of right and left acetabulum was 22.21±0.82mm and25.25±0.52mm. The horizontal diameter of right and left femur was 46.42±0.62mm and 43.85±01mm.The thickness of femoral head was 26.71±01mm on right (dominant) side but this thickness was29.17±01mm on left side.CONCLUSION: The left acetabulum was having a significant larger diameter in adult, allowing thesmaller left femoral head to fit snugly which can be correlated with the more common left congenitaldislocation hip. On the other hand, in adults, the left acetabulum is deeper, allowing the thicker left headof femur as an adjustment for weight bearing functionwhile the larger rightfemoral head fit into acomparatively shallow socket. This may be a factor to improve mobility at the cost of stability; as righttraumatic dislocationhip is less uncommon as compared to left side.KEY WORDS: Hip joint, Ball and socket joint. Dominant lower limb, Right footedness,Left footedness, Congenital dislocation hip, Traumatic dislocation hip.

scholarly journals Anterior Hip Dislocation in a Football Player: A Case Report

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Alexander Schuh ◽  
Sylvia Doleschal ◽  
Thomas Schmickal
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Closed Reduction ◽  
Hip Dislocation ◽  
Football Player ◽  
Medial Aspect ◽  
Anterior Hip Dislocation ◽  
Sporting Activities ◽  
The Right

Hip dislocations during sporting activities represent only 2%–5% of all hip dislocations. Most hip dislocations in sports can be categorised as “less complicated traumatic hip dislocations” by the Stewart-Milford classification due to the fact that minimal force is involved. The incidence of avascular necrosis of the femoral head greatly increases if the time to reduction is more than six hours. We report the case of a 38-year-old football player who suffered hip dislocation while kicking the ball with the medial aspect of the right foot in an external rotated manner of the right hip. Closed reduction was performed within 2 hours; postoperative follow-up was uneventful. Six months later the patient is out of any complaints; there is no sign of AVN of the femoral head.

Posterior hip dislocation associated with concomitant ipsilateral femoral head and shaft fractures: an unusual combination of injuries

2021 ◽  
Vol 14 (8) ◽  
pp. e244453
Author(s):  
Deepak Chouhan ◽  
Prateek Behera ◽  
Mohammed Tahir Ansari ◽  
Vijay Kumar Digge
Keyword(s):  
Femoral Head ◽  
Hip Dislocation ◽  
Femoral Shaft ◽  
Trauma Management ◽  
Femur Head ◽  
Basic Principles ◽  
Shaft Fractures ◽  
Unusual Combination ◽  
Posterior Hip Dislocation

The combination of posterior hip dislocation with an ipsilateral femoral head and shaft fractures is unusual. While cases of concomitant fractures of femoral head and shaft have been previously reported, the treatment of such injuries is challenging. Presence of an associated hip dislocation further complicates the matter. A timely diagnosis and treatment are crucial to have a good outcome.We are presenting the case of a 20-year-old man who sustained a traumatic posterior hip dislocation with ipsilateral femoral shaft and femur head fractures. After reducing the hip, we fixed the femoral shaft with a retrograde femur nail and the femoral head by the trochanteric flip approach in the same sitting. The patient returned to his pre-injury occupation after 4 months. He has been doing well until his last follow-up, 1 year after the surgery, thus emphasising the utility of following basic principles of trauma management in the management of unusual injuries.

OSTEOMYELITIS KRONIS MANDIBULA PASCA EKSTRAKSI GIGI DISERTAI BELL’S PALSY

2019 ◽  
Vol 6 ◽  
pp. 52
Author(s):  
Yayun Siti Rochmah
Keyword(s):  
Facial Nerve ◽  
Panoramic Radiograph ◽  
Surrounding Tissue ◽  
Facial Nerve Paralysis ◽  
Muscle Paralysis ◽  
Nerve Paralysis ◽  
The Right ◽  
Spread Of Infection ◽  
Nerve System ◽  
Intravenous Ketorolac

Background: Chronic osteomyelitis mandibula is one of the complications from dental extraction. Inadequate wound handling can have an impact on the spread of infection in the surrounding tissue like nerve which results in facial nerve paralysis. The purpose is to present a rare case that facilitative nerve paralysis as a result of the spread of osteomyelitis infectionCase Management: A 69 years old woman with chief complains numbness onher lips accompanied by pus out beside the lower teeth. No sistemic disease. Panoramic radiograph showed abnormal bone-like sequester. Extraoral examination appeared the bluish color on the right cheek and there was right facial muscle paralysis. Debridement, sequesterectomy by general anesthesia and medication using ceftriaxone intravenous, ketorolac injection, multivitamin, and corticosteroid, physiotherapy for facial nerve paralyze, also.Discussion: Pathogenesis mandibular osteomyelitis involves contiguous spreadfrom an odontogenic focus infection. The bacteria produce an exotoxin, which, while unable to cross the blood-brain barrier, can have deleterious effects on thePeripheral Nerve System (Fasialis Nerve) in up to 75% of cases, with the severity of presentation correlating with the severity of the infection.Conclusion: Chronic mandibular osteomyelitis can spread the infection to around another anatomy oral cavity like facials nerves.

scholarly journals A case report of femoral head fracture with osteochondral lesion treated by osteosynthesis and biomimetic scaffold: 2-year clinical and radiological follow-up

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Alessandro Casiraghi ◽  
Claudio Galante ◽  
Marco Domenicucci ◽  
Stefano Cattaneo ◽  
Andrea Achille Spreafico ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Articular Surface ◽  
Osteochondral Lesion ◽  
Hip Dislocation ◽  
Fracture Dislocation ◽  
Osteochondral Lesions ◽  
Femoral Head Fracture ◽  
Osteochondral Scaffold

AbstractThe aim of the present study was to present clinical and radiological outcome of a hip fracture-dislocation of the femoral head treated with biomimetic osteochondral scaffold.An 18-year-old male was admitted to the hospital after a motorcycle-accident. He presented with an obturator hip dislocation with a type IVA femoral head fracture according to Brumback classification system. The patient underwent surgery 5 days after accident. The largest osteochondral fragment was reduced and stabilized with 2 screws, and the small fragments were removed. The residual osteochondral area was replaced by a biomimetic nanostructured osteochondral scaffold. At 1-year follow-up the patient did not complain of hip pain and could walk without limp. At 2-year follow-up he was able to run with no pain and he returned to practice sports. Repeated radiographs and magnetic resonance imaging studies of the hip showed no signs of osteoarthritis or evidence of avascular necrosis. A hyaline-like signal on the surface of the scaffold was observed with restoration of the articular surface and progressive decrease of the subchondral edema.The results of the present study showed that the biomimetic nanostructured osteochondral scaffold could be a promising and safe option for the treatment of traumatic osteochondral lesions of the femoral head.Study Design: Case report.

scholarly journals Breast Angiosarcoma with a Preoperative Diagnosis of Late Recurrence of Breast Cancer: A Case Report

2021 ◽  
pp. 604-609
Author(s):  
Rika Kouhashi ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Tamami Morisaki ◽  
Sae Ishihara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Preoperative Diagnosis ◽  
Vascular Endothelial Cells ◽  
Interstitial Fibrosis ◽  
Late Recurrence ◽  
Breast Conserving Surgery ◽  
Surrounding Tissue ◽  
Axillary Lymph ◽  
Elevated Lesion ◽  
The Right

Angiosarcoma is a malignant mesenchymal tumor characterized by the presence of vascular endothelial cells. Although rare, angiosarcoma developing in the mammary glands has a poor prognosis. We report a case of breast angiosarcoma with a preoperative diagnosis of late recurrence of breast cancer. A 78-year-old woman noticed a tumor in her right breast and visited our hospital. The patient had undergone breast-conserving surgery and axillary lymph node dissection from the right breast 12 years before the visit. The tumor was diagnosed as T4bN0M0, stage IIIB. Anastrozole was administered as postoperative adjuvant therapy for 5 years; the patient also received 50-Gy whole-breast radiation therapy after surgery. Physical examination during her visit revealed an elevated lesion with blue purpura around the nipple in the right breast. We performed breast ultrasound and detected a well-defined 19.6 × 16.4 × 10.7 mm hypoechoic tumor in the left subareolar area. The patient underwent core needle biopsy (CNB). Based on the CNB specimen findings, she was suspected to experience late local recurrence after surgery. Therefore, she underwent total mastectomy after breast-conserving surgery. A dark-red tumor sized 18 × 12 mm was found in a specimen from the nipple. The pathological diagnosis of the specimen revealed short spindle-shaped tumor cells with strong nuclear pleomorphism and a significant interstitial fibrosis. Immunohistochemistry using D2-40 and CD31 antibodies showed irregular luminal proliferation at the anastomosis, infiltration into the surrounding tissue, and massive necrosis, thereby leading to the diagnosis of breast angiosarcoma. We have reported a case of breast angiosarcoma with a preoperative diagnosis of late recurrence of breast cancer.

Minimally invasive permanent pacemaker implantation immediately after birth: from delivery room to heart surgery

2021 ◽  
pp. 1-3
Author(s):  
Mehmet Taşar ◽  
Nur Dikmen Yaman ◽  
Burcu Arıcı ◽  
Ömer Nuri Aksoy ◽  
Huseyin Dursin ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Atrioventricular Block ◽  
Heart Surgery ◽  
Pacemaker Implantation ◽  
Skin Incision ◽  
Permanent Pacemaker ◽  
Invasive Technique ◽  
Permanent Pacemaker Implantation ◽  
Congenital Atrioventricular Block ◽  
The Right

Abstract Introduction: Congenital atrioventricular block is diagnosed in uterine life, at birth, or early in life. Atrioventricular blocks can be life threatening immediately at birth so urgent pacemaker implantation techniques are requested. Reasons can be cardiac or non-cardiac, but regardless of the reason, operations are challenging. We aimed to present technical procedure and operative results of pacemaker implantation in neonates. Materials and methods: Between June 2014 and February 2021, 10 neonates who had congenital atrioventricular block underwent surgical operation to implant permanent epicardial pacemaker by using minimally invasive technique. Six of the patients were female and four of them were male. Mean age was 4.3 days (0–11), while three of them were operated on the day of birth. Mean weight was 2533 g (1200–3300). Results: Operations were achieved through subxiphoidal minimally skin incision. Epicardial 25 mm length dual leads were implanted on right ventricular surface and generators were fixed on the right (seven patients) or left (three patients) diaphragmatic surface by incising pleura. There were no complication, morbidity, and mortality related to surgery. Conclusion: Few studies have characterised the surgical outcomes following epicardial permanent pacemaker implantation in neonates. The surgical approach is attractive and compelling among professionals so we aimed to present the techniques and results in patients who required permanent pacemaker implantation in the first month of life.

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