1/282. Pseudoaneurysm of the profunda femoris artery due to intertrochanteric fracture of the hip.Arterial injury caused by hip fracture is a rare event. We report a case of pseudoaneurysm of the profunda femoris artery that presented 4 weeks after correction of an intertrochanteric hip fracture with a dynamic hip screw. The diagnosis was confirmed by Duplex ultrasound scanning, and it was treated by ligation of the profunda femoris artery at the level of the pseudoaneurysm.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/282. The Mt. Tyndall incident.The authors describe the 53-hour rescue of a 6-foot, 1-inch tall, 250-pound hiker in the face of harsh environmental conditions in sequoia National Park. This 43-year-old man fell 25 feet, injured his leg, and was noted to be hypothermic and hypovolemic. weather, altitude, and the patient's size delayed and complicated his evacuation. After being carried down 1,500 vertical feet, he was hoisted into a hovering helicopter and flown to University Medical Center in Fresno, california. On arrival, the patient was determined to have a comminuted subtrochanteric right femur fracture, which was ultimately repaired surgically. The authors also discuss some of the unique aspects of wilderness and National Park Service EMS.- - - - - - - - - - ranking = 0.16666666666667keywords = fracture (Clic here for more details about this article) |
3/282. Insufficiency fracture of the femoral neck after intramedullary nailing.We report a patient with insufficiency fracture that occurred after intramedullary nailing for a subtrochanteric fracture. Intramedullary nailing is speculated to have increased the stress in the already osteoporotic subcapital region. It therefore should be recognized as a causative factor in insufficiency fracture of the femoral neck. Careful follow-up is needed for patients with this condition.- - - - - - - - - - ranking = 134189.77844386keywords = femoral neck, neck, fracture (Clic here for more details about this article) |
4/282. Subcapital femoral neck fracture after closed reduction and internal fixation of an intertrochanteric hip fracture: a case report and review of the literature.A subcapital femoral neck fracture in a healed intertrochanteric fracture treated by an open reduction and internal fixation is a rare, but catastrophic, event. We present the case of an 86-year-old woman, a community ambulator, who sustained a displaced right intertrochanteric hip fracture during a fall. She was treated with closed reduction and internal fixation with a dynamic compression hip screw and side plate. Four months later, she was noted to have a displaced subcapital femoral neck fracture and underwent hip screw and side plate hardware removal and cemented bipolar hemiarthroplasty. Both postoperative recoveries were uncomplicated, and she was discharged to a rehabilitation facility able to ambulate with minimal assistance. This devastating complication in patients with osteoporosis may be prevented by deeper placement of the dynamic hip compression lag screw to within 5 mm to 8 mm of the subchondral bone, which may decrease the stress forces in the subcapital femoral neck.- - - - - - - - - - ranking = 1440217.3121444keywords = femoral neck fracture, neck fracture, femoral neck, neck, fracture (Clic here for more details about this article) |
5/282. Lateral insufficiency fractures of the femur caused by osteopenia and varus angulation: a complication of total hip arthroplasty.Lateral femoral insufficiency fractures in total hip arthroplasty occur due to osteopenia and varus positioning of the femoral component, the femur itself, or both. The presentation of these fractures can be unclear but usually involves the insidious onset of unexplained thigh or groin pain. The patients are likely to have significant comorbidities as well. Characteristic radiographic findings may be present, depending on when the patient presents. The insufficiency fractures generally occur at the level of the femoral stem tip on the lateral cortex of the femur. If left untreated, pain and loss of function continue. Eventually an insufficiency fracture can progress to a displaced periprosthetic fracture. Nonsurgical treatment is not successful. Recommended treatment involves revision to a long-stem femoral component. The risk of postoperative complications is significant.- - - - - - - - - - ranking = 1.5keywords = fracture (Clic here for more details about this article) |
6/282. Insufficiency subchondral fracture of the femoral head.The authors recently encountered a 65-year-old osteoporotic woman who had had intractable pain in the hip joint that was diagnosed clinically as osteonecrosis. She was treated by total hip replacement. Histopathologically, the most striking finding was the presence of a subchondral fracture with associated callus formation and granulation tissue along both sides of the fracture line. There was no evidence of antecedent osteonecrosis. This case was diagnosed histopathologically as insufficiency subchondral fracture of the femoral head. This is the first case report to substantiate the presence of insufficiency subchondral fracture of the femoral head by both gross and microscopic examination. Because the treatment and management of insufficiency subchondral fracture are entirely different from osteonecrosis, it is important to differentiate between these two conditions.- - - - - - - - - - ranking = 1.5keywords = fracture (Clic here for more details about this article) |
7/282. ethics in practice.H. K. is a ninety-two-year-old woman with Alzheimer's disease and mild hypertension. She resides at a nursing home, where she transfers from bed to chair with maximal assistance. She presents to our emergency department with a painful right hip. physical examination demonstrates a confused, elderly patient with significant right hip pain and shortening and external rotation of the lower extremity. Radiographs demonstrate a displaced intertrochanteric hip fracture. The patient lacks the capacity for informed consent. Her family is contacted to obtain consent for insertion of a compression screw. The family refuses to give consent, stating that the patient is too old and the surgery is too dangerous.- - - - - - - - - - ranking = 0.16666666666667keywords = fracture (Clic here for more details about this article) |
8/282. fatigue failure of an AO spiral blade.We report an unusual case of a femoral neck stress fracture leading to the fatigue failure of an AO spiral blade. An unreamed femoral nail with a spiral blade was inserted to treat an unstable subtrochanteric femoral fracture. which lead to fracture union at 5 months. Eight months post-operatively the patient started to complain of left hip pain. Serial radiographs revealed progressive osteoporosis of the proximal femur possibly due to the stress sharing effect of a stiff intramedullary device, which continued to bear a significant amount of the transmitted load. The cause of pain was a stress fracture of the femoral neck and the AO spiral blade, which only became radiologically visible 4 months after the start of the symptoms (1 year after the initial operation). The implant was removed and replaced by a cemented hemiarthroplasty. This case reaffirms the difficulty in diagnosing a stress fracture through a metallic implant. The delay in diagnosis may be shortened if stress fracture were included as an expected complication following an intramedullary nailing.- - - - - - - - - - ranking = 53676.444710878keywords = femoral neck, neck, fracture (Clic here for more details about this article) |
9/282. Apophyseal fracture of the greater trochanter.Apophyseal fractures about the pelvis and proximal femur are well-described; however, these injuries rarely involve the greater trochanter. We report the case of a 15-year-old boy of large build who appeared to have all signs and symptoms of a left slipped capital femoral epiphysis. No specific inciting event had occurred before the hip pain. Radiographs and bone scan of the capital femoral epiphysis appeared normal, and follow-up radiographs confirmed an apophyseal fracture of the greater trochanter. This case represented a rare occurrence, and its interesting manifestation was similar to that of a slipped capital femoral epiphysis.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
10/282. Failure of osteosynthesis and prosthetic joint infection due to mycobacterium tuberculosis following a subtrochanteric fracture: a case report and review of the literature.We report a patient with a subtrochanteric fracture, for whom internal fixation failed and a prosthetic joint replacement was complicated by a local reactivation of a mycobacterium tuberculosis infection. After hip replacement with revision and adequate medical therapy, a full recovery was attained without the necessity of removing the artificial joint.- - - - - - - - - - ranking = 0.83333333333333keywords = fracture (Clic here for more details about this article) |
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