Cases reported "Hip Fractures"

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11/50. Transphyseal fracture-dislocation of the femoral neck: a case report and review of the literature.

    We describe a case of transphyseal hip fracture-dislocation in a 7.5-year-old patient who was treated initially by open reduction and internal fixation. Soon after the injury, the femoral head developed avascular necrosis. The treatment was focused on maintaining adequate hip range of motion and providing femoral head containment with a combined subtrochanteric femoral osteotomy and shelf acetabuloplasty. The patient's young age and good hip remodeling potential contributed to the favorable clinical outcome 3 years after the injury. The long-term prognosis remains guarded, however.
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12/50. Three part posterior fracture dislocation of the hip without fracture of the femoral head: review of literature and a case report.

    This case report describes a rare posterior dislocation of the hip with fractures of the ipsilateral femoral neck and greater trochanter, without fracture of the femoral head, in a young adult male following a railway accident. This patient was managed within 6h of injury by open reconstruction. This unusual injury has not been reported previously. Cases of posterior fracture dislocation of the hip with a fracture of the femoral neck without fracture of the femoral head were reviewed from the literature. Mechanism of injury, controversies regarding operative procedures and appropriate surgical approach are discussed. The authors also believe that this injury pattern merits inclusion in the existing classification system of fracture dislocation of hip for management and prediction of outcome.
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13/50. Laceration of femoral vessels by an avulsion fracture fragment of the lesser trochanter after bipolar hemiarthroplasty.

    Femoral vessel injuries after bipolar hemiarthroplasty have not been reported. The current report describes a case of a dual major vessel (superficial femoral artery and vein) injury associated with an avulsion fracture fragment of the lesser trochanter in a 76-year-old woman who had been treated with bipolar hemiarthroplasty because of a femoral neck fracture. The superficial femoral artery was repaired and the defect of the superficial femoral vein was reconstructed with a Gore-Tex graft (WL Gore and Associates Inc, Flagstaff, Ariz). The clinical result was satisfactory and there was no vascular problem at 1-year follow-up. early diagnosis of this vascular injury prevents serious complications including gangrene of the injured limb.
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14/50. Managing perioperative risk in the hip fracture patient.

    patients with hip fracture benefit from a multidisciplinary team approach for preoperative and postoperative care. Team members, consisting of the orthopedic surgeon, internal medicine consultant, and anesthesiologist, should each have a role in determining a patient's readiness for surgery and communicate with one another about appropriate management. How urgently a hip fracture needs repair depends on the type of injury. In general, most injuries should be repaired as soon as the patient can be medically optimized (preferably 24 to 48 hours), keeping in mind that procedures are often lengthy and maximally invasive, and frequently involve complications. Nondisplaced (impacted) femoral neck fractures, however, should be repaired within 6 hours if possible to avert avascular necrosis of the femoral head and the need for total hip replacement. The following interventions are helpful for preventing complications following hip fracture repair: perioperative prophylaxis against infection.
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15/50. fatigue failure of the sliding screw in hip fracture fixation: a report of three cases.

    Hardware failure of the sliding screw system used in hip fracture fixation is rare. The fatigue failure of the sliding screw is always related clinically to nonunion or refracture along the path of the screw. In both situations, cyclic loading of the implant exceeds its endurance limit, and failure can ensue. Three cases of failure of the sliding screw are presented: a nonunion of a basicervical fracture, a nonunion secondary to stress fracture at the plate-barrel junction, and a refracture through the femoral neck after healing of an intertrochanteric fracture. A biomechanical analysis of the stresses on the sliding screw focuses on design features such as the internal threaded region used for the compression screw or the barrel length that creates increased stresses in the screw, thus lowering the number of cycles to failure. Based on this analysis, recommendations are made concerning implant design and surgical technique.
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16/50. Central fracture-dislocation of the hip with ipsilateral femoral neck fracture: case report.

    Central fracture dislocation of the hip with associated fracture of the femoral neck is rare. Treatment of choice consists of open reduction of the displacement and internal fixation of both fractures. Nevertheless, inadequate reduction of the burst fracture of the acetabulum may lead to hip arthritis, and the surgical approach to the femoral neck jeopardizes its vitality. In elderly patients early full motion and prompt physical rehabilitation can be achieved by total hip arthroplasty after fusion of the displaced femoral head to the acetabular wall.
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17/50. The role of computerized tomography in the diagnosis of an occult femoral neck fracture associated with an ipsilateral femoral shaft fracture: case report.

    We report a nondisplaced femoral neck and head fracture diagnosed acutely by CT scanning. This case illustrates the potential benefits of an acute femoral neck/head CT scan in obtunded polytrauma patients with high-energy femoral shaft fractures.
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18/50. Subcapital fracture of the femoral neck following internal fixation with a dynamic hip screw.

    A case of subcapital femoral neck fracture following osteosynthesis of a trochanteric fracture is described. The implant used was the dynamic hip screw. This kind of fracture is very rare, and has to our knowledge never been described with the use of the dynamic hip screw.
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19/50. Subtrochanteric fractures following Gouffon pinning of subcapital femoral fractures.

    Of the first 158 patients in a series of 292 consecutive patients treated for a femoral neck fracture with multiple pinning according to Gouffon's method (Howmedica Inc.), four (2.5 per cent) subsequently suffered a subtrochanteric fracture at the site of the distal pins. The configuration of the fractures was identical. These fractures occurred spontaneously while walking, and one occurred after slight direct trauma. Re-osteosynthesis was required in all four cases using a screw-plate device. If necessary, one or two pins were left in place to secure rotational stability. After a review of these cases and the literature, various modifications to Gouffon's method were introduced, and none of the following 134 patients suffered secondary fractures.
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20/50. osteomalacia from Al and Mg antacids. Report of a case of bilateral hip fracture.

    Presented is a case of bilateral spontaneous fracture of the femoral neck in a 40-year-old woman who suffered from severe phosphate depletion due to excessive intake of antacids containing magnesium and aluminum. attention is drawn to this rare cause of osteomalacia, which can be easily treated.
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