Purpose: This study examined osteotomy union and heterotopic ossification (HO) after performing digastric trochanteric osteotomies during open reduction and internal fixation (ORIF) of acetabular and combined femoral head fractures. Femoral head osteonecrosis and trochanteric screw removal were secondarily assessed.
Methods: Twenty-six patients treated at a Level I trauma center, from years 2003 to 2019, who received a digastric trochanteric osteotomy during acetabular and combined femoral head fracture ORIF through a posterior surgical approach were retrospectively identified. Osteotomies were fixed with two 3.5 mm cortical lag screws. Rates of osteotomy union, HO, femoral head osteonecrosis, and trochanteric screw removal were determined.
Results: All osteotomies went onto union without displacement or failure of fixation. Only three (12%) patients developed severe HO (modified-Brooker class III-IV). There were no instances of femoral head osteonecrosis and only one (7%) patient required trochanteric screw removal.
Conclusions: The digastric trochanteric osteotomy heals reliably with low rates of severe HO, femoral head osteonecrosis, and screw removal for soft-tissue irritation. A review of the literature is presented and found comparable findings.
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http://dx.doi.org/10.1007/s00590-020-02753-9 | DOI Listing |
Sci Rep
December 2024
Department of Orthopedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
The humeral head is the second most common anatomical site of osteonecrosis after the femoral head. Studies have reported satisfactory clinical outcomes after shoulder arthroplasty to treat osteonecrosis of the humeral head (ONHH). However, there are concerns regarding implant longevity in relatively young patients.
View Article and Find Full Text PDFCureus
November 2024
Orthopaedic Surgery, The Aga Khan University, Karachi, PAK.
Background Acetabular fractures, a rising concern in developing countries, pose a significant challenge due to their complexity and association with post-operative complications. Often caused by high-energy mechanisms like falls and motor vehicle accidents, these fractures require accurate reduction to prevent long-term issues and the potential need for hip replacement. This study investigates the radiological outcomes of acetabular fracture surgery at six months, focusing on the effectiveness of achieving anatomical reduction using the Matta criteria in a low-and middle-income country (LMIC) setting.
View Article and Find Full Text PDFIndian J Orthop
January 2025
Department of Control Science and Engineering, Harbin Institute of Technology, Harbin, 150001 China.
Introduction: The Steinberg classification system is commonly used by orthopedic surgeons to stage the severity of patients with osteonecrosis of the femoral head (ONFH), and it includes mild, moderate, and severe grading of each stage based on the area of the femoral head affected. However, clinicians mostly grade approximately by visual assessment or not at all. To accurately distinguish the mild, moderate, or severe grade of early stage ONFH, we propose a convolutional neural network (CNN) based on magnetic resonance imaging (MRI) of the hip joint of patients to accurately grade and aid diagnosis of ONFH.
View Article and Find Full Text PDFRestoring leg length during total hip arthroplasty (THA) for femoral neck fracture is challenging due to the lack of an intact femoral neck on the fractured side. Thus, templating methods typically use size of the intact contralateral hip to estimate length. Common reference points include the distance from the lesser trochanter to the center of the femoral head (LTC) and femoral head diameter (FHD).
View Article and Find Full Text PDFCureus
November 2024
Department of Orthopaedics and Trauma, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE.
Femoral nerve palsy (FNP) is a rare but serious complication after total hip replacement (THP). Despite its rarity, FNP can significantly impact patient recovery and quality of life. This case report examines the occurrence of FNP in a patient following a primary THP and highlights the importance of surgical technique and postoperative detection and its management.
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