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Bilateral Uncemented Hemiarthroplasty in a Patient with Bilateral Lower limb PPRP with Right Knee Arthrodesis: Surgical Difficulties and Techniques

May 10, 2019/in May- Dec 2019 | Volume 5 | Issue 2

Vol 5 | Issue 2 | May-Dec 2019 | page: 05-07 | Bipul Kumar Garg, Harshit Dave, Dhiraj V. Sonawane, Om Parshuram Patil DOI 10.13107/ti.2019.v05i01.088 Author: Bipul Kumar Garg [1], Harshit Dave [1], Dhiraj V. Sonawane [1], Om Parshuram Patil [1] [1] Department Of Orthopaedics, Grant Medical College And Sir J.J. Group Of Hospitals Mumbai. […]

A Case Series of Occult Femoral Neck Fracture, Why Plain Radiograph is not Enough?

May 10, 2019/in May- Aug 2019 | Volume 5 | Issue 2

Vol 5 | Issue 2 | May-Dec 2019 | page: 02-04 | John Butarbutar, Rio Aditya, Prettysia Suvarly, Nyoman Aditya Sindunata DOI 10.13107/ti.2019.v05i02.086 Author: John Butarbutar [1], Rio Aditya [2], Prettysia Suvarly [2], Nyoman Aditya Sindunata [2] [1] Department of Orthopedic & Traumatology, Siloam Hospitals Lippo Village – Pelita Harapan University, Jl. Siloam No. 6, […]

Bilateral Uncemented Hemiarthroplasty in a Patient with Bilateral Lower limb PPRP with Right Knee Arthrodesis: Surgical Difficulties and Techniques

May 10, 2019/in May- Dec 2019 | Volume 5 | Issue 2

A Case Series of Occult Femoral Neck Fracture, Why Plain Radiograph is not Enough?

May 10, 2019/in May- Aug 2019 | Volume 5 | Issue 2

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Bilateral Uncemented Hemiarthroplasty in a Patient with Bilateral Lower limb PPRP with Right Knee Arthrodesis: Surgical Difficulties and Techniques

May 10, 2019/in May- Dec 2019 | Volume 5 | Issue 2

Vol 5 | Issue 2 | May-Dec 2019 | page: 05-07 | Bipul Kumar Garg, Harshit Dave, Dhiraj V. Sonawane, Om Parshuram Patil

DOI 10.13107/ti.2019.v05i01.088

Author: Bipul Kumar Garg [1], Harshit Dave [1], Dhiraj V. Sonawane [1], Om Parshuram Patil [1]

[1] Department Of Orthopaedics,
Grant Medical College And Sir J.J. Group Of Hospitals Mumbai.

Address of Correspondence
Dr. Bipul Kumar Garg,
Department Of Orthopaedics,
Grant Medical College And Sir J.J. Group Of Hospitals Mumbai.
E-mail: garg.bipul@gmail.com

Abstract

Introduction: Standard references such as knee and lower leg position cannot be used in patients with knee arthrodesis with a bilateral neck of femur fracture during bipolar hemiarthroplasty. We describe a simple technique that guides a surgeon in assessing the femoral stem version in such cases.
Case report: We present a case of 52 years old male with bilateral lower limb Post Polio Residual Paralysis with right knee arthrodesis who sustained bilateral neck of femur fractures. The difficulties, in this case, were the inability to flex the knee and to use the ankle or the opposite limb and its bony landmarks as reference.
Conclusion: We describe a simple surgical technique of inserting a Steinmann pin in the distal femur in the coronal plane parallel to the transcondylar axis for intraoperative assessment of neutral position and version of the femoral stem.
Keywords: Bilateral; hemiarthroplasty; femoral stem; anteversion; knee arthrodesis.

References

1. Hirata M, Nakashima Y, Ohishi M, Hamai S, Hara D, Iwamoto Y. Surgeon error in performing intraoperative estimation of stem anteversion in cementless total hip arthroplasty. The Journal of arthroplasty. 2013 Oct 1;28(9):1648-53.
2. Lewinnek GE, Lewis JL, Tarr RI, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. The Journal of bone and joint surgery. American volume. 1978 Mar;60(2):217-20.
3. D’lima DD, Urquhart AG, Buehler KO, Walker RH, Colwell Jr CW. The effect of the orientation of the acetabular and femoral components on the range of motion of the hip at different head-neck ratios. JBJS. 2000 Mar 1;82(3):315-21.
4. Malik A, Maheshwari A, Dorr LD. Impingement with total hip replacement. JBJS. 2007 Aug 1;89(8):1832-42.
5. Patel AB, Wagle RR, Usrey MM, Thompson MT, Incavo SJ, Noble PC. Guidelines for implant placement to minimize impingement during activities of daily living after total hip arthroplasty. The Journal of arthroplasty. 2010 Dec 1;25(8):1275-81.
6. Patii ND, Patel HB, Hussain N, Saidane K. Cemented Hemiarthroplasty of the Hip in a Patient with Ipsilateral Knee Arthrodesis: Surgical Difficulties and Techniques. Journal of orthopaedic case reports. 2018 Jan;8(1):75.
7. Unlu MC, Kesmezacar H, Kantarci F, Unlu B, Botanlioglu H. Intraoperative estimation of fe-moral anteversion in cementless total hip arthroplasty using the lesser trochanter. Archives of or-thopaedic and trauma surgery. 2011 Sep 1;131(9):1317-23..
8. Yun HH, Yoon JR, Yang JH, Song SY, Park SB, Lee JW. A validation study for estimation of femoral anteversion using the posterior lesser trochanter line: an analysis of computed tomography measurement. The Journal of arthroplasty. 2013 Dec 1;28(10):1776-80.

How to Cite this article: Garg B K, Dave H, Sonawane D V, Patil O P. | Bilateral Uncemented Hemiarthroplasty in a Patient with Bilateral Lower limb PPRP with Right Knee Arthrodesis: Surgical Difficulties and Techniques.| Trauma International | May – Dec 2019; 5(2): 05-07.

(Abstract)(Full Text HTML) (Download PDF)

A Case Series of Occult Femoral Neck Fracture, Why Plain Radiograph is not Enough?

May 10, 2019/in May- Aug 2019 | Volume 5 | Issue 2

Vol 5 | Issue 2 | May-Dec 2019 | page: 02-04 | John Butarbutar, Rio Aditya, Prettysia Suvarly, Nyoman Aditya Sindunata

DOI 10.13107/ti.2019.v05i02.086

Author: John Butarbutar [1], Rio Aditya [2], Prettysia Suvarly [2], Nyoman Aditya Sindunata [2]

[1] Department of Orthopedic & Traumatology, Siloam Hospitals Lippo Village – Pelita Harapan University, Jl. Siloam No. 6, Lippo Karawaci 1600 Tangerang 15811, Indonesia.
[2] Clinical Researcher at Orthopedic & Traumatology Department, Siloam Hospitals Lippo Village – Pelita Harapan University, Jl. Siloam No. 6, Lippo Karawaci 1600 Tangerang 15811, Indonesia.

Address of Correspondence
Dr. John Butarbutar,
Department of Orthopedic & Traumatology, Siloam Hospitals Lippo Village – Pelita Harapan University, Jl. Siloam No. 6, Lippo Karawaci 1600 Tangerang 15811, Indonesia.
E-mail: johnbutar2@gmail.com

Abstract

Background: About 10% of hip fractures are missed on initial presentation and potentially expose patients to increased morbidity and unnecessary complex surgeries. 2,3 CT-scan and MRI in the emergency settings have been proposed to avoid a misdiagnosis.3,6,7
Case Series: three cases (two female and one male patient) patients with hip pain were presented with normal x-ray on initial presentation. Further investigation using CT-scan and MRI revealed femoral neck fractures.
Case 1 : A 77 years-old female presented with right hip pain after a ground-level fall. Plain radiograph was normal and the patient was discharged from emergency. One week later, her hip pain worsened and a follow up x-ray showed a displaced femoral neck fracture. The fracture then treated with bipolar hemiarthroplasty.
Case 2 : An 87 years-old female presented with left hip pain after a fall in the bathroom. She was able to bear weight. Initial hip x-ray appeared normal. Further investigation with a pelvic CT scan revealed a displaced femoral neck fracture.
Case 3 : A 49 years-old male presented with worsening right hip pain since more than a week. The patient was physically active and has no history of trauma or associated hip injury. Initial x-ray showed a normal hip but further imaging study using MRI revealed an undisplaced femoral neck fracture. The patient was treated conservatively as he refused to do surgery.
Conclusion: Traumatic hip pain with negative plain radiograph should be followed by MRI or CT -scan to avoid misdiagnosis.
Keywords : Occult hip fracture, Missed hip fracture, Femoral Neck Fracture, Elderly patient

References

1. B. Gullberg, O. Johnell and J. Kanis, “World-wide projections for hip fracture,” Osteoporosis International, vol. 7, no. 5, pp. 407-13, 1997.
2. O. Lubovsky, M. Libergall, Y. Mattan, Y. Weil and R. Mosheiff, “Early diagnosis of occult hip fractures,” Injury, vol. 36, no. 6, pp. 788-92, 2005.
3. J. Cannon, S. Silvestri and M. Muntro, “Imaging choices in occult hip fracture,” The hournal of emergency medicine, vol. 37, no. 2, pp. 144-52, 2009.
4. W. Brox, K. Roberts and S. Taksali, “The American academy of orthopaedic surgeons evidence-based guideline on management of hip fracture in the elderly,” Journal of Bone and Joint Surgery, vol. 97, pp. 1196-9, 2015.
5. N. Yoshida, Y. Komaru and Y. Tsuchida, “Occult femoral neck fracture,” Case reports, vol. 2017, 2017.
6. S. Gill, J. Smith, R. Fox and C. T, “Investigation of occult hip fractures : the use of CT and MRI,” The scientific world journal, vol. 2013, pp. 1-4, 2013.
7. D. Collin, D. Dunker, J. Gothlin and M. Geijer, “Observer variation for radiography, computed tomograpy, and magnetic resonance imaging of occult hip fractures.,” Acta Radiologica, vol. 52, no. 8, pp. 871-4, 2011.
8. C. Wei, W. Tsai, C. Tiu, H. Wu and H. Chiou, “Systematic analysis of missed extremity fractures in emergency radiolgy,” Acta Radiol, vol. 47, pp. 710-7, 2006.
9. B. Yun, M. Myriam Hunink, A. Prabhakar, M. Heng, R. Qudsi and A. Raja, “Diagnostic imaging strategies for occult hip fractures : a decision and cost-effectiveness analysis,” Academic Emergency Medicine, vol. 23, no. 10, pp. 1161-9, 2016.
10. F. Frihagen, L. Norsletten, R. Tariq and J. Madsen, “MRI diagnosis of occult hip fractures,” Acta Orthop, vol. 76, no. 4, pp. 524-30, 2005.
11. R. Pandey, E. McNally, A. Ali and C. Bulstrode, “The role of MRI in the diagnosis of occult hip fractures,” Injury, vol. 29, pp. 61-3, 1998.
12. M. Haubro, C. Stougaard, T. Torfing and e. al, “Sensitivity and specificity of CT and MRI scanning in evaluation of occult fracture of the proximal femur,” Injury, vol. 46, pp. 1557-61, 2015.

How to Cite this article: Butarbutar J, Aditya R, Suvarly P, Sindunata N A. | A Case Series of Occult Femoral Neck Fracture, Why Plain Radiograph is not Enough? | Trauma International | May-Dec 2019; 5(2): 02-04.

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Bilateral Uncemented Hemiarthroplasty in a Patient with Bilateral Lower limb PPRP with Right Knee Arthrodesis: Surgical Difficulties and Techniques

A Case Series of Occult Femoral Neck Fracture, Why Plain Radiograph is not Enough?

Bilateral Uncemented Hemiarthroplasty in a Patient with Bilateral Lower limb PPRP with Right Knee Arthrodesis: Surgical Difficulties and Techniques

A Case Series of Occult Femoral Neck Fracture, Why Plain Radiograph is not Enough?

Full Sized Blog Element (Big Preview Pic)

Bilateral Uncemented Hemiarthroplasty in a Patient with Bilateral Lower limb PPRP with Right Knee Arthrodesis: Surgical Difficulties and Techniques

Author: Bipul Kumar Garg [1], Harshit Dave [1], Dhiraj V. Sonawane [1], Om Parshuram Patil [1]

Abstract

References

(Abstract)(Full Text HTML) (Download PDF)

A Case Series of Occult Femoral Neck Fracture, Why Plain Radiograph is not Enough?

Author: John Butarbutar [1], Rio Aditya [2], Prettysia Suvarly [2], Nyoman Aditya Sindunata [2]

Abstract

References

(Abstract)(Full Text HTML) (Download PDF)

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