scholarly journals Treatment of the femoral neck peudoarthrosis in childhood: Case report

2013 ◽  
Vol 141 (3-4) ◽  
pp. 237-241
Author(s):  
Zoran Vukasinovic ◽  
Igor Seslija ◽  
Mladen Pavlovic ◽  
Zorica Zivkovic
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Avascular Necrosis ◽  
Bed Rest ◽  
Primary Treatment ◽  
Femoral Neck Fractures ◽  
Coxa Vara ◽  
X Ray ◽  
Fractures In Children ◽  
Neck Fracture

Introduction. Femoral neck fractures in children and adolescents are rare. However, their complications are frequent - avascular necrosis, femoral neck pseudoarthrosis, premature physeal closure with consequent growth disturbance and coxa vara deformity. Case Outline. A 9.5?year?old boy was injured in a car accident, and femoral neck fracture was diagnosed. Prior to admission at our hospital he was surgically treated several times. He was admitted at our hospital eight months following the accident. On the X?ray transcervical pseudoarthrosis of the femoral neck was found, as well as coxa vara deformity and metaphyseal avascular necrosis. He was operated at our hospital; all previously placed ostefixation material was removed, valgus osteotomy of 30 degrees was done as well as additional local osteoplasty using the commercial osteoindactive agent (Osteovit?). Postoperatively, we applied skin traction, bed rest and physical therapy. At the final follow?up, the patient was recovered completely. He is now painless, the legs are of equal length, range of movements in the left hip is full, life activity is normal. The X?ray shows that the femoral neck pseudoarthrosis is fully healed. Conclusion. This case is presented in order to encourage other colleagues to challenge the problematic situation such as this one. Also, we would like to remind them what one should think about and what should be taken into consideration in the primary treatment of femoral neck fractures in children. Valgus femoral osteotomy, as a part of the primary treatment of femoral neck fracture in children (identically as in the adults) can prevent the occurrence of femoral neck pseudoarthrosis.

scholarly journals FEMORAL NECK FRACTURES GARDEN I AND II: EVALUATION OF THE DEVIATION IN LATERAL VIEW

2017 ◽  
Vol 25 (2) ◽  
pp. 107-109 ◽  
Author(s):  
Natália Zalc Leonhardt ◽  
Lucas da Ponte Melo ◽  
David Gonçalves Nordon ◽  
Fernando Brandão de Andrade e Silva ◽  
Kodi Edson Kojima ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Comparative Study ◽  
Femoral Neck Fracture ◽  
Lateral View ◽  
Femoral Neck Fractures ◽  
Level Of Evidence ◽  
X Ray ◽  
Neck Fracture ◽  
Anteroposterior View ◽  
Retrospective Comparative Study

ABSTRACT Objective: To evaluate the rate of deviation in the lateral radiographic incidence in patients with femoral neck fracture classified as non-diverted in the anteroposterior view (Garden I and II). Methods: Nineteen selected patients with femoral neck fractures classified as Garden I and II were retrospectively evaluated, estimating the degree of deviation in the lateral view. Results: Fifteen cases (79%) presented deviations in lateral view, with a mean of 18.6 degrees (±15.5). Conclusion: Most fractures of the femoral neck classified as Garden I and II present some degree of posterior deviation in the X-ray lateral view. Level of Evidence III, Retrospective Comparative Study.

scholarly journals Results of postoperative anti-rotation on the intracapsular femoral neck fracture fixed with cannulated screws

2020 ◽  
Author(s):  
bu-fang ren ◽  
quan-ping ma ◽  
xin lv ◽  
yunsheng yin ◽  
yaozhu gao
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Bed Rest ◽  
Femoral Neck Fractures ◽  
Wound Infections ◽  
Cannulated Screws ◽  
Fracture Nonunion ◽  
Neck Fracture ◽  
Intracapsular Femoral Neck Fracture ◽  
Medical University

Abstract Background: To investigate effect of postoperative anti-rotation on the union of intracapsular displaced femoral neck fracture treated with three cannulated screws. Methods: A retrospective analysis was performed on all the intracapsular femoral neck fractures treated in the department of orthopedics of the second Hospital of Shanxi Medical University from July 2015 to December 2018. Fractures of femoral neck were reduced and fixed with three cannulated screws. The patients who wore anti-rotation shoes in the affected side were kept at bed rest for 10-12 weeks after surgery. The results were analyzed.Results: A total of 135 patients were included in the analysis. Six patients (4.4%) were not united. There were 12 cases of avascular necrosis (9.3%). No wound infections, screw breakages was found.Conclusion: Anti-rotation after surgery can significantly reduce the rate of femoral neck fracture nonunion, but not significantly improve the femoral head necrosis

scholarly journals Open femoral neck fracture of 14 years old boy treated by emergency internal fixation with additional osteomuscular pedicle graft: case report

2020 ◽  
Vol 6 (6) ◽  
pp. 1303
Author(s):  
Hendra C. Kumara ◽  
Ariya M. Nasution ◽  
Bayu S. Jiwandono ◽  
Anung B. Satriadi ◽  
Pamudji Utomo
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Avascular Necrosis ◽  
Road Traffic ◽  
Healing Process ◽  
High Energy ◽  
Fractures In Children ◽  
Short Term Evaluation ◽  
Neck Fracture ◽  
Term Evaluation

<p>The incidence of femoral neck fractures in pediatric patients is rare, including &lt;1% in all cases of fractures in children. The mechanism of injury is a high-energy injury that can cause a fracture in the femoral neck, open fracture cases are rare. Avascular necrosis is the most common complication. We report a fourteen year old boy who was in a road-traffic accident and had a Gustillo Anderson grade IIIA open femoral neck fracture. On the X-ray findings, we classified the type of fracture into Delbet type II. We decided to do the debridement and ORIF accompanied by an osteomuscular pedicle graft using a quadratus femoris muscle tendon fixed with 3 interfragmentary screws. Short-term evaluation shows a clinical union picture and is still well reduced without any signs of infection. Long-term evaluation of the bone healing process is needed and recognizes complications in the form of avascular necrosis of the femoral head.</p>

scholarly journals Transphyseal Femoral Neck Fracture in a Twenty-Month Old Male Child

2016 ◽  
Vol 10 (1) ◽  
pp. 56-61
Author(s):  
Matthew J. Brown ◽  
Michael R. Ferrick
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Avascular Necrosis ◽  
Delayed Diagnosis ◽  
Rare Event ◽  
X Ray ◽  
Pediatric Fracture ◽  
Neck Fracture ◽  
Surgical Fixation ◽  
K Wires

Transphyseal femoral neck fractures are an extremely rare event, mainly occurring in children subjected to an significant traumatic force. The diagnosis is usually suggested by clinical examination with radiographic confirmation. Management varies; however, no consensus exists as to proper treatment. Intervention is primarily focused on the prevention of avascular necrosis (AVN) of the femoral epiphysis.We present the case of a 20-month-old male with a delayed diagnosis of transphyseal femoral neck fracture. X-ray (XR) and computed tomography (CT) scan images were used for diagnosis, to track healing, and monitor the possible emergence of avascular necrosis. Final imaging demonstrated full healing without AVN at two years.This study demonstrates the successful treatment of a rare pediatric fracture type with possible life-changing complications. Reduction, surgical fixation with K-wires, and spica casting are demonstrated as being acceptable treatment in the very young transphyseal fracture patient.

scholarly journals Muscle pedicle bone flap transplantation for treating femoral neck fracture in adults: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yipeng Wu ◽  
Muguo Song ◽  
Guangliang Peng ◽  
Yongqing Xu ◽  
Yang Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Avascular Necrosis ◽  
Surgical Techniques ◽  
Femoral Neck Fractures ◽  
Bone Flap ◽  
Cochrane Library ◽  
Number Of Patients ◽  
Neck Fracture

Abstract Background This systematic review was conducted to gather available evidence on the effectiveness of muscle pedicle bone flap transplantation in adult patients with femoral neck fractures. Methods Databases such as PubMed, EMBASE, IEEE, Web of Science, and Cochrane library were searched from their dates of inception until March 2021. Two reviewers independently selected the interventional studies on the assessment of the effectiveness of muscle pedicle bone flap transplantation for femoral neck fractures; data extraction and assessment of the methodological quality as per the Institute of Health Economics quality appraisal checklist were also performed by the reviewers. The effectiveness and complication outcomes were assessed by calculating the average rates. Results Overall, 20 studies with 1022 patients were included in this review. Notably, the methodologic quality of the included studies was typically poor. The average effective rates were as follows: good, 73.4%; fair, 15.4%; and poor, 10.9%. Moreover, the average nonunion rate, average avascular necrosis rate, average collapse rate, and the overall reoperation rate were 9.0%, 6.7%, 4.7%, and 7.3%, respectively. Conclusions This systematic review of heterogeneous studies with varying number of patients and varying surgical techniques indicated that muscle pedicle bone flap transplantation provides promising results with low rates of avascular necrosis and nonunion. Nevertheless, further controlled studies are required to ascertain the effectiveness of muscle pedicle bone flap transplantation in treating femoral neck fracture.

scholarly journals Results of postoperative anti-rotation on the intracapsular femoral neck fracture fixed with cannulated screws

2020 ◽  
Author(s):  
Bufang Ren ◽  
Quan-ping Ma ◽  
Xin Lv ◽  
Yun-sheng Yin ◽  
Yao-zhu Gao
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Bed Rest ◽  
Femoral Neck Fractures ◽  
Wound Infections ◽  
Cannulated Screws ◽  
Fracture Nonunion ◽  
Neck Fracture ◽  
Intracapsular Femoral Neck Fracture ◽  
Medical University

Abstract Background: To investigate effect of postoperative anti-rotation on the union of intracapsular displaced femoral neck fracture treated with three cannulated screws.Methods: A retrospective analysis was performed on all the intracapsular femoral neck fractures treated in the department of orthopedics of the second Hospital of Shanxi Medical University from July 2015 to December 2018. Fractures of femoral neck were reduced and fixed with three cannulated screws. The patients who wore anti-rotation shoes in the affected side were kept at bed rest for 10-12 weeks after surgery. The results were analyzed.Results: A total of 135 patients were included in the analysis. Six patients (4.4%) were not united. There were 12 cases of avascular necrosis (9.3%). No wound infections, screw breakages was found.Conclusion: Anti-rotation after surgery can significantly reduce the rate of femoral neck fracture nonunion, but not significantly improve the femoral head necrosis

Impaired renal function is an independent risk factor for complications after surgery for femoral neck fracture

2021 ◽  
pp. 112070002110285
Author(s):  
Pradip Ramamurti ◽  
Safa C Fassihi ◽  
David Sacolick ◽  
Alex Gu ◽  
Chapman Wei ◽  
...  
Keyword(s):  
Renal Function ◽  
Risk Factor ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Impaired Renal Function ◽  
Independent Risk Factor ◽  
Femoral Neck Fractures ◽  
Stage 4 ◽  
Ckd Stage ◽  
Neck Fracture

Background: The metabolic abnormalities that occur secondary to chronic kidney disease (CKD) increase the risk of femoral neck fractures compared to the general population. The purpose of this study is to determine whether impaired renal function is an independent risk factor for complications after surgery for femoral neck fracture. Methods: The ACS-NSQIP database was reviewed for patients who underwent total hip arthroplasty, hemiarthroplasty and open reduction internal fixation (ORIF) for femoral neck fractures between 2007 and 2018. Patients were split into cohorts based on calculated estimated glomerular filtration rate. Demographic information, comorbidities, and 30-day complications were analysed with univariate and multivariate analyses using chi-square, Fischer’s exact and analysis of variance testing. Results: The total number of patients for the study was 163,717. Patients with CKD stage 4 and 5 had an increased rate of any complication (39.1 and 36.7% respectively) compared with higher eGFRs ( p  < 0.001). Similarly, 30-day mortality was increased at 6.0% and 6.7% for both stage 4 and 5 ( p  < 0.001). By multivariate regression, those with CKD Stage 4 and 5 were at increased risk for any complication compared to patients with a normal preoperative eGFR of 90–120 ( p  < 0.001). Conclusions: This study demonstrated that patients with CKD Stage 4 and 5 are at increased risks of all complications, including death, renal, pulmonary and thromboembolic disease. Therefore, these patients should be cared for from a multidisciplinary approach with close attention to postoperative medications and fall prevention to help mitigate the risk of complications in the immediate postoperative period.

scholarly journals Calcar buttressed screw fixation for femoral neck fracture

2018 ◽  
Vol 5 (1) ◽  
pp. 145
Author(s):  
K. K. Arvind Manoj ◽  
R. Karthik ◽  
A. Vishnu Sankar
Keyword(s):  
Femoral Neck ◽  
Functional Outcome ◽  
Femoral Neck Fracture ◽  
Screw Fixation ◽  
Femoral Neck Fractures ◽  
Fixation Strength ◽  
Harris Hip Score ◽  
Average Period ◽  
Excellent Outcome ◽  
Neck Fracture

<p class="abstract"><strong>Background:</strong> The incidence of neck of femur fracture among elderly population is increasing day by day. Femoral neck fracture has always been an unsolved fracture<strong> </strong>as far as treatment and results are concerned. There are different views regarding the optimal method of internal fixation in femoral neck fractures. Biomechanical data from literature suggest that calcar fixation is superior to central screws placement. This study aims to analyse the functional and radiological outcome of femoral neck fractures treated by calcar buttressed screw fixation described by Filipov as biplane double supported screw fixation.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study conducted in our institution from May 2015 to May 2018.The study included 43 patients (31 male, 12 female) with femoral neck fracture. Three 6.5-mm cannulated screws were laid in two medially diverging oblique planes. The distal and the middle screws were supported on the calcar. The distal screw had additional support on the posterior neck cortex. Patients were followed up for average period of 2 years. Functional outcome was evaluated using Harris Hip score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Bone union occurred in 40 patients (93%) with average period of 3-4 months.<strong> </strong>51.2% of cases had<strong> </strong>excellent outcome. 23.2% of cases had good and 16.3% of cases had fair outcome. 9.3% of cases ended with poor outcome. Non union was reported in 3 patients (7%) and AVN in one patient. Various factors like age, Garden and Pauwel fracture types, time of presentation and time of surgery were statistically significant to the final functional outcome in our study.</p><p><strong>Conclusions:</strong> By providing additional calcar buttress compared to conventional method, this technique of screw fixation enhances femoral neck fracture fixation strength and reduces the fixation failure. </p>

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