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Sample records for canine femoral neck

  1. Biogeometry of femoral neck for implant placement

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    Patwa J

    2006-01-01

    Full Text Available Background : Treatment of fracture neck femur with three cannulated cancellous screws in an apex proximal configuration is practised in many parts of the world. Methods : Dimensions of femoral neck at the middle of transcervical neck using CT scan (live neck and vernier caliper (dry cadeveric neck in 20 subjects respectively were measured. Results : Inferior half of the neck is narrower than superior half. Conclusion : Biogeometry of the neck of femur does not accomodate two inferior screws and thus fixation of fracture neck femur with three canulated cancellous screws in an apex distal configuration is recommended.

  2. Ipsilateral femoral neck and trochanter fracture

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    Devdatta S Neogi

    2011-01-01

    Full Text Available Ipsilateral fractures in the neck and trochanteric region of the femur are very rare and seen in elderly osteoporotic patients. We present a case of a young man who presented with ipsilateral fracture of the femoral neck and a reverse oblique fracture in the trochanteric region following a motor vehicle accident. A possible mechanism, diagnostic challenge, and awareness required for identifying this injury are discussed.

  3. Ipsilateral Acetabular and Femoral Neck and Shaft Fractures

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    Hideto Irifune

    2015-01-01

    Full Text Available Floating hip injuries and ipsilateral femoral neck and shaft fractures are rare. Additionally, the simultaneous occurrence of these injuries is extremely rare, and only one case report of the simultaneous occurrence of these injuries has been published. Here, we report the case of a patient with ipsilateral acetabular and femoral neck and shaft fractures following a suicide attempt. The patient experienced nonunion of the femoral neck and shaft after the initial operation and therefore underwent reconstruction using a femoral head prosthesis with a long stem and interlocking screws. Our procedure may be used in primary and/or secondary reconstruction for ipsilateral acetabular and femoral neck and shaft fractures.

  4. MR evaluation of femoral neck version and tibial torsion

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    Koenig, James Karl; Dwek, Jerry R. [University of California, San Diego, Children' s Hospital and Health Center, Department of Radiology, San Diego, CA (United States); Pring, Maya E. [Rady Children' s Hospital, Department of Pediatric Orthopedic Surgery, San Diego, CA (United States)

    2012-01-15

    Abnormalities of femoral neck version have been associated with a number of hip abnormalities in children, including slipped capital femoral epiphysis, proximal femoral focal deficiency, coxa vara, a deep acetabulum and, rarely, developmental dysplasia of the hip. Orthopedic surgeons also are interested in quantifying the femoral neck anteversion or retroversion in children especially to plan derotational osteotomies. Historically, the angle of femoral version and tibial torsion has been measured with the use of radiography and later by CT. Both methods carry with them the risks associated with ionizing radiation. Techniques that utilize MR are used less often because of the associated lengthy imaging times. This article describes a technique using MRI to determine femoral neck version and tibial torsion with total scan times of approximately 10 min. (orig.)

  5. Bilateral nonunited femoral neck fracture in a child with osteopetrosis.

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    Steinwender, G; Hosny, G A; Koch, S; Grill, F

    1995-01-01

    We report a case of osteopetrosis with bilateral nonunited femoral neck and coxa vara in a 7-year-old boy. There was a history of traumatic transcervical left femoral neck fracture unsuccessfully treated by internal fixation. We performed a bilateral subtrochanteric valgus osteotomy. K-Wire fixation failed on the right side due to hardness of the bone. Finally, internal fixation with an angular plate after predrilling of the femoral neck offered stability. Bone union was achieved on both sides, resulting in full recovery of normal physical activity.

  6. Bilateral impacted femoral neck fracture in a renal disease patient

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    Pramod Devkota

    2013-01-01

    Full Text Available Spontaneous bilateral femoral neck facture in a renal disease patient is not common. We report a case of 47-year-old female patient with chronic renal failure and on regular hemodialysis for the past 5 years who sustained bilateral impacted femoral neck fracture without history of trauma and injury and refused any surgical intervention. The patient was mobilised on wheel chair one year after the fractures. The cause of the fracture and the literature review of the bilateral femoral neck fracture in renal disease are discussed.

  7. Treatment of the femoral neck peudoarthrosis in childhood: Case report

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    Vukašinović Zoran

    2013-01-01

    Full Text Available Introduction. Femoral neck fractures in children and adolescents are rare. However, their complications are frequent - avascular necrosis, femoral neck pseudoarthrosis, premature physeal closure with consequent growth disturbance and coxa vara deformity. Case Outline. A 9.5­year­old boy was injured in a car accident, and femoral neck fracture was diagnosed. Prior to admission at our hospital he was surgically treated several times. He was admitted at our hospital eight months following the accident. On the X­ray transcervical pseudoarthrosis of the femoral neck was found, as well as coxa vara deformity and metaphyseal avascular necrosis. He was operated at our hospital; all previously placed ostefixation material was removed, valgus osteotomy of 30 degrees was done as well as additional local osteoplasty using the commercial osteoindactive agent (Osteovit®. Postoperatively, we applied skin traction, bed rest and physical therapy. At the final follow­up, the patient was recovered completely. He is now painless, the legs are of equal length, range of movements in the left hip is full, life activity is normal. The X­ray shows that the femoral neck pseudoarthrosis is fully healed. Conclusion. This case is presented in order to encourage other colleagues to challenge the problematic situation such as this one. Also, we would like to remind them what one should think about and what should be taken into consideration in the primary treatment of femoral neck fractures in children. Valgus femoral osteotomy, as a part of the primary treatment of femoral neck fracture in children (identically as in the adults can prevent the occurrence of femoral neck pseudoarthrosis.

  8. Ipsilateral femoral neck and shaft fractures: An overlooked association

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    Daffner, R.H. (Dept. of Diagnostic Radiology, Allegheny General Hospital, Pittsburgh, PA (USA) Medical Coll. of Pennsylvania, Pittsburgh, PA (USA)); Riemer, B.L.; Butterfield, S.L. (Dept. of Orthopedic Surgery, Allegheny General Hospital, Pittsburgh, PA (USA) Medical Coll. of Pennsylvania, Pittsburgh, PA (USA))

    1991-05-01

    A total of 304 patients with injuries to the femoral shaft and ipsilateral hip presented between 1984 and 1990. Some 253 of them suffered fractures of the femoral shaft and dislocated hips or fractures of the acetabulum, and 51 of these sustained fractures of the femoral shaft and neck or trochanteric region. All of the trochanteric injuries were demonstrated on the initial radiographs. However, in 11 of the patients with combined femoral shaft and neck fractures, the diagnosis was delayed by as much as 4 weeks. This delay related to the fact that these fractures tended not to separate in the initial evaluation period and that there was external rotation of the proximal femoral fragment due to the femoral shaft fracture. (orig./GDG).

  9. Brodie's abscess of the femoral neck simulating osteoid osteoma.

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    Gulati, Yash; Maheshwari, Aditya V

    2007-10-01

    Subacute osteomyelitis (Brodie's abscess) is essentially a problem of diagnosis, and there may be considerable difficulty in distinguishing it from other benign and malignant bone lesions. Though reported in the metaphyseal region of the femur, Brodie's abscess is rarer in the femoral neck. The authors present a case of Brodie's abscess in the femoral neck, which clinico-radiologically simulated an osteoid osteoma. Retrospectively, the presence of a cortical sinus tract should have aroused suspicion.

  10. Osteoid Osteoma of the Femoral Neck in Athletes: Two Case Reports Differentiating From Femoral Neck Stress Injuries.

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    Cordova, Christopher B; Dembowski, Scott C; Johnson, Michael R; Combs, John J; Svoboda, Steven J

    2016-01-01

    The diagnosis of an intra-articular osteoid osteoma can be a challenging and lengthy process, with reports of delayed diagnosis of greater than 2 years. In the young, athletic patient with an atraumatic onset of groin pain, an overuse injury or muscle strain is the most likely etiology. However, an overuse injury of femoral neck stress fracture must be identified because of the potentially disastrous outcome of fracture completion. The similar clinical presentation of a femoral neck stress fracture and intra-articular osteoid osteoma of the femoral neck can further delay the diagnosis of the osteoid osteoma. In a patient with these differential diagnoses that do not improve with a period of nonweightbearing activity, a more intensive workup must ensue. The purpose of this case report is to describe the initial presentations, subsequent follow-up, and imaging findings leading to the diagnosis of osteoid osteoma as well as to differentiate an osteoid osteoma from femoral neck stress injuries.

  11. Three-dimensional measurement of femoral neck anteversion and neck shaft angle.

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    Sangeux, Morgan; Pascoe, Jessica; Graham, H Kerr; Ramanauskas, Fiona; Cain, Tim

    2015-01-01

    We present a three-dimensional measurement technique for femoral neck anteversion and neck shaft angles which do not require alignment of the femoral and scanner axes. Two assessors performed the measurements on 11 patients (22 femurs). Repeatability between assessors was 2.7 degrees for femoral neck anteversion and 4.8 degrees for neck shaft angle. Measurements compared with an alternative single slice method were different by 2 degrees (3 degrees) in average. The method was repeatable and appropriate for clinical practice.

  12. Femoral neck radiography: effect of flexion on visualization

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    Garry, S.C. [Univ. of Alberta, Dept. of Radiology and Diagnostic Imaging, Walter C Mackenzie Health Sciences Centre, Edmonton, Alberta (Canada); Jhangri, G.S. [Univ. of Alberta, Dept. Public Health Sciences, Edmonton, Alberta (Canada); Lambert, R.G.W. [Univ. of Alberta, Dept.of Radiology and Diagnostic Imaging, Walter C Mackenzie Health Sciences Centre, Edmonton, Alberta (Canada)]. E-mail: rglamber@cha.ab.ca

    2005-06-15

    To determine whether flexion improves radiographic visualization of the femoral neck when the femur is externally rotated. Five human femora, with varying neck-shaft and anteversion angles, were measured and immobilized. Degree of flexion required to bring the femoral neck horizontal was measured, varying the rotation. Next, one bone was radiographed in 16 positions, varying rotation in 15{sup o} and flexion in 10{sup o} increments. Radiographs were presented in randomized blinded fashion to 15 staff radiologists for scoring of femoral neck visualization. Following this, all 5 bones were radiographed in 4 positions of rotation and at 0{sup o} and 20{sup o} flexion, and blinded randomized review of radiographs was repeated. Comparisons between angles and rotations were made using the Mann-Whitney test. The flexion angle required to bring the long axis of the femoral neck horizontal correlated directly with the degree of external rotation ({rho} < 0.05). Visualization of the femoral neck in the extended position progressively deteriorated from 15{sup o} internal rotation to 30{sup o} external rotation ({rho} <0.01). However, when 20{sup o} flexion was applied to bones in external rotation, visualization significantly improved at 15{sup o} ({rho} <0.05) and 30{sup o} ({rho} <0.01). Flexion of the externally rotated femur can bring the femoral neck into horizontal alignment, and a relatively small amount (20{sup o}) of flexion can significantly improve radiographic visualization. This manoeuvre could be useful for radiography of the femoral neck when initial radiographs are inadequate because of external rotation of the leg. (author)

  13. A case report of missed femoral neck stress fracture

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    Onibere Oruaro Adebayo

    2015-01-01

    Full Text Available Femoral neck stress fracture (FNSF is an uncommon but potentially serious orthopaedic problem. This is a case report on missed femoral neck stress fracture in a 62-year-old female who was initially treated as early-onset coxarthrosis. She later presented to us with a displaced intra-capsular neck of left femur fracture and underwent total hip replacement. This case illustrates that causes other than osteoarthritis should be taken into consideration in patients presenting with anterior hip pain where symptoms are disproportionate to clinical and radiological findings. More advanced investigations such as MRI scan or regular follow up with plain radiographs should be performed. A delay in diagnosis can lead to secondary displacement of the femoral neck stress fracture.

  14. The Association of Femoral Neck Stress Fractures with Femoral Acetabular Impingement

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    Safran, Marc R.; Goldin, Michael; Anderson, Christian; Fredericson, Michael; Stevens, Kathryn J.

    2013-01-01

    Objectives: To determine if there is an increased incidence of femoral acetabular impingement (FAI) in patients presenting with stress fractures of the femoral neck. Methods: After IRB approval, the imaging studies of 25 athletes (22 females, 3 males, mean age 26, range 19 - 39 years) with femoral neck stress injuries were assessed for the presence of features suggesting FAI, including acetabular retroversion, coxa profunda, abnormal femoral head-neck junction, fibrocystic change, os acetabulae, labral tear and chondral injury. All subjects had to have an adequate AP Pelvis radiograph, a lateral radiograph of the affected hip, and an MRI of the affected hip. The alpha angle, anterior offset ratio, and center to edge (CE) angle were measured on radiographs. The grade of stress injury was determined on MR images. All images and measurements were made by a musculoskeletal fellowship trained radiologist, a fellowship trained orthopaedic surgeon, an orthopaedic sports medicine fellow and a physical medicine and rehabilitation resident. Charts were reviewed to determine treatment of the stress fracture, outcome and final follow up, as well as to determine if the patient had any further treatment for their hip. Results: Of the 25 hips (18 right, 7 left) with femoral neck stress reactions, 9 were grade 2 (bone marrow edema), 5 were grade 3 (high T2 and low T1 marrow signal), and 11 were grade 4 (stress fracture). Twenty patients (80%) had coxa profunda - where the floor of the cotyloid fossa touches or extends beyond the ilioischial line (incidence in general population is 15.2% of males, and 19.4% of females). Coxa profunda, defined by the floor of the cotyloid fossa touching or extending beyond the ilioischial line and a center edge angle of more than 35o, was present in 28% of subjects. Acetabular retroversion as assessed by the crossover sign was present in 42% (normal incidence is 5% of population). Center edge angle was greater than 35o in 20% and greater than 40 o

  15. Risk of pelvic injury from femoral neck guidewires.

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    Feeney, M; Masterson, E; Keogh, P; Quinlan, W

    1997-01-01

    Many of the devices used in the internal fixation of femoral neck fractures are cannulated and require the initial placement of one or more guidewires for accurate positioning. These wires are occasionally advanced inadvertently through the hip joint and the acetabulum. Pelvic visceral damage may follow. To assess this risk, we inserted three guidewires to a depth of 16 cm into each femoral neck of ten cadavers and explored the pelvis during autopsy. Thirty-two of the 60 guidewires had penetrated a pelvic organ. The literature on intrapelvic injuries associated with hip surgery is reviewed, and suggestions are offered on the avoidance of pelvic penetration during hip fracture fixation.

  16. Femoral head-neck junction reconstruction, after iatrogenic bone resection.

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    Guevara-Alvarez, Alberto; Lash, Nicholas; Beck, Martin

    2015-07-01

    Arthroscopic over-resection of the head-neck junction during the treatment of a cam deformity can be a devastating complication and is difficult to treat. Large defects of the femoral head-neck junction (FHNJ) increase the risk of femoral neck fracture and can also affect hip biomechanics. We describe a case of an iatrogenic defect of the FHNJ due to excessive bone resection, and a previously non-described treatment using iliac crest autograft to restore femoral head-neck sphericity and hip joint stability. After protecting the femoral neck with an angled blade plate, the large anterior FHNJ defect was reconstructed using autogenous iliac crest bone graft; sphericity was restored by contouring the graft using spherical templates. Clinical and radiographic follow-up was performed up to 2 years. Results at 2 years showed no residual groin pain and normal range of motion. The Oxford Hip Score was 46/48, rated as excellent. Computed tomography (CT) scanning showed union of bone graft without resorption, and CT arthrogram indicating retained sphericity of the FHNJ without evidence of degenerative changes in the articular surface. This novel surgical technique can be used to restore the structural integrity and contour of the FHNJ that contains a significant anterior defect.

  17. [Spontaneous disappearance of herniation pit on the femoral neck].

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    Lerais, J M; Jacob, D; Thibaud, J C; Fourrer, C; Cercueil, J P; Krause, D; Laredo, J D; Baudrillard, J C

    1995-09-01

    The authors present a case of a 39 years old patient who had a herniation pit of the left femoral neck, 5 years ago. This lesion disappeared spontaneously. To our knowledge, no report of healing of a herniation pit has been previously described.

  18. Cementless bipolar hemiarthroplasty in femoral neck fractures in elderly

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    SKS Marya

    2011-01-01

    Conclusion: Cementless bipolar hemiarthroplasty for femoral neck fractures in the very elderly permits early return to premorbid life and is not associated with any untoward cardiac event in the perioperative period. It can be considered a treatment option in this select group.

  19. Unstable femoral neck fractures in children - A new treatment option

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    Pruthi K

    2006-01-01

    Full Text Available Background : Femoral neck fractures in children are an uncommon but difficult situation. The aim of our study was to evaluate clinical results of closed reduction internal fixation and primary valgus osteotomy fixed with a tension band wire loop in high angled pediatric femoral neck fractures. Methods : In a prospective nonrandomized study conducted at 2 centres, sixteen children and adolescents with a Pauwel type 2/3 fracture neck femur were taken as participants. The femoral neck fractures were stabilized using closed reduction and internal fixation (6.5 mm noncannulated screw and a primary valgus osteotomy fixed with a tension band wire loop preferably within 24-36 hours of injury. Patients were evaluated to determine complications, clinical and radiological outcome. Results : At a mean post operative follow up of 5 years, union was achieved in all cases. Three patients had AVN and one developed coxavara. Results were evaluated using IOWA hip scores. Thirteen patients had an excellent result while 3 patients had a good result. Conclusion : Use of this technique holds promise in treating these difficult unstable fractures. Although results from a larger series are still awaited yet the use of this technique can safely be extended to stable fractures also, to minimize the incidence of complications as nonunion and AVN.

  20. Magnetic Resonance Imaging of the Femoral Neck Cortex

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    Sievaenen, H.; Karstila, T.; Apuli, P.; Kannus, P. [Bone Research Group, UKK Inst., Tampere (Finland)

    2007-04-15

    Purpose: To determine the in vivo precision and accuracy of magnetic resonance imaging (MRI) in evaluating the thin (emm) femoral neck cortex. Material and Methods: Hip regions of 30 volunteers were scanned with standard 1.5T MRI twice with repositioning, and the images of the narrow-neck cross-sections were obtained. Two radiologists independently delineated periosteal and endosteal cortical boundaries, and several structural variables were determined. For precision, 95% limits of agreement and coefficients of variation were calculated. Accuracy was determined with phantoms. Results: In vivo precision of the directly delineated measurements varied from 0.9% (periosteal circumference) to 1.6% (total area), while the precision of the calculated variables remained poorer, from 7.3% (cortical to total area ratio) to 15.1% (torsional rigidity). The root-mean-square error of the cortical thickness measurement was 0.15 mm. Conclusion: Thin cortical bone at the narrowest location of the femoral neck can be delineated precisely and accurately with a standard clinical 1.5T MRI device. MRI provides a feasible tool for the assessment of mechanically important cortical bone at the femoral neck and may be of clinical utility in assessing hip fragility. Keywords Bone densitometry, bone fragility, bone strength, osteoporosis, precision.

  1. Atraumatic femoral neck fracture secondary to prolonged lactation induced osteomalacia

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    Dhammapal Sahebrao Bhamare

    2013-01-01

    Full Text Available Presenting a case of atraumatic fracture neck femur secondary to 2 years of prolonged lactation. A 26-year-old lactating mother presented with pain in left hip from last 12 months. She was apparently alright before and during pregnancy. Plain radiograph showed a complete undisplaced fracture of femoral neck. Osteomalacia was diagnosed by radiological and serological investigations. The fracture was fixed using AO type cannulated cancellous screws. The fracture showed good clinical and radiological union at 3 months. Literature review shows that this is a first case of atraumatic fracture of neck femur due to prolonged lactational osteomalacia. It showed that even apparently healthy Indians are susceptible to osteomalacia, more so during pregnancy and lactation and can be presented as atraumatic fracture. Although considered relatively stable, a compression type incomplete fracture neck femur may progress to a complete fracture if not treated in time.

  2. Femoral neck non-union treatment by valgus intertrochanteric osteotomy

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    Schwartsmann, Carlos Roberto; Spinelli, Leandro de Freitas; Yépez, Anthony Kerbes; Boschin, Leonardo Carbonera; Silva, Marcelo Faria

    2015-01-01

    ABSTRACT OBJECTIVE : The purpose of this study was to evaluate the performance of valgus intertrochanteric osteotomy in femoral neck non-union. METHODS : Forty-two patients with femoral neck fractures with non-union treated using Pauwels' intertrochanteric osteotomy were reviewed. Demographics, time elapsed between fracture and surgery, follow--up, osteosynthesis used, Garden's classification, limb shortening, and x-rays were evaluated. RESULTS : Twenty-two men and 20 women were reviewed. The youngest patient was 18 years old and the oldest 65 years old, with a mean age of 42.4 years (±11.2). The minimum follow-up was 2 years, with a mean of 10.2 years. The average time elapsed between initial fracture and osteotomy was 6.5 months. Twel-ve cases were neglected femoral neck fractures. Nineteen patients were classified as Garden III, and 23 patients as Garden IV. After valgus osteotomy, non-union healing was observed in 38 patients (38/42; 90.4%). Healing of thirty-seven cases of pseudoarthrosis were obtained after the first-attempt osteotomy, and one case required two operations for healing. The osteotomy failed in four cases. Conside-ring the healed osteotomies, good to excellent functional results were achieved in 80.9% (34/42) of the patients. Total hip replacement was subsequently performed in 14.2% (6/42) of the patients for unfavoura-ble outcomes (two for cutting out, two for osteonecrosis, and two for osteoarthritis). CONCLUSIONS : Valgus intertrochanteric osteotomy has a high success rate in archiving healing in femoral neck non-union with good functional results. It is a biological and effective method. Level of Evidence IV, Therapeutic Study. PMID:27057146

  3. Genetic predisposition for femoral neck stress fractures in military conscripts

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    Barral Sandra; Sahi Timo; Ruohola Juha-Petri; Solovieva Svetlana; Pihlajamäki Harri; Hartikka Heini; Korvala Johanna; Ott Jürg; Ala-Kokko Leena; Männikkö Minna

    2010-01-01

    Abstract Background Stress fractures are a significant problem among athletes and soldiers and may result in devastating complications or even permanent handicap. Genetic factors may increase the risk, but no major susceptibility genes have been identified. The purpose of this study was to search for possible genetic factors predisposing military conscripts to femoral neck stress fractures. Results Eight genes involved in bone metabolism or pathology (COL1A1, COL1A2, OPG, ESR1, VDR, CTR, LRP5...

  4. Redox Status in Patients with Femoral Neck Fractures

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    Pesic Goran

    2016-09-01

    Full Text Available The femur transfers the body weight from the pelvic bone to the shinbone. Femur fractures are a significant cause of morbidity and mortality among the group of locomotor apparatus injuries, especially in the elderly population. Considering that oxidative stress occurs as a result of increased production of free radicals that damage cell function and cause numerous pathological conditions and diseases, the aim of this study was to investigate oxidative stress parameters in older patients with femoral neck fractures. This clinical study included 70 patients, of which 35 had femoral neck fractures (26 males and 9 females, while the other half of the patients formed the matched control group. Markers of oxidative stress (NO2−, TBARS, H2O2 and O2- and anti-oxidative enzymes (SOD, CAT, and GSH were measured. Results showed that the levels of O2- increased, while levels of NO2-, H2O2 and all the antioxidative enzymes decreased in patients with femoral neck fractures. These findings indicate that fractures cause oxidative stress, probably because of the reduced activity of osteoblasts and the increased activity of osteoclasts.

  5. Postmortem retrieved canine THR: femoral and acetabular component interaction.

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    Skurla, Carolyn P; James, Susan P

    2004-01-01

    Dogs are the preferred animal model for testing of human total hip replacements (THRs). A postmortem retrieval program for clinical, cemented, canine THR was established to analyze the long-term performance of THRs in dogs and to compare that performance to postmortem retrievals of human THRs. The purpose of the present study was to analyze the interaction between the femoral and acetabular components. Thirty-eight postmortem retrievals from 29 dogs were donated and analyzed. The acetabular components (ACs) were measured for volumetric wear and graded for articulating surface damage. Femoral and acetabular components were mechanically tested for implant stability. Digital image analysis was performed on contact radiographs of transverse femoral slices. Of 14 cases with a firmly implanted femoral component (FC). 6 articulated against loose ACs. Of 24 cases with a loose FC, 16 articulated against loose ACs. Only 4 specimens had both components firmly implanted, and 14 specimens had both components loose. There was a significant positive correlation between AC volumetric wear and FC loosening; however, there was no evidence of osteolysis or wear debris induced osteolysis as seen in human postmortem retrieval studies. There was a significant but weak negative correlation between FC loosening at the cement/bone interface and AC scores reflecting damage to the rim and creep across the entire AC. Although implant-on-implant damage to the AC was expected to positively correlate with FC loosening, this was not found. Researchers need to look at interactions between AC and FC to understand how the failure of one component affects performance of the other.

  6. To study the role of dynamic magnetic resonance imaging in assessing the femoral head vascularity in intracapsular femoral neck fractures

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    Kaushik, Abhishek, E-mail: abhiortho27@gmail.co [Department of Orthopedics, 513, Thermal Colony, Sector-22, Faridabad 121005, Haryana (India); Sankaran, Balu; Varghese, Mathew [Department of Orthopedics, St Stephen' s Hospital, Tis hazari, Delhi, New Delhi 110054 (India)

    2010-09-15

    Intracapsular femoral neck fractures remain unsolved fractures even after improvement in techniques of diagnosis and internal fixation. Individuals who sustain displaced femoral neck fractures are at high risk of developing avascular necrosis and non-union. Although several methods for predicting the viability of femoral head have been reported, they are not effective or widely used because of unreliability, potential complications and technical difficulties. Dynamic MRI was introduced in the recent past as a simple, non-invasive technique to predict the femoral head viability after the femoral neck fractures. In this study role of dynamic MRI was studied in 30 patients with 31 intracapsular femoral neck fractures. Fractures were divided in to three types according to dynamic curve patterns on MRI evaluation and were followed up for 6 months to 2 years to observe the final outcome. Sensitivity, Specificity and the Accuracy of dynamic MRI in predicting vascularity after femoral neck fracture are 87%, 88% and 87%, respectively. Type A or Type B curve pattern is a positive factor to successful osteosynthesis with p value <0.0001 (Chi-square test). This is a statistically significant value. From this finding it can be suggested that the reliability of dynamic curves A and B in predicting maintained vascularity of femoral head is high. This investigation can be used to predict the vascularity of femoral head after intracapsular femoral neck fractures. There was a good correlation between the outcomes of fractures and dynamic MRI curves done within 48 h of injury. This signifies the role of dynamic MRI in predicting the vascularity of femoral head as early as 48 h. A treatment algorithm can be suggested on the basis of dynamic MRI curves. The fractures with Type C dynamic curve should be considered as fractures with poor vascularity of femoral head and measures to enhance the vascularity of femoral head along with rigid internal fixation should be undertaken to promote

  7. Subtrochanteric femur fracture after removal of screws for femoral neck fracture in a child.

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    Song, Kwang Soon; Lee, Si Wook

    2015-01-01

    Displaced femoral neck fractures are rare in children and are associated with a high rate of complications. Subtrochanteric fractures after cannulated screw fixation of femoral neck fractures in adults are well recognized, and there are several reports on the topic. However, there are no reports on complications related to hardware or subtrochanteric fractures after removal of the screws in the treatment of femoral neck fractures in children. Here we report the case of a 10-year-old boy who sustained a subtrochanteric fracture after the screw removal and healing that followed a femoral neck fracture.

  8. An Advanced Quantitative Echosound Methodology for Femoral Neck Densitometry.

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    Casciaro, Sergio; Peccarisi, Marco; Pisani, Paola; Franchini, Roberto; Greco, Antonio; De Marco, Tommaso; Grimaldi, Antonella; Quarta, Laura; Quarta, Eugenio; Muratore, Maruizio; Conversano, Francesco

    2016-06-01

    The aim of this paper was to investigate the clinical feasibility and the accuracy in femoral neck densitometry of the Osteoporosis Score (O.S.), an ultrasound (US) parameter for osteoporosis diagnosis that has been recently introduced for lumbar spine applications. A total of 377 female patients (aged 61-70 y) underwent both a femoral dual X-ray absorptiometry (DXA) and an echographic scan of the proximal femur. Recruited patients were sub-divided into a reference database used for ultrasound spectral model construction and a study population for repeatability assessments and accuracy evaluations. Echographic images and radiofrequency signals were analyzed through a fully automatic algorithm that performed a series of combined spectral and statistical analyses, providing as a final output the O.S. value of the femoral neck. Assuming DXA as a gold standard reference, the accuracy of O.S.-based diagnoses resulted 94.7%, with k = 0.898 (p < 0.0001). Significant correlations were also found between O.S.-estimated bone mineral density and corresponding DXA values, with r(2) up to 0.79 and root mean square error = 5.9-7.4%. The reported accuracy levels, combined with the proven ease of use and very good measurement repeatability, provide the adopted method with a potential for clinical routine application in osteoporosis diagnosis.

  9. Spontaneous fracture of the femoral neck in preexisting avascular necrosis of femoral head in sickle cell disease

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    Raju Vaishya

    2012-01-01

    Avascular necrosis of the femoral head is a known complication of femoral neck fracture but on the contrary,femoral neck fracture in a case of preexisting avascular necrosis is a very rare phenomenon.We present a case study of a 47 year old Iraqi male who developed spontaneous ipsilateral subcapital femoral neck fracture under the condition of preexisting sickle cell disease and avascular necrosis of the femoral head.The fracture was unnoticed for a few months.The patient was managed successfully by uncemented total hip arthroplasty.Postoperative recovery was uneventful and he was discharged 4 days after surgery.At 1 year's follow-up,the patient had normal gait and hip function,with no sign of loosening or any other complications on radiograph.

  10. Genetic predisposition for femoral neck stress fractures in military conscripts

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    Barral Sandra

    2010-10-01

    Full Text Available Abstract Background Stress fractures are a significant problem among athletes and soldiers and may result in devastating complications or even permanent handicap. Genetic factors may increase the risk, but no major susceptibility genes have been identified. The purpose of this study was to search for possible genetic factors predisposing military conscripts to femoral neck stress fractures. Results Eight genes involved in bone metabolism or pathology (COL1A1, COL1A2, OPG, ESR1, VDR, CTR, LRP5, IL-6 were examined in 72 military conscripts with a femoral neck stress fracture and 120 controls. The risk of femoral neck stress fracture was significantly higher in subjects with low weight and body mass index (BMI. An interaction between the CTR (rs1801197 minor allele C and the VDR C-A haplotype was observed, and subjects lacking the C allele in CTR and/or the C-A haplotype in VDR had a 3-fold higher risk of stress fracture than subjects carrying both (OR = 3.22, 95% CI 1.38-7.49, p = 0.007. In addition, the LRP5 haplotype A-G-G-C alone and in combination with the VDR haplotype C-A was associated with stress fractures through reduced body weight and BMI. Conclusions Our findings suggest that genetic factors play a role in the development of stress fractures in individuals subjected to heavy exercise and mechanical loading. The present results can be applied to the design of future studies that will further elucidate the genetics of stress fractures.

  11. Cortical and trabecular load sharing in the human femoral neck.

    Science.gov (United States)

    Nawathe, Shashank; Nguyen, Bich Phuong; Barzanian, Nasim; Akhlaghpour, Hosna; Bouxsein, Mary L; Keaveny, Tony M

    2015-03-18

    The relative role of the cortical vs trabecular bone in the load-carrying capacity of the proximal femur-a fundamental issue in both basic-science and clinical biomechanics-remains unclear. To gain insight into this issue, we performed micro-CT-based, linear elastic finite element analysis (61.5-micron-sized elements; ~280 million elements per model) on 18 proximal femurs (5M, 13F, ages 61-93 years) to quantify the fraction of frontal-plane bending moment shared by the cortical vs trabecular bone in the femoral neck, as well as the associated spatial distributions of stress. Analyses were performed separately for a sideways fall and stance loading. For both loading modes and across all 18 bones, we found consistent patterns of load-sharing in the neck: most proximally, the trabecular bone took most of the load; moving distally, the cortical bone took increasingly more of the load; and more distally, there was a region of uniform load-sharing, the cortical bone taking the majority of the load. This distal region of uniform load-sharing extended more for fall than stance loading (77 ± 8% vs 51 ± 6% of the neck length for fall vs. stance; mean ± SD) but the fraction of total load taken by the cortical bone in that region was greater for stance loading (88 ± 5% vs. 64 ± 9% for stance vs. fall). Locally, maximum stress levels occurred in the cortical bone distally, but in the trabecular bone proximally. Although the distal cortex showed qualitative stress distributions consistent with the behavior of an Euler-type beam, quantitatively beam theory did not apply. We conclude that consistent and well-delineated regions of uniform load-sharing and load-transfer between the cortical and trabecular bone exist within the femoral neck, the details of which depend on the external loading conditions.

  12. Successful management of simple fractures of the femoral neck with femoral head and neck excision arthroplasty in two free-living avian species.

    Science.gov (United States)

    Burgdorf-Moisuk, Anne; Whittington, Julia K; Bennett, R Avery; McFadden, Mike; Mitchell, Mark; O'Brien, Robert

    2011-09-01

    A red-tailed hawk (Buteo jamaicensis) and a Canada goose (Branta canadensis) were evaluated for unilateral pelvic limb lameness. Physical examination findings and results of diagnostic imaging revealed femoral neck fractures in both birds. Both birds were treated with a femoral head and neck excision arthroplasty. The affected legs were not immobilized, and the birds were encouraged to use the legs immediately after surgery to encourage formation of a pseudoarthrosis. Within 2 weeks, both birds were using the affected limb well enough to be either successfully released or transferred to a wildlife rehabilitation facility. Femoral head and neck excision arthroplasty without immobilization of the limb is recommended for managing avian femoral neck fractures, especially in free-ranging species in which a rapid and complete or near complete return to function is vital for survival in the wild.

  13. Correlation Between Residual Displacement and Osteonecrosis of the Femoral Head Following Cannulated Screw Fixation of Femoral Neck Fractures.

    Science.gov (United States)

    Wang, Chen; Xu, Gui-Jun; Han, Zhe; Jiang, Xuan; Zhang, Cheng-Bao; Dong, Qiang; Ma, Jian-Xiong; Ma, Xin-Long

    2015-11-01

    The aim of the study was to introduce a new method for measuring the residual displacement of the femoral head after internal fixation and explore the relationship between residual displacement and osteonecrosis with femoral head, and to evaluate the risk factors associated with osteonecrosis of the femoral head in patients with femoral neck fractures treated by closed reduction and percutaneous cannulated screw fixation.One hundred and fifty patients who sustained intracapsular femoral neck fractures between January 2011 and April 2013 were enrolled in the study. All were treated with closed reduction and percutaneous cannulated screw internal fixation. The residual displacement of the femoral head after surgery was measured by 3-dimensional reconstruction that evaluated the quality of the reduction. Other data that might affect prognosis were also obtained from outpatient follow-up, telephone calls, or case reviews. Multivariate logistic regression analysis was applied to assess the intrinsic relationship between the risk factors and the osteonecrosis of the femoral head.Osteonecrosis of the femoral head occurred in 27 patients (18%). Significant differences were observed regarding the residual displacement of the femoral head and the preoperative Garden classification. Moreover, we found more or less residual displacement of femoral head in all patients with high quality of reduction based on x-ray by the new technique. There was a close relationship between residual displacement and ONFH.There exists limitation to evaluate the quality of reduction by x-ray. Three-dimensional reconstruction and digital measurement, as a new method, is a more accurate method to assess the quality of reduction. Residual displacement of the femoral head and the preoperative Garden classification were risk factors for osteonecrosis of the femoral head. High-quality reduction was necessary to avoid complications.

  14. MULTICENTRIC GIANT CELL TUMOR OF IPSILATERAL ACETABULUM AND FEMORAL HEAD WITH PATHOLOGICAL FRACTURE OF FEMORAL NECK: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Jayant

    2015-02-01

    Full Text Available INTRODUCTION: Multicentric Giant Cell Tumor is extremely rare; here we are presenting a case of pathological neck femur fracture in case of multicentric giant cell tumor involving ipsilateral acetabulum along with femoral head and neck. CASE PRESENTATION: 24 years old male presented with pain in groin region and inability to walk after he fell down while walking. He had pain in left groin on weight bearing for last six months. Radiological examination shows pathological trans - cervical femoral neck fracture with sub - articular lytic lesion in femoral head and neck suggestive of Giant cell tumor. MRI has been done to define the extent of involvement and to rule out soft tissue infiltration. Fine needle aspiration cytology which was done through anterior route was inconclusive. After review of literature, patient has been planned for excisional biopsy and un - cemented total hip arthroplasty. Intra - operatively, frozen section confirms the giant cell tumor and surprisingly acetabulum was found to be involved which was curetted and hydrogen - peroxide treated. Post - operatively, patient was pain - free with good range of movements at hip. CONCLUSION: Giant cell tumor involving femoral head and neck with pathological fracture though uncommon, but may present as multicentric with acetabular involvement.

  15. Simultaneous bilateral femoral neck fractures after electrical shock injury: a case report

    Institute of Scientific and Technical Information of China (English)

    Harminder Singh Sohal; Darsh Goyal

    2013-01-01

    Simultaneous bilateral fractures of the femoral necks are rare injuries,especially when there is no underlying pathological condition.We report a 20-year-old man who sustained bilateral femoral neck fractures resulting from an accidental electric shock with 440 Ⅴ direct current.Simultaneous bilateral femoral neck fractures after electrical shock injury without falling from a height are rather uncommon in clinic.The main cause of the fracture may be muscle contraction.This case highlights that even in the absence of primary and secondary bone disease,bilateral fractures of the femoral necks can occur following electric shock injury.We successfully managed this case with bilateral cannulated screw fixation without bone grafting.Surgeons caring for patients with electrical injury should be aware of the possibility of skeletal injuries which can go unnoticed,leading to delay in diagnosis and increased risk of complications.

  16. Logistic regression in estimates of femoral neck fracture by fall

    Directory of Open Access Journals (Sweden)

    Jaroslava Wendlová

    2010-04-01

    Full Text Available Jaroslava WendlováDerer’s University Hospital and Policlinic, Osteological Unit, Bratislava, SlovakiaAbstract: The latest methods in estimating the probability (absolute risk of osteoporotic fractures include several logistic regression models, based on qualitative risk factors plus bone mineral density (BMD, and the probability estimate of fracture in the future. The Slovak logistic regression model, in contrast to other models, is created from quantitative variables of the proximal femur (in International System of Units and estimates the probability of fracture by fall.Objectives: The first objective of this study was to order selected independent variables according to the intensity of their influence (statistical significance upon the occurrence of values of the dependent variable: femur strength index (FSI. The second objective was to determine, using logistic regression, whether the odds of FSI acquiring a pathological value (femoral neck fracture by fall increased or declined if the value of the variables (T–score total hip, BMI, alpha angle, theta angle and HAL were raised by one unit.Patients and methods: Bone densitometer measurements using dual energy X–ray absorptiometry (DXA, (Prodigy, Primo, GE, USA of the left proximal femur were obtained from 3 216 East Slovak women with primary or secondary osteoporosis or osteopenia, aged 20–89 years (mean age 58.9; 95% CI: −58.42; 59.38. The following variables were measured: FSI, T-score total hip BMD, body mass index (BMI, as were the geometrical variables of proximal femur alpha angle (α angle, theta angle (θ angle, and hip axis length (HAL.Statistical analysis: Logistic regression was used to measure the influence of the independent variables (T-score total hip, alpha angle, theta angle, HAL, BMI upon the dependent variable (FSI.Results: The order of independent variables according to the intensity of their influence (greatest to least upon the occurrence of values of the

  17. Femoroacetabular impingement: bone marrow oedema associated with fibrocystic change of the femoral head and neck junction

    Energy Technology Data Exchange (ETDEWEB)

    James, S.L.J. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom) and Department of Radiology, Royal Orthopaedic Hospital, Birmingham (United Kingdom)]. E-mail: jamesslj@email.com; Connell, D.A. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom); O' Donnell, P. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom); Saifuddin, A. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom)

    2007-05-15

    Aim: To describe the association of bone marrow oedema adjacent to areas of fibrocystic change at the femoral head and neck junction in patients with femoroacetabular impingement. Materials and methods: The clinical and imaging findings in six patients with bone marrow oedema adjacent to an area of fibrocystic change at the femoral head and neck junction are presented. There were five males and one female (age range 19-42 years, mean age 34.5 years). Three patients were referred with a clinical suspicion of femoroacetabular impingement, two with suspected osteoid osteoma and one with a clinical diagnosis of sciatica. The volume of bone marrow oedema (grade 1: 0-25%, grade 2: 26-50%, grade 3: 51-75% and grade 4: 76-100% of the femoral neck width), presence of labral and articular cartilage abnormality, joint effusion, and femoral head and neck morphology were recorded. Results: Magnetic resonance imaging (MRI) identified fibrocystic change in the anterolateral aspect of the femoral head and neck junction in all cases (mean size 9 mm, range 5-14 mm, three multilocular and three unilocular cysts). The volume of oedema was variable (one grade 1, two grade 2, one grade 3 and two grade 4). All patients had abnormality of the anterosuperior labrum with five patients demonstrating chondral loss. An abnormal femoral head and neck junction was identified in five patients. Conclusion: The radiological finding of fibrocystic change at the anterosuperior femoral neck with or without bone marrow oedema should prompt the search for femoroacetabular impingement. Bone marrow oedema may rarely be identified adjacent to these areas of cystic change and should be considered in the differential diagnosis of bone marrow oedema in the femoral neck.

  18. Posterior dislocation of the hip with ipsilateral displaced femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    Vivek Trikha; Tarun Goyal; Ram K.Jha

    2011-01-01

    Traumatic posterior dislocation of hip associated with ipsilateral displaced femoral neck fracture is a rare injury. Moreover, the management of such patients evokes strong views regarding primary replacement or preserving the femoral head. We presented a case of young adult with such an injury. He was operated upon with reduction of the dislocation and fixation of femoral neck fracture with the help of cancellous screws. Two years later, the fracture had united and the patient was asymptomatic. We further proposed the mechanism of injury for such a fracture and discussed the management in the changing trauma scenario of the developing world.

  19. Atypical femoral neck stress fracture in a marathon runner: a case report and literature review.

    LENUS (Irish Health Repository)

    2012-02-01

    BACKGROUND: Femoral neck stress fractures are relatively rare and may present as sports-related injuries. The presentation is variable, and prompt diagnosis facilitates the earliest return to pre-morbid functional activity levels. Delayed detection may precipitate femoral non-union or avascular necrosis, resulting in long-term functional deficit. AIMS: We present the case of a basicervical femoral neck stress fracture occurring in a 23-year-old marathon runner. The pathophysiology and practical management issues related to this unusual injury pattern are discussed. CONCLUSION: The growing interest in amateur athletic activities should raise the index of suspicion for stress fractures of the femoral neck in healthy adults with atypical hip pain. Increased levels of patient education and physician awareness can reduce the incidence of long-term morbidity in cases of this unusual sports-related injury.

  20. The role of acetabulum geometry and femoral head-neck ratio in the development of osteoarthritis in young men

    DEFF Research Database (Denmark)

    Halle, B; Halle, D M; Torfing, T;

    2007-01-01

    We studied the role of acetabulum geometry and head neck ratio in the development of osteoarthritis of the hip in young men. Contrary to previous studies we evaluated the significance of the anterior, posterior and total coverage of the femoral head, the influence of the femoral neck and the cons......We studied the role of acetabulum geometry and head neck ratio in the development of osteoarthritis of the hip in young men. Contrary to previous studies we evaluated the significance of the anterior, posterior and total coverage of the femoral head, the influence of the femoral neck...

  1. Factors affecting health-related quality of life in patients after femoral neck fracture.

    Science.gov (United States)

    Valavičienė, Rasa; Smailys, Alfredas; Macijauskienė, Jūratė; Hommel, Ami

    2010-01-01

    Quality of life in patients with femoral neck fracture is an issue frequently discussed in the literature. There is ongoing research on identifying factors that have an impact on quality of life in this particular group of patients. A great variety of factors affecting quality of life and lack of information on their importance encouraged us to perform a systematic literature review analyzing quality of life of patients who sustained femoral neck fracture. The search was performed in the PubMed and Medline databases according to the selected key words. In our systematic review, we included clinical and clinical randomized trials investigating patients with femoral neck fracture and their quality of life. Our analysis showed that treatment of femoral neck fracture with hip replacement was superior to osteosynthesis with regard to patients' quality of life. The data regarding the impact of different rehabilitation programs on quality of life were controversial; a few reports showed that special rehabilitation programs were associated with better health-related quality life. However, other studies did not report any differences in patients' quality of life when different rehabilitation programs were applied. Patient's nutrition may be an important factor affecting the quality of life in patients with femoral neck fractures; however, data supporting this fact are insufficient.

  2. Correlation between baseline femoral neck marrow status and the development of femoral head osteonecrosis in corticosteroid-treated patients: A longitudinal study by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Vande Berg, Bruno C. [Radiology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium)]. E-mail: vandeberg@rdgn.ucl.ac.be; Gilon, Raphael [Radiology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium); Malghem, Jacques [Radiology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium); Lecouvet, Frederic [Radiology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium); Depresseux, Genevieve [Rheumatology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium); Houssiau, Frederic A. [Rheumatology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium)

    2006-06-15

    Objective: To test the hypothesis that the development of corticosteroid (CS)-associated femoral head osteonecrosis (ON) is influenced by baseline femoral neck marrow status. Patients and methods: The population consisted of 20 untreated patients with a newly diagnosed rheumatic disease in whom a standardized CS regimen was planned. Before CS treatment, baseline femoral neck marrow status was determined by magnetic resonance (MR) imaging on T1-weighted images (proportion of surface area of femoral neck and intertrochanteric area occupied by fatty marrow; index of marrow conversion [IMC]) and on a quantitative MR sequence (bulk T1 values of femoral head and neck). The presence of ON was assessed by coronal T1-weighted MR images of the hips at 6 and 12 months. Results: None of the patients suffered from ON at baseline. Four patients (20%) developed bilateral femoral head ON at 6 months. The mean percentage of fat marrow in the femoral neck before treatment was significantly higher in ON-positive than in ON-negative patients (p = 0.0025). The mean baseline femoral neck IMC value, which parallels the degree of red to yellow marrow conversion, was higher in ON-positive than in ON-negative patients (p = 0.089). The mean baseline bulk T1 value of the femoral neck (but not of the femoral head), which inversely correlates with the amount of fat marrow, was significantly shorter in ON-positive than in ON-negative patients (p = 0.0298). Conclusion: The development of CS-associated femoral head ON is correlated with a high fat content in the proximal femur before CS therapy.

  3. Negative magnetic resonance imaging in femoral neck stress fracture with joint effusion: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Seki, Nobutoshi; Okuyama, Koichiro; Kamo, Keiji; Chiba, Mitsuho [Akita Rosai Hospital, Department of Orthopedic Surgery, Odate, Akita (Japan); Shimada, Yoichi [Akita University School of Medicine, Department of Orthopedic Surgery, Akita (Japan)

    2016-06-15

    Femoral neck stress fracture (FNSF) is well documented in the orthopedic literature and is generally associated with strenuous activities such as long-distance running and military training. The diagnostic yield of magnetic resonance imaging (MRI) for FNSF was reported to be 100 %, and early MRI is recommended when this fracture is suspected. We encountered a 16-year-old male long-distance runner with FNSF in whom the left femoral neck showed no signal changes on MRI although an effusion was detected in the left hip joint. One month later, roentgenograms revealed periosteal callus and oblique consolidation of the left femoral neck, confirming the diagnosis of compression FNSF. Because FNSF with a normal bone marrow signal on MRI is very rare, this patient is presented here. (orig.)

  4. Perioperative treatment of femoral neck fracture with deep venous thrombosis: A case report

    Institute of Scientific and Technical Information of China (English)

    Ming Liu; Lei Liu; Fuguo Huang; Yue Fang; Gang Zhong; Zhou Xiang

    2015-01-01

    Deep venous thrombosis (DVT) is an important cause of disability and mortality after major orthopedic surgery.The roles of perioperative treatment and prevention of DVT in patients with femoral neck fractures who require major surgery have not yet been well explored in Chinese clinical practice.Here we report a case of calf muscular venous thrombosis in a 55-year-old woman with femoral neck fracture before surgery.Preventive and treatment measures including the administration of heparin sodium, application of venous foot pump and placement of inferior vena cava filter were taken.The condition of the patient was stable during the perioperative period and the surgery was successful.Besides, postoperative examination showed that the femur healed well and the functional recovery was satisfactory.Our results suggest that femoral neck fracture patients combined with DVT can receive surgery after accurate preoperative assessment and proper preoperative treatment.

  5. Aneurysmal femoral neck cyst: Report of a paediatric case and review of literature

    Directory of Open Access Journals (Sweden)

    Oumar Ndour

    2016-01-01

    Full Text Available The aneurysmal bone cyst (ABC is a benign tumour of children and young adults. It represents approximately 1-2% of all bone tumours. The ABC may develop on all skeletal bones, but the proximal end of the femur is the most common location. The authors report a ABC femoral neck in a child of 13 years. This location is pretty special. Indeed, the fragility of the femoral neck due partly to the pathology itself and secondarily curettage requires a judicious attitude surgical (excisional curettage + bone graft + screw to prevent the risk of high local recurrence and pathological fracture.

  6. Forum. Femoral neck surgery using a local anaesthetic technique.

    Science.gov (United States)

    Howard, C B; Mackie, I G; Fairclough, J; Austin, T R

    1983-10-01

    Thirty cases of femoral sub-capital fractures, Garden grades 1-4, were reduced and internally fixed with crossed Garden screws using femoral nerve block. In addition, sedation and analgesia was provided by low dose ketamine and diazepam. No deaths or other complications occurred in these patients. In a similar group of patients who received spinal analgesia in the same unit under similar conditions there was one death and two cerebrovascular accidents.

  7. Bone mineral density of the femoral neck in resurfacing hip arthroplasty

    DEFF Research Database (Denmark)

    Penny, Jeannette Østergaard; Ovesen, Ole; Brixen, Kim;

    2010-01-01

    Resurfacing total hip arthroplasty (RTHA) may preserve the femoral neck bone stock postoperatively. Bone mineral density (BMD) may be affected by the hip position, which might bias longitudinal studies. We investigated the dependency of BMD precision on type of ROI and hip position....

  8. Promising Effect Of Intraarticular Ropivacaine In Femoral Neck Fractures Treated With Internal Fixation (Best Poster Award)

    DEFF Research Database (Denmark)

    Bech, Rune Dueholm

    2008-01-01

     Promising Effect Of Intraarticular Ropivacaine In Femoral Neck Fractures Treated With Internal Fixation Rune Bech*, Jens Lauritsen*+,Tine Dimon*, Ole Ovesen*, Claus Emmeluth, Søren Overgaard*. *:Dept. Ortopaedic Surgery, Odense University Hospital, +:Institute of Public Health-dept. biostatistic...

  9. A case of stress fracture of the femoral neck; Przypadek przeciazeniowego zlamania szyjki kosci udowej

    Energy Technology Data Exchange (ETDEWEB)

    Walenczak, K.; Widawski, T. [Szpital MSW, Lodz (Poland)

    1993-12-31

    A case of 28 years-old male with stress fracture of the femoral neck is presented. Heterogeneous clinical picture is blamed for diagnostic problems in the initial stage of the disease. Bone scintigraphy aids in the early diagnosis. The use of low frequency electromagnetic field had unquestionable effect on shortening of the treatment time in the case reported. (author). 10 refs, 1 fig.

  10. The societal costs of femoral neck fracture patients treated with internal fixation

    NARCIS (Netherlands)

    Zielinski, S.M.; Bouwmans, C.A.; Heetveld, M.J.; Bhandari, M.; Patka, P.; Lieshout, E.M. van; Kampen, A. van

    2014-01-01

    SUMMARY: The study rationale was to provide a detailed overview of the costs for femoral neck fracture treatment with internal fixation in the Netherlands. Mean total costs per patient at 2-years follow-up were 19,425. Costs were higher for older, less healthy patients. Results are compa

  11. Computed tomographic evaluation of the proximal femur: A predictive classification in displaced femoral neck fracture management

    Directory of Open Access Journals (Sweden)

    Narender Kumar Magu

    2014-01-01

    Full Text Available Background: Femoral neck fracture is truly an enigma due to the high incidence of avascular necrosis and nonunion. Different methods have been described to determine the size of the femoral head fragment, as a small head has been said to be associated with poor outcome and nonunion due to inadequate implant purchase in the proximal fragment. These methods were two dimensional and were affected by radiography techniques, therefore did not determine true head size. Computed tomography (CT is an important option to measure true head size as images can be obtained in three dimensions. Henceforth, we subjected patients to CT scan of hip in cases with displaced fracture neck of femur. The study aims to define the term "small head or inadequate size femoral head" objectively for its prognostic significance. Materials and Methods: 70 cases of displaced femoral neck fractures underwent CT scan preoperatively for proximal femoral geometric measurements of both hips. Dual energy X-ray absorptiometry scan was done in all cases. Patients were treated with either intertrochanteric osteotomy or lag screw osteosynthesis based on the size of the head fragment on plain radiographs. Results: The average femoral head fragment volume was 57 cu cm (range 28.3-84.91 cu cm; standard deviation 14 cu cm. Proximal fragment volume of >43 cu cm was termed adequate size (type I and of ≤43 cu cm as small femoral head (type II. Fractures which united (n = 54 had a relatively large average head size (59 cu cm when compared to fractures that did not (n = 16, which had a small average head size (49 cu cm and this difference was statistically significant. In type I fractures union rate was comparable in both osteotomy and lag screw groups (P > 0.05. Lag screw fixation failed invariably, while osteotomy showed good results in type II fractures (P < 0.05. Conclusion: Computed tomography scan of the proximal femur is advisable for measuring true size of head fragment. An objective

  12. Associations of parity, breast-feeding, and birth control pills with lumbar spine and femoral neck bone densities.

    Science.gov (United States)

    Hreshchyshyn, M M; Hopkins, A; Zylstra, S; Anbar, M

    1988-08-01

    The relationships between parity, breast-feeding, and the use of birth control pills and the bone densities of the lumbar spine and the femoral neck, measured by dual-photon densitometry, were studied in normal women. Femoral neck density was found to decrease by 1.1% per live-birth, whereas lumbar spine density showed no significant association with parity. Breast-feeding was found to increase lumbar spine density by 1.5% per breast-fed child, whereas femoral neck density was not significantly correlated. No significant relationships between the use of birth control pills and the bone densities were found.

  13. The Femoral Neck Mechanoresponse to Hip Extensors Exercise: A Case Study

    Science.gov (United States)

    Mokhtarzadeh, Hossein; Pivonka, Peter; Ebeling, Peter R.

    2017-01-01

    Physical activity is recommended to prevent age-related bone loss. However, the proximal femur mechanoresponse is variable, possibly because of a muscle-dependant mechanoresponse. We compared the proximal femur response with the femoral strain pattern generated by the hip extensor muscles. A healthy participant underwent a six-month unilateral training of the hip extensor muscles using a resistance weight regularly adjusted to the 80% of the one-repetition maximum weight. DXA-based measurements of the areal Bone Mineral Density (aBMD) in the exercise leg were adjusted for changes in the control leg. The biomechanical stimulus for bone adaptation (BS) was calculated using published models of the musculoskeletal system and the average hip extension moment in elderly participants. Volumetric (ΔvBMD) and areal (ΔaBMD) BMD changes were calculated. The measured and calculated BMD changes consistently showed a positive and negative effect of exercise in the femoral neck (ΔaBMD = +0.7%; ΔvBMD = +0.8%) and the trochanter region (ΔaBMD = −4.1%; ΔvBMD = −0.5%), respectively. The 17% of the femoral neck exceeded the 75th percentile of the spatially heterogeneous BS distribution. Hip extensor exercises may be beneficial in the proximal femoral neck but not in the trochanteric region. DXA-based measurements may not capture significant aBMD local changes. PMID:28168080

  14. The Femoral Neck Mechanoresponse to Hip Extensors Exercise: A Case Study

    Directory of Open Access Journals (Sweden)

    Saulo Martelli

    2017-01-01

    Full Text Available Physical activity is recommended to prevent age-related bone loss. However, the proximal femur mechanoresponse is variable, possibly because of a muscle-dependant mechanoresponse. We compared the proximal femur response with the femoral strain pattern generated by the hip extensor muscles. A healthy participant underwent a six-month unilateral training of the hip extensor muscles using a resistance weight regularly adjusted to the 80% of the one-repetition maximum weight. DXA-based measurements of the areal Bone Mineral Density (aBMD in the exercise leg were adjusted for changes in the control leg. The biomechanical stimulus for bone adaptation (BS was calculated using published models of the musculoskeletal system and the average hip extension moment in elderly participants. Volumetric (ΔvBMD and areal (ΔaBMD BMD changes were calculated. The measured and calculated BMD changes consistently showed a positive and negative effect of exercise in the femoral neck (ΔaBMD = +0.7%; ΔvBMD = +0.8% and the trochanter region (ΔaBMD = −4.1%; ΔvBMD = −0.5%, respectively. The 17% of the femoral neck exceeded the 75th percentile of the spatially heterogeneous BS distribution. Hip extensor exercises may be beneficial in the proximal femoral neck but not in the trochanteric region. DXA-based measurements may not capture significant aBMD local changes.

  15. Review of a single contemporary femoral neck fracture fixation method in young patients.

    LENUS (Irish Health Repository)

    Henari, Shwan

    2011-03-01

    An intracapsular femoral neck fracture in a young patient is a rare and difficult injury to manage. The occurrence of complications following fixation is multifactorial. Initial displacement and timing and accuracy of reduction are the key factors affecting outcome. The severities of the trauma to the hip and the impact of the intracapsular hematoma also play a role, the importance of which remains poorly understood. The purpose of this study was to evaluate the high incidence of femoral neck fractures treated in our institution over a 7-month period, to record the long-term outcome of these patients, all of whom were treated with contemporary methods of internal fixation, and to highlight the reasons for this injury being termed an "orthopedic emergency" and its differences from the same injury in the elderly population. We performed a retrospective analysis of 12 cases of intracapsular femur neck fracture in patients younger than 50 years treated over 7 months in a regional trauma center. All patients underwent satisfactory reduction and fixation. Nine of the 12 patients had a good outcome at a mean follow-up of 29 months. One patient developed a nonunion of the femoral head requiring total hip arthroplasty, one developed avascular necrosis of the femoral head, and one developed partial avascular necrosis. This compares favorably with other studies.

  16. Fixation of intracapsular femoral neck fractures: Effect of trans-osseous capsular decompression

    Directory of Open Access Journals (Sweden)

    Elsayed Ibraheem Elsayed Massoud

    2010-06-01

    Full Text Available Objectives: Intracapsular femoral neck fractures have been found as associated with hemarthrosis. The fluid in the intact capsule elevates the intracapsular pressure to a level could tamponades the vascular supply of the femoralhead. Therefore, capsular decompression seems necessaryto salvage the femoral head circulation. Negative impact of the capsular incision also has been reported. Therefore, we hypothesize that creation of a trans-osseousportal can decompress the capsule as well as not threaten the capsular related blood vessels.Materials and methods: In present study, 27 patients with intracapsular femoral neck fractures were included. Coinciding with closed reduction and internal fixation we made a trans-osseous portal for capsular decompression. Patients were followed-up prospectively for a mean periodof 43.1 months.Results: All fractures united. However, one patient 17 years-old who was nursed preoperatively in skin traction developed osteonecrosis of the femoral head.Conclusion: Our results supported that the trans-osseous capsular decompression has evacuated the intracapsular haematoma and has not threatened the capsular integrity. Preoperative traction of the injured limb particularly in the young patient may play a role in development of osteonecrosisof the femoral head.

  17. Bone density in relation to failure in patients with osteosynthesized femoral neck fractures

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Ryg, Jesper; Lauritsen, Jens;

    Background The treatment of femoral neck fracture with internal fixation (IF) is recommended in younger patients and has compared to arthroplasty the advantage of retaining the femoral head. A big problem with osteosynthesis is though failure. Finding predictors for fixation failure is still......,2 (75,4-79,0). Failure is defined as revision surgery or new fracture. Results 69 patients had a t-score (total hip) below -2,5 SD as defined for osteoporosis. At 1 year the overall (dislocated) failure rate was 34,5 % (44,7 %), at 2 years 45,4 % (60,0 %) and at end of follow-up 49,6 % (62...

  18. Bone density in relation to failure in patients with osteosynthesized femoral neck fractures

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Ryg, Jesper; Lauritsen, Jens;

    2011-01-01

    Background The treatment of femoral neck fracture with internal fixation (IF) is recommended in younger patients and has compared to arthroplasty the advantage of retaining the femoral head. A big problem with osteosynthesis is though failure. Finding predictors for fixation failure is still......,1 (75,3-78,9). Failure is defined as revision surgery or new fracture. Results 69 patients had a t-score (total hip) below -2,5 SD as defined for osteoporosis. At 1 year the overall (dislocated) failure rate was 34,3 % (44,2 %), at 2 years 45,1 % (59,4 %) and at end of follow-up 49,2 % (62...

  19. Transfracture abduction osteotomy: A solution for nonunion of femoral neck fractures

    Directory of Open Access Journals (Sweden)

    Jairamchander Pingle

    2014-01-01

    femur with or without bone graft, valgus osteotomy or hip arthroplasty. We conducted a retrospective analysis of cases of nonunion of femoral neck fracture treated by transfracture abduction osteotomy (TFAO. Materials and Methods: Over a period of 35 years (1974-2008, 30 patients with nonunion of femoral neck fractures were treated with TFAO over a period of 35 years (1974-2008, All patients were less than 50 years of age. Absence of clinical and radiological signs of union after four months was considered as nonunion. Patients more than 50 years of age were excluded from the study. Union was assessed at 6 months radiologically. Limb length was measured at six months. The mean duration of femoral neck fracture was 19 months (range 4 months 10 years. Results were analyzed in terms of radiological union at six months. Average followup was five years and six months. Results: Consistent union was noted at the followup after six months in 29 cases. One case was lost to followup after five and one-half months postoperatively. However, the fracture had united in this case at the last followup. Average shortening of the limb at six months was 1.9 cm. Average neck shaft angle was 127° (range 120-145°. Five cases went into AVN but were asymptomatic. Two cases required reoperation due to back out of Moore′s pins. These were reopened and cancellous screws were inserted in the same tracks. Conclusions: Consistent union of nonunion femoral neck fracture was noted at the followup after six months in 29 cases. The major drawback of the procedure is immobilization of the patient in the hip spica for eight weeks.

  20. Study of the anatomical position of the femoral nerve by magnetic resonance imaging in patients with fractured neck of femur: relevance to femoral nerve block.

    LENUS (Irish Health Repository)

    Mehmood, Shehzad

    2012-01-31

    STUDY OBJECTIVE: To determine the anatomical location of the femoral nerve in patients who have sustained fracture of the neck of femur, and its relevance to femoral nerve block technique. DESIGN: Prospective, observational clinical study. SETTING: Orthopedic and Radiology departments of a regional hospital. SUBJECTS: 10 consecutive adult ASA physical status II and III patients (mean age, 78.5 yrs) and 4 adult healthy volunteers. INTERVENTIONS: A T1 magnetic resonance imaging scan was performed of both upper thighs in patients and healthy volunteers successfully. MEASUREMENTS: The distance (mm) between the midpoint of the femoral artery and the midpoint of the femoral nerve, and the distance of the femoral nerve from the skin was measured at the mid-inguinal ligament, the pubic tubercle, and at the mid-inguinal crease. Data are shown as means (SD). Differences between both sides were compared using paired Student\\'s t-tests. P < 0.05 was significant. MAIN RESULTS: In patients the mean distance (mm) between the midpoint of the femoral nerve from the midpoint of femoral artery at the mid-inguinal crease on the fractured and non-fractured sides was 10.7 and 11.0, respectively (P = 0.87). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the mid-inguinal ligament on the fractured and non-fractured sides was 9.64 and 12.5, respectively (P = 0.03). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the pubic tubercle on the fractured and non-fractured sides was 8.74 and 10.49, respectively (P = 0.18). CONCLUSIONS: Blockade of the femoral nerve may be easier to perform at the mid-inguinal crease in patients with fractured neck of femur.

  1. Is surgeons' experience important on intra- and inter-observer reliability of classifications used for adult femoral neck fracture?

    OpenAIRE

    Turgut, Ali; Kumbaracı, Mert; Kalenderer, Önder; İlyas, Gökhan; Bacaksız, Tayfun; Karapınar, Levent

    2017-01-01

    Purpose: To evaluate whether surgeons' experience affect inter- and intra-observer reliability among mostly used classification systems for femoral neck fractures. Material and Methods: A power point presentation was prepared with 107 slides which were antero-posterior radiographs of each femoral neck fracture. 5 residents, 5 orthopaedic surgeons and 5 senior orthopaedic surgeons reviewed this presentation and classified the fractures according to Garden, Pauwels and AO classifications. ...

  2. Chondroblastoma: a rare cause of femoral neck fracture in a teenager.

    Science.gov (United States)

    Paloski, Michael D; Griesser, Michael J; Jacobson, Mark E; Scharschmidt, Thomas J

    2011-09-01

    Chondroblastomas usually present in the epiphyseal region of bones in skeletally immature patients. These uncommon, benign tumors are usually treated with curettage and use of a bone-void filler. Here we report a case of a hip fracture secondary to an underlying chondroblastoma in a 19-year-old woman. Open biopsy with intraoperative frozen section pointed toward a diagnosis of chondroblastoma. Extended curettage was performed, followed by cryotherapy with a liquid nitrogen gun and filling of the defect with calcium phosphate bone substitute. The femoral neck fracture was stabilized with a sliding hip screw construct. The patient progressed well and continued to regain functional status. A final pathology report confirmed the lesion to be a chondroblastoma. Clinicians should have heightened awareness of a pathologic lesion in a young person presenting with a femoral neck fracture and should consider the uncommon differential diagnosis that the lesion is located in the greater trochanter apophysis.

  3. Chondroblastoma of the femoral neck as a cause of hip synovitis.

    Science.gov (United States)

    Kaneko, Hiroshi; Kitoh, Hiroshi; Wasa, Junji; Nishida, Yoshihiro; Ishiguro, Naoki

    2012-03-01

    Chondroblastoma is a rare benign chondroid bone tumor, which typically arises from the epiphysis of a long tubular bone. We present a 13-year-old girl with persistent hip synovitis caused by a chondroblastoma that arose from the femoral neck (metaphysis) and uniquely extended extraosseously into the hip joint. Computed tomography scan clearly demonstrated a tumoral lesion of the left femoral neck and a periosteal reaction along the anterior cortex of the femur, distal to the legion. Magnetic resonance imaging showed reactive synovitis with marked joint effusion of the hip and an extensive edema in the proximal femur and the surrounding soft tissues. Aneurysmal bone cysts formation secondary to chondroblastoma was confirmed by histologic examinations of the excised specimens. Complete relief of pain and an improvement in the range of movement of the hip joint was obtained after surgical resection of the tumor.

  4. Microvascular medial femoral condylar flaps in 107 consecutive reconstructions in the head and neck.

    Science.gov (United States)

    Brandtner, Christian; Hachleitner, Johannes; Bottini, Gian Battista; Buerger, Heinz; Gaggl, Alexander

    2016-07-01

    We have assessed the role of the medial femoral condylar flap in 107 patients who had reconstructions of the head and neck. We retrospectively reviewed their medical records for indications, complications, and outcomes. The flap was primarily used for coverage of alveolar ridge defects (n=67), secondly for defects of the facial bone, calvaria, or skull base (n=35), and thirdly for partial laryngeal defects (n=5). Two flaps were lost. One patient fractured a femur 5 weeks postoperatively. The duration of follow up ranged from 6 months to 12 years. The medial femoral condylar flap is well-suited to individual reconstructions of the alveolar ridge, midface, calvaria, skull base, and part of the larynx with poor recipient sites. The flap does not replace other wellknown flaps, but offers new solutions for solving special problems in head and neck surgery.

  5. Malignant pleural mesothelioma with osseous metastases and pathologic fracture of femoral neck.

    Science.gov (United States)

    Lester, Todd; Xu, Haodong

    2008-10-01

    Malignant mesotheliomas occur in the pleura, peritoneum, pericardium, and tunica vaginalis. The majority of tumors are pleural in origin. The typical pattern of spread is usually contiguous or via implantation. Hematogenous or lymphatic metastasis is not uncommon; however, metastasis to bone has rarely been well documented. This is a case report of malignant pleural mesothelioma metastatic to the femur with a pathologic fracture of femoral neck.

  6. Case Reports: Treatment of Subtrochanteric and Ipsilateral Femoral Neck Fractures in an Adult with Osteopetrosis

    OpenAIRE

    2008-01-01

    We describe a patient with autosomal-dominant osteopetrosis, a subtrochanteric fracture, and an ipsilateral femoral neck fracture treated with a hip spica cast Although the fracture united with coxa vara and external rotation deformities, the patient successfully returned to his normal activities of daily living. Operative fracture treatment in patients with osteopetrosis is difficult, and our patient provides evidence that with nonoperative treatment these patients can return to a functional...

  7. MR findings in cases of suspected impacted fracture of the femoral neck

    Energy Technology Data Exchange (ETDEWEB)

    Stiris, M.G.; Lilleaas, F.G. [Aker Hospital, Oslo (Norway). Dept. of Diagnostic Radiology

    1997-09-01

    Purpose: To evaluate MR imaging of the hip in patients with a clinically suspected impacted fracture of the femoral neck in cases where conventional plain films show negative or equivocal findings. Material and Methods: Twenty-seven such patients were prospectively examined by MR imaging with a 1.0 T unit, within 24 hours of admittance to hospital. A coronal T1-weighted turbo spin-echo sequence (n=27), and a coronal STIR sequence (n=25) or a coronal T2-weighted turbo spin-echo fast saturation sequence (n=2) were used. The evaluations were made by 2 radiologists with experience in musculoskeletal radiology. Results: There were 6 patients with a petrochanteric fracture, 2 without and 4 with slight displacement. Five patients had an impacted fracture of the femoral neck, and 3 had a fracture of the superior pubic bone. Of 2 patients with advanced arthrosis, i had an impacted femoral neck fracture and the other a nondisplaced intertrochanteric fracture. There was 1 patient who had sustained a nondisplaced acetabular fracture with increased joint fluid and muscle contusions. Three patients had muscle contusions only. Two patients had bone marrow contusions only, while 2 others with advanced coxarthrosis had increased joint fluid only. Three patients showed normal findings. Our findings led to emergency surgery in 13 cases, and conservative measures directed to the specific MR findings in 14 patients. Conclusion: MR imaging should be the first modality of choice in examining patients with a clinically suspected impacted fracture of the femoral neck where conventional films show negative or equivocal findings. (orig.).

  8. Free fibular strut graft in neglected femoral neck fractures in adult

    Directory of Open Access Journals (Sweden)

    Azam Md Quamar

    2009-01-01

    Full Text Available Background: Neglected femoral neck fracture in adults still poses a formidable challenge. Existing treatment options varies from osteotomy (with or without graft to osteosynthesis using various implants and grafting techniques (muscle pedicle, vascularized, and nonvascularized fibula. The aim of this study was to assess outcome of nonvascularized fibular strut graft and cancellous screw fixation in neglected femoral neck fractures in the younger age group. Materials and Methods: Medical records of 32 patients of neglected femoral neck fracture, in the age group of 22-45 years (mean 37.8 years, operated between May 1994 to December 2001, were retrospectively reviewed. After the application of inclusion and exclusion criteria, 28 patients having three years minimum follow-up (mean 4.6 years were included. Delay between injury and operation varied from four weeks to 42 weeks (mean 16.4 weeks. Closed reduction was achieved in 17 patients; open reduction through Watson-Jones anterolateral approach was performed in the remaining 15 patients in whom closed reduction failed. The fracture was transfixed with three parallel guide wires. Appropriate sized cannulated lag screw (7 mm was then inserted in two of the wires. Selection of the third guide wire for fibula depended on the space available in both anteroposterior and lateral view. Results: Satisfactory bony union was obtained in 25 patients, of whom in four cases, the union occurred in 10-20° (mean 15° of varus. Nonunion occurred in three patients (9.37%, and aseptic necrosis occurred in another six patients (18.75%. Of the 25 patients where union was achieved, five patients showed excellent results; 14 good and six had poor functional result, as evaluated using modified Anglen criteria. Conclusion: Nonvascularized fibular strut graft along with cancellous screws provides a dependable and technically less-demanding alternative procedure for neglected femoral neck fractures in young adults. Fibula

  9. Lentivirus-TAZ Administration Alleviates Osteoporotic Phenotypes in the Femoral Neck of Ovariectomized Rats

    Directory of Open Access Journals (Sweden)

    Zhanhai Yin

    2016-01-01

    Full Text Available Background: Osteoporosis is characterized by impairment of bone mass, strength, and microarchitecture, leading to the susceptibility to fragility fractures, especially in femoral neck region. Transcriptional coactivator with PDZ-binding motif (TAZ facilitates osteogenesis while suppressing adipogenesis via regulation of transcriptional activities of runt-related transcription factor 2 and peroxisome proliferator-activated receptor γ. Here, we validated the role of TAZ in vivo using an ovariectomized (OVX rat model of osteoporosis. Methods: Serum alkaline phosphatase, triglyceride, cholesterol and urinary hydroxyproline were measured on an automatic analyzer using diagnostic reagent kits. Serum OCN and C-terminal cross-linked telopeptides of type I collagen were measured using ELISA. Bone mineral density was measured using dual-energy X-ray scanner. Mechanical parameters were detected by three-point bending assays. Bone volume per tissue volume (BV/TV, trabecular thickness (Tb. Th, trabecular number (Tb. No, and trabecular separation (Tb. Sp were measured by MicroCT. The mRNA and protein levels were quantified by Realtime PCR and Western Blotting respectively. Results: After injections of lentivirus overexpressing TAZ into the femoral neck region, bone mineral density, ultimate force, stiffness, BV/TV, Tb. Th, and Tb. No were significantly increased, whereas Tb. Sp was dramatically decreased. In the TAZ-overexpression region in the femoral neck of OVX rats, the mRNA levels of Runx2 and osteocalcin were obviously elevated, whereas that of PPARγ and adipocyte protein 2 were downregulated. Conclusion: Lentivirus-mediated TAZ gene therapy alleviated the osteoporotic phenotypes in the femoral neck of OVX rats, providing an alternative strategy for the treatment of postmenopausal osteoporosis and prevention of osteoporotic fracture.

  10. Maintenance of bone mineral density after implantation of a femoral neck hip prosthesis

    Directory of Open Access Journals (Sweden)

    Zurstegge Matthias

    2008-01-01

    Full Text Available Abstract Background Stress shielding of the proximal femur has been observed in a number of conventional cementless implants used in total hip arthroplasty. Short femoral-neck implants are claiming less interference with the biomechanics of the proximal femur. The goal of this study was to investigate the changes of bone-mineral density in the proximal femur and the clinical outcome after implantation of a short femoral-neck prosthesis. Methods We prospectively assessed the clinical outcome and the changes of bone mineral density of the proximal femur up to one year after implantation of a short femoral neck prosthesis in 20 patients with a mean age of 47 years (range 17 to 65. Clinical outcome was assessed using the Harris Hip Score. The WOMAC was used as a patient-relevant outcome-measure. The bone mineral density was determined using dual energy x-ray absorptiometry, performed 10 days, three months and 12 months after surgery. Results The Harris Hip Score improved from an average preoperative score of 46 to a postoperative score at 12 months of 89 points, the global WOMAC index from 5,3 preoperatively to 0,8 at 12 months postoperatively. In contrast to conventional implants, the DEXA-scans overall revealed a slight increase of bone mineral density in the proximal femur in the 12 months following the implantation. Conclusion The short femoral neck stem lead to a distinct bone reaction. This was significantly different when compared to the changes in bone mineral density reported after implantation of conventional implants.

  11. Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly.

    Science.gov (United States)

    Panteli, Michalis; Rodham, Paul; Giannoudis, Peter V

    2015-03-01

    Femoral neck fractures represent a relatively uncommon injury in the non-elderly population often resulting from high-energy trauma. The cornerstone of their management is anatomic reduction and stable internal fixation of the femoral neck in an attempt to salvage the femoral head. Complications including avascular necrosis of the femoral head, non-union and post-traumatic osteoarthritis are not uncommon. The clinical outcomes of these patients can be improved with good pre-operative planning, optimization of surgical procedures and introduction of new improved implants and techniques. In the herein study, we attempt to describe the biomechanical properties of the hip and compare the performance of the most commonly used devices. Experimental evidence suggests that in Pauwels type III fracture patterns a cephalomedullary nail was significantly stronger in axial loading. Moreover, in unstable basicervical patterns cannulated screws (triangular configuration) demonstrated a lower ultimate load to failure, whereas in subcapital or transervical patterns both the cannulated screws (triangular configuration) and the sliding hip screw demonstrated no compromise in fixation strength. The fracture pattern appears to be the major determinant of the ideal type of implant to be selected. For a successful outcome each patient needs to be considered on an individual basis taking into account all patient and implant related factors.

  12. Using biomechanics to improve the surgical technique for internal fixation of intracapsular femoral neck fractures.

    Science.gov (United States)

    Wu, Chi-Chuan

    2010-01-01

    Despite advances in science and technology, the success rate for the treatment of displaced intracapsular femoral neck fractures in high-energy injuries remains disappointing. The blood supply system in the femoral head of humans does not favor recovery from these fractures. Once these fractures occur, osteonecrosis and nonunion rates may be as high as 30%, even if the newest technique is used. There are some surgical techniques used to supplement internal fixation to reestablish the blood supply in the femoral head, but none have been evidently successful. After analysis of related studies, the author concludes that immediate surgical treatment using improved techniques incorporating the principles of biomechanics can improve the success rate of treatment of these fractures. Using these principles, the fracture site can achieve sufficient stability. Consequently, the blood supply in the femoral head and neck can be reestablished earlier and loss of reduction of fragments during treatment can be minimized. Thus, the chance of full recovery from these complicated fractures can be maximized. In this study, the biomechanical characteristics of these fractures and the principles associated with the surgical techniques used for treating them are reviewed and clarified. Finally, a surgical technique which is ideal from the author's viewpoint is presented. The author believes that the recommended surgical technique may become the best method for treating these complicated fractures.

  13. Nonvascularized fibular grafting in nonunion of femoral neck fracture: A systematic review

    Directory of Open Access Journals (Sweden)

    Sujit Kumar Tripathy

    2016-01-01

    Full Text Available Nonunion of femoral neck fractures following primary fixation and neglected femoral neck fracture in young adults is a challenging task. Every effort should be directed toward hip joint salvage in these patients. Among different available options of hip salvage, nonvascularized fibular graft (NVFG osteosynthesis is simple, easy to perform, and a successful technique. In this review, the available literature on NVFG in neglected and nonunion femoral neck fractures has been analyzed. After review of 15 articles on NVFG, the average nonunion rate was estimated to be 7.86% (range 0-31%. Six articles that evaluated the preoperative and postoperative osteonecrosis reported improvement in 50% patients. The clinical and/or functional outcome was good to excellent in 56-96% patients following fibular osteosynthesis. Few complications such as coxa vara deformity, limb shortening, and intraarticular penetration of the graft or hardware have been reported. However, there are minimal donor site morbidities such as mild ankle pain, transient loss of toe flexors and extensors and transient lateral popliteal nerve palsy.

  14. Results of cemented bipolar hemiarthroplasty for fracture of the femoral neck - 10 year study

    Directory of Open Access Journals (Sweden)

    Maini P

    2006-01-01

    Full Text Available Background : One of the most common treatments of displaced fracture of femoral neck in elderly is bipolar hemiarthroplasty. Method : Two hundred and seventy patients of displaced fracture of femoral neck were treated by bipolar hemiarthroplasty. The Mean age of the patients at the time of surgery was 69.80 years. Results : Follow up ranged between 12 months and 120 months. There were 8 cases each of acetabular erosion and protrusion with 10 cases of femoral stem loosening. Eight cases had post operative dislocation requiring open reduction. Eighteen patients got revision surgery to total hip replacement. The overall incidence of DVT/PE was 9.9% which declined after regular use of low molecular weight heparin. Eleven patients had post operative infection. There were 54.2 % excellent results, 21.0 % good results, 10.7 % fair and 3.7% poor results. Conclusion : Elderly patients with displaced fracture of neck femur are able to ambulate early after Cemented bipolar hemi arthroplasty. The complication rate is low, the component survival long and pre injury functional status is restored in majority of patients.

  15. Dual fibular grafting - A new technique of fixation of the femoral neck fractures

    Directory of Open Access Journals (Sweden)

    Yadav S

    2005-01-01

    Full Text Available Background: To achieve osteosynthesis of femoral neck fractures is a challenge to the treating surgeon. Plethora of devices and methods has been described. Method: A new technique of achieving union of femoral neck fractures by dual-fibular fixation has been reported in 150 patients. The age of the patients ranged from 6-75 years. Results: Nearly two-third of these were Garden type II and III with an average follow-up of 120 months. In this series 67% had good to excellent long term results. Conclusion: Two fibular struts provide autologous bone, filling the whole of the osteopenic femoral neck and prevent the rotational forces. Since the total fixation is biologically active, the technique has proved advantageous even when stable / desirable reduction is not possible and adequate fixation is not achieved, because of posterior communition at the fracture site or due to osteoporosis. Being autologous bone, the twin-fibular graft is advantageous even when there is ′subsequent loss of reduction′ of the fracture. It is, therefore, suggested that this simple, inexpensive and biological technique has many advantages over the existing methods of fixation of these fractures.

  16. Factors affecting the aluminium content of human femoral head and neck.

    Science.gov (United States)

    Zioła-Frankowska, Anetta; Dąbrowski, Mikołaj; Kubaszewski, Łukasz; Rogala, Piotr; Frankowski, Marcin

    2015-11-01

    Tissues for the study were obtained intraoperatively during hip replacement procedures from 96 patients. In all the cases, the indication for this treatment was primary or secondary degenerative changes in the hip joint. The subject of the study was the head and neck of the femur, resected in situ. Aluminium concentrations measured in femoral head and neck samples from patients aged between 25 and 91 were varied. Statistical methods were applied to determine the variations in relation to the parameters from the background survey. Significant differences in the aluminium content of femoral head samples were observed between patients under and over 60 years of age. Based on the results, it was confirmed that the aluminium accumulates in bones over a lifetime. The study showed that the content of aluminium in the head and neck of the femur depends on the factors such as: type of medicines taken, contact with chemicals at work, differences in body anatomy and sex. The study on the levels of aluminium in bones and the factors affecting its concentration is a valuable source of information for further research on the role of aluminium in bone diseases. Based on the investigations, it was found that the GF-AAS technique is the best analytical tool for routine analysis of aluminium in complex matrix samples. The use of femoral heads in the investigations was approved by the Bioethics Committee of the University of Medical Sciences in Poznań (Poland).

  17. The effect of aspirin on blood loss and transfusion requirements in patients with femoral neck fractures.

    LENUS (Irish Health Repository)

    Manning, Brian J

    2012-02-03

    Although it is widely accepted that aspirin will increase the risk of intra- and post-operative bleeding, clinical studies have not consistently supported this assumption. We aimed to assess the effect of pre-operative aspirin on blood loss and transfusion requirements in patients undergoing emergency fixation of femoral neck fractures. A prospective case-control study was undertaken in patients presenting with femoral neck fractures. Parameters recorded included intra-operative blood loss, post-operative blood loss, transfusion requirements and peri-operative reduction in haemoglobin concentration. Of 89 patients presenting with femoral neck fractures 32 were on long-term aspirin therapy. Pre-operative aspirin ingestion did not significantly affect peri-operative blood loss, or change in haemoglobin concentration or haematocrit. However those patients taking aspirin pre-operatively had a significantly lower haemoglobin concentration and haematocrit and were more likely to be anaemic at presentation than those who were not receiving aspirin. Patients taking aspirin were also more likely to receive blood transfusion post-operatively.

  18. Hollow-Bone-Graft Dynamic Hip Screw Can Fix and Promote Bone Union after Femoral Neck Fracture: an Experimental Research

    Directory of Open Access Journals (Sweden)

    Jia-zuo SHEN, Jian-fei YAO, Da-sheng LIN, Ke-jian LIAN, Zhen-qi DING, Bin LIN, Zhi-min GUO, Ming-hua ZHANG, Qiang LI, Lin LI, Peng QI

    2012-01-01

    Full Text Available Background: Delayed bone union, nonunion or osteonecrosis often occur after femoral neck fractures in young adults. Secondary bone healing requires strong internal fixation, intramedullary pressure reduction and early functional exercise.Objective: To compare bone healing of femoral neck fractures treated with hollow-bone-graft dynamic hip screws (Hb-DHS and standard dynamic hip screws (DHS in an animal model.Design: Testing of specifically designed fixation devices in a pig animal model.Interventions/Methods: We designed Hb-DHS and DHS devices appropriate to the femoral neck and head of experimental animals and used them in eight pigs (4-month-old, male or female, 30-40 kg/each. Under anesthesia, we induced medium neck type, Garden III type femoral neck fractures in each pig with fracture gaps of 0.5 mm and then fixed each left femur with Hb-DHS and each right femur with DHS. We assessed the animals radiographically and by postmortem visual appraisal of evidence of bone healing 8 and 16 weeks postoperatively.Results: There were significant differences in radiographic and general findings between the Hb-DHS and DHS groups at weeks 8 and 16 postoperatively. We found statistically significant differences between the Hb-DHS and DHS groups in bone healing scores, trabecular bone volume percentage and bone mineral density as assessed on plain radiographs and computed tomography images (P < 0.05. There were also significant differences between the Hb-DHS and DHS groups in postmortem visually assessed indicators of bone healing at both 8 and 16 weeks postoperatively.Conclusions: The Hb-DHS device promotes femoral neck bone union, stimulates trabecular bone formation, increases BMD and has advantages over DHS for internal fixation of femoral neck fractures. This animal experiment will contribute to developing optimal treatment for femoral neck fractures in young adults.

  19. Collagen fiber orientation in the femoral necks of apes and humans: do their histological structures reflect differences in locomotor loading?

    Science.gov (United States)

    Kalmey, J K; Lovejoy, C O

    2002-08-01

    Human hip joint anatomy differs substantially from that in other primates. Humans modulate pelvic tilt during walking with a highly developed abductor apparatus, but other primates (such as chimpanzees) clearly lack such an apparatus (they exhibit a Trendelenburg gait during bipedal progression). Because the primate femoral neck is cantilevered whenever it supports body mass, it must be consistently subjected to substantial bending at the neck/shaft interface during stance phase in quadrupedal or bipedal locomotion. It has been argued, however, that the powerful abduction during the single support phase in humans results in almost entirely compressive stress on the human femoral neck. We examined collagen fiber orientation in human and chimpanzee femoral neck cortices using circularly polarized light, which has been shown to be a strong correlate of bone loading patterns. Chimpanzee superior femoral neck cortex was shown to be largely nonbirefringent (dark), but the inferior cortex was strongly birefringent. Human femoral necks showed strong birefringence both superiorly and inferiorly. These results are consistent with loading patterns suggested from anatomical structure, and provide corroborative evidence of bone's ability to preferentially orient collagen fibers during extracellular matrix deposition.

  20. A Novel Method for Estimation of Femoral Neck Bone Mineral Density Using Forearm Images from Peripheral Cone Beam Computed Tomography

    Directory of Open Access Journals (Sweden)

    Kwanmoon Jeong

    2016-04-01

    Full Text Available The main goal of osteoporosis treatment is prevention of osteoporosis-induced bone fracture. Dual-energy X-ray absorptiometry (DXA and quantitative computed tomographic imaging (QCT are widely used for assessment of bone mineral density (BMD. However, they have limitations in patients with special conditions. This study evaluated a method for diagnosis of osteoporosis using peripheral cone beam computed tomography (CBCT to estimate BMD. We investigated the correlation between the ratio of cortical and total bone areas of the forearm and femoral neck BMD. Based on the correlation, we established a linear transformation between the ratio and femoral neck BMD. We obtained forearm images using CBCT and femoral neck BMDs using dual-energy X-ray absorptiometry (DXA for 23 subjects. We first calculated the ratio of the cortical to the total bone area in the forearm from the CBCT images, and investigated the relationship with the femoral neck BMDs obtained from DXA. Based on this relationship, we further investigated the optimal forearm region to provide the highest correlation coefficient. We used the optimized forearm region to establish a linear transformation of the form to estimate femoral neck BMD from the calculated ratio. We observed the correlation factor of r = 0.857 (root mean square error = 0.056435 g/cm2; mean absolute percentage error = 4.5105% between femoral neck BMD and the ratio of the cortical and total bone areas. The strongest correlation was observed for the average ratios of the mid-shaft regions of the ulna and radius. Our results suggest that femoral neck BMD can be estimated from forearm CBCT images and may be useful for screening osteoporosis, with patients in a convenient sitting position. We believe that peripheral CBCT image-based BMD estimation may have significant preventative value for early osteoporosis treatment and management.

  1. Reliability of using DXA around RTHAs. Bone Mineral Density of the femoral neck in resurfacing hip arthroplasty

    DEFF Research Database (Denmark)

    Penny, Jeannette Østergaard; Ovesen, Ole; Brixen, Kim;

    2010-01-01

      Background and purpose: Resurfacing Total Hip Arthroplasty (RTHA) may preserve the femoral neck bone-stock post-operatively. Bone Mineral Density (BMD), could theoretically be affected by the hip-position, and bias longitudinal studies. We aimed to investigate BMD precision dependency on type...... of ROI and position of hip. Method: We DXA scanned the femoral neck of 15 resurfacing patients twice with the hip in 3 different rotations; 15° internal, neutral, and 15° external. For each position BMD was analyzed with 3 different surface area models. One model measured BMD in the total femoral neck......, the second model divided the neck in two and the third model had 6 divisions. Results: When all hip positions were pooled a mean Coefficient of variation (CV) of 3.1%, 3.6% and 4.6% was found in the 1, 2 and 6-region models, respectively, The external rotated hip position was less reproducible. When the hip...

  2. Bilateral Simultaneous Femoral Neck Fracture Mimicking Abdominal Pain in a Cerebral Palsy Patient

    Directory of Open Access Journals (Sweden)

    P. Mariani

    2014-01-01

    Full Text Available Simultaneous bilateral femoral neck fractures are unusual lesions, generally associated with an underlying condition which causes impaired bone mineralization, triggered by an increased bone stress. We present a 24-year-old cerebral palsy patient, who was previously evaluated in another institution due to inability to walk, interpreted as abdominal pain. No alteration in blood analysis or abdominal X-rays was found. As no response to treatment was observed, a new abdominal X-ray was taken, which incidentally depicted bilateral medial femoral neck fracture. He was referred to our practice after a resection arthroplasty was offered in another institution. After admission, bilateral one-stage THA was performed. Several reports emphasize bone disease as a major precipitating factor, and there is an increased incidence of hip fractures in chronic epilepsy, renal osteodystrophy, and chronic steroid use. Femoral head resection has been proven to be effective in immobilized patients, whereas this was not a reasonable option in this patient who presented walking ability. Despite the treatment election, primary care physicians should be aware of and alert to the possibility of fractures in patients with neurological disorders and calcium metabolism alterations. Late diagnosis of orthopedic injuries in this type of patients may lead to permanent disability.

  3. Bilateral stress fractures of femoral neck in non-athletes: a report of four cases

    Directory of Open Access Journals (Sweden)

    Naik Monappa A

    2013-04-01

    Full Text Available 【Abstract】Femoral neck stress fractures (FNSFs are rare, constituting only 5% of all stress fractures in young adults. These fractures are usually seen in athletes, military recruits and patients with underlying metabolic diseases. The treatment of FNSFs is still controversial because of the inherent complications associated with the treatment procedure. We came across 4 cases of bilateral FNSFs in non-athletic individuals who were manual labourers with-out underlying bony disorders. Two patients with FNSFs and coxa vara deformity on both sides were managed by subtrochanteric valgus osteotomy and dynamic hip screw fixation. One of the remaining two patients was treated by cannulated cancellous screw fixation on one side and sub-trochanteric valgus osteotomy on the other side. The fourth patient received subtrochanteric valgus osteotomy on one side and bipolar hemiarthroplasty on the other side after failed cannulated screw fixation. All the fractures healed without any complications. No evidence of avascular ne-crosis or arthritis was noted in our series. Subtrochanteric valgus osteotomy restores normal neck-shaft angle in pa-tients suffering from FNSFs combined with coxa vara deformity. Moreover, it helps to bring the forces acting around the hip to normal biomechanical levels, leading to fracture union and better results. Replacement arthroplasty is recommended to patients who fail to achieve bony union after fixation. Key words: Fractures, stress; Femoral neck fractures; Coxa vara; Osteotomy

  4. Bilateral synchronous parathyroids cancer and femoral neck fracture as the complications of tertiary hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    A F Romanchishen

    2013-12-01

    Full Text Available In the paper has presented the first in Russia observation of bilateral synchronous parathyroids cancer in patient with urolithiasis complicated by chronic pyelonephritis, renal insufficiency with tertiary hyperparathyroidism and femoral neck fracture. During observation of the patient in our hospital were found hyperparathyroid osteodystrophy, medial right femoral neck fracture, very high level of parathormone (1969,0 pg/ml, tumorous of right (16,0 × 17,0 mm and left (23,0 × 17,0 mm parathyroid glands located behind of inferior thyroid poles during ultrasound research. Surgical exploration has found bilateral whitish parathyroid tumorous with invasion to right recurrent laryngeal nerve. Were performed right hemithyroidectomy, left thyroid lobe resection and central neck dissections. Parathormone level has decreased to 3.5 times (up to 582 pg/ml. 20 minutes later after bilateral inferior parathyroidectomies. The regular hemodialysis was restore and six months later was successfully undertaken the hip prosthetics. Two year later after the surgery signs of parathyroid cancer relapses were no found.

  5. High Reliability of a Scoring System for Implant Position in Undisplaced Femoral Neck Fractures

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Bartholin, Marie-Louise L; Weber, Kolja;

    2016-01-01

    OBJECTIVES: The aim of this study was to evaluate the intra-rater and inter-rater reliability of a scoring system for internal fixation (SIFA) in undisplaced femoral neck fractures (FNF). DESIGN: A reproducibility study with a historical consecutive cohort. SETTING: The patients were all treated...... of the screw position in femoral head had the largest difference of acceptable positioning, when comparing visual assessment with the measured. CONCLUSIONS: The SIFA scoring system demonstrates substantial intra-rater and inter-rater reliability (kappa (0.51-0.78), when raters make measurements of radiographs......, but lower reliability (kappa 0.13-0.78) when raters visually assess the radiographs without measuring. The SIFA scoring system should be assessed on a large cohort for correlation with clinical evaluation....

  6. Canine spontaneous head and neck squamous cell carcinomas represent their human counterparts at the molecular level.

    Directory of Open Access Journals (Sweden)

    Deli Liu

    2015-06-01

    Full Text Available Spontaneous canine head and neck squamous cell carcinoma (HNSCC represents an excellent model of human HNSCC but is greatly understudied. To better understand and utilize this valuable resource, we performed a pilot study that represents its first genome-wide characterization by investigating 12 canine HNSCC cases, of which 9 are oral, via high density array comparative genomic hybridization and RNA-seq. The analyses reveal that these canine cancers recapitulate many molecular features of human HNSCC. These include analogous genomic copy number abnormality landscapes and sequence mutation patterns, recurrent alteration of known HNSCC genes and pathways (e.g., cell cycle, PI3K/AKT signaling, and comparably extensive heterogeneity. Amplification or overexpression of protein kinase genes, matrix metalloproteinase genes, and epithelial-mesenchymal transition genes TWIST1 and SNAI1 are also prominent in these canine tumors. This pilot study, along with a rapidly growing body of literature on canine cancer, reemphasizes the potential value of spontaneous canine cancers in HNSCC basic and translational research.

  7. Management of neglected femoral neck fracture in above knee amputated limb: A case report

    Institute of Scientific and Technical Information of China (English)

    Umesh Meena; Ramesh Meena; Balaji S; Sahil Gaba

    2015-01-01

    The treatment of an above knee amputee who has sustained a fracture of the femoral neck is a challenging situation for both the orthopedic surgeon and the rehabilitation team.These fractures may be managed acutely either by reduction and internal fixation or by endoprosthetic replacement based on the same criteria as in any other patient with otherwise intact limbs.We present a neglected case treated successfully with valgus osteotomy.We conclude that these fractures should be treated with the same urgency and expertise as similar fractures in non-amputees as long-term survival and good quality of life can be expected.

  8. Nonunion of the femoral neck: Possibilities and limitations of the various treatment modalities

    Directory of Open Access Journals (Sweden)

    Raaymakers Ernst

    2008-01-01

    Full Text Available Nowadays in cases of nonunions of the femoral neck, the surgeon is tempted to perform prosthetic replacement of the hip, more so if there is also evidence of avascular necrosis of the head of femur. This provides rapid pain relief and allows early mobilization. However, long-term results of hip arthroplasties, especially in younger people and in the presence of osteopenia, are not always as expected; and a less radical approach is worth considering. The intertrochanteric valgization osteotomy, described by Pauwels, is an excellent alternative for healthy patients up to 65 years of age with a nonunion of the femoral neck. A union rate of 80-90% of the nonunion is described by most authors. Leg length inequallity, rotational and angular deformities can be corrected at the same time. During the period 1973-1995, we performed valgization osteotomy according to Pauwels in 66 patients of, 18-72 years old (mean 49.5 years. 24 (37% of our patients died 4 months to 24 years (mean: 9.5 years after the operation. Union of the femoral neck was achieved in 58 (88% of the 66 patients; union of the osteotomy in 65 patients (99%. A good or excellent result was achieved in 62% (23 uneventful and 13 with healed, necrosis/arthrosis without need for further treatment of our patients. However, the method has its limits. We feel if there is too little bone stock inside the femoral head, a valgization osteotomy does not give good result. The radiographic signs of avascular necrosis in patients over 30 years of age is considered a contraindication for an osteotomy. However our results show that it is worthwhile trying to save the joint of young patients even in case of a segmental collapse. In the race between revascularization and collapse, often revascularization is the winner. We deliberately give nature its chance and don′t rely on the result of bleeding from drill holes in the head, nuclear scans and other methods to estimate vascularity. A secondary total hip

  9. Octogenarian with an untreated femoral neck fracture: upright position during the postoperative course after aortic valve replacement

    Directory of Open Access Journals (Sweden)

    M. Polastri

    2015-06-01

    Full Text Available We describe a patient with a femoral neck fracture undergoing an aortic valve replacement. The study design was a case report. An 82-year-old female with an untreated right femoral neck fracture, and a severe aortic valve stenosis was admitted to a cardiac surgery department for surgical treatment of the valve disease. She underwent aortic valve replacement with a sutureless biological valve prosthesis through a partial sternotomy. At an early stage, the patient was instructed to make postural changes in the standing position. As a result, she was able to perform body movements associated with either a sitting or standing position. This case shows that appropriate early mobilization of a patient with a femoral neck fracture is feasible after aortic valve replacement, even though this does not necessarily mean that the patient needs to walk.

  10. Simultaneous bilateral fractures of the femoral neck caused by high energy:A case report and literature review

    Institute of Scientific and Technical Information of China (English)

    You-Shui Gao; Zhen-Hong Zhu; Chang-Qing Zhang

    2015-01-01

    Simultaneous bilateral fractures of the femoral neck are rare injuries,which are reportedly induced by low-speed energy with predisposing factors including systemic diseases,medications and eclamptic seizures.Those caused by high energy are even rarer.High energy-induced bilateral fractures of the femoral neck conceive of high incidence of mortality and present great challenges in the early management.We report one case of a 52-year-old man with simultaneous bilateral fractures of the femoral neck which resulted from a motor pedestrian accident.One-stage closed reduction and internal fixation was done following the emergent resuscitation and neurosurgical management for concomitant brain injuries.The fractures united.There was no pain in the hips,and they had a normal range of motion.The treatment protocol,mechanism of the injury and possible postoperative complications were discussed to expand a comprehensive understanding about these infrequent types of fractures.

  11. Lumbar spine degenerative disease : effect on bone mineral density measurements in the lumbar spine and femoral neck

    Energy Technology Data Exchange (ETDEWEB)

    Juhng, Seon Kwan [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of); Koplyay, Peter; Jeffrey Carr, J.; Lenchik, Leon [Wake Forest Univ. School of Medicine, Winston-salem (United States)

    2001-04-01

    To determine the effect of degenerative disease of the lumbar spine on bone mineral density in the lumbar spine and femoral neck. We reviewed radiographs and dual energy x-ray absorptiometry scans of the lumbar spine and hip in 305 Caucasian women with suspected osteoporosis. One hundred and eight-six patient remained after excluding women less than 40 years of age (n=18) and those with hip osteoarthritis, scoliosis, lumbar spine fractures, lumbar spinal instrumentation, hip arthroplasty, metabolic bone disease other than osteoporosis, or medications known to influence bone metabolism (n=101). On the basis of lumbar spine radiographs, those with absent/mild degenerative disease were assigned to the control group and those with moderate/severe degenerative disease to the degenerative group. Spine radiographs were evaluated for degenerative disease by two radiologists working independently; discrepant evaluations were resolved by consensus. Lumbar spine and femoral neck bone mineral density was compared between the two groups. Forty-five (24%) of 186 women were assigned to the degenerative group and 141 (76%) to the control group. IN the degenerative group, mean bone mineral density measured 1.075g/cm? in the spine and 0.788g/cm{sup 2} in the femoral neck, while for controls the corresponding figures were 0.989g/cm{sup 2} and 0.765g/cm{sup 2}. Adjusted for age, weight and height by means of analysis of variance, degenerative disease of the lumbar spine was a significant predictor of increased bone mineral density in the spine (p=0.0001) and femoral neck (p=0.0287). Our results indicate a positive relationship between degenerative disease of the lumbar spine and bone mineral density in the lumbar spine and femoral neck, and suggest that degenerative disease in that region, which leads to an intrinsic increase in bone mineral density in the femoral neck, may be a good negative predictor of osteoporotic hip fractures.

  12. Subtrochanteric fracture: a rare but severe complication after screw fixation of femoral neck fractures in the elderly.

    Science.gov (United States)

    Jansen, Hendrik; Frey, Soenke P; Meffert, Rainer H

    2010-12-01

    Cannulated screw fixation is a minimal invasive technique to treat undisplaced femoral neck fractures. It is the preferred method in elderly patients who often suffer co-morbidities. There is scarce literature on subtrochanteric femoral fracture as a complication of cannulated screw fixation of a femoral neck fracture. This complication occurred, without an adequate trauma, in two of 35 patients (5.7%) in this retrospective study of patients older than 65 years (mean age: 77 years) who were treated with cannulated screws for an undisplaced femoral neck fracture between 2004 and 2009. We reviewed the literature for the incidence of this complication and possible predisposing factors. The overall incidence reported in literature is 2.4-4.4% (mean: 2.97%). Despite a broad use of this type of osteosynthesis, the literature does not provide clear biomechanical or clinical indications for optimal screw placement to avoid this complication. Considering the literature and our personal results, surgeons should be aware of this severe complication; they may opt for a different implant in the very old, osteoporotic patient with an undisplaced femoral neck fracture.

  13. Trochanter/calcar preserving reconstruction in tumors involving the femoral head and neck

    Science.gov (United States)

    Cho, Hwan Seong; Lee, Young-Kyun; Ha, Yong-Chan; Koo, Kyung-Hoi

    2016-01-01

    AIM: To evaluate the results of hip reconstruction with extensive excision for tumor confined to the femoral head and neck. METHODS: We designed a resection preserving the greater trochanter and lower portion of calcar femorale, and utilized conventional total hip prosthesis. We retrospectively reviewed 7 patients, who underwent a wide resection and reconstruction using conventional hip prosthesis. There were 3 men and 4 women and their mean age was 42.5 years (22 to 65 years). The histologic diagnosis of each patient was low-grade osteosarcoma, diffuse large B-cell lymphoma, liposclerosing myxofibroma, intraosseous lipoma, chondroblastoma, giant cell tumor and focal intramedullary fibrosis. RESULTS: One patient with lymphoma died due to disease dissemination at 10 mo postoperatively and the remaining 6 patients were followed for a mean of 4.7 years (3 to 6 years). All patients were able to return to their daily activities and no patient had local recurrence. No radiographic signs of loosening, wear, and osteolysis were found at the last follow-up. CONCLUSION: Trochanter/calcar-preserving resection of the proximal femur and reconstruction using conventional total hip prosthesis, is a satisfactory treatment for tumors confined to the femoral head and neck. PMID:27458555

  14. Herniation pits in the femoral neck: a radiographic indicator of femoroacetabular impingement?

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Ah; Park, Ji Seon; Ryu, Kyungnam [Kyung Hee University, Department of Radiology, Kyung Hee University Medical Center, Seoul (Korea, Republic of); Jin, Wook [Kyung Hee University, Department of Radiology, East-West Neo Medical Center, Seoul (Korea, Republic of)

    2011-02-15

    The purpose was to assess the significance of herniation pits in the femoral neck for radiographic diagnosis of femoroacetabular impingement (FAI). Eighty hips in 62 patients (bilateral in 18) with neutral pelvic orientation were enrolled. Herniation pits were diagnosed when they were located at the anterosuperior femoral neck, close to the physis, and with a diameter of >3 mm. The five radiographic signs of FAI were used: lateral center edge angle (LCE) >39 , acetabular index (AI) {<=}0, extrusion index (EI) <25%, acetabular retroversion, and pistol-grip deformity. Patients with radiographs suggesting FAI were retrospectively correlated with their clinical symptoms. Positive radiographic signs were observed in 7 hips with LCE, 7 with AI, and 80 with EI criteria. Only 3 hips out of 80 (3.8%) showed all of the signs. The acetabular retroversion and pistol-grip deformity were seen in 12/80 and 3/80 hips, respectively. The total number of hips that met radiographic criteria for FAI, including pincer type and cam type, was 18 (23%). However, none of these hips were clinically diagnosed with FAI. All symptomatic hips (11/80) presented only with nonspecific pain, and 2 hips out of 11 showed radiographic signs of FAI. The low frequency of positive radiographic signs suggesting FAI with related symptoms among patients with herniation pits suggests that herniation pits have limited significance in the diagnosis of FAI. Therefore it can be concluded that an incidental finding of herniation pits does not necessarily imply a correlation with FAI. (orig.)

  15. A mountain among molehills: removing an impinging large femoral neck osteochondroma in a man with hereditary multiple exostoses.

    LENUS (Irish Health Repository)

    Fitzgerald, Conall W R

    2014-01-01

    A 31-year-old man with a history of hereditary multiple exostoses (HME) presented with persistent right groin pain and reduced hip range of movement. Examination demonstrated a positive FADIR (flexion, adduction and internal rotation) test suggesting femoroacetabular impingement (FAI). Investigations showed multiple sessile osteochondromata of the right femur with a dominant anterolateral femoral neck osteochondroma causing flexion block. The patient underwent an uncomplicated proximal femoral exostectomy. Six-week postoperative pain, range of movement and daily activity had greatly improved. This case highlights that even in the setting of multiple osteochondromata, excellent impingement relief can be achieved following selective proximal femoral exostectomy.

  16. Prosthetic replacement in treatment of subcapital femoral neck fractures in the elderly

    Institute of Scientific and Technical Information of China (English)

    徐莘香; 刘一; 刘建国; 李印良

    2002-01-01

    Objective: To compare the results of femoral head replacement (FHR) and total hip replacement (THR) in treatment of subcapital femoral neck fractures (SFNF).   Methods: Between May 1987 and July 1998, 56 elderly patients (65-90 years; average 73.5 years) with SFNF were treated with prosthetic replacement. Six cases were treated with unipolar FHR, 18 cases with Bateman bipolar FHR, and 32 cases with Bateman bipolar THR. All domestic prostheses were installed with cement.   Results: There was no significant difference between the 2 groups in operating time and blood transfusion. Forty-nine patients were followed-up for an average of 5 years and 10 months. No wound infection or death was related to surgery. Complications in Group FHR were significantly higher than that in Group THR.   Conclusions: Since FHR is difficult to fit the bony acetabulum, it is only indicated for senile cases with poor conditions. However, the bipolar THR installed with cement is indicated for most elderly patients. Since the femoral head and acetabulum can fit each other completely, it is more stable for taking weight-bearing earlier with less complications.

  17. Alumina-on-alumina total hip replacement for femoral neck fracture in healthy patients

    Directory of Open Access Journals (Sweden)

    Moretti Lorenzo

    2011-02-01

    Full Text Available Abstract Background Total hip replacement is considered the best option for treatment of displaced intracapsular fractures of the femoral neck (FFN. The size of the femoral head is an important factor that influences the outcome of a total hip arthroplasty (THA: implants with a 28 mm femoral head are more prone to dislocate than implants with a 32 mm head. Obviously, a large head coupled to a polyethylene inlay can lead to more wear, osteolysis and failure of the implant. Ceramic induces less friction and minimal wear even with larger heads. Methods A total of 35 THAs were performed for displaced intracapsular FFN, using a 32 mm alumina-alumina coupling. Results At a mean follow-up of 80 months, 33 have been clinically and radiologically reviewed. None of the implants needed revision for any reason, none of the cups were considered to have failed, no dislocations nor breakage of the ceramic components were recorded. One anatomic cementless stem was radiologically loose. Conclusions On the basis of our experience, we suggest that ceramic-on-ceramic coupling offers minimal friction and wear even with large heads.

  18. Femoral Neck Anteversion and Neck Shaft Angles: Determination and their Clinical Implications in Fetuses of Different Gestational Ages

    Directory of Open Access Journals (Sweden)

    Souza AD

    2015-07-01

    Full Text Available Precise anatomical assessment of femoral neck anteversion (FNA and the neck shaft angles (NSA would be essential in diagnosing the pathological conditions involving hip joint and its ligaments. The present study was undertaken on 48 fetal femurs to calculate the NSA and FNA in fetuses digitally. End on images of upper end of the femurs were taken for the estimation of FNA and a photograph in a perpendicular plane was taken to calculate the NSA. Microsoft Paint software was used to mark the points and Image J software was used to calculate the angles digitally. The FNA ranged from 17.08º to 33.97 º on right and 17.32 º to 45.08 º on left. The NSA ranged from 139.33 º to 124.91 º on right and 143.98 º to 123.8 º on left. Unpaired t test showed the FNA and NSA of femur did not vary significantly during the third trimester.

  19. 股骨干骨折合并同侧股骨颈或股骨髁上骨折漏诊的诊治%Analysis of misdiagnoses for femoral shaft fracture with ipsilateral femoral neck or femoral fractures

    Institute of Scientific and Technical Information of China (English)

    李守民; 朱晨; 孔荣; 夏睿; 方诗元; 张光平

    2010-01-01

    Objective To analyze the misdiagnoses of femoral shaft fracture combined with ipsilateral femoral neck or femoral fractures.Methods Over the past six years,eight misdiagnosed cases of ipsilateral femoral neck or femoral fractures missed patients,aged 25 to 59 years old(mean:41.7),were treated at our department.An initial diagnosis of femoral shaft fracture was later revised as ipsilateral femoral shaft with supra-condylar fracture of femoral neck or femur.Femoral shaft fracture was fixed with armor plate,3-screw hollow compression fixation of femoral neck;two cases of femoral condylar fractures of distal femoral condyle with anatomical plate fixation and 1 case of intraoperative change into the retrograde femoral intramedullary nail fixation.Results The mean post-operative follow-up was 3.5 years.All fractures healed with excellent hip and knee functions.Conclusion For those with a strong reverse and torsional violence,femoral shaft fracture combined with ipsilateral femoral neck or femoral fractures may be easily misdiagnosed.A preoperative conventional hip-knee X-ray film is an effective way to avoid a misdiagnosis.%目的 对股骨干骨折合并同侧股骨颈或股骨髁上骨折漏诊的治疗进行分析.方法 2002年12月至2008年12月安徽医科大学附属省立医院骨科收治8例股骨干合并同侧股骨颈或股骨髁上骨折漏诊患者,年龄25~59岁,平均41.7岁,初步诊断为股骨干骨折,后修正为股骨干合并同侧股骨颈或股骨髁上骨折.股骨干骨折行钢板内固定.股骨颈骨折行3枚空心加压螺丝钉内固定;股骨髁上骨折2例行股骨远端外髁解剖钢板的内固定,1例术中更改行逆行股骨交锁髓内钉内固定.结果 术后平均随访3.5年,骨折均愈合,髋膝关节功能良好.结论 凡强大暴力及有扭转暴力者股骨干合并同侧股骨颈或股骨髁上骨折易漏诊,术前常规髋膝摄片是避免漏诊的有效方法.

  20. Internal fixation and muscle pedicle bone grafting in femoral neck fractures

    Directory of Open Access Journals (Sweden)

    Gupta A

    2008-01-01

    Full Text Available Background: The treatment of displaced intracapsular femoral neck fracture is still an unsolved problem. Non-union and avascular necrosis are the two main complications of this fracture, especially if patient presents late. Muscle pedicle bone grafting has been advocated to provide additional blood supply. We present analysis of our 32 cases of displaced femoral neck fracture treated by internal fixation and quadratus femoris based muscle pedicle bone grafting. Materials and Methods: Open reduction and internal fixation with muscle pedicle grafting was done in 32 patients. The age of patients varied from 14-62 years (average age 45 years with male to female ratio of 13:3. Twenty-nine fractures were more than three weeks old. All the cases were treated by Meyers′ procedure. The fracture was internally fixed after open reduction and then a muscle pedicle graft was applied. It was supplemented by cancellous bone graft in seven cases. Fixation was done by parallel cancellous lag screws ( n = 19, crossed Garden′s screws ( n = 7, parallel Asnis screws ( n = 5 and Moore′s pin ( n = 1.Quadratus femoris muscle pedicle graft was used in 32 cases. In the initial 12 cases the graft was fixed with circumferential proline sutures, but later, to provide a secure fixation, the graft was fixed with a cancellous screw ( n = 20. Postoperative full weight bearing was deferred to an average of 10 weeks. Results: Union was achieved in 26/29 (89.65% cases which could be followed for an average period of 3.4 years, (2-8.5 years with good functional results and had the ability to squat and sit cross-legged. Results were based on hip rating system given by Salvatti and Wilson. The results were excellent in 15 cases, good in four cases, fair in four cases and poor in six cases. Complications were avascular necrosis ( n = 2, transient foot drop ( n = 2, coxa-vara ( n = 1 and temporary loss of scrotal sensation ( n = 1. Conclusion: Muscle pedicle bone grafting with

  1. Is cemented bipolar hemiarthroplasty a safe treatment for femoral neck fracture in elderly patients?

    Directory of Open Access Journals (Sweden)

    Yurdakul E

    2015-06-01

    Full Text Available Emre Yurdakul,1 Fatih Karaaslan,2 Murat Korkmaz,2 Fuat Duygulu,3 Ali Baktir41Department of Orthopedics and Traumatology, Osmaniye State Hospital, 2Department of Orthopedics and Traumatology, Faculty of Medicine, Bozok University, Yozgat, 3Department of Orthopedics and Traumatology, Kayseri Training Hospital, 4Department of Orthopedics and Traumatology, Modern Dünyam Hospital, Kayseri, TurkeyObjectives: Controversy exists regarding the use of cement in hemiarthroplasty when treating a displaced femoral neck fracture in elderly patients. The primary hypothesis of this study was that the use of cement would afford better visual analog pain and activity scores in elderly patients.Methods: This study included 133 patients over 65 years of age admitted to our clinics from 2006 to 2012 for the surgical treatment of a displaced femoral neck fracture. All patients were treated via hemiarthroplasty. The patients (66 males, 67 females; mean age: 78.16 years; range: 60–110 years were followed-up regularly. All patients were divided into one of two groups: group A was treated with cement; and group B without. Both groups were compared in terms of preoperative features (demographics and associated diseases, pre- and postoperative complications, mortality rates, pain and activity levels, and hip scores. Hospitalization time, average surgical duration, and time from fracture to operation were also recorded. Mean follow-up duration was 30.9 (range: 5–51 months.Results: We found no significant between-groups differences in terms of length of hospital stay, Harris Hip Score, complications, or follow-up mortality rates. Walking ability and pain scores were better in the cemented group in the early follow-up period. Duration of surgery and perioperative mortality rates were somewhat lower in the cementless group, but the difference was not statistically significant.Conclusion: The use of cement during hip hemiarthroplasty in patients over 65 years of age had

  2. Assessment of interobserver variation in Garden classification and management of fresh intracapsular femoral neck fracture in adults

    Institute of Scientific and Technical Information of China (English)

    Amit Aggarwal; Mahipal Singh; Aditya N Aggarwal; Shuchi Bhatt

    2014-01-01

    Objective:To assess the interobserver agreement on Garden classification of fresh femoral neck fracture and management plan based on anteroposterior (AP) view and also assess if the addition of lateral view changes the classification and management plan.Methods:Ten orthopaedic surgeons were asked to classify 35 femoral neck fractures on AP view only and propose the management plan.Then the same films were reshown in conjunction with their lateral view after 10 days.Results were compared with respect to the classification and management plan between two groups.Interobserver agreement was calculated using Fleiss' kappa.Results:There was only a fair interobserver agreement (kappa value 0.39) on Garden classification on AP view only which improved to moderate agreement (kappa value 0.52) after adding a lateral view.While there was only a slight improvement in the interobserver agreement on the management plan on AP view only (kappa value 0.50) and AP combined with lateral views (kappa value 0.52).Supplementation of the lateral view changed the classification in 15.42% of the cases and altered the management plan in 23.14% of the cases.Conclusion:We conclude that lateral view should be obtained routinely on all patients with suspected femoral neck fracture as it definitely has a role in planning treatment of femoral neck fracture.

  3. The variation of cancellous bones at lumbar vertebra, femoral neck, mandibular angle and rib in ovariectomized sheep.

    Science.gov (United States)

    Zhang, Yongqiang; Li, Yongfeng; Gao, Qi; Shao, Bo; Xiao, Jianrui; Zhou, Hong; Niu, Qiang; Shen, Mingming; Liu, Baolin; Hu, Kaijin; Kong, Liang

    2014-07-01

    This study aimed to compare the variation of cancellous bones at four skeletal sites: lumbar vertebra, femoral neck, mandibular angle and rib in ovariectomized sheep. Sixteen adult sheep were randomly divided into two groups: eight sheep were ovariectomized served as experimental group; the other eight untreated sheep were served as control group. Bone mineral density was assessed by dual-energy X-ray absorptiometry on lumbar vertebrae at baseline and twelve months after ovariectomy. After 12 months, lumbar vertebrae L3 and L4, femoral necks, mandibular angles and the fourth ribs were harvested for micro-CT scanning, histological analysis and biomechanical test. The results showed that bone mineral density of lumbar vertebra decreased significantly in twelfth month (pCT showed that the bone volume/total volume decreased by 45.6%, 36.1% 21.3% and 18.7% in lumbar vertebrae, femoral necks, mandibular angles and ribs in experimental group (psheep was site-specific on a pattern as follows: lumbar vertebra, femoral neck, mandibular angle and rib.

  4. Effectiveness of Selected Fitness Exercises on Stress of Femoral Neck using Musculoskeletal Dynamics Simulations and Finite Element Model.

    Science.gov (United States)

    Qian, Jing-Guang; Li, Zhaoxia; Zhang, Hong; Bian, Rong; Zhang, Songning

    2014-06-28

    The purpose of the study was to establish a dynamics model and a three-dimensional (3D) finite element model to analyze loading characteristics of femoral neck during walking, squat, single-leg standing, and forward and lateral lunges. One male volunteer performed three trials of the five movements. The 3D kinematic data were captured and imported into the LifeMOD to establish a musculoskeletal dynamics model to obtain joint reaction and muscle forces of iliacus, gluteus medius, gluteus maximus, psoas major and adductor magnus. The loading data LfeMOD were imported and transformed into a hip finite-element model. The results of the finite element femur model showed that stress was localized along the compression arc and the tension arc. In addition, the trabecular bone and tension lines of the Ward's triangle also demonstrated high stress. The compact bone received the greatest peak stress in the forward lunge and the least stress in the squat. However, the spongy bone in the femoral neck region had the greatest stress during the walk and the least stress in the squat. The results from this study indicate that the forward lunge may be an effective method to prevent femoral neck fractures. Walking is another effective and simple method that may improve bone mass of the Ward's triangle and prevent osteoporosis and femoral neck fracture.

  5. Large diameter metal on metal total hip replacement for femoral neck fractures with neurological conditions A retrospective assessment

    Directory of Open Access Journals (Sweden)

    Jia Li

    2014-01-01

    Conclusion: We believe the use of L-MoM can diminish the rate of instability or dislocation, after operation. The L-MoM is an option for patients with Parkinson′s disease and poliomyelitis with femoral neck fracture.

  6. Treatment of femoral neck fracture with muscle-bone flap of both tensor fasciae latae and sartorius

    Institute of Scientific and Technical Information of China (English)

    刘国平; 康斌; 曾晖; 唐嫄科; 唐新宇; 熊奡; 解笑宸; 黄伟

    2003-01-01

    Objective: To evaluate the effect of muscular pedicle bone grafts with sartorius or tensor fasciae latae and sartorius in fresh transcervical or subcapital fractures of the femoral neck. Methods: Thirty cases of fresh transcervical and subcapital fractures of the femoral neck were treated by the tail breakable screws and sartorius pedicle bone grafts (single muscular pedicle, SMP group). The other 23 cases were treated by cannulated pressure screws and bone grafts with the muscular pedicles of both sartorius and tensor fasciae latae (double muscular pedicles, DMP group). Results: Fifty-two cases were followed up for 3 to 5 years (mean, 4 years). In SMP group, ten cases showed poor therapeutic results. Excellent therapeutic effects were achieved in all cases of DMP group. Conclusions: The transcervical or subcapital fractures of the femoral neck can be treated by double muscular pedicles bone graft. The bone graft with double muscular pedicles is more effective than single sartorius muscular pedicles for fresh transcervical and subcapital fractures of the femoral neck during short and medium terms.

  7. Effectiveness of Selected Fitness Exercises on Stress of Femoral Neck using Musculoskeletal Dynamics Simulations and Finite Element Model

    Directory of Open Access Journals (Sweden)

    Qian Jing-Guang

    2014-07-01

    Full Text Available The purpose of the study was to establish a dynamics model and a three-dimensional (3D finite element model to analyze loading characteristics of femoral neck during walking, squat, single-leg standing, and forward and lateral lunges. One male volunteer performed three trials of the five movements. The 3D kinematic data were captured and imported into the LifeMOD to establish a musculoskeletal dynamics model to obtain joint reaction and muscle forces of iliacus, gluteus medius, gluteus maximus, psoas major and adductor magnus. The loading data LfeMOD were imported and transformed into a hip finite-element model. The results of the finite element femur model showed that stress was localized along the compression arc and the tension arc. In addition, the trabecular bone and tension lines of the Ward's triangle also demonstrated high stress. The compact bone received the greatest peak stress in the forward lunge and the least stress in the squat. However, the spongy bone in the femoral neck region had the greatest stress during the walk and the least stress in the squat. The results from this study indicate that the forward lunge may be an effective method to prevent femoral neck fractures. Walking is another effective and simple method that may improve bone mass of the Ward's triangle and prevent osteoporosis and femoral neck fracture.

  8. Analysis of prosthetic replacement in treatment of femoral neck fracture on the hemiplegia side in the elderly

    Institute of Scientific and Technical Information of China (English)

    冯明利; 沈惠良; 胡怀健; 雍宜民; 曹立; 王玮

    2004-01-01

    Objective: To study the effect of prosthetic replacement in treatment of femoral neck fractures on the hemiplegia side in the elderly.Methods: From May 1990 to May 2000, 189 elderly patients with femoral neck fractures were treated with prosthetic replacement in my hospital. Twenty-nine hemiplegia patients, who suffered from stroke previously,had Garden type Ⅲ and type Ⅳ femoral neck fractures on the hemiplegia side. Thirty non-hemiplegia patients were chosen randomly. The two groups were followed-up for 27-98 months (average: 59 months). The age, hospitalization days, operating time, blood loss, blood transfusion,complications during perioperative period and long-term complications were compared between the two groups and the results of femoral head replacement and total hip replacement in the hemiplegia group were also compared.Results: All the patients of the two groups survived the perioperative period. No significant difference was found in the age, hospitalization days, operation time,blood loss and blood transfusion and long-term complications between the two groups ( P > 0.05 ). However there was significant difference in complications during perioperative period between the two groups ( P < 0.05 ).Five patients died in the hemiplegia group with the mortality of 17.2% and two died in the non-hemiplegia group with the mortality of 6.7 % 11 months to 5 years after operation. There was significant difference in long-term complications between the femoral head replacement and the total hip replacement in the hemiplegia group (P <0.05). The result of the total hip replacement was better than that of the femoral head replacement.Conclusions: Prosthetic replacement is a reliable method in treatment of Garden type Ⅲ and type Ⅳfemoral neck fractures on the hemiplegia side in the elderly,and patients are safe during perioperative period. More complications during perioperative period occur in the hemiplegia group, and long-term complications are

  9. A canine model of osteonecrosis of the femoral head induced by MRI guided argon helium cryotherapy system

    Science.gov (United States)

    Wang, Dong; Sun, Lixin; Zhang, Huawu; Jiang, Honglei; Liu, Ming; Tian, Jing; Hu, Na; Sun, Shui

    2015-01-01

    Objective: This study is to identify the reliability of osteonecrosis of the femoral head (ONFH) modeling established by MRI guided argon helium cryotherapy system in beagles. Methods: A total of 15 beagles were used to establish the ONFH model. The left femoral heads of the beagles received two cycles of argon helium freezing-thawing under MRI guidance and were considered as experimental group while the right femoral heads received only one cycle of argon helium freezing-thawing and were considered as the control group. X-ray, MRI, general shape and histological examinations were performed so as to identify the effect of modeling. Results: At 4 week after modeling, MRI showed obvious bilateral hip joint effusion and marked femoral head bone marrow high signal. At 8 week after surgery, abnormal signal appeared in bilateral femoral heads. T1WI showed irregular patchy low signal, T2WI showed irregular mixed signals and the joint capsule effusion showed long T1 and T2 changes. Twelve weeks after operation, T1WI showed a low signal strip with clear boundary and T2WI showed intermediate signal. The changes of the left femoral heads were significant while compared with those of the right sides. The lacunae rates of femoral heads in the experimental group at 4, 8, and 12 week after surgery (40.75 ± 3.77, 57.46 ± 4.01, 50.27 ± 2.98) were higher than those in control group (30.08 ± 3.61, 49.43 ± 2.82, 40.56 ± 2.73). Conclusion: Canine model of ONFH was successfully established using an argon helium cryotherapy system. PMID:26550205

  10. Humeral cortical thickness in female Bantu - its relationship to the incidence of femoral neck fracture

    Energy Technology Data Exchange (ETDEWEB)

    Bloom, R.A.; Pogrund, H.

    1982-03-01

    Measurements of the humeral cortical thickness demonstrate that generalised osteoporosis in female Bantu commences in the fifth decade and gradually increases until, in the ninth decade, all subjects are osteoporotic. The combined cortical thickness (CCT) of the humerus in young adults is very similar to that found previously in a white London population and the loss of cortex with age is very similar. It is concluded that the known low incidence of femoral neck fracture in Bantu is not due to a lower incidence of generalised osteoporosis but to environmental factors. The chief environmental factor postulated is the greater amount of physical work performed by the Bantu. A more careful mode of walking is suggested as a subsidiary cause.

  11. Melatonin improves bone mineral density at the femoral neck in postmenopausal women with osteopenia

    DEFF Research Database (Denmark)

    Amstrup, Anne Kristine; Sikjaer, Tanja; Heickendorff, Lene

    2015-01-01

    Melatonin is known for its regulation of circadian rhythm. Recently, studies have shown that melatonin may have a positive effect on the skeleton. By increasing age, the melatonin levels decrease, which may lead to a further imbalanced bone remodeling. We aimed to investigate whether treatment...... with melatonin could improve bone mass and integrity in humans. In a double-blind RCT, we randomized 81 postmenopausal osteopenic women to 1-yr nightly treatment with melatonin 1 mg (N = 20), 3 mg (N = 20), or placebo (N = 41). At baseline and after 1-yr treatment, we measured bone mineral density (BMD) by dual...... X-ray absorptiometry, quantitative computed tomography (QCT), and high-resolution peripheral QCT (HR-pQCT) and determined calciotropic hormones and bone markers. Mean age of the study subjects was 63 (range 56-73) yr. Compared to placebo, femoral neck BMD increased by 1.4% in response to melatonin...

  12. Midterm results of a femoral stem with a modular neck design: clinical outcomes and metal ion analysis.

    Science.gov (United States)

    Silverton, Craig D; Jacobs, Joshua J; Devitt, Jeffrey W; Cooper, H John

    2014-09-01

    Modular neck femoral stems have a higher-than-anticipated rate of failure in registry results, but large single-center cohort studies are lacking. This is a retrospective cohort of 152 hips implanted with a single titanium stem with a modular titanium neck, presenting clinical, radiographic, and metal ion results at a mean 4.5-year follow-up. Five hips were revised during the study period, for an overall Kaplan-Meier survival of 0.894 at 8 years. There was one modular neck fracture (0.66%), but others demonstrated corrosion or adverse tissue reaction. Serum metal levels demonstrated wide variability. Despite good clinical results in the majority of patients, we confirmed an increased rate of femoral revision at mid-term follow-up, and therefore urge caution in the use of this particular stem design.

  13. Bilateral stress fractures of femoral neck in non-athletes:a report of four cases

    Institute of Scientific and Technical Information of China (English)

    Monappa A Naik; Premjit Sujir; Sujit Kumar Tripathy; Sandeep Vijayan; Shamsi Hameed; Sharath K Rao

    2013-01-01

    Femoral neck stress fractures (FNSFs) are rare,constituting only 5% of all stress fractures in young adults.These fractures are usually seen in athletes,military recruits and patients with underlying metabolic diseases.The treatment of FNSFs is still controversial because of the inherent complications associated with the treatment procedure.We came across 4 cases of bilateral FNSFs in non-athletic individuals who were manual labourers without underlying bony disorders.Two patients with FNSFs and coxa vara deformity on both sides were managed by subtrochanteric valgus osteotomy and dynamic hip screw fixation.One of the remaining two patients was treated by cannulated cancellous screw fixation on one side and subtrochanteric valgus osteotomy on the other side.The fourth patient received subtrochanteric valgus osteotomy on one side and bipolar hemiarthroplasty on the other side after failed cannulated screw fixation.All the fractures healed without any complications.No evidence of avascular necrosis or arthritis was noted in our series.Subtrochanteric valgus osteotomy restores normal neck-shaft angle in patients suffering from FNSFs combined with coxa vara deformity.Moreover,it helps to bring the forces acting around the hip to normal biomechanical levels,leading to fracture union and better results.Replacement arthroplasty is recommended to patients who fail to achieve bony union after fixation.

  14. Bilateral stress fractures of femoral neck in non-athletes: a report of four cases.

    Science.gov (United States)

    Naik, Monappa-A; Sujir, Premjit; Tripathy, Sujit-Kumar; Vijayan, Sandeep; Hameed, Shamsi; Rao, Sharath-K

    2013-01-01

    Femoral neck stress fractures (FNSFs) are rare, constituting only 5% of all stress fractures in young adults. These fractures are usually seen in athletes, military recruits and patients with underlying metabolic diseases. The treatment of FNSFs is still controversial because of the inherent complications associated with the treatment procedure. We came across 4 cases of bilateral FNSFs in non-athletic individuals who were manual labourers without underlying bony disorders. Two patients with FNSFs and coxa vara deformity on both sides were managed by subtrochanteric valgus osteotomy and dynamic hip screw fixation. One of the remaining two patients was treated by cannulated cancellous screw fixation on one side and subtrochanteric valgus osteotomy on the other side. The fourth patient received subtrochanteric valgus osteotomy on one side and bipolar hemiarthroplasty on the other side after failed cannulated screw fixation. All the fractures healed without any complications. No evidence of avascular necrosis or arthritis was noted in our series. Subtrochanteric valgus osteotomy restores normal neck-shaft angle in patients suffering from FNSFs combined with coxa vara deformity. Moreover, it helps to bring the forces acting around the hip to normal biomechanical levels, leading to fracture union and better results. Replacement arthroplasty is recommended to patients who fail to achieve bony union after fixation.

  15. Radiographic bone texture analysis is correlated with 3D microarchitecture in the femoral head, and improves the estimation of the femoral neck fracture risk when combined with bone mineral density

    Energy Technology Data Exchange (ETDEWEB)

    Ollivier, Matthieu [Aix-Marseille Université, CNRS, ISM UMR 7287, 13284 Marseille (France); APHM, Hôpital Sainte Marguerite, Orthopedic Surgery Department, 13009 Marseille (France); Le Corroller, Thomas, E-mail: Thomas.LeCorroller@ap-hm.fr [Aix-Marseille Université, CNRS, ISM UMR 7287, 13284 Marseille (France); APHM, Hôpital Sainte Marguerite, Radiology Department, 13009 Marseille (France); Blanc, Guillaume [APHM, Hôpital Sainte Marguerite, Orthopedic Surgery Department, 13009 Marseille (France); Parratte, Sébastien [Aix-Marseille Université, CNRS, ISM UMR 7287, 13284 Marseille (France); APHM, Hôpital Sainte Marguerite, Orthopedic Surgery Department, 13009 Marseille (France); Champsaur, Pierre [Aix-Marseille Université, CNRS, ISM UMR 7287, 13284 Marseille (France); APHM, Hôpital Sainte Marguerite, Radiology Department, 13009 Marseille (France); Chabrand, Patrick [Aix-Marseille Université, CNRS, ISM UMR 7287, 13284 Marseille (France); Argenson, Jean-Noël [Aix-Marseille Université, CNRS, ISM UMR 7287, 13284 Marseille (France); APHM, Hôpital Sainte Marguerite, Orthopedic Surgery Department, 13009 Marseille (France)

    2013-09-15

    Purpose: Femoral neck fracture is a major public health problem in elderly persons, representing the main source of osteoporosis-related mortality and morbidity. In this study, we aimed at comparing radiographic texture analysis with three-dimensional (3D) microarchitecture in human femurs, and at evaluating whether bone texture analysis improved the assessment of the femoral neck fracture risk other than that obtainable by bone mineral density (BMD). Materials and methods: Thirteen osteoporotic femoral heads from patients who fractured their femoral neck and twelve non-fractured femoral heads from osteoarthritic patients were studied using respectively (1) a new high-resolution digital X-ray device (BMA™, D3A Medical Systems) allowing for bone texture analysis with fractal parameter Hmean, and (2) a micro-computed tomograph (CT) for 3D microarchitecture. BMD was measured postoperatively by DXA in all patients in the contralateral femur. Results: In these femoral heads, we found that fractal parameter Hmean was correlated with 3D microarchitecture parameters: bone volume fraction (BV/TV), trabecular number (Tb.N), trabecular separation (Tb.Sp) and fractal dimension (FD) respectively (p < 0.05). Then, fractal parameter Hmean was significantly lower in the femoral heads from the fractured group than from the non-fractured group (p < 0.01). Finally, multiple regression analysis showed that combining bone texture analysis and total hip BMD significantly improved the estimation of the femoral neck fracture risk from adjusted r{sup 2} = 0.46 to adjusted r{sup 2} = 0.67 (p < 0.05). Conclusion: Radiographic bone texture analysis was correlated with 3D microarchitecture parameters in the femoral head, provided accurate discrimination between the femoral heads from the fractured and non-fractured groups, and significantly improved the estimation of the femoral neck fracture risk when combined with BMD.

  16. Cephalomedullary fixation for femoral neck/intertrochanteric and ipsilateral shaft fractures: surgical tips and pitfalls

    Institute of Scientific and Technical Information of China (English)

    Kamal Bali; Nitesh Gahlot; Sameer Aggarwal; Vijay Goni

    2013-01-01

    Objective:Surgical management options for femoral shaft fracture and ipsilateral proximal femur fracture vary from single-implant to double-implant fixation.Cephalomedullary fixation in such fractures has relative advantages over other techniques especially because of less soft tissue dissection and immediate postoperative weight beating with accelerated rehabilitation.However,the surgery is technically demanding and there is a paucity of literature describing the surgical techniques for this fixation.The aim of the study was to describe the surgical technique of cephalomedullary fixation for femoral shaft fracture and ipsilateral proximal femur fracture.Methods:Sixteen cases (10 males and 6 females with a mean age of 41.8 years) ofipsilateral proximal femur and shaft fractures were treated by single-stage cephalomedullary fixation at tertiary level trauma center in northern India.The fractures were classified according to AO classification.An intraoperative record of duration of surgery as well as technical challenges unique to each fracture pattern was kept for all the patients.ResuRs:The most common proximal femoral pattern was AO B2.1 observed in 9 of our patients.The AO B2.3 fractures were seen in 4 patients while the AO A1.2 fractures in 3 patients.Four of the AO B2.1 and 2 of the AO B2.3 fractures required open reduction with Watson-Jones approach.The mean operative time was around 78 minutes,which tended to decrease as the surgical experience increased.There was only one case of malreduction,which required revision surgery.Conclusion:Combination of ipsilateral femoral shaft fracture and neck/intertrochanteric fracture is a difficult fracture pattern for trauma surgeons.Cephalomedullary nail is an excellent implant for such fractures but it requires careful insertion to avoid complications.Surgery is technically demanding with a definite learning curve.Nevertheless,a majority of these fractures can be surgically managed by singleimplant cephaiomedullary

  17. Effect of dynamic hip system blade on the treatment of femoral neck fractures in elderly patients with osteoporosis

    Institute of Scientific and Technical Information of China (English)

    Zhao Wenbo; Liu Lei

    2014-01-01

    Objective:To discuss the curative effect of the dynamic hip system blade (DHS-blade) on the treatment of femoral neck fractures in elderly patients with osteoporosis.Methods:A retrospective study was conducted to analyse the clinical data of 60 elderly patients with osteoporosis who had been treated for femoral neck fractures with DHS-blade in our department between September 2012 and February 2014.There were 22 males and 38 females with a mean age of (66.8±3.2) years.According to the Singh Index Classification,all the patients' Singh index was below level 3.The Harris criterion and function recovery after operation were analysed.Results:All patients were followed up for 12-17 months (mean 14 months).No femoral head necrosis,femoral neck shortening,internal fixation loosening or backing out of the nails occurred.Bone nonunion was found in one case and he had a good recovery after total hip arthroplasty.The time for fracture healing ranged from 3-6 months (average 3.5 months).According to Harris criterion,35 cases were rated as excellent,22 good,2 fair and 1 poor.The Harris scale was significantly improved from 28.46±2.35 preoperatively to 91.98±3.26 at 6 months postoperatively (P<0.05).Conclusion:DHS-blade,being minimally invasive,allowing earlier postoperative exercise and avoiding the complications elicited by traditional internal fixation,is advisable for treatment of femoral neck fractured patients with osteoporosis.

  18. Corrosion at the head-neck interface of current designs of modular femoral components: essential questions and answers relating to corrosion in modular head-neck junctions.

    Science.gov (United States)

    Osman, K; Panagiotidou, A P; Khan, M; Blunn, G; Haddad, F S

    2016-05-01

    There is increasing global awareness of adverse reactions to metal debris and elevated serum metal ion concentrations following the use of second generation metal-on-metal total hip arthroplasties. The high incidence of these complications can be largely attributed to corrosion at the head-neck interface. Severe corrosion of the taper is identified most commonly in association with larger diameter femoral heads. However, there is emerging evidence of varying levels of corrosion observed in retrieved components with smaller diameter femoral heads. This same mechanism of galvanic and mechanically-assisted crevice corrosion has been observed in metal-on-polyethylene and ceramic components, suggesting an inherent biomechanical problem with current designs of the head-neck interface. We provide a review of the fundamental questions and answers clinicians and researchers must understand regarding corrosion of the taper, and its relevance to current orthopaedic practice. Cite this article: Bone Joint J 2016;98-B:579-84.

  19. Dislocation and spontaneous reduction of the femoral implant against the femoral neck in an infected metal on metal hip resurfacing with complex collection

    Energy Technology Data Exchange (ETDEWEB)

    Tins, Bernhard, E-mail: Bernhard.Tins@rjah.nhs.uk [Department of Radiology, RJAH Orthopaedic Hospital, Oswestry, Shropshire, SY 107 AG (United Kingdom)

    2011-07-15

    Metal on metal resurfacing hip implants are known to have complications unique to this type of implant. The case presented adds a further previously not described complication, the dislocation and spontaneous reduction of the pin of the femoral component against the femoral neck. The radiographic and CT findings are demonstrated. The dislocation was aided by bone loss due to an infection with a large periarticular collection. Periarticular collections in hip resurfacings are often due to a hypersensitivity type reaction to metal debris. However in the case presented it was due to infection. MRI was not able to discern the infection from a sterile collection. CT demonstrated bone loss and periosteal reaction suggestive of infection. In addition calcification of the pseudocapsule was seen, this is not a recognized feature of sterile collections.

  20. The correlation between preoperative levels of albumin and tlc and mortality in patients with femoral neck fracture.

    Science.gov (United States)

    Niccolai, F; Parchi, P D; Vigorito, A; Pasqualetti, G; Monzani, F; Lisanti, M

    2016-01-01

    A femoral neck fracture in an elderly patient often represents a major challenge for the orthopaedic surgeon who has to face not only the fracture, but also all the multiple issues related to age. Among others, malnutrition has been recognised as an important factor associated with severe aggravation in these patients. One-hundred-and-forty-seven patients were enrolled to investigate the use of two markers of patient nutritional status, i.e. serum albumin level and total leukocyte count (TLC), as predictors of mortality in the elderly patient suffering from proximal femur fracture. We found that low preoperative values of serum albumin and TLC proved to be directly related to worse outcomes. Therefore, these exams can be useful to identify patients with a femoral neck fracture that have higher risk of malnutrition and consequent higher mortality and that can benefit from some measures, such as albumin or protein nutritional supplement.

  1. The recent prevalence of Osteoporosis and low bone mass in the United States based on bone mineral density at the Femoral Neck or Lumbar Spine

    Science.gov (United States)

    The goal of our study was to estimate the prevalence of osteoporosis and low bone mass based on bone mineral density (BMD) at the femoral neck and the lumbar spine in adults 50 years and older in the United States (US). We applied prevalence estimates of osteoporosis or low bone mass at the femoral ...

  2. Combined with Bone Marrow-Derived Cells and rhBMP-2 for Osteonecrosis after Femoral Neck Fractures in Children and Adolescents: A case series

    Science.gov (United States)

    Gao, Fuqiang; Sun, Wei; Guo, Wanshou; Wang, Bailiang; Cheng, Liming; Li, Zirong

    2016-01-01

    Osteonecrosis of the femoral head (ONFH) following femoral neck fractures is a rare, yet severe, disorder in children and adolescents. This study evaluated the effectiveness of core decompression (CD) combined with implantation of bone marrow–derived cells (BMDC) and rhBMP-2 for osteonecrosis of femoral head (ONFH) after femoral neck fractures in children and adolescents. This study included 51 patients, aged 11.4–18.1 years, with ARCO stages I–III ONFH after femoral neck fractures between 2004 and 2010. The hips were divided into two groups based on whether the lateral pillar of the femoral head (LPFH) was preserved: LPFH and non-LPFH groups. All patients were followed up clinically and radiographically for a minimum of 5 years. 44 patients (86.3%) had improved clinical outcome. Radiologically, 9 of the 51 hips (17.6%) exhibited collapse onset or progression of the femoral head or narrowing of the hip joint space, and one patient in the non-LPFH group required hip arthroplasty due to the worsened syndrome. The technique provided an effective therapeutic option for children and adolescents with ONFH following femoral neck fractures. It relieves hip pain and prevents the progression of osteonecrosis in young patients lasting more than 5 years after surgery. PMID:27477836

  3. Effect of semisynthetic extracellular matrix-like hydrogel containing hepatocyte growth factor on repair of femoral neck defect in rabbits.

    Science.gov (United States)

    Liu, Pengfei; Guo, Lin; Huang, Lanfeng; Zhao, Dewei; Zhen, Ruixin; Hu, Xiaoning; Yuan, Xiaolin

    2015-01-01

    Using tissue engineering technology research to develop organized artificial bone, then repair bone defect. This work aims to investigate the role of semisynthetic extracellular matrix-like hydrogel (sECMH) containing hepatocyte growth factor (HGF) on repair of femoral neck defect in rabbits. 18 New Zealand rabbits were used in this study. According to autologous paired comparison method, the left and right sides of rabbit were used as control and experimental side, respectively. The models of bilateral femoral neck bone defect were established. In experimental side, sECMH containing HGF was implanted in the defect area. In control side, no material was implanted in the defect area. At the 2nd, 4th and 8th week after surgery, the gross observation, histological examination and molybdenum target (Mo-target) X-ray examination were performed on the specimens to study the repair of femoral neck defect. In gross observation, there was no macroscopic difference of femoral neck specimen between the 2nd and 4th postoperative week. At the 8th week, the defect orifice was closed with immature cortical bone, with unblocked marrow cavity. HE staining results showed that, at the 4th week, there were more new vessels in defect area of experimental side, compared with control side. At the 8th week, in experimental side there was immature cortical bone connecting the fracture end in defect area, with visible bone marrow cells. Mo-target X-ray examination found that, at the 8th week, the bone tissue repair in experimental side was better than control side. As a new drug delivery system, sECMH containing HGF has good application prospect in bone tissue repair.

  4. Bilateral Pseudarthrosis of the Femoral Neck in a 25-Year-Old Male with Hereditary Hypophosphatemic Rickets

    Directory of Open Access Journals (Sweden)

    Joris Anthonissen

    2014-01-01

    Full Text Available Hereditary hypophosphatemic rickets (HHR is a rare disorder of renal phosphate wasting and the most common form of heritable rickets. Here, we report a case of an active 25-year-old male with HHR showing atraumatic bilateral femoral neck pseudarthrosis after 4 years of consecutive knee pain. A conservative therapy was administered, taking into account both the risks of surgical treatment and the little impairment even in the sport activities which the patient experienced.

  5. The quality of life after a femoral neck fracture in elderly patients: a comparative study between internal fixation and arthroplasties

    Directory of Open Access Journals (Sweden)

    Dennis Sansanovicz

    2017-01-01

    Full Text Available Introduction: The femoral neck fracture is a frequent pathology in the elderly population, with about of 100,000 cases per year in Brazil. The surgical treatment by internal fixation or arthroplastic hip replacement is advocated today. The non-surgical treatment is reserved for cases of exception. Objective: To compare the quality of patient postoperative life treated for femoral neck fracture by two different techniques: hip arthroplasty and internal fixation. Methods: Through the SF-36 questionnaire, we study the quality of life of 60 patients with more than 65 years, treated between 2004 and 2012 in our service. Half of the patients was submitted to internal fixation and the other half to the arthroplastic replacement. Results: Higher averages in the large majority of the parameters of the questionnaire were obtained by the group which was carried out by internal fixation, but without statistical significance in most of these differences. Some international reports indicate that patients who have suffered a fracture of the femoral neck and were treated with internal fixation may recover the quality of life they had before the fracture. Paradoxically, there is a growing trend among orthopedic surgeons to perform a hip replacement surgery in these cases. Conclusion: Further studies are needed to define which is the best surgical treatment option.

  6. Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck offset.

    Science.gov (United States)

    Ito, K; Minka, M A; Leunig, M; Werlen, S; Ganz, R

    2001-03-01

    We have observed damage to the labrum as a result of repetitive acetabular impingement in non-dysplastic hips, in which the femoral neck appears to abut against the acetabular labrum and a non-spherical femoral head to press against the labrum and adjacent cartilage. In both mechanisms anatomical variations of the proximal femur may be a factor. We have measured the orientation of the femoral neck and the offset of the head at various circumferential positions, using MRI data from volunteers with no osteoarthritic changes on standard radiographs. Compared with the control subjects, paired for gender and age, patients showed a significant reduction in mean femoral anteversion and mean head-neck offset on the anterior aspect of the neck. This was consistent with the site of symptomatic impingement in flexion and internal rotation, and with lesions of the adjacent rim. Furthermore, when stratified for gender and age, and compared with the control group, the mean femoral head-neck offset was significantly reduced in the lateral-to-anterior aspect of the neck for young men, and in the anterolateral-to-anterior aspect of the neck for older women. For patients suspected of having impingement of the rim, anatomical variations in the proximal femur should be considered as a possible cause.

  7. Biomechanics Significance of Femoral Head and Neck of Grafting-bone Group After Femoral Neck Fracture-healing%股骨颈骨折愈合后钉道植骨的生物力学意义

    Institute of Scientific and Technical Information of China (English)

    唐洪涛; 仝允辉; 杨茹萍; 朱太永; 张美超; 赵卫东

    2011-01-01

    Objective To study biomechanical performance of fracture-healing femoral head and neck after the hollow compressionb screws are taken out in ungrafting-bone group, grafting-bone group, normal group, and provide theoretical basis for the treatment of necrosis of the femoral head by bone grafting in the channel of screws. Methods Nine femurs fixed and preserved by formalin were used in this test. They were randomly divided into three groups: normal group, ungrafting-bone group, grafting-bone group. According to inversed-triangle, at the range of physiological load, it tested the defixed bias-value of three group femoral head at different load. The data were collected and analyzed. The three-dimension finite element model of the femoral head and neck was calculated. Nodal solution of stress value and max-offset was calculated at area of femoral head and neck, then the data were compared and analyzed.Results Compared with the mean of load-offset about the femoral head and neck, biomechanical capability of ungrafting-bone group was lowest with regard to other two groups , the influence was very hard, P <0.05. But there was no singnificant difference between normal group and graflng-bone group, P >0.05. Analysis of the three-dimension finite element model showed that the massive stress was concentrated at weight loading region of ungrafting-bone group's femoral head, it was an dangerous chance to lead to femoral head collapse. Conclusion For the treatment of femur neck fractures with cannulated compression screws, bone grafting in the channel of screw should be used to improve biomechanical integrity after fracture healed and cannulated compression screws are taken out. This is of benefit to loading in early stage and to preventing the collapse of femoral head, etc.%目的 探讨股骨颈骨折愈合后取出空心加压螺钉遗留钉道不植骨、植骨及正常的股骨头颈部的生物力学特性,为临床提供实验依据.方法 收集9付股骨标本测量

  8. [Bilateral quadriceps tendon rupture and coexistent femoral neck fracture in a patient with chronic renal failure].

    Science.gov (United States)

    Kazimoğlu, Cemal; Yağdi, Serhan; Karapinar, Hasan; Sener, Muhittin

    2007-01-01

    Simultaneous bilateral quadriceps tendon rupture is a very rare injury mostly seen in patients with chronic renal failure or other systemic chronic diseases. Metabolic acidosis in chronic renal failure predisposes these patients to tendon degeneration. A 37-year-old woman who received hemodialysis for chronic renal failure for two years presented with complaints of severe pain in the left hip and inability to walk. She had a history of two consecutive falls in the past two months. On physical examination, there were joint spaces in both suprapatellar areas, active extension of both knees was inhibited, and movements of the left hip were quite painful. Knee ultrasonography and magnetic resonance imaging showed bilateral quadriceps tendon rupture from patellar attachment. At surgery, full-thickness quadriceps tendon tears were repaired with Tycron transpatellar suture anchors. Internal fixation was not considered for hip fracture due to the presence of chronic renal failure, so hemiarthroplasty with bipolar endoprosthesis was performed in the same session for femoral neck fracture. Six months after the operation, the patient was able to walk without support and almost regained her normal knee functions.

  9. Dual-energy X-ray absorptiometric densitometry in osteoarthritis of the hip. Influence of secondary bone remodeling of the femoral neck

    Energy Technology Data Exchange (ETDEWEB)

    Preidler, K.W. [Dept. of Radiology, Veterans Administration Medical Center and Univ. of California, San Diego, CA (United States); White, L.S. [Dept. of Radiology, Veterans Administration Medical Center and Univ. of California, San Diego, CA (United States); Tashkin, J. [Dept. of Radiology, Veterans Administration Medical Center and Univ. of California, San Diego, CA (United States); McDaniel, C.O. [Dept. of Radiology, Veterans Administration Medical Center and Univ. of California, San Diego, CA (United States); Brossmann, J. [Dept. of Radiology, Veterans Administration Medical Center and Univ. of California, San Diego, CA (United States); Andresen, R. [Dept. of Radiology, Veterans Administration Medical Center and Univ. of California, San Diego, CA (United States); Sartoris, D. [Dept. of Radiology, Veterans Administration Medical Center and Univ. of California, San Diego, CA (United States)

    1997-07-01

    Purpose: The aim of this study was to evaluate the influence of buttressing on bone densitometry measurements in the femoral neck, in Ward`s triangle, and in the greater trochanter. In addition, we attempted to establish the length of the femoral axis (FAL) and the true length of the femoral neck (FNL) as potential correlates with osteoarthritis (OA) or with buttressing. Material and Methods: Our study comprised 101 hips in 68 adult patients. Conventional radiographs of the hip joints were obtained in order to assess the presence and extent of OA by means of the 6-step grading system introduced in 1990 by CROFT et al., and in order to measure the cortical thickness at the medial aspect of the femoral neck. In addition, FAL and FNL were measured. All patients underwent dual energy X-ray absorptiometry so that bone density could be assessed in the femoral neck, in Ward`s triangle, and in the greater trochanter. The Spearman rank correlation was used to compare the measurements. Results: Statistical analysis showed a significant positive correlation between cortical thickness and bone density in the femoral neck and in Ward`s triangle. No correlation was found between cortical thickness and bone density in the greater trochanter, nor between cortical thickness and OA, FNL, and FAL, nor between OA and bone density, FNL, and FAL. (orig.).

  10. Comparison in bone turnover markers during early healing of femoral neck fracture and trochanteric fracture in elderly patients

    Directory of Open Access Journals (Sweden)

    Shota Ikegami

    2009-10-01

    Full Text Available Healing of fractures is different for each bone and bone turnover markers may reflect the fracture healing process. The purpose of this study was to determine the characteristic changes in bone turnover markers during the fracture healing process. The subjects were consecutive patients with femoral neck or trochanteric fracture who underwent surgery and achieved bone union. There were a total of 39 patients, including 33 women and 6 men. There were 18 patients (16 women and 2 men with femoral neck fracture and 21 patients (17 women and 4 men with trochanteric fracture. Serum bone-specific alkaline phosphatase (BAP was measured as a bone formation marker. Urine and serum levels of N-terminal telopeptide of type I collagen (NTX, as well as urine levels of C-terminal telopeptide of type I collagen (CTX and deoxypyridinoline (DPD, were measured as markers of bone resorption. All bone turnover markers showed similar changes in patients with either type of fracture, but significantly higher levels of both bone formation and resorption markers were observed in trochanteric fracture patients than in neck fracture patients. BAP showed similar levels at one week after surgery and then increased. Bone resorption markers were increased after surgery in patients with either fracture. The markers reached their peak values at three weeks (BAP and urinary NTX, five weeks (serum NTX and DPD, and 2-3 weeks (CTX after surgery. The increase in bone turnover markers after hip fracture surgery and the subsequent decrease may reflect increased bone formation and remodeling during the healing process. Both fractures had a similar bone turnover marker profile, but the extent of the changes differed between femoral neck and trochanteric fractures.

  11. Efficacy Evaluation for the Treatment of Subcapital Femoral Neck Fracture in Young Adults by Capsulotomy Reduction and Closed Reduction

    Institute of Scientific and Technical Information of China (English)

    Cong Liu; Meng-Ting Liu; Peng Li; Hong-Hai Xu

    2015-01-01

    Background:Subcapital femoral neck fracture in young adults has many complications,and the incidence is increasing year-by-year.The selection of the proper operation method to avoid them is an ambiguous matter.This study aimed to evaluate the treatment effect of subcapital femoral neck fracture by the capsulotomy and internal fixation with iliac bone grafting or closed reduction and intemal fixation in young adults.Methods:From March 2003 to February 2010,65 young patients with subcapital femoral neck fractures were treated,including 39 males and 26 females with average age of 34.5 years (range,19-50 years); 29 cases of the left side and 36 cases of the right side.They were randomly divided into Group A with 34 cases treated by closed reduction and internal fixation and Group B with 31 cases treated by the capsulotomy and internal fixation with iliac bone grafting.The two groups had no significant differences in sex,age,body mass index and preoperative Harris Hip Score.The observation criteria involved the length of the incision,blood loss,operation time,nonunion rate,avascular necrosis of the femoral head (ANFH) rate and Harris Hip Score.Results:Four of 65 patients were lost follow-up,and the follow-up rate was 93.8%,the average follow-up time was 38.7 months (range,33-47 months).In Group A,the incision length was 5.1 ± 2.2 cm,blood loss was 84.0 ± 13.2 ml,and operation time was 52.9 ± 10.2 min.In Group B,the incision length was 15.4 ± 4.6 cm,blood loss was 396.0 ± 21.3 ml,and operation time was 1 16.5 ± 15.3 min.Nonunion occurred in 8 patients (25.2%) in Group A and 1 patient (3.3%) in Group B.ANFH occurred in 9 patients (29.1%) in Group A and 2 patients (6.7%) in Group B.Postoperative Harris Hip Score was 89.0 ± 5.6 in Group A and 95.0 ± 4.5 in Group B.The above index of two groups was considered statistically significant (P < 0.05).Conclusions:Capsulotomy and internal fixation with iliac bone grafting can improve fracture healing,reduce ANFH

  12. 股骨干骨折合并同侧股骨颈骨折的外科治疗分析%Analysis of the surgical treatment on Femoral fracture merge ipsilateral with femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    赵钦福; 李云; 汪琪; 朱兰高; 王文

    2013-01-01

    Objective To explore clinical characteristics,misdiagnos reasons,clinical curative effect of the femoral fracture with lateral femoral neck fracture. Methods 22 cases of ipsilateral femoral with lateral femoral neck fracture treatment, 6 patients w ith hollow nail and AO plate fixed, 5 cases of DHS device fixed, 11 cases of femoral reconstruction nail fixed. Results femoral fracture healing time 6-16 months, femoral neck fracture healing 12~24 months. 3 cases of femoral fractures of lower section steel plate fracture delayed healing; 15 cases femoral neck fracture primary healing ,7 patients ischemic necrosis of femoral head ,according to Friedman evaluation criteria good in 15 cases, seven patients (misdiagnosis 5 cases).Conclusion femoral fracture with femoral neck fracture patients should be taken acetabulum X ray film,early diagnosis,early surgical treatment.%  目的探讨股骨干骨折合并同侧股骨颈骨折的临床特点、漏诊原因、临床疗效。方法22例同侧股骨干合并股骨颈骨折患者中6例采用空心钉加 AO 钢板固定,5例采用动力髋螺钉(DHS)装置固定,11例采用股骨重建钉固定。结果股骨干骨折愈合时间为6个月~16个月,股骨颈骨折愈合时间为12个月~24个月;有3例股骨干中下段骨折钢板断裂延迟愈合;股骨颈骨折Ⅰ期愈合15例,股骨头缺血坏死7例,按 Friedman评定标准优良15例,差7例(漏诊5例)。结论股骨干骨折患者应摄髋臼 X 线片,早期确诊,早期行手术治疗。

  13. Study of proximal femoral locking compression plate in extra capsular fracture neck of femur

    Directory of Open Access Journals (Sweden)

    Ravi G.O.

    2015-12-01

    Results: In our study of 21 cases, cases 13 cases were intertrochanteric fracture and remaining 8 were subtrochanteric fracture with the mean age was 51.47 years. Minimum age was 19 years and maximum age was 85 years. 14 patients (67% were males and 7 patients (33% were females, 13 IX patients (62% had right-sided fracture and 8 patients (38% had left-sided fracture. with right side being more common side affected. The average duration of stay in the hospital was 25.31 days. The average follow up was 18 months [11 to 23 months]. Out of 21 patients in our study 16 patients (76% are able to sit cross-legged and can squat on ground without any problem. The functional results were graded according to Harris Hip Scoring, In our study, 10 patients (48%had excellent results, 8 patients (38%had good results, 2 patients (10%had poor result, and 1 failed case (5% as she is an elderly female of 85 years with limited activity both preoperatively due to physiological age and general weakness. Conclusions: In conclusion the potentiality of the Proximal Femoral Locking Compression Plate (PF-LCP in varied indications, shows its versatility. Although not free of complications our study has demonstrated excellent results. The procedure offers, faster mobilization, rapid return to activities of daily living, improves the quality of life and gave a long term solution in patients with extracapsular fracture neck of femur. Larger studies with longer follow up will further validate the procedure. [Int J Res Med Sci 2015; 3(12.000: 3726-3733

  14. Evaluation of the health-related quality of life in elderly patients according to the type of hip fracture: femoral neck or trochanteric

    Directory of Open Access Journals (Sweden)

    Tânia Maria da Silva Mendonça

    2008-01-01

    Full Text Available OBJECTIVE: To evaluate the effect the type of hip fracture (femoral neck or trochanteric has on the Health-Related Quality of Life of elderly subjects. METHODS: Forty-five patients with hip fractures (mean 74.30 ± 7.12 years, 24 with a femoral neck fracture and 21 with a trochanteric fracture, completed the 36-item Short Form Health Survey (SF-36 at baseline and four months after fracture. The Health-Related Quality of Life scores were compared according to fracture type, undisplaced and displaced femoral neck fractures, and stable and unstable trochanteric fractures. RESULTS: Compared to baseline, all patients scored lower in the physical functioning, role limitation-physical, bodily pain and vitality categories four months after the fracture had occurred. The SF-36 scores for all the scales did not differ significantly between patients with femoral neck versus trochanteric fractures, or between patients with displaced versus undisplaced femoral neck fractures and stable versus unstable trochanteric fractures. CONCLUSIONS: The mental and physical quality of life of elderly patients with a hip fracture is severely impaired one month after fracture, with partial recovery by the end of the fourth month. The negative impact on the Health-Related Quality of Life did not differ significantly according to fracture type.

  15. Herniation pits and cystic-appearing lesions at the anterior femoral neck: an anatomical study by MSCT and {mu}CT

    Energy Technology Data Exchange (ETDEWEB)

    Panzer, Stephanie; Esch, Ulrich [Trauma Center Murnau, Department of Radiology, Murnau (Germany); Abdulazim, Ahmed Nabil; Augat, Peter [Paracelsus University Salzburg and Trauma Center Murnau, Biomechanics Laboratory, Murnau (Germany)

    2010-07-15

    To determine distinguishing features between herniation pits (HPs) and other cystic-appearing lesions at the anterior femoral neck in multi-slice computed tomography (MSCT) and micro-computed tomography (microCT) examinations. Institutional review board approval was obtained to examine 37 proximal femora of 23 cadaveric specimens (mean age available in 19 cadavers, 83 years; range 68-100 years; 9 female, 8 male, 6 unknown). All 37 femora were investigated by MSCT. 23 femora, which revealed cystic-appearing lesions at the anterior femoral neck in MSCT examinations, were additionally examined by microCT. Cystic-appearing lesions were categorized by their location, sclerotic margin, demarcation and shape in MSCT with assessment of inter-observer agreement. Detailed cortical and trabecular properties were evaluated in microCT examinations. There were seven HPs in three femora. There were a number of abnormalities potentially imitating HPs, including focal osteoporosis (13 in 13 femora), degenerative changes (5 in 4 femora) and trabecular restructuring (5 in 4 femora) at the anterior femoral neck. HPs were differentiated on the basis of their subchondral/subcortical location, completely surrounding sclerosis, clear demarcation and round-to-oval shape in MSCT. Because of their location and their microscopic appearance, HPs seem to resemble intra-osseous ganglia at the anterior femoral neck. HPs have to be differentiated from other cystic appearing lesions at the anterior femoral neck to avoid overestimation of their incidence in the context of diagnosis of femoroacetabular impingement. (orig.)

  16. Lower reoperation rate for cemented hemiarthroplasty than for uncemented hemiarthroplasty and internal fixation following femoral neck fracture

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Overgaard, Søren; Lauritsen, Jens;

    2013-01-01

    treated with either internal fixation (IF), cemented HA, or uncemented HA (with or without hydroxyapatite coating), after 12-19 years of follow-up. Methods 4 hospitals with clearly defined guidelines for the treatment of 75+ year-old patients with a displaced femoral neck fracture were included. Cohort 1...... an uncemented hydroxyapatite-coated Furlong HA. Data were retrieved from patient files, from the region-based patient administrative system, and from the National Registry of Patients at the end of 2010. We performed survival analysis with adjustment for comorbidity, age, and sex. Results Cemented HA had...

  17. Hepatocyte growth factor gene transfer effects on the femoral and intramuscular nerve in a canine model of lower limb ischemia

    Institute of Scientific and Technical Information of China (English)

    Xiaoqin Ha; Bin Liu; Zhen Qian; Tongde Lü; Ling Hui; Guanxian He; Qiang Yin; Tingxian Niu

    2008-01-01

    BACKGROUND: Recent advancements in gene therapy have provided new methodology for treating ischemia in lower extremities. Gene transfer of angiogenic factors to ischemic tissues may promote local proliferation of new vessels and form collateral circulation. OBJECTIVE: To observe histopathological changes in the femoral and intramuscular nerve three months after intramuscular injection of hepatocyte growth factor (HGF) into the peripheral skeletal muscle in a canine model of lower limb ischemia. DESIGN: Randomized occlusion modelled and verification animal study. SETTING: Experimental Center, Lanzhou General Hospital of Lanzhou Military Area Command of Chinese PLA. MATERIALS: This study was performed at Animal Experimental Center, Lanzhou General Hospital of Lanzhou Military Area Command of Chinese PLA from September to November 2006. A total of eight male mongrel dogs, weighing 12-15 kg and 1.5-3 years of age, were selected for this study. This experimental study was in accordance with local ethics standards. Recombinant plasmid carrying HGF (pUDKH) and occlusion model plasmid (pUDK) were provided by the Third Laboratory of Radiation Medical Institute, Academy of Military Medical Sciences of PLA. METHODS: Grouping and model establishment: under anesthesia, complete vascular occlusion models were established on the left lower extremities. The experimental dogs were randomly divided into a model group and a pUDKH treatment group, with four dogs in each group. Dogs in the pUDKH group were injected with 0.15 mg/kg pUDKH. Ten minutes later, intramuscular injections were performed at three spots into the peripheral skeletal muscle of the left hind limb, as well as lateral injections at two spots. The injection volume at each spot was 0.2 mL. Dogs in the model group were injected with pUDK, and dosage and injection method were identical to the treatment group.MAIN OUTCOME MEASURES: Histopathological changes in the femoral nerve, as well as internal and external

  18. The Modified Femoral Neck-Shaft Angle: Age- and Sex-Dependent Reference Values and Reliability Analysis.

    Science.gov (United States)

    Boese, Christoph Kolja; Frink, Michael; Jostmeier, Janine; Haneder, Stefan; Dargel, Jens; Eysel, Peer; Lechler, Philipp

    2016-01-01

    Background. The femoral neck-shaft angle (NSA) is of high importance for the diagnostics and treatment of various conditions of the hip. However, rotational effects limit its precision and applicability using plain radiographs. This study introduces a novel method to measure the femoral NSA: the modified NSA (mNSA), possibly being less susceptible against rotational effects compared to the conventional NSA. Patients and Methods. The method of measurement is described and its applicability was tested in 400 pelvis computed tomography scans (800 hips). Age- and gender-dependent reference values are given and intra- and interrater reliability are analyzed. Results. The mean age of all 400 patients (800 hips) was 54.32 years (18-100, SD 22.05 years). The mean mNSA was 147.0° and the 95% confidence interval was 146.7°-147.4°. Differences of the mNSA between sexes, age groups, and sides were nonsignificant. The absolute difference between NSA and mNSA was 16.3° (range 3-31°; SD 4.4°); the correlation was high (0.738; p < 0.001). Overall, the intra- and interrater reliability were excellent for the mNSA. Interpretation. We introduced a novel concept for the analysis of the neck-shaft angle. The high reliability of the measurement has been proven and its robustness to hip rotation was demonstrated.

  19. Dual photon absorptiometry in patients with Paget disease (bone mineral contents of lumbar spine and femoral neck)

    Energy Technology Data Exchange (ETDEWEB)

    Talbot, J.N.; Piketty, C.; Kiffel, T.; Coutris, G.; Milhaud, G.

    1988-01-01

    The bone mineral contents (BMC) of the lumbar spine (84 cases) and of one femoral neck (53 cases) were measured by dual photon absorptiometry (DPA) in patients suffering from Paget's disease of bone. The BMC of the patients and of 53 controls were compared, taking into account the occurrence of a scintigraphic hyperfixation, in each patient. A hyperfixation of the technetium labelled diphosphonate in the lumbar spine, more frequent in males, was associated with an elevated mean BMC value. The difference versus controls was significant in men but not in women. A hyperfixation of the femoral neck was associated with an elevated mean BMC value in both sexes. BMC values greater than the mean BMC of controls + 2 SD were observed in 83 per cent of these male patients and 50 per cent of the females. In contrast, BMC values lower than in controls were observed in non-pagetic areas. DPA allows the quantification of these abnormalities which cannot be evidenced by bone scintigraphy even if alkaline phosphatases levels are assayed.

  20. Effect of morselized bones on binding of the canine hydroxyapatite-coated femoral stem

    Institute of Scientific and Technical Information of China (English)

    SONG Ke-guan; MA De-sheng; HOU Jian-wen; WANG Huan; YAN Jing-long; YU Zhan-ge; LIANG Zhi-zhong

    2010-01-01

    Background Non-cement femoral stems are recognized in clinical use, but there are still some problems. The aim of this research was to make non-cement femoral stems to be press-fit with the medullary cavity. Methods Twenty-four healthy adult mongrel dogs were randomly divided into experimental and control groups. In the right hip joint, an artificial femoral bone replacement surgery was conducted. For the experimental group, the replacement surgery of hydroxyapatite (HA)-coated femoral stems was done, while autogeneous morselized bone was implanted into the medullary cavity. For the control group, morselized bone was not implanted. At postoperative 1, 3, 6 months, a test for interfacial shear characteristics was conducted in the MTS810 Tester. The comparison between the two groups' bone-prostheses in shear strength for their interface from shearing destruction was made. A histological observation to check prosthesis-bone interface contact ratios and bone growth was carried out. Results For the experimental group, shear strength was 0.317 MPa in 1 month, 1.447 MPa in 3 months, and 1.621 MPa in 6 months. For the control group, shear strength was 0.195 MPa in 1 month, 1.023 MPa in 3 months, and 1.483 MPa in 6 months. The difference was statistically significant. Stereomicroscope-based observation showed that the number of trabecular bones in the experimental group was larger than that of the control group, and bone growth of the former group was better than that of the latter group. Inverted microscopic observation showed that the binding degree between the prosthesis and trabecular bone of the experimental group was higher than that of the control group. Comparatively, the experimental group's trabecular bone had more stromal cells. Conclusions The morselized bones can effectively improve the biological bonding strength and bone-contact ratios in the short term for the HA-coated femoral stem and accelerate the bonding process. The use of morselized autogenous bones

  1. Multiple Small Diameter Drillings Increase Femoral Neck Stability Compared with Single Large Diameter Femoral Head Core Decompression Technique for Avascular Necrosis of the Femoral Head.

    Science.gov (United States)

    Brown, Philip J; Mannava, Sandeep; Seyler, Thorsten M; Plate, Johannes F; Van Sikes, Charles; Stitzel, Joel D; Lang, Jason E

    2016-10-26

    Femoral head core decompression is an efficacious joint-preserving procedure for treatment of early stage avascular necrosis. However, postoperative fractures have been described which may be related to the decompression technique used. Femoral head decompressions were performed on 12 matched human cadaveric femora comparing large 8mm single bore versus multiple 3mm small drilling techniques. Ultimate failure strength of the femora was tested using a servo-hydraulic material testing system. Ultimate load to failure was compared between the different decompression techniques using two paired ANCOVA linear regression models. Prior to biomechanical testing and after the intervention, volumetric bone mineral density was determined using quantitative computed tomography to account for variation between cadaveric samples and to assess the amount of bone disruption by the core decompression. Core decompression, using the small diameter bore and multiple drilling technique, withstood significantly greater load prior to failure compared with the single large bore technique after adjustment for bone mineral density (pcore decompression techniques. When considering core decompression for the treatment of early stage avascular necrosis, the multiple small bore technique removed less bone volume, thereby potentially leading to higher load to failure.

  2. Changes in bone mineral density of the acetabulum, femoral neck and femoral shaft, after hip resurfacing and total hip replacement: two-year results from a randomised study.

    Science.gov (United States)

    Penny, J O; Brixen, K; Varmarken, J E; Ovesen, O; Overgaard, S

    2012-08-01

    It is accepted that resurfacing hip replacement preserves the bone mineral density (BMD) of the femur better than total hip replacement (THR). However, no studies have investigated any possible difference on the acetabular side. Between April 2007 and March 2009, 39 patients were randomised into two groups to receive either a resurfacing or a THR and were followed for two years. One patient's resurfacing subsequently failed, leaving 19 patients in each group. Resurfaced replacements maintained proximal femoral BMD and, compared with THR, had an increased bone mineral density in Gruen zones 2, 3, 6, and particularly zone 7, with a gain of 7.5% (95% confidence interval (CI) 2.6 to 12.5) compared with a loss of 14.6% (95% CI 7.6 to 21.6). Resurfacing replacements maintained the BMD of the medial femoral neck and increased that in the lateral zones between 12.8% (95% CI 4.3 to 21.4) and 25.9% (95% CI 7.1 to 44.6). On the acetabular side, BMD was similar in every zone at each point in time. The mean BMD of all acetabular regions in the resurfaced group was reduced to 96.2% (95% CI 93.7 to 98.6) and for the total hip replacement group to 97.6% (95% CI 93.7 to 101.5) (p = 0.4863). A mean total loss of 3.7% (95% CI 1.0 to 6.5) and 4.9% (95% CI 0.8 to 9.0) of BMD was found above the acetabular component in W1 and 10.2% (95% CI 0.9 to 19.4) and 9.1% (95% CI 3.8 to 14.4) medial to the implant in W2 for resurfaced replacements and THRs respectively. Resurfacing resulted in a mean loss of BMD of 6.7% (95% CI 0.7 to 12.7) in W3 but the BMD inferior to the acetabular component was maintained in both groups. These results suggest that the ability of a resurfacing hip replacement to preserve BMD only applies to the femoral side.

  3. Minimally invasive positioning robot system of femoral neck hollow screw implants based on x-ray error correction

    Science.gov (United States)

    Zou, Yunpeng; Xu, Ying; Hu, Lei; Guo, Na; Wang, Lifeng

    2017-01-01

    Aiming the high failure rate, the high radiation quantity and the poor positioning accuracy of femoral neck traditional surgery, this article develops a set of new positioning robot system of femoral neck hollow screw implants based on X-rays error correction, which bases on the study of x-rays perspective principle and the Motion Principle of 6 DOF(degree of freedom) series robot UR(Universal Robots). Compared with Computer Assisted Navigation System, this system owns better positioning accuracy and more simple operation. In addition, without extra Equipment of Visual Tracking, this system can reduce a lot of cost. During the surgery, Doctor can plan the operation path and the pose of mark needle according to the positive and lateral X-rays images of patients. Then they can calculate the pixel ratio according to the ratio of the actual length of mark line and the length on image. After that, they can calculate the amount of exercise of UR Robot according to the relative position between operation path and guide pin and the fixed relationship between guide pin and UR robot. Then, they can control UR to drive the positioning guide pin to the operation path. At this point, check the positioning guide pin and the planning path is coincident, if not, repeat the previous steps, until the positioning guide pin and the planning path coincide which will eventually complete the positioning operation. Moreover, to verify the positioning accuracy, this paper make an errors analysis aiming to thirty cases of the experimental model of bone. The result shows that the motion accuracy of the UR Robot is 0.15mm and the Integral error precision is within 0.8mm. To verify the clinical feasibility of this system, this article analysis on three cases of the clinical experiment. In the whole process of positioning, the X-rays irradiation time is 2-3s, the number of perspective is 3-5 and the whole positioning time is 7-10min. The result shows that this system can complete accurately

  4. Postoperative start compared to preoperative start of low-molecular-weight heparin increases mortality in patients with femoral neck fractures

    Science.gov (United States)

    Leer-Salvesen, Sunniva; Dybvik, Eva; Dahl, Ola E; Gjertsen, Jan-Erik; EngesæTer, Lars B

    2017-01-01

    Background and purpose — Controversies exist regarding thromboprophylaxis in orthopedic surgery. Using data in the nationwide Norwegian Hip Fracture Register (NHFR) with postoperative death and reoperation in the first 6 months after surgery as endpoints in the analyses, we determined whether the thromboprophylaxis in patients who undergo hemiarthroplasty for femoral neck fracture should start preoperatively or postoperatively. Patients and methods — After each operation for hip fracture in Norway, the surgeon reports information on the patient, the fracture, and the operation to the NHFR. Cox regression analyses were performed with adjustments for age, ASA score, gender, type of implant, length of surgery, and year of surgery. Results — During the period 2005–2014, 25,019 hemiarthroplasties as treatment for femoral neck fractures were reported to the registry. Antithrombotic medication was given to 99% of the patients. Low-molecular-weight heparin predominated with dalteparin in 57% of the operations and enoxaparin in 41%. Only operations with these 2 drugs and with known information on preoperative or postoperative start of the prophylaxis were included in the analyses (n = 20,241). Compared to preoperative start of thromboprophylaxis, postoperative start of thromboprophylaxis gave a higher risk of death (risk ratio (RR) = 1.13, 95% CI: 1.06–1.21; p < 0.001) and a higher risk of reoperation for any reason (RR =1.19, 95% CI: 1.01–1.40; p = 0.04), whereas we found no effect on reported intraoperative bleeding complication or on the risk of postoperative reoperation due to hematoma. The results did not depend on whether the initial dose of prophylaxis was the full dosage or half of the standard dosage. Interpretation — Postoperative start of thromboprophylaxis increased the mortality and risk of reoperation compared to preoperative start in femoral neck fracture patients operated with hemiprosthesis. The risks of bleeding and of reoperation due to

  5. Dynamic condylar screw or hip joint(spanning)external fixator for treatment of pathological fractures of femoral neck and trochanter secondary to benign lesions

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chun-lin; ZENG Bing-fang; DONG Yang; Daria brooks Terrell; Martin M.Malawer

    2008-01-01

    @@ The treatment of pathological fractures of the femoral neck and trochanteric region secondary to benign lesions can be a challenge for orthopaedic surgeons because of the size and nature of the lesions,the resulting bony defect,the risk of recurrence,the possible associated defortuities,and the risk of osteonecrosis.

  6. Accuracy and the influence of marrow fat on quantitative CT and dual-energy X-ray absorptiometry measurements of the femoral neck in vitro

    NARCIS (Netherlands)

    J.W. Kuiper; C. van Kuijk (Cornelis); J.L. Grashuis (Jan); A.G.H. Ederveen (Antwan); H.E. Schütte (Henri)

    1996-01-01

    markdownabstractAbstract Bone mineral measurements with quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) were compared with chemical analysis (ChA) to determine (1) the accuracy and (2) the influence of bone marrow fat. Total bone mass of 19 human femoral necks in

  7. Total medical costs of treating femoral neck fracture patients with hemi- or total hip arthroplasty: a cost analysis of a multicenter prospective study

    NARCIS (Netherlands)

    P.T.P.W. Burgers (Paul); M. Hoogendoorn (Martine); E.A.C. Van Woensel; R.W. Poolman (Rudolf); M. Bhandari (Mohit); P. Patka (Peter); E.M.M. van Lieshout (Esther)

    2016-01-01

    textabstractSummary: The aim of this study was to determine the total medical costs for treating displaced femoral neck fractures with hemi- or total hip arthroplasty in fit elderly patients. The mean total costs per patient at 2 years of follow-up were €26,399. These results contribute to cost awar

  8. Assessment of volumetric bone mineral density of the femoral neck in postmenopausal women with and without vertebral fractures using quantitative multi-slice CT

    Institute of Scientific and Technical Information of China (English)

    Sheng-yong WU; Hui-hui JIA; Didier HANS; Jing LAN; Li-ying WANG; Jing-xue LI; Yue-zeng CAI

    2009-01-01

    Objective: To demonstrate the validity and reliability of volumetric quantitative computed tomography (vQCT) with multi-slice computed tomography (MSCT) and dual energy X-ray absorptiometry (DXA) for hip bone mineral density (BMD) measurements, and to compare the differences between the two techniques in discriminating postmenopausal women with osteoporosis-related vertebral fractures from those without. Methods: Ninety subjects were enrolled and divided into three groups based on the BMD values of the lumbar spine and/or the femoral neck by DXA. Groups 1 and 2 consisted of postmenopausal women with BMD changes <-2SD, with and without radiographically confirmed vertebral fracture (n=11 and 33, respectively).Group 3 comprised normal controls with BMD changes ≥-1SD (n=46). Post-MSCT (GE, LightSpeed16) scan reconstructed images of the abdominal-pelvic region, 1.25 mm thick per slice, were processed by OsteoCAD software to calculate the following parameters: volumetric BMD values of trabecular bone (TRAB), cortical bone (CORT), and integral bone (INTGL) of the left femoral neck, femoral neck axis length (NAL), and minimum cross-section area (mCSA). DXA BMD measurements of the lumbar spine (AP-SPINE) and the left femoral neck (NECK) also were performed for each subject. Results: The values of all seven parameters were significantly lower in subjects of Groups 1 and 2 than in normal postmenopausal women (P<0.05, respectively).Comparing Groups 1 and 2, 3D-TRAB and 3D-INTGL were significantly lower in postmenopausal women with vertebral fracture(s) [(109.8±9.61) and (243.3±33.0) mg/cm3, respectively] than in those without [(148.9±7.47) and (285.4±17.8) mg/cm3,respectively] (P<0.05, respectively), but no significant differences were evident in AP-SPINE or NECK BMD. Conclusion: the femoral neck-derived volumetric BMD parameters using vQCT appeared better than the DXA-derived ones in discriminating osteoporotic postmenopausal women with vertebral fractures from

  9. Treatment of femoral neck fractures in elderly patients over 60 years of age - which is the ideal modality of primary joint replacement?

    Directory of Open Access Journals (Sweden)

    Simmen Hans-Peter

    2010-10-01

    Full Text Available Abstract Background Femoral neck fractures in the elderly are frequent, represent a great health care problem, and have a significant impact on health insurance costs. Reconstruction options using hip arthroplasty include unipolar or bipolar hemiarthroplasty (HA, and total hip arthroplasty (THA. The purpose of this review is to discuss the indications, limitations, and pitfalls of each of these techniques. Methods The Pubmed database was searched for all articles on femoral neck fracture and for the reconstruction options presented in this review using the search terms "femoral neck fracture", "unipolar hemiarthroplasty", "bipolar hemiarthroplasty", and "total hip arthroplasty". In addition, cross-referencing was used to cover articles eventually undetected by the respective search strategies. The resulting articles were then reviewed with regard to the different techniques, outcome and complications of the distinct reconstruction options. Results THA yields the best functional results in patients with displaced femoral neck fractures with complication rates comparable to HA. THA is beneficially implanted using an anterior approach exploiting the internervous plane between the tensor fasciae latae and the sartorius muscles allowing for immediate full weight-bearing. Based on our findings, bipolar hemiarthroplasty, similar to unipolar hemiarthroplasty, cannot restorate neither anatomical nor biomechanical features of the hip joint. Therefore, it can only be recommended as a second line of defense-procedure for patients with low functional demands and limited live expectancy. Conclusions THA is the treatment of choice for femoral neck fractures in patients older than 60 years. HA should only be implanted in patients with limited life expectancy.

  10. Low bone mineral density is not related to failure in femoral neck fracture patients treated with internal fixation

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Ryg, Jesper; Overgaard, Søren;

    2014-01-01

    Background and purpose - Internal fixation (IF) in femoral neck fractures has high reoperation rates and some predictors of failure are known, such as age, quality of reduction, and implant positioning. Finding new predictors of failure is an ongoing process, and in this study we evaluated...... the importance of low bone mineral density (BMD). Patients and methods - 140 consecutive patients (105 females, median age 80) treated with IF had a dual-energy X-ray absorptiometry (DXA) scan of the hip performed median 80 days after treatment. The patients' radiographs were evaluated for fracture displacement......, or new hip fracture). A stratified Cox regression model on fracture displacement was applied and adjusted for age, sex, quality of reduction, implant positioning, comorbidity, and walking disability. Results - 49 patients had a T-score below -2.5 (standard deviation from the young normal reference mean...

  11. Bilateral femoral neck fractures resulting from a grand mal seizure in an elderly man with Down syndrome

    Directory of Open Access Journals (Sweden)

    Jonathan P. Marsh

    2010-03-01

    Full Text Available Simultaneous bilateral hip fractures are exceedingly rare and usually occur following a seizure. To our knowledge, only 22 cases of such injuries have been reported in the literature during the past forty years and the majority of fractures are treated with open reduction and internal fixation. We present a case of a 66-year old man with Down syndrome and severe dementia who was diagnosed with bilateral displaced femoral neck fractures following an epileptic seizure. He was treated with single staged bilateral uncemented monopolar hemi-arthroplasties through lateral Hardinge approaches. The treatment choice was governed by fracture displacement, the lack of pre-existing osteoarthritis, length of time to diagnosis, the patient’s age, ambulatory status and mental impairment, with the intention to minimize post-operative complications such as avascular necrosis, non-union and hip dislocation.

  12. Preoperative factors and early complications associated with hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures.

    Science.gov (United States)

    Miller, Christopher P; Buerba, Rafael A; Leslie, Michael P

    2014-06-01

    Displaced femoral neck fractures are common injuries in the elderly individuals. There is controversy about the best treatment with regard to total hip arthroplasty (THA) versus hemiarthroplasty. This study uses the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database to evaluate the preoperative risk factors associated with the decision to perform THA over hemiarthroplasty. We also evaluate the risk factors associated with postoperative complications after each procedure. Patients older than 50 years undergoing hemiarthroplasty or THA after fracture in the NSQIP database from 2007 to 2010 were compared to each other in terms of preoperative medical conditions, postoperative complications, and length of stay. Multivariate logistic regression models were used to adjust for preoperative risk factors for undergoing a THA versus a hemiarthroplasty and for complications after each procedure. In all, 783 patients underwent hemiarthroplasty and 419 underwent THA for fracture. Hemiarthroplasty patients had longer hospital stays. On multivariate logistic regression, the only significant predictor for having a THA after fracture over hemiarthroplasty was being aged 50 to 64 years. The patient characteristics/comorbidities that favored having a hemiarthroplasty were age >80 years, hemiplegia, being underweight, having a dependent functional status, being on dialysis, and having an early surgery. High body mass index, American Society of Anesthesiologists (ASA) class, gender, and other comorbidities were not predictors of having one procedure over another. Disseminated cancer and diabetes were predictive of complications after THA while being overweight, obese I, or a smoker were protective. High ASA class and do-not-resuscitate status were significant predictors of complications after a hemiarthroplasty. This study identified clinical factors influencing surgeons toward performing either THA or hemiarthroplasty for elderly patients

  13. Computer-assisted three-dimensional correlation between the femoral neck-shaft angle and the optimal entry point for antegrade nailing.

    Science.gov (United States)

    Anastopoulos, George; Chissas, Dionisios; Dourountakis, Joseph; Ntagiopoulos, Panagiotis G; Magnisalis, Evaggelos; Asimakopoulos, Antonios; Xenakis, Theodore A

    2010-03-01

    Optimal entry point for antegrade femoral intramedullary nailing (IMN) remains controversial in the current medical literature. The definition of an ideal entry point for femoral IMN would implicate a tenseless introduction of the implant into the canal with anatomical alignment of the bone fragments. This study was undertaken in order to investigate possible existing relationships between the true 3D geometric parameters of the femur and the location of the optimum entry point. A sample population of 22 cadaveric femurs was used (mean age=51.09+/-14.82 years). Computed-tomography sections every 0.5mm for the entire length of femurs were produced. These sections were subsequently reconstructed to generate solid computer models of the external anatomy and medullary canal of each femur. Solid models of all femurs were subjected to a series of geometrical manipulations and computations using standard computer-aided-design tools. In the sagittal plane, the optimum entry point always lied a few millimeters behind the femoral neck axis (mean=3.5+/-1.5mm). In the coronal plane the optimum entry point lied at a location dependent on the femoral neck-shaft angle. Linear regression on the data showed that the optimal entry point is clearly correlated to the true 3D femoral neck-shaft angle (R(2)=0.7310) and the projected femoral neck-shaft angle (R(2)=0.6289). Anatomical parameters of the proximal femur, such as the varus-valgus angulation, are key factors in the determination of optimal entry point for nailing. The clinical relevance of the results is that in varus hips (neck-shaft angle shaft angle between 120 degrees and 130 degrees , the optimal entry point lies just medially to the trochanter tip (at the piriformis fossa) and the use of stiff implants is safe. In hips with neck-shaft angle over 130 degrees the anatomical axis of the canal is medially to the base of the neck, in a "restricted area". In these cases the entry point should be located at the insertion of the

  14. Results of bone regenerate study after osteosynthesis with bioinert and calcium phosphate-coated bioactive implants in experimental femoral neck fractures (experimental study

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    K. S. Kazanin

    2015-01-01

    Full Text Available Objective - to analyze the results of X-ray, cytomorphometric and immunohistochemistry experimental studies of bone regenerates after osteosynthesis with bioinert and calcium phosphate-coated bioactive implants. Material and methods. The study was conducted on experimental femoral neck fractures in rabbit males. Reparative osteogenesis processes were studied in groups of bioinert titanium implant osteosynthesis and calcium phosphate-coated bioactive titanium implant osteosynthesis. The animals were clinically followed-up during the postoperative period. X-ray, cytomorphometric and immunohistochemistry studies of samples extracted from femoral bones were conducted over time on days 1, 7, 14, 30 and 60. The animal experiments were kept and treated according to recommendations of international standards, Helsinki Declaration on animal welfare and approved by the local ethics committee. All surgeries were performed under anesthesia, and all efforts were made to minimize the suffering of the animals. Results. In the animal group without femoral neck fracture osteosynthesis, femoral neck pseudoarthrosis was observed at the end of the experiment. The results of cytomorphometric and immunohistochemistry studies conducted on day 60 of the experiment confirmed that the cellular composition of the bone regenerate in the group of calcium phosphate-coated bioactive titanium implants corresponded to a more mature bone tissue than in the group of bioinert titanium implants. Conclusion. The results of the statistical analysis of cytomorphometric and immunohistochemistry data show that the use of calcium phosphate-coated bioactive titanium implants allows to achieve significantly earlier bone tissue regeneration.

  15. Functional integrative analysis of the human hip joint: the three-dimensional orientation of the acetabulum and its relation with the orientation of the femoral neck.

    Science.gov (United States)

    Bonneau, Noémie; Baylac, Michel; Gagey, Olivier; Tardieu, Christine

    2014-04-01

    In humans, the hip joint occupies a central place in the locomotor system, as it plays an important role in body support and the transmission of the forces between the trunk and lower limbs. The study of the three-dimensional biomechanics of this joint has important implications for documenting the morphological changes associated with the acquisition of a habitual bipedal gait in humans. Functional integration at any joint has important implications in joint stability and performance. The aim of the study was to evaluate the functional integration at the human hip joint. Both the level of concordance between the three-dimensional axes of the acetabulum and the femoral neck in a bipedal posture, and patterns of covariation between these two axes were analysed. First, inter-individual variations were quantified and significant differences in the three-dimensional orientations of both the acetabulum and the femoral neck were detected. On a sample of 57 individuals, significant patterns of covariation were identified, however, the level of concordance between the axes of both the acetabulum and the femoral neck in a bipedal posture was lower than could be expected for a key joint such as the hip. Patterns of covariation were explored regarding the complex three-dimensional biomechanics of the full pelvic-femoral complex. Finally, we suggest that the lower degree of concordance observed at the human hip joint in a bipedal posture might be partly due to the phylogenetic history of the human species.

  16. Accuracy and the influence of marrow fat on quantitative CT and dual-energy X-ray absorptiometry measurements of the femoral neck in vitro.

    Science.gov (United States)

    Kuiper, J W; van Kuijk, C; Grashuis, J L; Ederveen, A G; Schütte, H E

    1996-01-01

    Bone mineral measurements with quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) were compared with chemical analysis (ChA) to determine (1) the accuracy and (2) the influence of bone marrow fat. Total bone mass of 19 human femoral necks in vitro was determined with QCT and DXA before and after defatting. ChA consisted of defatting and decalcification of the femoral neck samples for determination of bone mineral mass (BmM) and amount of fat. The mean BmM was 4.49 g. Mean fat percentage was 37.2% (23.3%-48.5%). QCT, DXA and ChA before and after defatting were all highly correlated (r > 0.96, p defatting the QCT values were on average 0.35 g less than BmM and the DXA values were on average 0.65 g less than BmM. After defatting, all bone mass values increased; QCT values were on average 0.30 g more than BmM and DXA values were 0.29 g less than BmM. It is concluded that bone mineral measurements of the femoral neck with QCT and DXA are highly correlated with the chemically determined bone mineral mass and that both techniques are influenced by the femoral fat content.

  17. The application of closed reduction internal fixation and iliac bone block grafting in the treatment of acute displaced femoral neck fractures.

    Directory of Open Access Journals (Sweden)

    Zhiyong Li

    Full Text Available OBJECTIVE: This study aimed to evaluate the preliminary clinical and radiographic outcomes of acute displaced femoral neck fracture treated by closed reduction and internal fixation (CRIF with free iliac bone block grafting with comparison to a routine protocol of CRIF without bone grafting. METHODS: From December 2008 to February 2010, 220 adult patients with acute displaced femoral neck fractures were enrolled in this study. In study group, there were 124 patients (57 males, 67 females with a mean age of 44.8 years (range, 20-64 years. There were 70 transcervical fractures and 54 subcapital fractures. The patients were treated by CRIF and free iliac bone block grafting. The control group consisted of 96 adult patients (46 males, 50 females with a mean age of 46.3 years (range, 23-64 years. There were 61 transcervical fractures and 35 subcapital fractures. The patients in control group were treated by CRIF without bone grafting. RESULTS: In study group, 112 patients were followed up for an average of 27.4 months (range, 24-34 months. All fractures healed within 5 months. However, 10 patients presented AVN of the femoral heads. The mean Harris score was 88.6 (range, 41-100. In control group, 68 patients were followed up for an average of 31.2 months (range, 24-42 months. The rates of AVN of the femoral head and fracture nonunion in control group were 26.5% (18/68 and 16.2% (11/68, respectively, significantly higher than those in study group (both P<0.05. The mean Harris score in control group was 83.8 (41-100, significantly lower than that in study group (P<0.05. CONCLUSION: Acute displaced femoral neck fractures can be treated by CRIF and free iliac bone block grafting in a minimally invasive manner. This technique can guarantee uneventful fracture healing and significantly reduce the rate of femoral head osteonecrosis.

  18. Reliability of using DXA around RTHAs. Bone Mineral Density of the femoral neck in resurfacing hip arthroplasty. Precision biased by region of interest and rotation of the hip

    DEFF Research Database (Denmark)

    Penny, Jeannette Østergaard; Varmarken, Jens-Erik; Ovesen, Ole;

    2009-01-01

      Introduction:  Resurfacing Total Hip Arthroplasty (RTHA) may preserve the femoral neck bone-stock post-operatively. Bone Mineral Density (BMD), could theoretically be affected by the hip-position, and bias longitudinal studies. We aimed to investigate BMD precision dependency on type of ROI...... and position of hip.   Method and Materials  We DXA scanned the femoral neck of 15 resurfacing patients twice with the hip in 3 different rotations; 15° internal, neutral, and 15° external. For each position BMD was analyzed with 3 different surface area models. One model measured BMD in the total femoral neck......, the second model divided the neck in two and the third model had 6 divisions.   Results  When all hip positions were pooled a mean Coefficient of variation (CV) of 3.1%, 3.6% and 4.6% was found in the 1, 2 and 6-region models, respectively, The external rotated hip position was less reproducible. When...

  19. A displaced stress fracture of the femoral neck in an adolescent female distance runner with female athlete triad: A case report.

    Science.gov (United States)

    Okamoto, Shinichi; Arai, Yuji; Hara, Kunio; Tsuzihara, Takashi; Kubo, Toshikazu

    2010-03-05

    This report presents a case of a displaced stress fracture of the femoral neck in an adolescent female distance runner with amenorrhea. Both reduction and internal fixation were performed early after the injury. At 24 months postoperatively, magnetic resonance imaging and bone scintigraphy showed no positive signs of femoral head necrosis and bone union was confirmed on plain X-ray. A medical examination for the presence of the signs of the female athlete triad by checking weight, calorie intake and menstrual cycles is most important to prevent such stress fractures. Athletes as well as their coaches or parents therefore need to understand female athlete triad.

  20. A displaced stress fracture of the femoral neck in an adolescent female distance runner with female athlete triad: A case report

    Directory of Open Access Journals (Sweden)

    Okamoto Shinichi

    2010-03-01

    Full Text Available Abstract This report presents a case of a displaced stress fracture of the femoral neck in an adolescent female distance runner with amenorrhea. Both reduction and internal fixation were performed early after the injury. At 24 months postoperatively, magnetic resonance imaging and bone scintigraphy showed no positive signs of femoral head necrosis and bone union was confirmed on plain X-ray. A medical examination for the presence of the signs of the female athlete triad by checking weight, calorie intake and menstrual cycles is most important to prevent such stress fractures. Athletes as well as their coaches or parents therefore need to understand female athlete triad.

  1. Quantification of Femoral Neck Exposure Through a Minimally Invasive Smith-Petersen Approach

    Science.gov (United States)

    2010-06-01

    2004; 429:248 255. 9. Jacobs MA, Goytia RN, Bhargava T. Hip resurfacing through an anterolateral approach: surgical description and early review. J...neck blood supply than the posterior approach during hip resurfacing . J Bone Joint Surg (Br). 2007;89-B: 1293 1298. 11. Swiontkowski MF, Thorpe M, Seiler...approach to the hip . Methods: Ten fresh frozen hemipelves were dissected using a minimally invasive Smith Petersen approach. Upon completion of the

  2. 股骨颈骨折七例误漏诊原因分析%Causes of Misdiagnosis and Missed Diagnosis in 7 Patients with Femoral Neck Fractures

    Institute of Scientific and Technical Information of China (English)

    阳波; 杨静

    2016-01-01

    Objective To investigate clinical features, causes of misdiagnosis and missed diagnosis of femoral neck fractures and prevention measures. Methods Clinical data of 7 patients with femoral neck fractures between October 2013 and October 2015 was retrospectively analyzed. Results The 7 patients visited doctors for hip joint pain caused by traffic ac-cidents, falls, sprain, falls from heights and so on. Two patients were misdiagnosed as having left hip contusion;2 patients were misdiagnosed as having soft tissue contusion;2 patients were diagnosed as having middle left femoral transverse fractures, and femoral neck fractures were missed diagnosised;1 patient was diagnosed as having middle femoral transverse fractures, and femoral neck fractures were missed diagnosised. Misdiagnosis and missed diagnosis time was 2-7 d. Femoral neck frac-tures were confirmed by X ray or CT examination for the 7 patients, and the patients were treated with surgeries by titanium cannulated compression screw. During postoperative 1 year of follow-up, all fractures healed, and the healing time was 3. 0-4. 5 (3. 75 ± 0. 54) months. Harris score of hip joint was performed 1 year after operation, and excellent and good rate of Har-ris score in the 7 patients was 85. 71%. Conclusion Femoral neck fracture is easy to be misdiagnosed or missed diagnosed due to various causes. Patients with continuous hip pain and obvious tenderness without abnormalities by X-ray should be high-ly suspected femoral neck fracture, and CT examination should be performed early to avoid misdiagnosis or missed diagnosis.%目的 探讨股骨颈骨折的临床特点及误漏诊原因、防范措施.方法 对遂宁市中心医院2013年10月—2015年10月诊治的曾误漏诊的股骨颈骨折7例的临床资料进行回顾性分析.结果 本组7例因交通事故、跌倒、扭伤、高处跌落等原因导致髋关节疼痛就诊.2例误诊为左髋部挫伤,2例误诊为左膝部软组织挫伤,2例仅诊断左股

  3. An Investigation into Reliability of Knee Extension Muscle Strength Measurements, and into the Relationship between Muscle Strength and Means of Independent Mobility in the Ward: Examinations of Patients Who Underwent Femoral Neck Fracture Surgery

    OpenAIRE

    Katoh, Munenori; Kaneko, Yoshihiro

    2014-01-01

    [Purpose] The purpose of the present study was to investigate the reliability of isometric knee extension muscle strength measurement of patients who underwent femoral neck fracture surgery, as well as the relationship between independent mobility in the ward and knee muscle strength. [Subjects] The subjects were 75 patients who underwent femoral neck fracture surgery. [Methods] We used a hand-held dynamometer and a belt to measure isometric knee extension muscle strength three times, and use...

  4. Patterns of osteocytic endothelial nitric oxide synthase expression in the femoral neck cortex: differences between cases of intracapsular hip fracture and controls.

    Science.gov (United States)

    Loveridge, N; Fletcher, S; Power, J; Caballero-Alías, A M; Das-Gupta, V; Rushton, N; Parker, M; Reeve, J; Pitsillides, A A

    2002-06-01

    Evidence indicates that extensive amalgamation of adjacent resorbing osteons is responsible for destroying the microstructural integrity of the femoral neck's inferior cortex in osteoporotic hip fracture. Such osteonal amalgamation is likely to involve a failure to limit excessive resorption, but its mechanistic basis remains enigmatic. Nitric oxide (NO) inhibits osteoclastic bone destruction, and in normal bone cells its generation by endothelial nitric oxide synthase (eNOS, the predominant bone isoform) is enhanced by mechanical stimuli and estrogen, which both protect against fracture. To determine whether eNOS expression in osteocytes reflects their proposed role in regulating remodeling, we have examined patterns of osteocyte eNOS immunolabeling in the femoral neck cortex of seven cases of hip fracture and seven controls (females aged 68-96 years). The density of eNOS+ cells (mm(-2)) was 53% lower in the inferior cortex of the fracture cases (p bone.

  5. Clinical, Radiologic and scintigraphic evaluation of the results of A. Moore and Thompson prostheses in the management of femoral neck fractures

    OpenAIRE

    Kiran, Ugur; Orhan, Zafer; Parmaksizoglu, Atilla Sancar; Ozkaya, Ufuk; Yalaman, Okan; Yazıcı, Nüzhet

    2004-01-01

    140 patients had been operated due to femoral neck fractures in the Ortopaedics and Traumatology CIinic Taksim State Hospital during the period of 1985 to 1991 and of this group, 42 patient's results were clinically, radiologically and scintigraphically evaluated. We evaluated the technical criteria used in the A.Moore type and the Thompson type endoprostheses, and tried to emphasize the significance of Tc-99 bone scanning in assesment of the results of prosthetic replacement. In this study, ...

  6. Salvage of failed osteosynthesis of an intracapsular fracture of the femoral neck using two cannulated compression screws and a vascularised iliac crest bone graft.

    Science.gov (United States)

    Xiaobing, Y; Dewei, Z

    2015-07-01

    We evaluated the outcome of treatment of nonunion of an intracapsular fracture of the femoral neck in young patients using two cannulated screws and a vascularised bone graft. A total of 32 patients (15 women and 17 men, with a mean age of 36.5 years; 20 to 50) with failed internal fixation of an intracapsular fracture were included in the study. Following removal of the primary fixation, two cannulated compression screws were inserted with a vascularised iliac crest bone graft based on the ascending branch of the lateral femoral circumflex artery. At a mean follow-up of 6.8 years (4 to 10), union was achieved in 27 hips (84%). A total of five patients with a mean age of 40.5 years (35 to 50) had a persistent nonunion and underwent total hip arthroplasty as also did two patients whose fracture united but who developed osteonecrosis of the femoral head two years post-operatively. Statistical analysis showed that younger patients achieved earlier and more reliable union (p 45 years (p osteosynthesis of a displaced intracapsular fractures of the femoral neck has failed.

  7. Changes in bone mineral density and femoral neck narrowing in the proximal femur three to five years after hip resurfacing versus conventional total hip arthroplasty.

    Science.gov (United States)

    Gerhardt, Davey M J M; Smolders, José M H; Rijnders, Ton A J M; Hol, Annemiek; van Susante, Job L C

    2015-02-01

    We studied whether bone mineral density (BMD) is preserved without significant femoral neck narrowing (FNN) after hip resurfacing (RHA) (n=42) versus small diameter metal-on-metal total hip arthroplasty (MoM THA) (n=40). In this three to five year randomized trial BMD was measured in the calcar with dual energy absorptiometry (DXA) preoperatively, at three and six months, one, two, three and five years postoperatively. Four additional BMD regions of interest (ROIs) and femoral neck narrowing (FNN) were measured after RHA. BMD in the calcar increased to 107% (P<0.001) at one year and remained stable. Additional ROIs in the femoral neck and trochanter-area BMD changes fluctuated between 99.9% and 104.1%. FNN was minimal with a mean of 1.3% at three years. After THA BMD decreased in the calcar to 80% at one year (P<0.001) and stabilized. This bone stock preserving nature of RHA must be weighed against potential disadvantages caused by specific metal-on-metal bearing problems.

  8. THE RESULTS OF THE CLINICAL USE OF A NEW METHOD OF OSTEOSYNTHESIS WITH NON-FREE BONE AUTOPLASTY AT THE MEDIAL FEMORAL NECK FRACTURES

    Directory of Open Access Journals (Sweden)

    R. M. Tikhilov

    2013-01-01

    Full Text Available Objective - to improve treatment outcomes in patients with medial fractures of the femoral neck through the development and introduction into clinical practice a new method of fixation with non-free plastic by the autograft from the iliac crest on a permanent muscular-vascular pedicle. Materials and methods. A comparative analysis of short- and long-term results of surgical treatment of 57 patients with medial fractures of the femoral neck, which were divided into primary and control groups. The study group included 24 patients who have undergone an osteosynthesis with cannulated screws with additional autoplasty with vascularized graft from the iliac crest. The control group consisted of 33 patients who underwent fixation with cannulated screws for the traditional method. Results. The use of non-free bone autoplasty in the main group of patients provided the best short- and long-term outcomes: fracture healing occurred in all cases in a period of 6 to 8 months. The long-term results of treatment of 22 patients after 2-6 years after the operation showed comparatively better anatomical functional outcomes. Conclusions. The indications for the clinical use of the fixation with the non-free bone autotransplantation are prognostically unfavorable for the union medial fractures of the femoral neck (II-III types by Pauwels or III-IV types by Garden in patients aged under 60 years with no signs of deforming arthrosis II-III stages.

  9. Comparative study of anterolateral approach versus posterior approach for total hip replacement in the treatment of femoral neck fractures in elderly patients

    Institute of Scientific and Technical Information of China (English)

    WANG Gang; GU Gui-shan; LI Dan; SUN Da-hui; ZHANG Wei; WANG Tie-jun

    2010-01-01

    Objective: To compare the clinical outcome of anterolateral minimally invasive approach versus conventional posterior approach for total hip replacement against femoral neck fractures in elderly patients.Methods: The retrospective study was carried out on 42 patients who suffered from displaced femoral neck fractures (19 cases of Garden type Ⅲ, 23 cases of Garden type Ⅳ) treated by total hip replacement via anterolateral minimally invasive approach or conventional posterior approach by the same experienced surgeon. The average age of the patients was 78.1 years (range: 65-89 years). They were divided into anterolateral mini-invasive group (22 cases) and posterior group (20 cases). The mean time of follow-up was 13 months (range: 6-36 months). The anterolateral approach described by Hardinge goes through between anterior 1/3 and posterior 2/3 of the gluteus medius muscle, reaching the femoral neck from anterior capsule. The traditional posterior approach described by Moore (Southern incision) goes through the insertions of short external rotation muscles,reaching the femoral neck from posterior capsule. The related variables under observation were length of incision,operation time, postoperative limp, length of hospital stay and bed stay and dislolcation rate.Results: The length of the skin incision varied between 7 cm and 12 cm with the anterolateral minimally invasive technique, compared to 15-22 cm in the conventional procedure. It took less time (average 15 minutes) to complete the anterolateral minimally invasive approach (72 min±15 min), compared with the conventional approach (87 min±10 min). The average Harris hip score was 91.23±10.20 inanterolateral approach, 90.03±11.05 in the posterior approach. The average length of hospital stay for patients with the anterolateral approach was (6.4±2.2) days (range:4-9 days), while that in posterior approach was (9.2 ±3.1)days (range: 6-13 days). The average length of bed stay was (3.4±1.1) days (range: 2

  10. Do post-operative changes of neck-shaft angle and femoral component anteversion have an effect on clinical outcome following uncemented total hip arthroplasty?

    Science.gov (United States)

    Müller, M; Abdel, M P; Wassilew, G I; Duda, G; Perka, C

    2015-12-01

    The accurate reconstruction of hip anatomy and biomechanics is thought to be important in achieveing good clinical outcomes following total hip arthroplasty (THA). To this end some newer hip designs have introduced further modularity into the design of the femoral component such that neck-shaft angle and anteversion, which can be adjusted intra-operatively. The clinical effect of this increased modularity is unknown. We have investigated the changes in these anatomical parameters following conventional THA with a prosthesis of predetermined neck-shaft angle and assessed the effect of changes in the hip anatomy on clinical outcomes. In total, 44 patients (mean age 65.3 years (standard deviation (SD) 7); 17 male/27 female; mean body mass index 26.9 (kg/m²) (SD 3.1)) underwent a pre- and post-operative three-dimensional CT scanning of the hip. The pre- and post-operative neck-shaft angle, offset, hip centre of rotation, femoral anteversion, and stem alignment were measured. Additionally, a functional assessment and pain score were evaluated before surgery and at one year post-operatively and related to the post-operative anatomical changes. The mean pre-operative neck-shaft angle was significantly increased by 2.8° from 128° (SD 6.2; 119° to 147°) to 131° (SD 2.1; 127° to 136°) (p = 0.009). The mean pre-operative anteversion was 24.9° (SD 8; 7.9 to 39.1) and reduced to 7.4° (SD 7.3; -11.6° to 25.9°) post-operatively (p neck-shaft angles was found with a significant decrease of the post-operative anteversion and slight increase of the neck-shaft angles, but without any impact on clinical outcome.

  11. Mid term results of Furlong LOL uncemented hip hemiarthroplasty for fractures of the femoral neck.

    Science.gov (United States)

    Chandran, Prakash; Azzabi, Mohammed; Burton, Dave J C; Andrews, Mark; Bradley, John G

    2006-08-01

    We report the mid-term results of hemiarthroplasty with the Furlong hydroxyapatite coated bipolar prosthesis for displaced (Garden type III and IV) intracapsular hip fracture in 480 patients operated between 1989 and 2000. Three hundred sixty eight (77%) patients were lost to follow-up due to death, dementia or movement away from the area. In the patients followed up there was an 8% reoperation rate for infection, aseptic loosening, periprosthetic fracture and acetabular erosion. One hundred and twelve patients with a mean follow-up of 4 years (3-14) were studied. Eighty eight percent had no or slight pain, 77% could mobilise outdoors and 89% needed either no aid or a single walking stick to mobilise. Radiographic assessment revealed a stable implant with visible osseointegration in 91%. We conclude that hemiarthroplasty with the hydroxyapatite coated bipolar Furlong LOL prosthesis for displaced intracapsular fracture of the neck of the femur gives good mid term results in elderly patients for return to mobility, use of mobility aids and freedom from pain. It avoids the need for cement and provides satisfactory incorporation into the host bone. The use of a modular head makes revision to total hip replacement easier.

  12. Analgesic efficacy of continuous femoral nerve block commenced prior to operative fixation of fractured neck of femur

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    Szucs Szilard

    2012-06-01

    Full Text Available Abstract Background Peripheral nerve blocks are effective in treating acute pain, thereby minimizing the requirement for opiate analgesics. Fractured neck of femur (FNF is a common, painful injury. The provision of effective analgesia to this cohort is challenging but an important determinant of their functional outcome. We investigated the analgesic efficacy of continuous femoral nerve block (CFNB in patients with FNF. Methods Following institutional ethical approval and with informed consent, patients awaiting FNF surgery were randomly allocated to receive either standard opiate-based analgesia (Group 1 or a femoral perineural catheter (Group 2. Patients in Group 1 received parenteral morphine as required. Those in Group 2 received a CFNB comprising a bolus of local anaesthetic followed by a continuous infusion of 0.25% bupivacaine. For both Groups, rescue analgesia consisted of intramuscular morphine as required and all patients received paracetamol regularly. Pain was assessed using a visual analogue scale at rest and during passive movement (dynamic pain score at 30 min following first analgesic intervention and six hourly thereafter for 72 hours. Patient satisfaction with the analgesic regimen received was recorded using verbal rating scores (0-10. The primary outcome measured was dynamic pain score from initial analgesic intervention to 72 hours later. Results Of 27 recruited, 24 patients successfully completed the study protocol and underwent per protocol analysis. The intervals from recruitment to the study until surgery were similar in both groups [31.4(17.7 vs 27.5(14.2 h, P = 0.57]. The groups were similar in terms of baseline clinical characteristics. For patients in Group 2, pain scores at rest were less than those reported by patients in Group 1 [9.5(9.4 vs 31(28, P = 0.031]. Dynamic pain scores reported by patients in Group 2 were less at each time point from 30 min up to 54 hours [e.g at 6 h 30.7(23.4 vs 67

  13. Analgesic efficacy of continuous femoral nerve block commenced prior to operative fixation of fractured neck of femur

    LENUS (Irish Health Repository)

    Szucs, Szilard

    2012-06-27

    AbstractBackgroundPeripheral nerve blocks are effective in treating acute pain, thereby minimizing the requirement for opiate analgesics. Fractured neck of femur (FNF) is a common, painful injury. The provision of effective analgesia to this cohort is challenging but an important determinant of their functional outcome. We investigated the analgesic efficacy of continuous femoral nerve block (CFNB) in patients with FNF.MethodsFollowing institutional ethical approval and with informed consent, patients awaiting FNF surgery were randomly allocated to receive either standard opiate-based analgesia (Group 1) or a femoral perineural catheter (Group 2). Patients in Group 1 received parenteral morphine as required. Those in Group 2 received a CFNB comprising a bolus of local anaesthetic followed by a continuous infusion of 0.25% bupivacaine. For both Groups, rescue analgesia consisted of intramuscular morphine as required and all patients received paracetamol regularly. Pain was assessed using a visual analogue scale at rest and during passive movement (dynamic pain score) at 30 min following first analgesic intervention and six hourly thereafter for 72 hours. Patient satisfaction with the analgesic regimen received was recorded using verbal rating scores (0-10). The primary outcome measured was dynamic pain score from initial analgesic intervention to 72 hours later.ResultsOf 27 recruited, 24 patients successfully completed the study protocol and underwent per protocol analysis. The intervals from recruitment to the study until surgery were similar in both groups [31.4(17.7) vs 27.5(14.2) h, P = 0.57]. The groups were similar in terms of baseline clinical characteristics. For patients in Group 2, pain scores at rest were less than those reported by patients in Group 1 [9.5(9.4) vs 31(28), P = 0.031]. Dynamic pain scores reported by patients in Group 2 were less at each time point from 30 min up to 54 hours [e.g at 6 h 30.7(23.4) vs 67.0(32.0), P = 0

  14. 股骨颈骨折34例临床分析%The Clinical Analysis of 34 Cases of Femoral Neck Fracture

    Institute of Scientific and Technical Information of China (English)

    张仁忠

    2015-01-01

    目的:探讨股骨颈骨折患者手术治疗方法疗效。方法选取2013年1月~2014年6月收治的股骨颈骨折患者34例手术治疗资料进行分析。结果经手术治疗所有患者骨折均顺利愈合,优16例,良15例,差2例,优良率94.1%。结论若因某种原因不能采取手术治疗,则一旦疼痛缓解可尽量使患者早期活动,造成的骨折不愈合存在明显症状时可在晚期进行处理。手术包括内固定或一期关节成形术,一般对年轻患者应尽可能保留股骨头。%Objective The surgical treatment ef iciency of patients with femoral neck fracture is to be investigated. Methods Analyze the surgical treatment data selected from 34 patients with femoral neck fracture who are treated in hospital from January 2013 to June 2014. Results Al of patients with femoral neck fracture get healed after surgical treatment,including 16 cases of excel ence,15 cases of goodness and 2 cases of poorness,the excel ence and good incidence is up to 94.1%. Conclusion For the patients who are not available for surgical treatment due to some reason,once the pain is relieved,they are able to do some activities in early time and the symptoms caused by unhealed fracture can be treated in later stage of treatment. The surgical treatment of femoral neck fracture includes fixation and one-stage arthroplasty,in general, should be retained as far as possible the Femoral Head in younger patients.

  15. 股骨颈骨折愈合后钉道植骨应力分布的有限元分析%Finite element analysis of the stress distribution in femoral head and neck of bone grafting in nail path after femoral neck fracture heating

    Institute of Scientific and Technical Information of China (English)

    唐洪涛; 仝允辉; 张美超; 赵卫东

    2011-01-01

    Objective:To investigate the rationality of bone grafting in nail path after femoral neck fracture healing and internal fixator was removed so as to provide theoretical support for clinical therapy. Methods: Two three - dimensional finite element models of the femoral head and neck region were reconstructed after femoral neck fracture healing and internal fixator was removed,one undergone bone grafting.Both of the models were simulated under the load of body weight,and the stress and shift on the femoral head and neck were calculated and compared. Results: Analysis of the three - dimension finite element model showed that the massive stress concentrated on weight loading region of femoral head without bone grafting,while the massive stress concentrated on the region of calcar femorale of grafting- bone model.The max - stress value (0.482 E + 8) in the weight loading region of femoral head without bone grafting was far higher than the max - stress value(0.295 E +8) of ungrafting - bone model. In the nail path shift test,value of shift in the region of femoral head of the ungrafting -bone model (0.391 E - 0.3 ) significantly exceeded that of grafting - bone model (0.352 E - 0.3 ). Conclusion: For the treatment of femoral neck fracture with hollow compression screws, bone grafting in the channel of screw should be used to improve biomechanical integrity of femoral head and neck after fracture healed and hollow compression screws were taken out. This is of benefit to preventing the collapse of femoral head owing to excessive stress concentration on femoral head.%目的:探讨股骨颈骨折经空心加压螺钉固定,骨折愈合后取出螺钉遗留的钉道内是否应予植骨,为临床选择治疗方法提供依据.方法:重建人体股骨头颈部的三维有限元仿真模型,模拟钉道不植骨与钉道植骨的股骨头颈部,对模型进行虚拟加栽和仿真计算.比较2种模型在同一载荷下的应力分布及位移情况.结果:不植骨模型的

  16. Arthroplasty versus Internal Fixation for Displaced Intracapsular Femoral Neck Fracture in the Elderly: Systematic Review and Meta-analysis of Short- and Long-term Effectiveness

    Institute of Scientific and Technical Information of China (English)

    Chen-Yi Ye; An Liu; Ming-Yuan Xu; Nwofor Samuel Nonso; Rong-Xin He

    2016-01-01

    Background:There is conflicting evidence as to whether the femoral head should be preserved or replaced in elderly patients with displaced intracapsular femoral neck fractures.In this article,we performed a systematic review and meta-analysis to compare the short-and long-term effectiveness of arthroplasty (AR) and internal fixation (IF).Methods:PubMed,Embase,and the Cochrane Library were searched systematically up to January 2016.All randomized controlled trials directly comparing the effectiveness of AR and IF for displaced intracapsular fracture were retrieved with no limitation on language or publication year.Results:In total,eight prospective randomized studies involving 2206 patients were included.The results of our study showed that patients in the AR group reported significantly lower complication (risk ratio:0.56,95% confidence interval [CI] =0.38-0.80),re-operation (risk ratio:0.17,95% CI =0.13-0.22),revision rates (risk ratio:0.11,95% CI:0.08-0.16),and better function compared with their IF counterparts,and they were less likely to suffer postoperative pain.No statistically significant differences for the rates of mortality,infection,and/or deep vein thrombosis between AR and IF were found.Conclusions:Based on our analysis,we recommend that AR should be used as the primary treatment for displaced intracapsular femoral neck fractures in the elderly.However,IF may be appropriate for those who are very frail.

  17. Glutamine repeat variants in human RUNX2 associated with decreased femoral neck BMD, broadband ultrasound attenuation and target gene transactivation.

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    Nigel A Morrison

    Full Text Available RUNX2 is an essential transcription factor required for skeletal development and cartilage formation. Haploinsufficiency of RUNX2 leads to cleidocranial displaysia (CCD a skeletal disorder characterised by gross dysgenesis of bones particularly those derived from intramembranous bone formation. A notable feature of the RUNX2 protein is the polyglutamine and polyalanine (23Q/17A domain coded by a repeat sequence. Since none of the known mutations causing CCD characterised to date map in the glutamine repeat region, we hypothesised that Q-repeat mutations may be related to a more subtle bone phenotype. We screened subjects derived from four normal populations for Q-repeat variants. A total of 22 subjects were identified who were heterozygous for a wild type allele and a Q-repeat variant allele: (15Q, 16Q, 18Q and 30Q. Although not every subject had data for all measures, Q-repeat variants had a significant deficit in BMD with an average decrease of 0.7SD measured over 12 BMD-related parameters (p = 0.005. Femoral neck BMD was measured in all subjects (-0.6SD, p = 0.0007. The transactivation function of RUNX2 was determined for 16Q and 30Q alleles using a reporter gene assay. 16Q and 30Q alleles displayed significantly lower transactivation function compared to wild type (23Q. Our analysis has identified novel Q-repeat mutations that occur at a collective frequency of about 0.4%. These mutations significantly alter BMD and display impaired transactivation function, introducing a new class of functionally relevant RUNX2 mutants.

  18. Femoral neck anteversion, acetabular anteversion and combined anteversion in the normal Indian adult population: A computed tomographic study

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    Maheshwari Aditya

    2010-01-01

    Full Text Available Background: Abnormal femoral neck anteversion (FNA and/or acetabulum anteversion (AA have long been implicated in the etiogenesis of hip osteoarthritis (OA, developmental dysplasia of the hip (DDH, and impingement, instability and wear in total hip arthroplasty (THA. Since studies on the Indian population are sparse on this topic, the purpose of this study was to report the normal values of FNA, AA and the combined anteversion (CA= FNA+ AA in Indian adults. Materials and Methods: FNA, AA and CA were prospectively measured in 172 normal hips in 86 Indian adults using standardized computed tomographic (CT methods and this data was compared with the established Western values. Results: The median values and interquartile ranges were 8 o (6.5-10.0 o for FNA, 19 o (16.0-22.0 o for AA and 27 o (23.5-30.0 o for CA. AA and CA values were significantly (P< 0.05 lower in males, and there was also a trend towards lower FNA in males. Although a negative correlation was observed between the FNA and AA, this was not strong and may not be clinically relevant. Conclusion: When compared with the Western data, the FNA values were 3-12 o lower and the CA values were 3-5 o lower in Indian adults. The AA values were comparable, but were skewed towards the higher side. Further studies are needed to assess the clinical relevance of our basic science data in pathogenesis of OA, and to validate it in relation to hip surgeries like corrective osteotomies and THA.

  19. Bipolar femoral head replacement for the treatment of femoral neck fractures in elder Parkinson's disease patients%双极人工股骨头治疗老年帕金森患者股骨颈骨折

    Institute of Scientific and Technical Information of China (English)

    庄泽; 曾春; 曾花; 王昆

    2012-01-01

    BACKGROUND: Due to the muscle imbalance outcomes, Parkinson's patients are easy to fall and have a high risk of femoral neck fracture. OBJECTIVE: To explore the treatment outcomes of bipolar femoral head replacement for the femoral neck fractures in elder Parkinson's patients METHODS: A retrospective analysis was carried out on the clinical data of the 14 Parkinson's disease patients of femoral neck fractures, a total of 14 hips, who were treated with bipolar femoral head replacement. The patients were divided into three phases by Hoehn-Yahr classification, 3 cases in I phase, 4 cases in II phase, 5 cases in III phase and 2 cases in IV phase. The average surgery age was 62 to 83 years old. The Harris score, Fugl-Meyer scale and Unified Parkinson's Disease Rating Scale score were used as follow-up judgment. RESULTS AND CONCLUSION: The average follow-up time was 1 to 6 years. Harris score of 14 patients was postoperatively 85.4 better than preoperatively 22.3 (P < 0.05), Fugl-Meyer score was postoperatively 81.6 better than preoperatively 52.5 (P < 0.05). There was no significant difference of Unified Parkinson's Disease Rating Scale score before and after operation, and the Parkinson's disease controlled stable. No prosthesis loosening, dislocation or other complications. Early and mid-term follow-up showed under the effective medical control of the neurology drugs, bipolar femoral head replacement is a safe and effective treatment of femoral neck fracture for Hoehn-Yahr I -IV Parkinson's patient. There is relationship between the hip joint function and the control of the Parkinson's disease after replacement.%背景:帕金森患者由于肌力不平衡等原因更容易跌倒,发生股骨颈骨折的风险高.目的:观察双极人工股骨头置换对老年帕金森病合并股骨颈骨折患者的治疗效果.方法:回顾分析14例帕金森病合并股骨颈骨折行双极人工股骨头置换患者的临床资料,共14髋,Hoehn-Yahr分级Ⅰ期3例,Ⅱ期4

  20. 加长螺旋刀片股骨抗旋髓内钉治疗股骨干合并同侧股骨颈骨折16例%Lengthened proximal femoral nail antirotation for femoral shaft fractures combined with ipsilateral femoral neck fractures

    Institute of Scientific and Technical Information of China (English)

    李山珠; 赵宏谋; 袁锋; 朱辉; 俞光荣

    2012-01-01

    Objective To investigate the methods and results of lengthened proximal femoral nail antirotation (PFNA) in the treatment of femoral shaft fractures combined with ipsilateral femoral neck fractures. Methods Of the 21 patients with femoral shaft combined with ipsilateral femoral neck fractures treated by lengthened PFNA from 2006 to 2009,16 patients with complete follow-up were retrospectively studied.There were 15 males and 1 female,at mean age of 35 years (range,21-51 years).Injury causes were all high-energy trauma including traffic injuries in 11 patients and fall injuries in five.According to Garden classification,there were seven patients with type Ⅰ femoral neck fractures,six with type Ⅱ and three with type Ⅲ.Femoral shift fractures contained six superior part fractures and nine medial part fractures and one inferior part fracture.According to Winquist classification,there were two patients with type Ⅰ femoral shaft fractures,four with type Ⅱ,six with type Ⅲ and four with type Ⅳ.Two patients had open fractures belonging to type Ⅰ Gustilo-Anderson.Harris hip score was used to evaluate functional outcomes at the last follow-up postoperatively. Result The mean follow-up time was 2.4years (range,1-4 years ).The mean period for healing of femoral neck and shaft fractures was 4.2months ( range,3-6 months) and 5.1 months ( range,3-8 months) respectively.Four patients showed delayed diagnoses of femoral neck fractures ; two patients had delayed union of femoral shaft fractures ; one suffered from avascular necrosis of the femoral head ; one patient presented 3 cm of extension of the affected limb and was accompanied by active pain of the knee joint for over four months.According to Harris score,function of hip joints was excellent in seven patients,good in six and fair in three,with excellence rate of 82%. Conclusions It is relatively few that the femoral shaft fracture is combined with ipsilateral femoral neck fracture.The rate of missed diagnosis

  1. 老年股骨颈骨折术后谵妄的护理对策%Elderly Femoral Neck Fractures of Postoperative Delirium Nursing Countermeasures

    Institute of Scientific and Technical Information of China (English)

    徐云

    2014-01-01

    目的:探讨老年股骨颈骨折术后谵妄的原因,进而提出护理对策。方法比较股骨颈骨折手术后24例出现谵妄患者的手术前后血红蛋白变化,同时对这些患者睡眠情况、年龄及术后出现谵妄持续时间等进行分析,并给予相应护理。结果患者术后谵妄的因素包括高龄、环境因素、贫血、疼痛、睡眠不足、药物毒性等。经治疗护理,24例均痊愈出院。结论术前、术中、术后给予针对性的全程护理措施,可以减少老年患者股骨颈骨折术后谵妄的发生。%Objective To study the elderly femoral neck fracture reasons of postoperative delirium,put forward nursing countermeasures. Methods To compare the 24 cases of femoral neck fracture surgery in delirium in patients with hemoglobin before and after surgery,sleep in those patients, age, and at the same time appear postoperative delirium duration,etc were analyzed,and and giving corresponding nursing. Results The patients of postoperative delirium factors including age,environmental factors,anemia,pain,sleep deprivation,drug toxicity,etc. After care,24 cases were recovered discharge. Conclusion Preoperative,intraoperative and postoperative give pertinent nursing measures al the way,can reduce the happening of the elderly patients with femoral neck fractures of postoperative delirium.

  2. Ansys nonlinear buckling analysis for prediction of femoral neck fracture%股骨颈骨折预测的Ansys非线性屈曲分析

    Institute of Scientific and Technical Information of China (English)

    张国栋; 林海滨; 陈宣煌; 郑锋; 陈国立; 陶圣祥

    2012-01-01

    目的 实施10例股骨颈骨折的Ansys非线性屈曲分析,模拟与生物力学实验一致的股骨颈骨折实验全程.方法 采用10个股骨上段标本进行有限元建模,以十字坐标轴及绘图辅助软件TweakWindow实施精确的载荷施加及条件约束,进行特征值屈曲分析及非线性屈曲分析.结果 实现可控制的股骨颈骨折预测的Ansys非线性屈曲分析的载荷施加及条件约束;全部分析在达到结构崩溃时自动终止,发生股骨颈骨折的极限载荷为( 12 324.07±4439.733)N,最大位移为(7.6067 ±2.2716) mm,截取载荷-位移曲线;通过应力等值线图可判断股骨颈骨折位置.结论 非线性屈曲分析是一种适用于骨折预测的有限元算法;通过十字坐标轴及绘图辅助软件可以实现精确可控制的载荷施加及条件约束,实现与生物力学实验一致的条件设置.%Objective To simulate the whole femoral neck fractures experimental processes which were consistent with the biomechanical experiments by executing 10 cases of ansys nonlinear buckling analysis of femoral neck fracture.Methods 10 femoral superior segment specimens were used for finite element modeling.A cross axis as well as tweakwindow,which was a drawing auxiliary software,were used to execute the define loads and displacement procedures accurately,then the linear and nonlinear buckling analysis were executed successively.Results A controllable define loads and displacement in ansys nonlinear buckling analysis of prediction for femoral neck fracture; All analysises stop automatically when structural collapse happened.The ultimate load results of femoral neck fracture were (12 324.07 ±4439.73) N,the maximum displacement results were (7.6067 ± 2.2716) mm.The load-displacement curves were harvested; The positions of femoral neck fracture could be judged easily by stress contour plots.Conclusion The nonlinear buckling analysis was a suitable finite element calculation method for

  3. Necrosis avascular de cabeza y cuello de fémur en un paciente con sida Avascular osteonecrosis of femoral head and neck in an AIDS patient

    Directory of Open Access Journals (Sweden)

    María F. Villafañe

    2004-04-01

    Full Text Available La osteonecrosis avascular (ONA es una complicación que se describe con frecuencia creciente en pacientes infectados por el virus de la inmunodeficiencia humana tipo-1 (HIV-1. En su localización más común compromete la cabeza y cuello del fémur con dolor e impotencia funcional, en una o ambas caderas. Su etiología es multifactorial y la terapia antirretroviral de alta eficacia (HAART con inhibidores de proteasa (IP puede estar relacionada con la patogenia. En su evolución puede requerir el reemplazo total de la cadera con la colocación de una prótesis. Se presenta un paciente hemofílico, HIV-1 seropositivo, que desarrolló una ONA bilateral de cabeza y cuello de fémur mientras se encontraba bajo HAART.Avascular osteonecrosis (AON has increased in the last few years in patients infected with the human immunodeficiency virus type-1 (HIV-1. The most commonly affected bone is the femoral head and neck. Frequently these bilateral and clinical findings include moderate to severe pain and functional impotence of the affected joints. The etiology is multifactorial and highly active antiretroviral therapy (HAART with protease inhibitors (PI is probably related to its development. In the evolution, a total hip replacement may be needed. We present an hemophilic patient with AIDS, who developed a bilateral AON of the femoral head and neck during HAART.

  4. Intraoperative radiation of canine carotid artery, internal jugular vein, and vagus nerve. Therapeutic applications in the management of advanced head and neck cancers

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    Mittal, B.B.; Pelzer, H.; Tsao, C.S.; Ward, W.F.; Johnson, P.; Friedman, C.; Sisson, G.A. Sr.; Kies, M. (Northwestern Univ., Chicago, IL (USA))

    1990-12-01

    As a step in the application of intraoperative radiotherapy (IORT) for treating advanced head and neck cancers, preliminary information was obtained on the radiation tolerance of the canine common carotid artery, internal jugular vein, and vagus nerve to a single, high-dose electron beam. Both sides of the neck of eight mongrel dogs were operated on to expose an 8-cm segment of common carotid artery, internal jugular vein, and vagus nerve. One side of the neck was irradiated, using escalating doses of 2500, 3500, 4500, and 5500 cGy. The contralateral side of the neck served as the unirradiated control. At 3 and 6 months after IORT, one dog at each dose level was killed. None of the dogs developed carotid bleeding at any time after IORT. Light microscopic investigations using hematoxylin-eosin staining on the common carotid artery and internal jugular vein showed no consistent changes that suggested radiation damage; however, the Masson trichrome stain and hydroxyproline concentration of irradiated common carotid artery indicated an increase in the collagen content of the tunica media. Marked changes in the irradiated vagus nerve were seen, indicating severe demyelination and loss of nerve fibers, which appeared to be radiation-dose dependent. Four patients with advanced recurrent head and neck cancer were treated with surgical resection and IORT without any acute or subacute complications. The role of IORT as a supplement to surgery, external beam irradiation, and chemotherapy in selected patients with advanced head and neck cancer needs further exploration.

  5. Influences of head/neck ratio and femoral antetorsion on the safe-zone of operative acetabular orientations in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    LI Yong-jiang; YANG Guo-jing; ZHANG Li-cheng; CAI Chun-yuan; WU Li-jun

    2010-01-01

    Objective: To study the influences of head/neck ratio and femoral antetorsion on the safe-zone of operative acetabular orientations, which meets the criteria for desired range of motion (ROM) for activities of daily living in total hip arthroplasty (THA).Methods: Athree-dimensional generic, parametric and kinematic simulation module of THA was developed to analyze the cup safe-zone and the optimum combination of cup and neck antetorsion. A ROM of flexion≥ 120°, internal rotation ≥45° at 90° flexion, extension ≥30° and external rotation ≥ 40° was defined as the criteria for desired ROM for activities of daily living. The cup safe-zone was defined as the area that fulfills all the criteria of desired ROM before the neck impinged on the liner of the cup. For a fixed stemneck (CCD)-angle of 130°, theoretical safe-zones fulfilling the desired ROM were investigated at different general headneck ratios (GR=2, 2.17, 2.37, 2.61 and 2.92) and femoral anteversions (FA=0°, 10°, 20° and 30°).Results: Large GRs greatly increased the size of safezones and when the CCD-angle was 130°, a GR>2.37 could further increase the size of safe-zones. There was a complex interplay between the orientation angles of the femoral and acetabular components. When the CCD-angle was 130°, the optimum relationship between operative acetabular anteversion (OA) and femoral antetorsion (FA) could be estimated by the formula: OA=-0.80×FA+47.06, andthe minimum allowable operative acetabular inclination (OImin) would be more than 210.5×GR-2.255.Conclusions: Large GRs greatly increase the size of safe-zones and it is recommended that the GR be more than 2.37 so as to extend the acceptable range of error that surgeons cannot avoid completely during operation. As to the optimum operative acetabular inclination (OI), surgeons need to make a decision combining with other factors, including stress distribution, soft tissue and cup wear conditions, as well as patients' individual situations

  6. 老年股骨颈骨折的护理体会%Nursing care experiences on femoral neck fractures in older people

    Institute of Scientific and Technical Information of China (English)

    彭海容

    2011-01-01

    目的 探讨老年股骨颈骨折的护理效果及护理措施.方法 对2005年6月-2010年1月间在我院接受诊治的老年股骨颈骨折患者42例实施全面的护理措施.结果 经系统的手术治疗及护理,本组42例均获得临床痊愈,平均住院(26.20±2.52)d.本组共发生围手术期并发症4例,发生率为9.52%,其中肺部感染2例,泌尿道感染1例,切口感染1例.随访6个月~5年,所有患者康复良好.结论 全面的护理在老年股骨颈骨折患者围手术期中具有重要的作用.%Objective To investigate the effect and measure of nursing care to femoral neck fractures in older people. Methods 42 older patients with femoral neck fractures in our hospital from June 2005 to January 2010 received the comprehensive care. Results 42 cases got the clinical healing and the average length of stay was ( 26.20±2.52)days by the comprehensive care and treatment. There were 4 cases with perioperative complications and the rate was 9.52%,and there were 2 cases with pulmonary infection,1 case with urinary tract infection, 1 case with postoperative infection. All of them were recovered well by following-up for 6 months to 5 years. Conclusion The comprehensive care plays an important role on femoral neck fractures in older people during perioperative nursing.

  7. Analysis of Comfort Nursing on Patients With Femoral Neck Fracture%舒适护理对股骨颈骨折患者的影响分析

    Institute of Scientific and Technical Information of China (English)

    尚美佳

    2016-01-01

    ObjectiveComfort nursing methods and its effect on patients with femoral neck fracture are to be studied.MethodsChose 78 patients with femoral neck fracture who were treated in hospital from September 2014 to November 2015 and separated them into two groups randomly,44 patients in study group were given comfort nursing,while another 34 patients in control group were given conventional nursingand then compared nursing effects and patients’ recovery conditions between two groups.ResultsPatients’ nursing efficacy in study group was 95.45%,which was much higher than 82.35% in control group. There was a differential between two groups and such a differential had statistic value(P<0.05).Conclusion Comfort nursing is quite effective on patients with femoral neck fracture; it is conducive to increasing patients’satisfaction,reducing physical uncomfortable feeling and keeping them in good mood.%目的:探究股骨颈骨折患者采取舒适护理的措施和效果。方法选取我院在2014年9月~2015年11月收治的78例股骨颈骨折患者,随机分组,实验组44例患者采取舒适护理,对照组34例患者选择常规护理,比较两组患者的护理效果和身体恢复情况。结果实验组患者护理有效率为95.45%,对照组患者护理有效率为82.35%,实验组患者的护理效果更优,差异有统计学意义(P<0.05)。结论股骨颈骨折患者采取舒适护理可促使治疗效果以及护理满意度提高,效果好,减轻身体不适,保持良好的心理状态。

  8. 老年股骨颈骨折患者的循证治疗分析%Evidence - based treatment for elderly patient with femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    彭昊; 帕力哈提·白克吐尔逊

    2011-01-01

    Objective To develop an evidence - based treatment for an elderly patient with femoral neck fracture.Method Based on the clinical question raised by a elderly patient with femoral neck fracture, we searched PubMed ( 2000 ~ 2010), Cochrane (2008.4), Medline ( 2000 ~ 2010), Embase ( 2000 ~ 2010) ,Trip database, Ovid database and ACP online journal for related systematic review, RCT and metaanalysis.Then the evidence was assessed to obtain high - quality evidence for clinical treatment.Results A total of 1 evidence -based guideline ,2 RCT,8 systematic reviews and 9 meta -analyses were included.Based on these data and conditions of the individual patient, an evidence - based treatment plan was developed.Conclusion Using an evidence -based method,a rational and safe treatment strategy can be drawn for elderly patient with femoral neck fracture.%目的 为老年股骨颈骨折患者制定偱证治疗方案.方法 在充分评估患者病情后,进行临床提问,计算机检索Cochrane图书馆(2008年4月),PubMed(2002年至2010年),Medline(2000年至2010年)和Embase(2000年至2010年),Trip database,Ovid database 和 ACP(American College of physicians) online journal 关于股骨颈骨折治疗的偱证临床指南,RCT(Randomized controlled trial),系统评价和Meta分析,并评价其质量,获取最佳证据用于临床治疗.结果 共检出关于股骨颈骨折的8篇系统评价,9篇Meta分析,1篇偱证治疗指南,2篇 RCT.结合患者实际情况,制定出偱证治疗方案.结论 采用偱证治疗方法,可为患者确定合理而安全的治疗方案.

  9. Evaluation the treatment outcomes of intracapsular femoral neck fractures with closed or open reduction and internal fixation by screw in 18-50-year-old patients in Isfahan from Nov 2010 to Nov 2011

    Directory of Open Access Journals (Sweden)

    Mohammad Javdan

    2013-01-01

    Conclusion: This study showed that femoral neck fracture is associated with several complications, especially if open reduction was necessary. So, the surgical method and necessary equipments such as radiolucent bed, C-ARM machine, and implant cannulated screw set should be considered.

  10. Effects of different tunnel sizes of femoral head core decompression on femoral neck biomechanics%股骨头钻孔减压孔径对股骨颈生物力学影响的实验研究

    Institute of Scientific and Technical Information of China (English)

    何国忠; 庞清江; 陈先军; 余霄; 赵卫东

    2013-01-01

    Objective To observe the effects of different tunnel sizes of the femoral head core decompression on femoral neck biomechanics. Methods 24 fresh cadaver femur specimens were randomly divided into four groups: a normal group, a single-tunnel core decompression group (D=10 mm), a 2-tunnel core decompression group (D=7mm) and a 3- tunnel core decompression group (D=7mm). 3 points in main tension side, main pressure side and the lesser trochanter were chosen as the test points of strain from ON to 1200N load. Results The strain of the 2-tunnel group was the lowest among the normal group, the single-tunnel group, 2-tunnel group and 3-tunnel group; furthermore, the strain values of all of the 3 core decompression groups were larger than that in the normal group in tension side and the pressure side. Conclusions There is a significant effect on the femoral neck biomechanics by femoral head core decompression. The 2-tunnel (D= 7mm) with the lowest strain value may be the best choice to femoral head core decompression.%目的 观察经转子间股骨头减压钻孔的孔径对股骨颈生物力学的影响.方法 取新鲜尸体股骨标本24具,随机分成4组:正常组、单孔减压组(D=10 mm)、双孔减压组(D=7 mm)和3孔减压组(D=7 mm).在股骨颈主张力侧、主压力侧和小转子处各选择1点作为应变测试点,检测4组标本在,0~1200N分级载荷下各测点的应变.结果 在股骨颈主张力侧和主压力侧的测试点中,单孔减压组、双孔减压组和3孔减压组的应变值均大于正常组,其中双孔减压组的应变值在三组钻孔组间最小,并且与其它组间相比差异具有显著性(P<0.05).结论 经转子间股骨头钻孔减压明显影响股骨颈生物力学性能,与单纯大孔钻孔面积相同的2小孔钻孔减压对股骨颈生物力学性能影响较小.

  11. Hansson Pin 治疗股骨颈骨折的生物力学测试与临床应用分析%Biomechanical Experiment and Clinical Application of Hansson Pin for the Treatment of Femoral Neck Fracture

    Institute of Scientific and Technical Information of China (English)

    林博文; 肖德明; 黎伟凡; 麦汉溪; 朱杰诚; 曾纪葵

    2001-01-01

    目的 探讨HanssonPin治疗股骨颈骨折的疗效。方法 临床治疗39例,并作生物力学测试。结果 全部病例得到随访,时间4~36个月,平均23个月。骨性愈合31例,其中12例有滑针、股骨颈缩短表现,半年内出现滑针、塌陷移位3例;股骨头缺血性坏死5例。生物力学性能显示HanssonPin的承力效果优于骨圆针。结论 HanssonPin作为股骨颈内固定操作简单,但术后早期负重行走滑针率较高。%Objective To investigate the clinical therapeatic effectivenessof the femoral neck fracture treated by Hansson pin and biomechanical test was carried out in cadaveri femoral specimens.Methods Thirty-nine cases of femoral neck fracture were treated by Hansson Pin and biomechanical test was carried out in cadaveri femoral specimens.Results All patients were foll owed up for an average duration of 23 months.The results show that 31 cases healed up, as a result of pins sliding, so that femoral neck was shortening in 12 cases; femoral head collapsed was found in 3 cases and ischemic necrosis of femoral head appeared in 5 cases . The biomechanical character of Hansson pin is only better than round pin.Conclusion Hansson pinis easy to be used , but the rate of sliding pin is 38.46%,which is resulted from allowing the patient to wear early

  12. Prediction of femoral neck and spine bone mineral content from the BMC of the radius or ulna and the relationship between bone strength and BMC

    Science.gov (United States)

    Wilson, C. R.

    1974-01-01

    The bone mineral content (BMC) is extensively used to provide information about the status of an entire skeleton. Changes in BMC are employed to evaluate the effect of various drugs, disease states, weightlessness, exercise, renal dialysis and others on the skeleton. Clinical and functional information is discussed that may be derived from the BMC of a limited region of the skeleton. In particular there is a fairly high degree of correlation between the BMC of the radius or ulna and that of the femoral neck, r about 0.85 and a somewhat lower relationship between the BMC of the radius or ulna and the thoracic vertebrae, r about 0.65. Also the BMC is highly related to the strength of bone at that scan site.

  13. A new measurement for posterior tilt predicts reoperation in undisplaced femoral neck fractures: 113 consecutive patients treated by internal fixation and followed for 1 year

    DEFF Research Database (Denmark)

    Palm, Henrik; Gosvig, Kasper; Krasheninnikoff, Michael

    2009-01-01

    BACKGROUND AND PURPOSE: Preoperative posterior tilt in undisplaced (Garden I-II) femoral neck fractures is thought to influence rates of reoperation. However, an exact method for its measurement has not yet been presented. We designed a new measurement for posterior tilt on preoperative lateral......, and rate of reoperation within the first year. In a subgroup of 50 randomly selected patients, reliability tests for measurement of posterior tilt were performed. RESULTS: Intra- and interclass coefficients for the new measurement were > or = 0.94. 23% (26/113) of patients were reoperated and increased...... score, time from admission to operation, surgeon's expertise, postoperative reduction, and implant positioning, a preoperative posterior tilt of > or = 20 degrees was the only significant predictor of reoperation (p measurement for posterior tilt appears to be reliable...

  14. Extracapsular wide resection of a femoral neck osteosarcoma and its reconstruction using a pasteurized autograft-prosthesis composite: A case report.

    Science.gov (United States)

    Yasuda, Taketoshi; Hori, Takeshi; Suzuki, Kayo; Hachinoda, Jun; Matsushita, Isao; Ito, Yoshiaki; Kanamori, Masahiko; Kimura, Tomoatsu

    2013-10-01

    The requirement for an extracapsular resection is indicated for malignant bone tumors that have disseminated intracapsularly. Extracapsular resections are often performed for malignant tumors arising from the knee joint, but there are relatively few studies that have described an extracapsular resection of a tumor arising from the hip joint. The present study describes a case of extracapsular wide resection of the hip joint using rotational acetabular osteotomy. The patient was a 17-year-old female and the diagnosis was an osteoblastic osteosarcoma with a pathological fracture of the femoral neck. The joint was reconstructed using an allograft-implant composite graft and total hip arthroplasty. Although the patient presented a slight Trendelenburg gait, no recurrence or metastases were identified during a follow-up period of 3 years. The clinical features and surgical procedure of the case are described.

  15. Damage Control Orthopedics Management as Vital Procedure in Elderly Patients with Femoral Neck Fractures Complicated with Chronic Renal Failure: A Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Chenhui Dong

    Full Text Available Chronic renal failure (CRF predisposes to hip fractures in elderly patients, with high subsequent mortality. Selection and timing of the surgical procedure of such patients is a serious challenge. Many clinicians believe in earlier surgery as preferable and providing better outcomes. Damage control orthopedics (DCO aids to adjust and optimize the overall condition of patients.In 32 patients with femoral neck fractures complicated with CRF, we evaluated how the timing of the surgery determines the mortality rates if the DCO approach is applied. Preoperative ASA grading, POSSUM score, P-POSSUM score and DCO were carried out. Based on the assessment, timing of the surgery was ascertained.Of a total of 32 patients, twenty-nine patients were accepted for either early (< 48 hours; n = 18 or delayed (3-10 days; n = 10 surgery. Hip arthroplasty (total hip arthroplasty and hemiarthroplasty was the principal surgery option. All patients survived operation and were followed up postoperatively with the average time of 30 days. Postoperative complications tended to occur at higher rates in the early vs. delayed surgery group (7/18 vs. 5/10. During follow up, a total of 3 patients died in both groups (2/18 in the early surgery and 1/10 in the delayed surgery group, mostly from multi-organ failures and acute respiratory distress syndrome. There was no significant difference in complication rates and Harris hip score between both groups.In patients with femoral neck fracture complicated with CRF, delaying the surgery for several days does not increase the incidence of postoperative adverse events.

  16. 吻合血管腓骨移植治疗陈旧性股骨颈骨折%Treatment of Non-union Femoral Neck Fractures with Vascularized Fibula Grafting

    Institute of Scientific and Technical Information of China (English)

    王春生; 王坤正; 党晓谦; 陈君长; 张开放; 金辽沙

    2003-01-01

    Objective: To investigate the value of transplantation of vascularized fibula intreating non-union femoral neck fractures and preventing ischemic necrosis of the femoral head. Meth-ods:Vascularized heterotopic fibula was transplanted to the anterior-lateral part of the femoral neck.The fibula artery and vein were anastomosised with lateral circumflex artery and vein. Results:Onehundred and twenty-nine cases of non-union femoral neck fracture were treated with vascularized fibulagraft in our hospital from 1982 to 2002. Eighty-seven cases of them were followed up for 3 to 19years with functional and X-ray examination. The percentage of fracture healing and effect were 94. 3and 81.6, respectively. Conclusion:The fibula with blood supply has a synergistic fixation impacton the non-union femoral neck fractures. The fibula is solid enough for supporting the femoral headand preventing it from collapse. The vascularized fibula grafting, by providing blood supply to the af-fected femoral head and neck, could promote the femoral head restoration and reconstruction. In addi-tion, the periosteum of fibula plays a role in fracture healing.%目的:了解吻合血管腓骨移植治疗陈旧性股骨颈骨折和预防股骨头坏死的效果.方法:带血管腓骨移植到股骨颈的前外侧,腓动静脉与旋股外动静脉吻合.结果:1982~2002年间共吻合血管腓骨移植治疗陈旧性股骨颈骨折129例.获得随访89例,随访时间3~19年,随访患者进行X线和功能检查.按骨折愈合和功能情况分析,有效率和良好率分别是95.4%和85.1%.结论:对股骨颈骨折,腓骨有协同固定作用,对股骨头坏死腓骨作为皮质骨有支撑和防止塌陷的作用,吻合的腓骨血管为股骨头颈部提供血供,促进了股骨颈骨折的愈合和股骨头的恢复与重建.腓骨骨膜在骨折的愈合中可能起一定的作用.

  17. Osteotomia femoral em cúpula para correção do ângulo de inclinação do colo do fémur Femoral cupola osteotomy for correction of femoral neck inclination angle

    Directory of Open Access Journals (Sweden)

    Paulo lamaguti

    1996-04-01

    Full Text Available Utilizou-se a osteotomia femoral em cúpula em um cão que apresentava aumento do ângulo de inclinação do colo do fêmur e subluxação da articulação coxofemoral. A linha de osteotomia situou-se cerca de 1 cm distal ao trocanter menor, no sentido látero-medial. Para a imobilização utilizou-se um fio de Steinmann passando pelo trocanter maior e por toda a extensão do fêmur. Um fio de aço foi colocado em orifícios ósseos produzidos nos segmentos proximal e distal do fêmur para a realização de sutura óssea. A técnica empregada culminou em: diminuição de 35° no ângulo de inclinação, rebaixamento da cabeça do fêmur, elevação do trocanter maior, congruência da articulação e encurtamento de 3cm do membro. A consolidação ocorreu cerca de 90 dias após a cirurgia.Femoral cupola osteotomy was performed in a dog with a large femoral inclination angie and hip subluxation. Osteotomy owas performed 1 cm distal to the lesser trochanter from lateral to medial cortex. Immobilization was performed owith a Steinamnnpin drivenfrom the greater trochanter and through two boles drilled proximal and distal to the osteotomy line. The technique produced: 35° decrease on inclination angle, lowering of the femoral head, elevation of the greater trochanter, congruity of the hip and 3cm limb shortening. Consolidation occured 90 days after the surgery.

  18. Aspectos biomecânicos compressivos de diáfises femorais caninas conservadas em glicerina a 98% ou em mel Biomechanical compressive aspects of canine femoral shafts preserved in 98% glycerin or honey

    Directory of Open Access Journals (Sweden)

    Gustavo Frassetto Amendola

    2008-08-01

    Full Text Available Neste estudo foi comparada a resistência compressiva axial de diáfises femorais caninas a fresco (grupo F, conservadas por trinta dias em glicerina a 98% (grupo G ou em mel (grupo M. Cada grupo continha 50 amostras que foram submetidas a testes biomecânicos compressivos, em uma prensa de compressão axial, até ocorrer fissura. Os ossos conservados em glicerina ou mel foram reidratados antes da avaliação. Pelos resultados obtidos, foi verificada maior resistência nos ossos conservados em glicerina, depois nos ossos conservados em mel, sendo mais frágeis aqueles testados a fresco.This study aimed at evaluating the axial compressive resistance of fresh canine femoral shafts (group F, canine femoral shafts preserved in 98% glycerin (group G or honey (group M for a 30-day period. The femoral shafts (50 samples in each group were submitted to biomechanical evaluation in a machine of axial compression in order to observe the pressure necessary to determine bone fissure. The shafts preserved in 98% glycerin or honey were rehydrated in saline 0.9% before evaluation. Bones stored in 98% glycerin have more resistance than bones preserved in honey and fresh implants presented the worst performance.

  19. Osteotomia valgizante para pseudartrose do colo do fêmur: relato de 32 casos Valgusing intertrochanteric osteotomy for the treatment of femoral neck non-unions: report of 32 cases

    Directory of Open Access Journals (Sweden)

    Carlos Roberto Schwartsmann

    2009-04-01

    Full Text Available OBJETIVO: Avaliar a consolidação pós-osteotomia osteotomia valgizante do fêmur no tratamento do pseudartrose do colo femoral. MÉTODO: Durante 15 anos (1988-2003, 32 casos de pseudartrose do colo do fêmur foram tratados com osteotomia valgizante e fixação. O seguimento médio dos casos foi de 9,8 anos e a média de idade dos pacientes foi de 41,7 anos. RESULTADOS: Dos 32 casos quatro evoluíram para prótese total do quadril e 28 evoluíram para consolidação (87,4%. Oito casos evoluíram necrose parcial. CONCLUSÃO: A osteotomia valgizante é altamente eficaz para obtenção da consolidação na pseudartrose do colo do fêmur 87,4% (28/32 A recuperação integral da função do quadril só foi obtida em 56,2% (18/32PURPOSE: The purpose of the present study was to review the results of femoral neck non-unions treatment with valgusing intertrochanteric osteotomy. METHODS: Between 1988 and 2003 we treaded thirty two femoral neck non-unions with valgusing osteotomy and fixation. The mean follow-up time was 9.8 years and the mean age was 41.7 years. RESULTS: Twenty eight (87.4% of the thirty two valgusing osteotomies evolved to femoral neck union, while four cases (12.6% evolved to total hip arthroplasty. Eight cases evolved to partial osteonecrosis. CONCLUSIONS: The valgusing intertrochanteric osteotomy for treating femoral neck non-unions achieved consolidation in 87.4% (28/32. However, only 56.2% (18/32 achieved full recovery of hip function.

  20. Evaluation of rhBMP-2/collagen/TCP-HA bone graft with and without bone marrow cells in the canine femoral multi defect model.

    Science.gov (United States)

    Luangphakdy, V; Shinohara, K; Pan, H; Boehm, C; Samaranska, A; Muschler, G F

    2015-01-12

    Recombinant human bone morphogenetic protein-2, when applied to an absorbable type 1 bovine collagen sponge (rhBMP-2/ACS) is an effective therapy in many bone grafting settings. Bone marrow aspirate (BMA) has also been used as a source of transplantable osteogenic connective tissue progenitors. This study was designed to characterize the performance of a scaffold comprising rhBMP-2/ACS in which the sponge wraps around tri-calcium phosphate hydroxyapatite granules (rhBMP-2/ACS/TCP-HA) and to test the hypothesis that addition of BMA will improve the performance of this construct in the Canine Femoral Multi Defect Model. In each subject, two sites were grafted with rhBMP-2/ACS/TCP-HA scaffold loaded with BMA clot and two other sites with rhBMP-2/ACS/TCP-HA scaffold loaded with wound blood (WB). After correction for unresorbed TCP-HA granules, sites grafted with rhBMP-2/ACS/TCP-HA+BMA and rhBMP-2/ACS/TCP-HA+WB were similar, with mean percent bone volumes of 10.9 %±1.2 and 11.2 %±1.2, respectively. No differences were seen in quantitative histomorphometry. While bone formation using both constructs was robust, this study did not support the hypothesis that the addition of unprocessed bone marrow aspirate clot improved bone regeneration in a site engrafted with rhBMP-2/ACS/TCP-HA+BMA. In contrast to prior studies using this model, new bone formation was greater at the center of the defect where TCP-HA was distributed. This finding suggests a potential synergy between rhBMP-2 and the centrally placed ceramic and cellular components of the graft construct. Further optimization may also require more uniform distribution of TCP-HA, alternative cell delivery strategies, and a more rigorous large animal segmental defect model.

  1. Refractory metabolic acidosis in patients with sepsis following hemiarthroplasty for femoral neck fracture: a causative role for paracetamol and flucloxacillin?

    OpenAIRE

    2011-01-01

    The authors report two cases of pyroglutamic acidosis as a result of paracetamol and flucloxacillin therapy in patients with prosthesis infection following hemiarthroplasty for neck of femur fractures. Pyroglutamic acidosis is an important and often unrecognised cause of refractory metabolic acidosis that disproportionately affects older women, and can be caused by drugs such as paracetamol and flucloxacillin in the setting of sepsis, renal failure and malnutrition. Although relatively rare, ...

  2. Sexual dimorphism of femoral neck cross-sectional bone geometry in athletes and non-athletes: a hip structural analysis study.

    Science.gov (United States)

    Hind, Karen; Gannon, Lisa; Whatley, Emma; Cooke, Carlton

    2012-07-01

    The characterisation of bone geometry in male and female athletes may increase our understanding of how physical loading may enhance bone strength in both sexes. This study investigated sexual dimorphism in hip geometry of athletes and age- and sex-matched non-athletes. Dual energy X-ray absorptiometry of the left proximal femur was performed in 62 male (n = 31; 30.2 ± 4.6 years) and female (n = 31; 27.9 ± 5.2 years) competitive endurance runners, and 36 male (n = 18; 28.7 ± 5.8 years) and female (n = 18; 29.1 ± 5.3 years) non-athletes. The hip structural analysis programme determined areal bone mineral density (aBMD), bone area (BA), hip axis length, cross-sectional area (CSA), and cross-sectional moment of inertia (CSMI) of the femoral neck. Strength indices were derived from the femoral strength index (FSI) (Yoshikawa et al., J Bone Miner Res 9:1053-1064, 1994). Despite similar size-adjusted aBMD, sexual dimorphism was apparent for BA, CSA and CSMI, with superior values in men compared to women (P < 0.01). FSI was greater in male and female athletes than non-athletes (P < 0.01). From all groups, results in male athletes inferred greatest resistance to axial (CSA) and bending loads (FSI). Estimates of bone strength (FSI) were greater in female athletes than male and female non-athletes, supporting the osteogenic value of regular loading of the hip.

  3. Internal fixation of femoral neck fractures in the elderly%老年股骨颈骨折的内固定治疗

    Institute of Scientific and Technical Information of China (English)

    危杰; 吴晓亮; 王满宜

    2009-01-01

    目的 探讨内固定治疗老年股骨颈骨折的疗效. 方法回顾研究2000年1月至2007年12月采用内固定治疗且获得随访的139例老年股骨颈骨折患者资料,其中男52例,女87例;年龄65~93岁,平均71.6岁;受伤至入院时间为1 h~30 d,平均56.7 h.骨折按Garden分型:Ⅰ型17例,Ⅱ型43例,Ⅲ型62例,Ⅳ型17例.移位骨折79例,非移位骨折60例.内固定材料:空心钉131例,动力髋螺钉5例,动力髋螺钉加空心钉3例.对患者住院时间、骨折愈合率、术后并发症、股骨头缺血坏死率、内固定失效率及患者功能恢复情况进行总结分析. 结果 139例患者住院时间为5~59 d,平均15.4 d.术后获7~77个月(平均35个月)随访.骨折愈合126例,占90.6%(126/139);愈合时间2~12个月,平均6.2个月.其中22例患者术后出现并发症.骨折不愈合内固定失效13例,占9.4%(13/139);股骨头缺血性坏死9例,占6.5%(9/139).正常行走者81例,占58.3%(81/139),需要助行器械者50例,占36.0%(50/139),不能行走者8例,占5.7%(8/139).结论 老年股骨颈骨折内固定治疗骨折愈合率高,股骨头缺血坏死率较低,内固定治疗老年股骨颈骨折具有积极意义.术前病情评估和合并症的积极治疗非常重要,条件允许时应尽早手术.%Objective To evaluate the outcome of the old patients who were treated for femoral neck fractures in our hospital during 2000-2007. Methods A retrospective study was conducted to evaluate outcomes of the 139 old patients who had received internal fixation for femoral neck fractures in our department during 2000-2007. The mechanism of injury, duration between injury and hospitalization, severity of fracture, anamnesis, time of hospital stay, anaesthesia, operation, postoperative complications, fracture healing, in-cidence of avascular necrosis of femoral head, failure of fixation, and functional restoration of the patients were documented. Results Fracture healing was found in 126 cases (90

  4. Retrospective comparison of the effects of epidural anesthesia versus peripheral nerve block on postoperative outcomes in elderly Chinese patients with femoral neck fractures

    Directory of Open Access Journals (Sweden)

    Jin JW

    2015-08-01

    Full Text Available Jianwen Jin,1 Gang Wang,2 Maowei Gong,3 Hong Zhang,3 Junle Liu21Department of Clinical Medicine, Fujian Health College, Fuzhou, 2Department of Anesthesiology, Chinese People’s Liberation Army 105 Hospital, Hefei, 3Anesthesia and Operation Center, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of ChinaBackground: Geriatric patients with femoral neck fracture (FNF have unacceptably high rates of postoperative complications and mortality. The purpose of this study was to compare the effects of epidural anesthesia versus peripheral nerve block (PNB on postoperative outcomes in elderly Chinese patients with FNF.Methods: This retrospective study explored mortality and postoperative complications in geriatric patients with FNF who underwent epidural anesthesia or PNB at the Chinese People’s Liberation Army General Hospital from January 2008 to December 2012. The electronic database at the Chinese People’s Liberation Army General Hospital includes discharge records for all patients treated in the hospital. Information on patient demographics, preoperative comorbidity, postoperative complications, type of anesthesia used, and in-hospital, 30-day, and 1-year mortality after surgery was obtained from this database.Results: Two hundred and fifty-eight patients were identified for analysis. The mean patient age was 79.7 years, and 71.7% of the patients were women. In-hospital, 30-day, and 1-year postoperative mortality was 4.3%, 12.4%, and 22.9%, respectively, and no differences in mortality or cardiovascular complications were found between patients who received epidural anesthesia and those who received PNB. More patients with dementia or delirium were given PNB. No statistically significant differences were found between groups for other comorbidities or intraoperative parameters. The most common complications were acute cardiovascular events (23.6%, electrolyte disturbances (20.9%, and hypoxemia (18.2%. Patients

  5. Measuring the osteochondral connection of the femoral head and neck in patients with impingement femoroacetabulare by determining the angle of two alpha in lateral and anteroposterior hip radiographic images

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    Anđelković Zoran

    2013-01-01

    Full Text Available Background/Aim. Femoroacetabular impingement, a pathophysiological mechanism of small morphological changes of the hip leads to early arthritic changes. The aim of this study was to present a simple method for the quantification of femoral head and neck junction in patients with cam form of femoroacetabular impingement, in standardized anteroposterior and profile DUNN 90 radiograms of the hips. Methods. In standardized anteroposterior and profile DUNN 90 images of the hips we determined the angle of 2 alpha, defined by our own original method. We tested 141 hips in 81 patients without clinical signs of femoroacetabular impingement, and 153 hips in 76 patients with clinically clear signs of femoroacetabular impingement. Results. The value of the angle 2 alpha in anteroposterior hip radiograms was on average 113.7° for the patients with clinical symptoms of impingement, and 84.2° for the control group of patients (p ≤ 0.0001, and in DUNN 90 profile radiography of the hip, the value of 2 alpha angle in the patients group was 97.2°, and 74.6° in the control group (p ≤ 0.0001. The proposed method of determining the angle 2 alpha showed a high level sensitivity (97.8% and specificity (98.7 and positive predictive value (98.6%. It was false positive in only 1.3%, and false negative in 2.12% of patients. Conclusion. Using standardized anteroposterior and profile radiographs of the hips, and without determination of femoral neck axis in patients with femoroacetabular impingement with the cam effect at the junction of the femoral head and neck, we proposed the method of measuring joint abnormalities of femoral head and neck junction, very capable to predict the disease development in an asymptomatic risk group of patients and high sensitive in the diagnosis of the disease in the group of patients.

  6. Biopolymer augmentation of the lag screw in the treatment of femoral neck fractures - a biomechanical in-vitro study

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    Paech A

    2010-04-01

    Full Text Available Abstract The cut-out of the sliding screw is one of the most common complications in the treatment of intertrochanteric fractures. The reasons for the cut-out are: a suboptimal position of the hip-screw in the femoral head, the type of fracture and poor bone quality. The aim of this study was to reproduce the cut-out event biomechanically and to evaluate the possible prevention of this event by the use of a biopolymer augmentation of the hip screw. Concerning the density and compression force of osteoporotic femoral bone polyurethane foam according to the terms of the Association for Standard Testing Material (ASTMF 1839-97 was used as test material. The polyurethane foam Lumoltan 200 with a compression force of 3.3 Mpa and a density of 0.192 g/cm3 was used to reproduce the osteoporotic bone of the femoral fragment (density 12 lbm/ft3. A cylinder of 50 mm of length and 50 mm of width was produced by a rotary splint raising procedure with planar contact. The axial load of the system was performed by a hydraulic force cylinder of a universal test machine type Zwick 1455, Ulm, Germany. The CCD-angle of the used TGN-System was preset at 130 degrees. The migration pattern of the hip screw in the polyurethane foam was measured and expressed as a curve of the distance in millimeter [mm] against the applied load in Newton [N] up to the cut-out point. During the tests the implants reached a critical changing point from stable to unstable with an increased load progression of steps of 50 Newton. This unstable point was characterized by an increased migration speed in millimeters and higher descending gradient in the migration curve. This peak of the migration curve served as an indicator for the change of the hip screw position in the simulated bone material. The applied load in the non-augmented implant showed that in this group for a density degree of 12 (0,192 g/cm3 the mean force at the failure point was 1431 Newton (± 52 Newton. In the augmented

  7. The use of recombinant human bone morphogenetic protein-2 for the treatment of a delayed union following femoral neck open-wedge osteotomy

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    Axel W.A. Baltzer

    2012-03-01

    Full Text Available Although the clinical potential of bone morphogenetic proteins (BMPs has been known for decades, their use in humans has only been approved for a limited number of orthopaedic conditions. Promising results in animals demonstrate the utility of BMP-2 in regional bone repair without using osteoconductors. To our knowledge, no comparable human case has been described. We report the case of a 50- year-old who suffered a femoral neck fracture. After 9 months of extensive treatment, he was still not pain-free. The following open-wedge osteotomy resulted in a therapy-resistant delayed union. We therefore conducted 4 computer tomography-guided injections of recombinant human (rh BMP-2 into the bone gap. No osteoconductor was employed. Six weeks later, there was a 55-60% defect filling. Followup examination showed a complete union of the bone defect. Our case report shows that in a complicated delayed union rhBMP-2 can be successfully used to induce bone formation without any osteoconductor.

  8. Perioperative nursing for elder patients with femoral neck fracture%高龄股骨颈骨折患者围术期护理

    Institute of Scientific and Technical Information of China (English)

    常艳; 常伟丽

    2011-01-01

    Objective: To analyze the features of perioperative nursing for elder patients with femoral neck fracture who over the age of 80, and provide insight into the treatment care for elder patients. Methods: Retrospective study was performed of 61 cases of femoral neck fracture patients over the age of 80 receiving surgery during the period from June 2000 to June 2008. Care providing included preoperative health education, nichetargeting psychological care. Heart condition of the patients during and after operation was monitored, and blood pressure and blood sugar level were controlled. The vital signs after operation and sensorimotor distal limb blood circulation were closely observed, and the nursing of complications such as bedsores, lung infections, urinary tract infection and deep venous thrombosis were strengthened. Results: 61 patients were successfully operated, discharged with crutches or a walker and without incision infection and symptomatic deep venous thrombosis. Patients were able to sit up 3 to 5 day after operation and ambulate with crutches 5 to 10 days after operation. There occurred 6 cases of electrolyte disturbance, 4 cases of postoperative pulmonary infection, 3 cases of hy -potension, 2 cases of cardiac insufficiency, 2 cases of atrial fibrillation, 2 cases of stress ulcer, 1 case of postoperative uri -nary tract infection, and 1 case of bedsore. After active treatment and care, the symptoms of all patients improved. Conclusion: Patients with femoral neck fracture over the age of 80 should be given surgical treatment as early as possible to shorten the time in bed. Thus reasonable and effective perioperative nursing for patients with femoral neck fracture over the age of 80 is an important guarantee of successful operation.%目的:分析80岁以上高龄股骨颈骨折患者的围术期护理,总结围术期的特点,对今后高龄患者的治疗护理提供帮助.方法:回顾性研究2000年6月~2008年6月我院手术治疗的61例80

  9. Individualized surgical treatment of femoral neck fracture with strategy andoutcome%股骨颈骨折个体化手术治疗策略与结果

    Institute of Scientific and Technical Information of China (English)

    戢良超; 谌刚; 李世林; 徐映明; 周平

    2012-01-01

    Objective To discuss the Individualized surgical treatment of fresh femoral neck fracture with strategy and outcome. Methods From January 2005 to January 2011 ,admitted femoral neck fracture and a complete follow-up information on 86 cases,they were 47 men and 39 women, age from 18 to 65 in 18 cases,from 66 to 86 in 38 cases. By Garden classification, type Ⅰ were 23 cases, type Ⅱ were 25 cases, type Ⅲ were 26 cases, type Ⅳ were 12 cases . 48 cases were used open reduction. Of 22 cases with cannulated cancellous bone screws , 26 cases with dynamic hip screws. Hemi-hip replacement were 30 cases . Total hip replacement were 8 cases. Results 86 cases were followed up for 1 ~6 years, with an average of 3. 1 years. Internal fixation group 48 cases, the healing time 17 ~ 24 weeks ( an average of 20. 5 weeks) , the varus deformity of hip in 5 cases, avascula r necrosis of femoral head in 3 cases, and the excellent and good rate was 79. 2%. Hip joint replacement group 38 cases, early dislocation in 2 cases,incision infection in 1 case, and the excellent and good rate was 84. 2%. Conclusion With the age, bone density activity ability and fracture type of the patients to choose personalized surgical treatment plan, can gel good curative effect.%目的 探讨新鲜股骨颈骨折个体化手术治疗策略与结果.方法 2005年1月~2011年1月,收治新鲜股骨颈骨折并获得完整随访资料者86例,男47例,女39例,年龄18 ~ 65岁48例,66 ~ 86岁38例,骨折按Garden分型:Ⅰ型23例,Ⅱ型25例,Ⅲ型26例,Ⅳ型12例;分别采用切开复位空心松质骨螺钉内固定22例,动力髋螺钉内固定26例,半髋关节置换30例,全髋关节置换8例.结果 获得1~6年(平均3.1年)随访,内固定组48例,骨折愈合时间17~24周(平均20.5周),髋内翻5例,股骨头缺血坏死3例,优良率79.2%.关节置换组38例,早期脱位2例,切口感染1例,优良率84.2%.结论 根据股骨颈骨折患者年龄、活动能力、骨

  10. Artroplastia parcial no tratamento das fraturas do colo do fêmur Hemiarthroplasty in the treatment of fractures of the femoral neck

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    Nelson Keiske Ono

    2010-01-01

    Full Text Available OBJETIVO: Realizar avaliação epidemiológica e clínica dos pacientes com fratura desviada do colo femoral, que foram submetidos ao tratamento cirúrgico, com artroplastia parcial do quadril cimentada. MÉTODOS: Foram avaliados, de forma retrospectiva, todos os pacientes com fratura desviada do colo do fêmur (Garden III e IV submetidos à artroplastia parcial do quadril com prótese unipolar (Thompson, cimentada pela via de acesso posterolateral do quadril, no período de junho de 2005 a setembro de 2008. RESULTADOS: Foram avaliados, inicialmente, 70 pacientes. A média de idade foi de 83,1 anos. Houve predomínio de pacientes do sexo feminino (84,3%. Houve acompanhamento ambulatorial de 36 pacientes, cujo tempo de seguimento variou de 10 a 48 meses (média de 26,5 meses. Houve perda de seguimento de 15 pacientes. Dezenove pacientes foram a óbito, com uma taxa de mortalidade no primeiro ano de 25,4%. Os pacientes classificados como ASA III apresentaram taxa de 25,7%, enquanto os pacientes ASA II, uma taxa de 12,1%. Dois pacientes apresentaram trombose venosa profunda sintomática; um paciente, infecção do sítio operatório; e nenhum paciente apresentou luxação do quadril. A maioria dos pacientes evoluiu sem dor. Doze pacientes (33%, durante a evolução, apresentaram piora na capacidade de deambulação. CONCLUSÃO: Nenhum caso de luxação do quadril foi observado. Os pacientes classificados como ASA III apresentaram um índice de mortalidade mais elevado, em relação aos pacientes ASA I e II. Houve uma piora da capacidade de deambular em 33% dos pacientes. Não foi necessária revisão de nenhum paciente por soltura ou dor. Trinta pacientes não apresentavam dor (83,3%, quatro apresentavam dor moderada (11,1% e dois apresentavam dor intensa (5,5%.OBJETIVE: To epidemiologically and clinically evaluate patients with displaced femoral neck fractures that had surgical treatment with cemented hemiarthroplasty. METHODS: We evaluated

  11. Assessment of Methods for Rapid Intraoperative Concentration and Selection of Marrow-Derived Connective Tissue Progenitors for Bone Regeneration Using the Canine Femoral Multidefect Model.

    Science.gov (United States)

    Luangphakdy, Viviane; Boehm, Cynthia; Pan, Hui; Herrick, James; Zaveri, Phil; Muschler, George F

    2016-01-01

    Treatment of large bone defects remains an unsolved clinical challenge, despite a wide array of existing bone graft materials and strategies. Local deficiency in osteogenic connective tissue progenitors (CTP-Os) due to tissue loss is one of the central biological barriers to bone regeneration. Density separation (DS) and selective retention (SR) represent two promising methods that can be used intraoperatively to rapidly concentrate cells and potentially select CTP-Os. This project was designed to compare DS and SR using the canine femoral multidefect (CFMD) model. Mineralized cancellous allograft (MCA) was used as a standardized scaffold for cell transplantation. Two experiments were performed using a cohort of six animals in each comparison. In Cohort I, unprocessed bone marrow aspirate (BMA) clot was compared to DS processing. MCA combined with raw BMA or DS processed cells produced a robust and advanced stage of bone regeneration throughout the defect in 4 weeks with reconstitution of hematopoietic marrow. However, the retention of DS processed cells and CTP-Os in the MCA matrix was low compared to BMA clot. In Cohort II, MCA with DS-T cells (addition of calcium chloride thrombin to induce clotting and enhance cell and CTP-O retention) was compared to MCA with SR cells. A mean of 276 ± 86 million nucleated cells and 29,030 ± 10,510 CTP-Os were implanted per defect in the DS-T group. A mean of 76 ± 42 million nucleated cells and 30,266 ± 15,850 CTP-Os were implanted in the SR group. Bone formation was robust and not different between treatments. Histologically, both groups demonstrated regeneration of hematopoietic marrow tissue. However, SR sites contained more hematopoietic vascular tissues, less fibrosis, and less residual allograft, particularly in the intramedullary cavity, suggesting a more advanced stage of remodeling (p = 0.04). These data demonstrate excellent overall performance of DS and SR processing methods. Both methods achieve a bone

  12. Early functional results after Hemiarthroplasty for femoral neck fracture: a randomized comparison between a minimal invasive and a conventional approach

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    Renken Felix

    2012-08-01

    Full Text Available Abstract Background A minimal invasive approach for elective hip surgery has been implemented in our institution in the past. It is widely hypothesized that implanting artificial hips in a minimal invasive fashion decreases surgical trauma and is helpful in the rehabilitation process in elective hip surgery. Thereby geriatric patients requiring emergency hip surgery also could theoretically benefit from a procedure that involves less tissue trauma. Methods Sixty patients who sustained a fractured neck of femur were randomly assigned into two groups. In the minimal invasive arm, the so called “direct anterior approach” (DAA was chosen, in the conventional arm the Watson-Jones-Approach was used for implantation of a bipolar hemi-arthroplasty. Primary outcome parameter was the mobility as measured by the four-item-Barthel index. Secondary outcome parameters included pain, haemoglobin-levels, complications, duration of surgery, administration of blood transfusion and external length of incision. Radiographs were evaluated. Results A statistically significant difference (p = 0,009 regarding the mobility as measured with the four-item Barthel index was found at the 5th postoperative day, favouring the DAA. Evaluation of the intensity of pain with a visual analogue scale (VAS showed a statistically significant difference (p = 0,035 at day 16. No difference was evident in the comparison of radiographic results. Conclusions Comparing two different approaches to the hip joint for the implantation of a bipolar hemi-arthroplasty after fractured neck of femur, it can be stated that mobilization status is improved for the DAA compared to the WJA when measured by the four-item Barthel index, there is less pain as measured using the VAS. There is no radiographic evidence that a minimal invasive technique leads to inferior implant position. Level of Evidence: Level II therapeutic study.

  13. Longitudinal study on physical fitness parameters influencing bone mineral density reduction in middle-aged and elderly women: bone mineral density in the lumbar spine, femoral neck, and femur.

    Science.gov (United States)

    Iida, Tadayuki; Ikeda, Hiromi; Shiokawa, Michihisa; Aoi, Satomi; Ishizaki, Fumiko; Harada, Toshihide; Ono, Yuichiro

    2012-06-01

    The prolongation of the average life span of women has been associated with the rapidly aging society. However, serious problem have arisen as a result, such as an increase in the number of bed-ridden elderly patients with osteoporosis-associated femoral neck fracture. As preventive measures against osteoporosis for middle-aged to elderly women, 10,000 steps per day and intense exercise have been reported to inhibit bone mineral density (BMD) reduction. However, only a few studies have concretely reported on the type of physical fitness that is effective for BMD in particular parts of the body. In this study, a one-year longitudinal survey was performed involving generally healthy postmenopausal women to investigate physical fitness parameters influencing BMD in the lumbar spine, femoral neck, and femur. The subjects were 38 female residents of M City, aged 49-73 years. As physical fitness parameters, sit-ups, anteflexion in a sitting position, grip strength, mean amount of exercise (kcal), and area of outer body sway on standing straight with the eyes closed (m2) were measured. The BMD was measured in the lumbar spine (L2-L4), femoral neck, and femur. Logistic regression analysis was performed regarding the physical fitness parameters as explanatory variables and groups with and without BMD reduction over one year as those with and without risk as dependent variables. The number of sit-ups (odds ratio: 0.76, 95% CI: 0.61-0.96, p=0.022) was a preventive factor against BMD reduction of the lumbar spine, and ante flexion in a sitting position was a preventive factor against BMD reduction of the femoral neck (odds ratio: 0.88, 95% CI: 0.78-0.99, p=0.029). Regarding BMD reduction of the femur, the area of outer body sway on standing straight with the eyes closed tended to be not significant to the risk. It is suggested that physical fitness and local muscle strength are associated with BMD reduction in the lumbar spine, femoral neck, and femur.

  14. Femoral bowing plane adaptation to femoral anteversion

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    Alp Akman

    2017-01-01

    Full Text Available Background: Femoral bowing plane (FBP is the unattended subject in the literature. More over the femoral shaft with its bowing is neglected in established anteversion determination methods. There is limited information about the relationship between FBP and anteversion. Thus we focused on this subject and hypothesized that there could be an adaptation of FBP to anteversion. Materials and Methods: FBP is determined on three-dimensional solid models derived from the left femoral computerized tomography data of 47 patients which were taken before for another reason and comparatively evaluated with anteversion. There were 20 women and 27 men. The mean age of patients was 56 years (range 21-84 years. Results: The anteversion values were found as the angle between a distal condylar axis (DCA and femoral neck anteversion axis (FNAA along an imaginary longitudinal femoral axis (LFA in the true cranio-caudal view. The FBP was determined as a plane that passes through the centre-points of three pre-determinated sections on the femoral shaft. The angles between DCA, FNAA and FBP were comparatively evaluated. The independent samples t-test was used for statistical analysis. At the end, it was found that FBP lies nearly perpendicular to the anteversion axis for the mean of our sample which is around 89° in females and 93° in males (range 78-102°. On the other hand, FBP does not lie close to the sagittal femoral plane (SFP; instead, there is an average 12.5° external rotation relative to the SFP. FBP is correlated well with anteversion in terms of FBP inclination from SFP and femoral torsion (i.e., angle between FBP and femoral neck anteversion axis (P0 < 0.001; r = 0.680 and r = −0.682, respectively. Combined correlation is perfect (R[2] = 1 as the FBP, SFP, and posterior femoral plane forms a triangle in the cranio-caudal view. Conclusions: We found that FBP adapts to anteversion. As FBP lies close to perpendicularity for the mean, femoral component

  15. Femoral bowing plane adaptation to femoral anteversion

    Science.gov (United States)

    Akman, Alp; Demirkan, Fahir; Sabir, Nuran; Oto, Murat; Yorukoglu, Cagdas; Kiter, Esat

    2017-01-01

    Background: Femoral bowing plane (FBP) is the unattended subject in the literature. More over the femoral shaft with its bowing is neglected in established anteversion determination methods. There is limited information about the relationship between FBP and anteversion. Thus we focused on this subject and hypothesized that there could be an adaptation of FBP to anteversion. Materials and Methods: FBP is determined on three-dimensional solid models derived from the left femoral computerized tomography data of 47 patients which were taken before for another reason and comparatively evaluated with anteversion. There were 20 women and 27 men. The mean age of patients was 56 years (range 21–84 years). Results: The anteversion values were found as the angle between a distal condylar axis (DCA) and femoral neck anteversion axis (FNAA) along an imaginary longitudinal femoral axis (LFA) in the true cranio-caudal view. The FBP was determined as a plane that passes through the centre-points of three pre-determinated sections on the femoral shaft. The angles between DCA, FNAA and FBP were comparatively evaluated. The independent samples t-test was used for statistical analysis. At the end, it was found that FBP lies nearly perpendicular to the anteversion axis for the mean of our sample which is around 89° in females and 93° in males (range 78–102°). On the other hand, FBP does not lie close to the sagittal femoral plane (SFP); instead, there is an average 12.5° external rotation relative to the SFP. FBP is correlated well with anteversion in terms of FBP inclination from SFP and femoral torsion (i.e., angle between FBP and femoral neck anteversion axis (P < 0.001; r = 0.680 and r = −0.682, respectively). Combined correlation is perfect (R2 = 1) as the FBP, SFP, and posterior femoral plane forms a triangle in the cranio-caudal view. Conclusions: We found that FBP adapts to anteversion. As FBP lies close to perpendicularity for the mean, femoral component positioning

  16. Persistent knee complaints after retrograde unreamed nailing of femoral shaft fractures

    NARCIS (Netherlands)

    El Moumni, Mostafa; Schraven, Pim; ten Duis, Henk Jan; Wendt, Klaus

    2010-01-01

    Retrograde nailing is an attractive method for stabilisation of femoral shaft fractures in cases of polytrauma, ipsilateral pelvic, acetabular, tibial and femoral neck fractures, bilateral femoral fractures, obese and pregnant patients. However, retrograde nailing may result in complaints about the

  17. One Stage Plasty for Acetabulum and Femoral Neck to Treat Congenital Hip Dislocation%先天性髋脱位髋臼股骨颈一次成形术

    Institute of Scientific and Technical Information of China (English)

    朱葆伦; 严幼华; 应灏; 沈金根

    1994-01-01

    1971年9月~1988年8月,共手术治疗先天性髋脱位患儿101例.采用髋臼、股骨颈一次成形术,由于大部分畸肜得到矫正,股骨头获得满意的覆盖,符合生物力学的要求,远期效果良好者达80.2%.%From 1971 to 1988,101 children with congenital hip dislocation were treated.The method was to curet the acetabulum and correct the anteversion of femoral neck by one stage procedure.The femoral head has been got a nice cover.It was adapted to biomechanics of hip joint.96 patients were followed up for 6 months to 10 years with a satisfactory rate of 80.2%.

  18. Analysis of the gynecological risk factors of femoral neck fracture with osteoporosis in elderly women%老年女性股骨颈骨折妇科相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    陈古福; 查前龙; 朱德军

    2015-01-01

    目的:探讨老年女性骨质疏松性股骨颈骨折的危险因素,为早期准确预测其骨质疏松股骨颈骨折提供客观依据。方法采用病例对照研究方法,选择150例年龄>60岁的骨质疏松性股骨颈骨折女性患者作为骨折组,同时在周边地区随机选取150例年龄相当的无股骨颈骨折的老年女性作为对照组。通过问卷调查的方法,调查两组年龄、初潮年龄、绝经年龄、怀孕次数、生产次数、母乳喂养时间、体重指数等妇科相关情况。采用 Logistic 回归分析的方法对影响股骨颈骨折的因素进行分析。结果对照组与骨折组的初潮年龄、绝经年龄、怀孕次数、生产次数、母乳喂养时间、体重指数比较差异均有统计学意义(P <0.05或 P <0.01),其中老年女性骨质疏松性股骨颈骨折的发生与初潮年龄、怀孕次数、生产次数、母乳喂养时间呈正相关(P <0.05或 P<0.01),与绝经年龄、体重指数呈负相关(P <0.01)。结论初潮晚、绝经早、孕产次数多、母乳喂养时间长、体重指数低可能是老年女性骨质疏松性股骨颈骨折的重要危险因素。%Objective To investigate the risk factors for osteoporosis in elderly women with femoral neck fracture for accurately predicting early femoral neck fracture of osteoporotic and providing an objective basis. Methods 150 os-teoporotic femoral neck fracture women older than 60 years were selected as a research group with case-control study. Age-matched 150 cases were randomly selected in the surrounding area without femoral neck fractures as a control group. Through questionnaire survey, including age, menarche age, menopause age, number of pregnancies, number of births, breast feeding time, body mass index and other gynecological relevant circumstances. Logistic regression a-nalysis was used to evaluate the effect. Results The difference of menarche age, menopause age, number of preg

  19. Biomechanical characteristics of bipolar femoral head prosthesis replacement and internal fixation for femoral neck fractures in the elderly%股骨头双极假体置换及内固定修复老年股骨颈骨折的生物力学特征

    Institute of Scientific and Technical Information of China (English)

    姜源涛; 焦建宝; 薛金伟; 王云飞

    2016-01-01

    背景:双极人工股骨头假体在股骨颈骨折患者中虽然能够取得理想的修复效果,但是临床上对于双极人工股骨头假体的生物力学性能尚存在较大的争议。目的:比较股骨头双极假体置换及内固定修复老年股骨颈骨折的生物力学性能。方法:选取23具(46侧)老年股骨颈骨折股骨标本进行分析,随机将标本分为内固定组和股骨头双极假体置换组,每组23侧。内固定组标本行常规金属植入物内固定,股骨头双极假体置换组行股骨头双极假体置换。在万能试验机上测定股骨假体柄的力学性能,比较股骨头双极假体置换及内固定的生物力学性能。结果与结论:①股骨头双极假体置换组的最大承载负荷显著高于内固定组(P<0.05);最大承载负荷趋势图显示,股骨头双极假体置换组最大承载负荷显著高于内固定组(P<0.05);②股骨头双极假体置换组轴向拔出试验位移显著短于内固定组(P<0.05);轴向拔出试验位移趋势图显示,股骨头双极假体置换组轴向拔出试验位移显著短于内固定组(P<0.05);③结果提示,与内固定植入物相比,股骨头双极假体置换修复老年股骨颈骨折更加稳定,修复效果更佳,能够提高患者髋关节功能,获得良好的初始稳定性。%BACKGROUND:Bipolar femoral head prosthesis has achieved the desired repair effect in patients with femoral neck fracture, but there is stil much controversy on the biomechanical properties of bipolar artificial femoral head prosthesis. OBJECTIVE:To compare biomechanical properties of the bipolar femoral head prosthesis replacement and internal fixation in the repair of femoral neck fracture in the elderly. METHODS:Twenty-three (46 sides) senile femoral neck fracture specimens were analyzed and randomized into internal fixation group(n=23)and bipolar femoral head prosthesis replacement group (n=23). Specimens in the internal

  20. 激素性股骨头坏死与股骨头、颈部骨髓脂肪含量关系的MRI研究%Relationship between bone marrow fat content of femoral head-neck and femoral head osteonecrosis in corticosteroid-treated pa-tients

    Institute of Scientific and Technical Information of China (English)

    陈兴灿; 邬亚军; 潘永青; 张永强; 刘淼; 何东

    2014-01-01

    Objective To investigate the relationship between bone marrow fat content of femoral head- neck and femoral head osteonecrosis in corticosteroid- treated patients. Methods Twenty seven patients aged above 18 years, with rheumatoid arthritis (n=12), ankylosing spondylitis (n=10) or renal transplantation (n=5), who had no history of hip disorders and previous corticosteroid treatment, underwent corticosteroid treatment. MRI examinations were performed before and 25, 50 weeks after the initiation of corticosteroid therapy. The bulk T1 signal intensity values were measured by GE/AW4.2 work station. If MRI showed femoral head osteonecrosis, the pathology examination was fol owed. t test was used (P<0.05) for statistical analysis. Results Four patients developed lateral femoral head osteonecrosis (2 in right and 2 in left)at week 25. The mean base T1 value of femoral head- neck before corticosteroid treatment was significantly shorter in femoral head osteonecrosis than that in normal femoral head (P<0.05). Conclusion The development of corticosteroid associated femoral head osteonecrosis is correlated with a high fat content in the marrow of femoral head- neck before corticosteroid therapy.%目的:通过MRI检查研究激素性股骨头坏死与股骨头、颈部骨髓脂肪含量的关系。方法对18周岁以上,无任何髋关节疾病及糖皮质激素治疗病史的27例患者(其中类风湿性关节炎12例,强直性脊柱炎10例,肾移植5例),在正规糖皮质激素治疗前后作MRI检查并进行随访,包括糖皮质激素治疗前基础MRI检查及糖皮质激素治疗后(基础MRI检查后)25、50周共2次随访MRI检查。采用GE/AW4.2工作站提供的T1信号值测量软件对基础MRI检查的股骨头、颈部骨髓进行T1信号值测量;MRI显示股骨头坏死者均经活检病理检查证实。结果4例发生股骨头坏死(左右侧各2例)。所有患者左右侧股骨头、颈部大范围平均T1信号值均无

  1. Association and linkage analysis of COL1A1 and AHSG gene polymorphisms with femoral neck bone geometric parameters in both Caucasian and Chinese nuclear families

    Institute of Scientific and Technical Information of China (English)

    Hui JIANG; Shu-feng LEI; Su-mei XIAO; Yuan CHEN; Xiao SUN; Fang YANG; Li-ming LI; Shun WU; Hong-wen DENC

    2007-01-01

    Aim: To simultaneously investigate the contribution of the alpha 1 chain of col-lagen type 1 (COL1A1) and alpha2-HS-glycoprotein (AHSG) genes to the varia-tion of bone geometric parameters in both Caucasians and Chinese. Methods: Six hundred and five Caucasian individuals from 157 nuclear families and 1228 Chi-nese subjects from 400 nuclear families were genotyped at the AHSG-Sacl, COL1A1-PCOL2 and Sp1 polymorphisms using polymerase chain reaction (PCR)-restric-tion fragment length polymorphism (RFLP). 5 FN bone geometric parameters were calculated based on bone mineral density and bone area of femoral neck (FN)measured by dual energy X-ray absorptiometry. Population stratification, total family association, within-family association, and linkage tests were performed by the quantitative transmission disequilibrium test program. Results: The t-test showed the significant differences of all bone geometric phenotypes (except ED)between Caucasians and Chinese in the offspring using both unadjusted and adjusted (by age, height, weight, and gender) data. In Caucasians, we found significant within-family association results between the COL1A1-Sp1 polymor-phism (rs1800012) and cross sectional area (CSA), cortical thickness (CT),endocortical diameter (ED), buckling ratio (BR) (P=0.018, 0.002, 0.023, and 0.001,respectively); the COL1A1-Sp1 polymorphism also detected significant linkage with BR (P=0.039). In the population of China, the within-family associations between the COL1A1-PCOL2 polymorphism (rs1107946) and CT, BR were signifi-cant (P=0.012 and 0.008, respectively). Furthermore, evidence of linkage were observed between the AHSG-SacI polymorphism (rs4918) and CT, BR (P--0.042 and 0.014, respectively) in Caucasians, but not in Chinese. Conclusion: Our results suggest that the COL1A1 gene may have significantly association with bone geometry in both Caucasians and Chinese, and the AHSG gene may be linked to bone geometry in Caucasians, but not in Chinese. This study

  2. Evaluation of a pig femoral head osteonecrosis model

    Directory of Open Access Journals (Sweden)

    Kim Harry

    2010-03-01

    Full Text Available Abstract Background A major cause of osteonecrosis of the femoral head is interruption of a blood supply to the proximal femur. In order to evaluate blood circulation and pathogenetic alterations, a pig femoral head osteonecrosis model was examined to address whether ligature of the femoral neck (vasculature deprivation induces a reduction of blood circulation in the femoral head, and whether transphyseal vessels exist for communications between the epiphysis and the metaphysis. We also tested the hypothesis that the vessels surrounding the femoral neck and the ligamentum teres represent the primary source of blood flow to the femoral head. Methods Avascular osteonecrosis of the femoral head was induced in Yorkshire pigs by transecting the ligamentum teres and placing two ligatures around the femoral neck. After heparinized saline infusion and microfil perfusion via the abdominal aorta, blood circulation in the femoral head was evaluated by optical and CT imaging. Results An angiogram of the microfil casted sample allowed identification of the major blood vessels to the proximal femur including the iliac, common femoral, superficial femoral, deep femoral and circumflex arteries. Optical imaging in the femoral neck showed that a microfil stained vessel network was visible in control sections but less noticeable in necrotic sections. CT images showed a lack of microfil staining in the epiphysis. Furthermore, no transphyseal vessels were observed to link the epiphysis to the metaphysis. Conclusion Optical and CT imaging analyses revealed that in this present pig model the ligatures around the femoral neck were the primary cause of induction of avascular osteonecrosis. Since the vessels surrounding the femoral neck are comprised of the branches of the medial and the lateral femoral circumflex vessels, together with the extracapsular arterial ring and the lateral epiphyseal arteries, augmentation of blood circulation in those arteries will improve

  3. 小儿急性化脓性股骨颈骨髓炎的早期诊断%The Early Diagnosis of Acute Suppurative Osteomyelitis of Femoral Neck in Children

    Institute of Scientific and Technical Information of China (English)

    胡月光; 蒋映兰; 彭素华; 杨小红; 汪从秀; 褚先秋

    1996-01-01

    Objective:To discuss early diagnosis of acute suppurative osteomyelitis of the femoral neck and the differential diagnosis from acute pyogenic arthritis of the hip.Method:28 children with acute femoral suppurative osteomyelitis were studied basing on the clinical presentation,isotopic bone scan and exploration findings.Results:Swelling and tenderness were found in the greater trochanter region in addition to the regions anterior and posterior to the hip,and thin seepage was obtained by arthrocentesis.The uptake of radioisotope was concentrated in affected femoral neck.Conclusion:Early diagnosis of acute suppurative osteomyelitis of the femoral neck can be made by careful clinical examination and isotopic bone scan.Surgical exploration should he performed on difficult cases to achieve an early diagnosis and treatment.%为了研讨小儿急性化脓性股骨颈骨髓炎的早期诊断和与化脓性髋关节炎的鉴别诊断,通过28例小儿急性化脓性股骨颈骨髓炎的临床观察和核医学等检查,以及手术中发现,小儿急性化脓性股骨颈骨髓炎早期除髋关节前后压痛外,股骨大粗隆附近亦有肿胀和压痛,髋关节腔穿刺液体为稀薄的渗出液体.同位素股骨颈扫描,可见患侧同位素吸收增多.因此,经过仔细的临床检查和同位素检查,可以早期作出诊断.对诊断困难,临床高度怀疑的病例应行手术探查,以达到早期诊断和早期治疗.

  4. Estimation of pretraumatic femoral antetorsion in bilateral femoral shaft fractures

    Energy Technology Data Exchange (ETDEWEB)

    Citak, Musa; Jagodzinski, Michael; Krettek, Christian; Huefner, Tobias [Hannover Medical School, Trauma Department, Hannover (Germany); Citak, Mustafa [BG-University Hospital Bergmannsheil, Department of Surgery, Bochum (Germany); Kendoff, Daniel; O' Loughlin, Padhraig F. [Hospital for Special Surgery, Orthopaedic Department, New York, NY (United States); Tavassol, Frank [Hannover Medical School, Department of Oral and Maxillofacial Surgery, Hannover (Germany)

    2009-12-15

    To describe a system for measurement of the pretraumatic femoral antetorsion angle post-bilateral femoral shaft fracture with the use of new imaging software which allows segmentation and three dimensional (3D) reconstruction of DICOM (digital imaging and communications in medicine) images. This case involved a 20-year-old patient with bilateral femoral shaft fractures. Following initial clinical examination, CT scans of both femurs were performed. Subsequently, the DICOM datasets were uploaded to the new software tool. Following segmentation and 3D reconstruction, pretraumatic femoral antetorsion angles were determined. Femoral antetorsion was described and assessed in two ways by referring to the intersection of the posterior condylar plane and (1) a line drawn between the center of the femoral head and femoral neck, (2) a line drawn between the centers of the femoral head and greater trochanter. Using these definitions, values for femoral antetorsion were found to be, respectively, 20 at the right fracture site and 19 on the left site, and 33 bilaterally. The investigators describe in this current technical report the use of new imaging software which enables the calculation of femoral AV following reduction of virtual fracture fragments which are created from standard DICOM images. We believe that this 3D reconstruction method of measuring the antetorsion angle can be integrated into a regular treatment algorithm and may potentially optimize clinical outcomes. (orig.)

  5. Finite element analysis of femoral neck fracture with different fixation ways%三种内固定方式修复股骨颈骨折的有限元分析

    Institute of Scientific and Technical Information of China (English)

    夏志锋; 梁明; 李亚峰; 曾冠楠

    2016-01-01

    BACKGROUND:Finite element method is widely used in the femoral neck fracture, but the study concerning different fixation methods of femoral neck fracture is not much. OBJECTIVE:To analyze biomechanical properties of different fixation methods for femoral neck fracture using finite element analysis. METHODS:The femur of voluntters was scanned with CT, at thickness 0.6 mm, from the site above the greater trochanter of the femur. Scanning data were saved in .DICOM format. Data of right proximal femur were imported into Mimics software. Osteotomy was performed according to Pauwels I type fracture. Models of two tensile force screws, ful y threaded hol ow screw and proximal femoral locking plate were established. Three-dimensional finite element method was used to analyze stress distribution, stress concentration position, displacement distribution and maximum displacement in different models of femoral neck fracture with different internal fixation methods. RESULTS AND CONCLUSION:(1) The maximum stress value of two lag screws model was biggest. The maximum stress value of ful y threaded hol ow screw model was minimized. The maximum stresses of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al were concentrated in the fixed end of fractures. (2) The femoral maximum stress of two lag screws model was biggest. The femoral maximum stress value of proximal femoral locking plate model was minimized. The femoral maximum stresses of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al were concentrated in the medial femoral smal rotor near and medial femoral and fixation contact points. (3) The maximum displacement of two lag screws model was biggest. The maximum displacement of ful y threaded hol ow screw model was minimized. The maximum displacement of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al was in the femoral head. (4

  6. Biomechanics study on the femoral neck with side hole hollow nail combined with bone cement%股骨颈带侧孔空心钉添加骨水泥的生物力学实验探究

    Institute of Scientific and Technical Information of China (English)

    闫作

    2014-01-01

    objective To study the healing effects by applying femoral neck with side hole hollow nail combined with bone cement for the promotion of fracture.Methods 58 adult femoral neck specimens were seletced based on the maximum axial pull output (F-Max) in experimental group, 12 femoral neck in bored after the hollow screw directly into the center of the axial, the other 12 femoral neck in the center of the axial drilling will polymethacrylate again after infusion of bone cement into side holes with hollow screw. To pull out the experiment, the hollow nail pulling power of the maximum axial and screw in the process of cycle resistance to bending experiment in loose could withstand the maximum load were determined.Results In PMMA bone cement injection hole hollow nail was signiifcantly higher than that of the maximum axial force ,which was higher than pure hollow nail maximum axial pull output, the difference was statistically signiifcant (P<0.05). Conclusion For hip osteoporosis fracture, the side holes by using methyl methacrylate hollow nail ifxed the fracture end, can signiifcantly reduce the risk of femoral head loose, falling off, and improve the stability of the ifxed the fracture end, accelerate fracture healing.%目的:探讨股骨颈带侧孔空心钉添加骨水泥对骨折愈合的促进效果。方法选取58具成人尸体股骨颈标本,依据最大轴向拔出力(F-max)进行实验分组,12个股骨颈在轴向正中钻孔后将空心钉直接置入,另12个股骨颈在轴向正中钻孔将聚甲基丙烯酸酯骨水泥输注后再置入带侧孔空心钉。进行拔出实验,对空心钉最大轴向的拔出力及周期抗屈实验过程中螺钉在松动时所能承受的最大负荷进行测定。结果注入PMMA骨水泥侧孔空心钉最大轴向力显著高于高于单纯空心钉最大轴向拔出力,对比差异有统计学意义(P<0.05)。结论对于髋部骨质疏松骨折来说,采用加入聚甲基丙烯酸甲酯侧孔

  7. Choice of Treatment and Clinical Analysis of Femoral Neck Fracture in Children%儿童股骨颈骨折的治疗选择及疗效分析

    Institute of Scientific and Technical Information of China (English)

    谢惠缄; 谢曦衷; 巫洪波; 郭汉明; 赖志军; 黄玉良; 张建民

    2001-01-01

    【目的】了解儿童股骨颈骨折不同治疗方法与治疗效果的关系,为治疗该病提供选择。【方法】分析我科1983年~1996年13年间收治的21例儿童股骨颈骨折的疗效。【结果】第1组14例采用电视X-ray下闭合复位+多根克氏针或小口径空心钉内固定术,11例愈合满意,合并股骨头缺血性坏死3例。第2组行皮肤牵引+髋人字石膏固定4例,3例治愈,合并股骨头缺血性坏死1例。第3组3例,行切开复位多根克氏针或小口径空心钉子内固定,治愈1例,合并股骨头缺血性坏死2例。【结论】儿童股骨颈骨折的治疗应以电视X-ray下闭合复位多克氏针内固定为首选,除非其它治疗方法失败,否则,不应轻易行切复位内固定术。%【Objective】To compare different approaches and their effectiveness on the treatment of the femoral neck fracture in children,in order to provide a reliable and effective way for the treatment of the disease.【Methods】Clinical data of 21 cases with femoral neck fracture from 1983 to 1993 were analyzed retrospectively.【Results】21 cases were divided into three groups:① group Ⅰ:14 cases underwent closed reduction and internal fixation with multiple Kirscher′s pins or cannulate compression screws under C-arm X-ray monitor.Of the 14 cases,11 cases were healed,3 cases developed ischemic necrosis of femoral head;② group Ⅱ:4 cases was treated with skin traction and hip spica cast plaster fixation,3 cases was healed,1 case developed ischemic necrosis of femoral head;③ group Ⅲ:3 cases underwent opened reduction and internal fixation with multiple pins or cannulate compression screws,1 case was healed,2 cases developed ischemic necrosis of femoral head.【Conclusion】Closed reduction and multiple pins internal fixation under C-arm X-ray monitor may be the best choice of treatment of femoral neck fracture in children.

  8. 股骨颈骨折内固定手术简史%A brief history of internal fixation of femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    梅炯

    2014-01-01

    1858年,德国外科医师VonLangenbeck采用镀银螺钉完成了世界第1例股骨颈骨折内固定手术.1875年,德国医生Franz K(o)nig在消毒后,成功利用金属螺钉实施股骨颈内固定术.1883年,美国外科医生Nicholass Senn提出了股骨颈骨折都应手术治疗的观点,但未能得到广泛认可.1931年,美国医生Smith-Petersen和他的同事发表了股骨颈骨折切开复位三翼钉内固定的治疗结果.随后,瑞典医生Sven Johansson、美国医生H.Heyward Wescott分别于1932年和1934年为闭合三翼钉内固定手术设计了相应的手术辅助器械.1941年,AAOS建议对股骨颈骨折使用三翼钉内固定.1976年,The British Medical Research Council指出,三翼钉不适用于有移位的股骨颈骨折.1980年,Asnis空心螺钉开始使用,并沿用至今.20世纪40年代,孟继懋和叶衍庆相继开展三翼钉内固定术治疗股骨颈骨折.1989年,危杰首先在中国就用AO空心钉治疗股骨颈骨折.此后,空心加压螺钉治疗股骨颈骨折在全国范围内得到了广泛的推广.%In 1858,a German surgeon named Von Langenbeck did the first internal fixation of femoral neck fracture (FNF) with metal silver screw.In 1875,a German doctor Franz K? nig did the same operation successfully with metal screws under antiseptic condition.In 1883,an American surgeon,Nicholass Senn suggested that all of the FNF should be treated by operation,but the proposition was not accepted extensively.In 1931,Smith-Petersen from the USA and his colleagues first published the report on the result of open reduction and internal fixation of FNF by the use of trifin nail.Due to the help of auxiliary appliance designed separately by the Swedish Sven Johansson (1932) and American H.Heyward Wescott (1934).In 1941,the American Academy of Orthopaedic Surgeons (AAOS) advocated the technique of trifin nail for its internal fixation.However,in 1976,the British Medical Research Council pointed out that the trifin nail was not

  9. Effects of ground and joint reaction force exercise on lumbar spine and femoral neck bone mineral density in postmenopausal women: a meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Kelley George A

    2012-09-01

    Full Text Available Abstract Background Low bone mineral density (BMD and subsequent fractures are a major public health problem in postmenopausal women. The purpose of this study was to use the aggregate data meta-analytic approach to examine the effects of ground (for example, walking and/or joint reaction (for example, strength training exercise on femoral neck (FN and lumbar spine (LS BMD in postmenopausal women. Methods The a priori inclusion criteria were: (1 randomized controlled trials, (2 exercise intervention ≥ 24 weeks, (3 comparative control group, (4 postmenopausal women, (5 participants not regularly active, i.e., less than 150 minutes of moderate intensity (3.0 to 5.9 metabolic equivalents weight bearing endurance activity per week, less than 75 minutes of vigorous intensity (> 6.0 metabolic equivalents weight bearing endurance activity per week, resistance training g was calculated for each FN and LS BMD result and pooled using random-effects models. Z-score alpha values, 95%confidence intervals (CI and number-needed-to-treat (NNT were calculated for pooled results. Heterogeneity was examined using Q and I2. Mixed-effects ANOVA and simple meta-regression were used to examine changes in FN and LS BMD according to selected categorical and continuous variables. Statistical significance was set at an alpha value ≤0.05 and a trend at >0.05 to ≤ 0.10. Results Small, statistically significant exercise minus control group improvements were found for both FN (28 g’s, 1632 participants, g = 0.288, 95% CI = 0.102, 0.474, p = 0.002, Q = 90.5, p I2 = 70.1%, NNT = 6 and LS (28 g’s, 1504 participants, g = 0.179, 95% CI = −0.003, 0.361, p = 0.05, Q = 77.7, p I2 = 65.3%, NNT = 6 BMD. Clinically, it was estimated that the overall changes in FN and LS would reduce the 20-year relative risk of osteoporotic fracture at any site by approximately 11% and 10%, respectively. None of the mixed

  10. Accuracy of closed reduction for displaced subcapital femoral neck fractures assisted by C-arm X-ray machine%移位股骨颈头下骨折模拟C臂X射线机观察闭合复位的真实精确性

    Institute of Scientific and Technical Information of China (English)

    戚珊红

    2012-01-01

    BACKGROUND: Traction bed C-arm X-ray machine is used for closed reduction and internal fixation to treat femoral neckfracture has some errors.OBJECTIVE: To perspectively analyze the accuracy of closed reduction for femoral neck fractures by assisted C-arm X-raymachine.METHODS: Complete reduction of artificial femoral neck fractures was realized under direct vision and then fixed by kirschnerpins which were knocked in at both fractured ends respectively on lateral femoral neck to be used as metal marker. Femoral neckspecimens and C-arm X-ray machine were not removed and then the femoral neck specimens revolved 15° clockwise and 30°anticlockwise respectively. Anterior-posterior of the standard femoral neck was examined by C-arm X-ray machine, thencorresponding imaging was collected.RESULTS AND CONCLUSION: There was no significant difference of the displacement in the both ends of the subcapitalfemoral neck fractures (around 1 mm both) when the necks were located at the position of 15°, 30° clockwise and anticlockwiserespectively. There was significant difference of the displacement in the both ends of the subcapital femoral neck fractures(around 2 mm both) when the necks were located at the position of 30°, 30° clockwise and anticlockwise respectively. It is shownthat C-arm X-ray machine is used to observe the subcapital femoral neck fractures and can meet the reduction requirement ofGarden scores, but the femur head rotation cannot be identified. As a result, displaced femoral neck fractures necessitate openreduction.%背景:采用牵引床C臂X射线机下闭合复位、内固定治疗股骨颈头下骨折,可能有一定的误差.目的:模拟C臂X射线机下闭合复位透视分析骨折闭合复位的真实精确性.方法:直视下完全复位人工骨股骨颈头下骨折标本,使用克氏针固定.在股骨颈外侧,两个断端处分别使用克氏针打入,作为金属标志物.保持股骨颈标本、C臂X射线机位置不动,随后将股骨头

  11. Perioperative Treatment of Elderly Patients With Femoral Neck Fracture With Diabetes Mellitus%老年股骨颈骨折伴糖尿病患者围手术期的治疗研究

    Institute of Scientific and Technical Information of China (English)

    王玉金

    2016-01-01

    Objective Analysis of therapeutic intervention for elderly patients with femoral neck fracture and diabetes mellitus during perioperative period, and make a summary.Methods 50 cases of elderly patients with femoral neck fracture associated with diabetes in our hospital from July 2014 to July 2015 were randomly selected as the main research subjects, in view of the treatment plan, which is accepted in the perioperative period to carry on the inquisition.ResultsAll patients underwent a complete follow-up, the mean length of follow-up time was 6 months. 50 patients who were no deaths and cases of infection occur, and patients are to achieve the therapeutic effect of bone healing; discharge length were between 5~18 days, the average number is (7.43±1.25) days.Conclusion In the perioperative phase, and femoral neck fractures in elderly patients with diabetes to appropriate therapeutic intervention, can make them more successful completion of the surgery, reducing the risk of infection.%目的:针对股骨颈骨折且伴有糖尿病的老年患者在围术期阶段接受的治疗干预展开分析,并且作以总结。方法随机选取2014年7月~2015年7月于我院就诊的50例股骨颈骨折伴有糖尿病的老年患者作为主要的研究对象,针对其围术期接受的治疗方案进行探究。结果全部患者均接受了完整随访,随访时长平均为6个月。50例患者中均没有死亡以及发生感染的病例,且患者术后均实现骨性愈合的治疗效果;住院时长5~18 d,平均住院时长(7.43±1.25)d。结论围术期阶段,对股骨颈骨折并且伴有糖尿病的老年患者行以适当的治疗干预,能够令其更顺利地完成手术,降低发生感染的隐患。

  12. 股骨颈自锁钉板系统的研制及其生物力学结构测试%Design and biomechanical structure evaluation of self-locking screw plate system for femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    昌耘冰; 尹东; 李凭跃

    2004-01-01

    BACKGROUND: A lot of internal fixators were used in femoral neck fracture, but they had quite a few defects in biomechanics.OBJECTIVE: To design the self-locking screw-plate(SLSP) system for the treatment of femoral neck fracture and to evaluate its biomechanical performance as well.DESIGN: A randomized controlled open trial.SETTING and PARTICIPANTS: The study was conducted in the Key Laboratory for Biomechanics, First Military Medical University. Twelve fresh cadaver specimens of human femur were used as testing materials.INTERVENTION: A new SLSP system was design based on the pathological and biomechanical characteristics of femoral neck fracture, which was composed of a main compressive screw, two affiliated screws and a self-locking plate. The specimens were divided into four groups for biomeMAIN OUTCOME MEASURES: Vertical displacement(rigidity), horizontal displacement (rigidity), counter-torsion strength and ultimate loads of femoral head after internal fixation in different groups RESULTS: The vertical displacements under 600 N vertical loads of the above four groups were(4. 25 ±0. 20), (5.58 ±0.41), (5.87 t0.35) and (6.40 ±0. 43) mm respectively, and the horizontal displacements were (1.78±0.25), (2.41±0.04), (2.42±0.25), and (2.79±0.31)mm respectively. There were statistical differences between SLSP group and the rest three groups( P < 0. 01). Compared with the torsional angle under equal 43% smaller than that of TCS group, HP group and DHS group respectively with significant differences( F = 96. 7, P < 0.01 ) . The ultimate loads and displacement of SLSP group were (3 830 ± 66) N and (7.49 ± 1.2) mm respectively significantly higher than that of the rest three groups.CONCLUSION: After the internal fixation with SLSP system in treating femoral neck fracture, the mechanical performance is superior to those of the others in vertical and horizontal displacement as well as counter-torsion strength and ultimate loads. SLSP system organically

  13. Preparation of artificial canine femoral stem with HA-Ti ladder-type coating on plasma-sprayed pure Ti substrate and its performance evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Zeng Xianlin, E-mail: zxlxhh@163.com [Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022 (China); Li Jingfeng; Yang Shuhua; Zheng Qixin; Zou Zhenwei [Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022 (China)

    2012-03-01

    An ideal, biological-type, artificial femoral stem prosthesis has good stability and improved bone-prosthesis bonding capacity. In the current study, pure hydroxyapatite (HA)-coated, cementless, artificial femoral stems were prepared by adopting different plasma spray powers and distances and were tested in terms of shear strength. The pure titanium (Ti) substrates, HA coatings, and composite Ti-HA ladder-type coatings prepared under vacuum and atmospheric conditions were examined to compare the shear strengths, microscopic constitutions, and structures of the coatings. The coating was fabricated and the bond strength was improved by adopting 35 kW of spray power and an 80 mm spray distance. The comparisons show that the shear strength of the Ti coating prepared under vacuum conditions was higher than that of the coating prepared under atmospheric conditions (P < 0.05). Moreover, the pressure-shear strength of the Ti + HAG + Ti + V group coating was statistically significantly different from those of the HA + Ti + V and HA + Ti + A groups (P < 0.05). The coatings were compared using scanning electron microscopy, X-ray diffraction, and infrared spectrum analysis. The composite HA-Ti ladder-type coating group, where pure Ti substrate was sprayed onto the Ti alloy under vacuum conditions, had a successive laminate structure. In addition, the intergranular bond in the HA surface layer on the gradient coating was compact and highly crystallized. Under vacuum conditions, the plasma-sprayed layer was characterized by higher tightness, moderate porosity, higher bonding strength to HA, and higher HA crystallinity. The proposed coating can be used in new, cementless, artificial femoral stems with improved bone-prosthesis bonding capacity and stability.

  14. 生物型与骨水泥型人工股骨头置换治疗高龄股骨颈骨折%Biotype and bone cement-type artificial femoral head replacement for the treatment of femoral neck fracture in elderly patients

    Institute of Scientific and Technical Information of China (English)

    史建国; 邱南海

    2013-01-01

      BACKGROUND: With the maturity and development of artificial joint materials, processes and technology, artificial femoral head replacement has been widely used for the treatment of femoral neck fracture, especial y the elderly patients with displaced femoral neck fracture. OBJECTIVE: To observe the clinical efficacy of biotypes and cementless artificial femoral head replacement for the treatment of elderly femoral neck fracture combined with heart disease. METHODS: Thirty-five elderly femoral neck fracture patients with heart disease treated in the Department of Orthopedic Center, Tianjin Nursing Home from January 2004 to December 2009 were selected, including 16 cases of coronary heart disease combined with angina pectoris, eight cases of myocardial infarction coronary heart disease, eight cases of asymptomatic coronary heart disease and three cases of ischemic cardiomyopathy and coronary heart disease. And 18 cases were treated with biotypes artificial femoral head replacement, 17 cases were treated with cementless artificial femoral head replacement. RESULTS AND CONCLUSION: One of the 35 patients was dead in the surgery, other 34 cases were fol owed-up for 8 to 36 months. Three cases of complications occurred in surgery were belongs to cementless group, and one patient died during surgery, two cases had to drop in blood pressure and suffered from difficulty breathing in surgery, whose life characteristics returned to normal after efforts to save. In the fol ow-up process, part of the prosthesis implanted in the two cases of patients with severe osteoporosis appears sinking in the biotype group, the excel ent rate of biotype group was 89%(16/18), and the cementless group was 94%(16/17). It suggests that biotype artificial femoral head replacement is suitable for the patients with severe heart disease, while the cementless artificial femoral head replacement is suitable for osteoporosis patients.%  背景:随着人工关节材料、工艺及技术的

  15. Biomechanical factors in the design of new femoral neck screw in children%新型儿童股骨颈螺钉设计中的生物力学因素

    Institute of Scientific and Technical Information of China (English)

    黄煊怀; 廖瑛; 范伟杰; 陈志伟

    2013-01-01

    BACKGROUND:As the epiphyseal plate has an important role in the growth and development of femur, the design of internal fixation should avoid the damage to the epiphyseal plate. Therefore, the positioning of pediatric femoral epiphyseal plate is particularly important. OBJECTIVE:To investigate the biomechanical property of the new femur neck screw internal fixation in treatment of children femoral neck fracture. METHODS:Twelve femurs were col ected from six fresh children cadavers provided by Dissecting Room of University of South China. After exclusion of bone disease with X-ray film, three new children femoral neck screws and three Kirschner wires with the diameter of 2.0 mm were used for fixation. The biomechanical tests were conducted to detect the axial compression and torsion stiffness. RESULTS AND CONCLUSION:In the children femoral neck screw group, the axial compression stiffness and torsion stiffness under the torsional torque of maximum 3 N?m were (190.74±20.88) N/mm and (0.18±0.045) N?m/° respectively;(138.95±15.19) N/mm and (0.120±0.036) N?m/° respectively in the Kirschner wire group;there were significant differences in the axial compression stiffness and torsion stiffness between two groups (P  目的:探讨新型儿童股骨颈螺钉固定儿童股骨颈骨折的生物力学性能。  方法:由南华大学解剖室提供的6具儿童尸体上取下股骨12根,X射线排除骨病后,分别采用3枚新型儿童股骨颈螺钉固定;3枚2.0 mm克氏针固定。分别进行生物力学实验,测试其轴向压缩、扭转刚度。  结果与结论:轴向压缩刚度及最大3 N?m 的扭转力矩下扭转刚度,儿童股骨颈螺钉分别为(190.74±20.88) N/mm、(0.18±0.045) N?m/(°),克氏针为(138.95±15.19) N/mm、(0.120±0.036) N?m/(°),两者比较差异均有显著性意义(P<0.05);显示儿童股骨颈螺钉的抗压能力和抗扭能力上明显强于克氏针。实验说明儿童股骨颈螺钉是一

  16. 老年人股骨颈骨折股骨头置换术中短柄假体的有限元分析%Finite element analysis of the short-stem prothesis in femoral head replacement among the elderly femoral neck fractures

    Institute of Scientific and Technical Information of China (English)

    吕大伟; 苏琴; 姚咏明; 赵晓东

    2015-01-01

    目的:针对老年人股骨颈骨折后假体置换术,使用有限元分析的方法对股骨短柄假体与常规股骨假体的生物力学特性进行对比。方法利用薄层CT资料建立股骨三维有限元模型,利用我院股骨中空多孔股骨假体相关参数建立两种髋关节股骨假体三维有限元模型;应用Ansys 5.7有限元分析软件考察两种假体植入后的应力分布,并进行比较。结果短柄假体所受最大mises应力较常规股骨假体明显减小;力学传导模式仍为远端应力集中,最大mises应力仍出现在张力侧。结论老年人股骨颈骨折关节置换术中短柄假体力学特性优越。%Objective To compare biomechanical properties of the short-stem prosthesis with conventional prosthesis with the finite element analysis method for the elderly femoral neck fracture after femoral head replace -ment.Methods Three-dimensional finite element models of the upper femur and prosthesis were established .The stress distribution difference between the short-stem prosthesis and conventional prosthesis was compared by using fi-nite element analysis software Ansys 5.7.Results The maximum mises stress of the short-stem prosthesis de-creased significantly,while stress distribution model remained the same .Conclusion The short-stem prosthesis presents superior mechanical properties in femoral head replacement among the elderly femoral neck fractures .

  17. Development of artificial femoral neck and its application in the study of biomechanics%人工股骨的研制及在股骨颈骨折生物力学研究中的应用

    Institute of Scientific and Technical Information of China (English)

    马剑雄; 马信龙; 杨阳; 毕平; 王志彬

    2010-01-01

    目的 比较人工与防腐股骨颈骨折模型在股骨颈骨折生物力学研究中的力学差异.方法 选取股骨颈长度相似的防腐股骨标本5个,自制聚甲基丙烯酸甲酯(PMMA)人工股骨标本5个,制备内收型(Pauwels角70°)股骨颈骨折模型,均用动态套筒式三翼钉固定断端.标本摸拟人体单足站立位固定于英斯特朗-8874液压伺服力学实验机上,以速率10 mm/min线性载荷0~1 200 N分级加载,测定2种标本 1200 N载荷下股骨上段11个关键点的应变值;测定不同载荷下头下沉位移、主压力侧的应变值和主张力侧的应变值.结果 1200 N载荷下,应变值变化最明显的区域均集中于2种标本股骨头-颈结合部下方的压应变位置,并在6号电阻应变片的位置出现峰值,其数值差异有显著性意义(P<0.01);同一载荷下2种标本之间比较头下沉位移,差异有显著性意义(P<0.05).结论 动态套筒式三翼钉固定股骨颈骨折稳定可靠;在进行股骨颈骨折的生物力学实验研究中,往往需要大量的股骨标本,在股骨标本获得日益困难的情况下,人工股骨标本在一定程度上可以替代防腐股骨进行股骨颈骨折生物力学研究.%Objective To compare the biomechanical difference between embalmed femoral specimens and artificial femoral neck fracture models. Methods Five embalmed human femoral specimens were selected with similar length of femoral neck, and five PMMA femurs were made, and adductor type (Pauwels angle 70° )femoral neck fracture model were prepared and fixed with dynamic sleeve three-wing screw. Specimens were fixed at simulated uniped standing position at Instron-8874 servo-hydraulic mechanical testing machine. Linear load of 0~1 200 N was loaded at the rate of 10 mm/min and strains at 11 key points under 1 200 N load were measured, as well as head sink displacement and the strain at principal pressure side and principal tension side under different loads. Results

  18. Eccentricity adjustment in artificial hip replacement for treatment of femoral neck fracture%股骨颈骨折人工髋关节置换的偏心距调整

    Institute of Scientific and Technical Information of China (English)

    李瓦里; 孙波; 滕东辉; 刘世珑

    2009-01-01

    背景:研究表明,股骨偏心距短缩会导致外展肌肌力下降,偏心距过大,则增加置换后股骨颈假体折断的风险及增加骨水泥型股骨柄假体骨鞘的压应力,使其易松动和下沉.目的:探讨高龄股骨颈骨折人工髋关节置换过程中偏心距调整的重要性.设计、时间及地点:观察件实验,病例来自2004-01/2005-12天津中医药大学第一附属医院骨科.对象:选择天津中医药大学第一附属医院骨科收治的股骨颈骨折患者30例,男12例,女18例,年龄62~90岁,平均73.8岁.方法:全部患者均实施了人工髋关节置换术(由同一组手术医师操作),术前利用X-Caliper仪器,仔细测量骨盆正位片中健侧股骨头旋转中心、髋关节旋转中心、颈干角、股骨的横向偏心距、外展力臂、重力力臂等,利用三角函数进行准确计算.确定截骨平面的角度,选择合适假体以及术中对于偏心距的调整,比较置换后与健侧的差异.主要观察指标:偏心距的数值及置换后关节功能.结果:30例患者术前健侧偏心距平均38.7mm(22~57mm),术后患侧偏心距平均39.2 mm(21~59 mm):健侧平均38.7 mm.术后肢体不等长范围1.8~8.7 mm,平均3.4 mm,患侧肢体长者26例,占86.7%,短者4例,占13.3%.术后随访0.5~2.5年,根据Harris评分标准,优10例,良19例,可1例,优良率达97%.结论:股骨颈骨折人工关节置换中偏心距的合适与否与置换后关节功能密切相关.%BACKGROUND:It has been demonstrated that shortening of femoral eccentricity would lead to decreased abductor muscle strength,and overlengthening eccentricity would increase the risk of femoral neck prosthesis fracture and the compressive stress of cemented femoral stem prosthesis after artificial hip replacement,which easily causes prosthetic loosening and subsidence.OBJECTIVE:To investigate the importance of eccentricity adjustment in the artificial hip replacement for treatment of femoral neck fracture in

  19. Clincal Observation on Pressurized Hollow Screw for Treating Femoral Neck Fracture of the Young and Middle-aged%加压空心螺纹钉治疗青壮年股骨颈骨折临床观察

    Institute of Scientific and Technical Information of China (English)

    朱庆东; 张家恒

    2012-01-01

    Objective:To investigate the clinical efficacy of pressurized hollow screw for the treatment of femoral neck fracture of the young and middle-aged patients. Methods; The pressurized hollow screw treatment was given under the C-arm X-ray fluoroscopy after traction. Results:The design of the compression screw was in line with the requirements of biomechanics,with great carrying capacity, which not only had the characteristics of compression, torsion and bending, but also could pressurize to make the fracture fragments in close contact in order to generate stress stimuli to promote fracture healing and femoral revascularization in the area of the fracture. Conclusion; The pressurized hollow screw for treatment of femoral neck fracture of the young and middle-aged patients is simple for operation and firm in fixation with high healing rate,less trauma and bleeding,which shows good clinical efficacy.%目的:探讨加压空心螺纹钉治疗青壮年股骨颈骨折的临床疗效.方法:56例患者行牵引后在C型臂X线机透视下进行加压空心螺纹钉治疗.结果:加压螺钉的设计符合生物力学的要求,其承载能力大,不但具有抗压、抗扭、抗弯的特性,又能加压使骨折断端紧密接触,在骨折处产生有利于骨折愈合的应力刺激,促进骨折愈合及股骨头再血管化.结论:加压空心螺纹钉治疗青壮年股骨颈骨折操作简单,创伤小,出血少,固定牢固,愈合率高,临床疗效较好.

  20. 股骨颈骨折空心加压螺钉内固定后股骨头坏死分析%Cannulated Compression Screws for the Treatment of Adult Femoral Neck Fractures Clinical Analy-sis of Risk Factors for Avascular Necrosis of the Femoral Head

    Institute of Scientific and Technical Information of China (English)

    顾小明; 黄立新

    2014-01-01

    Objective To explore the related factors femoral head necrosis after the operation on adult femoral neck frac-tures by compressed hollow screws fixation. Methods The author reviewed the patients who were treated by compressed hol-low screws fixation from January 1st,2001 to December 31st,2010 and then made a statistical analysis on the following eight factors:age,gender,fracture type(Garden type),surgical reduction quality(Garden index),the time gap between injury and the operation,reset mode( open reduction or close reduction),the partial weight-bearing time after the operation,whether the fixation is removed. Among these eight factors,the statistically significant factors were selected and then analyzed by logistic re-gression analysis one by one. Results There are 185 cases with a complete set of follow-up data and the follow-up lasts from three to ten years(the average duration is 5. 5 years). Among the 185 cases,28 patients suffered from femoral head ischemic necrosis,which accounts for 15. 14% and the independent factors influencing femoral head necrosis included the following:fracture type,fracture reduction,the time gap between injury and the operation,the partial weight-bearing time after the opera-tion. Conclusion The major complication of femoral neck fractures operation by compressed hollow screws fixation is femoral head ischemic necrosis and the major risk factors are fracture type,fracture reduction,the time gap between injury and the op-eration and the partial weight-bearing time after the operation. Among those factors,reduction quality,the time gap between in-jury and the operation and the partial weight-bearing time after the operation are controlling factors and it is found that femoral head ischemic necrosis can be lowered down when the patient receives compressed hollow screws fixation at an earlier time,im-proves reduction quality and tries to bear partial weight after three months'fixation. The present data shows that compressed hol

  1. The curative effect evaluations of 46 Bone cement type artificial bipolar femoral head replacement for femoral neck fracture in the elderly patients%骨水泥型人工双极股骨头置换治疗老年人股骨颈骨折46例疗效分析

    Institute of Scientific and Technical Information of China (English)

    张庆凯; 李忠义; 马也

    2014-01-01

    目的:探讨骨水泥型人工双极股骨头置换治疗老年人股骨颈骨折的疗效。方法:我院2009-12至2012-12共收治并采用骨水泥型人工双极股骨头置换治疗老年人股骨颈骨折患者46例,其中,男性15例,女性31例,年龄在65—91岁之间,平均78.8岁;左侧19例,右侧27例,均为单侧股骨颈骨折;致伤原因:摔伤所致35例,交通事故所致11例。骨折按Garden分型:Ⅲ型33例,Ⅳ13例。通过手术时间,出血量及术后肢体功能Harris评分等,评价手术效果。结果:46例患者全部获得随访,随访时间为6-36个月,平均20.5个月。假体松动2例,肺内感染2例,股骨头脱位1例,并发症发生率为:11%;经处理后,患者痊愈。所有患者肢体功能恢复良好。术前Harris评分:43.2±8.3分,术后6个月及12个月分别为91.4±3.2分93.2±4.6分,较置换前明显提高,P<0.01,差异有统计学意义。结论:骨水泥型人工双极股骨头置换治疗老年人股骨颈骨折具有固定牢固,返修率小,术后并发症少,肢体功能恢复良好等优点,是治疗该类疾病一种较为良好的选择。%Objective:To report and discuss The curative effect of surgical treatment with Bone cement type artificial bipolar femoral head replacement for Femoral neck fracture in the elderly patients.Method:From December 2009 to December 2012,46 cases with Femoral neck fractures in the elderly patients were treated with Bone cement type artificial bipolar femoral head replacement in our hospital, Including 15 males and 31 females ,with an average of 78.8 years old .(range,65 to 91 years old).19 cases in the left,27 cases in the right. And al the cases were unilateral fractures. The causes of injury:35 cases were related to fal ing ,11 cases were related to traffic accident. According to Garden classification ,33 cases were of typeⅢ, 14 cases were of typeⅣ. Evaluate the curative effect by the

  2. Short-term Results of Muscle-Pedicle Bone Grafting with Tensor Fascia Lata for Delayed Femoral Neck Fractures; Case Series and Literature Review

    Directory of Open Access Journals (Sweden)

    Kuldip Salgotra

    2016-04-01

    Full Text Available Neglected, untreated and delayed femur neck fractures are commonly encountered and the treatment dilemma arises especially when the patient is physiologically young and osteosynthesis is the preferred option. Controversy exists in the current literature as the various head salvage surgeries like valgus subtrochanteric osteotomy, non-vascularized fibular bone grafting, muscle pedicle bone grafting (Tensor fascia lata and Quadratus femoris graft and vascularized bone grafting do not have clear lines of indications. The current study is a case series of 7 patients with femur neck fractures with delayed presentation beyond the vascular emergency period who were treated with osteosynthesis with muscle pedicle bone graft (MPBG using tensor fascia lata muscle pedicle graft. Patients were followed clinical and radiologically at 6 weeks, 3 and 6 months, 1 year and 3 years and patients were regularly followed. The mean age of the patients was 47 ± 1.1 ranging from 38 to 55 years. There were 6 (85.7% men and 1 (14.3% women among the patients. Overall 5 (71.5% patients had transcervical and 2 (28.5% had subcapital fractures. At the end of 6 months, 6 (85.7% patients were pain free and on plain radiographs fracture union was noted. One (14.3% patient developed collapse and persistent nonunion. Younger group less than 50 years presenting with neglected fracture neck femur should always be give an option of head salvage surgery in selected cases. Muscle pedicle bone grafting has been proven although inconsistently as a valid option for fracture neck femur. We encourage osteosynthesis with the use of tensor fascia lata muscle pedicle grafting along with cancellous cannulated screws as a first option in selected cases of neglected femur neck fractures.

  3. 6岁儿童股骨有限元模型的建立及股骨颈损伤的仿真分析%Establishment of 6-Year-Old Children Femoral Finite Element Model and Simulation Analysis of Femoral Neck Injury

    Institute of Scientific and Technical Information of China (English)

    王翰林; 李海岩; 贺丽娟; 崔世海

    2012-01-01

    A 6-year-old children's femur finite element model was developed based on the CT image data and children anatomical features. The three dimentional geometric model was reconstructed based on the CT scanning data first, and then a finite element mesh was developed. The finite element model was used to simulate the falling of a child during an accident. Analysis of the results of the simulated experiment showed that the instantaneous large contact force between the femoral neck and ground occurred during the falling after the child was hit in a car accident. The peak stress was found on the ecto-condyle of femoral neck which could lead to a fracture. The reseach results agreeded with the past experiments and could provide some insights into 6-year-old children's femoral injury biomechanics.%基于6岁儿童解剖学结构,对其下肢的CT扫描数据进行三维几何重构,并利用有限元的建模技术建立6岁儿童股骨的三维有限元模型.通过加载弯矩的仿真实验,模拟交通事故中儿童跌倒状态下的股骨受力情况以及所引起的股骨颈骨折.研究结果表明:6岁儿童在交通事故中跌倒瞬时产生较大的股骨与地面接触力,股骨颈外侧应力最大,易出现骨折现象.仿真结果与以往实验结论相符合并与医学结论吻合,从而验证了模型有效.建立的6岁儿童股骨三维有限元模型可以为跌倒所引起的股骨颈骨折损伤生物力学响应提供理论依据.

  4. Biomechanical study of different internal-fixations in femoral neck fractures%不同内固定器固定股骨颈骨折的生物力学比较研究

    Institute of Scientific and Technical Information of China (English)

    马信龙; 马剑雄; 杨阳; 朱少文; 马宝意; 姬树青; 马韬; 陈阳; 王志彬

    2011-01-01

    Objective To compare the biomechanical effect of several commonly used internal fixators in treating the femoral neck fractures so as to provide clinical basis for the selection of ideal internal fixation.Methods Twelve artificial PMMA femoral models were selected,and the central neck of the specimens was sawn with an electric saw at Pauwels angle of 70° to form adduction type femoral neck fracture models.After anatomic reduction,the specimens were fixed with dynamic hip screw ( DHS),three hollow screws,proximal femoral nail (PFN) and dynamic sleeve three-wing screw according to the operative approach,respectively.Instron-8874 servo-hydraulic mechanical testing machine was used to fix the specimens which simulated uniped standing.Fifteen key points on proximal femur were selected as test points and were given gradation loading at speed of 10 mm/min with linear load 0-1 200 N.The strain of each point under 1200 N load,head sink displacement under different loads and the strain of eight points on principal pressure side were measured.Results There was a peak at the eight resistance strain gage at 1200 N load and the strain values of the DHS,three hollow screws,PFN and dynamic sleeve three-wing screw were (700 ±35) μεz,(756 ± 14) με,( 1362 ± 136) με and (3024 ± 127) με,with statistical significance (P < 0.01 ).Under the same load,the head sink displacement in the group of dynamic sleeve three-wing screw was greater than that of the hollow screws group and the PFN group ( P <0.01 ),but smaller thau that of the DHS group ( P < 0.01 ).The strain values at the eight resistance strain gage in the group of dynamic sleeve three-wing screw was larger than that of the other three groups under the same load (P < 0.01 ),and the strain values increased with the increase of load at the same fixation group.Conclusion Dynamic sleeve three-wing screw has good biomechanical stability for treatment of femoral neck fracture,which can be applied in the clinical

  5. Analysis of close reduction under the C-arm X-ray perspective for femoral neck fractures%股骨颈骨折闭合复位的实际效果分析

    Institute of Scientific and Technical Information of China (English)

    李欣; 陈仲; 杨洪昌

    2011-01-01

    Objective To evaluate the actual displacement of a femoral neck fracture following close reduction under the C-arm X-ray perspective.Methods From June, 2006 to June, 2009, we managed 12 patients with femoral neck fracture by open reduction and internal fixation.They were 8 males and 4 females, aged from 23 to 65 (average, 42.3) years old.We tried close reduction of their fractures under the C-arm X-ray perspective before a temporary fixation.Next we performed open reduction, readjusted the fracture ends, and placed internal fixation.The actual displacement of the fracture measured after open reduction was carefully compared with the close reduction under the X-ray perspective.Results A substantial displacement was found after open reduction in 7 patients who had achieved anatomic reduction under the X-ray perspective.In the other 5 patients who presented with a slight displacement after close reduction under X-ray perspective, the actual displacements were larger than the X-ray observations but completely reduced after open reduction.The actual measurements after open reduction were significantly larger (3.21 ± 0.96 mm on average) in the anteroposterior displacement ( t = 11.540, P = 0.000), but insignificantly larger (0.58 ±0.93 mm on average) in the superior-inferior displacement ( t = 2.184, P = 0.346) than those after close reduction.Conclusions In general, anatomic reduction can not be achieved for a femoral neck fracture under the C-arm X-ray perspective.Consequently, open reduction may be better than close reduction in the treatment of femoral neck fracture in that improper reduction can block blood supply to the femoral neck and dissection of the capsula articularis coxae can improve blood supply as well as help decompression.%目的 探讨股骨颈骨折闭合复位在C型臂X线机下达解剖复位时骨折端的实际移位情况.方法 自2006年6月至2009年6月对12例股骨颈骨折患者行切开复位内固定,其中男8例,女4例;年龄23

  6. Optimum Configuration of Cannulated Lag Screws for the Fixation of Femoral Neck Fractures:A Biomechanical Study%空心钉在股骨颈中构型的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    王世坤; 王志义; 刘振宇

    2011-01-01

    Objective To determine which of configurations,a inverse triangular configuration and an upright triangular configuration,provide significantly improved fixation strength for fixation of femoral neck fractures with three cannulated lag screws. Methods Eight pairs of femurs were selected. A osteotomy was made. One femur of each pair was randomly selected for stabilization using cannulated lag screws in either an inverse triangular configuration or an upright triangular configuration. An Universal Material Testing Machine was used to apply vertical loads directly onto the femoral head. At each applied load, the inferior femoral head displacement reading and shearing displacement of the osteotomy were recorded. Results The inverse triangular configuration group sustained a higher (P<0. 05) average ultimate load to failure (3375 N) than did specimens in the upright triangular configuration (2725 N). At a load of 8 0 0 N , the average shearing displacement was less for specimens stabilized in the inverse triangular configuration (39. 1 μm) than for those stabilized in the upright triangular configuration (93. 1 μm;P<0. 05). Conclusion Three cannulated lag screws placed in the inverse triangular configuration provide significantly improved fixation strength compared with three screws placed in the upright triangular configuration for fixation of femoral neck fractures without posterior comminution.%目的 通过生物力学实验探讨空心钉固定股骨颈骨折时,3枚螺钉的构型对固定强度和稳定性的影响.方法 选取25~70岁尸体股骨8对,左右股骨随机分成两组.倾角50°截骨,3枚空心钉分别呈正三角和倒三角构型固定股骨颈骨折.生物力学实验机对股骨-螺钉复合体进行线性递增的加载,同时测量股骨头的位移和沿截骨面的剪切化移.结果 倒三角形构型的空心固定组较正三角形组具有更高的极限负荷和抗剪切能力,差异有统计学意义(P<0.05).结论 对于无

  7. Prosthetic replacement in elderly with femoral neck fracture of hemiplegic extremity%人工关节置换治疗老年人卒中后偏瘫侧股骨颈骨折

    Institute of Scientific and Technical Information of China (English)

    周伟; 倪江东; 贺学军; 易惠军

    2014-01-01

    Objective:To study the curative of prosthetic replacement in the elderly with femoral neck fracture of the hemiplegic ex -tremity.Methods:From June 2010 to June 2012,37 cases of the femoral neck fracture (Garden typeⅢand typeⅣ) of the hemiplegic ex-tremity were treated by prosthetic replacement .All the cases were followed up , the follow-up time was from 10 months to 34 months, av-eraging 20 months.The curative effects were evaluated by harris hip score .The harris hip scores before and after operation was observed , at the same time, according to its content was divided into pain , function, degree of motion, limb deformities four aspects to rate respec-tively.Resulst :The average harris hip score improved from 14.61 ±6.51 point preoperatively to 81.13 ±8.76 point at the last follow -up.Patients with postoperative scores were significantly higher than the former , and pain, function, degree of motion, limb deformities preoperative postoperative evaluation of the project were significant difference .Conclusion:Prosthetic replacement in the treatment of the elderly with femoral neck fracture of the hemiplegic extremity might be safe and effective method .%目的:观察和分析人工关节置换治疗脑卒中患者偏瘫侧股骨颈骨折的疗效和方法。方法:自2010年6月~2012年6月,我院采用人工关节置换术治疗老年人脑卒中患者偏瘫侧股骨颈骨折 GardenⅢ、Ⅳ型37例,随访10个月-34个月,平均20个月,观察手术前后harris评分,同时按其内容分为疼痛、功能、关节活动度、肢体畸形四方面分别进行评分。结果:患者harris评分由术前的(14.61±6.51)分恢复到术后末次随访时的(81.13±8.76)分。患者术后评分明显高于前者,而且疼痛、功能、关节活动度、肢体畸形各项目术前术后评定均差异显著。结论:人工关节置换治疗老年人卒中后偏瘫侧股骨颈骨折是安全有效的方法,在缓解疼痛

  8. Walking function follow up in near future after treatment of senile femoral neck fracture with bony cemented artificial hip replacement%骨水泥型人工髋关节置换治疗老年股骨颈骨折术后近期行走功能随访

    Institute of Scientific and Technical Information of China (English)

    胡明鉴; 郑晨希; 张玉鑫; 石化洋; 陈伶; 马红兵; 刘强; 龚文斌; 蒋伟

    2002-01-01

    Objective To investigate the effect of cemented artificial hip replacement in the treatment of senile femoral neck fracture.Method Follow up the 18 patients with senile femoral neck fracture who received bony cemented artificial hip replacement during January 1999 to September 2001.Mean following- up duration:15.7 months(3~ 23).Result Harris score:15 cases got excellent result,3 cases got good result,none got fair result.Total X ray plain film:Position of prothesis was normal with no loosing,heterotopic ossification or dislocation. Conclusion (1)Variant cemented artificial hip replacements all have satisfying effect in near future.(2)It is feasible for patients with poor economic condition to choose native prothesis in arthroplasty.(3)Di- polar artificial thigh bone replacement is a better choice for weak patient with great age.

  9. Biomechanics study of interal fixation with hollow compression screw and composite calcium phosphate cement of osteoporotic femoral neck%复合磷酸钙骨水泥强化骨质疏松股骨颈加压空心螺钉的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To evaluate the biomechanics of hollow compression screw in the osteoporotic femoral neck with composite calcium phosphate cement (CCPC).Methods Sixteen femurs of superior segment were randomly divided into two groups: augmentation group and non augmentation group.CCPC was used in augmentation group.Result Augmentation with CCPC would improve the initial mobile force of hollow compression screw,the initial mobile force and the maximal axial pull out strength for augmentation group,non augmentation group increased from (192.7± 14.0)N and (202.8± 14.0)N to(328.5± 34.7)N and( 347.8± 31.2)N.There was significant difference of two groups(P< 0.01).Conclusion CCPC can enhance hollow compression screw fixation in osteoporotic femoral neck.

  10. Computer-assisted navigation systems for insertion of cannulated screws in femoral neck fractures: a comparison of bi-planar robot navigation with optoelectronic navigation in a Synbone hip model trial

    Institute of Scientific and Technical Information of China (English)

    WANG Jun-qiang; ZHAO Chun-peng; SU Yong-gang; ZHOU Li; HU Lei; WANG Tian-miao; WANG Man-yi

    2011-01-01

    Background Computer-assisted procedures have recently been introduced for navigated femoral neck screw placement.Currently there is little information available regarding accuracy and efficiency of the different navigated procedures.The aim of this study was to compare two fluoroscopic navigation tracking technologies,a novel bi-planar robot navigation and standardized optoelectronic navigation,versus standard freehand fluoroscopic insertion in a Synbone hip model.Methods Eighteen fixed Synbone hip models were divided into 3 groups.C-arm navigated cannulated screws (AO-ASIF,diameter 7.3 mm) were inserted using freehand targeting (control group).A novel bi-planar robot system (TINAV,GD2000) and an optoelectronic system (Stryker OTS Navigation System) were used for the navigated procedures (robot group and optoelectronic group).Accuracy was measured using radiographic evaluation including the measurement of screw parallelism and decentralization,and joint penetration.To evaluate the efficiency,the number of guidewire passes,operative time and fluoroscopic images taken were noted.Results The two computer-assisted systems provided significantly improved accuracy compared to the freehand technique.Each of the parameters,including guidewire passes and number of fluoroscopy images,was significantly lower when using the computer-assisted systems than for freehand-unguided insertion (P <0.05),but operative time was significantly shorter when using freehand-unguided insertion than for the computer-assisted systems (P <0.05).Accuracy,operative time and number of fluoroscopy images taken were similar among the two navigated groups (P >0.05),but guidewire passes in the robot group were significantly less than in the optoelectronic group (P <0.05).Conclusions Both bi-planar robot navigation and optoelectronic navigation were similarly accurate and have the potential to improve accuracy and reduce radiation for freehand fluoroscopic targeting for insertion of cannulated

  11. Different implant fixation repairs femoral neck combined with ipsilateral subtrochanteric fractures:comparisons of biomechanical properties%不同植入物内固定修复股骨颈合并同侧转子下骨折:生物力学性能比较

    Institute of Scientific and Technical Information of China (English)

    王延军; 侯军; 万博; 刘刚; 牛刚; 张扬; 党晓谦

    2016-01-01

    背景:选择强度和刚度良好的内固定器植入物是修复股骨颈合并同侧转子下骨折的关键。目的:比较不同植入物内固定修复股骨颈不和同侧转子下骨折的生物力学性能。方法:将24根成年防腐尸体标本制作成为股骨颈骨折合并同侧转子下内侧皮质缺损5 cm的骨折模型,并按照随机数字表法将其均分为股骨近端锁定板组、加长型股骨近端防旋髓内钉组和加长型股骨近端髓内钉组,比较3组轴向压缩实验、扭转实验以及轴向压缩破坏实验结果。结果与结论:加长型股骨近端防旋髓内钉组轴向抗压刚度、破坏载荷大于股骨近端锁定板组和加长型股骨近端髓内钉组,加长型股骨近端髓内钉组大于股骨近端锁定板组,差异有显著性意义(P 0.05)。一定程度上讲,加长型股骨近端防旋髓内钉内固定股骨颈合并同侧转子下骨折相对股骨近端锁定板和加长型股骨近端髓内钉而言,更具有生物力学方面的优势。%BACKGROUND:Choosing internal fixator implants with good strength and stiffness is the key to repair femoral neck combined with ipsilateral subtrochanteric fractures. OBJECTIVE:To compare the biomechanical properties of different implant fixation for femoral neck combined with ipsilateral subtrochanteric fractures. METHODS:Totaly 24 adult antiseptic cadaver specimens were used to produce fracture models with femoral neck fracture combined with 5 cm of ipsilateral subtrochanteri medical cortical defect, and were divided into femoral proximal locking plate group, lengthening proximal femur anti-rotation intramedulary nail group and lengthening proximal femoral nail group according to the random number table method. The results of axial compression test, torsion test and axial compression failure rest in three groups were compared. RESULTS AND CONCLUSION: The axial compressive stiffness and failure load in lengthening proximal femur anti

  12. Stress distribution after total hip arthroplasty with a neck-retaining femoral prosthesis%股骨颈保留型人工全髋关节置换后的应力分析

    Institute of Scientific and Technical Information of China (English)

    孙玉玺; 付志厚

    2013-01-01

    BACKGROUND:Col um Femoris Preserving prosthesis is developed by Pipino, an Italian surgeon, and LINK (Germany). Whether the femoral osteotomy plane recommended in the surgical manual is suitable for Chinese people and whether the osteotomy method can cause stress changes of the prosthesis and femur has not been yet reported. OBJECTIVE:Based on clinical reviews and three-dimensional finite element model, to analyze the clinical efficacy of total hip arthroplasty with Col um Femoris Preserving prosthesis and relevant stress distribution. METHODS:We retrospectively analyzed 36 patients undergoing total hip arthroplasty with neck-retaining femoral prosthesis and 36 patients receiving total hip arthroplasty with biotype prosthesis in terms of Harris scores, visual analog scale scores, preoperative and postoperative measurements of eccentricity changes, IDES-Engh radiological evaluation and the incidence of complications. Two different osteotomy plane finite element analysis models were created to analyze the eccentricity difference and changes in the stress distribution of prosthesis and femur when the osteotomy plane was set 1.5 cm above the intertrochanteric fossa or at the junction of femoral head and neck. RESULTS AND CONCLUSION:Neck-retaining total hip arthroplasty with the osteotomy plane set at the junction between the head and neck achieved good short-term outcomes, showing no difference from total hip arthroplasty with normal biological prosthesis. The finite element analysis showed that the eccentricity increased and the stress on the prosthesis and femur also increased when the osteotomy plane was set at the junction of femoral head and neck compared with that set 1.5 cm above the intertrochanteric fossa. But there was no difference in stress distribution between two osteotomy planes.%背景:股骨颈保留型(Col um Femoris Preserving,C.F.P)假体为意大利骨科医生Pipino与德国LINK公司联合设计开发。该假体手术操作手册中推荐

  13. Effects of Salmon Calcitonin on Bone Metabolism of Osteoporotic Femoral Neck Fracture and Bone Mineral Density%鲑鱼降钙素对骨质疏松性股骨颈骨折骨代谢及骨密度的影响

    Institute of Scientific and Technical Information of China (English)

    刘卓; 孙琪

    2014-01-01

    To investigate the effect of salmon calcitonin on bone metabolism of osteoporotic femoral neck fracture and bone mineral density.Methods:86 cases of femoral neck fracture patients were randomly divided into two groups:treatment group and control group,All patients were performed with surgical treatment,The treatment group used the salmon calcitonin combined calcium,Control group simply used calcium.Results:Blood calcium of treatment group increased,urine HOP declined obviously,femoral neck was a significant increase in the density,there was a significant difference compared with control group (P<0.05).Conclusion:Salmon calcitonin on bone metabolism in blood calcium,urine HOP and femoral neck bone mineral density has significant effect.%目的:探讨鲑鱼降钙素对骨质疏松性股骨颈骨折骨代谢及骨密度的影响。方法:选取86例股骨颈骨折患者,随机分为两组:治疗组和对照组,两组患者均采用手术治疗,治疗组采用鲑鱼降钙素联合钙剂治疗,对照组单纯使用钙剂治疗。结果:治疗组血钙值增加,尿HOP明显下降,股骨颈密度较治疗前显著增加,与对照组相比有显著差异(P<0.05)。结论:鲑鱼降钙素对骨代谢中血钙、尿HOP及股骨颈骨密度有显著影响。

  14. Non-operation related risk factors for femoral neck narrowing after resurfacing arthroplasty of the hip%全髋表面置换术后发生股骨颈狭窄非手术相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    蒋志勇; 茹江英; 胡玉华; 仓海斌; 胡传亮

    2013-01-01

    [目的]探讨全髋表面置换术(resurfacing arthroplasty of the hip,RSAH)术后发生股骨颈狭窄的非手术相关危险因素.[方法]回顾性分析行全髋表面置换术的患者53例(61髋),男31例,女22例;年龄26 ~ 54岁,平均45.3岁;体重指数(RMI)为20.4~37.8,平均为27.4.按病因学分类:股骨头坏死22例(26髋),先天性髋关节发育不良13例(15髋),骨性关节炎10例(12髋)和创伤性关节炎8例(8髋).观察术后股骨颈狭窄发生情况并分组,股骨颈狭窄率≥5%纳入研究组,<5%列入对照组.对可能导致股骨颈狭窄的17个变量进行单因素分析,对差异有统计学意义的变量进行多因素非条件logistic回归分析.[结果]将37例(43髋)狭窄率>0%且<5%和未狭窄的病例纳入对照组;将16例(18髋)狭窄率≥5%的病例,纳入研究组.在研究组中,2例在术后1年于股骨头杯柄周围1、3区出现透光线;1例于术后2年出现假体松动、移位.单因素分析显示,体重指数、患髋疾病、颈干角、头颈比、股骨头囊肿大小及股骨假体柄固定方式6个变量差异有统计学意义(P值均<0.05);多因素分析显示,患髋疾病、颈干角、头颈比为独立危险因素(P值均<0.05).[结论]髋关节原发病的诊断、头颈比、颈干角是全髋表面置换术术后股骨颈狭窄发生的非手术独立危险因素.%[Objective] To analyze the non-operation related risk factors for femoral neck narrowing after resurfacing arthroplasty of the hip (RSAH).[Methods] Fifty-three cases (61 hips) treated with RSAH were retrospectively analyzed.The study included 31 men and 22 women with a mean age of 45.3 years (range,26 ~ 54 years) and body mass index of 27.4 kg/m2 (range,20.4 ~ 37.8 kg/m2).Twenty-two cases (26 hips) were diagnosed as osteonecrosis of the femoral head,13 (15 hips) as developmental dysplasia of the hip,10 (12 hips) as osteoarthritis,and 8 (8 hips) as traumatic arthritis.Post-operative femoral

  15. 老年股骨颈骨折患者术后痴呆发病的影响因素分析%The study of postoperative delirium in predicting dementia in elderly patients with femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    胡国伦; 陈代全; 龚定华; 李学斌; 齐晓岚

    2015-01-01

    Objective To study the postoperative delirium in predicting dementia in elderly patients with femoral neck frac‐ture and provide prevention advises for postoperative delirium .Methods 120 elderly patients with femoral neck fracture were in‐cluded .All patients were tested normal by Clinical Dementia Rating (CDR) preoperative .Basic imformation and postoperative deliri‐um in predicting dementia were recored in detail .After one year of follow up ,all patients were tested by CDR again and divided into dementia group and without dementia group .Results There were 40 patients (33 .3% ) with delirium postoperative with dementia 1 week after operation;there were 16 patients got 0 .5 -3 .0 CDR score after one year follow up (40 .0% ) .There were 80 patients (66 .7% ) did not experience delirium postoperative 1 week after operation ,and 4 patients (5 .0% ) with dementia got CDR score higher than zero after one year folloew up;the difference was statistically significant (P<0 .05) .Single factor analyse showed that there were close correlation between age ,introverted ,level of education < 6 years ,diabetes mellitus ,delirium ,LDL‐C level and de‐mentia (P<0 .05) .Multiple factors showed that age ,diabetes history and delirium were the independent risk factors of dementia in elderly patients with femoral neck fracture (P<0 .05) .ROC curve showed that the AUC area of postoperative delirium in predic‐ting dementia in elderly patients with femoral neck fracture was 0 .878 .Conclusion In elderly patients without the history of de‐mentia ,age ,diabetes history and delirium after hip fracture surgery are the major predictor of dementia within half years .%目的:探讨老年股骨颈骨折患者术后痴呆发病的影响因素分析,为该类患者术后痴呆发生的预防提供可参考依据。方法共纳入120例贵州盘江投资控股(集团)有限公司总医院骨科因股骨颈骨折行手术治疗的老年患者作为研究对象,所有患者

  16. Hip arthroplasty in the treatment of old femoral neck fractures in the elderly%人工髋关节置换术治疗老年陈旧性股骨颈骨折

    Institute of Scientific and Technical Information of China (English)

    杨勇; 郭庆华; 贺占坤

    2013-01-01

      目的评估人工髋关节置换术治疗老年陈旧性股骨颈骨折的短期临床疗效.方法2006年1月至2011年12月,采用人工髋关节置换术治疗老年陈旧性股骨颈骨折25例26髋,男12例,女13例,其中1例女性为双侧,平均年龄72岁(55~84岁),骨折至手术时间平均5.6个月(3~25个月).术前分析延迟治疗的原因,术前拍摄X线片,仔细进行模板测量,确定髋关节旋转中心、偏距、髋臼和股骨假体大小、颈长和截骨位置;术后3、6个月、1年及以后每年均复查并拍X线片了解假体的状况,采用 Harris 评分评估术后患髋功能恢复情况.结果术后随访36个月(12~60个月),术后1年内死亡2例,发生深静脉栓塞1例,出现坐骨神经麻痹1例.无术后关节感染及脱位,无术后人工假体下沉、断裂、松动等并发症发生.术后1年随访 Harris 评分83.68分(59~90分),与术前相比(Harris 评分28.70分)差异有统计学意义(P<0.05);18例患髋无疼痛,5例偶尔存在疼痛,2例存在中度不适,疗效满意.结论人工髋关节置换术能有效改善老年陈旧性股骨颈骨折患者髋关节功能,减轻疼痛,提高患者的生活质量.%Objective To evaluate the short-term clinical outcomes of hip arthroplasty in the treatment of old femoral neck fractures in elderly patients. Methods From January 2006 to December 2011, 25 elderly patients (26 hip joints) with old femoral neck fractures were treated with hip arthroplasty. There were 12 males and 13 females, among whom 1 female patient had bilateral fractures. The mean age of the patients was 72 years old (range; 55-84 years). The mean time interval from injury to operation was 5.6 months (range; 3-25 months). Preoperatively the reason of the delayed treatment was analyzed, and the X-ray films were shot. The templates were measured carefully, and the hip rotation center, offset distance, the acetabulum and the size of the femoral prosthesis, the neck length and cut bone

  17. 经后外侧入路小切口全髋关节置换治疗股骨颈骨折%Total hip arthroplasty with posterior minimal incision for the treatment of femoral neck fractures

    Institute of Scientific and Technical Information of China (English)

    刘程俊; 谢直跃; 顾祖超; 杨立明; 张宇

    2011-01-01

    背景:全髋关节置换已成为老年人创伤性股骨颈骨折常见的治疗方式之一,小切口微创方式可减少手术创伤及患者痛苦,便于老年患者假体置换后早期康复.目的:探讨经后外侧入路小切口行全髋关节置换后治疗股骨颈骨折的临床效果.方法:回顾性分析25例创伤后股骨颈骨折(Garden Ⅲ、Ⅳ型)患者资料,均行经后外侧入路小切口全髋关节置换.结果与结论:25例患者随访≥6个月.置换后复查X射线示假体位置良好;1例出现脱位,处理后未再发生脱位;1例下肢不等长,不影响行走.置换后9个月Harris评分平均85.7.置换后未发生感染、神经损伤、假体松动、假体周围骨质情况及深静脉血栓形成.说明经后外侧入路小切口全髋关节置换具有创伤小、人工关节稳定性强、患者恢复时间短等优点,适合老年股骨颈骨折(Garden Ⅲ、Ⅳ型)患者.%BACKGROUND: Total hip arthroplasty has become one of the common treatment modalities of the traumatic femoral neckfractures in the aged. Total hip arthroplasty with minimal incision not only reduces the surgical trauma and the patients suffering,but also benefits the recovery from operation in the aged.OBJECTIVE: To explore the clinical results of total hip arthroplasty with posterior minimal incision for the treatment of femoralneck fractures.METHODS: A total of 25 cases of traumatic femoral neck fractures (Garden Ⅲ and Ⅳ) underwent total hip arthroplasty withposterior minimal incision were retrospectively analyzed.RESULTS AND CONCLUSION: All 25 cases were followed up for more than 6 months. According to the X-ray examination afteroperation, the prosthesis was in good position. One case had prosthesis dislocation, and the dislocation didn't happen aftertreatment. One case had lower limb discrepancy which did not influence walks. The average Harris score was 85.7 in the 9thmonth after operation. There was no infection, nerve injury, prosthetic

  18. 股骨颈关节囊内骨样骨瘤的临床及影像特点%Clinical and imaging features of intra-articular osteoid osteoma in the femoral neck

    Institute of Scientific and Technical Information of China (English)

    曾泳瀚; 程晓光; 栾贻新; 顾翔; 李江涛

    2012-01-01

    Objective To evaluate the clinical and imaging characteristics of osteoid osteoma in femoral neck and to improve diagnostic accuracy of this disease.Methods Twenty-one patients (18 males and 3 females,age,7-26 years,median age,13 years) with pathologically proven osteoid osteoma of the femoral neck were retrospectively analyzed for their clinical profile and radiologic features.CT and X-ray examinations were performed in all patients,10 of them pefformed post-contrast CT scan and 4 of them performed MRI examinations.Results Nineteen patients had hip pain (pain worse at night in 11,and 8 received salicylates treatment with good response),and 2 patients only with intermittent claudication.The duration ranged from 2 months to 54 months (median duration 12 months).X-ray: Nidus was seen on plain film in 10 cases,18 cases showed different degrees of bone sclerosis of the nidus.CT: Nidus was demonstrated in all cases.Among them,8 were intracortical,6 were subperiosteal,7 were endosteal.Twenty cases showed different degrees of bone sclerosis of the nidus-extra-articular anteromedial cortical surface of the femur neck.Nineteen cases showed "vascular groove sign".MRI: Nidus was seen in 4 cases.Bone sclerosis was low signal on all sequences.Three cases had joint effusion,4 cases had bone marrow edema,and 2 cases had synovial thickening.Conclusions Although osteoid osteoma of femoral neck has non-specific clinical features,the radiographic findings are usually typical.The nidus of osteoid osteoma is often located within the joint.Bony sclerosis occurs at the area of extra-articular anteromedial cortical surface of the femur neck.CT examination remains an optimal method to identify the nidus.%目的 分析股骨颈骨样骨瘤的临床及影像特点,提高对本病的诊断水平.方法 回顾性分析21例经手术病理证实的股骨颈骨样骨瘤的临床及影像学资料.其中男18例、女3例;年龄7~26岁,中位年龄13岁.所有病例均行常规X线及CT检

  19. Treatment of displaced femoral neck fractures with percutaneous compression plate in young and middle-aged patients%经皮加压钢板固定治疗中青年移位型股骨颈骨折

    Institute of Scientific and Technical Information of China (English)

    王松华; 刘璠; 查涛; 杨志刚

    2016-01-01

    Objective To explore the operative treatment of displaced femoral neck fractures with percutaneous compression plate (PCCP) in young and middle-aged patients.Methods Forty-three young and middle-aged patients with displaced femoral neck fracture were treated with PCCP from May 2011 to May 2015.They were 24 males and 19 females,aged from 21 to 55 years (mean,38.2 years).According to the Garden classification,29 cases were type Ⅲ and 14 type Ⅳ.According to the Pauwels classification,18 cases were type Ⅱ and 25 type Ⅲ.After reduction was conducted manually or using percutaneous joystick technique,nailing was carried out under the guidance of the three-dimensional position sticker which had been invented by ourselves for minimally invasive treatment of hip fractures.Clinical and radiographic outcomes were recorded after operation and postoperative hip function was evaluated using Harris score.Results Manual reduction succeeded in 38 cases and the other 5 cases experienced reduction by percutaneous joystick technique after failure of manual reduction.For this series,the operation time ranged from 35 to 60 minutes (mean,53.2 minutes),explicit blood loss from 20 to 80 mL (mean,65.3 mL),frequency of X-ray exposure from 6 to 20 times (mean,11.8 times) during operation,the partial weight-bearing time from 14 to 30 days (mean,22.5 days),and the full weight-bearing time from 2.5 to 4.0 months (mean,3.2 months).The 43 cases were followed up for 12 to 46 months (mean,28.5 months).Bone union was achieved in all after 3 to 7 months (mean,4.3 months).The Harris hip scores at the final follow-ups ranged from 71 to 98 points (mean,92.7 points).The excellent to good rate was 95.3%,with 26 excellent cases,15 good ones and 2 fair ones.Two cases developed femoral avascular necrosis.No nonunion,implant failure or hip varus was observed during follow-ups.Conclusion Although it is difficult to treat displaced femoral neck fractures in young and middle-aged patients using PCCP

  20. Platelet-rich plasma combined with closed reduction and hollow screw internal fixation for femoral neck fracture%PRP联合闭合复位空心螺钉内固定治疗股骨颈骨折

    Institute of Scientific and Technical Information of China (English)

    陈志军; 杨彪; 张大华

    2016-01-01

    目的:分析自体富血小板血浆( PRP)联合闭合复位空心螺钉内固定治疗股骨颈骨折的临床效果。方法回顾性分析2010年5月至2014年8月在我院治疗的200例股骨颈骨折患者的临床资料,分为PRP组和对照组,各100例。 PRP组采用PRP联合闭合复位空心螺钉内固定治疗,对照组单纯采用闭合复位空心螺钉内固定治疗,记录2组患者住院时间、骨折愈合时间、切口愈合情况、术后并发症、Harris评分及髋关节功能恢复情况。结果 PRP组住院时间、骨折愈合时间明显短于对照组,切口甲级愈合率高于对照组,术后合并股骨头坏死及骨折不愈合率明显低于对照组,差异均具有统计学意义(P<0.05)。 PRP组患者术后6个月、12个月Harris评分分别为87.35、90.82分,均高于对照组的81.37、84.32分,术后6个月、12个月髋关节功能优良率分别为86%、90%,高于对照组的67%和76%,差异均具有统计学意义(P<0.05)。结论 PRP联合闭合复位空心螺钉内固定治疗股骨颈骨折能明显缩短骨折愈合时间,减少术后并发症,提高患者髋关节功能及术后生活质量,安全性和有效性较高。%Objective To explore the clinical effect of autologous platelet-rich plasma ( PRP) combined with closed reduction and hol-low screw internal fixation for femoral neck fracture .Methods Totally 200 cases of femoral neck fracture were collected from May 2010 to August 2014 in our hospital .Randomly divided them into two groups , namely the PRP group and the control group , with 100 patients in each group.The PRP group were given autologous platelet-rich plasma ( PRP) combined with closed reduction and hollow screw internal fixation , while the control group were given closed reduction and hollow screw internal fixation merely .The length of stay , time of fracture healing , wound healing state , postoperative complications rate

  1. 应用皮质支撑原理固定股骨颈骨折的生物力学研究%Biomechanical study on femoral neck fracture fixation based on cortical screw support theory

    Institute of Scientific and Technical Information of China (English)

    王立江; 魏海强; 郭连江; 黎宁; 彭阿钦

    2009-01-01

    Objective To evaluate the biomechanical effect of cortical screw support technique in fixation of the femoral neck fractures. Methods The models of subcapital femoral neck fracture were made in eight matched pairs of embamled cadaver femurs and decided into experiment group and control group (four pairs per group). The side of experiment group was fixed using three cannulated compression screws with cortical screw support and that of control group with conventional screw placement. The speci-mens in two groups were tested in aspects of torsion and axial loading. Results In axial load test at load of 600 N and 800 N, the displacements in cortical screw support group were (0.677±0.135) mm and (0.907±0.132) mm respectively, while those of femoral head in conventional screw placement group were (0.899±0.160) mm and (1.202±0.152) nun respectively (P <0.05). There was signifi-cant difference between the two groups (P < 0.05). The maximal vertical loading for failure of the fixa-tion was (2 782±228) N in cortical screw support group and (1 950±281) N in conventional screw placement group (P < 0.01). In torsibility test at 4° and 6° torsibility, the torque-moments of cortical screw support group were (10.406±1.515) Nm and (15.328 ±1.471) Nm respectively and those of conventional screw placement group (6.628±1.163) Nm and (9.072±1.570) Nm respectively, with statistical difference between two groups (P <0.01). The maximal torque-moment for failure of the fixa-tion was (25.437±5.213) Nm in cortical screw support group and (13.235±3.012) Nm in conven-tional screw placement group (P < 0.01). Conclusion Fixation of femoral neck fractures by using cortical screw support can significantly enhance anti-torsion and anti-compression of internal fixation.%目的 根据皮质支撑的方法 ,探讨应用空心螺钉固定股骨颈骨折的生物力学效果.方法 选择8具成人防腐股骨标本,用随机数字表法分成两组,每组4具,制成股

  2. 股骨颈断端愈合去除空心钉后的有限元分析%The finite element analysis of the femoral head after repair of the femoral neck fracture and removal of the inserted cannulated screws

    Institute of Scientific and Technical Information of China (English)

    吴伟; 喻爱喜; 漆白文; 肖卫东

    2015-01-01

    Objective To discuss the biomechanics factors which caused osteonecrosis of the femoral head (ONFH) after removal of the cannulated screws inserted in the healing operation of femoral neck fracture.Methods Using the finite element analysis,finite element models with three or two cannulated screws inserted in the healing operation were established respectively.In the models,the directions of inserted cannulated screws and the femoral neck were parallel.The distribution of inserted cannulated screws was the most centralized,the most dispersive and between them.The far-end depth of inserted cannulated screws was 10,5,and 2 mm.Under the same load and constraint,the stresses of the femeral head in different models were compared by the finite element analysis.Results The stress of the femeral head reached to a maximum value of 46.1 mPa when the distribution of three inserted cannulated screws was the most dispersive and their far-end depth was 2 mm.And it reached to a mimimum value of 10.3 mPa when the distribution of two inserted cannulated screws was the most centralized and their far-end depth was 10 mm.Conclusion The distribution,the far-end depth and number of inserted cannulated screws were the biomechanics factors which caused ONFH.This experiment indirectly proved the cannulated screws insert method recommended by international institute for internal fixation (AO) foundation made the least effect to the stress of femeral head after the inserted cannulated screws were removed.%目的 探讨股骨颈骨折断端骨性愈合去除空心钉后股骨头坏死的生物力学因素.方法 利用有限元分析技术分别建立3枚或2枚空心钉固定股骨颈骨折的有限元模型,空心钉平行于股骨颈方向,排列分布处于最集中、最分散及介于两者之间,空心钉远端分别位于股骨头下10、5、2 mm.在相同的加载和约束情况下,通过有限元分析计算比较各模型中内固定去除以后股骨头的受力情况.结果 当3

  3. Canine Distemper

    Science.gov (United States)

    Although this brochure provides basic information about canine distemper, your veterinarian is always your best source of ... Consult your veterinarian for more information about canine distemper and its prevention. And Now A Note On ...

  4. 两种手术方式治疗老年患者股骨颈骨折疗效的比较%Comparison of the Efficacy of Two Operative Methods on Elder Patients with Femoral Neck Fractures

    Institute of Scientific and Technical Information of China (English)

    伍燕臻; 黄承夸

    2012-01-01

    Objective To compare the efficacy of two operative methods on elder patients with femoral neck fractures. Methods 96 elder patients defined as femoral neck fracture were enrolled and randomly assigned into artificial entire hip replace and artificial thighbone head replacement. The operative time, blood loss during operation, early post-operative complications, and Harris hip score were compared between these two methods. Results ①Compared to the artificial entire hip replacement, the operative time in artificial thighbone head replacement was significantly shorter (P0.05 ); ② the incidence of early post-operative complications was low in both groups and there was no significant difference ; ③the Harris hip score was significantly higher in artificial entire hip replacement than that in artificial thighbone head replacement (89. 6% vs. 75% ,P =0.04). Conclusion Although the operative time is longer, the Harris hip score in artificial entire hip replacement is significantly higher than that in artificial thighbone head replacement, which deserved to be clinically applied.%目的 比较两种手术方式治疗老年患者股骨颈骨折的疗效. 方法 收集96例确诊为股骨颈骨折老年患者,随机分为人工全髓置换术及人工股骨头置换术,每组各48例,比较两种手术方式的手术时间、术中出血量、术后早期并发症以及随访2年后Harris评分. 结果 ①与人工全髋置换术组患者相比,采用人工股骨头置换术可以缩短手术治疗时间(P<0.05),人工股骨头置换术术中失血量少于人工全髋置换术,但差别无统计学意义(P>0.05);②两种手术方式术后早期并发症发生率均较低,组间差别无统计学意义(P>0.05);③人工全髋置换术优良率高于人工股骨头置换术,差异具有统计学意义(89.6% vs.75%,P=0.04). 结论 对于老年股骨颈骨折患者,采用人工全髋关节置换术治疗虽然手术时间较长,但Harris评分高于人工股骨头置换术,值得临床推广.

  5. 老年股骨颈骨折患者护理中的伦理学问题%Ethical Considerations in the Nursing of Elderly Femoral Neck Fracture Patients

    Institute of Scientific and Technical Information of China (English)

    翁蔚

    2012-01-01

    目的 了解在护理过程中,老年股骨颈骨折患者在心理、生理及康复训练中的需求.方法 针对老年骨折患者生理、心理的特点及护理中的伦理学问题进行有针对性的护理指导.结果 老年患者心理压力减轻、疑虑消除、自理能力增加、康复训练效果明显.结论 必须正确认识老年人的生理和心理特点,针对其身体状况制订合理的护理计划,老年人护理工作不仅要提供疾病护理还应重视心理护理.%Objective:To investigate the demands of psychology, physiology and rehabilitation training in the nursing of elderly femoral neck fracture patients. Method: Guidance was performed in the nursing according to the physiological and psychological characteristics and ethical considerations of elderly patients. Result: Elderly patients psychological pressure was reduced and eliminated, self - care ability increased, rehabilitation training effects obviously improved. Conclusion: The physiological and the psychological characteristics of elderly patients should be correctly understood, reasonable nursing plan should be established according to their physical condition. In the nursing of elderly patients, not only disease nursing but also psychological care should be paid attention to.

  6. Hydrogel containing hepatocyte growth factor promotes the repair of femoral neck defects in rabbits%含肝细胞生长因子水凝胶修复家兔股骨颈部缺损

    Institute of Scientific and Technical Information of China (English)

    郭林; 甄瑞鑫; 赵德伟; 田丰德; 于晶; 朱瑞萍

    2014-01-01

    背景:肝细胞生长因子可促进骨组织再生,在骨组织修复方面有着巨大的潜力,但是在体内较短的半衰期限制了其在临床的应用。  目的:观察含有肝细胞生长因子的半合成细胞外基质样水凝胶体内促进股骨颈骨缺损修复的作用。  方法:取12只兔制作双侧股骨颈骨缺损模型,采用自体配对对比,左侧为对照侧不对骨缺损做任何处置,右侧为实验侧植入含有肝细胞生长因子的半合成细胞外基质样水凝胶。  结果与结论:苏木精-伊红染色见2周时实验侧缺损修复区血管分布较对照侧均匀;4周时实验侧缺损区均匀填充新生骨小梁,而对照侧由外向内骨小梁形成减少;8周时实验侧缺损区皮质骨形成,并且骨髓腔再通,有骨髓细胞填充,对照侧仍有粗大骨痂填充缺损区,堵塞髓腔。钼靶X射线观测到8周时,实验侧难以区分正常骨质与新生骨质交界线,而对照侧缺损区与周围骨质分界明显。证实含有肝细胞生长因子的半合成细胞外基质样水凝胶可以促进家兔股骨颈部骨缺损的骨组织修复。%BACKGROUND:Hepatocyte growth factor can promote bone regeneration and has a great potential in bone repair, but its shorter half-life in vivolimits its clinical application. OBJECTIVE:To observe the promoting effect of semisynthetic extracelular matrix-like hydrogel containing hepatocyte growth factor on the repair of femoral neck defectsin vivo. METHODS:Twelve rabbits were taken to make bilateral femoral neck defect models. Based on autologous paired comparison, the left side was control side without treatment, and the right side served as experimental side undergoing implantation of semisynthetic extracelular matrix-like hydrogel containing hepatocyte growth factor. RESULTS AND CONCLUSION: Hematoxylin-eosin staining showed more uniform distribution of vessels in the defect area of the experimental

  7. 老年股骨颈骨折患者的围手术期特点及手术处理%Perioperative characteristics of femoral neck fractures in the elderly patients and surgical treatment

    Institute of Scientific and Technical Information of China (English)

    黄河; 宋涛; 吴永涛

    2011-01-01

    Objective To summarize the perioperative characters of femoral neck fractures in patients aged at over 75 years by analyzing the surgical treatment procedures. Methods A retrospective study was done on data of patients with femoral neck fractures treated surgically from June 2005 and June 2008,There were 51 males and 35 females,at average age of 79.4 years.Of all, there were 79 patients with fresh fractures including 9 with type Garden Ⅰ or Ⅱ fractures and 70 with type Garden Ⅲ or Ⅳ fractures,7 with old fractures(all type Garden Ⅳ). 9 patients with type Garden Ⅰ or Ⅱ fractures were treated with caunulated screw fixation(CSF). Among 77 patients with type Garden Ⅲ or Ⅳ fractures including 70 fresh fractures and 7 old ones,72 patients were treated by hip hemiarthroplasty(HHA). but the other 5 by cemented total hip arthroplasty (THA) because of preexisting hip osteoarthritis. Results The average operation duration and blood loss were 51 minutes and 50 ml in CSF group, 81 minutes and 180 ml in HHA group,105 minutes and 350 ml in THA group.Postoperative hemoglobin was decreased by 12% ,17% and 18 % on average respectively in CSF group, HHA group and THA group, and postoperative albumin decreased by 11 % , 18 % and 20 % on average respectively in CSF group, HHA group and THA group.Conclusions The patients aged ≥ 75 years with femoral neck fractures are usually accompanied with preexisted internal medical or neurolosical diseases and have high risk in operation. Adequate preoperative preparation and active prevention and treatment of perioperative complications are important for successful operation and good postoperative results.%目的 分析75岁以上高龄股骨颈骨折患者的手术治疗过程,总结围手术其特点,对于今后高龄患者的治疗提供帮助.方法 回顾性研究自2005年6月至2008年6月手术治疗的86例75岁以上的股骨颈骨折患者的治疗过程,男51例、女35例,平均年龄79.4

  8. 磷酸钙骨水泥对股骨颈骨折内固定辅强作用的组织学评价%Histological evaluation of calcium phosphate cement in augmentation of femoral neck fracture fixation

    Institute of Scientific and Technical Information of China (English)

    张伟; 赵军; 胡春明; 李玉林; 森川圭造; 杉本友宏; 佐藤啓二; 丹羽滋郎; 徐莘香

    2006-01-01

    宿主骨的改变.主要观察指标:术后不同时间各组骨水泥周围新骨形成情况及宿主骨的变化.结果:实验选用45只成熟中国绵羊,全部进入结果分析.术后不同时间各组骨水泥周围新骨形成情况及宿主骨的变化:①非辅强组:术后3周在螺钉周围产生少量纤维组织,且宿主骨骨床有显微破坏,但显微破坏在术后6及12周时可见修复.②磷酸钙骨水泥辅强组:术后3,6,12周磷酸钙骨水泥充满于螺钉和宿主骨之间,而且磷酸钙骨水泥表面有新骨形成,在新骨和磷酸钙骨水泥之间没有纤维组织介入.在术后12周可见大量新骨形成,且见许多骨小管.③聚甲基丙烯酸甲酯辅强组:术后3周在骨床与聚甲基丙烯酸甲酯之间产生大量纤维组织,可见明显骨吸收,术后6及12周尤为明显.结论:由于磷酸钙骨水泥具有良好的组织相容性、骨传导性及自身改建能力,因此对股骨颈骨折提供了长期有益的辅强作用.%BACKGROUND: Structural characteristics of calcium phosphate cement (CPC) offer substantial mechanical integrity for fracture stabilization and fixation during the healing process, with particular applications in mechanically compromised osteoporotic bone.OBJECTIVE: To investigate the mechanism of the augmentation to fixation with CPC, comparing with screw fixation augmented by polymenthymethacrylate (PMMA) bone cement or with unaugmented screw fixation for femoral neck fractures in sheep by histological evaluation.DESIGN: Randomized controlled, duplicated observation and opening study.SETTING: Departments of Orthopeadics and General Surgery, the First Hospital of Jilin University; Department of Pathology, Basic Medical College of Jilin University; Department of Plastic Surgery, Aichi Medical University of Japan.MATERIALS: The experiment was completed in the Taonan Municipal Hospital of Jilin, Jilin University and Aichi Medical University of Japan from January 1999 to January 2004. A

  9. Total hip arthroplasty for the treatment of old femoral neck fractures with lower limb length discrepancy%全髋关节置换治疗伴有下肢短缩的陈旧性股骨颈骨折☆

    Institute of Scientific and Technical Information of China (English)

    魏人前; 曹兴海; 涂大华

    2012-01-01

    BACKGROUND: Most femoral neck fracture patients with lower limb length discrepancy have experienced long-term traction orfailure internal fixation, the hip has severe osteoporosis, soft tissues around the hip joint and joint capsules contracture oravascular necrosis as well as the lower limb length discrepancy, so the clinical treatment is difficult.OBJECTIVE: To explore the clinical effect of total hip arthroplasty for treatment of old femoral neck fracture complicated with limplength discrepancy.METHODS: Thirty-five cases of old femoral neck fractures with lower limb length discrepancy were treated with total hiparthroplasty. Skeletal traction on the femoral condyle and the X-ray measurement of both lower extremities and pelvis wereprepared preoperatively, it was done to anticipate for the level of femoral neck osteotomy and the level of loosing up tissuearound hip joint, as well as to adjust the length of the prosthesis head and neck in order to maintain the length of the limbs duringsurgery.RESULTS AND CONCLUSION: Results of the 6 patients with shortened limb ranging 3.0-4.0 cm preoperartively, only 1 casehad limb length discrepancy in 1 cm after surgery, as for the rest 5 cases and 29 patients with shortened limb ranging 1 to 2 cmpreoperatively, none limb had been shortened postoperatively compared with its contralateral limb. According to Harris scoresystem, the mean preoperative Harris score was significantly improved after 1 year postoperatively (P < 0.05). Total hipreplacement can recover hip function rapidly and steady with a high good rate and satisfactory short term effect. Therefore,total hip arthroplasty is a very important and an effective treatment method for old femoral neck fracture with limp lengthdiscrepancy.%背景:由于多数伴有下肢短缩的陈旧性股骨颈骨折患者经历过长期牵引或失败的内固定手术,髋部已严重骨质疏松,髋关节周围软组织及关节囊挛缩或股骨头缺血坏死,下肢短缩,临床治疗

  10. Two I.CO.S.s and general cannulated compression screw in femoral neck fracture fixation: a biomechanical comparison of 2 different configurations%2种构型2枚I.CO.S.固定股骨颈骨折的生物力学比较

    Institute of Scientific and Technical Information of China (English)

    陆慧; 吴元勇; 朱明; 倪卫东

    2011-01-01

    目的:探讨双重空心加压螺钉(Ideal compression screw,I.CO.S.)在治疗股骨颈骨折中的生物力学作用,并为临床上选择合适空间构型的2枚此类螺钉治疗股骨颈骨折提供一定的理论依据.方法:采集20具尸体股骨标本,模拟股骨颈头下型骨折,随机分为I.CO.S.组(实验组)和普通空心加压螺钉组(对照组),每组各10个标本,分别随机采用2枚水平位(2枚螺钉前后平行位于股骨颈轴心上方)和垂直位(2枚螺钉上下平行位于股骨颈轴心上下方)固定各5个.测定各组载荷下的应变值、股骨头的水平和垂直位移、并进行屈服力学性能测试.结果:在生物力学稳定性方面,I.CO.S.在水平位移和屈服载荷方面较普通空心加压螺钉好,螺钉水平位固定在应变、水平位移和屈服载荷方面较垂直位好.结论:I.C0.S.固定股骨颈骨折的稳定性较好,且2枚I.CO.S.水平位固定有较高的稳定性可应用于临床.%Objective : To explore the hiomechanical stability for treatment of femoral neck fracture with ideal compression screw ( I.CO. s. ) and to provide theoretical basis for choosing appropriate geometric configurations of two I.CO.S.s in clinical application. Methods : 20 cadaveric human femurs were selected and divided randomly into two groups : experiment group and control group, 10 in each one which was then divided equally into two sub-groups. The model of subcapital femoral neck fracture was made , then given anatomical reduction and fixed with I.CO.S. ( experiment group ) and general cannulated compression screw ( control group)separately with two different configurations : horizontal one ( parallel screws in superior aspect of femoral neck ) and vertical one( parallel screws in sagittal plane of femoral neck ) . The different biomechanical performances were evaluated through experimental stress analysis. Results : In hiomechanical stahility aspect,I.CO.S.was better than general screw in the horizontal

  11. Correlation study between 25-OH-D2, 25-OH-D3, and the bone mineral density of the femoral neck%25-OH-D2、25-OH-D3与股骨颈骨密度的相关性研究

    Institute of Scientific and Technical Information of China (English)

    宋红

    2014-01-01

    Objective To investigate the correlation between the content of the 25-hydroxyvitamin D2 ( 25-( OH ) D2 ) and 25-hydroxyvitamin (25-(OH)D3) and the bone mineral density of the femoral neck (femoral neck BMD).Methods The femoral neck BMD of 205 patients was detected using dual energy X-ray absorptiometry.The serum levels of 25-( OH) D2 and 25-( OH) D3 were determined using high performance liquid chromatography.The correlation between Vitamin D ( Vit D) content and the femoral neck BMD was analyzed.Results In patients younger than 50 years old, no correlation between the VitD (25-(OH)D2 and 25-(OH)D3) content and the femoral neck BMD was observed (P>0.05).But in patients elder than 50 years old, a positive linear correlation was observed (P<0.05 or P<0.01).This existed both in men and women.Conclusion In patients elder than 50 years old, the serum Vit D level decreases along with the increase of age, which may cause a decline in the femoral neck BMD.%目的:研究人体内25羟维生素D2(25-OH-D2)、25羟维生素D3(25-OH-D3)含量与股骨颈骨密度的相关性。方法利用双能X线骨密度测量法检测205例患者股骨颈骨密度,同时用高效液相色谱法检测其血清中25-OH-D2及25-OH-D3的含量,并根据维生素D(VitD)含量分析VitD与骨密度的关系。结果人体内VitD(25-OH-D2+25-OH-D3)含量与50岁以下者的股骨颈骨矿含量无相关性(P>0.05),与50岁以上者呈正向直线相关(P<0.05或P<0.01),男女性别均一致。结论对于50岁以上者,随着年龄的增长,其体内血清VitD的含量降低很可能会导致其股骨颈骨矿含量下降。

  12. Surgical Technique of Cannulated Screw Placement Guided by 3D Printing Template in Pediatric Femoral Neck Fracture%3D打印个体化手术导航模板引导儿童股骨颈骨折空心螺钉置入的应用

    Institute of Scientific and Technical Information of China (English)

    郑朋飞; 楼跃; 徐鹏; 唐凯

    2016-01-01

    目的:探讨利用计算机辅助设计和3D打印技术制作的个体化手术导航模板实现儿童股骨颈骨折空心螺钉精确置入的可行性。方法:选取1例儿童股骨颈骨折患者,依据CT数据使用计算机辅助模拟骨折复位和股骨颈空心螺钉置入过程,通过软件设计并打印出与复位后股骨近端匹配的经颈螺钉置入导航模板,术前3D模型模拟手术验证可行后,术中在导航模板辅助下置入导针及螺钉。结果:3D打印的导航模板术中与股骨近端骨性标志匹配良好,能够辅助螺钉精确置入股骨颈并稳定骨折端,螺钉置入后经术中X检查与术前设计基本一致。螺钉置入的手术时间约为12min,术中使用X线透视仅4次。术后X线片示股骨颈骨折复位良好,两枚空心螺钉的进钉点、进钉方向、螺钉长度均与术前设计方案一致,螺钉未损伤骺板。术后3个月随访,股骨颈骨折临床愈合,按Ratliff评价标准评价髋关节术后功能情况为优,螺钉无松动、断裂。结论:3D打印个体化手术导航模板可以辅助股骨颈空心螺钉的精确置入,减少医源性股骨颈骨骺及血供损伤,节省手术时间,减少术中出血,减少患者及手术操作人员的射线暴露,值得推广应用。%Objective: To investigate the feasibility and accuracy of a drill template for the placement of screws in femoral neck based on digital design and 3D printing technology. Methods: The preoperative CT images of 1child with femoral neck fracture were collected. With the data, the individual proximal femur model was made by the 3D printer. The reduction of fracture and the cannulated screw of femoral neck were simulated by the computer. The screw which was through the femoral neck designed by the software and printed to match the proximal femur after reduction was placed into the navigate template. After the feasibility of the 3D model operation was

  13. 新型人工生物活性接骨板治疗犬股骨骨折%LIM mineralization protein 1 gene transfected bone marrow mesenchymal stem cells combined with nano-hydroxyapatite/polyamide 66 plate in the treatment of canine femoral fractures

    Institute of Scientific and Technical Information of China (English)

    徐小平; 倪卫东; 高仕长; 蒲超; 黄伟弘

    2012-01-01

    BACKGROUND: Studies have shown that nano-hydroxyapatite/polyamide 66 (n-HA/PA66) is a kind of high-strength and high-toughness composite material with excellent biocompatibility, biological safety, biological activity and bone conduction ability.OBJECTIVE: To investigate the effect and feasibility of n-HA /PA66 plate combined with bone marrow mesenchymal cells (BMSCs) transfected with human LIM mineralization protein 1 (LMP-1) gene for treatment of canine femoral fractures. METHODS: Canine BMSCs were isolated and cultured with density gradient centifugation method and adhesive culture method. The third-generation BMSCs were transfected with Adv-hLMP-1, and then combined with n-HA /PA66 plate. The dog models of femoral fractures were established in 48 dogs and were divided into four groups: Ad-LMP-1 transfection group, non-transfected group, n-HA/PA66 alone group and plate and screw groups.RESULTS AND CONCLUSION: The failure rate in the transfection group was lower than that in non-transfected group and n-HA/ PA66 plate group at 8 or 12 weeks postoperatively (P 0.05). The healing time of the transfection group was shorter than that of the other three groups. The plate in the transfection group was completely fused with canine femoral lateral cortex after 12 weeks of operation, and there was obvious bone formation between material and bone. The plate and canine lateral femoral cortex were only partially fused in the non-transfected group and n-HA/PA66 plate group, and there was no or a small amount of bone tissue formation between material and bone. The treatment of canine femoral fractures with n-HA/PA66 plate combined with BMSCs transfected with LMP-1 gene can get good fixation effects, promote the fracture healing and fusion with autogenous bone, without the need for a second operation to take out, but the strength of materials have some limitations, which must be combined with external fixation in the treatment of canine femoral fractures.%背景:研究表明纳

  14. Treatment of femoral neck fracture with muscle-bone flap of both musculus tensor fasciae latae and musculus sartorius%阔筋膜张肌缝匠肌骨瓣移植治疗股骨颈骨折

    Institute of Scientific and Technical Information of China (English)

    刘国平; 康斌; 曾辉

    2001-01-01

    Objective To evaluate the effects of bone grafts with muscular pedicles of both musculus tensor fasciae latae and musculus sartorius in treating fresh transcervical or subcapital fractures of femoral neck (TSFFN). Methods 30 cases of TSFFN were treated by tail breakable screws and sartorius muscular pedicles bone grafts. The other 23 cases were treated by hollow pressure screws and bone grafts with muscular pedicles of both musculus tensor fasciae latae and musculus sartorius. Results 52 cases were followed up for 3 to 5 years, 4 years on average. In sartorius muscular pedicles, 8 cases showed the poor therapeutic results. The excellent therapeutic effects were achieved in all cases of musculus sartorius. Conclusion TSFFN can be treated by double muscular pedicles bone graft. The double muscular pedicles bone graft is more effective than single sartorius muscular pedicles in treating TSFFN of short-mid-term.%目的观察阔筋膜张肌和缝匠肌联合双肌蒂骨瓣移植治疗新鲜股骨颈头下型和经颈型骨折的疗效。方法缝匠肌蒂组30例用可折螺钉固定加缝匠肌蒂骨瓣移植;双肌蒂组23例采用可折螺钉或空心加压螺钉固定加阔筋膜张肌和缝匠肌双肌蒂骨瓣移植。结果随访52例,时间3~5年,平均4年,缝匠肌蒂组8例疗效较差,双肌蒂组均愈合良好。结论联合双肌蒂骨瓣治疗股骨颈头下型和经颈型骨折,其近期和中期疗效均较缝匠肌单肌蒂骨瓣移植好。

  15. Mechanical properties of femoral trabecular bone in dogs

    Directory of Open Access Journals (Sweden)

    Nolte Ingo

    2005-03-01

    Full Text Available Abstract Background Studying mechanical properties of canine trabecular bone is important for a better understanding of fracture mechanics or bone disorders and is also needed for numerical simulation of canine femora. No detailed data about elastic moduli and degrees of anisotropy of canine femoral trabecular bone has been published so far, hence the purpose of this study was to measure the elastic modulus of trabecular bone in canine femoral heads by ultrasound testing and to assess whether assuming isotropy of the cancellous bone in femoral heads in dogs is a valid simplification. Methods From 8 euthanized dogs, both femora were obtained and cubic specimens were cut from the centre of the femoral head which were oriented along the main pressure and tension trajectories. The specimens were tested using a 100 MHz ultrasound transducer in all three orthogonal directions. The directional elastic moduli of trabecular bone tissue and degrees of anisotropy were calculated. Results The elastic modulus along principal bone trajectories was found to be 11.2 GPa ± 0.4, 10.5 ± 2.1 GPa and 10.5 ± 1.8 GPa, respectively. The mean density of the specimens was 1.40 ± 0.09 g/cm3. The degrees of anisotropy revealed a significant inverse relationship with specimen densities. No significant differences were found between the elastic moduli in x, y and z directions, suggesting an effective isotropy of trabecular bone tissue in canine femoral heads. Discussion This study presents detailed data about elastic moduli of trabecular bone tissue obtained from canine femoral heads. Limitations of the study are the relatively small number of animals investigated and the measurement of whole specimen densities instead of trabecular bone densities which might lead to an underestimation of Young's moduli. Publications on elastic moduli of trabecular bone tissue present results that are similar to our data. Conclusion This study provides data about directional elastic

  16. Application of comfort painless nursing in femoral neck fracture nursing%舒适无痛护理在股骨颈骨折护理中的应用

    Institute of Scientific and Technical Information of China (English)

    郑丽芳

    2015-01-01

    目的:研究分析舒适无痛护理在股骨颈骨折护理中的应用疗效。方法选择2010年2月~2014年2月我院接诊的80例手术患者进行研究。按照护理方式不同将其分为治疗组(40例)和对照组(40例)。对照组单纯给予患者常规的临床护理。治疗组在给予常规的临床护理的同时,对患者选派责任护士,进行专职舒适无痛护理。对比两组中的临床效果,采用VAS法对患者的疼痛情况作出评价,记录患者治疗过程中的并发症的发生情况,并比较患者对此次治疗的满意度。结果治疗组在接受舒适无痛护理后的疼痛级别均有所改善,而且患者整体的疼痛发生率(50.00%)要明显低于对照组(87.50%)。治疗组中的术后并发症(2.50%)明显低于对照组(27.50%)。在治疗结束后,采用调查问卷法对护理效果进行评估,得出舒适无痛护理使患者非常满意,其整体满意率高达97.50%,明显高于普通常规的护理(77.50%)。结论舒适无痛护理在股骨颈骨折护理中有着良好的医疗效果,可以有效的减轻患者的疼痛,大大提高患者的满意度,值得在临床医学中推广使用。%Objective To study the clinical effect of comfort painless nursing in the treatment of femoral neck fracture.Methods 80 cases of patients were selected in our hospital for study from February,2013 to August,2014. The patients were randomly divided into the treatment group (40 cases) and control group (40 cases). The control group were received conventional clinical nursing alone. The treatment group were received routine clinical nursing, while the patients had been given comfort painless nursing for the environment, patients’ psychological and physiological and complication prevention. Clinical effects were compared between the two groups by VAS method to the patient’s pain evaluated, records of patients during the treatment of

  17. Discussion on spinal anesthesia dosage of elderly patients in the open operation of femoral neck and intertrochanter fracture%老年股骨颈、粗隆间骨折手术脊麻用药剂量探讨

    Institute of Scientific and Technical Information of China (English)

    费建平; 雷月; 张代玲

    2015-01-01

    Objective To explore reasonable medication doses of the elderly during femoral neck and intertrochanteric fractures open surgery,allofthepatientsadoptcombinedspinal-epiduralanesthesia(CSEA).Methods 52ASAⅠ~Ⅲpa-tients undergoing femoral neck and intertrochanteric fractures open surgery were randomly divided into two groups according to the different medication doses A group (10mg) 29 cases.B group(≤8mg) 23 cases.They were treated with L-bupivacaine 10mg(group A) and L-bupivacaine do not exceed 8 mg(group B),To observe adverse events of circulation and respiration caused by spinal anesthesia with different doses in elderly patients .At last,elderly patients are given reasonable dose in spinal anesthesia.Results In different age groups,the heart rate,diastolic blood pressure after spinal anesthesia was no statistically significant(P>0.05).After completion of spinal anesthesia ,systolic blood pressure decreased significantly within 30min,the difference was statistically significant (P0.05).The pain relief rate was 100%,all patients can successfully complete the surgery .The pain relief rate of A group and B group has no statistically significant (P>0.05).The blood circulation fluctuation rate of B group (21.7%,5/23) was lower than that of A group(65.5%,19/29),the difference was statistically significant (P0.05).The arrhythmia,respiratory depression and additional epidural medication rate of 2 group was no statistically significant(P>0.05).Conclusion Patients aged 75 years and older,≤6mg L-bupivacaine spinal anesthesia is more safe .In patients younger than 75 years old,the right spinal anesthesia dosage is not more than 8mg of L-bupivacaine.At the same time, Its were also important to preoperative treatment of basic diseases ,prolong anesthesia induction period ,try to shorten the opera-tion time.At last,we should renamed the meaning of “the anesthesia induction period” of elderly patients with spinal ,in order to actively processing cycle fluctuations after

  18. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures

    Directory of Open Access Journals (Sweden)

    Sampat S Dumbre Patil

    2016-01-01

    Full Text Available Background: When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN or surface implants like Dynamic Condylar Screw (DCS are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Materials and Methods: Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22-65 years and mean followup period was 52.1 months (range 27-72 months. Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. Results: All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Conclusions: Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion.

  19. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures

    Science.gov (United States)

    Dumbre Patil, Sampat S; Karkamkar, Sachin S; Patil, Vaishali S Dumbre; Patil, Shailesh S; Ranaware, Abhijeet S

    2016-01-01

    Background: When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN) or surface implants like Dynamic Condylar Screw (DCS) are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP) of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Materials and Methods: Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22–65 years) and mean followup period was 52.1 months (range 27–72 months). Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. Results: All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Conclusions: Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion. PMID:27512218

  20. The surgical treatment of femoral neck fracture of shift type in young adults(Garden Ⅲ, Ⅳ)%青壮年移位型股骨颈骨折(Garden Ⅲ、Ⅳ)的手术治疗

    Institute of Scientific and Technical Information of China (English)

    周俊; 周传友; 陈武

    2014-01-01

    ObjectiveTo evaluate the effects of the hollow compression screws joint hip musculoskeletal flap transplantation in treating femoral neck fracture of shift type in young adults.MethodsBetween June 2008 and June 2012, 27 young adults with femoral neck fracture(GardenⅢ,Ⅳ) were treated with hollow compression screws joint hip musculoskeletal flap transplantation in treating femoral neck fracture of shift type using modified Smith-Peterson(S-P).Results27 patients were followed up 18 to 60 months, on average 36 months. The time of fracture healing was 4 to 8 months, on average 6.5 months. 35 cases of healing, healing rate was 93.3%. 3 cases of femoral head necrosis, necrosis rate was 10.0%.ConclusionHollow compression screws joint hip musculoskeletal flap transplantation is a reliable method for treating femoral neck fracture of shift type in young adults, with a high rate of fracture healing and a low rate of head necrosis, and is worthy of clinical promotion.%目的:评价空心加压螺钉联合臀中肌骨瓣移植治疗青壮年移位型股骨颈骨折的疗效。方法2008年6月~2012年6月我院对27例移位型青壮年股骨颈骨折(Garden Ⅲ、Ⅳ)患者采用改良Smith-Peterson入路(S-P)空心加压螺钉联合臀中肌骨瓣移植治疗。结果27例患者均获随访,随访时间18~60个月,平均36个月。骨性愈合时间4~8个月、平均6.5个月,骨折愈合25例,愈合率93.3%,股骨头坏死3例、其中2例骨折不愈合后期发展为股骨头缺血坏死、另1例为内固定取出术后出现股骨头坏死。股骨头坏死率为10.0%。结论采用改良S-P入路对股骨头周围血供破坏小,臀中肌骨瓣移植联合空心加压螺钉治疗青壮年移位型股骨颈骨折,对提高青壮年移位型股骨颈骨折愈合率和降低股骨头缺血坏死率疗效肯定,值得临床使用。

  1. 全髋关节置换术治疗老年股骨颈骨折48例临床分析%Clinical analysis of total hip arthroplasty in the treatment of 48 cases of older femoral neck fractures

    Institute of Scientific and Technical Information of China (English)

    陈刚; 曹怀焱; 贺检

    2012-01-01

    Objective To investigate the best surgical method and \\.h.e, clinical effects of older femoral neck fracture. Methods 96 cases of older femoral neck fracture were randomly divided into the observation group and the control group, each group had 48 cases respectively.The observation group was implemented total hip arthroplasty (THA), but the control group was implemented femoral head replacement. Then the clinical effects and adverse reaction (ADR) of the two groups were compared. Results The operation time of the observation group was shorter than that of the control group, the difference was statistically significant (P < 0.05). The amount of bleeding of the observation group was more than that of the control group, but the postoperatton activities time of observation group was earlier than that of the control group, there were significant. Differences between the two groups (P < 0.01). The excellent rate of the observation group was 87.50%, while the control group was 66.67%, after comparison, there was a significant difference between the two groups (P < 0.01). The observation group and the control group had 4 cases (8.33%) and 13 cases (27.08%) of postoperative complications respectively, the two groups had significant differences (P < 0.05). Conclusion T11A in the treatment of older femoral neck fractures can recover the normal position of hip joint quickly, rebuild hip joint function, improve limb pain and dysfunction, avoid complications caused by long-term stay in bed and reduce the mortality of older patients with femoral neck fracture, which is one of the excellent and ideal treatment in nowadays.%目的 探讨老年股骨颈骨折的最佳手术方式及临床疗效.方法 将96例老年股骨颈骨折患者随机分为观察组和对照组,每组各48例,观察组采用全髋关节置换术,对照组采用人工股骨头置换术,比较两组临床疗效及不良反应.结果 观察组手术时间短于对照组,两组比

  2. Fixed treatment for femoral neck fracture of young adults by bone flap M. sartorious transplanting and hollow pulling nails%缝匠肌骨瓣移植空心拉力钉固定治疗青壮年股骨颈骨折

    Institute of Scientific and Technical Information of China (English)

    蔡明; 白金广

    2000-01-01

    目的:通过采用缝匠髂骨瓣移植、空心拉力钉固定治疗青壮年股骨颈骨折,获得更好的疗效。方法:自1992年1月~1999年12月,采用缝匠肌骨瓣移植桥接与空心拉力钉固定治疗青壮年股骨颈骨折,随访时间1~5年,平均4年。结果:73例新鲜骨折中1例骨折不愈合,股骨头坏死,1例骨折愈合股骨头坏死;27例移位型陈旧骨折中3例骨折不愈合,股骨头坏死,2例骨折愈合后股骨头坏死。骨折愈合率96%,股骨头坏死率7%。结论:缝匠肌骨瓣移植可改善股骨头血供并使植骨以"活骨骨折愈合"的方式完成,陈旧性骨折股骨颈吸收的可重建股骨颈,并有一定的强度支撑防止股骨头坏死应力塌陷,与空心拉力钉有协同支撑固定作用。三根空心拉力钉固定创伤小而连接控制面积大是理想的内固定物。%Objective: To achieve better effects through the application of bone flap M. Sartorious transplanting and hollowpulling nails for the treatment of the femoral neck fracture of young adults. Methods: From 1,1992 to 12, 1999, We treatedfemoral neck fracture of young adults by bone flap M. Sartorious transplanting and hollow pulling nails with one to five yearsfollow-up,averaging 4 years. Results: Among 73 fresh (new) fracture 1 not healed up,femoral head necrosis, 1 healed up, withtemoral head necrosis;27 transferred old fractures, 3 not healed up, femoral head necrosis, 2 healed up, femoral head necrosis.Fracture healing rate was 96 percent, femoral head necrosis rate was 7 percent. Conclusion: That the bone flap M. Sartorioustransplanting can improve femoral blood supply, finish bone transplanting in a way of"live bone fracture healing up", rebuildfemoral neck for old fracture and together with hollow pulling nails prevent femora from necrosis. Three hollow pulling forcenails make little wound and large joined controlling area. They are the ideal inner fixed objects.

  3. Comparison the efficacy of minimally invasive and conventional incision in artificial hip replacement for treatment of femoral neck fracture in elderly%快捷小切口与常规切口人工髋关节置换术治疗老年股骨颈骨折的疗效对比

    Institute of Scientific and Technical Information of China (English)

    李军民; 肖信约; 张伟; 任云峰; 贾福; 张仲子; 吴中雄; 宣靖; 杨正宗

    2012-01-01

    Objective To compare the efficacy of the minimally invasive incision and conventional incision in artificial hip replacement for treatment of femoral neck fracture in elderly. Methods All of 240 old patients with displaced femoral neck fracture were randomly divided into four groups, the minimally invasive incision total hip replacement group, the conventional incision total hip replacement group, the minimally invasive incision femoral head arthroplasty group, and the conventional incision femoral head arthroplasty group, 60 cases each. Then each group underwent statistical analysis, for incision length, operation time, the amount of blooding, postoperative drainage volume,activity time and Harris score after operation. Results There was statistically significant difference in incision length, operation time, the amount of blooding, postoperative drainage volume and activity time between the minimally invasive incision total hip replacement group and conventional incision group (P 0.05). There was statistically significant difference in incision length, operation time, the amount of blooding, postoperative drainage volume and activity time between the minimally invasive incision femoral head arthroplasty group and conventional incision group (P 0.05). The efficacy of minimally invasive incision group was better than conventional incision group. Conclusion The minimally invasive incision hip arthroplasty has the advantages of minimal incision, short operation time, less trauma, little scar, quicker recovery. It is an ideal method for treatment of displaced femoral neck fracture in elderly.%目的 对比快捷小切口与常规切口行人工髋关节置换治疗老年股骨颈骨折的临床疗效.方法 将240例老年移位股骨颈骨折随机分为全髋置换小切口组、全髋置换常规切口组、半髋置换小切口组、半髋置换常规切口组(各60例).对每组切口长度、手术时间、出血量、术后引流量、下地活动时间、术

  4. Preliminary study of influence of bone tissue from osteonecrosis of femoral head on the proliferation and differentiation of canine bone marrow mesenchymal stem cells%股骨头坏死骨组织对骨髓间充质干细胞增殖分化的影响

    Institute of Scientific and Technical Information of China (English)

    王萌; 廖琦; 周斌; 仇志强; 程立明

    2013-01-01

    Objective To examine the effects of bone tissue from osteonecrosis of femoral head on the proliferation and differentiation of canine bone marrow mesenchymal stem cells in vitro culture.Methods A canine model of femoral head osteonecrosis was induced by liquid nitrogen freezing.BMSC were isolated from dog ilium bone marrow by a combination of gradient centrifugation and adherent wall culture.Different bone tissues and BMSC were cultivated indirectly in vitro by co-cultured in Transwell plate.According to the culture media,3 groups were established:blank group (10% FBS/DMEM),control group (10% FBS/DMEM + bone tissue from natural femoral head) and experimental group(10% FBS/DMEM + bone tissue from osteonecrosis of femoral head).Cell proliferation was measured by methylthiazol tetrazolium (MTT)method.Cell differentiation was examined by alkaline phosphatase (ALP) staining and its concentration examined.Alizarin red staining method was used to study the calcification effects and Oil red O staining method was used to detect if there was fat emergence.Results As compared with the blank group,the proliferation in the control and experiment groups were significantly promoted after culturing for Days 1,3 and 5 (P < 0.05).The proliferation of the experiment group was higher than the control group at Day 5 and 7 day (P < 0.05).After a 7-day co-culturing,ALP staining was positive in the control and experiment groups.At Day 7 and 9,the ALP activity in culture fluid was in this order:control group > experiment group >blank group(P <0.05).Alizarin red staining show control group had the most calcium nodules(12.17 ±2.48,P < 0.05) and the number of calcium nodules in the experiment group was more than the blank group (P <0.05).Oil red O staining show there was no fat emergence after 21 days in every group.Conclusion Both natural and osteonecrotic bone tissue of femoral head could promoted the proliferation of canine BMSC and induces them osteogenic

  5. The efficacy comparison between hollow screw fixation and head and tail nail fixation treatment for the elderly femoral neck fractures%空心拉力螺钉内固定与首尾钉内固定治疗老年人不同类型股骨颈骨折疗效比较

    Institute of Scientific and Technical Information of China (English)

    郝应文; 唐军伟

    2014-01-01

    Objective To analyze and compare the efficacies of internal fixation by the cancellous bone screw and by the head and tail nail in the treatment of femoral neck fracture of the elderly. Methods 103 cases of elderly femoral neck fractures who were followed up for more than one year accepted the retrospective analysis. They were divided into group A(n=55)and group B(n=48)according to the treatment they received. Group A was treated by cancellous bone screw,and group B was treated by head and tail nail. The efficacy was evaluated by Harris score. Results There was no statistical difference in the efficacy of the treatment between two groups( P >0. 05)and Harris score was improved in each type of femoral neck fracture. However,the excellent rate was higher in group A than in group B(91. 2% vs. 62. 5%)for subcapital type ( P 0. 05),and lower in group A than in group B(66. 7% vs. 95. 0%) ( P 0.05)。两组患者不同类型术后髋关节Harris评分均有不同程度的改善。头下型骨折:A组优良率为91.2%,B组优良率为62.5%,A组优良率高于B组( P 0.05);基底型骨折:A组优良率为66.7%,B组优良率为95.0%,B组优良率高于A组( P <0.05)。结论空心拉力螺钉内固定与首尾钉内固定治疗老年人股骨颈骨折,都可以达到良好的骨折复位效果,头下型骨折空心拉力螺钉内固定效果更优,基底型骨折首尾钉内固定效果更优。

  6. Treatment of 66 cases of femoral neck fracture in aged patients with artificial joint replacement with small incision%后外侧小切口人工关节置换术治疗高龄股骨颈骨折66例

    Institute of Scientific and Technical Information of China (English)

    黄伟

    2016-01-01

    目的:分析后外侧小切口人工关节置换术在治疗高龄股骨颈骨折中的临床效果。方法:选取我院2010年1月~2013年8月66例进行后外侧小切口人工关节置换术治疗高龄股骨颈骨折患者的临床资料加以分析,随之定期进行术后走访。结果:手术过程中无一例死亡,经过为期10个月走访可知,66例患者中有疗效显著的患者59例,有所改善的患者为5例,2例患者出现下肢深静脉血栓等并发症(并发症发生率为3.03%),随之采取热敷、溶栓治疗,并发症消失。结论:后外侧小切口人工关节置换术治疗高龄股骨颈骨折患者,其效果显著,术中创伤小,术后恢复快,并发症少,值得临床推广使用。%Objective To analyze small lateral incision arthroplasty clinical effect in the treatment of femoral neck fracture.Methods I Hospital in January 2010~ August 2013 after 66 cases were small lateral incision arthroplasty in treatment of elderly patients with femoral neck fracture clinical data to be analyzed, along with regular postoperative visits.Result No deaths during surgery, after a period of 10 months visited found that 66 patients had a significant effect in 59 patients, improved patient for five cases, two cases of patients with complications such as deep vein thrombosis (complication rate was 3.03%), followed by taking heat, thrombolytic therapy, complications disappear. The results were statistically significant (P <0.05).Conclusions Posterolateral small incision arthroplasty in treatment of elderly patients with femoral neck fracture, the effect is significant, small surgical trauma, rapid recovery, fewer complications, worthy of clinical use.

  7. Effects of nutrition management based on health quotient in elderly postoperative patients with femoral neck fracture%以健商为基础的营养管理在老年股骨颈骨折术后患者中应用的效果

    Institute of Scientific and Technical Information of China (English)

    朱宏伟; 霍晓鹏; 孙红; 赖小星

    2016-01-01

    目的 运用健商理念对老年股骨颈骨折患者实施综合性的营养管理,探讨术后患者营养状况改善的效果.方法 将健商理念引入患者术后综合营养管理,建立一套系统的三级营养评估筛查系统,并实施持续改进的以健商分数为标准的分级细化营养干预和健康教育制度,比较71例患者入院及术后14d健商指数和营养相关指标.结果 71例老年股骨颈骨折患者入院和手术后14d健商评分差异有统计学意义(P<0.01),患者McDonald营养学指数的差异有统计学意义(P<0.05).结论 以健商为基础的营养管理,能够更好地解决老年股骨颈骨折术后患者营养健康相关的问题,提高营养支持,改善营养相关的指标,利于疾病的恢复.%Objective To implement comprehensive nutrition management based on the advanced concept of health quotient in elderly patients with femoral neck fracture,and explore the effect in improving nutriture of patients after operation.Methods The concept of health quotient was introduced to comprehensive nutrition management,and a systematic assessment and screening system of three-level nutrition was built.Besides,we carried out hierarchical and thinning nutritional intervention based on health quotient score and health education system with continual improvement.The index of health quotient and relevant index of nutrition were evaluated among 71 patients after being hospitalized and 14 days after operation.Results There were statistically significant differences in the score of health quotient and McDonald nutrition index among 71 elderly patients with femoral neck fracture after being hospitalized and 14 days after operation (P < 0.05).Conclusions Nutrition management based on health quotient can solve the problem related to nutrition and health after operation among elderly patients with femoral neck fracture,improve the nutritional support and nutrition-related indicators,it is conducive to the recovery.

  8. 关节置换治疗56例老年股骨颈骨折患者围术期安全性分析%Analysis on safety of joint arthroplasty during perioperative period in 56 aged cases of femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    邓玉海; 王序全; 黄平; 陈浩; 陈益果; 赵智君; 王征; 宋翼; 华晨曦

    2013-01-01

    目的探讨高龄股骨颈骨折髋关节置换术的围术期安全性。方法回顾性分析56例行髋关节置换术的65岁以上老年髋部骨折病例资料。结果56例中54例平均住院21 d(18~31 d)顺利出院,Harris 评分从术前30分(0~38分)增加至出院时83分(72~91分),髋关节功能明显改善;围术期死亡2例,均为术前手术耐受力评分较差;术后形成血肿3例(5.4%),血肿穿刺后继发感染1例(1.79%),术后早期后脱位3例(5.4%),无1例有临床症状的深静脉血栓发生。结论髋关节置换术是治疗高龄股骨颈骨折的有效手段,但是,手术耐受能力较差者应慎重选择手术。%Objective To investigate the safety of hip arthroplasty during the perioperative period in aged patients with femoral neck fracture .Methods The clinical data in 56 elderly cases of femoral neck fracture treated by hip arthroplasty ,aged more than 65 years old ,were performed the retrospective analysis .Results Among 56 cases ,54 cases hospitalized for 21d[(18-31)d] and suc-cessfully were discharged ,the Harris scores were increased from preoperative 30 (0 -38) to postoperative 83 (72 -91) ,the func-tion of hip joint was obviously improved ;2 cases with the preoperative poor tolerance score died during perioperative period ,there were 3 cases(5 .4% ) of postoperative hip hematoma ,1 cases(1 .79% ) of postoperative hematoma developed secondary bacterial in-fection after puncture and 3 cases (5 .4% ) of postoperative posterior dislocation in the early stage and no case of deep venous thrombosis (DVT) accompanying clinical symptoms .Conclusion Hip arthroplasty is a effective measure for treating aged patients with femoral neck fracture .But those patients with poor operative tolerance should select this operation cautiously

  9. 三维影像处理技术在成人髋关节发育不良联合前倾角匹配中的应用研究%3D-CT used to determine an optimal combined anteversion angle of femoral neck-acetabulum in total hip arthroplasty for adult hip developmental dysplasia

    Institute of Scientific and Technical Information of China (English)

    许燕飞; 常敏; 郭英; 吴继昆; 杨景帆; 王涛; 艾元亮; 张俊; 孙皓民

    2015-01-01

    目的 探讨三维影像处理(3D-CT)技术在成人髋关节发育不良(DDH)全髋关节置换术(THA)中对于股骨颈~髋臼联合前倾角匹配的指导作用. 方法 回顾性分析2011年3月至2014年3月通过3D-CT技术进行THA的21例(21髋)DDH患者资料,男5例,女16例(;年龄30 ~ 78岁,平均55.3岁.DDH按Crowe分型:Ⅱ型6例,Ⅲ型11例,Ⅳ型4例.所有患者术前行薄层CT扫描并将二维原始数据导入M3D可视数字化软件进行三维重建,通过3D-CT技术进行术前预演制定最合适的股骨颈~髋臼联合前倾角调整方案,拟定最佳的联合前倾角度进行THA.术后通过3D-CT技术评估臼杯的骨性覆盖情况、测量臼杯的前倾角度及联合前倾角度,验证术后联合前倾角度与术前拟定角度的吻合情况,并采用Harris评分标准评定疗效. 结果 21例患者术后获3~36个月(平均12.8个月)随访.末次随访时采用Harris评分评定疗效:优17例,良4例.术前Harris评分[(46.2±5.3)分]与末次随访时[(86.3±4.3)分]比较差异有统计学意义(P<0.05).所有患者髋臼杯的覆盖率均大于70%,术后髋臼杯前倾角度与术前拟定角度吻合率达95%,股骨颈~髋臼联合前倾角度在安全范围内,所有患者均未出现脱位.结论 3D-CT技术可以通过术前预演制定最佳的股骨颈~髋臼联合前倾角调整方案,对成人DDH患者THA股骨颈~髋臼联合前倾角的调整具有较高的指导价值,按拟定的方案进行手术臼杯可获得最好的骨性包容、最大的初始稳定性,同时可获得最佳的头臼匹配度,降低术后假体脱位率,提高假体生存率.%Objective To investigate how 3D-CT was used to determine an optimal combined anteversion angle of femoral neck-acetabulum in total hip arthro (THA) for adult developmental dysplasia of the hip(DDH).Methods 3D-CT was used in 21 adult patients(21 hips) with DDH who had been treated by THA from March 2011 to March 2014.They were 5 men and 16

  10. 三枚与四枚螺钉置入治疗Pauwels Ⅲ型股骨颈骨折的有限元分析%Finite element analysis of the three and four cannulated screws for Pauwels III femoral neck fractures

    Institute of Scientific and Technical Information of China (English)

    张浩; 史雪峰; 杨春宝; 吕继宏; 项毅; 孙振军; 官敬涛; 唐勇; 续力民

    2016-01-01

    背景:股骨颈骨折的内固定方式主要采用3枚空心螺钉倒三角固定,有学者提出Pauwels Ⅲ型的股骨颈骨折在应用3枚空心拉力螺钉固定的基础上增加1枚抗螺钉,以增强固定效果,但稳定性未得到验证。目的:研究3枚与4枚螺钉置入治疗Pauwels Ⅲ型股骨颈骨折中的生物力学稳定性及螺钉应力分布。方法:将第4代人工骨sawbones的CT数据导入Mimics软件中,进行三维重建,将模型导入3-matic软件中,创建股骨颈中段PauwelsⅢ型骨折模型,应用UG 8.0软件制作空心螺钉模型,导入到骨折模型中,创建3枚螺钉与4枚螺钉置入治疗Pauwels Ⅲ型股骨颈骨折的有限元模型。在相同条件下,应用abaqus软件中对两模型股骨头顶端施加轴向载荷411 N,比较两模型骨折断端两标志点的位移变化及内固定系统Von Mises应力分布情况。结果与结论:①3枚钉模型两点间位移为0.42 mm,4枚钉模型两点间位移为0.17 mm,4枚螺钉模型骨折断端移位小于3枚螺钉模型;②两模型Von Mises应力峰值分别为547 MPa、27.8 MPa,4枚螺钉模型的Von Mises峰值小于3枚螺钉模型,两模型的应力集中部位为均为骨折断端处,但4枚螺钉模型的应力范围更广、应力更加分散;③从有限元分析的结果来看,4枚螺钉置入治疗Pauwels Ⅲ型股骨颈骨折具有更强的抗剪切力效果,具有更强的生物力学稳定性,其临床优势尚需进一步的临床对比研究证实。%BACKGROUND:Femoral neck fracture is mainly fixed by three inverted triangle cannulated screws. Scholars have proposed to add a cannulated screw to enhance the fixation strength of femoral neck fracture of Pauwels III type based on three cannulated screw fixation, but the stability is not verified. OBJECTIVE:To analyze the biomechanical stability and stress of the three and four cannulated screws for the treatment of the Pauwels III femoral neck

  11. Comparison of the postoperative quality of life between internal fixation and hemiarthroplasty for the elderly with femoral neck basement fracture%高龄股骨颈基底型骨折人工关节置换与内固定术后生活质量评价

    Institute of Scientific and Technical Information of China (English)

    申剑; 薛庆云; 文良元; 黄公怡

    2012-01-01

    背景:股骨颈基底型骨折属于股骨颈骨折,同时又是囊外骨折,治疗方法有多种选择,由于发生率低故相关研究甚少.目的:比较分析高龄(70岁以上)股骨颈基底型骨折行人工股骨头置换与闭合复位内固定患者术后生活质量差异.方法:1995年9月至2009年6月共收治38例股骨颈基底型骨折患者,男12例,女26例;年龄70~91岁,平均79.4岁;全部患者均为外伤性新鲜骨折,其中16例选择人工股骨头置换为一组,另22例选择内固定术为一组.对比两组患者手术时间、术中出血量、术后下地时间及术后1年运用Harris评分中部分项目评定患者生活质量并结合术后1年髋部正侧位X线片.结果:两组在手术时间、术中出血量、术后下地时间等比较,差异有统计学意义(P <0.001).人工股骨头置换组在1年后生活自理、髋部疼痛及行走距离等方面较内固定组优异.人工股骨头置换组1年后均未出现假体松动,而内固定组骨折均愈合.结论:人工股骨头置换术治疗高龄股骨颈基底型骨折近期效果较理想,具有以下优点:(1)术后可早期负重活动,较快恢复伤前活动能力;(2)降低术后并发症和内科合并症的发生几率;(3)近期感觉及功能优于内固定.但同时股骨颈基底型骨折作为囊外骨折血供较好,骨折愈合率高,对于预期生存时间超过5年、骨质量较好的老年患者考虑行内固定治疗,可避免人工关节置换后期的磨损、松动及下沉.%Background:The femoral neck basement fracture is classified as both femoral neck fracture and extracapsular fracture. Sowe have many choices of treatment for it. However, there are few studies on it for low incidence rate.Objective: The aim of the present study is to compare the postoperative quality of life in aged patients (70 years old and a-bove) who had undergone the hemiarthroplasty versus internal fixation, with femoral neck basement fracture

  12. Coxa vara with proximal femoral growth arrest in patients who had neonatal extracorporeal membrane oxygenation.

    Science.gov (United States)

    DiFazio, Rachel L; Kocher, Minider S; Berven, Sigurd; Kasser, James

    2003-01-01

    This is a retrospective review of four patients in whom a pattern of coxa vara with proximal femoral growth arrest and metaphyseal irregularities developed. These patients were all treated with neonatal extracorporeal membrane oxygenation and presented with a progressive gait disturbance and pain, leg-length discrepancy, and limited abduction. Imaging revealed coxa vara with proximal femoral growth arrest. Two patients (three hips) underwent proximal femoral valgus osteotomy, one patient underwent fixation of a femoral neck fracture with subsequent greater trochanter transfer, and one patient is being observed. This case series suggests an association between neonatal extracorporeal membrane oxygenation and this unusual pattern of coxa vara with proximal femoral growth arrest.

  13. The pathological characteristics and total hip replacement treatment of nonunion old-femoral-neck fracture%陈旧性股骨颈骨折不愈合的临床病理特点和全髋关节置换术的治疗对策

    Institute of Scientific and Technical Information of China (English)

    叶志强; 宋炎成; 蔡道章

    2011-01-01

    目的从临床病理角度探讨全髋关节置换术(THA)治疗陈旧性股骨颈骨折不愈合的经验教训.方法 分析39例陈旧性股骨颈骨折不愈合在该院行THA患者的病例资料,通过术前和术中观察的临床病理特点,总结术前、术中和术后处理的注意事项.结果 陈旧性股骨颈骨折不愈合多具有患肢明显的短缩畸形,关节囊挛缩、肥厚,股骨上端和髋臼的骨质疏松,同侧膝关节和踝关节不同程度的功能障碍.由于患髋周围软组织挛缩,术中需进行广泛松解,手术创面大,术后渗血较多,术中应注意彻底止血.2例于术后1周内发生关节脱位,1例发生深静脉血栓,这3例并发症保守治疗均治愈.经平均3年4个月的随访,所有髋关节功能恢复良好,Harris评分优良率84.6%.结论 THA是治疗陈旧性股骨颈骨折不愈合的较为理想的方法,根据患髋周围软组织挛缩、患肢明显的短缩畸形等病理特点,术前充分准备,术中应注意彻底止血,术后早期功能锻炼是手术成功和术后取得较好疗效的关键.%Objective To summarize the experience in trealing the unhealed anliqualed femoral neck fracture with total hip replacement as the clinical palhology was concerned. Methods A relrospeclive study was carried out based on the data of 39 palienls wilh unhealed anliqualed femoral neck fraclure who underwent lolal hip arlhroplasly ( THA). According to the clinical pathological characteristics which were observed preoperalively and inlraopertively, the experiences of the preoperative preparalion and the inlraoperative as well as posloperative managemenl were summed up. Results The unhealed antiqualed femoral neck fracture presented obvious short deformity of involved limb, the conlraclion and hypertrophy of the articular capsule, osteoporosis of the acelabulum and upper segment of the femur, and various dysfunction of collateral knee and ankle. During the operation, the capsule needed to be

  14. The Curative Effect Analyze of Treatment Old Displacement Type Femoral Neck Fracture by Hollow Compression Screw Internal Fixation%空心加压螺钉内固定治疗老年移位型股骨颈骨折疗效分析

    Institute of Scientific and Technical Information of China (English)

    马永成

    2016-01-01

    目的:探讨空心加压螺钉内固定治疗老年移位型股骨颈骨折疗效情况.方法分析我院骨外科2014年8月—2015年11月收治的老年移位型股骨颈骨折患者80例临床资料,依据固定方式不同进行临床分组,钢板固定组40例和空心加压螺钉内固定组40例.观察两组老年移位型股骨颈骨折患者术后功能恢复优良率和术后并发症发生率情况.结果空心加压螺钉内固定组老年移位型股骨颈骨折患者术后功能恢复优良率95%高于钢板固定组75%,空心加压螺钉内固定组老年移位型股骨颈骨折患者术后并发症发生率0低于钢板固定组10%,P<0.05,差异均有统计学意义.结论空心加压螺钉内固定治疗老年移位型股骨颈骨折患者临床疗效明显,并发症少,值得临床推广应用.%Objective To approach curative effect of treatment old displacement type femoral neck fracture by hollow com-pression screw internal fixation. Methods The 80 cases clinical data of old displacement type femoral neck fracture patients in our hospital bone surgery from 2014.8 to 2015.11 were analyzed,which was to be divided into two groups by different fixed mode,steel plate fixed group 40 cases and hollow compression screw internal fixation group 40 cases. The functional recovery excellent rate and complication rate of two groups old displacement type femoral neck fracture patients after oper-ation were detected. Result The functional recovery excellent rate 95% of hollow compression screw internal fixation group hollow compression screw internal fixation group was higher than steel plate fixed group 75%,the complication rate 0 of hollow compression screw internal fixation group hollow compression screw internal fixation group was lower than steel plate fixed group 10%,P<0.05,the difference were statistical significance. Conclusion The clinical curative effect of treatment ? old displacement type femoral neck fracture by hollow compression screw

  15. Anteversão do colo do fêmur: avaliação clínica versus radiológica Femoral neck anteversion: a clinical vs radiological evaluation

    Directory of Open Access Journals (Sweden)

    Roberto Sérgio de Tavares Canto

    2005-01-01

    Full Text Available O objetivo deste trabalho foi o de verificar a correlação entre o ângulo de anteversão femoral medido radiograficamente e os valores das rotações dos quadris apresentados clinicamente. Para isso, foram estudados 64 quadris de 32 pessoas sem nenhuma patologia coxo-femoral prévia, avaliando-se suas rotações com o auxílio de um aparelho específico - o flexímetro - e radiografando os quadris dos pacientes de acordo com o método de Rippstein-Müller. Os resultados obtidos foram analisados estatisticamente, concluindo-se que não houve correlação estatisticamente significante e que, possivelmente, outros fatores, além da anteversão femoral, têm importância na determinação da amplitude das rotações do quadril.The purpose of the present study was to verify the correlation between the femoral anteversion angle measured by biplanes radiography and the values of internal and external rotation of the hip obtained by clinical assessment. Sixty-four hips of 32 individuals with no previous coxofemoral pathologies were studied by taking their hip rotation values with a proper instrument - the fleximeter - and taking radiographic images using the Rippstein- Müller method. The results obtained were statistically analyzed and it was concluded that there was no statistically significant correlation and that it is possible that other factors, in addition to the femoral anteversion angle, may be important in determining the range of rotation of the hip joint.

  16. Canine gastritis.

    Science.gov (United States)

    Webb, Craig; Twedt, David C

    2003-09-01

    Gastritis--inflammation of the stomach--is a frequently cited differential yet rarely characterized diagnosis in cases of canine anorexia and vomiting. Although the list of rule-outs for acute or chronic gastritis is extensive, a review of the veterinary literature reveals fewer than 15 articles that have focused on clinical cases of canine gastritis over the last 25 years. The dog frequently appears in the human literature as an experimentally manipulated model for the study of endoscopic techniques or the effect of medications on gastric mucosa. In the veterinary patient, cases of acute gastritis are rarely pursued with the complete diagnostic armamentarium, and cases of chronic gastritis are rarely found to occur as an entity isolated from the rest of the gastrointestinal tract. This article focuses on those findings most clinically relevant to cases of canine gastritis in veterinary medicine.

  17. 中央柄设计对髋关节表面置换术后股骨颈骨折风险影响的有限元分析%The influence of prosthesis stem design on femoral neck fracture by using finite element analysis

    Institute of Scientific and Technical Information of China (English)

    高宗炎; 高雁卿; 郑稼; 金毅; 唐超; 杨卫兵

    2015-01-01

    Objective To investigate the influence of prosthesis metaphyseal stem design on femoral neck fracture with a range of implant orientations.Methods A finite element model of the hip resurfacing arthroplasty was reconstructed on the basis of data of a normal femur (from a 63-year-old male) and a 50 mm birmingham hip resurfacing (BHR) prosthesis.And this modeling was used to indicate the effects of prosthesis metaphyseal stem design on femoral neck fracture with a given load of 0-6 kN,with a range of varus-valgus implant orientations.Results The analysis suggested that the intact femoral neck strength could be maintained across a wider range of varus-valgus orientations for short-stemmed and stemless prostheses.The model predicted that the damage initiation load would be decreased by approximately 20% with varus implant orientation and 10% in neutral orientation.Compared with the stemmed,traditional-design prosthesis,the short-stemmed and stemless designs had less weakening effect upon the femoral neck.For the stemless design in all orientations,the femoral neck strength was predicted to be within 5% of that for the intact bone,and the strength with the short-stemmed design was within 3% of the intact case.Conclusion The study suggests that a short-stemmed resurfacing head offers improved tolerance to misalignment over traditional designs.While femoral neck fractures are multifactorial,biomechanical factors are of clear importance to the clinical outcome,so this may reduce the risk for patients at the edge of the indications for hip resurfacing.%目的 观察表面置换股骨假体中央柄不同设计对置换术后股骨颈骨折风险的影响.方法 CT扫描1名63岁健康男性股骨近端,构建股骨近端有限元模型,以直径50 mm的Birmingham hip resurfacing(简称BHR)假体为模板,建立传统假体、短中央柄假体、无中央柄假体的模型,分别于中立位、外翻10°、内翻10°放置假体并骨水泥固定,模拟下肢单腿

  18. InterTan钉板系统与空心钉固定Pauwels Ⅲ型股骨颈骨折的有限元分析%InterTan compression hip screw versus three parallel cannulated screws for Pauwels Ⅲ femoral neck fractures: a finite element analysis

    Institute of Scientific and Technical Information of China (English)

    张晟; 王一民; 王博炜; 佟矿; 余斌

    2013-01-01

    目的 用有限元分析的方法研究InterTan钉板系统与3枚互相平行的空心钉固定PauwelsⅢ型股骨颈骨折的生物力学特点. 方法选取1名男性健康志愿者,28岁,体质量为75 kg,通过16排螺旋CT扫描,取右侧近端股骨数据作为样本.通过逆向工程软件分别重建PauwelsⅢ型股骨颈骨折三维可视化模型、InterTan钉板系统固定模型及3枚互相平行空心钉固定模型,并于Ansys软件中建立2种内固定模型的三维有限元模型,予以轴向700 N应力,研究不同内固定的von Mises应力分布和位移分布、股骨的yon Mises应力分布和位移分布,并比较内固定和股骨模型的应力峰值和位移峰值. 结果 内固定物的应力主要集中于骨折线附近,其中InterTan钉板系统钉板系统固定模型的应力峰值(65.7 MPa)低于空心钉固定模型(116.4 MPa);骨端的应力分布集中于股骨近端内侧,InterTan钉板系统固定模型的应力峰值(13.2 MPa)小于空心钉固定模型(27.6 MPa).lnterTan钉板系统固定模型中,内固定物位移方向为垂直向下,内固定物和骨端的位移峰值分别为0.84和0.76 mm;空心钉固定模型中,位移方向沿着股骨颈方向,内固定物和骨端的位移峰值分别为1.49和1.61 mm. 结论 使用InterTan钉板系统固定PauwelsⅢ型股骨颈骨折时,应力分布均匀,固定稳定性优于3枚互相平行空心钉固定.InterTan钉板系统固定时,位移方向垂直向下,髋内翻是需要预防的并发症;后者位移方向沿着股骨颈向外侧,股骨颈短缩为需要预防的并发症.%Objective To explore the biomechanical properties of InterTan compression hip screw versus versus three parallel cannulated screws in the fixation of Pauwels Ⅲ femoral neck fracture and their clinical implications.Methods A healthy male volunteer,28 years of age and 75 kg in weight,was enrolled in the present study.The spiral CT scans of his right proximal femur were used for reconstruction

  19. 股骨颈骨折直接行髋关节置换术与内固定失败后再行髋关节置换术的比较%Comparison of primary hip replacement with secondary replacement after failed internal fixation in the treatment of femoral neck fractures

    Institute of Scientific and Technical Information of China (English)

    王剑火; 张玉九; 李玉茂; 李平生

    2011-01-01

    Objective To explore the difference of the outcomes of primary hip replacement and secondary replacement after failed internal fixation in the treatment of femoral neck fractures for optimal choice of operation method for femoral neck fractures. Methods 43 patients with a secondary hip replacement after failed internal fixation (Group A) and 52 patients with a primary hip replacement (Group B) in the treatment of femoral neck fractures were retrospectively analyzed.All patients were followed up at least 2 years. Details of operation, complications, hip function and quality of life at 2 years after operation were compared between two groups. The hip function, including the pain movement and walking, was evaluated by the Charnley scoring system. The health-related quality of patients' life was evaluated by using the EQ-5D index. Results Operation time, amount of hemorrhage during operation, the Chamley score of hip function and EQ-5D index score of quality of life were 1.9±0.2 and 1.4±0.2h 、 525.6±50.8 and 462.3±47.8ml 、 13.4±2.3 and15.2±2.4 、 0.67±0.26 and 0.72±0.25 for Group A and Group B,respectively. The difference was significant for the above 4 respects (P<0.05).Conclusion The outcomes of secondary hip replacement after failed internal fixation is worse than those of primary hip replacement in the treatment of femoral neck fractures, which indicates that primary hip replacement is worth being recommended for patients with femoral neck fractures who are easier to develop to be a fracture nonunion or avascular necrosis of femoral head if they are treated with internal fixation.%目的 通过对股骨颈骨折直接行髋关节置换术与内固定失败后再行髋关节置换术临床结果的比较,为股骨颈骨折手术方式的选择提供依据.方法 回顾性分析随访2年的43例股骨颈骨折内固定失败后冉次行髋关节置换术(A组)和52例股骨颈骨折直接行髋关节置换术(B组)的临床资料,比较两组患者

  20. Neck Pain

    Science.gov (United States)

    ... antidepressants for pain relief. Therapy Physical therapy. A physical therapist can teach you correct posture, alignment and neck- ... therapy, under supervision of a medical professional and physical therapist, may provide relief of some neck pain, especially ...

  1. EVALUATION OF NECK SHAFT ANGLE OF FEMUR ON DRY BONES

    OpenAIRE

    Radha; Ravi Shankar; Naveen; Roopa

    2015-01-01

    BACKGROUND: Evaluation of the neck shaft angle of femur helps to understand clinical relevance in bio mechanics of the hip joint. It helps for the better treatment of different pathological conditions of hip and femur and also to design prosthesis. Femoral neck shaft angle is important to convey the information regarding the race to ...

  2. Short-term Results of Muscle-Pedicle Bone Grafting with Tensor Fascia Lata for Delayed Femoral Neck Fractures; Case Series and Literature Review

    Science.gov (United States)

    Salgotra, Kuldip; Kohli, Sarabjeet; Vishwakarma, Nilesh

    2016-01-01

    Neglected, untreated and delayed femur neck fractures are commonly encountered and the treatment dilemma arises especially when the patient is physiologically young and osteosynthesis is the preferred option. Controversy exists in the current literature as the various head salvage surgeries like valgus subtrochanteric osteotomy, non-vascularized fibular bone grafting, muscle pedicle bone grafting (Tensor fascia lata and Quadratus femoris graft) and vascularized bone grafting do not have clear lines of indications. The current study is a case series of 7 patients with femur neck fractures with delayed presentation beyond the vascular emergency period who were treated with osteosynthesis with muscle pedicle bone graft (MPBG) using tensor fascia lata muscle pedicle graft. Patients were followed clinical and radiologically at 6 weeks, 3 and 6 months, 1 year and 3 years and patients were regularly followed. The mean age of the patients was 47 ± 1.1 ranging from 38 to 55 years. There were 6 (85.7%) men and 1 (14.3%) women among the patients. Overall 5 (71.5%) patients had transcervical and 2 (28.5%) had subcapital fractures. At the end of 6 months, 6 (85.7%) patients were pain free and on plain radiographs fracture union was noted. One (14.3%) patient developed collapse and persistent nonunion. Younger group less than 50 years presenting with neglected fracture neck femur should always be give an option of head salvage surgery in selected cases. Muscle pedicle bone grafting has been proven although inconsistently as a valid option for fracture neck femur. We encourage osteosynthesis with the use of tensor fascia lata muscle pedicle grafting along with cancellous cannulated screws as a first option in selected cases of neglected femur neck fractures. PMID:27331067

  3. 前外侧和外侧联合入路的股骨颈肿瘤刮除植骨及内固定术%Surgical technique of combined anterior-lateral and lateral approach in the management of bone tumor of femoral neck

    Institute of Scientific and Technical Information of China (English)

    伦登兴; 胡永成; 黄洪超; 夏群; 苗军; 于金虎

    2011-01-01

    Objective To explore surgical procedure of combined anterior-lateral and lateral approach for the treatment of bone tumors of femoral neck. Methods Forty patients with bone tumors of femoral neck treated in Tianjin Hospital were included from July 2005 to August 2009. Of the patients, 12 who were treated with curettage and bone graft through combined anterior-lateral and lateral incision were analyzed in this study. There were 7 males and 5 females with an average age of 34 years ranging from 17 to 68 years. 4 patients were diagnosed as chondroblastoma, 2 giant cell tumor, 3 fibrous dysplasia, and 3 single bone cysts. 7 patients suffered from pathologic fractures, and 5 had presented thin cortical bone because of tumor involvement. There were 1 tumor located in H1 zone, 4 in H2 zone and 7 in H1,2 zone according to ISOLS femoral neck classification. All patients were treated by curettage and bone graft via anterior-lateral approach, 10 cases underwent internal fixation with anatomical plate, and 2 cases with canulated screws with lateral approach. Results The follow-up time ranged from 10 to 68 months with an average of 35 months.Pain disappeared in all patients, and there were not recurrence of tumor, pathologic fractures and avascular necrosis. One case had complained of lateral femoral skin numbness which may be caused by injures of femoral lateral nerves. One case had difficulties in the valgus of hip joint. The mean MSTS score was 29.2 points ranging from 27 to 30 points. Conclusion Anterior approaches of "SP" incision is helpful to thorough curettage which decrease the risk of recurrence due to good visualization and intemal fixation is easy to perform via lateral approaches. The result suggested that combined anterior-lateral "SP" and lateral incision is liable option in treatment of bone tumors of femoral neck.%目的 探讨前外侧和外侧联合入路肿瘤刮除植骨重建治疗股骨颈骨肿瘤的疗效.方法 2005年7月至2009年8月采用前外侧

  4. Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism

    Science.gov (United States)

    Fujiwara, Yasuhiro; Hayashida, Tatsuro; Murakami, Koji; Makio, Satoshi; Shimizu, Yuichi; Oka, Yoshinobu; Kim, Wook-Choel; Ogura, Taku; Kubo, Toshikazu

    2017-01-01

    Slipped capital femoral epiphysis (SCFE) is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1); however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered. PMID:28154765

  5. Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism

    Directory of Open Access Journals (Sweden)

    Yoshihiro Kotoura

    2017-01-01

    Full Text Available Slipped capital femoral epiphysis (SCFE is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1; however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered.

  6. Femoral hernia causing pneumoperitoneum.

    OpenAIRE

    King, H. A.; Boulter, P. S.

    1986-01-01

    Richter's hernia, in which only a portion of the circumference of the intestine lies within the sac, is a common complication of femoral hernia. This case report is of 39 year old female who presented with a pneumoperitoneum and was found at laparotomy to have a right femoral Richter's hernia containing a knuckle of perforated small bowel. This is a previously unreported presentation of femoral hernia.

  7. Femoral hernia repair

    Science.gov (United States)

    Femorocele repair; Herniorrhaphy; Hernioplasty - femoral ... During surgery to repair the hernia, the bulging tissue is pushed back in. The weakened area is sewn closed or strengthened. This repair ...

  8. 全髋关节置换与空心螺钉置入内固定修复中老年股骨颈骨折:髋关节功能比较%Total hip arthroplasty versus hollow screw fixation for the repair of femoral neck fractures in the middle-aged and elder patients:hip function

    Institute of Scientific and Technical Information of China (English)

    林庆波

    2015-01-01

    BACKGROUND:The repair method of femoral neck fractures included internal fixation and hip arthroplasty. The selection of repair methods is affected by many factors, such as age, condition of patients, and own physical condition. The selection of repair methods for femoral neck fractures is always controversial. OBJECTIVE:To compare the hip function and prognosis of elderly patients with femoral neck fractures after total hip arthroplasty and hol ow screw fixation. METHODS:140 patients aged less than 60 years, who accepted treatment in Rizhao Hospital of Traditional Chinese Medicine from April 2012 to February 2014, were selected. They were randomly divided into replacement group and fixation group (n=70). Patients in the replacement group received total hip arthroplasty, and patients in the fixation group received hol ow compression screw fixation. Harris score of the hip, complications and satisfactions of the hip were observed, compared and analyzed between the two groups at 1 month post surgery. RESULTS AND CONCLUSION:The excel ent and good rate of Harris score at 1 month post surgery was significantly higher in the replacement group (90%) than in the fixation group (63%) (P  目的:对比中老年股骨颈骨折患者行全髋关节置换与空心螺钉置入内固定治疗后的髋关节功能及预后。  方法:选取2012年4月至2014年2月日照市中医医院收治的140例股骨颈骨折患者,年龄小于60岁,随机分为置换组和内固定组,每组70例。置换组采用全髋关节置换治疗,内固定组患者采取空心加压螺钉置入内固定治疗。观察两组患者治疗后1个月的髋关节功能Harris评分、并发症发生情况及关节功能满意度,并进行对比分析。  结果与结论:治疗后1个月,置换组Harris评分的优良率为90%,明显高于内固定组63%,差异有显著性意义(P<0.05);置换组并发症发生率为6%,明显低于内固定组29%

  9. Effect observation of prosthesis for total hip replacement in treatment of femoral neck fractures in the elderly%假体全髋关节置换治疗老年移位性股骨颈骨折的效果观察

    Institute of Scientific and Technical Information of China (English)

    潘波

    2015-01-01

    目的:探讨在老年移位性股骨颈骨折患者中实施假体全髋关节置换治疗的临床价值.方法:将2012-06/2014-06到我院骨科治疗的64例老年移位性股骨颈骨折患者纳入研究,给予患者假体全髋关节置换术治疗,术后给予10个月~2年时间随访,同时结合美国骨科学会5级评分标准与 Harris髋关节评分标准,评估患者的远期情况.结果:本组64例病例均顺利完成手术,术中未见患者血管神经受累,且无其他合并症.经随访统计,共有54例患者骨折愈合良好,临床优良率是84.38%.且与术前相比,患者末次随访的 Harris 分值明显提高,有统计学意义(P <0.05).结论:在老年移位性股骨颈骨折患者中实施假体全髋关节置换术治疗,疗效显著、安全,有利于患者髋关节功能早日恢复,值得加强普及.%AIM:To investigate the clinical value of prosthesis for total hip replacement in treatment of elderly patients with dis-placed femoral neck fracture.METHODS:64 cases of elderly patients with displaced femoral neck fractures from June 2012 to June 2014 in our hospital department of orthopedics were included in the study,patients were given a prosthesis in total hip replace-ment treatment,and 10 months ~2 years follow-up were given af-ter operation.Meanwhile long-term assessment of the situation in patients were made combined with USA Department of Orthope-dics Level 5 standard score and Harris hip score standard.RE-SULTS:The operation of 64 cases were successfully completed, without vascular nerve involvement during operation,or other complications.After the follow-up statistics,a total of 54 patients with fracture were healing well,the rate was 84.38% in clinical. Compared with the preoperative,the Harris score of the last fol-low-up of patients increased significantly,with statistical signifi-cance (P <0.05).CONCLUSION:When the elderly patients with displaced femoral

  10. 老年患者股骨颈骨折术后肺部感染的临床分析及干预对策%Clinical analysis and intervention strategies of pulmonary infection after surgery in elderly patients with femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    邓月华

    2015-01-01

    目的:分析老年患者股骨颈骨折术后并发肺部感染的危险因素,提出针对性的预防护理干预对策,以降低感染率。方法收集本科室2008年1月至2013年12月病历齐全的老年股骨颈骨折176例患者资料,根据是否发生肺部感染分为两组(即感染组和非感染组),比较两组患者感染的高危因素。结果高龄、早期缺乏活动、合并糖尿病、慢性支气管炎、长期反复使用抗菌药物、营养状况差、长期吸烟等因素可增加肺部感染的发生率,以上指标均具有统计学意义(P均<0.05)。感染组42例患者经积极治疗后感染于7~14 d得到控制。结论针对上述因素,积极干预,鼓励患者早期活动,彻底吸痰、加强肺功能锻炼、体位干预、饮食干预及加强基础护理,积极治疗原发病等措施,可以降低老年患者股骨颈骨折术后肺部感染的发生率。%Objectives To analyze the risk factors of pulmonary infection after surgery in elderly patients with femoral neck fracture, to propose targeted prevention and nursing intervention strategies, and to reduce the infection rates. Methods The clinical date of 176 elderly patients with femoral neck fracture were collected from January 2008 to December 2013 in our department, and those cases were divided into two groups (the infected group and the non-infected group) depending on whether they had pulmonary infection, then compared and summarized risk factors of infection. Results Advanced age, early lack of activity, diabetes, chronic bronchitis, long-term repeated use of antibiotics, poor nutritional status and long-term smoking could increase the incidence of pulmonary infection, all the indicators mentioned-above had significant differences (P all < 0.05). There were 42 cases with severe infetion in the infected group were treated within 7-14 d. Conclusions In response to these factors, doctors and nurses should take active intervention

  11. The clinical efficacy of small incision for total hip arthroplasty on osteoporosis treatment of elder patients with fracture of the femoral neck%老年股骨颈骨折患者小切口全髋关节置换术联合抗骨质疏松治疗的效果观察

    Institute of Scientific and Technical Information of China (English)

    赵春斌; 宋建军; 张占山; 平少华

    2014-01-01

    Objective To investigate the clinical effect of small incision for total hip arthroplasty on osteoporosis treatment of elder patients with fracture of the femoral neck.Methods Fifty-six elder patients with femoral neck methods were selected as our subjects,who were hospitalize from Jan.2011 to Dec.2013 in Xiahuayuan Meikuang Hospital,Zhangjiakou Company Limited.They were randomly divided into the observation group (26 cases) and control group (30 cases).All patients were treated with small incision total hip arthroplasty.The patients in the observation group were given the alendronate sodium.The curative effect,hospitalization time,bone mineral density were recorded.Results The long-term efficacy of the excellent and good rate of the observation group was 96.2% (25/26),higher than that in control group(86.6% (26/30)),and the difference was statistically significant(x2 =4.125,P < 0.05).The length of hospitalized time in observation group was (26 ± 4) d,shorter than that in the control group (35 ± 3) d,and the difference was statistically significant(t =9.102,P < 0.05).The bone density of patients in the observation group was (0.64 ± 0.03) g/cm2,higher than that in control((0.61 ± 0.05) g/cm2),and there was significant difference between two groups (t =8.461,P < 0.05).Conclusion The effect of small incision total hip arthroplasty combined with anti osteoporosis drugs for the treatment of femoral neck fractures in the elderly is good and worthy of clinical usage.%目的 探讨小切口全髋关节置换术联合抗骨质疏松药物治疗老年股骨颈骨折的临床效果.方法 2011年1月至2013年12月收入我院的56例老年股骨颈骨折患者,按随机数字表分为观察组26例和对照组30例,两组患者均给予小切口全髋关节置换术治疗.观察组术后加服抗骨质疏松药物阿仑膦酸钠.观察两组的疗效、住院时间和骨密度的差异.结果 观察组远期疗效优良率为96.2%(25/26),对照组为86.6

  12. Comparison of cementless and bone-cement protheses in total hip arthroplasty for osteoporotic femoral neck fracture in elderly patients%生物型和骨水泥型股骨假体全髋关节置换术治疗老年骨质疏松性股骨颈骨折的临床效果对比

    Institute of Scientific and Technical Information of China (English)

    王华国; 叶劲; 邹仲兵; 白波

    2014-01-01

    Objective To compare the therapeutic effects of bone-cement stem and cementless stem used in the total hip arthroplasty ( THA) for treating the osteoporotic fracture of the femoral neck in the senile patients .Methods A retrospective study was carried out to analyse 100 cases of osteoporotic femoral neck fracture in the elderly patients who underwent THA in our hospital .The patients were divided into two groups by the operation methods:group A, 60 cases applied bone-cement stem in THA;group B, 40 cases applied cementless stem in THA .The hip joint function , the motion range of the joint , the imaging characteristics of the hip and posoperative pain were all compared between the two groups . Results Therewere significant differences in the clinical therapeutic effects between the two groups ( P<0.05).Conclusions The postoperative effects of the bone-cement stem is much better than the cementless stem in THA for the osteoporotic femoral neck fracture in elderly , but it may cause the risks of deep venous thromboembolism and bone cement crisis .%目的:对比老年骨质疏松股骨颈骨折使用生物型股骨假体柄与骨水泥型股骨假体柄行全髋关节置换术治疗效果。方法对本组进行老年骨质疏松股骨颈骨折100例(100髋)进行的全髋关节置换术根据手术方式分为A组(股骨假体柄骨水泥型全髋关节置换术,60髋), B组(股骨假体柄生物型全髋关节置换术,40髋)。对比两组髋关节功能、关节活动度、髋关节影像学特点及术后疼痛情况。结果老年骨质疏松股骨颈骨折行全髋关节置换术,采用生物型股骨假体柄与骨水泥型股骨假体柄的全髋关节置换术临床疗效对比差异显著( P<0.05)。结论对于老年骨质疏松股骨颈骨折行全髋关节置换术,应用骨水泥型者股骨假体柄术后近期疗效明显优于生物型,但它有诱发深静脉血栓栓塞和骨水泥危象的风险。

  13. 医护合作的功能锻炼指导在股骨颈骨折术后老年患者功能锻炼中的应用%Application of physician-nurse collaborative functional exercise instruction to improve the compliance of elderly femoral neck fracture patients after surgery

    Institute of Scientific and Technical Information of China (English)

    高丽; 贾燕瑞

    2012-01-01

    Objective To investigate the influence of physician-nurse collaborative functional exercise instruction mode on the compliance of elderly femoral neck fracture patients.Methods 60 elderly patients with femoral neck fracture were randomly divided into the experimental group and the control group,each with 30 cases.The control group was treated with conventional functional exercise instruction while the experimental group was treated with physician-nurse collaborative functional exercise instruction.Results The patients who took functional exercise according to the exact action,time and part as doctors and nurses requested were more in the experimental group than in the control group,and the differences were statistically significant (x2 =10.184,10.311,15.148,respectively;P < 0.05).When discharged from the hospital,the patients in the experimental group could grasp (5.65 ± 0.63) exercise action,better than (3.62 ± 0.64) in the control group,and the difference was statistically significant (t =11.963,P < 0.01).Conclusions Physician-nurse collaborative functional exercise instruction mode is helpful to improve the compliance of elderly femoral neck fracture patients in the hospital.%目的 探讨医护合作的功能锻炼指导模式对股骨颈骨折术后患者住院期间功能锻炼依从性的影响.方法 选取60例股骨颈骨折老年患者,随机分为观察组与对照组各30例.对照组给予常规的功能锻炼指导模式,观察组给予医护合作的功能锻炼指导模式.结果 观察组患者完全按照医护人员要求的动作、时间和部位进行功能锻炼的人数多于对照组,差异均有统计学意义(x2分别为10.184,10.311,15.148;P <0.05);出院时观察组患者功能锻炼动作掌握的平均个数为(5.65±0.63)个,多于对照组的(3.62±0.64)个,差异有统计学意义(t=11.963,P<0.01).结论 医护合作的功能锻炼指导模式有利于提高股骨颈骨折术后老年患者住院期间功能锻炼的依从性.

  14. Analysis of function and related impact factors after operation of femoral neck fracture for patients aged less than sixty years%60岁以下股骨颈骨折手术治疗术后功能及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    周靖; 党育; 张培训; 王静; 付中国; 张殿英; 王天兵; 徐海林; 薛峰

    2011-01-01

    Objective: To investigate function and related impact factors after operation of femoral neck fracture for patients aged less than sixty years. Methods: In our study,93 patients aged less than sixty years with femoral neck fractures receiving operation from April 2001 to August 2009 and having complete follow-up data were evaluated in terms of age, sex, co-diseases, side of bone fracture, type of bone fracture (Garden classification) , time between injury and operation, operation procedures, operation time, time in bed, removal internal fixation and function score during follow-up period. Nonparametric test, rank correlation analysis and Logistic regression analysis were used by SPSS 13.0. Results: Function scores showed non-normal distribution. By nonparametric test, the following variable in function scores was of statistic significance; the Garden classification (H = 7.900, P = 0.048). By analysis of correlation , the following variable in function scores was of statistic significance: Garden classification ( rs = 0.206, P= 0.048). By Logistic regression analysis, the following variable in function scores was of statistic significance; Garden classification (P =0.030). Conclusion: Hip function score is of non-normal distribution, and Garden classification is the most important factor influencing the function after operation for femoral neck fracture for patients aged less than sixty years.%目的:探讨60岁以下患者股骨颈骨折术后随访资料中关节功能及相关影响因素.方法:回顾性分析2001年4月至2009年8月采用手术治疗的93例60岁以下股骨颈骨折患者的临床资料,就年龄、性别、合并疾病、骨折侧别、骨折类型(Garden分型)、自受伤至手术的时间、手术方式、手术时间、卧床时间、内固定是否取出以及随访时髋关节功能评分等因素进行术后随访调查.应用SPSS 13.0统计软件包进行非参数检验、等级相关分析、Logistic回归分析等统计学分析.

  15. One-stage total hip arthroplastyversusfemoral head arthroplasty for elderly femoral neck fractures:a meta-analysis of hip function and complications%一期全髋置换与股骨头置换修复老年股骨颈骨折:髋关节功能与并发症的Meta分析

    Institute of Scientific and Technical Information of China (English)

    叶向阳; 王华磊; 赵玉果; 王海羽; 程省

    2016-01-01

    BACKGROUND:There are objections to the efficacy and safety of total hip arthroplasty and artificial femoral head arthroplasty in the treatment of femoral neck fracture. OBJECTIVE:To assess the efficacy and safety of one-stage total hip arthroplasty and femoral head arthroplasty for > 60-year-old patients with femoral neck fractures. METHODS:According to the search strategy of Cochrane colaboration network, we searched PubMed (1966 to December 2014), EMbase (1974 to December 2014), Cochrane Library (Issue 3, 2011), China Biology Medicine database(1978 to December 2014), China National Knowledge Infrastructure (1994 to December 2014), VIP database (1989 to December 2014), and Wanfang Database (1979 to December 2014). Twenty-one articles on total hip arthroplasty and hemiarthroplasty for elderly femoral neck fractures were included. Two reviewers independently evaluated the quality of the included studies and extracted the data. In case of disagreement, settlement was made by negotiation. Meta-analysis was performed by RevMan 5.0 software in the included studies. RESULTS AND CONCLUSION:(1) Literature analysis: five randomized controled studies, three quasi-randomized controled studies, and thirteen retrospective cohort studies were included, containing 2 250 patients. (2) Meta-analysis: No significant differencein rate of dislocation, deep infection rate and mortality rate in 1 year after replacement was detected between total hip arthroplasty and hemiarthroplasty for elderly femoral neck fractures (dislocation rate:RR=1.38, 95%CI: 0.81-2.34; deep infection rate RR=1.12, 95%CI: 0.60-2.11; mortality rateRR=0.90, 95%CI: 0.69-1.18). Reoperation rate was higher in the hemiarthroplasty group than in the total hip arthroplasty group (RR=0.46, 95%CI: 0.32-0.66). Harris score on the affected side between1 and 4 years was significantly higher in the total hip arthroplasty group than in the hemiarthroplasty group (MD=5.64, 95%CI: 2.82-8.46). (3) Results suggested that if

  16. Application of left femoral neck radioactive uptake ratio in 99Tcm-MDP bone scan for evaluation of osteoporosis%99Tcm-MDP骨显像左侧股骨颈放射性计数比值评价骨质疏松的价值

    Institute of Scientific and Technical Information of China (English)

    朱宝; 邵科晶; 杨丹; 袁航; 朱蕙; 浦晓佳; 王菲

    2013-01-01

    Objective To evaluate the value of 99Tcm-MDP uptake by left femoral neck for diagnosing osteopomsis.Methods A total of 58 cases (23 males,35 females,mean age:(66.15±8.45) years) with spondyloarthmpathies from May to December of 2012 were selected.Serum concentrations of type Ⅰ collagen telopeptide (sCTX-1) and bone ALP (BALP) were determined.All patients underwent dual-energy X-ray absorptiometry (DXA) to detect bone mineral density (BMD).According to the T scores,patients were divided into 2 groups:normal group (NG) (T>-1.0) and osteoporosis group (OG) (T≤-2.5).99TcmMDP bone scan was further performed.The average radioactive ratio of the left femoral neck to the medial soft tissue of left femur (T/N) was measured.Data differences between the 2 groups were compared by twosample t test and Pearson correlation analysis.Results According to BMD,13 patients (7 males,6 females) were included in NG and 28 patients (10 males,18 females) were included in OG.The mean ages of OG and NG were significantly different ((68.82± 10.41) years vs (62.46± 11.77) years; t =3.560,P<0.05).The BMD of left femoral neck in OG was significantly lower than that in NG ((0.67±0.08) g/cm2 vs (0.91±0.10) g/cm2 ; t=9.917,P<0.01).Although BALP level of OG was significantly higher than that of NG ((35.92±11.58) U/L vs (22.38±6.34) U/L; t=-3.397,P<0.05),no significant difference was observed on sCTX-1 between the 2 groups (t=-0.463,P>0.05).T/N ratio of OG (11.63±6.22) was higher than that of NG (9.74±4.44) (t =-3.027,P< 0.05).There were significant correlations between the T/N ratio of the left femoral neck and the sCTX-1 and BALP concentrations (r=0.376,0.483,both P<0.01).No correlations between the T/N ratio of the left femoral neck and age,BMI and BMD were observed (r=-2.031,-0.017,0.134,all P>0.05).Conclusion The uptake ratio of the left femoral neck in 99Tcm-MDP bone scan could evaluate the metabolism of bone,and it is useful for the early diagnosis of osteoporosis

  17. Intramedullary fixation of a femoral shaft fracture with preservation of an existing hip resurfacing prosthesis.

    Science.gov (United States)

    Bilkhu, A; Sisodia, G; Chakrabarty, G; Muralikuttan, K P

    2015-04-01

    Femoral neck fractures have been reported as a cause for failure in patients with a hip resurfacing arthroplasty. However, the incidence and management of fractures of the femoral shaft with an ipsilateral hip resurfacing arthroplasty is relatively absent in current literature. Although, the gold standard for the fixation of a closed femoral shaft fracture is with the use of an intramedullary nail, this can be a challenge in the presence of a hip resurfacing arthroplasty. We describe the case of anterograde intramedullary nail fixation for a femoral shaft fracture in a patient with an ipsilateral hip resurfacing arthroplasty in situ.

  18. The Clinic Study of the 3DCT with Low-dose Scanning in Measurement of Femoral Neck Anteversion of Developmental Dysplasia of the Hip (DDH)%低剂量扫描技术在三维CT测量DDH股骨颈前倾角中的临床应用研究

    Institute of Scientific and Technical Information of China (English)

    刘伟伟; 李军

    2014-01-01

    Objective To evaluate the application value of 3DCT with low dose scanning for femoral neck anteversion of developmental dysplasia of the hip (DDH). Methods The DDH children were scanned by using different scan parameters, keeping 120kV while setting mAs from 200-25mAs, thickness 4mm, Pitch 3.0-5.0mm and then matched 5 different groups of parameters. CT dose parameters were recorded and image qualities evaluated. Results In the 5 selected groups of scan parameters , CT dose parameters were 25.7±0.5、16.6±0.6、3.5±0.7、3.2±0.7 and 2.8±0.8, image qualities were excellent, good, moderate ,moderate and bad respectively. Except for the last group, the other 4 groups can meet the requirement of measuring femoral neck anteversion. Conclusion Low-dose 3DCT scanning can effectively reduce the radiation dosage, which better meets the demand of the radiation protection principle.%目的:探讨低剂量扫描技术在三维CT测量DDH股骨颈前倾角中的应用。方法选择不同的扫描参数对DDH患儿进行扫描,120kV保持不变,mAs选择200mAs-25mAs,层厚选择4mm,螺距选择3.0-5.0mm,对于不同扫描参数进行5组匹配,记录CT剂量指数,评价图像质量。结果在选择的五组扫描参数中,CT剂量指数分别为25.7±0.5、16.6±0.6、3.5±0.7、3.2±0.7、2.8±0.8,图像质量为优、良、中、中、差,前四组的图像能够满足股骨颈前倾角的测量。结论在满足临床诊断的情况下,低剂量扫描有效地降低了DDH患儿的辐射剂量,更加符合防护原则。

  19. Neck pain

    OpenAIRE

    2002-01-01

    Non-specific neck pain has a postural or mechanical basis, and affects about two thirds of people at some stage, especially in middle age. Acute neck pain resolves within days or weeks, but becomes chronic in about 10% of people.Whiplash injuries follow sudden acceleration–deceleration of the neck, such as in road traffic or sporting accidents. Up to 40% of people continue to report symptoms 15 years after the accident.

  20. 空心加压螺钉与动力髋螺钉螺旋刀片治疗股骨颈骨折的临床疗效及生物力学分析%Cannulated compression screw versus dynamic hip screw-blade in the treatment of femoral neck fractures

    Institute of Scientific and Technical Information of China (English)

    骆东; 孙大辉; 姚霁航; 杨凯; 张晓猛; 鞠维娜; 祁宝昌

    2016-01-01

    Objective To compare the curative effect and biomechanical performance of cannulated compression screw (CCS) and dynamic hip screw-blade (DHS-B) in the treatment of patients with femoral neck fracture.Methods Between February 2010 and February 2014,102 patients with femoral neck fracture were treated with CCS or DHS-B at our department.They were 54 males and 48 females,aged from 15 to 86 years.There were 30 subcapital fractures,51 transcervical ones and 21 base ones.CCS was used in 60 patients and DHS-B in 42.In-hospital data were collected retrospectively to compare the curative effects in 2 groups.Furthermore,femoral neck fracture models were established using 12 adult cadaveric femoral specimens.The 12 models were randomized into 2 equal groups (n =6).Group A was subjected to fixation by 3 CCSs and group B to fixation by DHS-B.The 2 groups were compared in terms of axial loading test,rotation test and destructive axial loading test.Results The operation time (59.4 ± 20.2 min),incision size (4.1 ±0.6 cm) and intraoperative blood loss (25.9 ±9.9 mL) in the CCS group were significantly less than those in the DHS-B group (88.6±22.9 min,12.1 ±1.2cmand 156.7±107.1 mL) (P <0.05).The Harris hip score for the DHS-B group (91.9±9.8) was significantly higher than that for the CCS group (87.2 ± 9.2) (P < 0.05).There were no significant differences between the 2 groups in hospital stay,partial weight-bearing time,or postoperative complications (P > 0.05).At 500 N vertical loading,the stress values at both medial and lateral sides of the femur in group A were significantly smaller than those in group B (P < 0.05).There were no significant differences between groups A and B in the average sinking displacement of femoral head or the torque at a torsion angle of 6° (P > 0.05).The maximum load in group A (2,135 ±120 N) was significantly smaller than that in group B (2,986 ± 98 N) (P < 0.05).Conclusion In treatment of femoral neck fracture,DHS-B fixation is

  1. Biomechanical characteristics of two geometric configurations of cannulated compression screws in the fixation of femoral neck fracture%两种构型空心加压螺钉固定头颈型股骨颈骨折的生物力学特征

    Institute of Scientific and Technical Information of China (English)

    史威; 范婕; 张英泽; 杨搏贵; 贾卫斗; 李素红

    2007-01-01

    BACKGROUND : After femoral neck fracture, incidences of ischemic necrosis and bone non-healing are closely related to biomechanical characteristics of internal fixation devices. Compression stress can improve fracture healing, tension force can delay fracture healing, and shear stress can inhibit fracture healing. How to relieve shear stress and expand compression stress is of significance for theories and clinical applications.OBJECTIVE: To compare the biomechanical characteristics of the two geometric configurations of three cannulated compression screws in the fixation for femoral neck fracture and to provide a theoretical foundation in the treatment of femoral neck fracture.DESIGN : Observational contrast study.SETTING: Department of Orthopaedics, the 251 Hospital of Chinese PLA; Department of Orthopaedics, the Third Hospital, Hebei Medical University.PARTICIPANTS: The experiment was carried out in the Hebei Orthopaedic Institute from November 2002 to March 2003. Five cadavers including 4 males and 1 female with similar bone mineral density (BMD) were provided by Department of Anatomy, Hebei Medical University. X-ray photographs proved that all the cadavers did not have rheumatism, tuberculosis, tumor, fracture or deformity.METHODS: Ten femurs were randomly divided into inverted and upright isosceles triangle with 5 in each group. Femur samples with femoral neck fracture were fixed with three cannulated screws and measured with the biomechanical machine (CSS-44020, made in Changchun Experimental Researching Institute, provided by Hebei Orthopaedics Institute). The compression strength, torsibility and the maximal vertical loading were compared between the two configurations of screws.MAIN OUTCOME MEASURES:①Displacement of femoral head at 600 N and 750 N during torsibility test; ②torque-moment at 2°and 4°during torsibility test;③load during maximal vertical loading test.CONCLUSION: The effect of three cannulated compression screws configured as an

  2. Modified Watson-Jones approach with locking compression paediatric hip plate for femoral neck fractures in children%改良Watson-Jones入路联合小儿髋部锁定加压接骨板治疗股骨颈骨折

    Institute of Scientific and Technical Information of China (English)

    王波; 楼跃; 唐凯; 张志群; 林刚; 孙祥水; 刘飞; 倪磊; 鞠黎

    2016-01-01

    Objective To evaluate the methods and curative effect of modified Watson-Jones approach with locking compression paediatric hip plate(LCP-PHP) for femoral neck fractures in children.Methods From January 2012 to August 2014,11 children including 6 male and 5 female with femoral neck fractures(5 lefts,6 rights) underwent operation of modified Watson-Jones approach with LCP-PHP in Nanjing Children's Hospital Affiliated to Nanjing Medical University.The average age at injury was 7.8 years old.All the children received preoperative X-ray and postoperative X-ray regularly.Neck stem angles of preoperative health side,neck stem angles of the sick side 3 days after surgery and the last follow-up were measured,and the loss of neck stem angles,delayed union,nonunion,osteonecrosis,premature physeal closure were evaluated by using X-ray.Meanwhile,hip function of the last follow-up was evaluated by Harris score.Results All the patients were postoperatively followed up for 13-44 months with an average of 26 months.The neck stem angles of preoperative health side 134.70° ± 3.58°,postoperative sick side in 3 days 134.60°±3.46° and the last follow-up 133.50°±3.25°,and there was no statistical difference (F=3.63,P>0.05).The loss of neck stem angles,delayed union,nonunion,and premature physeal closure did not occur.Osteonecrosis(Ratliff type Ⅰ) occurred in 1 child.Harris score was very good in 9 cases(82.0%) and good in 2 cases (18.0%).Conclusions The modified Watson-Jones approach with LCP-PHP for unsuccessful closed reduction femur neck fractures in children can clearly show the fracture,with internal fixation stability and less complications.%目的 探讨改良Watson-Jones入路联合小儿髋部锁定加压接骨板(LCP-PHP)治疗股骨颈骨折的方法及疗效.方法 2012年1月至2014年8月南京医科大学附属南京儿童医院采用改良Watson-Jones入路联合LCP-PHP治疗11例闭合复位失败的股骨颈骨折患儿,其中男6例,女5

  3. Radiographic femoral varus measurement is affected unpredictably by femoral rotation

    DEFF Research Database (Denmark)

    Miles, James Edward

    Radiographic measurements of femoral varus are used to determine if intervention to correct femoral deformity is required, and to calculate the required correction. The varus angle is defined as the angle between the proximal femoral long axis (PFLA) and an axis tangential to the distal femoral c...

  4. Neck lump

    Science.gov (United States)

    ... the neck lump treated. When to Contact a Medical Professional Call your health care provider if you have an abnormal neck swelling or ... to Expect at Your Office Visit The health care provider will take your medical history and do a physical exam. You may ...

  5. 55岁以下成年移位股骨颈骨折内固定术后失败的研究分析%Failure of internal fixation on displaced femoral neck fractures in adults under fifty-five years old

    Institute of Scientific and Technical Information of China (English)

    俞银贤; 马金忠; 朱力波; 陆海明; 桑伟林

    2012-01-01

    目的:回顾性研究年龄55岁以下成年患者移位股骨颈骨折内固定治疗失败病例以提高对其治疗的重视.方法:2007年1月至2010年6月治疗55岁以下移位股骨颈骨折内固定术后失败患者18例,男13例,女5例;年龄27~55岁,平均(48.0±6.0)岁;空心钉治疗17例,髓内钉治疗1例.入院时诊断为股骨头坏死16例,骨不连合并股骨头坏死2例.结果:18例患者内固定术后至手术失败时间8~32个月,平均23个月.复位内固定术后Garden指数不佳;入院时髋关节Harris评分33~80分,平均(56.0±12.5)分.8例股骨头坏死病例和2例骨不连合并股骨头坏死病例接受了全髋关节置换术,5例股骨头坏死病例接受了表面髋关节置换术,3例虽然影像学有股骨头坏死征象但临床症状不明显,接受了保守治疗.所有行髋关节表面置换和全髋关节置换的病例术后随访12~53个月,平均34个月,术后Harris评分(94.0±3.0)分(89~96分).结论:股骨头坏死是55岁以下成年移位股骨颈骨折闭合复位内固定术后常见并发症,必须提高对青壮年股骨颈骨折闭合复位内固定治疗的重视.%Objective:To investigate the failure of internal fixation on displaced femoral neck fractures in adults under fifty-five years old retrospectively inorder to pay more attention to the treatment of these fractures. Methods: From Junary 2007 to June 2010,18 failed cases of internal fixation on displaced femoral neck fractures in adults under fifty-five years old were treated,there were 13 males and 5 females with an average age of (48.0±6.0) years old ranging from 27 to 55. Among them, 17 patients were treated with cannulated screws and ) patient was treated with intramedullaiy nail; 16 patients were diagnosed as osteonecrosis and 2 patients as osteonecrosis associated with nonunion. Results:The average time from internal fixation to failure was 23 months (ranged, 8 to 32 months). The quality of fracture reduction in

  6. 半髋置换术与内固定术治疗老年移位型股骨颈骨折的系统评价%Hemiarthroplasty compared with internal fixation for displaced femoral neck fractures in the elderly: a systematic review

    Institute of Scientific and Technical Information of China (English)

    王丛; 陈根元; 萧文耀; 杨成业; 侯卫华; 李俊锋

    2011-01-01

    [目的]系统评价一期人工股骨头置换术与闭合复位内固定术治疗老年移位型股骨颈骨折的疗效.[方法]计算机检索MEDLINE(1966 ~2011年3月)、EMBASE(1966 ~ 2011年3月)、Cochrane图书馆(2011第3期)及CBM、CNKI、万方、维普中文数据库(均截止2011年3月),手工检索中、英文已发表或未发表的资料和会议论文并查阅相关文章的参考文献.纳入人工股骨头置换术与闭合复位内固定术治疗老年移位型股骨颈骨折的所有随机对照试验(RCT).由2名评价员独立提取资料,并对其方法学质量进行评价.对符合纳入标准的研究用RevMan 5.0进行统计分析.[结果]纳入7个随机对照试验,共计1 537例病人.Meta分析显示:与闭合复位内固定术相比,人工股骨头置换术治疗老年移位型股骨颈骨折能降低术后24 ~ 36个月的再手术率[RR=0.15,95% CI (0.10 ~0.24)P <0.000 01]和主要并发症发生率[RR =0.17,95% CI (0.12 ~0.23) P<0.00001].[结论]治疗老年移位型股骨颈骨折,人工股骨头置换术较闭合复位内固定术能降低术后24 ~36个月的再手术率和主要并发症发生率;两种治疗方法术后12~36个月的病死率差异无统计学意义.但年龄及精神状况是否对手术方式选择产生影响,尚需包含以上两种因素的大样本、多中心随机对照试验的开展.%[Objective]To evaluate the effects of hemiarthroplasty and internal fixation for treatment of displaced femoral neck fracture in elderly persons. [Method] We searched and internalized for all randomized controlled trials and quasi-randomized controlled trials of hemiarthroplasty and internal fixation for displaced femoral neck fractures in the elderly by electronically searching MEDLINE( 1966 to march,2011) ,EMBASE (1966 to march,2011) .Cochrane Library( Issue 3,2011) ,CBM,CNKI, WANFANG,and VIP (up to march 2011 ). Published or unpublished materials and conference papers in Chinese and English

  7. 全髋关节置换修复髋关节骨性关节炎和股骨颈骨折:隐性失血的对比%Total hip arthroplasty for hip osteoarthritis and femoral neck fracture:comparison of hidden blood loss

    Institute of Scientific and Technical Information of China (English)

    史高龙; 董启榕; 陈明; 佘昶

    2015-01-01

    intervention should be conducted for a particular cause? OBJECTIVE:To compare and analyze the hidden blood loss of patients with hip osteoarthritis and femoral neck fracture after total hip replacement. METHODS:The clinical data of 150 patients who received the unilateral total hip arthroplasty treatment from June 2013 to January 2015 were colected and analyzed, including 54 patients with hip osteoarthritis (30 male cases and 24 female cases ), 96 patients with femoral neck fracture (41 male cases and 55 female cases). The pre-and post-operative blood routine and intro-and post-operative blood loss and transfusion were recorded, and hidden blood loss during pen-operation period was evaluated. RESULTS AND CONCLUSION:Total blood loss was (1 616±216) mL, hidden blood loss was (699±102) mL, and hidden blood loss accounted for 43.3% of the total blood loss. The total blood loss was (1 742±254) mL in the hip osteoarthritis group, hidden blood loss was (758±127) mL, hidden blood loss accounted for 44.6% of the total blood loss; The average total blood loss was (1 470±189) mL in the femoral neck fracture group, hidden blood loss was (625±98) mL, hidden blood loss accounts for 42.1% of the total blood loss. The total blood loss and hidden blood loss in hip osteoarthritis group were significantly higher than those in the femoral neck fracture group (P< 0.05). However, there was no significant difference on the hidden blood loss accounts for the proportion of the total blood loss between two groups (P=0.419 3). These results suggest that the total blood loss and hidden blood loss are different for the patients who underwent total hip arthroplasty in the premise of both pathogenesis. Therefore, before the total hip arthroplasty, we should fuly take into account the primary cause of patients and estimate the total blood loss and hidden blood loss, so as to take appropriate preventive measures in time to ensure the safety of the replacement process.

  8. 不同角度植骨和空心钉固定股骨颈骨折的生物力学研究%Biomechanical study of femoral neck fracture fixed by cannulated screws and iliac bone graft at different angles

    Institute of Scientific and Technical Information of China (English)

    李智勇; 张奇; 张英泽; 王娟; 田帅; 秦士吉; 刘跃驹; 许斌

    2015-01-01

    Objective To investigate the biomechanical stability of iliac bone grafts at different angles with three cannulated screws for fixation of femoral neck fractures in order to provide scientific basis for clinical application.Methods The nine pairs of proximal femora and ipsilateral iliac bone grafts with lateral and upper surface retaining cortex were harvested from nine cadavers fixed in formalin,which were randomly divided into two groups: cannulated screw with medial bone graft fixation group ( CMB group) ,cannulated screw with cross bone graft fixation group ( CCB group) .The specimens were cut with power saw to create a standardized midcervical osteotomy perpendicular to the cervical neck.The fracture was then reduced and fixed with three parallel 7.3mm cannulated screws and an iliac bone graft.The cannulated screws were placed triangularly with one screw superior and two inferior.In the CMB group,the bone graft was in the middle of three cannulated screws and parallel with it,however,in the CCB group,the bone graft was made an angle of 30°with the screws on postero-anterior position.All the bone grafts were passed across the fracture line about 1.5cm.Every specimen was detected by Electroforce 3520-AT biomechanical machine.Results When femoral head was rotated to 3°and 5°, the torque values in CCB group were significantly higher than those in CMB group ( P <0.05) ,however,during axial displacement at the load of 700N and 1000N, the displacement values in CCB group were significantly lower than those in CMB group ( P <0.05).All the specimens underwent cycling compression test at 700N compression force successfully,without fatigue fracture or screw failure.The mean ultimate load in CMB group and CCB group was (2112.689 ±186.913)N and (2360.811 ±204.340)N,respectively,there was a significant difference between two groups ( P <0.05).Conclusion The biomechanical stability of fixation of femoral neck fracture with three cannulated screws in CCB group is

  9. The biomechanical comparison of original and new dynamic sleeve three-wing screws for femoral neck fracture%改良前后动态套筒式三翼钉固定股骨颈骨折的生物力学比较

    Institute of Scientific and Technical Information of China (English)

    马信龙; 王杰; 王志彬; 马剑雄; 马韬; 杨阳; 徐卫国; 朱少文; 马宝意; 陈阳; 邢丹

    2012-01-01

    Objective To compare the biomechanical property of original and new dynamic sleeve three-wing screws.Methods Twelve artificial polymethylmethacrylate (PMMA) femoral models and twelve adult cadaver femurs were selected,and then adduction-type femoral neck fracture models were prepared.The specimens were divided randomly into 2 groups,and each group had 6 specimens.According to the operative approach,the fractures were fixed with original dynamic sleeve three-wing screw (DSTS) or new DSTS after anatomic reduction.Then the specimens were fixed in simulated uniped standing position with an instron-8874 servo-hydraulic mechanical testing machine.Ten key points at the proximal femurs and two key points at the femoral shaft were selected to be the positions at which the strain was recorded.The continuous load (PMMA group:0-1200 N; cadaver femur group:0-800 N) was put to the specimens at the rate of 10 mm/min.The strain values under the maximum load,the femoral head sinking displacement and the strain values of No.8 gauge under different loads were recorded.Results There was a peak at the No.8 resistance strain gauge under 1200 N in PMMA group,and the strain values of original and new DSTS were (-2744±35) and (-718±14) με,respectively.There was a peak at the No.8 resistance gauge under 800N in cadaver femur group,and the strain values of original and new DSTS were (-2813±38) and (-2032±22) με,respectively.The differences of strain values above were significant.The femoral head sinking displacement of the new DSTS was much less than that of original DSTS under the same load.Conclusion The new DSTS has better biomechanical properties,using which the femoral neck fracture can be fixed more stably.%目的 比较动态套筒式三翼钉改良前后的生物力学性能.方法 采用聚甲基丙烯酸甲酯(polymethyl methacrylate,PMMA)制作人工股骨模型12根,收集成人尸体股骨12根,制备内收型股骨颈骨折模型.均随机分为两组,每组6根标本.

  10. Treatment of benign pathological femoral neck or trochanteric lesions by using dynamic condylar screw or hip joint spanning external fixator%动力髁螺钉或超关节外固定支架治疗股骨颈和转子良性病损病理性骨折

    Institute of Scientific and Technical Information of China (English)

    张春林; 曾炳芳; 董扬

    2009-01-01

    目的 探讨继发于股骨颈和转子良性病损病理性骨折的治疗方法.方法 回顾性研究2002-2004年间治疗的25例股骨近端良性病损病理性骨折患者.采取病灶刮除、苯酚烧灼、自体或异体骨移植,然后根据病损涉及股骨近端范围的大小,选择采用动力髁螺钉(DCS)或超髋关节外固定支架进行固定.平均随访时间为2.5年(2~4年).结果 所有患者术后3~6个月影像学上均可见良好的骨性愈合.未见局部复发和缺血性股骨头坏死及感染、骨折等并发症.采用美国骨与软组织肿瘤学会(Musculoskeletal Tumor Society,MSTS)-87、MSTS-93和多伦多保肢评分(Toronto Extremity Salvage Score,TESS)系统进行功能评估,均为良好和优秀.结论 与单纯植骨、牵引、髋"人"字石膏支具等传统方法相比,DCS或超髋关节外固定支架是治疗股骨颈和转子良性病损病理性骨折的又一可靠方法.%Objective To investigate treatment method for existing and impending benign pathological femoral neck and trochanteric lesions.Methods A retrospective study wad done on 25 patients with benign proximal femur lesions treated between 2002 and 2004.All patients were treated with lesion curettage,cauterization,autografting and/or allografting.Then,dynamic condylar screw (DCS) or hip joint-span external fixator were selected according to the involved area of the lesion of the proximal femur.The duration of follow-up was mean 2.3 years (2-4 years).Results Sound bony union was seen on the radiographs of all patients by 3-6 months after surgery.There found no local recurrence or avascular necrosis of the femoral head,or complications like necrosis,infections or fractures.Function of the patients in the current series was graded excellent,assessed by the validated outcome measures MSTS-87,MSTS-93 and TESS lower extremity.Conclusion DCS or hip joint-span external fixator may be better alternative treatment of benign pathological femoral neck and

  11. Chondroblastoma of the femoral head: management and outcome.

    Science.gov (United States)

    Strong, D P; Grimer, R J; Carter, S R; Tillman, R M; Abudu, A

    2010-03-01

    Chondroblastoma of the femoral head presents particular problems in treatment because the tumour is surrounded by articular cartilage on one side and epiphyseal plate on the other. Ten patients underwent treatment for a chondroblastoma involving the proximal femoral capital epiphysis. The patients were aged between eight and 19 years and in four the epiphysis was not yet fused. Five had curettage via a drill hole created up the femoral neck, of whom two developed local recurrence. Five had a direct approach to the chondroblastoma through the femoral neck, and there were no local recurrences in this group. Both patients with local recurrence were under 14 years of age-one was cured by a direct approach through the neck of the femur and the other by lifting a trap door of articular cartilage. Apart from one patient with a temporary leg length discrepancy, there were no other complications. We conclude that a direct approach is likely to lead to the best outcome for this rare condition.

  12. Treatment of ipsilateral hip and femoral shaft fractures with reconstructive intramedullary interlocking nail

    Institute of Scientific and Technical Information of China (English)

    吴立东; 吴琼华; 严世贵; 潘志军

    2004-01-01

    Objective: To evaluate the results of reconstructive intramedullary interlocking nail in the treatment of ipsilateral hip and femoral shaft fractures. Methods: From August 1997 to November 2001, 13 patients were treated with the reconstructive intramedullary interlocking nail. Nine patients were associated with ipsilateral femoral neck fractures, three with ipsilateral intertrochanteric fractures, and one with subtrochanteric fracture. Results: The follow-up time was from 6 to 38 months with an average of 14 months. All the femoral shaft and hip fractures healed up well. There was no nonunion of the femoral neck, and only one varus malunion. No patient had avascular necrosis of the femoral head. The average healing time for femoral neck fracture was 4.6 months and for shaft fracture 5.8 months. The joint movement and other functions were fairly resumed. Conclusions: The reconstructive intramedullary interlocking nail, with less trauma, reliable fixation, and high rate of fracture healing, is an ideal method of choice in the treatment of ipsilateral hip and femoral shaft fractures.

  13. MORPHOLOGICAL STUDY OF MEDIAL CIRCUMFLEX FEMORAL ARTERY IN HUMAN CADAVERS

    Directory of Open Access Journals (Sweden)

    Brijesh R. Aghera

    2014-10-01

    Full Text Available Background: Medial circumflex femoral artery is an important branch of Profunda femoris artery. It is an important artery in supplying blood to the head and neck of the femur, the adductor muscles and form anastomosis around head of femur. So study of variation of medial circumflex femoral artery great value for surgeon and orthopaedic surgeries. Materials and Methods: The present study includes 102 lower limbs of adult formalin fixed human cadavers used for the routine dissection procedure for under graduate and post graduate students in the department of Anatomy, M.R. Medical College, KBN Medical college and H K E Homeopathic College, Gulbarga (India during 2011-2014.The study was done by dissection method as per Cunningham’s manual of practical Anatomy. Result: In present study, we found that 25 extremities (25.49% medial circumflex femoral artery was originated directly from femoral artery. In 10 extremities (9.80% a common trunk was observed form medial circumflex femoral with femoral artery. Normal study was observed in 66 extremities (64.70%. Conclusion: In present study and other past studies we conclude that knowledge of variation in this artery is very important to preventing injury to vessels during surgical procedures around hip joint and also has important value in plastic surgery operations as the vascular pedicle of grafts such as the transverse upper gracilis (TUG flap, medial thigh flap and medial circumflex femoral (gracilis perforator free flap. During case of selective arteriography in ischaemic necrosis of the femoral head to know the arterial supply of the femoral head it is used.

  14. Fixation with percutaneous cannulated screws assisted by robot navigation for femoral neck fractures%机器人导航定位系统辅助下经皮空心螺钉内固定治疗股骨颈骨折

    Institute of Scientific and Technical Information of China (English)

    刘建全; 刘黎军; 黄俊锋; 尤微; 王大平

    2015-01-01

    目的 探讨机器人导航定位系统辅助下经皮空心螺钉内固定治疗股骨颈骨折的疗效.方法 回顾性分析2012年10月至2014年6月采用机器人导航定位系统辅助下经皮空心螺钉内固定治疗的21例股骨颈骨折患者资料(导航组),男8例,女13例;年龄为20 ~ 85岁,平均(65.2±4.2)岁;骨折按Garden分型:Ⅰ型2例,Ⅱ型5例,Ⅲ型9例,Ⅳ型5例.选择同期采用传统徒手定位方法手术治疗的25例股骨颈骨折患者作为对照组.比较两组患者的手术时间、术中透视次数、术中出血量、总钻孔次数、骨折愈合时间及末次随访时髋关节Harris评分等. 结果 导航组患者的手术时间[(75.2±10.6) min]和骨折愈合时间[(5.3±2.5)个月]短于对照组[(85.1±11.3) min、(6.1±3.0)个月],但差异均无统计学意义(P>0.05).导航组患者的术中透视次数[(28.5±9.8)次]、术中出血量[(9.4±7.6)mL]及总钻孔次数[(9.2±4.5)次]显著少于对照组[(48.6±8.1)次、(40.2±10.3)mL、(17.5±8.5)次],差异均有统计学意义(P<0.05).导航组患者末次随访时髋关节Harris评分平均为(87.6±3.1)分,对照组患者平均为(86.9±4.7)分,差异无统计学意义(P>0.05).随访期间导航组无一例患者发生伤口感染、内固定物松动、骨折再移位及股骨头缺血性坏死等并发症. 结论 与传统徒手定位方法相比,机器人导航定位系统辅助下经皮空心螺钉内固定治疗股骨颈骨折具有设备操作相对简单、术中螺钉置入更加精准和规范等优点,实现了手术的微创化,减少了放射线的接触时间.%Objective To discuss clinical efficacy of fixation with percutaneous cannulated screws assisted by robot navigation for femoral neck fractures.Methods From October 2012 to June 2014,21 patients with femoral neck fracture were treated by internal fixation with percutaneous cannulated screws assisted by robot navigation.They were 8 men and 13 women,20 to 85 years of age

  15. The control analysis of different internal fixation surgical methods in the treatment of unstable femoral neck fracture%不同内固定手术方法治疗不稳定型股骨颈骨折的对照分析

    Institute of Scientific and Technical Information of China (English)

    周军杰; 曹成福; 庞金辉; 陈贤奇; 高文武

    2013-01-01

    [目的]评价不稳定型股骨颈骨折分别采用滑动式鹅头钉(DHS)和InterTAN髓内钉内固定的临床疗效.[方法]回顾性分析2007年2月~2011年2月,307例接受内固定手术治疗的股骨颈骨折患者,男189例,女118例;年龄38 ~69岁,平均(50.64±5.25)岁.股骨颈骨折分型按Pauwels分型:Ⅱ型86例,Ⅲ型221例.本研究病例损伤至手术时间2~5d,平均(3.15±2.03)d.本组病例随机采用滑动式鹅头钉(DHS)或InterTAN髓内钉内固定,采用滑动式鹅头钉(DHS) 136例,采用InterTAN髓内钉内固定171例.患者手术后经规范术后随访,临床髋关节功能按Harris评价标准.[结果]283例患者获得随访,随访时间11 ~32个月,平均(15.4±3.25)个月.Harris评分:DHS组从术前平均(13.52±3.06)分提高到末次随访时的平均(83.54 ±2.15)分;其中优65例,良48例,可17例,差6例,优良率为83.1% (113/136),差评中1例(0.74%)发生骨不连,3例(2.21%)发生髋内翻畸形,2例(1.47%)发生股骨头坏死.InterTAN组从术前平均(11.86±4.75)分提高到末次随访时的平均(91.75±3.62)分;其中优92例,良66例,可13例,优良率为92.4% (158/171),无骨折不愈合及髋内翻畸形、无髓内钉断裂.本研究中所有病例均无感染.[结论]应用InterTAN髓内钉内固定技术治疗不稳定型股骨颈骨折,手术创伤小,固定坚强,可早期活动,与DHS比较,具有较少的骨不连和髋内翻发生率,结果令人满意.%[ Objective] To evaluate the clinical outcome of unstable femoral neck fracture treated by internal fixation of dynamic hip screw system ( DHS) and the InterTAN(R) intramedullary nail. [ Method ] Retrospective analysis of 307 cases of femoral neck fractures treated by internal fixation (from February 2007 to February 2011) was made,including 189 males and 118 females with an average age of 50. 64 ±5. 25 years (range,38 -69 years). According to the Pauwels classification,there were 86 cases of type Ⅱ,and 221 cases of

  16. 先天性短股骨颈人工全髋关节置换时避免下肢延长的临床研究%A METHOD TO AVOID LENGTHENING LOWER LIMBS AFTER TOTAL HIP ARTHROPLASTY IN PATIENTS WITH CONGENITAL SHORT FEMORAL NECK

    Institute of Scientific and Technical Information of China (English)

    陈涛; 尚希福; 贺瑞; 胡飞; 葛畅

    2012-01-01

    Objective To investigate the method to avoid lengthening lower limbs after total hip arthroplasty in patients with congenital short femoral neck. Methods The clinical data were analyzed retrospectively from 38 patients undergoing unilateral total hip arthroplasty between April 2005 and December 2010. There were 26 males and 12 females, aged 45-78 years (mean, 62.3 years). Among these cases, there were 11 cases of avascular necrosis of the femoral head, 17 cases of hip osteoarthritis, and 10 cases of femoral neck fracture. Before operation, 29 cases had leg length discrepancy; and the shortened length of the legs was 10-24 mm with an average of 14.5 mm by clinical measurement, and was 11-25 mm with an average of 14.7 mm by X-ray film measurement. The Harris score before operation was 44.0 ± 3.6. Results At 1 day after operation, 3 cases had legs lengthening by clinical and X-ray film measurement; limb length difference less than 10 mm was regarded as equal limb length in the other 35 patients (92.1%). All incisions healed by first intention, and no complication of infection or lower limb deep venous thrombosis occurred. In 3 patients who had legs lengthening, 1 patient had abnormal gait and slight limping after increasing heel pad because the lower limb was lengthened by 16 mm, and 2 patients had slight limping. The other patients could walk normally and achieved pain relief of hip. Thirty-six patients were followed up 12-68 months (mean, 43.8 months). The Harris score was 86.7 ± 2.3 after 6 months, showing significant difference (t=3.260, P=0.031) when compared with that before operation. The X-ray films showed no prosthetic loosening or subsidence. Conclusion For patients with congenital short femoral neck during total hip arthroplasty, the surgeons should pay attention to osteotomy plane determination, limb length measurement, and use of the prosthesis with collar to avoid the lengthening lower limbs.%目的 探讨对先天性短股骨颈患者行人工全髋

  17. Comparison of different procedures in the treatment of displaced femoral neck fractures in middle-aged and elderly patients.%不同手术方法治疗中老年移位型股骨颈骨折的疗效分析

    Institute of Scientific and Technical Information of China (English)

    桂先革; 曾晖; 熊奡; 康斌; 张勇; 陶可; 辛风

    2011-01-01

    Objective To evaluate the clinical outcome of the internal fixation and arthroplasty for the displaced femoral neck fractures in the middle-aged and elderly patients. Methods All the 80 middle-aged and elderly patients with displaced femoral neck fractures who had been treated from January 2006 to June 2009 were reviewed. Of them, 23 cases received internal fixation (Croup A), 27 femoral head arthroplasty ( FHA, Croup B) and the other 28 total hip arthroplasty (THA, Croup C). Comparisons were made among the 3 groups in hospitalization, operating time, intraoperative bleeding, postoperative complications, and functional recovery. Results The operating time and blood loss in Group C is the most than that in Group A and Group B. Group A have the most postoperative complication, Group B have the leastKarris score. Croup C have the more pain score than Croup B, Croup C have the most turn-lion score and Croup Fi have (he least- Statistical analysis showed that there is a significant difference in operating time, intraoperative bleeding, poslopera-live complications and postoperative Harris score, and no significant difference in the hospitalizalion , walking score and motion range. Conclusion Internal fixation can he applied lo patients who are relatively young and active, have good quality of bone and can tolerate ambulalion lately; THA is suitable for patients with the displaced femoral neck fractures of the elderly those who are active , have good genera! Condition or have relatively longer life expectancy or preexislent hip diseases. FHA is suitable for patients who have a poor general condition or have serious medical diseases but can lolerale general surgery in preoperative assessment.%目的 评价不同手术方法治疗中老年移位型股骨颈骨折的疗效.方法 回顾性分析2006年1月至2009年6月收治的80例分别采用内固定(A组,25例)、人工股骨头置换(B组,27例)及全髋关节置换(C组,28例)手术治疗的中老年移位型股骨

  18. Fracture of the neck of the femur after radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Gantscheff, M.; Wassilew, T.; Tantschew, P. (Meditsinska Akademiya, Sofia (Bulgaria))

    1983-02-01

    Several etiopathogenetic factors of the femoral neck fracture after radiotherapy are discussed taking extensive references into consideration. Results are described paying special attention to the discongruence of the hip joint existing in this fracture. The change of the volume of the femoral head, which can be considered as a consecutive symptom of some vascular lesions, leads to pathologic conditions in the biomechanics of the hip joint causing a special kind of stress fracture.

  19. 关节置换与植入物内固定治疗老年移位型股骨颈骨折的系统评价%Systematic review of arthroplasty combined with internal fixation for displaced femoral neck fractures in elderly patients

    Institute of Scientific and Technical Information of China (English)

    陈跃平; 高辉; 陈亮; 罗东方; 尹庆水

    2012-01-01

    背景:老年移位型股骨颈骨折治疗常需要内固定或人工髋关节置换,两种术式如何选择一直是骨科医生争论的焦点.目的:对髋关节置换与内固定治疗老年移位型股骨颈骨折的疗效和安全性进行系统评价.方法:计算机检索Cochrane图书馆(2011年第5期)、MEDLINE(1966-01/2011-05)、EMbase(1984-01/2011-05)、CNKI (1979-01/2011-05).收集所有髋关节置换与内固定比较治疗老年人(>60岁)移位型股骨颈骨折的随机对照试验(RCT),筛选出符合纳入标准的文献,对其进行严格的质量评价,利用Cochrane 协作网提供的RevMan5.1.2软件对纳入研究结果进行Meta 分析,使用GRADEpro version3.2.2软件对纳入研究进行证据评级.结果与结论:共检索到相关文献87篇,最终纳入13个RCT,共2 436例患者.Meta 分析结果显示,随访2年、10年或10年以上病死率,关节置换和内固定组比较差异均无显著意义.随访2 年、10年或10年以上再手术率及并发症,关节置换组均显著低于内固定组.提示无论短期还是长期选择关节置换治疗老年人移位型股骨颈骨折可明显降低术后再次手术率及主要并发症.%BACKGROUND: Treatment of femoral neck fracture in elderly patients is always through internal fixation or arthroplasty, but howto choose the two procedures for the treatment is the debate focus of orthopedic surgeons.OBJECTIVE: To review the clinical outcomes and safety between arthroplasty and internal fixation in treatment of elderly patientswith femoral neck fracture.METHODS: Cochrane central register of controlled trials (fifth book in 2011), MEDLINE (1966-01/2011-05), EMbase(1984-01/2011-05) and CNKI (1979-01/2011-05) were (> 60 years) searched. Only randomized clinical trials that comparedarthroplasty with internal fixation for the treatment of femoral neck fracture in the elderly (>60 years) were included. The analysiswas performed with software RevMan5.1.2 from the Cochrane collaboration

  20. Curative effect of cemented prosthesis and cement-less prosthesis in the treatment of old aged femoral neck fracture%骨水泥型与生物型假体髋关节置换术治疗老年股骨颈骨折疗效研究

    Institute of Scientific and Technical Information of China (English)

    马川; 江锋; 黄陈翼; 刘宗超

    2016-01-01

    目的:探讨骨水泥型与生物型假体髋关节置换术治疗不稳定型老年股骨颈骨折的疗效。方法于2013年1月至2015年1月在选择初次接受全髋关节置换手术的不稳定型老年股骨颈骨折患者60例,随机分为骨水泥型组和生物型假体组,各30例,分别行相应假体髋关节置换术,术后随访6个月。比较两组患者手术时间、术中出血量、住院天数、术后并发症发生情况、术后髋关节脱位发生情况和髋关节 Harris评分。结果骨水泥型组和生物型组手术时间、术中出血量比较差异无统计学意义(P>0.05),骨水泥型组住院时间短于生物型组(P<0.05)。骨水泥型组术后并发症总发生率高于生物型组(P<0.05)。术后1个月和6个月时,两组患者均出现髋关节脱位的情况。术后1个月和6个月时,骨水泥型组 Harris评分高于生物型组( P<0.05)。结论与生物型假体髋关节置换术相比,骨水泥型假体髋关节置换术不增加手术时间和术中出血量,患者住院时间更短,在改善患者术后早期髋关节功能方面有重要作用,但更易发生并发症。%Objective To observe the clinical effect of cemented prosthesis and cement‐less prosthesis in the treatment of old aged femoral neck fracture .Methods From Jan .2013 to Jan .2015 ,60 old patients with femoral neck fracture were randomly divided into cemented prosthesis group and cement‐less prosthesis group .Relevant index were compared between the two groups .Results The operative time and blood loss were without significant differences between the two groups (P>0 .05) ,but the time for hospital stay of cemented prosthesis group was less than cement‐less prosthesis group(P< 0 .05) .The Harris scores ,detected one month and six months after operation ,of cemented prosthesis group were significantly higher than cement‐less prosthesis group ( P<0 .05) .Conclusion Compared with

  1. Open Reduction and Internal Fixation with DHS Combined with Anti-rotation Screw to Treat Pauwels Type Ⅲ Femoral Neck Fracture in Young Adults%切开复位DHS联合抗旋螺钉固定治疗青壮年股骨颈PauwelsⅢ型骨折

    Institute of Scientific and Technical Information of China (English)

    曲国胜; 刘建华; 马英; 杨国良; 冯世斌

    2011-01-01

    目的:评价切开复位DHS 联合抗旋螺钉固定治疗青壮年股骨颈Pauwels Ⅲ型骨折的临床效果.方法:采用回顾性分析的方法,总结2005 年2月~2009 年4月,我院手术治疗的Pauwels Ⅲ型骨折患者26 例.其中,男22 例,女4例,年龄19~47 岁,平均38.4 岁.骨折按Pauwels 型均为Ⅲ型,采用切开复位DHS 联合空心钉固定.结果:本组患者随访时间20~70 个月,平均31.2 个月.除3例发生股骨头缺血性坏死外,其余23名患者骨折均得到愈合.根据Harris 髋关节功能评分系统评估疗效,优18 例,良5例,差3例.结论:切开复位DHS 联合抗旋螺钉固定治疗青壮年股骨颈Pauwels Ⅲ型骨折的疗效肯定,解剖复位、坚强固定是获得满意疗效的关键.%Objective:To evaluate the result of Pauwels type Ⅲ femoral neck fracture in young adults treated with open reduction and internal fixation with DHS combined with anti-rotation screw.Methods:A retrospective analysis was done on the clinical date of 16 cases of young Pauwels type Ⅲ fracture,which were surgically treated in our hospital from February 2005 to April 2009.There were 15 males and 1 females,with an average of 38.4 years old (ranged from l9 to 47 years old).All were Pauwels type Ⅲ fracture and treated with the method of open reduction and fixed with DHS combined with anti-ration screw.Results: The average period of follow-up of these 16 cases was 20~70 months.l4 patients got fracture union,and 2 cases suffered from osteonecrosis of femoral neck.According to Harris criterion,the results of the treatment was evaluated as excellent in 11 cases,good in 3 cases,bad in 2 cases.Conclusion:Effect of the open reduction and internal fixation with DHS combine with anti-rotation screw to treat young Pauwels type Ⅲ fracture is definite,anatomic reduction and rigid fixation of operation can lower the rate of complications effectively.

  2. [Subtrochanteric femoral fractures].

    Science.gov (United States)

    Ulmar, B; Simon, S; Eschler, A; Mittlmeier, T

    2013-12-01

    Subtrochanteric femoral fractures are proximal femoral fractures which are located between the trochanter minor and an area of 3 cm below the minor trochanter on the femoral shaft. About 10-15% of all proximal femoral fractures correspond to this fracture site. Elderly or geriatric patients are generally affected and the injury is often the result of a fall in the home, while high-energy trauma is the cause in a small group of generally younger patients. Clinical evaluation of the affected extremity shows disability of axial weight-bearing and pain during compression and rotation of the hip joint. Basic diagnostics include conventional x-rays of the injured femur in the anterior-posterior and lateral planes. These subtrochanteric femoral fractures are almost always treated surgically due to the inherent high degree of instability. The main goals of surgical intervention are to achieve anatomic fracture reduction and primary full weight-bearing stability of the corresponding leg. Intramedullary interlocking nails are used for primary treatment, while extramedullary implants are often used in revision surgery. Early mobilization and intensive respiratory exercises are necessary to prevent early postoperative complications.

  3. Early curative effects and influencing factors of primary total hip replacement for senile femoral neck fractures%初次全髋关节置换术治疗老年股骨颈骨折的近期疗效及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    邓波; 王静成; 熊传芝; 颜连启; 孙钰

    2016-01-01

    Objective To investigate the early curative effects and influencing factors of primary total hip replacement for senile femoral neck fractures.Methods Between January 2013 and May 2015,116 elderly patients with femoral neck fracture underwent primary total hip replacement.They were 34 males and 82 females,with an average age of 70.2 years.By the Garden classification,we had 23 cases of type Ⅰ,34 cases of type Ⅱ,38 cases of type Ⅲ,and 21 cases of type Ⅳ.Their clinical data were statistically analyzed,including gender,age,body mass index (BMI),preoperative concomitant diseases,Garden classification,injury causes,operative indexes,postoperative rehabilitation time,and postoperative complications.Single factor analyses were conducted to find out the relative factors using x2 test before multiple factors analyses using logistic regression to screen the significant factors influencing hip functional recovery.Results The 116 patients obtained follow-ups for 12 to 23 months (mean,18.3 months).According to the Harris hip scores for hip function at the last follow-up evaluation,36 cases were excellent,52 good,20 fair,and 8 poor,giving a good to excellent rate of 75.9%.Single factor analyses found that age,BMI,operation time,surgical approach,discrepancy in bilateral lower limb lengths,postoperative analgesia,total blood loss,postoperative rehabilitation time,and postoperative complications were significantly related to hip functional recovery (P < 0.05).Logistic regression analyses found that BMI,surgical approach,discrepancy in bilateral lower limb lengths,postoperative analgesia,total blood loss,and postoperative rehabilitation time were the main factors influencing hip function recovery (P < 0.05).Conclusions Primary total hip replacement may lead to fine early curative effects for elderly patients with femoral neck fracture.Smaller BMI,minimally invasive approach,less discrepancy in bilateral lower limb lengths,post-operative analgesia,less total blood loss

  4. 重建后关节囊及外旋肌群人工全髋关节置换术在股骨颈骨折的临床疗效%Therapeutic effect of total hip replacement with Posterior arthrosis cpsule reconstruction and Short external rotator muscle repair on Femoral neck fractures

    Institute of Scientific and Technical Information of China (English)

    陈春雷; 李拱榆

    2014-01-01

    Objective To explore the therapeutic effect of total hip replacement with Posterior arthrosis cpsule reconstruction and Short external rotator muscle repair on Femoral neck fractures. Methods Fourty patients with Femoral neck fractures. were select-ed and divided into two groups with 20 cases in each groups. A group was given the treatment of total hip replacement with Poste-rior arthrosis cpsule reconstruction and external rotator muscle repair whiIe B group was given the treatment of traditional total hip replacement only with external rotator muscle repair. The operation incision length, operation time, intraoperative bleeding volume, postoperative drainage volume and hospital stay were all recorded. And postoperative complication in 6 months of two groups in-cluding infection, hematoma, nerve injury, joint dislocation, deep vein thrombosis and Harris hip score were observed and com-pared. Results ①The intraoperative bleeding volume and postoperative drainage volume in A group were less than those in A group (P0.05). ②There was no significant difference of Harris hip score at 6 months after surgery between the two groups (95%VS 85%, P>0.05). ③There were lower incidence of postoperative infection, hematoma and joint dislocation in group A than those in group B (P0.05). Conclusion The therapeutic effect of total hip replacement with Posterior arthrosis cpsule reconstruction and Short external rotator muscle repair on Femoral neck fractures is obvious were less postoperative infection, hematoma and joint disloca-tion, which is worthy of clinical application.%目的:探讨重建后关节囊及外旋肌群人工全髋关节置换术在股骨颈骨折中的临床疗效。方法选择我院2012年3月-2013年3月收治的股骨颈骨折的患者40例,根据手术方式不同随机分为两组,每组20例:A 组采取重建后关节囊及外旋肌群人工全髋关节置换术;B组采取传统经后侧入路行髋关节置换术(仅修补外旋肌群

  5. 动态套筒式三翼钉固定不同角度PMMA股骨颈骨折的生物力学研究%Biomechanical research of dynamic sleeve three-wing screw in fixing femoral neck fracture of different angles

    Institute of Scientific and Technical Information of China (English)

    杨阳; 马信龙; 马剑雄; 王志彬; 马宝意; 王沛

    2010-01-01

    Objective To explore the biomechanical stability of dynamic sleeve three-wing screw for treatment of femoral neck fracture and to provide theoretical basis for choosing the screw in clinical application.Methods Nine artificial PMMA femoral model were prepared and divided randomly into three groups (n=3),and the specimens were saw up with a hand saw at Pauwels angle of 30° ,50° and 70° in the central neck ,respectively and then fixed with dynamic sleeve three-wing screw.Specimens were fixed at simulated uniped standing position at Instron-8874 servo-hydraulic mechanical testing machine.Linear load of 0~1 200 N was loaded at the rate of 10 mm/min and strains at 11 key points under 1 200 N load were measured,as well as head sink displacement and the strain at principal pressure side and principal tension side under different loads.Results Strengthening peaks were observed at the number six resistance strain gage under the 1 200 N load in all tree groups,and the numerical difference of the three groups was statistically significant(P<0.01).Under the load of 600~1 200 N,head sink displacement compare were performed in each two of the three groups under the same load,respectively,and showed statistically significant difference(P<0.01) ;the strain of principal pressure side and principal tension side of the femoral neck was higher with the increasing Pauwels angle under the same load,the difference was significant(P<0.01).Conclusion With the increasing Pauwel's angle,the shearing force was greater,the contact area of fracture line was smaller,and the fracture was more unstable;in contrast,the shearing force was smaller with the Pauwel's angle smaller,the contact area of fracture line was larger,and the fracture was more stable.%目的 探讨动态套筒式三翼钉治疗股骨颈骨折中的生物力学作用,为临床选择此内固定器治疗股骨颈骨折提供理论依据.方法 利用聚甲基丙烯酸甲酯(PMMA)制作人工股骨模型9

  6. 不同手术时机行关节置换术对老年股骨颈骨折患者术后髋关节功能的影响%Different timing of surgery for joint replacement surgery on femoral neck fracture patients about harris indexes

    Institute of Scientific and Technical Information of China (English)

    尹虎

    2012-01-01

    Objective According to the assessment of the curative effect on different operation time of total hiparthroplasty for femoral neck fractures,to explore the effect of the different timing of surgery,itraoperative and postoperative blood loss,early postoperative complications and hip function recovery,and provide theoretical basis for selection of operation time of total hip arthroplasty for femoral neck fractures,to better guide clinical practice.Methods Retrospective analysis 90 femoral neck fracture patients with complete follow-up data for total hip arthroplasty,90 patients were divided into two groups,observation group was given the emergency surgery,the control group was given the delayed operation group.The differences of two groups about operation time,intraoperative blood loss,postoperative drainage,early postoperative complications and postoperative functional restoration of hip joint were compared.Results After 3 months follow-up,the comparison of operation time,intraoperative blood loss and postoperative drainage for the emergency operation group and the delayed operation group,the difference was statistically significant(t=2.37,15.38,22.73,all P<0.05).The emergency operation group and the delayed operation group in the postoperative complications,P>0.05,the difference was not statistically significant.After 1 month,the difference of the two groups of hip joint function by Harris score was statistically significant(t=2.76,P<0.05);and after 3 months,the difference was not statistically significant(P>0.05).Conclusion Emergency surgery can effectively shorten the operation time,reduce blood loss and postoperative drainage and conducive to the recovery of hip function in patients,reduce the pain caused by the disease,but the ultimate the hip function is not affected.%目的 探讨不同手术时机行全髋关节置换术治疗老年股骨颈骨折患者对术后髋关节功能的影响.方法 回顾性分析随访资料完整的全髋关节置换

  7. Treatment of senile femoral neck fractures using bipolar hemiarthroplasty with enhanced repair of a U-shaped capsular flap via a modified posterior mini-incision%改良后路微创切口并强化修复“U”形关节囊瓣的双极头置换治疗高龄股骨颈骨折

    Institute of Scientific and Technical Information of China (English)

    周雪明; 刘彬; 吴润柏; 王智; 莫新发; 刘先银

    2015-01-01

    Objective To evaluate the efficacy of bipolar hemiarthroplasty with cnhanced repair of a U-shaped capsular flap via a modified posterior mini-incision for senile femoral neck fractures.Methods Between June 2008 and June 2013,86 senile patients with femoral neck fracture were treated operatively.They were 20 males and 66 females,80 to 95 years of age (mean,84.6 years).There were 70 cases of Garden type Ⅲ and 16 cases of Garden type Ⅳ.They all underwent bipolar hemiarthroplasty via a modified posterior mini-incision.A U-shaped posterior capsular flap with its base close to the acetabulum was made before exposure of the hip joint.Next this flap and short external rotators were repaired particularly after the bipolar prostheses were implanted.Incision length,surgical time,iotra-operative loss of blood,and length of lower limb were measured.Malposition of prosthesis,hip dislocation and other complications were monitored.The outcomes were assessed according to Harris hip score at the last follow-up.Results The mean incision length was 9.2 cm (range,8 to 12 cm).The mean surgical time was 75.2 min (range,55 to 130 min).The mean intra-operative loss of blood was 250.1 mL (range,120 to 620 mL).The proximal skin margin of the incision was bruised in 3 cases,deep venous thrombosis occurred at the lower limb 3 weeks postoperatively in one case,and length discrepancy between bilateral lower limbs was observed in 6 cases.No dislocation,incision infection,sciatic nerve injury,or component malpositioning happened in this group.All patients were evaluated after a mean follow-up period of 14 months(from 12 to 35 months).One patient died from lung cancer one year postoperatively.According to the Harris hip scores at the last follow-up,68 cases were excellent,15 good and 3 fair,giving an excellent to good rate of 96.5%.Conclusions The modified posterior mini-incision for localization of body surface is accurate,reliable and simple for senile femoral neck fractures.The bipolar

  8. Femoral varus: what's the angle

    DEFF Research Database (Denmark)

    Miles, James Edward; Svalastoga, Eiliv Lars; Eriksen, Thomas

    Agreement and reliability of femoral varus measurements: a comparison of four techniques Three different techniques have been described for measuring femoral varus radiographically in the dog, but how the measurements from these techniques compare is unknown. Further, measurement reliability has ...

  9. Does hip osteoarthritis have a protective effect against proximal femoral fractures? A retrospective study.

    Science.gov (United States)

    Calderazzi, Filippo; Groppi, Giulia; Ricotta, Agostino; Ceccarelli, Francesco

    2014-01-01

    The inverse relationship between proximal femoral fracture incidence and hip osteoarthritis remains controversial. However, femoral neck fractures rarely occur in patients with hip osteoarthritis, suggesting a protective effect of osteoarthritis. We sought to determine if the severity of osteoarthritis influenced fracture type. We examined the radiographs of 190 consecutive patients treated at our institution after hip trauma. They were divided into three groups according to the outcome of the trauma: femoral neck fracture; trochanteric fracture; and no fracture. We then analysed the severity of osteoarthritis within these groups. No relationship between the grade of hip osteoarthritis and the presence of a proximal femoral fracture was found. However, the grade of osteoarthritis was related both to the outcome of the trauma (posteoarthritis of the hip had a three-fold increased likelihood of trochanteric fracture compared to femoral neck fracture. Osteoarthritis does not protect against proximal femoral fractures, but strongly affects the location of the fracture in the proximal femur, increasing the possibility of a trochanteric location.

  10. Laparoscopic repair of femoral hernia

    OpenAIRE

    Yang, Xue-Fei; Liu, Jia-Lin

    2016-01-01

    Laparoscopic repair of inguinal hernia is mini-invasive and has confirmed effects. Femoral hernia could be repaired through the laparoscopic procedures for inguinal hernia. These procedures have clear anatomic view in the operation and preoperatively undiagnosed femoral hernia could be confirmed and treated. Lower recurrence ratio was reported in laparoscopic procedures compared with open procedures for repair of femoral hernia. The technical details of laparoscopic repair of femoral hernia, ...

  11. An analysis of factors affecting the mercury content in the human femoral bone.

    Science.gov (United States)

    Zioła-Frankowska, A; Dąbrowski, M; Kubaszewski, Ł; Rogala, P; Kowalski, A; Frankowski, M

    2017-01-01

    The study was carried out to determine the content of mercury in bone tissue of the proximal femur (head and neck bone) of 95 patients undergoing total hip replacement due to osteoarthritis, using CF-AFS analytical technique. Furthermore, the investigations were aimed at assessing the impact of selected factors, such as age, gender, tobacco smoking, alcohol consumption, exposure to chemical substance at work, type of degenerative changes, clinical evaluation and radiological parameters, type of medications, on the concentration of mercury in the head and neck of the femur, resected in situ. Mercury was obtained in all samples of the head and neck of the femur (n = 190) in patients aged 25-91 years. The mean content of mercury for the whole group of patients was as follows: 37.1 ± 35.0 ng/g for the femoral neck and 24.2 ± 19.5 ng/g for the femoral head. The highest Hg contents were found in femoral neck samples, both in women and men, and they amounted to 169.6 and 176.5 ng/g, respectively. The research showed that the mercury content of bones can be associated with body mass index, differences in body anatomy, and gender. The uses of statistical analysis gave the possibility to define the influence of factors on mercury content in human femoral bones.

  12. Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports

    Directory of Open Access Journals (Sweden)

    Engelsma Yde

    2012-11-01

    Full Text Available Abstract Introduction In slipped capital femoral epiphysis the femoral neck displaces relative to the head due to weakening of the epiphysis. Early recognition and adequate surgical fixation is essential for a good functional outcome. The fixation should be secured until the closure of the epiphysis to prevent further slippage. A slipped capital femoral epiphysis should not be confused with a femoral neck fracture. Case presentation Case 1 concerns a 15-year-old boy with an adequate initial screw fixation of his slipped capital femoral epiphysis. Unfortunately, it was thought that the epiphysis had healed and the screw was removed after 11 weeks. This caused new instability with a progressive slip of the femoral epiphysis and subsequently re-fixation and a subtrochanteric correction osteotomy was obligatory. Case 2 concerns a 13-year-old girl with persistent hip pain after screw fixation for slipped capital femoral epiphysis. The screw was removed as lysis was seen around the screw on the hip X-ray. This operation created a new unstable situation and the slip progressed resulting in poor hip function. A correction osteotomy with re-screw fixation was performed with a good functional result. Conclusion A slipped epiphysis of the hip is not considered ‘healed’ after a few months. Given the risk of progression of the slip the fixation material cannot be removed before closure of the growth plate.

  13. Corrosion behavior of tantalum-coated cobalt-chromium modular necks compared to titanium modular necks in a simulator test.

    Science.gov (United States)

    Dorn, Ulrich; Neumann, Daniel; Frank, Mario

    2014-04-01

    This study compared the corrosion behavior of tantalum-coated cobalt-chromium modular necks with that of titanium alloy modular necks at their junction to titanium-alloy femoral stem. Tests were performed in a dry assembly and two wet assemblies, one contaminated with calf serum and the other contaminated with calf serum and bone particles. Whereas the titanium modular neck tested in the dry assembly showed no signs of corrosion, the titanium modular necks tested in both wet assemblies showed marked depositions and corrosive attacks. By contrast, the tantalum-coated cobalt-chromium modular necks showed no traces of corrosion or chemical attack in any of the three assemblies. This study confirms the protective effect of tantalum coating the taper region of cobalt-chromium modular neck components, suggesting that the use of tantalum may reduce the risk of implant failure due to corrosion.

  14. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

  15. Reconstruction plate fixation of subtrochanteric femoral fractures in children.

    Science.gov (United States)

    El-Sayed, Moustafa; Abulsaad, Mazen; El-Hadidi, Mahmoud; El-Adl, Wael; El-Batouty, Magdy

    2007-08-01

    Pediatric subtrochanteric femoral fractures are rare and have received limited attention in the literature Treatment is controversial. Different treatment options are used: skin traction, 90/90 skeletal traction, spica casting, cast bracing, internal fixation and external fixation. The aim of this study is to present our results with internal fixation of subtrochanteric femoral fractures in children using a reconstruction plate. Between 2000 and 2004, eighteen patients with closed subtrochanteric femoral fractures were treated in the Mansoura Emergency Hospital. The average age at the time of injury was 8.2 years (range 5.3 years to 11.5 years). Pathological fractures and fractures associated with neuromuscular diseases were excluded from this study. Eight patients had head injuries and/or multiple injuries. In all cases a single 4.5 mm contoured reconstruction plate was used and a 6.5 mm cancellous screw was inserted through the plate into the femoral neck. Average follow-up was 38 months (range, 12 to 47 months). All fractures united with anatomical alignment within an average of 8 weeks (range 6 to 12 weeks). There were no deep infections and no significant limb length discrepancies. At the latest follow-up, no patient had any restriction of activities. Internal fixation with a reconstruction plate appears as a good treatment option for children with subtrochanteric femoral fractures.

  16. Proximal Focal Femoral Deficiency

    Directory of Open Access Journals (Sweden)

    Vishal Kalia, Vibhuti

    2008-01-01

    Full Text Available Proximal focal femoral deficiency (PFFD is a developmental disorder of the proximal segment of thefemur and of acetabulum resulting in shortening of the affected limb and impairment of the function. It isa spectrum of congenital osseous anomalies characterized by a deficiency in the structure of the proximalfemur. The diagnosis is often made by radiological evaluation which includes identification and descriptionof PFFD and evaluation of associated limb anomalies by plain radiographs. Contrast arthrography orMagnetic Resonance Imaging is indicated when radiological features are questionable and to disclose thepresence and location of the femoral head and any cartilagenous anlage. The disorder is more commonlyunilateral and is apparent at birth. However, bilateral involvement is rarely seen. Therapy of the disorder isdirected towards satisfactory ambulation and specific treatment depending on the severity of dysplasia.

  17. Proximal Focal Femoral Deficiency

    OpenAIRE

    Vishal Kalia, Vibhuti

    2008-01-01

    Proximal focal femoral deficiency (PFFD) is a developmental disorder of the proximal segment of thefemur and of acetabulum resulting in shortening of the affected limb and impairment of the function. It isa spectrum of congenital osseous anomalies characterized by a deficiency in the structure of the proximalfemur. The diagnosis is often made by radiological evaluation which includes identification and descriptionof PFFD and evaluation of associated limb anomalies by plain radiographs. Contra...

  18. Enamel Hypoplasia of Deciduous Canine

    OpenAIRE

    加納, 隆; 平出, 百合子; 舟津, 聡; 峯村, 隆一; 恩田, 千爾; 正木, 岳馬

    1993-01-01

    From observation of frequency and measurement of the lengths and widths of enamel hypoplasia on the maxillary and mandibular deciduous canines, extracted from 50 Indians' skulls, the following results were obtained. 1) Enamel hypoplasia occurred in 15% of the maxillary deciduous canines and 44% of the mandibular deciduous canines. 2) Symmetrical cases of enamel hypoplasia occurred in 8.0% of the maxillary deciduous canins and in 34% of the mandibular deciduous canines. The enamel hypoplasia o...

  19. Neck Injuries and Disorders

    Science.gov (United States)

    ... or upper arms. Muscle strain or tension often causes neck pain. The problem is usually overuse, such as from ... or accidents, including car accidents, are another common cause of neck pain. Whiplash, a soft tissue injury to the neck, ...

  20. Narrowing of the neck in resurfacing arthroplasty of the hip: a radiological study.

    Science.gov (United States)

    Hing, C B; Young, D A; Dalziel, R E; Bailey, M; Back, D L; Shimmin, A J

    2007-08-01

    Narrowing of the femoral neck after resurfacing arthroplasty of the hip has been described previously in both cemented and uncemented hip resurfacing. The natural history of narrowing of the femoral neck is unknown. We retrospectively measured the diameter of the femoral neck in a series of 163 Birmingham hip resurfacings in 163 patients up to a maximum of six years after operation to determine the extent and progression of narrowing. There were 105 men and 58 women with a mean age of 52 years (18 to 82). At a mean follow-up of five years, the mean Harris hip score was 94.8 (47 to 100) and the mean flexion of the hip 112.5 degrees (80 degrees to 160 degrees ). There was some narrowing of the femoral neck in 77% (125) of the patients reviewed, and in 27.6% (45) the narrowing exceeded 10% of the diameter of the neck. A multiple logistic regression analysis showed a significant association (chi-squared test (derived from logistic regression) p = 0.01) of narrowing with female gender and a valgus femoral neck/shaft angle. There was no significant association between the range of movement, position or size of the component or radiological lucent lines and narrowing of the neck (chi-squared test; p = 0.10 (flexion), p = 0.08 (size of femoral component), p = 0.09 (size of acetabular component), p = 0.71 (femoral component angulation), p = 0.99 (lucent lines)). There was no significant difference between the diameter of the neck at a mean of three years (2.5 to 3.5) and that at five years (4.5 to 5.5), indicating that any change in the diameter of the neck had stabilised by three years (sign rank test, p = 0.60). We conclude that narrowing of the femoral neck which is found with the Birmingham hip resurfacing arthroplasty is in most cases associated with no adverse clinical or radiological outcome up to a maximum of six years after the initial operation.

  1. Groove model of tibia-femoral osteoarthritis in the rat.

    Science.gov (United States)

    de Visser, Huub M; Weinans, Harrie; Coeleveld, Katja; van Rijen, Mattie H P; Lafeber, Floris P J G; Mastbergen, Simon C

    2017-03-01

    Several experimental models of osteoarthritis in rats are used to study the pathophysiology of osteoarthritis. Many mechanically induced models have the limitation that permanent joint instability is induced by, for example, ligament transection or meniscal damage. This permanent instability will counteract the potential beneficial effects of therapy. The groove model of osteoarthritis uses a one-time trigger, surgically induced cartilage damage on the femoral condyles, and has been validated for the canine tibia-femoral compartment. The present study evaluates this model for the rat knee joint. The articular cartilage of the weight bearing surface of both femoral condyles and trochlea were damaged (grooved) without damaging the underlying subchondral bone. Severity of joint degeneration was histologically assessed, in addition to patella cartilage damage, and subchondral bone characteristics by means of (contrast-enhanced) micro-CT. Mild histological degeneration of the surgically untouched tibial plateau cartilage was observed in addition to damage of the femoral condyles, without clear synovial tissue inflammation. Contrast enhanced micro-CT demonstrated proteoglycan loss of the surgically untouched patella cartilage. Besides, a more sclerotic structure of the subchondral bone was observed. The tibia-femoral groove model in a rat results in mild knee joint degeneration, without permanent joint instability and joint inflammation. This makes the rat groove model a useful model to study the onset and progression of post-traumatic non-inflammatory osteoarthritis, creating a relatively sensitive model to study disease modifying osteoarthritic drugs. © 2016 The Authors. Journal of Orthopaedic Research published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society. J Orthop Res 35:496-505, 2017.

  2. A semi-automated method for measuring femoral shape to derive version and its comparison with existing methods.

    Science.gov (United States)

    Berryman, F; Pynsent, P; McBryde, C

    2014-11-01

    The measurement of femoral version is important in surgical planning of derotational osteotomies particularly for patients with proximal femoral deformity. It is, however, difficult to measure version accurately and differences of 10° to 15° have been found between repeated measurements. The aim of this work was first to develop a method of measuring femoral version angle where the definition of the neck axis is based on the three-dimensional point cloud making up the neck, second to automate many of the processes involved thus reducing the influence of human error and third to ensure the method could run on freely available software suitable for most computer platforms. A CT scan was performed on 44 cadaveric femurs to generate point clouds of the femoral surfaces. The point clouds were then analysed semi-automatically to determine femoral version angle between a neck axis defined by the bone surface points belonging only to the neck and a femoral condylar axis. The results from the neck fitting method were compared against three other methods typically used in the clinic (Murphy, Reikeras and Lee methods). Version angle measured by the new method gave 19.1° ± 7.3° (mean ± standard deviation) for the set of cadaveric femurs, 3.5° lower than the Murphy method and 6.8° and 11.0° higher than the Reikeras and Lee 2D methods respectively. The results demonstrate a method of measuring femoral version angle incorporating a high level of automation running on free software.

  3. Progressive slippage after pinning for slipped capital femoral epiphysis.

    Science.gov (United States)

    Sanders, James O; Smith, William J; Stanley, Earl A; Bueche, Matthew J; Karol, Lori A; Chambers, Henry G

    2002-01-01

    The authors retrospectively reviewed seven cases of progressive slipped capital femoral epiphysis after screw fixation. All seven patients initially presented with chronic symptoms, and five had an acute exacerbation of symptoms with the appearance of an acute-on-chronic slip. Of the other two, one had obvious motion at the proximal femoral physis and the other had increased symptoms but did not have an obvious acute slip radiographically. All underwent percutaneous screw fixation. In four patients a single screw was placed, and in three patients two screws were placed. No patient became symptom-free after surgery. Slip progression was noted on average 5 months after treatment. Radiographs in all patients revealed an increase in slip severity and loss of screw purchase in the femoral neck while fixation in the proximal femoral epiphysis remained secure. One patient had hypothyroidism and another Cushing disease, both diagnosed after the slipped epiphysis. Slips occurring in children with underlying endocrinopathies, and unstable slips in children with a history of antecedent knee or hip pain (commonly called an acute-on-chronic slip) may be susceptible to screw fixation failure. In such patients, close radiographic follow-up, particularly in the presence of continued symptoms, is required to document slip progression and fixation failure as soon as possible.

  4. Femoral pseudoaneurysms in drug addicts

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Rørdam, Peter; Jensen, L P

    1997-01-01

    OBJECTIVE: To evaluate the outcome of treatment of femoral pseudoaneurysms in drug addicts. METHODS: The records of eight patients undergoing vascular surgery for femoral pseudoaneurysms from substance abuse identified from a vascular database were reviewed. RESULTS: Were good in four out of five...

  5. ASSESSMENT OF RELATIONSHIP BETWEEN NECK SHAFT ANGLE AND NECK LENGTH WITH INTEREPICONDYLAR DISTANCE IN FEMUR

    Directory of Open Access Journals (Sweden)

    Ishita Ghosh

    2015-12-01

    Full Text Available Background: Femur is the longest and strongest bone of the body. It transmits body weight from hip bone to tibia in standing position. Femoral neck is a constricted part connecting head with shaft at an angle of about 125°-known as angle of inclination or neck shaft angle (NSA; this facilitates the movement of hip joint enabling the limb to swing clear of pelvis. Abnormal femoral neck angle (FNA may be associated with various clinical problems ranging from harmless in toeing gait in childhood to disabling osteoarthritis in adults. The current study attempted to find out if a co-relation exists between those parameters and other clinically measurable variables like inter-epicondylar distance or distance between greater trochanter to lateral epicondyle. This may help to predict the risk of fracture neck femur without any risk of radiation exposure and proper prophylactic measures can be undertaken (Vit-D, calcium to decrease risk of fracture. Results: Measurements were taken in dry femora mostly in East Indian population. Variables that were measured in 158 dry femora (85 femora from left side and 73 from the right side are: - a Neck shaft angle of femur, b Neck length of femur, c Neck circumference of femur, d Inter-epicondylar distance of femur, e Distance between lateral epicondyle and greater trochanter of femur. No significant difference was found between the right and left sided femoral groups regarding any of the study variables. From the analysis it was revealed that no positive or negative correlation exists between the study variables. Therefore, it is not possible to predict the value of one or more of them from the magnitude of the other variable(s. Conclusions: Our study attempted to find out if it was possible to predict the risk of fracture neck femur by simple clinical procedure without exposing the subjects to radiation hazards associated with a radiological imaging. A screening test and subsequent prophylactic measures could

  6. A multiple correlation factors analysis of avascular necrosis after closed reduction and cannulated compression screws fixation of intra-capsular femoral neck fracture.A multi-center retrospective study%股骨颈骨折闭合复位加压螺纹钉内固定术后股骨头坏死多中心多因素相关分析

    Institute of Scientific and Technical Information of China (English)

    周锦春; 郭敦明; 王青; 陈哲峰; 崔维顶; 范卫民; 刘锋

    2013-01-01

    Objective To determine the incidence of avascular necrosis after closed reduction and cannulated compression screws fixation of intra-capsular femoral neck fracture and to investigate the multiple factors correlated to avascular femoral head necrosis.Methods All the patients of intra-capsular femoral neck fracture who accepted closed reduction and cannulated compression screws fixation between 2001 and 2010 in Jiangsu Province were reviewed in multi-centers retrospectively.The multiple factors were analyzed including age,gender,affected side,mechanism of injury,fracture classification,procedure delay,quality of reduction,time of full-weight-bearing,configuration of the screws and removal of the screws.Multiple correlation factors were analyzed with SPSS 13.0 statistic system.Results Complete case records were documented in 1849 cases who were followed up for an average 6.5±2.7 years (range,2-10 years).Avascular necrosis occurred in 246 cases (13.3%).The average time of diagnosis of avascular necrosis was 17±4.6months (range,8-72 months) after injury.The average Harris score of the hips which didn't develop to avascular necrosis was 93.8±8.9 (range,78~100) at the last follow up.Multiple correlation factors analysis indicated that displacement degrees of fracture and the quality of reduction were significantly correlated to the incidence of avascular necrosis (OR=2.078,3.423).Conclusion Closed reduction and cannulated compression screws fixation after the intra-capsular femoral neck fracture can get satisfactory results.Displacement degrees of fracture and the quality of reduction are significantly correlated to the incidence of avascular femoral head necrosis.%目的 调查股骨颈骨折闭合复位加压螺纹钉内固定术后股骨头坏死的发生率,探讨各影响因素与股骨头坏死的相关性.方法 对江苏地区2001至2010年期间接受闭合复位加压螺纹钉内固定治疗的股骨颈骨折患者进行回顾性调查.以股骨头坏

  7. Femoral anatomy of Aegyptopithecus zeuxis, an early oligocene anthropoid.

    Science.gov (United States)

    Ankel-Simons, F; Fleagle, J G; Chatrath, P S

    1998-08-01

    Three partial femora from Quarries I and M of the early Oligocene Jebel Qatrani Formation in the Fayum of Egypt are attributed to Aegyptopithecus zeuxis on the basis of their appropriate size and anthropoid morphology. Compared with extant catarrhines, Aegyptopithecus is unusual in having a distinct gluteal tuberosity (third trochanter) and a relatively deep distal femoral articulation. In the estimated neck angle, Aegyptopithecus resembles arboreal quadrupeds rather than either leaping or suspensory primates. It seems likely that the femur of this species was relatively robust and short for its body mass. In aspects of its femoral anatomy, Aegyptopithecus is quite different from the parapithecid Apidium and more similar to Catopithecus from late Eocene deposits of the Fayum, and also to small hominoids from the Miocene of East Africa.

  8. 鲑鱼降钙素围手术期应用对骨质疏松性股骨颈骨折镇痛效果的随机对照研究%Randomized controlled trials assessing the analgesic effect of perioperative application of salmon calcitonin on osteoporotic femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    李晓菲; 刘国伟; 朱玉磊; 张天龙; 朱明双

    2011-01-01

    目的 探讨骨质疏松症(OP)性股骨颈骨折疼痛的缓解作用.方法 将68例拟进行人工全髋置换术或人工半髋置换术的患者随机分为试验组和对照组,其中试验组34例,给予鲑鱼降钙素治疗;对照组34例,给予双氯芬酸钠双释放肠溶胶囊治疗.观察指标:术前第3天、术后第1天、术后第4天和术后第7天,两组患者均行VAS评分,以评估疼痛改善的情况.结果 术后第1天双氯芬酸钠双释放肠溶胶囊的止痛效果优于鲑鱼降钙素(P<0.05);至术后第7天,鲑鱼降钙素的止痛效果则优于双氯芬酸钠双释放肠溶胶囊(P<0.05).结论 在急性创伤反应期双氯芬酸钠双释放肠溶胶囊的止痛作用优于鲑鱼降钙素,随着创伤反应的减轻,其止痛作用有限,而鲑鱼降钙素的止痛作用逐渐显现,其止痛效果可能与改善OP性骨痛作用有关.%Objective To evaluate the pain relief effect of calcitonin salmon for osteoporotic femoral neck fractures in perioperative period ( preoperative three days to postoperative seven days ). Methods 68 patients who accepted total hip replacement ( THR ) or artificial half hip arthroplasty were randomly divided into trial group and control group. Trial group ( 34 patients ) were given calcitonin salmon and control group ( 34 patients ) were given Diclofenac sodium double release Intestine-sol Capsule. Observing indexes : on the lst day before operation and, respectively on the 1st, 4th and 7th day after the operation, both groups used the scores of VAS to estimate the pain improvement. Results The pain relief effectiveness of Diclofenac sodium double release Intestine-sol Capsule was better than calcitonin salmon at the 1st day after the operation ( P< 0. 05 ). On the 7th day after the operation calcitonin salmon was superior to Diclofenac sodium double release Intestine-sol Capsule ( P < 0. 05 ). Conclusions During the period of the acute traumatic reaction, the pain relief effect of Diclofenac

  9. A Comparison of General and Epidural Anaesthesia for Hip Replacement of Femoral Neck Fracture in the Elderly%全身麻醉和硬膜外麻醉对老年股骨颈骨折髋关节置换术的影响

    Institute of Scientific and Technical Information of China (English)

    岳喜军; 唐雪彬; 曹贞国; 魏东

    2016-01-01

    Objective:To explore a reasonable anesthesia method for the hip replacement in elder patients suffered from femoral neck fractures by comparing the effect of general and epidural anaesthesia .Methods:A total of 91 patients were treated with hip joint replacement .50 patients received general anaesthesia ,the other patients received epidural anaes‐thesia .Operating time ,blood loss ,post‐operative transfusion ,post‐operative nausea and vomiting ,urinary retention and the length of hospital stay were assessed .Results:There was statistical significance in post‐operative nausea and vomi‐ting ,post‐operative transfusion and the length of hospital stay between the two anesthesia method(P0 .05) .Conclusion:Compared with general anaesthesia ,the epidural anaesthesia decrease the incidence of post‐operative nausea and vomiting and post‐op‐erative transfusion ,and also shorten the length of hospital stay ,which is a better anesthesia method for the hip arthro‐plasty operation .%目的:评价全身麻醉与硬膜外麻醉对老年股骨颈骨折患者髋关节置换手术的影响,探讨适合老年患者行髋关节置换术的麻醉方法。方法:共91例老年股骨颈骨折患者接受髋关节置换术。其中全身麻醉组50例,硬膜外麻醉组41例。比较2种麻醉方法在手术时间、出血量、术后输血量、术后恶心呕吐、术后尿潴留、住院天数等方面的指标。结果:硬膜外麻醉组患者在术后恶心呕吐、术后输血量、住院天数优于全身麻醉组,差异有统计学意义(P<0.05);手术时间、出血量、术后尿潴留方面比较,差异无统计学意义(P>0.05)。结论:老年股骨颈骨折患者行髋关节置换术时,实施硬膜外麻醉方法与全身麻醉方法相比,硬膜外麻醉方法能降低术后恶心呕吐发生率,减少术后输血量,缩短住院时间,有一定的优越性,值得推荐。

  10. Focal femoral condyle resurfacing.

    LENUS (Irish Health Repository)

    Brennan, S A

    2013-03-01

    Focal femoral inlay resurfacing has been developed for the treatment of full-thickness chondral defects of the knee. This technique involves implanting a defect-sized metallic or ceramic cap that is anchored to the subchondral bone through a screw or pin. The use of these experimental caps has been advocated in middle-aged patients who have failed non-operative methods or biological repair techniques and are deemed unsuitable for conventional arthroplasty because of their age. This paper outlines the implant design, surgical technique and biomechanical principles underlying their use. Outcomes following implantation in both animal and human studies are also reviewed. Cite this article: Bone Joint J 2013;95-B:301-4.

  11. Modular titanium alloy neck failure in total hip replacement: analysis of a relapse case.

    Science.gov (United States)

    Ceretti, Marco; Falez, Francesco

    2016-04-29

    Modular neck hip prosthesis born in the 1990 with the aim of allowing the surgeon to modify CCD angle, offset and femoral anteversion intra-operatively restoring patient's original biomechanics. In order to achieve the best biomechanics of the reconstructed hip, preoperative planning is essential. In the last few years modularity has been questioned and an argument made for the return to mono block stems due to events of breakage or disconnection of modular components. Fretting or crevice corrosion may lead to failure of such modular device due to the contamination inside the modular coupling or to high loads. We present a case of repetitive modular femoral neck prosthesis fracture.

  12. The ligaments of the canine hip joint revisited.

    Science.gov (United States)

    Casteleyn, C; den Ouden, I; Coopman, F; Verhoeven, G; Van Cruchten, S; Van Ginneken, C; Van Ryssen, B; Simoens, P

    2015-12-01

    Numerous conventional anatomical textbooks describe the canine hip joint, but many contradictions, in particular regarding the ligament of the femoral head, are present. This paper presents a brief overview of the different literature descriptions. These are compared with own observations that have resulted in a revised description of the anatomy of the ligament of the femoral head in the dog. To this purpose, the hip joints of 41 dogs, euthanized for reasons not related to this study and devoid of lesions related to hip joint pathology, were examined. It was observed that the ligament of the femoral head is not a single structure that attaches only to the acetabular fossa, as generally accepted, but it also connects to the transverse acetabular ligament and is complemented by a strong accessory ligament that courses in caudal direction to attach in the elongation of the acetabular notch that extends on the cranioventral surface of the body of the ischium. The description of this accessory ligament in conventional anatomical handbooks is incomplete. This description of the accessory ligament of the femoral head could support the research unravelling the etiopathogenesis of hip instability.

  13. Indications for the microvascular medial femoral condylar flap in craniomaxillofacial surgery.

    Science.gov (United States)

    Thiele, Oliver Christian; Kremer, Thomas; Kneser, Ulrich; Mischkowski, Robert Andreas

    2014-07-01

    The medial femoral condylar flap makes it possible to reconstruct bone, cartilage, and skin, but elongation of the pedicle is usually required to bridge the distances to the vascular connections in the neck. The indications in the maxillofacial area include reconstruction of the temporomandibular joint (TMJ), pseudarthrosis of the jaws, osteonecrosis of the jaws and skull, and augmentation of bone in irradiated or otherwise compromised tissue. If small bony defects require safe and reliable osseous, osteochondral, or osteocutaneous reconstruction, the medial femoral condylar flap can be used to fill the gap between small avascular, and larger microvascular, bone transplants.

  14. Femoralni trikotnik: The femoral triangle:

    OpenAIRE

    Mlakar, Boštjan; Ravnik, Dean

    1999-01-01

    The topography and structures of the femoral triangle are presented. The femorai triangle lies between the inguinal ligament at the base, the sartoriusmuscle at the lateral border and the long adductor muscle at the medial border. The apex of the femoral triangle is situated at the meeting point of the medial borders of the sartorius and long adductor muscles. The subinguinal space, which is divided into the lacuna musculorum and lacuna vasorum, provides a passageway for the lateral cutaneous...

  15. Is there added risk in resurfacing a femoral head with cysts?

    Directory of Open Access Journals (Sweden)

    Liu Fei

    2011-10-01

    Full Text Available Abstract Background Femoral head cysts have been identified as a risk factor for early femoral failures after metal-on-metal hip resurfacing arthroplasty (HRA based on limited scientific data. However, we routinely performed HRA if less than 1/3 of the femoral head appeared destroyed by cysts on the preoperative radiograph. This study was undertaken to analyze whether there was an added risk of early femoral failures in HRA when femoral head cysts were present. Methods This retrospective case-control study included 939 MOM HRAs operated by a single surgeon with use of the posterior minimally invasive surgical (MIS approach between November 2005 and January 2009. Patients with all diagnoses except osteonecrosis were included. Among them, 117 HRAs had femoral head cysts ≥ 1 cm identified in surgery. All cysts were treated with bone grafting using acetabular reamings packed into the cavitary defect (instead of filling the cysts with cement. The control group, which had no cyst observed at the time of surgery, was randomly selected from our database using computer algorithms to match those cases in the study group for the parameters of surgical date, age, gender, body mass index, diagnosis, femoral fixation method, and the size of the femoral component. Results The minimum follow-up was 24 months for both groups. The early femoral failure rate in the study group was 3/117 (2.6% and 0/117 in the control group; there was no statistical difference between these two groups (P = 0.08. In the study group, there were two femoral neck fractures (revised: both occurred in patients having a cyst size of 1 cm3; and there was one femoral component loosening at 3-year follow up in a patient having a cyst size of 2 cm3. Conclusion Although the risk of early femoral failures among the group with cysts appeared higher than the group without cysts, we could not demonstrate a significant statistical difference between the two groups. It is possible that bone

  16. A locked hip screw-intramedullary nail (cephalomedullary nail) for the treatment of fractures of the proximal part of the femur combined with fractures of the femoral shaft.

    Science.gov (United States)

    Alho, A; Ekeland, A; Grøgaard, B; Dokke, J R

    1996-01-01

    Twenty-seven patients with complex femoral fractures (combined shaft and proximal femoral fractures) were treated with a modified Grosse-Kempf slotted locking nail (cephalomedullary nail), wherein two screws were inserted in the hip. Four types of complex, multifocal femoral fractures were represented in the series. Eleven of the femoral shaft fractures were secondary to a previous, internally fixed, not yet united hip fracture (type I). Ten comminuted peritrochanteric fractures occurred in normal bone (type II). Three similar fractures were pathologic because of metastasis. Two patients had an ipsilateral fracture of the femoral shaft and the trochanteric area (type III), and one of the shaft and the femoral neck (type IV). Locking was made static in 24 cases. Additional cerclage wiring was used in three type II fractures. Five complications were as follows: one cutting out of a screw in the femoral head, two fractures of the nail, one deep venous thrombosis, and one wound hematoma. Reoperations were two salvage operations using a new nail and one evacuation of hematoma. One patient with multiple injuries and four elderly patients died within 2 months. Eighteen patients with fractures in normal bone were followed for a median of 20 (6 to 37) months. All fractures united. Two nails were removed. The end result was excellent in ten patients, good in seven, and fair in one (2-cm shortening and 20-degree external rotation). We conclude that a locked intramedullary construct with locking screws in femoral neck and distal femur controls a complex fracture situation well.

  17. Vaccines for Canine Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Faeze Foroughi-Parvar

    2014-01-01

    Full Text Available Leishmania infantum is the obligatory intracellular parasite of mammalian macrophages and causes zoonotic visceral leishmaniasis (ZVL. The presence of infected dogs as the main reservoir host of ZVL is regarded as the most important potential risk for human infection. Thus the prevention of canine visceral leishmaniasis (CVL is essential to stop the current increase of the Mediterranean visceral leishmaniasis. Recently considerable advances in achieving protective immunization of dogs and several important attempts for achieving an effective vaccine against CVL lead to attracting the scientists trust in its important role for eradication of ZVL. This paper highlights the recent advances in vaccination against canine visceral leishmaniasis from 2007 until now.

  18. Pigmented Villonodular Synovitis Causing Osteonecrosis of the Femoral Head: A Case Report

    Directory of Open Access Journals (Sweden)

    Tomohiro Mimura

    2013-01-01

    Full Text Available We report a case of a 27-year-old man with pigmented villonodular synovitis of the hip joint with coincident osteonecrosis of the femoral head. According to our review of the English-language literature, no detailed report of osteonecrosis of the femoral head complicated with pigmented villonodular synovitis has been published. Preoperative X-ray images showed joint narrowing and severe multiple bone erosions at the acetabulum and femoral neck. Magnetic resonance imaging revealed a low-intensity band attributable to osteonecrosis of the femoral head and massive diffuse pigmented villonodular synovitis lesions. Comparison of a three-dimensional computed tomographic image of this patient with an angiographic image of a normal individual demonstrated proximity of the pigmented villonodular synovitis-induced bone erosions to the medial and lateral femoral circumflex arteries and retinacular arteries, suggesting likely the compromise of the latter by the former. We propose that the massive pigmented villonodular synovitis may have contributed to the pathogenesis of osteonecrosis of the femoral head in this patient. We performed open synovectomy and total hip arthroplasty. No operative complications occurred, and no recurrence of the pigmented villonodular synovitis was detected for 3 years after the operation.

  19. Neck x-ray

    Science.gov (United States)

    X-ray - neck; Cervical spine x-ray; Lateral neck x-ray ... There is low radiation exposure. X-rays are monitored so that the lowest amount of radiation is used to produce the image. Pregnant women and ...

  20. EVALUATION OF NECK SHAFT ANGLE OF FEMUR ON DRY BONES

    Directory of Open Access Journals (Sweden)

    Radha

    2015-04-01

    Full Text Available BACKGROUND: Evaluation of the neck shaft angle of femur helps to understand clinical relevance in bio mechanics of the hip joint. It helps for the better treatment of different pathological conditions of hip and femur and also to design prosthesis. Femoral neck shaft angle is important to convey the information regarding the race to which they belong. Hence the present study was under taken to determine the neck shaft angle of femur in humans. OBJECTIVE: 1. To correct the different types of deformity and to have a normal good walking Mechanism. 2. To know the recent methodology and attempt to evaluate the range of normal Angles of femora and their sex differences. METHODS: ANTHROPOMETRIC: 100 Adult dry bones were studied and analyzed . The neck shaft angle of femur was measured by tracing outlines of contours of all femora. RESULTS: The neck shaft angle of the femur have revealed that there is no much difference in between males and females. There was slightly higher 0.2° in females. INTERPRETATION & CONCLUSION: There was no significant gender difference in neck shaft angle. The Knowledge of knowing the neck shaft angle helps to understand the Biomechanics of the hip joint and also for better treatment of pathological condition of hip and femur.

  1. Mathematical formulae to calculate the theoretical range of motion of prosthetic hip implants with non-circular neck geometry.

    Science.gov (United States)

    Ellison, Peter

    2012-10-01

    Component design and position are major factors in achieving adequate range of motion post hip replacement. It is therefore important to understand how implant design and positioning impact the motion available before impingement. The Yoshimine-Ginbayashi equations allow the theoretical range of motion of total hip replacements to be calculated accurately and quickly. However, a significant limitation of these equations is that they can only be applied to femoral neck geometry with a circular cross section. The objective of the present study was to reformulate the equations to allow fast and accurate calculation of the range of motion for prostheses with any femoral neck geometry. Using vector analysis, formulae were derived such that the range of motion could be calculated from the cross section of the neck at the point of impingement, cup radius at the point of impingement, cup inclination angle, cup anteversion angle, neck angle of the femoral component from the transverse plane and neck anteversion. The range of motion was calculated for circular, truncated circle and free-form femoral neck geometry under a range of component positions. These values were successfully compared with those measured from analysis of solid models in three-dimensional computer-aided design software. The method of analysis presented offers a powerful new technique enabling hip prostheses to be analysed in an accurate and efficient manner, therefore facilitating optimisation of the design geometry, assessment of existing pre-clinical designs and clinical pre- or postoperative evaluation.

  2. Canine pulmonary angiostrongylosis

    DEFF Research Database (Denmark)

    Koch, Jørgen; Willesen, Jakob Lundgren

    2009-01-01

    Canine pulmonary angiostrongylosis is an emerging snail-borne disease causing verminous pnemonia and coagulopathy in dogs. The parasite is fund in Europe, North and South America and Africa, covering tropical, subtropical and temperate regions. Its distribution has been characterised by isolated ...

  3. Cadaveric study: study of lateral circumflex femoral arterial origin in Rajkot

    Directory of Open Access Journals (Sweden)

    Pradip Rameshbhai Chauhan

    2015-05-01

    Full Text Available Background: Lateral circumflex femoral artery contributes cruciate, trochanteric and knee joint anastomosis. In addition Lateral circumflex femoral artery flaps are used for the reconstruction of large tissue loss in the head and neck region, aortopopliteal bypass, coronary artery bypass grafting and extracranial intracranial bypass surgery. This work was carried out (a to study the origin of lateral circumflex femoral artery and (b to measure and compare (between male and female the circumference at its origin. Methods: In this cross sectional study, 51 femoral triangles from 26 (18 male and 08 female human adult cadavers were dissected and studied at P.D.U. government medical college, Rajkot, Gujarat. Site of origin of lateral circumflex femoral artery was identified and noted. The distance of origin of the artery from the origin of profunda femoris artery was measured and noted. Circumference at the level of origin was measured and diameter was calculated. Collected data was analysed by standard statistical formulas with the help of Microsoft excel 2013 and Epi info 7TM software. Results: 90.19% lateral circumflex femoral arteries originated from the profunda femoris artery and remaining 9.81% from the femoral artery. The mean distance of origin of the artery from the origin of profunda femoris artery was 18.44 mm. Lateral circumflex femoral artery circumference and diameter were significantly different between male and female (95% confidence interval, P <0.05. Conclusion: In this presented study maximum distance of origin of the artery from the origin was 65 mm while minimum distance of origin was 6 mm. In addition difference in circumference of the artery was statistically significant. [Int J Res Med Sci 2015; 3(5.000: 1066-1069

  4. Vaccines for canine leishmaniasis

    Directory of Open Access Journals (Sweden)

    Clarisa B. Palatnik-De-Sousa

    2012-04-01

    Full Text Available Leishmaniasis is the third most important vector-borne disease worldwide. Visceral leishmaniasis (VL is a severe and frequently lethal protozoan disease of increasing incidence and severity due to infected human and dog migration, new geographical distribution of the insect due to global-warming, co-infection with immunosuppressive diseases and poverty. The disease is an anthroponosis in India and Central Africa and a canid zoonosis (ZVL in the Americas, the Middle East, Central Asia, China and the Mediterranean. The ZVL epidemic has been controlled by one or more measures including the culling of infected dogs, treatment of human cases and insecticidal treatment of homes and dogs. However, the use of vaccines is considered the most cost-effective control tool for human and canine disease. Since the severity of the disease is related to the generation of T-cell immunosuppression, effective vaccines should be capable of sustaining or enhancing the T-cell immunity. In this review we summarize the clinical and parasitological characteristics of ZVL with special focus on the cellular and humoral canine immune response and review state-of-the-art vaccine development against human and canine visceral leishmaniasis. Experimental vaccination against leishmaniasis has evolved from the practice of leishmanization with living parasites to vaccination with crude lysates, native parasite extracts to recombinant and DNA vaccination. Although more than 30 defined vaccines have been studied in laboratory models no human formulation has been licensed so far; however three second-generation canine vaccines have already been registered. As expected for a zoonotic disease, the recent preventive vaccination of dogs in Brazil has led to a reduction in the incidence of canine and human disease. The recent identification of several Leishmania proteins with T-cell epitopes anticipates development of a multiprotein vaccine that will be capable of protecting both humans

  5. The unipolar ASR : Viable option in unsalvageable femoral head conditions in the young patient

    Directory of Open Access Journals (Sweden)

    Marya SKS

    2006-01-01

    Full Text Available Background: The management of unsalvageable femoral head conditions in the young patient has remained an unresolved dilemma. Articular surface replacement of the hip has recently made some headway in terms of providing near-normal hip joint mechanics and function. However, this surgery has been limited to early stages of arthritis only with reasonable maintenance of head-neck congruity and morphology. Femoral neck fractures, osteonecrosis with large segment collapse, advanced arthritis with femoral incongruity, etc are traditional contraindications to the resurfacing technique. Methods: We present here a report on our series of 20 cases of unsalvageable femoral heads in young patients (age range, 27 to 52yrs, over a twelve month period (Aug 2004 to Jul 2005, treated with the unipolar ASR prosthesis. Fifteen patients (two had bilateral hip pathology had primary or secondary arthritis (degenerative, post-traumatic, ankylosing spondylitis and post-avascular necrosis while three had old operated femoral neck fractures. All patients underwent hip replacement surgery using the Unipolar ASR prosthesis. Results: Clinical and radiological results at 6-month follow up have been very encouraging and warrant further study. At an average of 4 months post-operatively, patients were able to squat, sit on the ground and perform light sporting activities. Conclusions: The Unipolar ASR prosthesis is an extension of the articular resurfacing technique employing similar principles (large size bearings, metal-on-metal interfaces, and has incorporated the advantages of the uncemented technique. We propose that this technique be more frequently used so as to brighten the prognosis of the young active patient with unsalvageable hip conditions, especially in the Asian scenario.

  6. Evaluation of radiation resistance of the bacterial contaminants from femoral heads processed for allogeneic transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Rita [Radiation Dosimetry and Processing Group, Defence Laboratory, Jodhpur 342011 (India)], E-mail: singhritadr@yahoo.com; Singh, Durgeshwer [Radiation Dosimetry and Processing Group, Defence Laboratory, Jodhpur 342011 (India)

    2009-09-15

    Femoral heads excised during surgery were obtained from patients who had a fractured neck of the femur and were processed as bone allograft. The bacterial contaminants were isolated from femoral heads at different stages of processing and identified based on morphological characteristics and biochemical tests. Bacterial contaminants on bone were mainly Gram-positive bacilli and cocci (58.3%). Twenty-four isolates from bone samples were screened for resistance to radiation. The D{sub 10} values for Gram-negative bacteria isolated from femoral heads ranged from 0.17 to 0.65 kGy. Higher D{sub 10} values 0.56-1.04 kGy were observed for Gram-positive bacterial isolates.

  7. Recurrent femoral hernia and associated ovarian pathology.

    Science.gov (United States)

    Gately, Ryan Patrick; Concannon, Elizabeth Sarah; Hogan, A; Ryan, R S; O'Leary, M; Barry, K

    2012-08-27

    The following case describes an ovarian tumour presenting in a highly unusual manner-in the form of a recurrent femoral hernia. Recurrent femoral herniae are unusual and should prompt awareness of underlying pathology causing increased intra-abdominal pressure.

  8. [Chondrosarcoma of the femur neck simulating a normal variant. A difficult diagnostic pitfall].

    Science.gov (United States)

    Lerais, J M; Baudrillard, J C; Hulin, P H; Laredo, J D; Devillebichot, C

    1991-05-01

    We report a case of chondrosarcoma of the femoral neck wrongly considered as a normal variant during a long time due to the initial aspect on the plain films and its location. Precise radiological criteria must allow the differential diagnosis and will be detailed.

  9. Femoral hernia; Clinical significance of radiologic diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Bergenfeldt, M.; Lasson, A. (Lund University (Sweden). Department of Surgery Malmo General Hospital (Sweden)); Ekberg, O.; Kesek, P. (Lund University (Sweden). Department of Radiology Malmo General Hospital (Sweden))

    A retrospective study of 18 patients with femoral hernia assessed by herniography is presented. Although a palpable lump was present in 11 patients (61%), the diagnosis of a femoral hernia was not made before herniography. Surgical exploration was performed in 12 patients and a femoral hernia was found and repaired with beneficial outcome in 9 of them. In conclusion: herniography is of value for the diagnosis of a femoral hernia in patients with obscure groin pain. (author). 14 refs.; 2 figs.

  10. Three-dimensional magnetic resonance imaging analysis of hip morphology in the assessment of femoral acetabular impingement

    Energy Technology Data Exchange (ETDEWEB)

    Kavanagh, E.C. [Department of Radiology, Mater Misericordiae Hospital, Dublin (Ireland); Read, P.; Carty, F.; Zoga, A.C. [Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Parvizi, J. [The Rothman Institute of Orthopedics, Philadelphia, PA (United States); Morrison, W.B., E-mail: William.Morrison@Jefferson.edu [Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (United States)

    2011-08-15

    Aim: To determine a possible association between femoral-acetabular impingement (FAI) volume and the development of labral tear using a three-dimensional (3D) model reconstruction of the acetabulum and the femoral head. Materials and methods: Magnetic resonance arthrography images of the hip in 42 patients with pain and suspected labral tear were acquired using a 1.5 T MRI machine. Using 3D analysis software, outlines of the acetabular cup and femoral head were drawn and 3D reconstruction obtained. To control for differences in patient size, ratios of acetabulum : femoral head volume (AFV) and acetabulum : femoral head surface area (AFA) were used for analysis. The association between volume of acetabulum : femoral head and FAI was investigated using ANOVA analysis. Results: There were 19 men and 23 women with a mean age of 39 years (range 18-78 years). The average AFV was 0.64 (range 0.37-1.05, SD 0.16) and AFA was 0.73 (range 0.36-1.26, SD 0.23). Herniation pit was significantly associated with a small AFV. Conclusion: Femoral neck herniation pits are associated with a low AFV. Gross volume and surface area ratios do not appear to correlate with labral tears or cartilage loss. This technique will enable more advanced analysis of morphological variations associated with FAI.

  11. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

    Full Text Available Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD, limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD and lateral distal femoral angle (LDFA for the entire group as well as the subgroups. Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction.

  12. [Canine histoplasmosis in Japan].

    Science.gov (United States)

    Sano, Ayako; Miyaji, Makoto

    2003-01-01

    Histoplasmosis is a fungal infection caused by Histoplasma capsulatum and is distributed a worldwide. Although the disease has been treated as an imported mycosis, some autochthonous human, 1 equine and 4 canine cases suggested that the disease is endemic. Histoplasmosis is classified depending on the variety of causative agent. Histoplasmosis farciminosi known as pseudofarcy, is manifested only in Perissodactyla where it invades lymph nodes and lymph ducts, and is recognized by isolation from horses. Historically, Japan was one of the endemic areas of pseudofarcy before World War II, and more than 20,000 cases were recorded in horses used by the military. Interestingly, Japanese canine histoplasmosis uniformly showed skin ulcers and granulomatous lesions on the skin without pulmonary or gastrointestinal involvement, both of which were very similar to pseudofarcy. It was diagnosed as histoplasmosis by the detection of internal transcribed spacer legions of rRNA gene of H. capsulatum from paraffin embedded tissue samples. Furthermore, the fungal isolate from the human case with no history of going abroad or immigrating was identified as H. capsulatum var. farciminosum by a gene sequence. These facts indicated that pseudofarcy is not only an infectious disease in horses, but also a zoonotic fungal infection. Japanese autochthonous canine histoplasmosis might be a heteroecism of pseudofarcy because of its likeness to the human case, the similarity of clinical manifestations and the historical background at this stage.

  13. Design of new generation femoral prostheses using functionally graded materials: a finite element analysis.

    Science.gov (United States)

    Oshkour, A A; Abu Osman, N A; Yau, Y H; Tarlochan, F; Abas, W A B Wan

    2013-01-01

    This study aimed to develop a three-dimensional finite element model of a functionally graded femoral prosthesis. The model consisted of a femoral prosthesis created from functionally graded materials (FGMs), cement, and femur. The hip prosthesis was composed of FGMs made of titanium alloy, chrome-cobalt, and hydroxyapatite at volume fraction gradient exponents of 0, 1, and 5, respectively. The stress was measured on the femoral prosthesis, cement, and femur. Stress on the neck of the femoral prosthesis was not sensitive to the properties of the constituent material. However, stress on the stem and cement decreased proportionally as the volume fraction gradient exponent of the FGM increased. Meanwhile, stress became uniform on the cement mantle layer. In addition, stress on the femur in the proximal part increased and a high surface area of the femoral part was involved in absorbing the stress. As such, the stress-shielding area decreased. The results obtained in this study are significant in the design and longevity of new prosthetic devices because FGMs offer the potential to achieve stress distribution that more closely resembles that of the natural bone in the femur.

  14. Head and Neck

    DEFF Research Database (Denmark)

    Højgaard, Liselotte; Berthelsen, Anne Kiil; Loft, Annika

    2014-01-01

    Positron emission tomography (PET)/computed tomography with FDG of the head and neck region is mainly used for the diagnosis of head and neck cancer, for staging, treatment evaluation, relapse, and planning of surgery and radio therapy. This article is a practical guide of imaging techniques......, including a detailed protocol for FDG PET in head and neck imaging, physiologic findings, and pitfalls in selected case stories....

  15. 双侧股骨颈对称性骨内腱鞘囊肿一例报告%Intraosseous ganglion of the bilateral femoral neck:1 case report

    Institute of Scientific and Technical Information of China (English)

    张跃; 杨晓东; 刘利君

    2016-01-01

    Objective To report 1 case of intraosseous ganglion of the bilateral femoral neck.Methods We conducted history inquiry in detail, comprehensive imaging examination and postoperative pathological detection. Results Left hip pain had lasted for more than 1 month without any inducement, injury or local swelling. Pain aggravated in the night and after the walking. Clinical examination: both lower limbs were of identical length without any swelling, except for a little tenderness and gaenslen ( + ) of the left hip. X-ray: bilateral femoral neck showed cystic photic zone. CT: the partial low-density shadow could be seen from the anterior portion of the bilateral femoral neck. MRl: anterior portion of the bilateral femoral neck showed heterogeneous signals. Multiple nodular with long T1 and T2 signals, shorter T1 and longer T2 signals could be seen around. Surgical ifndings: a few wormy holes distributed in the bilateral femoral neck with translucent gelatinous materials and granulation tissues in it. Pathological examination showed visible ifbrous capsule in the osseous tissues.Conclusions Combined with patient’s clinical manifestations, pathological results and imaging features, a etiologic diagnosis of the intraosseous ganglion can be achieved.

  16. Restoration of missing or misplaced canines.

    Science.gov (United States)

    Bower, C F; Reinhardt, R A

    1985-06-01

    Restorative treatments for canines were discussed to correct three clinical abnormalities: (1) fully erupted permanent canine in the lateral incisor position, (2) missing permanent canines, and (3) partially exposed canines in normal arch position. The primary concerns are the development of esthetics, anterior guidance, and adequate support for fixed restorations.

  17. A Case of Acute Prosthesis Migration after Femoral Head Replacement due to Osteomalacia by FGF23-Induced Tumor

    Directory of Open Access Journals (Sweden)

    Shinya Hayashi

    2012-01-01

    Full Text Available Fibroblast growth factor 23 (FGF23 was recently identified as an important factor involved in the development of hypophosphatemic rickets and osteomalacia. We experienced a rare case of acute prosthesis migration after hemihip arthroplasty due to FGF23-induced tumor. The patient underwent femoral head replacement because of femoral neck fracture, but prosthesis migration was occurred at 1 week after operation. The patient took various examinations, and FGF23-induced tumor was found in his right wrist. The tumor was resected, and he underwent total hip arthroplasty 8 month later. Finally, he was able to obtain free gait without pain.

  18. Design and validation of automated femoral bone morphology measurements in cerebral palsy.

    Science.gov (United States)

    Park, Noyeol; Lee, Jehee; Sung, Ki Hyuk; Park, Moon Seok; Koo, Seungbum

    2014-04-01

    Accurate quantification of bone morphology is important for monitoring the progress of bony deformation in patients with cerebral palsy. The purpose of the study was to develop an automatic bone morphology measurement method using one or two radiographs. The study focused on four morphologic measurements-neck-shaft angle, femoral anteversion, shaft bowing angle, and neck length. Fifty-four three-dimensional (3D) geometrical femur models were generated from the computed tomography (CT) of cerebral palsy patients. Principal component analysis was performed on the combined data of geometrical femur models and manual measurements of the four morphologic measurements to generate a statistical femur model. The 3D-2D registration of the statistical femur model for radiography computes four morphological measurements of the femur in the radiographs automatically. The prediction performance was tested here by means of leave-one-out cross-validation and was quantified by the intraclass correlation coefficient (ICC) and by measuring the absolute differences between automatic prediction from two radiographs and manual measurements using original CT images. For the neck-shaft angle, femoral anteversion, shaft bowing angle, and neck length, the ICCs were 0.812, 0.960, 0.834, and 0.750, respectively, and the mean absolute differences were 2.52°, 2.85°, 0.92°, and 1.88 mm, respectively. Four important dimensions of the femur could be predicted from two views with very good agreement with manual measurements from CT and hip radiographs. The proposed method can help young patients avoid instances of large radiation exposure from CT, and their femoral deformities can be quantified robustly and effectively from one or two radiograph(s).

  19. Risk of femoral hernia after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Mikkelsen, T; Bay-Nielsen, M; Kehlet, H

    2002-01-01

    BACKGROUND: Small case series have suggested an increased risk of femoral hernia after previous inguinal herniorrhaphy, but no large-scale data with complete follow-up are available. METHODS: Data were extracted from the Danish Hernia Database covering the interval from 1 January 1998 to 1 July...... 2001, and included 34 849 groin hernia repairs. RESULTS: Of 1297 femoral hernia repairs, 71 patients had previously had an operation for inguinal hernia within the observation period. These 71 femoral hernias represented 7.9 per cent of all reoperations for groin hernia recorded in the database....... The median time to reoperation for a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 7 months, compared with 10 months for inguinal recurrences. The risk of developing a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 15 times higher than the rate of femoral hernia...

  20. MRI of joint fluid in femoral head osteonecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Chan, W.P. [Chief in Department of Radiology, Taipei Medical University, Municipal Wan Fang Hospital, 111 Hsing-Long Road, Section 3, Taipei 116 (Taiwan); Liu, Y.-J. [Institute of Electric Engineering, National Taiwan University, 1 Roosevelt Road, Section 4, Taipei 106 (Taiwan); Huang, G.-S. [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, 325 Cheng-Kung Road, Section 2, Taipei 114 (Taiwan); Jiang, C.-C.; Huang, S. [Department of Orthopedic Surgery, National Taiwan University Hospital, 7 Chung-San S. Road, Taipei 100 (Taiwan); Chang, Y.-C. [Department of Mathematics, Tamkang University, 151 Ying-Chuan Road, Tamsui, Taipei 251 (Taiwan)

    2002-11-01

    To evaluate the relationship between joint fluid, intramedullary pressure (IMP), bone marrow edema, and stages of osteonecrosis of the femoral head (ONFH). Material and methods: We reviewed the magnetic resonance (MR) images of 28 patients with 40 documented ONFHs. IMP was measured in 16 symptomatic hips. The amount of joint fluid was graded as 0 (no fluid), 1 (fluid <5 mm in width), or 2 (fluid {>=} 5 mm in width) adjacent to the entire length of the femoral neck. Associated focal and diffuse bone marrow abnormalities were evaluated. A control group of 29 recruited individuals without symptoms related to hip disease were examined. Follow-up MR images were obtained in four patients (five affected hips) 6-10 months after core decompression. Results: Of the 40 affected hips, the severity of ONFH was divided into stages 0 (n=4), I (n=28), and II (n=8 hips) on MR findings. The correlation of joint fluid to IMP and to the presence of bone marrow edema was poor. The amount of joint fluid correlated significantly with the stage of ONFH. None of the five affected hips showed decreased joint fluid on follow-up MR images. Conclusion: The amount of joint fluid correlates well with the stage of ONFH. The amount of joint fluid does not correlate with IMP or bone marrow edema. (orig.)

  1. The role of altered proximal femoral geometry in impaired pelvis stability and hip control during CP gait: A simulation study.

    Science.gov (United States)

    Bosmans, Lode; Jansen, Karen; Wesseling, Mariska; Molenaers, Guy; Scheys, Lennart; Jonkers, Ilse

    2016-02-01

    Children with cerebral palsy (CP) often present aberrant hip geometry, more specifically increased femoral anteversion and neck-shaft angle. Furthermore, altered gait patterns are present within this population. This study analyzed the effect of aberrant femoral geometry, as present in subjects with CP, on the ability of muscles to control hip and knee joint kinematics. Given the specific gait deficits observed during crouch gait, increased ability to abduct, externally rotate the hip and extend the knee and hip were denoted as beneficial effects. We ran dynamic simulations of CP and normal gait using two musculoskeletal models, one reflecting normal femoral geometry and one reflecting proximal femoral deformities. The results show that the combination of aberrant bone geometry and CP-specific gait characteristics beneficially increased the ability of gluteus medius and maximus to extend the hip and knee. In contrast, the potentials of the hamstrings to extend the hip decreased whereas the potentials to flex the knee increased. These changes closely followed the observed changes in the muscle moment arm lengths. In conclusion, this study emphasizes the concomitant effect of the presence of proximal femoral deformity and CP gait characteristics on the muscle control of hip and knee joint kinematics during single stance. Not accounting for subject-specific geometry will affect the calculated muscles' potential during gait. Therefore, the use of generic models to assess muscle function in the presence of femoral deformity and CP gait should be treated with caution.

  2. Canine mammary gland tumors.

    Science.gov (United States)

    Sorenmo, Karin

    2003-05-01

    The National Consensus Group recommends that all women with tumors larger than 1 cm be offered chemotherapy regardless of tumor histology of lymph node status. This recommendation is to ensure that everyone at risk for failing, even though the risk may be low in women with relatively small tumors and favorable histology, has a choice and receives the benefit of adjuvant chemotherapy. This type of treatment recommendation may also be made in dogs based on recognized, well-accepted prognostic factors such as tumor size, stage, type, and histologic differentiation. Based on the limited clinical information available in veterinary medicine, the drugs that are effective in human breast cancer, such as cyclophosphamide, 5-fluorouracil, and doxorubicin, may also have a role in the treatment of malignant mammary gland tumors in dogs. Randomized prospective studies are needed, however, to evaluate the efficacy of chemotherapy in dogs with high-risk mammary gland tumors and to determine which drugs and protocols are the most efficacious. Until such studies are performed, the treatment of canine mammary gland tumors will be based on the individual oncologist's understanding of tumor biology, experience, interpretation of the available studies, and a little bit of gut-feeling. Table 2 is a proposal for treatment guidelines for malignant canine mammary gland tumors according to established prognostic factors, results from published veterinary studies, and current recommendations for breast cancer treatment in women.

  3. Morbidity of the neck after head and neck cancer therapy

    NARCIS (Netherlands)

    van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

    2004-01-01

    Background. Studies on morbidity of the neck after head and neck cancer therapy are scarcely described. Methods. Patients who underwent surgery, including neck dissection, with and without radiation therapy at least 1 year before the study were asked to participate. We assessed neck pain, loss of se

  4. Femoral rotation unpredictably affects radiographic anatomical lateral distal femoral angle measurements

    DEFF Research Database (Denmark)

    Miles, James Edward

    2016-01-01

    Objective: To describe the effects of internal and external femoral rotation on radiographic measurements of the anatomical lateral distal femoral angle (a-LDFA) using two methods for defining the anatomical proximal femoral axis (a-PFA). Methods: Digital radiographs were obtained of 14 right fem...

  5. A randomised controlled trial of cemented and cementless femoral components for metal-on-metal hip resurfacing: a bone mineral density study.

    Science.gov (United States)

    Tice, A; Kim, P; Dinh, L; Ryu, J J; Beaulé, P E

    2015-12-01

    The primary purpose of this study of metal-on-metal (MoM) hip resurfacing was to compare the effect of using a cementless or cemented femoral component on the subsequent bone mineral density (BMD) of the femoral neck. This was a single-centre, prospective, double-blinded control trial which randomised 120 patients (105 men and 15 women) with a mean age of 49.4 years (21 to 68) to receive either a cemented or cementless femoral component. Follow-up was to two years. Outcome measures included total and six-point region-of-interest BMD of the femoral neck, radiological measurements of acetabular inclination, neck-shaft and stem-shaft angles, and functional outcome scores including the Harris hip score, the Western Ontario and McMaster Universities Osteoarthritis Index and the University of California at Los Angeles activity scale. In total, 17 patients were lost to follow-up leaving 103 patients at two years. There were no revisions in the cementless group and three revisions (5%) in the cemented group (two because of hip pain and one for pseudotumour). The total BMD was significantly higher in the cementless group at six months (p < 0.001) and one year (p = 0.01) than in the cemented group, although there was a loss of statistical significance in the difference at two years (p = 0.155). All patient outcomes improved significantly: there were no significant differences between the two groups. The results show better preservation of femoral neck BMD with a cementless femoral component after two years of follow-up. Further investigation is needed to establish whether this translates into improved survivorship.

  6. Self-reported weight at birth predicts measures of femoral size but not volumetric BMD in eldery men: MrOS.

    Science.gov (United States)

    Javaid, M Kassim; Prieto-Alhambra, Daniel; Lui, Li-Yung; Cawthon, Peggy; Arden, Nigel K; Lang, Thomas; Lane, Nancy E; Orwoll, Eric; Barrett-Conner, Elizabeth; Nevitt, Michael C; Cooper, Cyrus; Cummings, Steven R

    2011-08-01

    The mechanism whereby poor intrauterine growth increases risk of adult hip fracture is unclear. We report the association between birth weight and proximal femoral geometry and density in community-dwelling elderly men. We used self-reported birth weight, measured adult height and weight and proximal femoral quantitative computed tomography (QCT) measurements of femoral neck axis length, cross-sectional area, and volumetric BMD (vBMD) among the participants in the Osteoporotic Fractures in Men (MrOS), a cohort study of community-dwelling US men aged 65 and older. We compared men with birth weight <7 pounds (lower birth weight [LBW]; n = 501) and ≥ 9 pounds (higher birth weight [HBW]; n = 262) with those weighing 7-8.9 pounds (medium birth weight [MBW], referent group; n = 1068) using linear regression adjusting for current age, height, and BMI. The mean age of the 1831 men who had both birth weight and QCT measurements was 73 years (SD 5.9). Compared with the referent MBW, HBW men had concordantly longer femoral neck (+0.16 SD; p = .028) and cross-sectional area (+0.24 SD, p = .001). LBW men had a smaller cross-sectional (-0.26 SD, p < .001) but longer femoral neck for their height (+0.11 SD, p = .05). Neither cortical nor trabecular vBMD at the femoral neck was associated with birth weight. These findings support the hypothesis that the skeletal envelope, but not density, is set, in part, at birth. Further research exploring the association between early developmental factors and lifetime fracture risk is needed and may inform primary preventative strategies for fracture prevention.

  7. Pathological femoral fractures due to osteomalacia associated with adefovir dipivoxil treatment for hepatitis B: a case report

    Directory of Open Access Journals (Sweden)

    Tanaka Motoyuki

    2012-08-01

    Full Text Available Abstract We present a case of a 62-year-old man who underwent total hip arthroplasty for treatment of pathologic femoral neck fracture associated with adefovir dipivoxil-induced osteomalacia. He had a 13-month history of bone pain involving his shoulders, hips, and knee. He received adefovir dipivoxil for treatment of lamivudine-resistant hepatitis B virus infection for 5 years before the occurrence of femoral neck fracture. Orthopedic surgeons should be aware of osteomalacia and pathological hip fracture caused by drug-induced renal dysfunction, which results in Fanconi’s syndrome. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1600344696739249

  8. Melanoma - neck (image)

    Science.gov (United States)

    This melanoma on the neck is variously colored with a very darkly pigmented area found centrally. It has irregular ... be larger than 0.5 cm. Prognosis in melanoma is best defined by its depth on resection.

  9. Head and Neck Cancers

    Science.gov (United States)

    ... oral cancer ( 12 , 13 ). Preserved or salted foods . Consumption of certain preserved or salted foods during childhood ... head and neck cancers―particularly those who use tobacco―should talk with their doctor about ways that ...

  10. Ultrasound-guided femoral nerve block for pain control in an infant with a femur fracture due to nonaccidental trauma.

    Science.gov (United States)

    Frenkel, Oron; Mansour, Karim; Fischer, Jason W J

    2012-02-01

    A 3-month-old infant girl was transferred to our emergency department (ED) with a subtrochanteric femoral neck fracture due to nonaccidental trauma. She received multiple doses of parenteral analgesics both before arrival and in our ED. We performed an ultrasound-guided femoral nerve block using 2.0 mL of 0.25% bupivicaine (approximately 1.25 mg/kg) before placing the patient in a Pavlik harness. Successful pain control was achieved within 15 minutes of the procedure allowing pain-free manipulation of the affected extremity. The patient required only a single dose of parenteral narcotics during the ensuing 18 hours. To our knowledge, this is the first report of an ultrasound-guided femoral nerve block used in the ED for pain control in a pediatric patient.

  11. Osteonecrosis of Femoral Head Occurred after Stent Placement of Femoral Artery

    Directory of Open Access Journals (Sweden)

    Akiyoshi Shimatani

    2014-01-01

    Full Text Available We present a case of osteonecrosis of femoral head (ONFH that occurred after stent angiography of femoral artery for the treatment of arteriosclerosis obliterans (ASO of left inferior limb in a 76-year-old woman. No case of late collapse of femoral head as a complication of endovascular procedure such as stent placement has been previously documented. We considered that ONFH occurred after detaining stent at a junction of left deep femoral artery for the treatment of the ischemia of left lateral and medial femoral circumflex artery.

  12. Head and neck teratomas

    OpenAIRE

    Shah, Ajaz; Latoo, Suhail; Ahmed, Irshad; Malik, Altaf H

    2009-01-01

    Teratomas are complex lesions composed of diverse tissues from all 3 germinal cell layers and may exhibit variable levels of maturity. Head and neck teratomas are most commonly cervical with the oropharynx (epignathus) being the second commonest location. In this article, clinical presentation, behaviour and associated significance of head and neck teratomas have been highlightened. Because of their obscure origin, bizarre microscopic appearance, unpredictable behaviour and often dramatic cli...

  13. Femoral revision surgery with impaction bone grafting

    NARCIS (Netherlands)

    B.L.E.F. ten Have (Bas); R.W. Brouwer (Reinoud); F.C. van Biezen (Frans); J.A.N. Verhaar (Jan)

    2012-01-01

    textabstractThe purpose of this prospective study was to evaluate the long-term clinical and radiological outcomes of revision of the femoral component of a total hip replacement using impaction bone grafting. Femoral revision with an impacted allograft was performed on 29 patients (31 hips). In all

  14. The femoral sulcus in total knee arthroplasty.

    Science.gov (United States)

    Lingaraj, Krishna; Bartlett, John

    2009-05-01

    The position of the femoral sulcus relative to the midline of the distal femoral resection in total knee arthroplasty (TKA) was studied to determine if centralized placement of the femoral component on the distal femur was justified in terms of aligning the prosthetic sulcus with the native femoral sulcus. The location of the femoral sulcus was studied in 112 consecutive patients undergoing TKA. The mean sulcus position was 0.7 mm lateral to the midline of the distal femoral resection (SD 1.4, 95% CI, 0.5-1.0 mm). However, the variation in sulcus positions ranged from 4 mm medial to 4 mm lateral to the midline. The mean sulcus position in valgus knees was 1.0 mm lateral to the midline (SD 1.8), and that in varus knees was 0.7 mm lateral to the midline (SD 1.2) (P = 0.501). It appears prudent to centre the femoral component on the native sulcus rather than the midline of the distal femoral resection, so as to ensure accurate alignment of the prosthetic sulcus with the native sulcus and to encourage normal patella tracking.

  15. Computerized tomography in evaluation of decreased acetabular and femoral anteversion; Besonderheiten bei der Bestimmung der Hueftpfannenanteversion und Schenkelhalsantetorsion durch Computertomographie

    Energy Technology Data Exchange (ETDEWEB)

    Toennis, D.; Skamel, H.J. [Institut fuer Strahlendiagnostik, Klinikum Dortmund GmbH (Germany)

    2003-09-01

    Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum. (orig.) [German] Fuer die Computertomographie hat sich eine neue Aufgabe ergeben. Es hat sich gezeigt, dass verringerte Pfannenanteversion und Schenkelhalsantetorsion haeufige Ursachen von Hueftschmerz und -arthrose sind, v. a. wenn beide gegen 0 gehen. Da operative Massnahmen vor Eintreten der Arthrose ergriffen werden sollten, sind genaue Messwerte erforderlich. Die Untersuchung sollte in Bauchlage durchgefuehrt werden, um eine einheitliche und weitgehend normale Beckenkippung zu gewaehrleisten. Die Schenkelhalstorsion wird zwischen der Kniegelenk- und der Schenkelhalsachse gemessen. Zur Festlegung der Sagittalebene legt man am besten eine Mittellinie zwischen die Beckenschaufeln. Die Messung der Pfannenanteversion sollte in der Schnitthoehe erfolgen, wo die Bewegungseinschraenkung der Innenrotation auftritt. (orig.)

  16. The Reliability of Classifications of Proximal Femoral Fractures with 3-Dimensional Computed Tomography: The New Concept of Comprehensive Classification

    Directory of Open Access Journals (Sweden)

    Hiroaki Kijima

    2014-01-01

    Full Text Available The reliability of proximal femoral fracture classifications using 3DCT was evaluated, and a comprehensive “area classification” was developed. Eleven orthopedists (5–26 years from graduation classified 27 proximal femoral fractures at one hospital from June 2013 to July 2014 based on preoperative images. Various classifications were compared to “area classification.” In “area classification,” the proximal femur is divided into 4 areas with 3 boundary lines: Line-1 is the center of the neck, Line-2 is the border between the neck and the trochanteric zone, and Line-3 links the inferior borders of the greater and lesser trochanters. A fracture only in the first area was classified as a pure first area fracture; one in the first and second area was classified as a 1-2 type fracture. In the same way, fractures were classified as pure 2, 3-4, 1-2-3, and so on. “Area classification” reliability was highest when orthopedists with varying experience classified proximal femoral fractures using 3DCT. Other classifications cannot classify proximal femoral fractures if they exceed each classification’s particular zones. However, fractures that exceed the target zones are “dangerous” fractures. “Area classification” can classify such fractures, and it is therefore useful for selecting osteosynthesis methods.

  17. Classification of subtrochanteric femoral fractures.

    Science.gov (United States)

    Loizou, C L; McNamara, I; Ahmed, K; Pryor, G A; Parker, M J

    2010-07-01

    A review of the literature identified 15 different classification methods for subtrochanteric femoral fractures. Only eight of those classifications defined the area of bone, which constituted a subtrochanteric fracture. The actual length of femur defined as the subtrochanteric zone varied from 3 cm up to the level of the femoral isthmus. There was no agreement between the different classifications regarding the proximal and distal border or for those fractures, which traverse anatomical boundaries. In the various classifications, fractures were subdivided into 2-15 subgroups. The majority of the identified studies were unable to find the classifications useful in either determining treatment or predicting the outcome after treatment. We subdivided subtrochanteric fractures into three types based on the degree of fracture comminution. We examined the inter- and intra-observer agreement of our recommended classification. One orthopaedic consultant, one specialist hip fracture surgeon, two trainee registrar orthopaedic surgeons and one specialty trainee in orthopaedics, on two different occasions, 8 weeks apart, independently classified the radiographs of 20 patients with a subtrochanteric fracture. The mean kappa value for inter- and intra-observer variation was 0.71 and 0.79, respectively, with both showing substantial agreement and, therefore, this simpler classification is recommended. Based on the review of previous classification methods, we also recommend that the subtrochanteric zone be defined as the one in which the fracture line crossing the femur is predominantly within the area of bone extending 5 cm below the lower border of the lesser trochanter.

  18. Incarcerated Femoral Hernia Containing Ipsilateral Fallopian Tube

    Directory of Open Access Journals (Sweden)

    Stefanos Atmatzidis

    2010-01-01

    Full Text Available Femoral hernias are more common in women and lead to a substantial higher rate for an emergency operation, due to strangulation. Incarcerated femoral hernia with fallopian tube as a content is an extremely rare condition. A 20-year-old woman presented to the emergency department complaining of a 6-day right groin swelling, which became painful and tender to palpation during the last 48 hours. Preoperative ultrasonography detected an oedematous hernia sac, above the femoral vessels, suggesting the presence of an incarcerated femoral hernia. The patient eventually underwent emergency surgery and the diagnosis of a strangulated femoral hernia sac, containing fallopian tube, was established. No resection of the uterine tube was performed and the hernia was repaired with polypropylene plug. The postoperative period was uneventful and the woman was discharged on the second postoperative day.

  19. 9 CFR 113.305 - Canine Hepatitis and Canine Adenovirus Type 2 Vaccine.

    Science.gov (United States)

    2010-01-01

    ... Type 2 Vaccine. 113.305 Section 113.305 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION... STANDARD REQUIREMENTS Live Virus Vaccines § 113.305 Canine Hepatitis and Canine Adenovirus Type 2 Vaccine. Canine Hepatitis Vaccine and Canine Adenovirus Type 2 Vaccine shall be prepared from virus-bearing...

  20. Long-term effectiveness of canine-to-canine bonded flexible spiral wire lingual retainers

    NARCIS (Netherlands)

    Renkema, Anne-Marie; Renkema, Alianne; Bronkhorst, Ewald; Katsaros, Christos

    2011-01-01

    Introduction: The flexible spiral wire (FSW) canine-to-canine lingual retainer bonded to all 6 anterior teeth is a frequently used type of mandibular fixed retainer. This study aimed to assess the long-term effectiveness of FSW canine-to-canine lingual retainers in maintaining the alignment of the m

  1. Long-term effectiveness of canine-to-canine bonded flexible spiral wire lingual retainers

    NARCIS (Netherlands)

    Renkema, A.M.; Bronkhorst, E.M.; Katsaros, C.

    2011-01-01

    INTRODUCTION: The flexible spiral wire (FSW) canine-to-canine lingual retainer bonded to all 6 anterior teeth is a frequently used type of mandibular fixed retainer. This study aimed to assess the long-term effectiveness of FSW canine-to-canine lingual retainers in maintaining the alignment of the m

  2. Pain syndrome in patient after hip replacement with a dual-modular femoral component (case report

    Directory of Open Access Journals (Sweden)

    R. M. Tikhilov

    2014-01-01

    Full Text Available Total hip replacements with dualmodular femoral components (stemneck interface allow optimization of hip joint biomechanics via selective restoration of femoral anteversion, offset, and limb length theoretically improving muscle function and stability. Potential disadvantages are the additional stemneck interface and the possible generation of metal ions and debris by fretting and crevice corrosion. The authors reported a case of patient with dualmodular stem presenting with pain and decreased function. Earlyonset adverse inflammatory tissue reactions developed as a result of corrosion at the stemneck interface of a dualmodular implant, requiring subsequent revision of wellfixed components with an extended trochanteric osteotomy. Additional examinations excluded infection. We consider that patients with a modular stem and neck junction and presenting with pain should be suspected on corrosion at the stemneck interface and adverse inflammatory tissue reaction after infection exclusion.

  3. Dose-Effect Relationships for Femoral Fractures After Multimodality Limb-Sparing Therapy of Soft-Tissue Sarcomas of the Proximal Lower Extremity

    Energy Technology Data Exchange (ETDEWEB)

    Pak, Daniel; Vineberg, Karen A. [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Griffith, Kent A. [Biostatistics Unit, Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI (United States); Sabolch, Aaron [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Chugh, Rashmi [Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI (United States); Ben-Josef, Edgar [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Biermann, Janet Sybil [Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI (United States); Feng, Mary, E-mail: maryfeng@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)

    2012-07-15

    Purpose: We investigated the clinical and dosimetric predictors for radiation-associated femoral fractures in patients with proximal lower extremity soft tissue sarcomas (STS). Methods and Materials: We examined 131 patients with proximal lower extremity STS who received limb-sparing surgery and external-beam radiation therapy between 1985 and 2006. Five (4%) patients sustained pathologic femoral fractures. Dosimetric analysis was limited to 4 fracture patients with full three-dimensional dose information, who were compared with 59 nonfracture patients. The mean doses and volumes of bone (V{sub d}) receiving specified doses ({>=}30 Gy, 45 Gy, 60 Gy) at the femoral body, femoral neck, intertrochanteric region, and subtrochanteric region were compared. Clinical predictive factors were also evaluated. Results: Of 4 fracture patients in our dosimetric series, there were three femoral neck fractures with a mean dose of 57.6 {+-} 8.9 Gy, V30 of 14.5 {+-} 2.3 cc, V45 of 11.8 {+-} 1.1 cc, and V60 of 7.2 {+-} 2.2 cc at the femoral neck compared with 22.9 {+-} 20.8 Gy, 4.8 {+-} 5.6 cc, 2.5 {+-} 3.9 cc, and 0.8 {+-} 2.7 cc, respectively, for nonfracture patients (p < 0.03 for all). The femoral neck fracture rate was higher than at the subtrochanteric region despite lower mean doses at these subregions. All fracture sites received mean doses greater than 40 Gy. Also, with our policy of prophylactic femoral intramedullary nailing for high-risk patients, there was no significant difference in fracture rates between patients with and without periosteal excision. There were no significant differences in age, sex, tumor size, timing of radiation therapy, and use of chemotherapy between fracture and nonfracture patients. Conclusions: These dose-volume toxicity relationships provide RT optimization goals to guide future efforts for reducing pathologic fracture rates. Prophylactic femoral intramedullary nailing may also reduce fracture risk for susceptible patients.

  4. Head and neck cancers masquerading as deep neck abscesses.

    Science.gov (United States)

    Soon, Sue Rene; Kanagalingam, Jeevendra; Johari, Shirish; Yuen, Heng Wai

    2012-12-01

    Deep neck space abscesses are common otolaryngological emergencies, and prompt incision and drainage is the treatment of choice. Head and neck cancers often present with cervical metastases that may become secondarily infected. Clinical presentation is similar to a deep neck abscess. Surgical drainage of such collections has implications on subsequent treatment. In this case series, we describe six cases with this unusual presentation that were subsequently found to have a head and neck malignancy, and where three patients had their abscesses treated surgically. We aim to raise awareness of this unusual presentation of a head and neck carcinoma, and to avoid a potential pitfall in the management of deep neck abscess.

  5. Pediatric Neck Mass

    Directory of Open Access Journals (Sweden)

    Guilherme Machado de Carvalho

    2015-11-01

    Full Text Available Introduction  Neck masses include a wide variety of diagnostic possibilities, with more than 60 etiologies that depend on clinical aspects such as age, location and time of disease progression. The interview and physical examination guide research that cross the neck masses in pediatric patients in 3 groups: infectious / inflammatory, and neoplastic embryonic remnants. The aim of this study was to present a protocol for evaluation of neck masses in the pediatric age group, based on a review of literature on the subject and experience of this service. Materials and Methods Survey of literature data from PubMed / Medline, Google Scholar and Scopus Database without language restriction, since 1980 sources, with the MeSH term "Pediatric neck mass".  Results Prepared flowchart guidelines to be followed according with diagnostic suspicions. Patients were divided into 3 groups according to the initial clinical manifestations and according to etiological hypotheses formulated recommend evaluations protocols.  Conclusion The standardization of the evaluation of neck masses in children proves valuable and can help in the differential diagnosis of different etiologies involved.

  6. Atraumatic intracapsular neck of femur fractures after prolonged bisphosphonate treatment: a new atypical variant?

    Science.gov (United States)

    Khan, Sameer Khalid; Savaridas, Terence; Hemers, Jennifer S.; Maarouf, Zouheir; Orgee, Jane M.; Orr, Michael M.

    2016-01-01

    Summary We present 2 cases of elderly females presenting with atraumatic, near-vertical (Pauwells grade 3), intracapsular neck of femur fractures. Following diagnosis of osteoporosis on DEXA scans, they had received alendronic acid for 7 and 10 years respectively. Routine blood tests and serum estimations of calcium, vitamin-D and thyroid-stimulating hormone, done at admission, were within the normal ranges. These patients were managed with a hemiarthroplasty and a dynamic hip screw (DHS) respectively, following discontinuation of bisphosphonates. We present these 2 cases in light of emerging evidence that associates long-term bisphosphonate use with atypical low energy femoral fractures. Only subtrochanteric/diaphyseal fractures have been reported to date. We present a new variant of atypical femoral neck fractures in metaphyseal bone related to prolonged bisphosphonate therapy. PMID:27252743

  7. Modular titanium alloy neck failure in total hip replacement: analysis of a relapse case

    Directory of Open Access Journals (Sweden)

    Ceretti Marco

    2016-01-01

    Full Text Available Modular neck hip prosthesis born in the 1990 with the aim of allowing the surgeon to modify CCD angle, offset and femoral anteversion intra-operatively restoring patient’s original biomechanics. In order to achieve the best biomechanics of the reconstructed hip, preoperative planning is essential. In the last few years modularity has been questioned and an argument made for the return to mono block stems due to events of breakage or disconnection of modular components. Fretting or crevice corrosion may lead to failure of such modular device due to the contamination inside the modular coupling or to high loads. We present a case of repetitive modular femoral neck prosthesis fracture.

  8. Tension free femoral hernia repair with plug

    Institute of Scientific and Technical Information of China (English)

    Milivoje Vukovi; Neboja Moljevi; Sinia Crnogorac

    2013-01-01

    Objective: To investigate the conventional technique involves treatment of femoral hernia an approximation inguinal ligament to pectineal ligament. In technique which uses mesh closure for femoral canal without tissue tension. Method: A prospective study from January 01. 2007-May 30. 2009. We analyzed 1 042 patients with inguinal hernia, of which there were 83 patients with 86 femoral hernia. Result: Femoral hernias were present in 7.96% of cases. Males were 13 (15.66%) and 70 women (84.34%). The gender distribution of men: women is 1:5.38. Urgent underwent 69 (83%), and the 14 election (17%) patients. Average age was 63 years, the youngest patient was a 24 and the oldest 86 years. Ratio of right: left hernias was 3.4:1. With bilateral femoral hernias was 3.61% of cases. In 7 patients (8.43%) underwent femoral hernia repair with 9 Prolene plug. Conclusions: The technique of closing the femoral canal with plug a simple. The plug is made from monofilament material and is easily formed. This technique allows the reduction of recurrence and can be used safely, quickly and easily in elective and emergency situations.

  9. Variations of femoral condyle shape.

    Science.gov (United States)

    Biscević, Mirza; Hebibović, Mujo; Smrke, Dragica

    2005-12-01

    The aim of this study is to mathematically approximate the shape of the femoral articulating line and compare radiuses of condylar curves within and between males and females. Ten male and ten female participants were included in the study. Radiuses of medial and lateral condylar curves were calculated from the side view knee X-ray by original mathematical equation. Average radiuses of condylar curves were between 4.5 and 1.7 cm medially, and between 3.2 and 1.8 cm laterally, for 0 degrees and 90 degrees flexion contact point respectively. Males had longer curve radiuses of both condyles (p knee geometry, and other ellipsoidal structures in human body, like wrist, scull segments, dental arches, etc.

  10. 活血补肾中药联合植骨支撑治疗非创伤性股骨头坏死%Combined treatment of HUOXUEBUSHEN Decoction and bone impaction grafting for nontraumatic osteonecrosis of the femoral head

    Institute of Scientific and Technical Information of China (English)

    韦标方; 孙丙银

    2014-01-01

      结果与结论:治疗组患者Harris总分、疼痛程度、关节活动范围分值均显著高于对照组(P 0.05);治疗组患者疗效优良率显著高于对照组(88%,74%,χ2=4.54, P OBJECTIVE:To investigate clinical efficacy of combined treatment of HUOXUEBUSHEN decoction and bone impaction grafting through a femoral neck window at high location for non-traumatic osteoporosis of the femoral head. METHODS:This study is a prospective control ed trial. The patients with non-traumatic osteoporosis of the femoral head were divided into two groups:treatment group (n=52, 60 hips) and control group (n=51, 60 hips). The treatment group was given a combined treatment of HUOXUEBUSHEN decoction and bone impaction grafting through a femoral neck window (the decoction was prepared in People’s Hospital of Linyi, China). The control group underwent simple bone impaction grafting through a femoral neck window. Al the involved patients were fol owed up for 12 months, Harris hip score and the excellent-good rate at the last fol ow-up were used to evaluate clinical efficacy. RESULTS AND CONCLUSION:The Harris score, pain degree, and joint range of motion scores in the treatment group were higher than that in control group (P0.05). The excellent-good rate in the treatment group was significantly higher than that in control group (88%, 75%;χ2=4.91, P<0.05). The combined treatment of HUOXUEBUSHEN decoction and bone impaction grafting through a femoral neck window at high location is effective in the treatment of non-traumatic osteonecrosis of the femoral head, and is better than simple bone impaction grafting at al eviating pain and improving joint range of motion.

  11. Modular titanium alloy neck failure in total hip replacement: analysis of a relapse case

    OpenAIRE

    Ceretti Marco; Falez Francesco

    2016-01-01

    Modular neck hip prosthesis born in the 1990 with the aim of allowing the surgeon to modify CCD angle, offset and femoral anteversion intra-operatively restoring patient’s original biomechanics. In order to achieve the best biomechanics of the reconstructed hip, preoperative planning is essential. In the last few years modularity has been questioned and an argument made for the return to mono block stems due to events of breakage or disconnection of modular components. Fretting or crevice cor...

  12. Femoral hernia sac laparoscopy: a case report.

    Science.gov (United States)

    Ramirez Valderrama, Alexander; Ruiz, Dan; Malik, Manmeet; Tiszenkel, Howard

    2014-01-01

    We present the case of a 64-year-old female with an incarcerated right femoral hernia, associated with a small bowel obstruction that was successfully treated with an open femoral hernia repair with plug. At the same time we performed a hernia sac laparoscopy to evaluate the viability of the previously reduced small bowel. The hernioscopy was performed with a 0° 5 mm scope with reliable evaluation of the peritoneal cavity. We confirm that hernioscopy is a safe and feasible procedure and provides useful information for the appropriate management of acute incarcerated femoral/inguinal hernias.

  13. Head and Neck Cancer Treatment

    Science.gov (United States)

    ... oncologist will listen to the history of your problem and perform a physical examination. Consultations with other members of the head and neck team, such as the head and neck surgeon, pathologist, ...

  14. Podoplanin Expression in Canine Melanoma.

    Science.gov (United States)

    Ogasawara, Satoshi; Honma, Ryusuke; Kaneko, Mika K; Fujii, Yuki; Kagawa, Yumiko; Konnai, Satoru; Kato, Yukinari

    2016-12-01

    A type I transmembrane protein, podoplanin (PDPN), is expressed in several normal cells such as lymphatic endothelial cells or pulmonary type I alveolar cells. We recently demonstrated that anticanine PDPN monoclonal antibody (mAb), PMab-38, recognizes canine PDPN of squamous cell carcinomas, but does not react with lymphatic endothelial cells. Herein, we investigated whether PMab-38 reacts with canine melanoma. PMab-38 reacted with 90% of melanoma cells (9/10 cases) using immunohistochemistry. Of interest, PMab-38 stained the lymphatic endothelial cells and cancer-associated fibroblasts in melanoma tissues, although it did not stain any lymphatic endothelial cells in normal tissues. PMab-38 could be useful for uncovering the function of PDPN in canine melanomas.

  15. Femoral shaft fracture fixed with intramedullary nailing in a child resulting in femoral neck narrowing deformity and fracture

    Institute of Scientific and Technical Information of China (English)

    WAN Lin; ZHAO Lin; LIU Yan-qing; WANG Xu; LIU Jing-sheng

    2008-01-01

    @@ Treatment of factures in children is different from that of adults because improper internal fixation,including selection of internal fixation device and epiphysis approaching,may cause epiphysis injury,which may result in a series of secondary lesions in bone development,such as growth arrest,limb length discrepancy, osteonecrosis, and other deformities.

  16. Changes in bone mineral density of the acetabulum, femoral neck and femoral shaft, after hip resurfacing and total hip replacement

    DEFF Research Database (Denmark)

    Penny, J O; Brixen, K; Varmarken, J E;

    2012-01-01

    It is accepted that resurfacing hip replacement preserves the bone mineral density (BMD) of the femur better than total hip replacement (THR). However, no studies have investigated any possible difference on the acetabular side. Between April 2007 and March 2009, 39 patients were randomised into ...

  17. Canine and feline parasitic zoonoses in China.

    Science.gov (United States)

    Chen, Jia; Xu, Min-Jun; Zhou, Dong-Hui; Song, Hui-Qun; Wang, Chun-Ren; Zhu, Xing-Quan

    2012-07-28

    Canine and feline parasitic zoonoses have not been given high priority in China, although the role of companion animals as reservoirs for zoonotic parasitic diseases has been recognized worldwide. With an increasing number of dogs and cats under unregulated conditions in China, the canine and feline parasitic zoonoses are showing a trend towards being gradually uncontrolled. Currently, canine and feline parasitic zoonoses threaten human health, and cause death