Great Trochanter

2020 ◽  
Author(s):  
Keyword(s):  
Great Trochanter

Development of a wearable orthotic device pattern to prevent hip dislocation in children with cerebral palsy

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hyunjung Han ◽  
Jeong Ha Kim
Keyword(s):  
Cerebral Palsy ◽  
Great Trochanter ◽  
Hip Dislocation ◽  
Virtual Model ◽  
Persons With Disabilities ◽  
Content Type ◽  
Final Version ◽  
Orthotic Device ◽  
Children With Cerebral Palsy ◽  
Child Patient

PurposeThis study suggest the development of a wearable orthotic device pattern that can reduce pain and deformation, and help in the normal development of children with cerebral palsy. Such a pattern enables daily wear before hip subluxation occurs, to prevent hip dislocation and subluxation.Design/methodology/approachThis study set the design line by carrying out cell work on the actual model, then proceeded with the first pattern design. The final version of the second orthotic device was designed by conducting discussions with experts and the patient's guardian, with the device fitted to the child patient. The evaluation of the second orthotic device used the virtual model to check the pressure area and level through virtual fitting. An evaluation was then conducted with the device fitted to the child patient, to verify the functionality and suitability of the final pattern.FindingsFollowing the initial fitting evaluation, the second pattern was presented after modifying and supplementing issues such as movement suitability with posture change, position change of the great trochanter when wearing a diaper, pressure control of the X-shaped band on the genital area and thigh abduction. The master pattern of the final version of the second orthotic device was proposed after confirming that the femoral head of the hip joint was stably fixed, and the compression was applied through a verification based on the virtual fitting using the virtual model, and with the device fitted to the child patient.Originality/valueWith this study, it is expected that the process and design plan for the development of wearable orthotic device patterns for the persons with disabilities impaired mobility can be used as a basic resource to create devices that merge the clothing and medical fields.

Positioning bedridden patients to reduce interface pressures over the sacrum and great trochanter

2015 ◽  
Vol 24 (7) ◽  
pp. 319-325 ◽  
Author(s):  
Y. Yoshikawa ◽  
N. Maeshige ◽  
M. Sugimoto ◽  
M. Uemura ◽  
M. Noguchi ◽  
...  
Keyword(s):  
Great Trochanter ◽  
Interface Pressures

Increase in Bone Density in Patients with Spondyloarthritis During Anti-Tumor Necrosis Factor Therapy: 6-year Followup Study

2013 ◽  
Vol 40 (10) ◽  
pp. 1712-1718 ◽  
Author(s):  
Anne Durnez ◽  
Simon Paternotte ◽  
Jacques Fechtenbaum ◽  
Robert B.M. Landewé ◽  
Maxime Dougados ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Great Trochanter ◽  
Therapy Group ◽  
Control Group ◽  
Mineral Density ◽  
Hip Bmd ◽  
Factor Therapy ◽  
Necrosis Factor

Objective.To assess the effects on bone mineral density (BMD) of prolonged anti-tumor necrosis factor (anti-TNF) therapy in patients with spondyloarthritis (SpA); to compare the BMD changes to those observed in SpA patients not treated with anti-TNF; and to identify the predictors of these changes.Methods.Fifty-nine patients with SpA according to the European Spondylarthropathy Study Group criteria who were treated with anti-TNF therapy for at least 4 years were included. Thirty-four patients with SpA from an international longitudinal observational study (OASIS cohort) were used as a control group. Lumbar spine and hip BMD were measured by dual-energy x-ray absorptiometry at baseline, after 1 year, and after at least 4 years.Results.Over an average 6.5 years’ followup, the increase in BMD was 11.8% (± 12.8%) at the lumbar spine (p < 0.0001) and 3.6% (± 9.3%) at the great trochanter (p = 0.0001) in patients treated with anti-TNF. At the lumbar spine, the increase was similar in patients with and those without syndesmophytes. BMD changes were significantly higher in the anti-TNF group than in the control group at lumbar spine (p < 0.0001), at femoral neck (p = 0.002), and at trochanter (p = 0.011), but not at total hip (p = 0.062). Multivariate analysis showed that the predictors of lumbar spine BMD changes in the total population were the use of anti-TNF (p < 0.0001) and, in the anti-TNF therapy group, the 1-year lumbar spine BMD change (p = 0.007).Conclusion.This study shows that prolonged anti-TNF therapy increases lumbar spine and trochanter BMD. This effect should be taken into account before introducing antiosteoporotic treatment in these patients.

scholarly journals Transposition of the great trochanter: A look at the problem

2021 ◽  
Vol 9 (2) ◽  
pp. 195-202
Author(s):  
Ivan Y. Pozdnikin ◽  
Pavel I. Bortulev ◽  
Dmitry B. Barsukov ◽  
Vladimir E. Baskov
Keyword(s):  
Surgical Treatment ◽  
Femoral Neck ◽  
Range Of Motion ◽  
Hip Joint ◽  
Proximal Femur ◽  
Great Trochanter ◽  
Clinical Parameters ◽  
Greater Trochanter ◽  
Hip Joints ◽  
High Position

BACKGROUND: Multiplanar deformity of the proximal femur with a high position of the greater trochanter is one of the most common residual deformities of the hip joint. The VeauLamy transposition of the greater trochanter does not fully treat the mutual trauma of the components of the hip joint, as it only brings down the greater trochanter to provide tension for the gluteal muscles. AIM: This study aimed to share the experience of performing transposition of the greater trochanter according to our proposed technique. MATERIALS AND METHODS: The study included 15 patients (15 hip joints) aged 916 years with a high position of the greater trochanter of the femur, who underwent surgical treatment in the period from 2018 to 2019. In addition to the actual transposition of the greater trochanter, the intervention provided a modeling resection of the base (bed) of the greater trochanter and the formation of an offset of the femoral neck. RESULTS: Patients were followed up for period of up to 30 months. All patients showed positive changes after surgical treatment with improvement of radiological and clinical parameters. CONCLUSIONS: The proposed intervention allows restoration of the function of the gluteal muscles, improves the range of motion in the hip joint, and prevents and treats extra-articular impingement syndrome.

scholarly journals Successful application of Translocation of the Great Trochanter to Coxofemoral Luxation in a Calf

1994 ◽  
Vol 47 (3) ◽  
pp. 185-187
Author(s):  
Saburo MINAMI ◽  
Yoshiharu OKAMOTO ◽  
Kohji KAWAMURA ◽  
Akira MATSUHASHI
Keyword(s):  
Great Trochanter

scholarly journals Tuberculosis of the Great Trochanter

BMJ ◽  
1947 ◽  
Vol 2 (4525) ◽  
pp. 492-482 ◽  
Author(s):  
B. McMurray
Keyword(s):  
Great Trochanter

scholarly journals Uncemented short stems in primary total hip arthroplasty

2018 ◽  
Vol 3 (5) ◽  
pp. 149-159 ◽  
Author(s):  
Mattia Loppini ◽  
Guido Grappiolo
Keyword(s):  
Great Trochanter ◽  
Stress Shielding ◽  
Specific Pattern ◽  
Short Term ◽  
Physiological Loading ◽  
Bone Atrophy ◽  
Long Stem ◽  
Short Stems ◽  
Primary Total Hip Arthroplasty

Over the last two decades, several conservative femoral prostheses have been designed. The goals of conservative stems include: the spearing of the trochanteric bone stock; a more physiological loading in the proximal femur reducing the risk of stress shielding; and to avoid a long stem into the diaphysis preventing impingement with the femoral cortex and thigh pain. All stems designed to be less invasive than conventional uncemented stems are commonly named ‘short stems’. However, this term is misleading because it refers to a heterogeneous group of stems deeply different in terms of design, biomechanics and bearing. In the short-term follow-up, all conservative stems provided excellent survivorship. However, variable rates of complications were reported, including stem malalignment, incorrect stem sizing and intra-operative fracture. Radiostereometric analysis (RSA) studies demonstrated that some conservative stems were affected by an early slight migration and rotation within the first months after surgery, followed by a secondary stable fixation. Dual-energy x-ray absorptiometry (DEXA) studies demonstrated an implant-specific pattern of bone remodelling. Although the vast majority of stems demonstrated a good osseointegration, some prostheses transferred loads particularly to the lateral and distal-medial regions, favouring proximal stress shielding and bone atrophy in the great trochanter and calcar regions.Cite this article: EFORT Open Rev 2018;3:149-159. DOI: 10.1302/2058-5241.3.170052

scholarly journals AB0922 BUROSUMAB (ANTI-FGF23 MONOCLONAL ANTIBODY) IN THE TREATMENT OF A PATIENT WITH RECURRENT TUMOR INDUCED OSTEOMALACIA.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1762.3-1762
Author(s):  
C. Crotti ◽  
F. Zucchi ◽  
P. Messa ◽  
R. Caporali ◽  
M. Varenna
Keyword(s):  
Monoclonal Antibody ◽  
Vitamin D ◽  
Great Trochanter ◽  
Fibroblast Growth Factor 23 ◽  
Well Being ◽  
Hypophosphatemic Rickets ◽  
Imaging Evaluation ◽  
Left Femur ◽  
Pet Ct ◽  
Fgf 23

Background:Tumor-induced Osteomalacia (TIO) is a rare paraneoplastic syndrome caused by tumoral overproduction of fibroblast growth factor 23 (FGF23), resulting in hyperphospaturia, hypophosphatemia and osteomalacia. Surgery is the only curative treatment, but tumor can locally recur, even after years from primary surgery. Furthermore, some tumors cannot be removed by surgery due to their location.Objectives:To describe a case of a 53-year-old woman affected by recurrent TIO after three surgical attempts of removal treated with Burosumab.Methods:We describe the case of a 53 years old woman with TIO treated with Burosumab, an anti-FGF-23 monoclonal antibody at present approved for X-linked hypophosphatemic rickets only.Results:A 46-year-old Caucasian female was referred to our Bone Unit after experiencing several fractures in different sites. She reported being in good health until three years prior consultation. At the time of symptoms onset, she experienced a progressive muscle pain, enabling her to stand for a long period. During imaging evaluation for atraumatic fracture of right great trochanter, the MRI abdomen and18FDG- PET-CT showed a metabolic pre-sacral lesion. She unsuccessfully underwent to an exploratory laparotomy of that lesion. Then, she suffered from atraumatic intertrochanteric fracture of right femur, surgically treated, and after 3 months, she had an insufficiency dyaphiseal fracture of the left femur, surgically treated. Furthermore, she experienced several ribs fractures. At the time of first evaluation, lab works showed: serum-Phosophate (PS) 1.2 mg/dL (reference range (RR) 2.5-4.5 mg/dL), urinary-phosphate of 24h (PU) 842 mg/24h, alkaline phosphatase (ALP) 565 UI (RR<300), 1,25(OH)2vitamin D327 ng/L (RR 25-86.5), PTH 24 (RR<75 pg/mL), intact-FGF-23 117 (RR 25-45 pg/mL), normal serum and 24h-urinary Calcium. Patient underwent to68Ga-DOTATATE-PET-CT that showed a pre-sacral lesion, who was studied with MRI and CT before surgery. In 2013 patient underwent surgical excision of the pre-sacral region. After 18 months of well-being, patient complained worsening of articular pain and muscle weakness, and further ribs fractures. Another68Ga-DOTATATE-PET-CT reported a relapse of the previous pre-sacral lesion (32x12x47 mm) with an increase of FGF-23levels (54.6 pg/mL). Even the subsequent surgery was not able to remove the tumor. Since 2015, patient was maintained in phosphorus supplements and 1,25(OH)2vitamin D3, but PS levels never normalized. We asked for compassionate use of Burosumab and, after ethical committee approval, in September 2019 she was started on Burosumab, at a dose of 30 mg per month (0.3 mg/kg). At baseline, she had PS 1.2 mg/dL, PU 1874 mg/24h, TRP 25.96%. After two months, she improved in pain symptom (VAS reduction from 65 to 12 mm), which allow her to walk and stand without crutches. She did not normalize her PS levels (1.3 mg/dL), while PU reduced to 1000 mg/24h. We titred Burosumab dose at 40 mg per month (0.6 mg/kg) and patient is still under therapy, waiting for next blood works.Conclusion:This is the first European patient affected by TIO treated with Burosumab. Burosumab could be a promising therapy in the medical treatment of TIO refractory or not eligible for definitive surgery. Further data are needed to standardize the proper dose regimen.Disclosure of Interests:Chiara Crotti: None declared, Francesca Zucchi: None declared, Piergiorgio Messa: None declared, Roberto Caporali Consultant of: AbbVie; Gilead Sciences, Inc.; Lilly; Merck Sharp & Dohme; Celgene; Bristol-Myers Squibb; Pfizer; UCB, Speakers bureau: Abbvie; Bristol-Myers Squibb; Celgene; Lilly; Gilead Sciences, Inc; MSD; Pfizer; Roche; UCB, Massimo Varenna: None declared

Great trochanter bursitis vs sciatica, a diagnostic–anatomic trap: differential diagnosis and brief review of the literature

2018 ◽  
Vol 27 (7) ◽  
pp. 1509-1516 ◽  
Author(s):  
Aristeidis H. Zibis ◽  
Vasileios D. Mitrousias ◽  
Michail E. Klontzas ◽  
Theofilos Karachalios ◽  
Sokratis E. Varitimidis ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Great Trochanter ◽  
Review Of The Literature
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