Concomitant ipsilateral acetabular and femoral fractures – an appraisal of outcomes and complications in 34 patients

Concomitant ipsilateral femoral and acetabular fractures are complex injuries which result from high-velocity trauma. Surgical treatment is the accepted management of such injuries. The objectives of this study were to evaluate the outcomes and study the complications in patients treated for concomitant ipsilateral acetabular and femoral fractures (type ‘B’ floating hip injuries). This retrospective study was conducted at a tertiary care teaching hospital on patients operated for type B floating hip injuries, who had completed a minimum of one-year follow-up after the surgery and whose complete records were available. Those with floating hip injuries with pelvic fractures were excluded. All patients were operated on the femoral side first, followed by the acetabular side. 34 patients were included ; most of them were young males. A road traffic accident was the most common mode, with a dashboard injury being the most common mechanism of injury. No association between the type of acetabular and femoral fractures was found. The clinical (measured with Harris hip score) and radiological (Matta’s method) outcomes at the latest follow-up were excellent or good in >60% cases and had a significant association with the quality of reduction on the post-operative radiographs. Com- plications were seen in 12 out of the 34 patients. Type B floating hips injuries can be managed well with acceptable short-term results by following a femur first strategy. However, patients must be informed of the possible complications and the probabilities of poorer outcomes when compared to isolated acetabular or femoral fractures.

Can the Open Stance Forehand Increase the Risk of Hip Injuries in Tennis Players?

Background: The open stance forehand has been hypothesized by tennis experts (coaches, scientists, and clinicians) to be more traumatic than the neutral stance forehand as regards hip injuries in tennis. However, the influence of the forehand stance (open or neutral) on hip kinematics and loading has not been assessed. Purpose: To compare the kinematics and kinetics at the hip joint during 3 common forehand stances (attacking neutral stance [ANS], attacking open stance [AOS], defensive open stance [DOS]) in advanced tennis players to determine whether the open stance forehand induces higher hip loading. Study Design: Descriptive laboratory study. Methods: The ANS, AOS, and DOS forehand strokes of 8 advanced right-handed tennis players were recorded with an optoelectronic motion capture system. The flexion-extension, abduction-adduction, and external-internal rotation angles as well as intersegmental forces and torques of the right hip were calculated using inverse dynamics. Results: The DOS demonstrated significantly higher values than both the ANS and AOS for anterior ( P < .001), medial ( P < .001), and distractive ( P < .001) forces as well as extension ( P = .004), abduction ( P < .001), and external rotation ( P < .001) torques. The AOS showed higher distractive forces than the ANS ( P = .048). The DOS showed more extreme angles of hip flexion ( P < .001), abduction ( P < .001), and external rotation ( P = .010). Conclusion: The findings of this study imply that the DOS increased hip joint angles and loading, thus potentially increasing the risk of hip overuse injuries. The DOS-induced hip motion could put players at a higher risk of posterior-superior hip impingement compared with the ANS and AOS. Clinical Relevance: Coaches and clinicians with players who have experienced hip pain or sustained injuries should encourage them to use a more neutral stance and develop a more aggressive playing style to avoid the DOS, during which hip motion and loading are more extreme.

Hip fractures in elderly with evaluation of risk factors

Background: Fractures in the neck and Perirtrochanteric region of hip contribute significantly to health problem globally. Primary occurrence in elderly osteoporotic people and create a major socioeconomical and public health problem. Almost every such fractures require surgery, hospitalization, and prolonged rehabilitation. The objective of the study was to evaluate the risk factors of hip fractures among the elderly population.Methods: This observational study was conducted among the elderly patients admitted in the department of orthopedics Government Medical College Jammu. Elderly patients regardless of sex and education admitted with hip fractures from August 2019 to July 2020 were included in the study.Results: There were 330 patients admitted with hip injuries. Among these 330 patients admitted with hip fractures, 205 (62.12%) were females and 125 (37.88%) males, mean age was 72.8 years. Age limit was >60 and <100 years. Majority of the patients i.e., 192 (58.18%) were in between the age group of 60 to 79 years.Conclusions: Increasing age is directly proportional to increasing incidence of hip fractures. This proportional rise can be reduced with early steps for prevention of osteoporosis and hence ultimately alleviate the disability and burden of the disease.

Epidemiology of Hip Injuries in Professional Rodeo: A 4-Year Analysis

Background: Professional rodeo is a sport with a high risk of injuries for which research is needed to support interventions. To date, there have been no epidemiological studies performed specifically on hip conditions sustained during rodeo. Purpose: To describe the epidemiology of hip conditions in professional rodeo. Study Design: Case series; Level of evidence, 4. Methods: Deidentified hip injury data from electronic medical records of the Justin Sportsmedicine Team from 2011 to 2014 were analyzed for risk, frequency, type, location, and mechanism, as well as activity phase, of hip injuries. Results: A total of 84 hip injuries among 82 adult male and female athletes were reported, resulting in an overall hip injury density of 0.41 injuries per 1000 competitor-exposures (95% CI, 0.0003-0.0005) and a risk probability of 0.04%. Rough stock athletes sustained 83.3% of hip injuries, with bull riders sustaining 50.0% of the injuries. Contusions (45.2%), impingement (15.5%), and hip strains (13.1%) were the most common injuries. Athletes were most likely to be injured during the dismount (36.1%), and 36.9% of injuries were due to contact with the ground. Conclusion: Rough stock athletes have the greatest risk for hip injury in professional rodeo, with bull riders sustaining the most hip injuries. Athletes are most likely to be injured during the dismount. Common hip injuries in professional rodeo are contusions, impingement, and strains. The majority of contusions result from collision with the ground. Applicable measures to prevent or reduce the severity of injuries to the hip, such as protective padding, proprioceptive training, and eccentric strength training, should be implemented.