Biomechanical Test after Hip Cannulated Screw Removal (in vitro Analysis).

 This study aims to evaluate, through biomechanical tests, the resistance and energy required for proximal femoral fracture in synthetic bones after removing cannulated screws shaped as an inverted triangle, comparing the obtained results to those of a reinforcement technique with polymethylmethacrylate (PMMA) as bone cement.  Twenty synthetic bones were used: 10 units for the control group (CG), 5 units for the test group without reinforcement (TGW/O), and 5 units for the test group using a reinforcement technique with PMMA (TGW). The biomechanical analysis simulated a fall on the large trochanter using a servo-hydraulic machine.

Tenotomy of the Gluteus Maximus in Total Hip Arthroplasty with Prevention of Sciatic Nerve Injury.

The authors report a single case of complex primary hip total arthroplasty in a 34-year-old female patient with a 5.5 cm lower limb dysmetria, in whom a maximum gluteus tenotomy was performed in order to prevent sciatic nerve injury. The surgery was performed under electroneurophysiological monitoring of the fibular and tibial branches of the sciatic nerve, collecting pretenotomy, posttenotomy, and postarthroplasty reduction data.

Traumatic Open Anterior Hip Dislocation in an Adult Male: A Case Report.

This case report describes the surgical treatment and one-year follow-up of an adult male patient, who was treated for a severe anterior open hip dislocation fracture with no sign of femoral head necrosis and maintaining a Harris Hip Score (HHS) of 93.

The role of the medial plate for Pauwels type III femoral neck fracture: a comparative mechanical study using two fixations with cannulated screws.

Background: The biomechanical behavior of Pauwels type III fractures should be taken into consideration when performing internal fixation, since this repair should resist the shear force inherent in the vertical fracture line to the greatest extent possible. Recently, the use of a small fragment plate on the medial face of the femoral neck has been proposed by some authors, with satisfactory initial results. In the current study we analyze the mechanical role a medial plate used as a buttress plate for Pauwels type III femoral neck fractures, comparing the resistance of two fixation configurations using three cannulated screws.

Correction: Traumatic Open Anterior Hip Dislocation in an Adult Male: A Case Report.

[This corrects the article DOI: 10.7759/cureus.2862.

PRELIMINARY MECHANICAL TEST OF PROXIMAL FEMUR REINFORCEMENT WITH CEMENTED X-SHAPED PMMA.

Objective: To evaluate the mechanical behavior of the proximal end of the femur submitted to the X-shaped polymethylmethacrylate (PMMA) reinforcement technique.

Methods: Fifteen synthetic femurs, with a Nacional density of 10 PCF, were divided into two groups: the DX group, with 5 units that were submitted to PMMA reinforcement, and the DP group, with 10 units, which were evaluated intact. The volume of PMMA required, the maximum load, and the absorbed energy to fracture were analyzed by means of a static mechanical bending test simulating a fall on the greater trochanter.

BIOMECHANICAL ANALYSIS OF FEMORAL NECK FRACTURE FIXATION IN SYNTHETIC BONE.

Objectives: To analyze the results of biomechanical assays of the fixation of Pauwels type II femoral neck fractures in synthetic bones, using two parallel cannulated screws or three cannulated screws in an inverted pyramid formation.

Methods: Ten Brazilian-made synthetic bones were divided into 2 groups. Groups A and B utilized three and two cannulated screws, respectively, after osteotomy in the middle third of the femur, perpendicular to the axis of the femoral neck, simulating a Pauwels type II femoral neck fracture.

CONTRALATERAL PATELLAR TENDON AUTOGRAFT IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION.

Objective: To conduct a systematic review of literature about the use of contralateral patellar tendon autograft in anterior cruciate ligament reconstructions and present the results.

Methods: The LILACS, MEDLINE, Cochrane, PubMed, Scielo and Google Scholar databases were searched without date restrictions for the keywords "anterior cruciate ligament reconstruction" combined with "contralateral" in the article title. After the studies were identified, two independent evaluators collected the qualitative characteristics of the studies and classified them according to clinical outcomes of these grafts as positive, neutral, or negative.

EVALUATION OF A BONE REINFORCEMENT TECHNIQUE USING FINITE ELEMENT ANALYSIS.

Objectives: To compare the results of a simulated fall on the greater trochanter in the proximal portion of a synthetic femur before and after femoral reinforcement with tricalcium phosphate bone cement (TP) and polymethyl methacrylate (PMMA), using finite element analysis (FEA).

Methods: Using two synthetic proximal femurs, a FEA simulating a fall on the greater trochanter was performed, using the Bi-directional Evolutionary Structural Optimization (BESO) program. For this analysis, the femurs were filled with TP and PMMA after perforations were created in the trochanteric region and neck.

Massive hemoptysis successfully treated with extracorporeal membrane oxygenation and endobronchial thrombolysis.

Extracorporeal membrane oxygenation has been used to treat refractory hypoxemia in numerous clinical scenarios. The fundamental principles for the management of massive hemoptysis patients include protecting the airway and healthy lung, locating the source of bleeding and controlling the hemorrhage. We report the case of a patient with acute respiratory failure associated with massive hemoptysis secondary to lung laceration during cardiac surgery.

Stability of L-shaped and inverted triangle fixation assemblies in treating Pauwels type II femoral neck fracture: a comparative mechanical study.

Purpose: The aim of our study is to compare the mechanical resistance of two screw configurations in fixating type II Pauwels femoral neck fractures.

Methods: Fifteen synthetic models of femur bones in young adults were divided into three equal groups: intact (G1), models with fixation of a 5.0-mm failure zone created in the posterior cortex of the femoral neck using an L-shaped screw arrangement (G2, n = 5), and models with an identical failure zone fixated using an inverted triangle assembly (G3, n = 5).

Static bending test after proximal femoral nail (PFN) removal - analysis.

Objective: To evaluate, through biomechanical testing, the resistance to and energy required for the occurrence of proximal femoral fracture in synthetic bone after removal of a proximal femoral nail model (PFN), comparing the results obtained with a reinforcement technique using polymethylmethacrylate (PMMA).

Methods: Fifteen synthetic bones were used: five units for the control group (CG), five for the test group without reinforcement (TGNR), and five for the test group with reinforcement (TGR). The biomechanical analysis was performed simulating a fall on the trochanter using a servo-hydraulic machine.

Reconstruction of the distal biceps tendon using triceps graft: a technical note.

Rupture of the distal biceps brachii tendon typically occur in a contraction against resistance with the elbow in 90° of flexion. Chronic ruptures are uncommon and are complicated by tendon and muscle retraction and poor quality. Some reconstruction techniques have been described in the literature, with variations on the surgical exposures, type of graft (allo or autograft), graft donor site, and type of attachment to the radial tuberosity.

Simultaneous bilateral femoral neck fracture in a patient with renal osteodystrophy.

We present a unique case of displaced simultaneous bilateral fractures, Garden 3 type, in a 49 year woman treated with non-cemented total hip arthroplasty. The patient showed a Harris hip score of 86 on the right hip and a 81 on the left side on the fourth postoperative year, besides a bilateral Trendelenburg gait, more pronounced on the right side. She needed a cane to walk, and felt pain in the left thigh.

APOPHYSEAL FRACTURE OR AVULSION OF THE GREATER TROCHANTER.

The apophyseal fracture or avulsion of the greater trochanter occurs in skeletally immature patients. It has at etiological factors indirect mechanisms (avulsion) and direct mechanisms (trauma on the trochanter), the latter being the most common. The clinical presentation is easily identified and a simple X- ray can confirm the diagnosis.

Treatment of an Acute Fracture of the Femoral Neck in a Young Female Adult with a Transfemoral Amputation: A Case Report.

Introduction: Fracture of the femoral neck in a young adult with an ipsilateral transfemoral amputation is uncommon, and there is no consensus regarding the best treatment.

Methods: We present a unique case of a displaced right femoral neck fracture treated with closed reduction and percutaneous screw fixation in a twenty-eight-year-old woman with a preexisting ipsilateral transfemoral amputation.

Results: We observed satisfactory healing of the fracture with a slight varus deformity and no radiographic signs of osteonecrosis at one year.

Atypical, unusual, and misleading imaging presentations of spondylolysis.

Although lumbar spondylolysis is a widely known and easily recognizable condition in its typical presentation, there are some less well-known forms that may occasionally be challenging and/or demand special attention on imaging. Examples include: acute and/or incomplete lesions; unilateral defects; lesions at unusual levels (cervical, upper lumbar, and multi-level spondylolyses); iatrogenic lesions; non-isthmic spondylolysis; and spondylolysis related to underlying diseases. In addition to their atypical, uncommon or confusing imaging presentations, these forms of spondylolysis are far rarer than the classic type and have been described, to a great extent, in the surgical literature, thus reducing the awareness of radiologists about them and raising the potential for misdiagnosis and inadequate treatment.

Mechanical analysis of femoral neck fracture fixation with dynamic condylar screw in synthetic bone.

Objective: To analyze statistically results in biomechanical testing of fixation of femoral neck Pauwels type III fractures, on synthetic bone, with dynamic condylar screw (DCS) and control group.

Methods: Ten synthetic bones of a national brand were used. Test Group: fixation was performed after osteotomy at 70(o) tilt using DCS plate with four holes.

Mechanical analysis of femoral neck fracture fixation in synthetic bone.

Objective: To analyze statistically results obtained between biomechanical assays on fixation of femoral neck fracture type Pauwels III, on synthetic bone, using 7.5 mm non parallel cannulated screws and control group.

Methods: Ten synthetic bones from a national brand were used.

MRI of subchondral fractures: a review.

Several authors have recently emphasized the role of magnetic resonance imaging (MRI) in the diagnosis of subchondral fractures. There is increasing interest about this type of fractures, mostly because they have been implicated in the genesis of some well-known destructive articular conditions whose cause was previously undetermined, such as distal clavicular osteolysis, rapidly progressive osteoarthritis of the hip, spontaneous osteonecrosis of the knee and adult-type Freiberg's infraction. Subchondral fractures may ultimately lead to bone collapse, secondary osteonecrosis and severe articular damage, and there may be rapid progression of joint destruction over a period of weeks to months.