Introduction: The direct anterior approach (DAA) is generally accepted method for minimal invasive arthroplasty of the hip. As good results for total hip arthroplasty are already published, there is a lack of evidence for the implantation of bipolar hip hemiarthroplasty (BHH) in elderly patients with osteoporosis after femoral neck fracture.
Materials And Methods: For hip arthroplasty using a direct anterior approach (DAA) in elderly patients with femoral neck fractures, a number of modifications of the original technique are being described. The modified DAA considers in particular the co-morbidity and the bone quality of the geriatric patient population. A consecutive series of 16 hemiarthroplasties using this technique is presented. In all 16 cases, the BHH was implanted in modified DAA technique. Mobility measured by 4-item Barthel Index, pain via visual analogue scale (VAS), duration of surgery, external length of incision and blood loss were evaluated.
Results: There was no major operative complication during the procedures. The pain level decreased from 7 (preoperatively) to 0 at postoperative day 40. The Barthel Index increased from 5 at first postoperative day to 40 at day 40. Early postoperative mobilisation is efficiently accelerated. Mean operating time was 71 min; the medium skin incision length was 8 cm. The mean haemoglobin level decreased from 118 g/dl preoperatively to 101 g/dl at first postoperative day.
Conclusion: The described modifications of the DAA help to implant a BHH gently in elderly patients with increasing risk of complications like iatrogenic fractures, wound or prosthesis infections and haematoma. This will hopefully lead to a faster rehabilitation and lower mortality rate for patients with femoral neck fractures in the future.
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http://dx.doi.org/10.1007/s00402-013-1831-5 | DOI Listing |
Surg Radiol Anat
January 2025
Faculty of Dental Medicine, University of Porto, Porto, Portugal.
Purpose: The greater palatine foramen (GPF) represents the inferior opening of the greater palatine canal and is located posterolaterally on both sides of the hard palate. The aim of this study is to morphometrically characterise the GPF and to determine its anatomical relationships in a Portuguese population.
Methods: A retrospective study was performed based on the clinical records which included all permanent teeth erupted and a cone beam computed tomography (CBCT) of the entire maxilla.
Trauma Case Rep
February 2025
Department of Orthopaedic Surgery, Misawa City Hospital, 164-65 Horiguchi, Misawa, Misawa-shi, Aomori 033-0022, Japan.
Irreducible ankle fracture-dislocations due to posterior tibialis tendon (PTT) interposition in the distal tibiofibular and tibiotalar joints are rarely reported, and their diagnoses are often missed and delayed. In addition, previous reports lacked a longer clinical follow-up period, and objective and subjective evaluations of such cases have not been reported. A 22-year-old man sustained an open fracture-dislocation of the ankle joint associated with a distal third of the fibular shaft fracture and diastasis of the distal tibiofibular joint.
View Article and Find Full Text PDFStrabismus
January 2025
Department of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology, Shroff's Charity Eye Hospital, New Delhi, India.
: Trauma to extraocular muscle without globe perforation is rare. This case report describes the clinical features and principles of repair of the simultaneous injury to two extraocular muscles sustained from a goat's horn. : Case records of the 36-year-old man who suffered trauma to his left eye were reviewed.
View Article and Find Full Text PDFBMC Res Notes
January 2025
Department of Orthopaedic Surgery, Chiba GEKA-NAIKA Hospital, 4-41 Haramachi, Kawaguchi, Saitama, 332-0025, Japan.
Objective: This study aimed to clarify the relationship between the directions of humeral head translation, the presence of acromial or coracoid spurs, and the locations of tendon tears in massive rotator cuff tears. Thirty shoulders from thirty patients with massive rotator cuff tears who underwent reverse shoulder arthroplasty were included. Preoperative 3DCT classified humeral head translation into three groups: minimal type, posterosuperior type, and anterosuperior type.
View Article and Find Full Text PDFPLoS Biol
January 2025
Key Laboratory of Brain Aging and Neurodegenerative Diseases, Fujian Medical University, Fuzhou, China.
The anterior cingulate cortex (ACC) is recognized as a pivotal cortical region involved in the perception of pain. The retrosplenial cortex (RSC), located posterior to the ACC, is known to play a significant role in navigation and memory processes. Although the projections from the RSC to the ACC have been found, the specifics of the synaptic connections and the functional implications of the RSC-ACC projections remain less understood.
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