• Title/Summary/Keyword: Femoral Head

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An Irreducible Hip Dislocation with Femoral Head Fracture

  • Kim, Tae-Seong;Oh, Chang-Wug;Kim, Joon-Woo;Park, Kyeong-Hyeon
    • Journal of Trauma and Injury
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    • v.31 no.3
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    • pp.181-188
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    • 2018
  • Urgent reduction is required in cases of traumatic hip dislocation to reduce the risk of avascular necrosis of the femoral head. However, in cases of femoral head fractures, the dislocated hip cannot be reduced easily, and in some cases, it can even be irreducible. This irreducibility may provoke further incidental iatrogenic fractures of the femoral neck. In an irreducible hip dislocation, without further attempting for closed reduction, an immediate open reduction is recommended. This can prevent iatrogenic femoral neck fracture or avascular necrosis of the femoral head, and save the natural hip joint.

A Hip 14 Years after a Non-surgiclly-treated Pipkin Type-II Fracture of the Femoral Head - A Case Report - (핍킨 2형 대퇴골두골절의 보존적 치료 14년 후 결과 - 증례보고 -)

  • Lee, Young-Kyun;Ha, Yong-Chan;Koo, Kyung-Hoi
    • Journal of Trauma and Injury
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    • v.25 no.1
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    • pp.25-27
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    • 2012
  • A 30-year-old, male truck driver had a traffic accident and visited a hospital due to left hip pain. The patient's femoral head was fractured, and he was treated conservatively. For 14 years afterwards, he walked without a limp, had no pain, and drove his truck. He was involved in another traffic accident and experienced a comminuted fracture of the left distal femur 14 years after the initial injury. Although he was symptom-free, while being treated by open reduction and internal fixation for the distal femur fracture, he was concerned about the status of his left femoral head. Pelvis radiographs and reconstructed CT images were done, and they showed a spur change around the femoral head which had a dense sclerotic band within and revealed a slight depression of subchondral bone of the medial portion of the femoral head. The diagnosis was a Pipkin type-II fracture of the femoral head.

Extraction of the Femoral Heads in MR Images and Measurement of the Parameters for the Diagnosis of the Avascular Necrosis (MR 영상에서 대퇴골두 영역의 추출과 무혈성 괴사의 진단에 필요한 인자의 측정)

  • Lee, Kyung-Su;Lee, Sung-Kee
    • Journal of KIISE:Software and Applications
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    • v.27 no.8
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    • pp.846-854
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    • 2000
  • In this paper, we propose effecient methods to extract the femoral head region in MR images. The femoral head area in MRI is approximated using Hough transform and the anatomical features of the femoral heads. Then, modified region growing method is applied to extract the femoral head region. We measured the parameters for the diagnosis of the avascular necrosis of the femoral heads from the segmented femoral head region. The proposed methods are proved very effective to extract the femoral head of healthy volunteer and of the patient having heavy avascular necrosis. The measured parameters can be used very efficiently for the quantitative analysis and the diagnosis of the avascular necrosis of the femoral heads.

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Assessment of the Optimal Site of Femoral Artery Puncture and Angiographic Anatomical Study of the Common Femoral Artery

  • Ahn, Ho-Young;Lee, Hyung-Jin;Lee, Hong-Jae;Yang, Ji-Ho;Yi, Jin-Seok;Lee, Il-Woo
    • Journal of Korean Neurosurgical Society
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    • v.56 no.2
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    • pp.91-97
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    • 2014
  • Objective : The purpose of this study was to evaluate demographic and clinical factors affecting the common femoral artery diameter and length, and anatomical relationship between the femoral head and the common femoral artery during angiography. Methods : We retrospectively reviewed 109 femoral angiograms. We collected the clinical data of the patients and estimated the common femoral artery diameter and length. We divided the areas in the angiogram from cephalic to caudal direction (zone 0 to 5). The lowest levels of the inferior epigastric artery loop and points of the common femoral artery bifurcation were checked. Results : The luminal diameter of the common femoral artery was $6.19{\pm}1.20mm$. Height, weight, body surface area, as well as common femoral artery diameter were significantly greater in men than in women (p<0.005). The length of the common femoral artery was $27.59{\pm}8.87mm$. Height, weight and body surface area showed strong positive relationships with common femoral artery diameter. All of the inferior epigastric artery loops were located above the center of the femoral head. The point of common femoral artery bifurcation was above the center of the femoral head in 4.59% of femoral angiograms. Conclusions : Males and patients with a high body surface area have a larger common femoral artery diameter. The cumulative probability of optimal targeting between the lowest margin of the inferior epigastric artery loop and the common femoral artery bifurcation is the highest in zone 3 puncture.

Superior Gluteal Artery-pedicled Iliac Crest for the Treatment of Avascular Necrosis of Femoral Head (상둔 동맥 혈관경 후방 장골릉 골 이식을 이용한 대퇴골 두 무혈성 괴사의 치료)

  • Lee, Sang-Uk;Song, Seok-Whan;Suh, Yoo-Jun;Park, Seung-Bum
    • Archives of Reconstructive Microsurgery
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    • v.17 no.1
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    • pp.42-47
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    • 2008
  • Introduction: To evaluate the efficacy of superior gluteal artery-pedicled iliac crest for the treatment of avascular necrosis of femoral head. Material & Method: From January 2001 to October 2001, we used the superior deep branches of superior gluteal artery for the pedicled posterior iliac crest bone graft to revascularize the avascular femoral head in 4 patients. They were 1 man and 3 women, and the mean age of the patients was 34 years (range, 27 to 60). The average follow-up after surgery was over 57 months (range, 15 to 82). We analyzed the clinical results by the Harris hip score, and evaluated the vascularity of the femoral head by radiographic methods. Results: All cases showed no evidence of collapse on femoral heads and good revascularizations on the radiographic images. The average Harris hip score was 88.5 points. There was no complication. Conclusion: The revascularization procedure using the superior gluteal artery-pedicled posterior iliac crest was thought to be one of the effective and promising techniques for the treatment of the avascular necrosis of femoral head.

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The solid angle estimation of acetabular coverage of the femoral head using 3D method (입체각 측정을 통한 대퇴골두에 대한 관골구 coverage 측정)

  • Choi, K.H.;Kim, M.C.;Lim, C.T.;Kim, S.I.
    • Proceedings of the KOSOMBE Conference
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    • v.1997 no.05
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    • pp.123-126
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    • 1997
  • We present a method for the estimation of 3D solid angle assessment of the acetabular coverage of the femoral head in 3D space. At first, femoral head and acetabulum is segmented from the original CT scan images. The slice thickness is 1.5mm and the number of slices is usually 30-40 to cover the entire acetabulum. The superior half of the femoral head is modeled as part of a sphere. Thus, the axial cross sections of the upper half of the femoral head are also modeled as circles. A set of points from each outline image of femoral head is fitted recursively into a circle by minimizing root-mean-square (RMS) error. With these fitted circles, a center point of the femoral head model is evaluated. This is a reference point for calculating the solid angle of the acetabular inner surface. Next, the tangent lines connecting from a set of points of the acetabular edge to the center of the fitted sphere are obtained. The lines pass through the unit sphere whose center is the same as that of the femoral head. With the points on the unit sphere, we calculate area and estimate the solid angle. Based on this solid angle, the deformity of the acetabulum is analyzed. In case of normal subject, the solid angle is about 4.3 (rad) and acetabular coverage is 68%.

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A Case Report of Conservative Treatment of Femoral Neck Stress Fracture Developed in Avascular Necrosis of the Femoral Head (대퇴골두 무혈성 괴사에 속발한 대퇴경부 피로골절 환자에서의 보존적 치료 치험 1례)

  • Ro, Hae-Rin;Park, So-Hyun;Kim, Jeong-Won;Cho, Tae-Young
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.2
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    • pp.79-85
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    • 2011
  • Objectives : The Purpose of this study is to investigate the clinical application of conservative treatment for femoral neck stress fracture developed in avascular necrosis of the femoral head. Methods : Patient is hospitalized at Dept. of Oriental Rehabilitation Medicine, Bu-Chun Jaseng Oriental Medicine Hospital, diagnosed as femoral neck stress fracture developed in avascular necrosis of the femoral head and treated by herbal medicine, acupuncture and moxibustion. This study was measured by Visual Analogue Scale(VAS) score, range of motion and walking time. Results : After conservative treatment, the patient's pain was controlled and VAS score was decreased. Range of motion and walking time were improved. Conclusions : As seen in this one case, Oriental conservative treatment has a positive effect to control pain with femoral neck stress fracture developed in avascular necrosis of the femoral head.

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A Case Report of Avascular Necrosis of the Femoral Head (대퇴골두 무혈성 괴사로 진단받은 고관절 통증 1례에 대한 증례보고)

  • Heo, Yoon-kyoung;Lee, Hyun;Moon, Ik-ryoul;Park, Ki-bum;Park, Hyoung-seon;Seo, Won-hee;Kim, Yeon-jin;Kim, Joung-keun
    • Journal of Acupuncture Research
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    • v.21 no.6
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    • pp.299-309
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    • 2004
  • Objective : The etiology and treatment of the avascular necrosis of the femoral head continiue to be controversial and the pathogenesis remains obscure. And its clinical study and report about oriental treatment are absolutely insufficient. Therefore, we report a case of avascular necrosis of the femoral head. Methods : The patient was treated with Bee-Venom therapy, Electro Acupuncture and Sopungwhalhyul-tang(疎風活血湯). Results : After 26days of Oriental treatments, there was remarkable improvement in condition of the patient. Conclusions : In this case, oriental treatments for avascular necrosis of the femoral head was effective. Futher studies are required to prove effectiveness of oriental treatments for treating avascular necrosis of the femoral head.

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Relevance of the Watson-Jones anterolateral approach in the management of Pipkin type II fracture-dislocation: a case report and literature review

  • Nazim Sifi;Ryad Bouguenna
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.161-165
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    • 2024
  • Femoral head fractures with associated hip dislocations substantially impact the functional prognosis of the hip joint and present a surgical challenge. The surgeon must select a safe approach that enables osteosynthesis of the fracture while also preserving the vascularization of the femoral head. The optimal surgical approach for these injuries remains a topic of debate. A 44-year-old woman was involved in a road traffic accident, which resulted in a posterior iliac dislocation of the hip associated with a Pipkin type II fracture of the femoral head. Given the size of the detached fragment and the risk of incarceration preventing reduction, we opted against attempting external orthopedic reduction maneuvers. Instead, we chose to perform open reduction and internal fixation using the Watson-Jones anterolateral approach. This involved navigating between the retracted tensor fascia lata muscle, positioned medially, and the gluteus medius and minimus muscles, situated laterally. During radiological and clinical follow-up visits extending to postoperative month 15, the patient showed no signs of avascular necrosis of the femoral head, progression toward coxarthrosis, or heterotopic ossification. The Watson-Jones anterolateral approach is a straightforward intermuscular and internervous surgical procedure. This method provides excellent exposure of the femoral head, preserves its primary vascularization, allows for anterior dislocation, and facilitates the anatomical reduction and fixation of the fracture.

Mechanical Properties of Trabecular Bone in femoral Head & Neck (넙다리뼈 머리/목 부분 해면뼈의 기계적 물성)

  • Kwak Dai-Soon;Choi Kwang-Nam;Kim Sang-Kuk;Lee Sang-Ho;Kim Tae-Joong;Han Seung-Ho;Oh T.Y.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.10a
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    • pp.518-521
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    • 2005
  • We performed the mechanical test for obtaining properties of femoral head. Tested sample was male and 35 years old. We measured bone mineral density by dual X-ray absorption method(DEXA). Results of DEXA, he has normal condition of bone density. His BMD $1.159g/cm^2$ and T-Score is 1.6. Tested femurs were harvested by surgical method from donated cadaver. We made 9 specimens in femoral head, 8 specimens in neck used by diamond core drill. Then we performed compressive test in saline solution at $38^{\circ}C$. We obtained results that elastic modulus of femoral head was 0.439GPa, neck was 0.459GPa. Compressive strength of femoral head was 7.441 MPa, neck was 7.095MPa. There was no significant difference of mechanical properties between left and right femoral head & neck. Invested local properties of femoral head have more strength superior and anterior side, femoral neck has more strength in superior and inferior side but other side except for superior has more weakness along the lateral side.

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