scholarly journals Arthroscopic Reduction and Fixation of a Lesser Trochanter Avulsion Nonunion

2019 ◽  
Vol 8 (12) ◽  
pp. e1525-e1531
Author(s):  
Alex G. Dukas ◽  
Taylor L. King ◽  
Temitope F. Adeyemi ◽  
Travis G. Maak
Keyword(s):  
Lesser Trochanter ◽  
Arthroscopic Reduction ◽  
Lesser Trochanter Avulsion

scholarly journals Biomechanical Comparison of Anterograde and Retrograde Lesser Trochanter Avulsion Repair

2020 ◽  
Vol 8 (1) ◽  
pp. 232596711989228
Author(s):  
Alexander Otto ◽  
Joshua B. Baldino ◽  
Alyssa M. DiCosmo ◽  
Katherine Coyner ◽  
Jeremiah D. Johnson ◽  
...  
Keyword(s):  
Cyclic Loading ◽  
Suture Anchors ◽  
Retrograde Approach ◽  
Avulsion Fractures ◽  
Iliopsoas Tendon ◽  
Lesser Trochanter ◽  
Cortical Button ◽  
Load To Failure ◽  
Biomechanical Comparison ◽  
Lesser Trochanter Avulsion

Background: Lesser trochanter avulsions are rare injuries in adolescents. Severe cases with relevant fragment displacement can be treated surgically. However, no standard approach is available in the literature. Operative techniques are presently limited to anterograde fixations. A new retrograde approach to reduce operative difficulty and postoperative morbidity has been proposed. So far, no biomechanical comparison of these techniques is available. Hypothesis: Retrograde repair of the lesser trochanter with a titanium cortical button will produce superior stability under load to failure and similar displacement under cyclic loading compared with anterograde fixation with titanium suture anchors. Study Design: Controlled laboratory study. Methods: Sixteen paired hemipelvic cadaveric specimens (mean age, 62.5 ± 10.7 years) were dissected to isolate the lesser trochanter and iliopsoas muscle. After repair of a simulated lesser trochanter avulsion, specimens were tested under cyclic loading between 10 and 125 N at 1 Hz for 1500 cycles before finally being loaded to failure at a rate of 120 mm/min in a material testing machine. Motion tracking was used to assess displacement at the superior and inferior aspects of the iliopsoas tendon under cyclic loading. Results: Load to failure was significantly greater for the retrograde repair compared with the anterograde repair (1075.24 ± 179.39 vs 321.85 ± 62.45 N; P = .012). Mean displacement at the superior repair aspect (retrograde vs anterograde: 3.29 ± 1.84 vs 4.39 ± 4.50 mm; P = .779) and mean displacement at the inferior aspect (3.54 ± 2.13 vs 4.22 ± 4.48 mm; P = .779) of the iliopsoas tendon did not significantly differ by the type of repair. Mode of failure was tendon tearing by the sutures for each retrograde repair and anchor pullout for each anterograde repair. Conclusion: Surgical repair of lesser trochanter avulsion fractures with retrograde fixation using a titanium cortical button demonstrated superior load to failure and similar displacement under cyclic loading compared with anterograde fixation using suture anchors. Clinical Relevance: The retrograde approach provides a biomechanically validated alternative to other surgical techniques for this injury.

Lesser Trochanter Avulsion Fracture in an Adolescent after Seizure

2016 ◽  
Vol 51 (4) ◽  
pp. 457-460 ◽  
Author(s):  
Tristan McMillan ◽  
Haroon Rehman ◽  
Martin Mitchell
Keyword(s):  
Avulsion Fracture ◽  
Lesser Trochanter ◽  
Lesser Trochanter Avulsion

Lesser Trochanter Avulsion Fracture

2013 ◽  
Vol 45 (2) ◽  
pp. 256-257 ◽  
Author(s):  
Nicholas C. Papacostas ◽  
Christopher T. Bowe ◽  
Tania D. Shaffer Strout
Keyword(s):  
Avulsion Fracture ◽  
Lesser Trochanter ◽  
Lesser Trochanter Avulsion

scholarly journals Preliminary Presentation of Metastatic Non-Small Cell Carcinoma of the Lung as Atraumatic Avulsion Fracture of the Lesser Trochanter

2020 ◽  
Vol 13 (1) ◽  
pp. 436-441
Author(s):  
Adam Creissen ◽  
Aysha Rajeev ◽  
Kumud Jain ◽  
Paul Banaszkiewicz
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Groin Pain ◽  
Avulsion Fracture ◽  
Small Cell ◽  
Avulsion Fractures ◽  
Lesser Trochanter ◽  
Tumour Biopsy ◽  
History Of ◽  
Lesser Trochanter Avulsion

Traumatic avulsion fractures of the lesser trochanter are usually seen along with fractures of the proximal femur and with young adolescents involved in high-intensity sporting injuries. Atraumatic isolated lesser trochanter avulsion in adults are most commonly associated with malignancy. We describe a case of a female in her sixties who was previously fit and healthy with no systemic illness and no history of trauma presenting with groin pain. The X-ray demonstrated an isolated lesser trochanter avulsion fracture. Further imaging including MRI and a staging CT scan of the neck, chest, abdomen and pelvis revealed a pulmonary tumour. Biopsy later confirmed this as a non-small cell carcinoma of the lung. At the time of publication, she had been started on palliative chemotherapy (afatinib) with encouraging results.

scholarly journals Sequential bilateral lesser trochanter avulsion fractures in an adolescent patient

2014 ◽  
Vol 2014 (nov24 1) ◽  
pp. bcr2014207911-bcr2014207911 ◽  
Author(s):  
N. J. Obi ◽  
C. Allman ◽  
E. Moore-Thompson ◽  
M. D. Latimer
Keyword(s):  
Adolescent Patient ◽  
Avulsion Fractures ◽  
Lesser Trochanter ◽  
Lesser Trochanter Avulsion

scholarly journals Hip geometry in hip fracture patients in Greenland occurring over a 7.7-year period

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Inuuteq Fleischer ◽  
Mogens Laursen ◽  
Stig Andersen
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Cortical Thickness ◽  
Geometric Analysis ◽  
Osteoporotic Fractures ◽  
Premature Death ◽  
Neck Length ◽  
Hip Geometry ◽  
Lesser Trochanter

Abstract Background Hip geometry influences hip fracture risk. Hip fractures are common, and they are associated with pain, disability, premature death and marked costs on society. Osteoporotic fractures are frequent in Arctic populations and increase with advancing age in this society with a steep rise in life expectancy. Greenland Inuit is a distinct ethnic group, and data on hip geometry is missing. We thus aimed to describe hip geometry in 7.7 years of consecutive hip fracture patients in Greenland. Methods We evaluated collodiaphysial angle, femoral neck length, the outer and inner diameter of the femur at 2 and 5 centimetres below the centre of the lesser trochanter and the cortical thickness from pelvic and hip radiographs in all patients operated in Greenland over 7.7 years. We included all 84 patients with one non-fractured hip visible for geometric analysis. Analyses were conducted in duplicate. Results We found a collodiaphysial angle of 134.8/132.6o in men/women (p = 0.06) and a femoral neck length of 38.0/33.9 mm in men/women (p = 0.001). Cortical thickness was affected by sex in the adjusted analysis (p < 0.001). Cortical thickness index at 5 cm below the centre of the lesser trochanter decreased with age (p = 0.026) and may be influenced by height (2 cm below the centre of the lesser trochanter, p = 0.053). Conclusion Our findings differed from European data and suggest a delicate balance in hip geometry in Arctic populations. Ethnic peculiarities influence the structure of the hip and may influence fracture risk. A focus on hip geometry and risk factors for osteoporotic fractures in Arctic populations is warranted.

scholarly journals A Novel Measurement Using Digital Radiography to Minimize Fluoroscopy in Total Hip Arthroplasty

2021 ◽  
Author(s):  
Andrew G. Yun ◽  
Marilena Qutami ◽  
Kory B. Dylan Pasko
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Radiation Exposure ◽  
Hip Arthroplasty ◽  
Fluoroscopy Time ◽  
Lesser Trochanter ◽  
Total Hip ◽  
Preoperative Templating ◽  
The Mean ◽  
Templating Technique

AbstractPreoperative templating for total hip arthroplasty (THA) is fraught with uncertainty. Specifically, the conventional measurement of the lesser trochanter to the center (LTC) of the femoral head used in preoperative planning is easily measured on a template but not measurable intraoperatively. The purpose of this study was to examine the utility of a novel measurement that is reproducible both on templating and in surgery as a more accurate and practical guide. We retrospectively reviewed 201 patients with a history of osteoarthritis who underwent primary THA. For preoperative templating, the distance from the top of the lesser trochanter to the equator (LeTE) of the femoral head was measured on a calibrated digital radiograph with a neutral pelvis. This measurement was used intraoperatively to guide the choice of the trial neck and head. As with any templating technique, the goal was to construct a stable, impingement-free THA with equivalent leg lengths and hip offset. In evaluating this novel templating technique, the primary outcomes measured were the number of trial reductions and the amount of fluoroscopic time, exposures, and radiation required to obtain a balanced THA reconstruction. Using the LeTE measurement, the mean number of trial reductions was 1.21, the mean number of intraoperative fluoroscopy images taken was 2.63, the mean dose of radiation exposure from fluoroscopy was 0.02 mGy, and the mean fluoroscopy time per procedure was 0.6 seconds. In hips templated with the conventional LTC prior to the LeTE, the mean fluoroscopy time was 0.9 seconds. There was a statistically significant difference in fluoroscopy time (p < 0.001). The LeTE is a reproducible measurement that transfers reliably from digital templating to surgery. This novel preoperative templating metric reduces the fluoroscopy time and consequent radiation exposure to the surgical team and may minimize the number of trial reductions.

Central Compartment Release Versus Lesser Trochanter Release of the Iliopsoas Tendon for the Treatment of Internal Snapping Hip: A Comparative Study

2014 ◽  
Vol 30 (7) ◽  
pp. 790-795 ◽  
Author(s):  
Victor M. Ilizaliturri ◽  
Martín Buganza-Tepole ◽  
Anell Olivos-Meza ◽  
Marco Acuna ◽  
Eduardo Acosta-Rodriguez
Keyword(s):  
Comparative Study ◽  
Central Compartment ◽  
Iliopsoas Tendon ◽  
Lesser Trochanter ◽  
Snapping Hip

scholarly journals ORV Arthroscopic Reduction and Internal Fixation of Tibial Eminence Fractures

2013 ◽  
Vol 2 (4) ◽  
pp. e341-e345 ◽  
Author(s):  
Daniel M. Myer ◽  
Gregory J. Purnell ◽  
Paul E. Caldwell ◽  
Sara E. Pearson
Keyword(s):  
Internal Fixation ◽  
Arthroscopic Reduction ◽  
Tibial Eminence
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