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1.
Acta ortop. mex ; 34(1): 16-21, ene.-feb. 2020. tab
Article in Spanish | LILACS | ID: biblio-1345079

ABSTRACT

Resumen: Introducción: La necrosis avascular de cabeza femoral (NACF) es una patología frecuente que en sus inicios es asintomática y se manifiesta de forma insidiosa, por lo que a menudo el diagnóstico se realiza en estadios avanzados, donde la única solución eficaz es la artroplastía total de cadera (ATC). El diagnóstico en fases precoces permitirá utilizar opciones terapéuticas que eviten o retrasen la ATC. Nuestro objetivo es valorar los resultados demográficos, clínicos y la tasa de éxito en nuestro centro de pacientes con diagnóstico de NACF y que han sido subsidiarios de cirugía de preservación de cadera. Material y métodos: Estudio clínico unicéntrico, prospectivo, no controlado de pacientes con diagnóstico de NACF entre Enero de 2012 y Septiembre de 2017 con un estadio Steinberg ≤ IIIA. La técnica quirúrgica utilizada es el forage descompresivo, asociado a relleno con aloinjerto y aspirado de médula ósea. Resultados: Se intervinieron 26 caderas con nuestra técnica quirúrgica. La tasa de éxito obtenida es de 61.54%, ya que 10 casos han precisado ATC durante el estudio (38.46%). Conclusión: El éxito terapéutico en la NACF está directamente relacionado con el grado de la enfermedad, por lo que es importante el diagnóstico precoz. El forage descompresivo con relleno de aloinjerto que asocia aspirado de médula ósea es una opción a tener en cuenta, ya que en estadios iniciales muestra una elevada tasa de éxito.


Abstract: Introduction: Avascular osteonecrosis of the femoral head (ONFH) is a frequent pathology with an insidious and asymptomatic presentation in early stages, so the diagnosis is often made in advanced stages, where the only effective solution is total hip arthroplasty (THA). Diagnosis in early stages will allow the use of therapeutic options that avoid or delay ATC. Our objective is to evaluate the demographic, clinical results and the success rate in our center of patients diagnosed with ONFH and who have been subsidiary of hip preservation surgery. Material and methods: Unicentric, prospective, uncontrolled clinical study of patients diagnosed with ONFH between January 2012 and September 2017 with a Steinberg ≤ IIIA stage. The surgical technique used is decompressive forage, associated with bone allograft and bone marrow aspiration. Results: 26 hips were operated on with our surgical technique. The success rate obtained is 61.54%, since 10 cases have required THA during the study (38.46%). Conclusions: The therapeutic success in ONFH is directly related to the degree of the disease, which is why early diagnosis is important. The decompressive forage with bone allograft that associates bone marrow aspiration is an option to be taken into account, since in early stages it shows a high success rate.


Subject(s)
Humans , Arthroplasty, Replacement, Hip , Femur Head Necrosis/surgery , Femur Head Necrosis/epidemiology , Prospective Studies , Treatment Outcome , Femur Head/surgery
2.
Article in Chinese | WPRIM | ID: wpr-879350

ABSTRACT

OBJECTIVE@#To observe the clinical effect of platelet rich plasma (PRP) combined with β tricalcium phosphate bioceramic bone in the treatment of non traumatic necrosis of the femoral head in ARCO stageⅡ.@*METHODS@#From January 2017 to December 2018, 100 patients (160 hips) with ARCO stageⅡnon traumatic necrosis of the femoral head were divided into PRP group and control group. In PRP group, 50 patients (80 hips), 22 males and 28 females, aged from 18 to 65 (43.47± 7.23) years, with a course of 4 to 18 (15.8±2.9) months, underwent core decompression and bone grafting combined with PRP implantation. There were 50 cases (80 hips) in the control group, including 27 males and 23 females, aged 20 to 63 (45.72± 7.43) years, and the course of disease was 6 to 19 (14.9±3.8) months. Hip X-ay film was followed up after operation. Harris score and VAS score were used to evaluate the curative effect, and the survival rate of hip joint was recorded.@*RESULTS@#All patients had good wound healing, no infection, thrombosis and other complications. All patients were followed up for 12 to 14 (12.0±0.4) months. Twelve months after operation, the image expression of PRP group was better than that of control group(@*CONCLUSION@#Platelet-rich plasma(PRP) combined with artificialbone for core decompression and bone grafting can change the situation of simple artificial bone implantation and uncertain curative effect, improve the success rate of this operation, effectively reduce the collapse rate of femoral head necrosis in the early and middle stage, delay or even avoid hip replacement.


Subject(s)
Adolescent , Adult , Aged , Artemisinins , Bone Transplantation , Decompression, Surgical , Female , Femur Head/surgery , Femur Head Necrosis/surgery , Humans , Male , Middle Aged , Naphthoquinones , Platelet-Rich Plasma , Treatment Outcome , Young Adult
3.
Rev. bras. ortop ; 53(1): 125-127, Jan.-Feb. 2018. graf
Article in English | LILACS | ID: biblio-899237

ABSTRACT

ABSTRACT Slipped capital femoral epiphysis is a very frequently seen condition in orthopedics centers worldwide. Even in successfully treated cases, complications related either with the pathology per se or with the chosen synthesis method are not rare. This report presents a case of bilateral slipped capital femoral epiphysis treated with pinning, in which one of the limbs developed a very rare condition: the formation of a femoral pseudoaneurysm that ruptured.


RESUMO A epifisiólise proximal da cabeça femoral é uma patologia frequentemente tratada em centros de ortopedia. Mesmo nos casos de tratamento bem-sucedido, complicações relacionadas tanto ao fenômeno em si quanto à síntese escolhida não são raras. Os autores relatam um caso de epifisiólise da cabeça femoral bilateral, submetido a pinagem, que evoluiu com uma complicação raríssima em um dos membros: a formação de um pseudoaneurisma femoral, com posterior rotura.


Subject(s)
Humans , Male , Adolescent , Aneurysm/etiology , Femoral Artery/injuries , Femur Head/surgery , Orthopedic Procedures , Slipped Capital Femoral Epiphyses
4.
Article in English | WPRIM | ID: wpr-101621

ABSTRACT

Avascular necrosis of the femoral head is caused by a multitude of etiologic factors and is associated with collapse with a risk of hip arthroplasty in younger populations. A focus on early disease management with the use of stem cells was proposed as early as 1985 by the senior author (PH). We undertook a systematic review of the medical literature to examine the progress in cell therapy during the last 30 years for the treatment of early stage osteonecrosis.


Subject(s)
Cell- and Tissue-Based Therapy , Femur Head/surgery , Femur Head Necrosis/surgery , Humans , Mesenchymal Stem Cell Transplantation , Tissue Engineering
5.
Article in English | WPRIM | ID: wpr-70758

ABSTRACT

BACKGROUND: Recently, various femoral head fixation devices (HFDs) for trochanteric fractures have become available. However, there are some cases in which femoral head rotation with excessive sliding of the HFD is observed and it is often followed by cutout. The purpose of this study is to compare the ability of the three types of HFDs to prevent femoral head rotation. METHODS: Between July 2005 and December 2009, 206 patients aged over 60 years with trochanteric fractures who had undergone surgical treatment using a short femoral nail in our institution were enrolled into the study. We used the gamma 3 nail (GMN) as the screw-type HFD in 66 cases, the gliding nail (GLN) as a non-cylindrical blade in 76 cases, and the proximal femoral nail antirotation (PFNA) as a cylindrical blade in 64 cases. The sliding length of HFDs and the occurrence of femoral head rotation were evaluated by assessing radiographs as the main outcome, and the results were compared among these devices. RESULTS: A comparison of the degree of sliding in the GMN group showed that femoral head rotation was observed significantly more frequently in cases with rotation. Further, it appeared that femoral head rotation occurred more frequently in comminuted fractures. However, no significant differences between the sliding lengths of the different HFDs were observed among three groups. Femoral head rotation was observed in 15 cases of GMN (22.7%), 0 case of GLN, and 5 case of PFNA (7.8%). Significant differences with regard to the occurrence of femoral head rotation were observed among the three groups. Furthermore, significant differences were also observed between GLN and PFNA with respect to the occurrence of femoral head rotation. CONCLUSIONS: The ability to stabilize femoral head appears to be greater with blade-type materials than with screw-type materials. Furthermore, we believe that a non-cylindrical blade is preferable to a cylindrical blade for the surgical treatment of comminuted, unstable trochanteric fractures in order to prevent femoral head rotation and cut-out.


Subject(s)
Aged , Aged, 80 and over , Female , Femur Head/surgery , Hip Fractures/surgery , Humans , Internal Fixators/statistics & numerical data , Male , Postoperative Complications/epidemiology , Range of Motion, Articular/physiology , Retrospective Studies
6.
Article in English | WPRIM | ID: wpr-74484

ABSTRACT

An English setter (case 1) and a Tibetan mastiff (case 2) presented with intermittent weight-bearing lameness on the right hind limb when trotting. The dogs had a history of femoral head and neck ostectomy (FHNO). Orthopedic examination revealed pain and crepitus on the right hip joint. The dogs underwent total hip replacement (THR). At the 2-year (case 1) and 1-year (case 2) follow-up, both dogs had resumed normal activity without lameness. The muscle mass and range of motion were significantly improved in the affected hind limb. In conclusion, FHNO with poor functional outcomes can be successfully ameliorated with THR.


Subject(s)
Animals , Arthroplasty, Replacement, Hip/methods , Dog Diseases/surgery , Dogs , Female , Femur Head/surgery
7.
Rev. Asoc. Argent. Ortop. Traumatol ; 79(4): 224-231, 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-743073

ABSTRACT

Introducción: Una vez detenida la progresion del deslizamiento, las caderas experimentan un fenomeno complejo de remodelacion. Mientras tanto, el choque femoro-acetabular provoca daño irreversible del cartilago articular. El proposito del trabajo es determinar si la remodelacion es suficiente para impedir el deterioro articular en el corto plazo. Materiales y Métodos: Se diseñó un estudio de cohorte retrospectivo de pacientes con deslizamientos moderados y graves, que recibieron como tratamiento la fijacion in situ. Se evaluó la capacidad de remodelación con el ángulo de Southwick y el ángulo alfa. El deterioro funcional se evaluó con el puntaje de Harris y el radiologico, con la escala de Tonnis. Seguimiento minimo: 4 años. Resultados: Diecisiete pacientes, mediana de seguimiento: 63 meses (Ri 55-81). El angulo de Southwick prequirurgico 57o (Ri 50-72) versus el posquirurgico 48o (Ri 45-74) disminuyó significativamente (p 0,023). lo mismo ocurrio con el angulo alfa complementario. El deterioro radiologico evaluado con la escala de Tonnis fue estadisticamente significativo (p 0,012). los resultados funcionales, cuantificados con el puntaje de Harris no mostraron diferencias estadisticamente significativas (p 0,49). Conclusiones: En esta serie, las epifisiolisis moderadas y graves fijadas in situ presentaron deterioro radiologico en 63 meses de seguimiento promedio. Sin embargo, la funcionalidad no se deterioro con la misma rapidez. Nivel de Evidencia: IV.


Background: After stopping the slip progression, hips undergo a remodeling complex phenomenon. Meanwhile femoro-acetabular shock causes irreversible joint cartilage damage. The purpose of the study is to determine if remodeling is sufficient to prevent joint deterioration in the short-term. Methods: a retrospective cohort study of patients with moderate and severe landslides, treated with in situ fixation was designed. Remodeling capacity was evaluated with Southwick angle and alpha angle. Functional and radiological impairment was evaluated with the Hip Harris Score and Tonnis scale, respectively. Minimum follow-up: 4 years. Results: Seventeen patients, median follow-up 63 months (iR 55-81). The pre-surgical Southwick angle 57o (iR 50-72) versus the postoperative one 48o (iR 45-74) significantly decreased (p 0.023). The same happened with the complementary angle alpha. The radiological deterioration was statistically significant (p 0.012). Functional results showed no statistically significant differences (p 0.49). Conclusions: in this series, moderate and severe slipped capital femoral epiphysis fixed in situ showed radiological deterioration during a 63-month follow-up. However, the functionality is not deteriorating as quickly. Level of Evidence: IV.


Subject(s)
Child , Hip Joint/surgery , Femur Head/surgery , Slipped Capital Femoral Epiphyses/surgery , Slipped Capital Femoral Epiphyses , Retrospective Studies , Follow-Up Studies , Femur/pathology , Femur , Bone Remodeling , Treatment Outcome
8.
Rev. bras. ortop ; 48(2): 204-208, abr. 2013. graf
Article in English | LILACS | ID: lil-677015

ABSTRACT

We presente a case of a fracture of a cobalt-chrome femoral head after revision of a hip total prosthesis with ceramic femoral head fracture. During surgery we found the cobalt-chrome femoral head fracture, wear of the polyethylene and massive metallosis in muscular and cartilaginous tissue. Both femoral stem and acetabular cup were stable and without apparent wearing. After surgical debridement, we promoted the substitution of the femoral head and the acetabular polyethylene by similar ones. After 12 months of follow-up, the patient has no pain complaints, function limit or systemic signs associated with malign metallosis.


Subject(s)
Humans , Male , Middle Aged , Arthroplasty, Replacement, Hip , Femur Head/surgery , Femoral Fractures/surgery , Femoral Fractures/rehabilitation , Metal Ceramic Alloys
9.
Article in English | WPRIM | ID: wpr-104700

ABSTRACT

This study was conducted to assess the effects of femoral varus osteotomy on joint congruency in dogs affected by early stage hip dysplasia. Preoperative planning to move the femoral head within the acetabulum was carried out. Varisation of the femoral inclination angle (fIA) was achieved by Intertrochanteric Osteotomy (ITO). Norberg angle (NA), percent coverage (PC) of the femoral head by the acetabulum and fIA was measured from preoperative, immediate postoperative and first and second recheck radiographs of seven dogs that underwent an ITO (joint n = 9). There was significant (p < 0.05) improvement of both NA and PC in all patients as indicated by a change in the mean +/- standard deviation of 78.9degrees +/- 7.5 and 36.9% +/- 5.2 to 92.2degrees +/- 6.7 and 50.6% +/- 8.3, respectively. No significant difference (p < 0.05) was observed between the values of the planned femoral inclination angle (pfIA) of the femur and the effective femoral inclination angle (efIA) obtained after surgery (115.9degrees +/- 2.5 and 111.3degrees +/- 6.4, respectively). These findings could encourage the use of ITO in veterinary practice and indicate that intertrochanteric varus osteotomy should be re-considered for the treatment of early stage hip dysplasia in dogs with radiological signs of joint incongruency.


Subject(s)
Animals , Dogs , Female , Femur Head/surgery , Hip Dislocation/surgery , Joint Diseases/surgery , Male , Osteotomy/methods , Radiographic Image Interpretation, Computer-Assisted/methods
10.
Rev. bras. ortop ; 47(4): 460-466, 2012. ilus, tab
Article in Portuguese | LILACS | ID: lil-656127

ABSTRACT

OBJETIVO: Verificar a porcentagem de pacientes ideais elegíveis à cirurgia do tipo resurfacing do quadril em um serviço referência de artroplastias do quadril. MÉTODOS: Analisamos, dentre todos os casos de artroplastia do quadril realizadas no Hospital do Servidor Público Estadual de São Paulo (HSPE) entre janeiro de 2009 e dezembro de 2010, um total de 592 artroplastias, as quais se enquadrariam nos critérios de indicação ideal para artroplastia de resurfacing segundo avaliação clínica e radiológica preconizada com os critérios estabelecidos pela Food and Drug Administration (FDA) e por Seyler et al. RESULTADOS: Considerando o universo total das artroplastias de substituição do quadril, foram elegíveis 5,74% dos pacientes. Nos pacientes submetidos à artroplastia primária, encontrou-se 8,23% em condições ideais a este procedimento. CONCLUSÃO: Demonstra-se o papel ainda restrito desta modalidade cirúrgica entre as cirurgias do quadril.


OBJECTIVE: To investigate the percentage of ideal patients who would be eligible for hip-resurfacing surgery at a reference service for hip arthroplasty. METHODS: Out of all the cases of hip arthroplasty operated at Hospital do Servidor Público Estadual de São Paulo (HSPE) between January 2009 and December 2010, we assessed a total of 592 procedures that would fit the criteria for indication for resurfacing arthroplasty, after clinical and radiological evaluation according to the criteria established by the Food and Drug Administration (FDA) and by Seyler et al. RESULTS: Among the total number of hip replacement arthroplasty cases, 5.74% of the patients were eligible. Among the patients who underwent primary arthroplasty, we found that 8.23% presented ideal conditions for this procedure. CONCLUSION: The study demonstrated that this type of surgery still has a limited role among hip surgery methods.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged, 80 and over , Arthroplasty, Replacement, Hip , Femur Head/surgery , Femoral Neck Fractures
11.
Rev. colomb. biotecnol ; 12(2): 67-85, dic. 2010. graf, ilus, tab
Article in Spanish | LILACS | ID: lil-590775

ABSTRACT

La causa más común de falla en prótesis coxofemorales es el aflojamiento entre los componentes que conforman el sistema, de manera específica la copa acetabular y la cabeza femoral. En esta investigación se presenta un análisis tribológico del desgaste en los componentes mencionados, ya que cuando las superficies en contacto se desgastan, la funcionalidad mecánica del sistema se compromete, debido al cambio de geometría de los mismos, dando como resultado un juego mecánico entre la copa y la cabeza. Los materiales considerados en este estudio son el polietileno de ultra elevado peso molecular (UHMWPE, por sus siglas en inglés) para la copa acetabular, y acero inoxidable 316L para la cabeza femoral. Esta combinación de materiales representa hoy en día la recomendación más usual por parte de los cirujanos para pacientes de la tercera edad. La tasa anual de desgaste se determinó de manera experimental y se cuantificó la cantidad de material desprendido durante el contacto. Se establecieron las condiciones de carga de forma analítica, considerando las que actúan sobre la cabeza femoral a lo largo del área de desgaste durante la marcha humana. Posteriormente, se realizó el análisis experimental de desgaste utilizando una máquina tribológica de configuración perno-sobre-disco (pin-on-disk), diseñada de manera específica para este estudio. Las pruebas para determinar la pérdida volumétrica de los componentes se realizaron bajo tres condiciones de operación: en seco, lubricada con agua destilada y lubricada con suero bovino. El marco experimental considerado consistió en pernos de UHMWPE sobre discos de acero inoxidable 316l simulando el desgaste equivalente a diez años de uso de la prótesis. Finalmente, de los resultados obtenidos se puede establecer que el desgaste y la cantidad de partículas desprendidas disminuyen considerablemente cuando se utiliza suero bovino como lubricante para replicar las condiciones reales de operación del sistema...


The most common cause of failure in coxofemoral prostheses is the loosening between the components of the system, namely the acetabular cup and the femoral head. In this work a tribologic analysis of wear suffered in the components is presented, due to when the surfaces in contact are worn, the mechanical function of the system is compromised as the wearing implies a change in the geometry of the components, thus in their dimensions, resulting on a looseness between the cup and the head. The materials considered in this study are Ultra High Molecular Weight Polyethylene (UHMWPE) for the cup and 316L Stainless Steel for the femoral head, which represent the surgeons choice for elderly patients. The annual wearing rate between these components was experimentally determined, as well as the amount of debris produced during contact. Firstly, the loading conditions were determined analytically considering those acting on the femoral head taking into consideration the wearing area during human walk. Secondly, the experimental analysis consisted in wearing tests using a tribology pin-on-disk machine, specifically built for this study. The tests to determine the volumetric loss of the components were performed under three different operational conditions: dry, lubricated with bovine serum and lubricated with destilated water. The experimental set up consisted on UHMWPE pins and 316L Stainless steel discs simulating the equivalent wear of ten years of usage of the prostheses. Lastly, the obtained results proved that using the bovine serum as lubricant the wear and debris of the components was significantly reduced when compared with other cases, being the dry scenario where more damage was produced. It is important to point out that the bovine serum was chosen to simulate the synovial fluid in which the system is embedded.


Subject(s)
Femur Head/abnormalities , Femur Head/surgery , Femur Head/growth & development , Femur Head/physiology , Femur Head/injuries , Femur Head , Femur Head/transplantation , Artificial Limbs
12.
Article in English | WPRIM | ID: wpr-76421

ABSTRACT

BACKGROUND: Ganz surgical hip dislocation is useful in the management of severe hip diseases, providing an unobstructed view of the femoral head and acetabulum. We present our early experience with this approach in pediatric hip diseases. METHODS: Twenty-three hips of 21 patients with pediatric hip diseases treated using the Ganz surgical hip dislocation approach were the subjects of this study. The average age at the time of surgery was 15.7 years. There were 15 male and 6 female patients who were followed for an average of 15.1 months (range, 6 to 29 months). Diagnoses included hereditary multiple exostoses in 9 hips, slipped capital femoral epiphysis in 7, Legg-Calve-Perthes disease in 4, osteoid osteoma in 1, pigmented villonodular synovitis in 1, and neonatal septic hip sequelae in 1. Medical records were reviewed to record diagnoses, principal surgical procedures, operative time, blood loss, postoperative rehabilitation, changes in the range of hip joint motion, and complications. RESULTS: Femoral head-neck osteochondroplasty was performed in 17 patients, proximal femoral realignment osteotomy in 6, open reduction and subcapital osteotomy for slipped capital femoral epiphysis (SCFE) in 2, core decompression and bone grafting in 2, hip distraction arthroplasty in 2, and synovectomy in 2. Operative time averaged 168.6 minutes when only osteochondroplasty and/or synovectomy were performed. Hip flexion range improved from a preoperative mean of 84.7degrees to a mean of 115.0degrees at the latest follow-up visit. Early continuous passive motion and ambulation were stressed in rehabilitation. No avascular necrosis of the femoral head was noted up to the time of the latest follow-up visit, except for in one SCFE patient whose surgical intervention was delayed for medical reasons. CONCLUSIONS: Ganz surgical hip dislocation provides wide exposure of the femoral head and neck, which enables complete and precise evaluation of the femoral head and neck contour. Hence, the extensive impinging bump can be excised meticulously, and the circulation of the femoral head can be monitored during surgery. The Ganz procedure was useful in severe pediatric hip diseases and allowed for quick rehabilitation with fewer complications.


Subject(s)
Acetabulum/surgery , Adolescent , Adult , Cartilage, Articular/surgery , Child , Female , Femur Head/surgery , Hip Dislocation/surgery , Hip Joint/abnormalities , Humans , Male , Osteotomy/methods , Treatment Outcome , Young Adult
13.
Article in English | WPRIM | ID: wpr-76419

ABSTRACT

BACKGROUND: The authors report the results of femoroacetabular impingement (FAI) treated with a surgical dislocation. METHODS: From April 2005 to May 2007, 15 FAI hips were treated with a surgical dislocation. The male/female ratio, mean age and mean symptom duration was 12/2, 35.8 years and 2.3 years, respectively. Radiographs and MR arthrograms were taken. The clinical evaluation involved changes in the pre- and postoperative Harris hip score (HHS). RESULTS: There were 12 hips (80%) with at least one structural abnormality in the radiographs, with 11 (79%) labral tears and 8 (73%) abnormally high angles in the MR arthrograms. We performed 15 osteochondroplasties, 12 labral repairs, 12 acetabuloplasty, and 3 debridements. The mean HHS improved from 76 to 93 points. Three non-unions of the trochanteric osteotomy sites were encountered as complications. CONCLUSIONS: Radiographs and MR arthrograms are important for making a proper diagnosis of FAI and planning treatment. A surgical dislocation can be used to treat FAI but further technical improvements will be needed for fixation of the greater trochanteric osteotomy sites.


Subject(s)
Acetabulum/surgery , Adult , Female , Femoracetabular Impingement/diagnostic imaging , Femur Head/surgery , Humans , Ligaments, Articular/surgery , Male , Middle Aged , Orthopedic Procedures/methods , Osteotomy , Treatment Outcome , Young Adult
14.
Col. med. estado Táchira ; 12(3): 32-36, sept.-dic. 2003. tab, graf
Article in Spanish | LILACS | ID: lil-417326

ABSTRACT

En este trabajo se presenta una revisión de 5 años (1998-2002) de los pacientes con diagnóstico de fracturas intracapsulares y extracapsulares de fémur, ingresados al servicio de Ortopedia y traumatología del Hospital Central de San cristobal "Dr. José María Vargas", que cumplían con los requisitos de un formulario elaborado previamente, cuyo objetivo fue determinar y asociar causas, complicaciones más frecuentes, días de hospitalización e incidencia anual de los casos estudiados. Para tal fin, se diseño un estudio descriptivo, transversal y retrospectivo, el cual reporto un total de 116 pacientes, 65 casos del sexo femenino (56.03 por ciento) y 51 casos del sexo masculino (43.97 por ciento). El grupo etáreo más afectados es mayor después de los 55 años con un 80.17 por ciento el trazo de fractura se localiza en el 56.03 por ciento) de los casos en el área intertrocantérica del lado derecho y la mayoría procede del área urbana. El 56 por ciento de los pacientes laboraban en su domicilio; refirieron más de dos enfermedades preexistentes; el 91.34 por ciento caminaban o estaban de pie en el momento de la caída; el 94 por ciento eran independientes, tanto en la casa como en la comunidad. El 27.59 por ciento tenían hábitos tabáquicos y el 18.10 por ciento ingerían alcohol de manera rutinaria. En conclusión los resultados de este estudio evidencian que este tipo de patología afecta en su mayoría a las mujeres mayores de 55 años, consumidoras de tabaco, las cuales se caen de su propia altura y se producen fracturas intertrocantéricas, que ameritan ser hospitalizadas para tratamiento quirúrgico


Subject(s)
Humans , Male , Female , Femur Head/surgery , Femoral Neck Fractures , Hip Fractures , Skull Fractures , Orthopedics , Traumatology , Venezuela
15.
Acta cir. bras ; 18(2): 102-106, mar.-abr. 2003. tab
Article in Portuguese | LILACS | ID: lil-331121

ABSTRACT

OBJETIVO: Avaliar a ação do laser diodo Arseneto de Gálio na evolução pós-operatória de cães submetidos à excisão artroplástica da cabeça e colo do fêmur. MÉTODOS: Treze cães portadores de Legg-Calvé-Perthes Disease ou Necrose Asséptica da Cabeça do Fêmur (NACF) foram divididos em dois grupos: (I) sete cães que não foram irradiados - grupo controle; (II) seis cães irradiados uma vez ao dia durante cinco dias consecutivos com o laser Arseneto de Gálio (904nm), densidade de energia 4J/cm2 e tempo de exposição automaticamente ajustado pelo aparelho. Para a avaliação da evolução pós-operatória preencheu-se protocolo com graduação da dor de apoio do membro operado. Utilizou-se teste estatístico não paraméRESULTADOS: O grupo I iniciou o apoio do membro com uma média de 12 dias de pós-operatório e o grupo II com uma média de quatro dias de pós-operatório, sendo estatisticamente significante (p=0.0012). trico U de Mann-Whitney para análise dos resultados. CONCLUSÃO: A irradiação com o laser de baixa potência Arseneto de Gálio (904nm) na dose 4J/cm2, periarticular, promoveu rápido retorno da função do membro em cães após a excisão artroplástica da cabeça do fêmur, otimizando a recuperação pós-operatória.


Subject(s)
Animals , Male , Female , Dogs , Arthroplasty , Femur Head/surgery , Pain, Postoperative/therapy , Lasers , Intermittent Claudication/physiopathology , Legg-Calve-Perthes Disease/diagnosis , Femur Head Necrosis/diagnosis , Pain Measurement
16.
Ciênc. rural ; 32(2): 275-280, mar.-abr. 2002. ilus
Article in Portuguese | LILACS | ID: lil-349496

ABSTRACT

Uma técnica cirúrgica para o tratamento da luxaçäo coxofemoral que substituiu o ligamento da cabeça do fêmur por fáscia lata associada ao enxerto ósseo foi realizada em 20 cäes. Estes foram separados em cinco grupos e submetidos à eutanásia para realizaçäo dos exames macro e microscópicos aos 15, 30, 60, 90 e 120 dias do pós-operatório. Na macroscopia, näo foi observada luxaçäo da articulaçäo. Em 65 por cento dos animais, o enxerto de fáscia lata estava presente. Microscopicamente, a fáscia lata utilizada como substituto do ligamento da cabeça do fêmur näo desenvolveu reaçöes inflamatórias, permanecendo preservada e integrada ao tecido ósseo. O uso da fáscia lata como substituto do ligamento da cabeça do fêmur mostrou-se viável, podendo ser utilizada para reforçar a estabilidade articular.


Subject(s)
Animals , Dogs , Femur Head/surgery , Femur Head/injuries , Dog Diseases/surgery , Fascia Lata , Transplantation, Autologous/veterinary
17.
Rev. mex. ortop. traumatol ; 14(5): 429-432, sept.-oct. 2000. tab
Article in Spanish | LILACS | ID: lil-302827

ABSTRACT

La displasia acetabular lleva a la artrosis degenerativa en personas jóvenes. Se han descrito múltiples osteotomías del iliaco en un intento de aumentar la cobertura de la cabeza femoral. Este es un informe preliminar de seis pacientes, con edades que oscilaron de 11 a 26 años tratados con una plastía acetabular de aumento ranurado. Todos con displasia acetabular, ángulo de Wiber menor de 20 grados, y cabeza femoral muy grande o extruída, pero concéntrica. Se valoró la presencia de dolor, rigidez articular, estabilidad de la cadera, aumento del techo acetabular. Tuvimos cuatro resultados excelentes y dos buenos. Requerimos de un mayor número de pacientes y más tiempo de seguimiento para tener los resultados finales.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Acetabulum/surgery , Acetabulum/transplantation , Femur Head/surgery , Femur Head Necrosis/rehabilitation , Transplants
18.
Rev. bras. ortop ; 33(10): 815-21, out. 1998. ilus, tab, graf
Article in Portuguese | LILACS | ID: lil-225341

ABSTRACT

Foram estudados 46 quadris com diagnóstico de epifisiólise proximal do fêmur submetidos à fixaçao in situ através da colocaçao de um único parafuso tipo esponjosa AO de 6,5mm de diâmetro. Através do estudo radiográfico, avaliaram-se o posicionamento dos parafusos e o fechamento da placa fisária, assim como foi pesquisada a presença de escorregamento adicional. Os resultados funcionais foram avaliados pelos critérios de Heyman & Herndon, tendo sido encontrados 90 por cento de bons resultados no grupo de quadris com escorregamento do tipo I, II e III (pré-escorregamento, leve e moderado). Conseguiu-se o fechamento da placa fisária, evitando-se escorregamento adicional em todos os pacientes analisados, tendo sido relatados como complicaçoes do atos cirúrgicos o hematoma na ferida operatória, a penetraçao nao-diagnosticada do parafuso na articulaçao, a quebra da broca durante o ato cirúrgico, a condrólise e a necrose avascular da cabeça femoral. Em razao dos resultados apresentados, é recomendada a fixaçao in situ com um único parafuso esponjosa AO de 6,5 mm de diâmetro nos casos leves, moderados e nos pré-escorregamentos. Nos escorregamentos graves (tipo IV), outros procedimentos devem ser considerados.


Subject(s)
Humans , Femur Head/surgery , Epiphyses, Slipped/surgery , Fracture Fixation, Internal , Hip Joint/surgery , Bone Screws , Femur Head , Epiphyses, Slipped , Femur Head Necrosis , Growth Plate , Hip Joint
19.
Acta ortop. bras ; 5(4): 139-42, out.-dez. 1997. ilus, tab
Article in Portuguese | LILACS | ID: lil-212478

ABSTRACT

Apresenta-se uma proposta de padronizaçao dos estudos científicos que utilizam a técnica da fixaçao in situ para o escorregamento epifisário proximal do fêmur com um parafuso canulado. O objetivo é criar subsídios para que futuros estudos sobre esse tema possam comparar resultados obtidos e por diferentes autores, utilizando técnicas cirúrgicas semelhantes.


Subject(s)
Humans , Femur Head/surgery , Epiphyses, Slipped/surgery , Fracture Fixation, Internal , Treatment Outcome
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