1/9. Malunion of femoral head fractures treated by partial ostectomy: three case reports.Malunion of femoral head fractures has been rarely reported. We report on three cases of malunion of the femoral head, which were treated by partial ostectomy. All patients were involved in traffic accidents and had a posterior fracture-dislocation of the hip. The types of femoral head fractures were Pipkin type I with inferomedial fracture fragment in all cases. Initially, they were treated by closed reduction and skeletal traction for between 6 and 8 weeks. The patients were then transferred to our hospital; the chief complaint was of limited hip motion. A protruding bony mass limiting the hip motion was resected in all cases. The Smith-Petersen approach was used in all cases. The malunion sites were located distally to the original fracture site in all cases. Full weight bearing was permitted, and a range of motion exercises was started postoperatively. Excellent results were obtained with almost complete restoration of hip motion without pain. In the follow-up radiographs, there were no cases of avascular necrosis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/9. Transphyseal fracture-dislocation of the femoral neck: a case report and review of the literature.We describe a case of transphyseal hip fracture-dislocation in a 7.5-year-old patient who was treated initially by open reduction and internal fixation. Soon after the injury, the femoral head developed avascular necrosis. The treatment was focused on maintaining adequate hip range of motion and providing femoral head containment with a combined subtrochanteric femoral osteotomy and shelf acetabuloplasty. The patient's young age and good hip remodeling potential contributed to the favorable clinical outcome 3 years after the injury. The long-term prognosis remains guarded, however.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
3/9. Arthroscopically assisted replacement of dynamic hip screw for unrecognized joint penetration of lag screw through a new portal.nails penetrating into the hip joint after fixation of intertrochanteric fractures may account for one third of all treatment failures. Some authors recommend leaving the nail in the penetrated position until union is certain. However, if the lag screw is long enough penetrate the acetabular joint surface and cause severe pain and limited range of motion, a new shorter one should replace it. In this situation, direct visualization of the joint surface may not be possible, and fluoroscopy can be difficult to interpret. To our knowledge, this is the first case report of left intertrochanteric fracture with unrecognized joint penetration of the lag screw that was replaced by a new shorter one with arthroscopic assistance through a new portal of the screw canal. This case constitutes a unique and interesting application of hip arthroscopy.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
4/9. Traumatic inferior hip dislocation in an adult with ipsilateral trochanteric fracture.Traumatic Inferior dislocation of hip in adult is an extremely rare occurrence. We report a case of an inferior hip dislocation associated with an intertrochanteric fracture. Treatment consisted of an initial closed manipulative reduction of the dislocation with the aid of a Schanz screw inserted in a T handle universal chuck and using C-arm imaging. A dynamic hip screw was then used to fix the intertrochanteric fracture. At 2.5 years after the injury, the patient has symmetrical range of motion versus his contra lateral normal hip. Radiographs of the hip show normal anatomy without signs of avascular necrosis of the femoral head. To our knowledge, this is the first reported case of an adult with an inferior hip dislocation with a trochanteric fracture.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
5/9. Central fracture-dislocation of the hip with ipsilateral femoral neck fracture: case report.Central fracture dislocation of the hip with associated fracture of the femoral neck is rare. Treatment of choice consists of open reduction of the displacement and internal fixation of both fractures. Nevertheless, inadequate reduction of the burst fracture of the acetabulum may lead to hip arthritis, and the surgical approach to the femoral neck jeopardizes its vitality. In elderly patients early full motion and prompt physical rehabilitation can be achieved by total hip arthroplasty after fusion of the displaced femoral head to the acetabular wall.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
6/9. Anterior perineal dislocation of the hip with fracture of the femoral head. A case report.Traumatic anterior perineal hip dislocation with an associated fracture of the femoral head is a rare entity. A 26-year-old man injured in a motorcycle accident was treated by closed reduction of the dislocation within three hours after admission. However, several reports of patients with anterior hip dislocation with associated femoral head fractures were treated nonoperatively and had unfavorable results when treatment failed to achieve anatomical position of the fragments. Consequently, this patient was treated by open reduction and internal fixation of the fractured fragment. Follow-up examination three and one-half years after the operation showed painless functional range of hip motion with only minimal discomfort after prolonged exertion.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
7/9. Intrapelvic migration of Knowles pin through external iliac vein.Intrapelvic migration of a Knowles pin is rare. A case is reported of Knowles pin migration into the pelvis and through the external iliac vein. This was caused by a combination of excessive motion of the femoral neck nonunion and osteoporosis of the femoral head which allowed forward migration of the pin.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
8/9. Ender nailing of intertrochanteric and subtrochanteric fractures of the femur.Condylocephalic intramedullary Ender nailing of fractures of the proximal end of the femur offers four advantages. The operation is short and is minimally traumatic, with little blood loss. The patient returns to functional ambulatory status within a few days. infection of the fracture site and at the nail portals is a negligible risk, and the risk of delayed union and non-union is greatly reduced. The method has also introduced a group of new complications such as irritation at the knee, decreased range of knee motion, and distal and proximal migration and penetration of the nails, yet these problems did not cause failures of the method. osteoporosis was found to be a significant factor contributing to complications. External rotation deformity has not been a major problem in the present study and was improved by use of nails that had an anteversion bend. Delayed union was observed in only one patient with an intertrochanteric fracture which eventually healed. All subtrochanteric fractures healed within three months, which represents a favorable result in comparison with other methods.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
9/9. Osteoarticular allograft reconstruction for recurrent post-traumatic dislocation of the hip.A patient with post-traumatic mechanical instability associated with a significant posterior acetabular deficiency in the presence of an otherwise good articular surface was treated with an allograft reconstruction. The short-term result was good; at 10-month follow-up there was full range of motion with no clinical evidence of instability. This procedure may be indicated in rare instances of post-traumatic mechanical instability where insufficiency of the posterior acetabular wall is felt to be a significant factor.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |