• Title/Summary/Keyword: Femoral fixation

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Physeal Remodeling after Internal Fixation of Slipped Capital Femoral Epiphysis (대퇴골두골단분리증 환자 중 금속내고정술을 시행받은 환자에서의 골단판의 재형성)

  • Kim, Se-Dong;Park, Byung-Won
    • Journal of Yeungnam Medical Science
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    • v.20 no.1
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    • pp.28-35
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    • 2003
  • Purpose: To evaluate physeal remodeling after internal fixation of slipped capital femoral epiphysis, We performed a retrospective review of the medical records and radiographs of 14 children (17 cases) who had had slipped capital femoral epiphysis. Materials and Methods: We reviewed 14 patients who had slipped capital femoral epiphysis. They were divided two groups. Group I were in situ pinning with single screw and group II were corrective osteotomy with multiple pinning. We identified physeal remodeling camparing with their preoperative, postoperative and last follow-up radiographs with measuring physeal-shaft angle. Results: Early closure of the physis was observed in 6 cases among 14 patients (17 hips). Compared with their postoperative radiographs, the last follow up radiographic study revealed that physeal remodeling was observed in 4 patients (4 hips) at group I (mean, $7.8^{\circ}$), in 2 patients (3 hips) at group II (mean, $10.7^{\circ}$). Conclusion: In this study, physeal remodeling was observed in 4 patients (4 hips) in group I and 2 patients (3 hips) in group II. The incidence of physeal remodeling was related with degree of epiphyseal slippage, and age was not related with physeal remodeling potential.

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Graft Selection and Fixation in Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술 시 이식건의 선택과 고정)

  • Kim, Du-Han;Bae, Ki-Cheor;Choi, Byung-Chan
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.294-304
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    • 2020
  • Anterior cruciate ligament (ACL) reconstruction is a successful procedure independently by patient selection, timing of surgery, surgical technique, choice of graft, and fixation methods. Among these factors, graft selection and fixation methods might be the most critical yet controversial questions for surgeons. Although recent studies showed that grafts have advantages and drawbacks, there is still no ideal graft. Similarly, many fixation methods of femoral and tibial tunnels have been proposed over the last few decades, with no clear superiority of one technique over another. Surgeons should be familiar with a variety of grafts, fixation techniques, and their specific associated surgical procedures as well as the advantages and disadvantages of each. Therefore, this article summarizes the current literature and discusses the current state of graft selection and fixation methods in the treatment of an ACL injury.

The Distal Filling Effects on Hip Jont Function in Cementless Total Hip Replacement (인공 고관절 대치술에서 무시멘트형 스템의 원위부 압박이 고관철 성능에 미치는 영향)

  • 채수원;박상석;박재원
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.24 no.11
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    • pp.2777-2785
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    • 2000
  • In cementless total hip replacement(THR), an initial stability of the femoral component is important to long term fixation of femoral stem. The intial stability has close relationship with the relative displacement of prosthessis and sponge bone at the proximal of femur. After implantation of the proshesis, the surrounding bone is partially shielded from load carrying and starts to resorb. Stress shielding is the cause of the loss of proximal bone. Assessing stress distribution of femur is important to predict stress shielding. The initial stability and the stress shielding were investigated for two loading conditions approximating a single leg stance and a stair climbing. Three types of stems were studied by the finite element method to analyze the biomechanical effects of distal filling of cementless femoral stems. Three types of stems empolyed are a distal filling stem, a distal flexible stem, and a distal tapered stem.

Bilateral distal femoral epiphyseal detachment in a young adult: a case report

  • Armand Yepie;Moctar Traore;Mensah Yaovi;Michel Anoumou
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.458-461
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    • 2023
  • Epiphyseal dislocations and fractures frequently occur in children and adolescents. However, these injuries seldom involve the distal femur, and bilateral cases are even rarer. We present an unusual case of bilateral epiphyseal detachment of the femur in a 21-year-old man who was involved in a traffic accident. Open reduction and fixation surgery were performed 5 days after the incident. The patient experienced favorable progress, with consolidation occurring at 3 months. No lower limb length discrepancies were observed at the 20-month follow-up. In summary, bilateral distal femoral epiphyseal detachment is an uncommon condition that can be effectively treated through surgical intervention.

Arthscopic Treatment of Osteochondritis Dissecans in Femoral Condyle (관절경을 이용한 대퇴골과 박리성 골연골염에 대한 치료)

  • Kim Sung-Jung;Kyung Hee-Soo;Ihn Joo-Chul;Lee Seong-Man
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.138-143
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    • 2000
  • Purpose : We analyzed clinical and radiological results of the treatment of osteochondritis dissecans in the femoral condyle under arthroscopic guidance. Materials and Methods : The study group consists 19 cases in 17 patients. Average follow up period was 34 months and average age was 16 years. The cases were classified by 4 different groups, using the fellowing system: Group 1-stable lesion and no specific treatment after arthroscopic examination; Group 2-early separation and multiple drilling; Croup 3-unstable lesion and Herbert screw fixation; Croup 4-loose body removal and/or crater curettage. The results were analyzed by the criteria of Hughston which including clinical and radiologic outcomes. Results : There were 14 cases$(74\%)$ of good and excellent results in 19 knees in which, $75\%$(3/4) in Group 1, $75\%$(3/4) in Group 2, $86\%$(7/8) in Group 3 and $33\%$(1/3) in Group 4. The result of Herbert screw fixation group was better than that of other groups with statistically significant differences. Conclusion : In the treatment of osteochondritis dissecans of skekletally immature patients, arthroscopic finding was reliable guidance in decision of treatment method and active fixation was recommended in patients with large, unstable lesion.

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Modified External Skeletal Fixation for Craniodorsal Coxofemoral Luxation in 5 Dogs (개의 전배측 고관절 탈구에서 변형된 외골격 고정 적용 5례)

  • Jung, Chang-Su;Lim, Ji-Hey;Byeon, Ye-Eun;Kim, Wan-Hee;Yoon, Jung-Hee;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.631-635
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    • 2007
  • Luxation of the hip is the most common luxation seen in small animals. Luxations are classified by the direction in which the femoral head lies in relation to the acetabulum and craniodorsal luxations are the most common type. Recommendations for treatment are based on the presence of preexisting disease, the type and duration of luxation and severity of concurrent injuries. In this study modified external skeletal fixation was used for craniodorsal coxofemoral luxation in 5 dogs. Luxated head Joint was reduced and fixator pins were applied into the greater trochanter, the middle point of iliac body and the lateral surface of sacroiliac joint in a closed fashion. Reduction was successful in 4 of the 5 operated limbs. Complications noted in this study included pin tract drainage, pin loosening and secondary fracture at the pin insertion site.

Long Bone Fractures in Raptors: 28 cases (2004-2007)

  • Yoon, Hun-Young;Fox, Derek B.;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.25 no.3
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    • pp.215-217
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    • 2008
  • Medical records from the Veterinary Medical Teaching Hospital of the University of Missouri-Columbia from 2004 to 2007 were available for 28 raptors that underwent long bone fracture repair. There were 14 owls, 10 hawks, 2 vultures, 1 eagle, and 1 falcon. Mean body weight was 780 g (ranged from 150 to 1400 g) for 14 owls; 650 g (ranged from 150 to 1270 g) for 10 hawks; 1760 g (ranged from 1520 to 2000 g) for 2 vultures; 5000 g for 1 eagle; and 130 g for 1 falcon. Of all 28 fracture cases, 11 cases (39%) and 1 case (3%) were related to hit-by-car and shooting respectively. Physical examination revealed dehydration in 18 raptors (64%) and lethargy in 12 raptors (42%). Forty one long bone fractures were included in 28 cases. The radiographs revealed 13 ulnar fractures (32%), 12 humeral fractures (30%), 10 radial fractures (25%), 4 tibiotarsal fractures (9%), 1 femoral fracture (2%), and 1 fibular fracture (2%). External skeletal fixation using polymethylmethacrylate (PMMA) combined with intramedullary fixation was used in 19 long bone fractures (46%). Intramedullary fixation using intramedullary Kirschner pin was used in 16 long bone fractures (39%). No surgical treatment was performed in 6 long bone fractures (15%). This study reported that many of raptors presented dehydration and lethargy when admitted for treatment. Therefore, proper hydration and nutrition are critical pre-surgical requirements. In addition, combination of internal fixation and external skeletal fixation using PMMA might be better option to treat raptors with comminuted fracture that results from mostly trauma of hit-by-car.

Cement Augmentation of Dynamic Hip Screw to Prevent Screw Cut Out in Osteoporotic Patients with Intertrochanteric Fractures: A Case Series

  • Rai, Avinash Kumar;Goel, Rajesh;Bhatia, Chirag;Singh, Sumer;Thalanki, Srikiran;Gondane, Ashwin
    • Hip & pelvis
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    • v.30 no.4
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    • pp.269-275
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    • 2018
  • Purpose: The purpose of this study is to describe a method of inserting cement in the femoral head before fixation with dynamic hip screw to prevent screw cut out due to osteoporosis and to evaluate its clinical outcome in these patients. Materials and Methods: In this prospective study, 30 patients aged 60 years and older with intertrochanteric fracture were included. Bone mineral density was measured. After reaming of the femoral head and neck with a triple reamer and polymethyl methacrylate, bone cement was introduced into the femoral head using a customized nozzle and a barrel fitted on a cement gun. A Richard screw was inserted and the plate was fixed over the femoral shaft. Patients were mobilized and clinical outcomes were rated using the Salvati and Wilson's scoring system. Results: More patients included in this study were between 66 and 70 years old than any other age group. The most common fracture according to the Orthopaedic Trauma Association classification was type 31A2.2 (46.7%). The T-score was found to be $-2.506{\pm}0.22$ (mean${\pm}$standard deviation); all patients were within the range of -2.0 to -2.8. The duration of radiological union was $13.67{\pm}1.77$ weeks. Salvati and Wilson's scoring at 12 months of follow up was $30.96{\pm}4.97$. The majority of patients were able to perform their normal routine activities; none experienced implant failure or screw cut out. Conclusion: Bone cement augmentation may effectively prevent osteoporosis-related hardware complications like screw cut out in elderly patients experiencing intertrochanteric fractures.

Total Hip Arthroplasty in Patients with Avascular Necrosis of the Entire Femur (전체 대퇴골에 발생한 골괴사 환자에서 인공 고관절 전치환술)

  • Yi, Seung Rim;Im, Se Hyuk;Park, Sang Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.281-286
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    • 2019
  • Avascular necrosis (AVN) is defined as the cellular death of bone and bone marrow components due to the loss of blood supply, and associated with post-traumatic or non-traumatic events. AVN usually involves the epiphysis of a long bone, such as the femoral and humeral heads, which are susceptible to osteonecrosis. Many studies have been conducted but they were restricted to investigations of femoral head avascular necrosis. The presence of osteonecrosis in the proximal femur may impair biological fixation after total hip arthroplasty. We report a 56-year-old male patient with avascular necrosis located not only at the femoral head, but also in the entire femur, including the medullary cavity, who underwent total hip arthroplasty 2 years earlier along with a review of the relevant literature.