Nonunion neck of femur can be a difficult problem to treat, particularly in the young, and is associated with high complication rates of avascular necrosis due to the precarious blood supply and poor biomechanics. The various treatment options that have been described can be broadly divided according to the aim of improving either biology or biomechanics. Surgeries aimed at improving the biology, such as vascularized fibula grafting, have good success rates but require high levels of expertise and substantial resources. A popular surgical treatment aimed at improving the biomechanics-valgus intertrochanteric osteotomy-optimizes conditions for fracture healing by converting shear forces across the fracture site into compressive forces. Numerous variations of this surgical procedure have been developed and successfully applied in clinical practice. As a result, the proximal femoral orientation for obtaining a good functional outcome has evolved over the years, and the present concept of altering the proximal femoral anatomy as little as possible has arisen. This technical objective supports attaining union as well as a good functional outcome, since excessive valgus can lead to increased joint reaction forces. This review summarizes the historical and current literature on valgus intertrochanteric osteotomy treatment of nonunion neck of femur, with a focus on factors predictive of good functional outcome and potential pitfalls to be avoided as well as controversies surrounding this procedure.
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http://dx.doi.org/10.5312/wjo.v7.i5.301 | DOI Listing |
Skeletal Radiol
December 2024
Department of Orthopedic Surgery, Akita Hospital, 2-6-12 Takara, Chiryu City, Aichi, 472-0056, Japan.
Objective: To determine which parameters, including femur morphology, proximal femur bone mineral density, or patient characteristics, are associated with bisphosphonate-related atypical femur fractures (AFFs) and to investigate the relationships between AFF location and these parameters.
Materials And Methods: Sixteen females with a history of bisphosphonate use who presented with AFFs and 38 females without AFFs, even those with long-term bisphosphonate use of > 5 years, were compared. Patient characteristics; physique, gait ability, and history of pain and medication, were recorded.
Orthop Traumatol Surg Res
December 2024
Société Française de Chirurgie Orthopédique et Traumatologique, 56 rue Boissonade, 75014 Paris Cedex, France.
Introduction: Lower limb length discrepancy (LLD) following hip arthroplasty after proximal femoral fracture (PFFA) is little studied. The aim of this work was to answer the following questions: 1) What are the incidence and mean values of LLD after PFFA? 2) What are the clinical consequences (tolerance) of LLD after PFFA? 3) Can we identify risk factors for LLD after PFFA? 4) Is there a significant difference in terms of LLD after PFFA to treat intra- versus extra-capsular fractures?
Hypothesis: LLD after proximal femoral fracture arthroplasty is rare but has good clinical tolerance, given the low functional demands of the patients.
Patients And Methods: This is a multicenter prospective observational cohort study (15 centers), including 590 patients, operated on for hip arthroplasty for proximal femur fracture between May 2022 and June 2023.
Quant Imaging Med Surg
December 2024
Department of Orthopedic, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
Background: Hip fractures significantly reduce the quality of life and mobility of older adults. This study aimed to analyze the correlation between volumetric bone mineral density (vBMD) in different regions of the proximal femur as measured by quantitative computed tomography (QCT) and various subtypes of hip fractures.
Methods: This case-control study included patients over the age of 65 years admitted to Huadong Hospital Affiliated to Fudan University for hip fractures from November 2022 to December 2023; additionally, patients from the health examination center or outpatient center treated during the same period were included as a control group.
J Orthop Surg Res
December 2024
Department of Emergency Surgery and Orthopaedic Surgery, Qilu Hospital of Shandong University, No. 107, West Wenhua Road, Jinan, Shandong, 250012, PR China.
Objective: Femoral neck fractures (FNFs) are a common orthopedic type, and there are many treatment methods for it, and cannulated screw internal fixation is currently one of the main treatment methods. The choice of fully threaded cannulated screw (FCS) or partially threaded cannulated screw (PCS) remains controversial. Therefore, we performed this meta-analysis to evaluate the outcomes of FCS and PCS in the treatment of FNF.
View Article and Find Full Text PDFComput Biol Med
December 2024
Griffith Center of Biomedical and Rehabilitation Engineering (GCORE), Griffith University, Australia; School of Medicine and Dentistry, Griffith University, Australia; Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, Australia. Electronic address:
Background And Objective: Proximal femoral osteotomy (PFO) is a surgical intervention, typically performed on paediatric population, that aims to correct femoral deformities caused by different pathologies (e.g., slipped capital femoral epiphysis).
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