Management of Avascular necrosis of femur head with the help of Arthrox- A case study.

Osteonecrosis or bone infarction, which is a death of bone tissue due to interruption of the blood supply, is also called as avascular necrosis (AVN) and the most commonly affected bone is femur. Line of treatment may include some medication, bed rest, stretching, physiotherapy and surgery. As many as 20,000 people develop AVN each year, most ages between 20 and 50 commonest being in male then in female. Due to lack of promising results patient search for alternative therapies and remedies. We can apply basic principles of Ayurveda to treat any modern disease like AVN. This disease can be correlated with Asthi majja gata vata described in the Samhitas and Asthivaha srotodushti vikaras. ). In this article a male patient diagnosed as Asthi Majja gata vata is treated with Arthrox treatment which includes Virechana, Karma Basti and Hip dhara. His symptoms were assessed by two methods: Visual Analog Scale (VAS) change in pain and Harris Hip Score. Both help to ascertain overall quality of life. The patient was also given customized herbal remedies, manufactured by Ayushakti Ayurveda. With the help of this we can avoid the surgery, we can reduce the pain and we can serve a better quality of life for the patients with avascular necrosis of femur head. The recovery in this case was promising and was worth for documentation.

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

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.

AYURVEDIC INSIGHTS OF AVASCULAR NECROSIS OF FEMORAL HEAD

Avascular necrosis of the femur head (AVNFH) is a debilitating disease caused due to the use of alcohol, steroids, following trauma or unclear (idiopathic) etiology, affecting mostly the middle aged population. Clinically AVNFH is associated with impaired blood supply to the femoral head resulting in bone necrosis and collapse.In Ayurveda, there is no direct reference of disease resembling to Avascular necrosis of femoral head, hence it can be understand on the basis of Vikaraprakriti of disease caused by vitiation of Dosa, Adhisthana (abodesite) and Hetu (causes of vitiation of Dosa). In the present study an effort has been made to understand AVN on the ground of Ayurveda.

Slipped capital femoral epiphysis in a healed Perthes hip

Perthes disease and slipped capital femoral epiphysis (SCFE) in the same child is a rare occurrence. A 7-year-old boy with the left hip Perthes’ disease was managed with femur osteotomy. The femur head healed with a spherical congruent hip. After 3 years, he developed right tibia vara which was treated with growth modulation. The deformity was corrected after one and a half years. At age of 15 years, he presented with left side painful limp and typical features of SCFE. The left hip was managed with modified Dunn’s osteotomy. The hip range of movements was painless and near-normal range at final follow-up. Though this is the first case of ipsilateral SCFE following healed Perthes in a non-syndromic child, one must always consider SCFE in adolescents with hip or knee pain or altered gait, even if they have had other conditions like Perthes disease in the past.

42 Activity and Bone Lesion Analysis on Gilt Retention to the Breeding Herd

A consistent theme in swine production is to increase efficiency and reduce input costs. In this study, sow activity traits and lesions were analyzed to identify associations with lameness and gilt retention. Gilts (n = 73) were culled based on structural unsoundness as determined by an experienced herdsman. Females (n = 132) that had been retained for breeding, but either did not show estrus at an appropriate age or were excessed due to limited farrowing space were used as controls. Gilts were recorded with the NUtrack System for 1 week prior to selection. The NUtrack System records distance travelled (m), time standing (s), eating (s), and laying (s), angle rotated (degrees) and average speed (m/s). Animals were humanely harvested in a USDA inspected abattoir. Both ends of the humerus and the femur head were evaluated for osteochondrosis or osteoarthritis lesions. Joint lesions were categorized as Major or Minor lesions. Major lesions were severe osteochondrosis lesions where cartilage was severely fractured or cartilage exhibited a region of necrosis larger than 2 millimeters in diameter. Minor lesions were defined creases or indentations in the cartilage or where abnormal blood flow existed in bone tissue underneath cartilage. Ninety-eight animals were identified with minor or major lesions (28 cull and 70 control). Unexpectedly, chi-square analysis did identify control animals as having higher incidences of minor or major lesions than cull animals (p < 0.05). Data were analyzed using logistic regression (RStudio V1.2.5033) with farrowing group included in the model. No NUtrack trait was predictive of joint lesions (P > 0.1). However, time standing (P < 0.001) and average speed (P < 0.05) were significantly associated with being retained for breeding. These data suggest that animal behavior and movement, as analyzed by NUtrack, can enhance herdsman efforts in making culling decisions of breeding animals.

Pathological progress of traumatic femur head necrosis after femoral neck fracture in children and adolescents: a case series study

The pathological progression and prognosis of traumatic femur head necrosis (TFHN) after femoral neck fracture (FNF) in children and adolescent is relatively unknown and has never been specifically characterized. As we speculated, the prognosis in such population would be poor and characterized as the high risk of femoral head collapse, hip deformity and degeneration in a short term. This retrospective case series enrolled 64 children and adolescent with TFHN who treated with observational treatment from 2000.1 to 2018.1. The primary outcomes, the progression of femoral head collapse, hip deformity (Stulberg classification) and hip degeneration (Tönnis grade), and their prognostic factors were analysed. Sixty-four patients with a mean age of 13 years (6–16 years) were included. A total of 28 hips (44%) showed unsatisfactory outcome and 25 (39%) hips collapsed progressively during a mean follow-up of 48 months (24–203 months). Finally, 38 hips (59%) experienced hip deformity, 20 of them were Class IV/V. Thirty-four hips (53%) generally progressed to osteoarthritis, 14 of them were classified as Grades II/III. The location of the lesion and the presence of subluxation were found to be related to progression of collapse; however, the presence of subluxation was the only independent risk factor of severe hip deformity and degeneration. TFHN in children and adolescent is a rapidly progressing disease with a poor prognosis characterized by a high risk of femoral head collapse progression. If the subluxation emerged, collapsed cases showed increasingly tendency towards hip deformity and degeneration.