For patients too young to be fitted with an expandable prosthesis, limb salvage surgery requires other strategies. The main problems are related to the impossibility of implanting an expandable prosthesis to the residual bone growth that is much too big in relation to the bone size, with the precocious implant loosening and/or the residual absence of bone growth, as well as the problem of limb length and shape difference. In this paper, we report a possible reconstruction solution using a composite prosthesis for an Ewing's sarcoma of the proximal femur in an infant patient. After resection, a femoral stem was cemented into the distal third of a homoplastic humerus; a carbon fiber plate was used to stabilize the bone/homograft interface. At the one-year follow-up, the patient was free of disease and able to walk with only a slight limp. This case report describes a possible solution for very small patients. An adult humerus is of the right size to replace a child's lower limb segments, and the distal humerus can be shaped, maintaining a cortex stiff enough to support a prosthesis. Very young patients might obtain a faster osteointegration of the graft than adults, due to their higher biological activity and, in this case, the diapasonal shape of the allograft might also have contributed to accelerated fusion. Moreover, the use of a graft to fit the prosthesis avoids loosening issues due to canal widening, hypothetically providing more growing time before system failure and revision surgery. However, although this technique is promising, further studies are necessary to confirm our findings and to verify if this procedure allows easier future prosthesis implantation.
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http://dx.doi.org/10.3390/children8060442 | DOI Listing |
Cephalomedullary nail is the gold standard treatment for intertrochanteric fracture in geriatric population. The aim of the study was to investigate the differences of the reamed versus the unreamed short proximal femoral nailing (PFN), in terms of the duration of surgery and the outcome. The impact of patients and fracture characteristics to the outcome was also evaluated.
View Article and Find Full Text PDFThe aim of this comparative study was to examine the possible benefits of a dedicated Orthopaedic Trauma Room (DOTR) and in the care of patients with proximal femur fractures. A retrospective study of all orthopaedic cases with a hip fracture from 2020 to 2022 at CHC Montlegia has been undertaken, the group is compared to patients with the same impairment from 2018-2020 admitted to Saint Joseph/Esperance CHC hospitals (before the merge and the existence of a DOTR). The delay between the arrival at the emergency department and transfer to the operating room, as well as the mortality are evaluated.
View Article and Find Full Text PDFArch Bone Jt Surg
January 2024
Hospital Universitario La Princesa, Madrid, Spain.
Objectives: Treatment of subtrochanteric fractures of the proximal femur may be challenging due to their anatomical and biomechanical features. Intramedullary nails are the most frequently used devices, although there is no consensus concerning their optimal length. The aim of this study is to compare the functional and radiological outcomes of the fragility subtrochanteric fractures treated with short versus long cephalomedullary nails.
View Article and Find Full Text PDFWorld J Orthop
January 2025
Department of Orthopaedics, Indira Gandhi Medical College and Hospital, Shimla 171001, Himāchal Pradesh, India.
Background: Total hip arthroplasty (THA) has increased along with an increasing demand for improved quality of life. Combined with prolonged life expectancy, the number of revision surgeries is expected to increase. Stress shielding is a significant issue with traditional femoral stems used in THA, making revision surgeries particularly challenging in younger patients.
View Article and Find Full Text PDFJ Arthroplasty
January 2025
Department of Orthopaedic Surgery, Tulane University School of Medicine, 1415 Tulane Ave, New Orleans, Louisiana, 70112, USA.
Background: Hip fractures are prevalent orthopaedic injuries with substantial morbidity and mortality. Failed primary treatments of these fractures often necessitate conversion to total hip arthroplasty (CTHA); a complex procedure requiring extensive exposure and hardware removal. It poses major challenges and is associated with high rates of complications such as infection, dislocation, and periprosthetic fractures.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!