ABSTRACT
INTRODUCTION AND IMPORTANCE: Aseptic loosening in high placement of the acetabular component seriously affects the hip and femoral head loads. Surgery revision is highly recommended with defect closure in previous place. CASE PRESENTATION: A-40-year-old man came with chief complaint of right groin pain and noticeable leg length discrepancy gait. The first hip arthroplasty through pseudo-acetabulum cup was done three years ago after neglected femoral head necrosis due to eight years of unknown hip dislocation in vehicle accident. On hip x-ray there is a screws and cup loosening, without any sign of infection from blood or from soft tissue which undergoes pathological and mold examination. The patient than assessed with periprosthetic aseptic loosening of hip dextra and simple total hip arthroplasty revision using true acetabulum location was done. The pseudo-acetabulum area closed with morselized bone autograft. One weeks after surgery, the wound healed properly. Hence, the patient sent to the rehabilitation. CLINICAL DISCUSSION: Hip arthroplasty revision of aseptic loosening in high placement acetabular component should perform by returning to anatomical acetabular position. Cancellous morselized bone autograft (MBA) was used to closed the defect formed by previous procedure. CONCLUSION: Revision of hip arthroplasty combined with morselized bone autograft can be considered for high placement acetabular component defect closure to provide better stability and strength in weight loads transfer.
ABSTRACT
INTRODUCTION AND IMPORTANCE: The rotational deformity is formed due to the instability of the fixation device used before in a spiral or oblique fracture pattern, and will create uncomfortable sensation also disturb daily activities. This condition usually treated with several methods of osteotomies and implants, that involving large wound and longer period of healing. CASE PRESENTATION: A 27-year-old male with chief complaint of discomfort sensation when the ring finger flexed and it was disturbing the daily activities. Two years ago, the patient was diagnosed with minimally displace closed fracture of the ring finger phalanx media and treated with buddy tapping for six months and become a malunion until now. Multiple drill hole osteotomy were made to correct the rotational position and fixed with Herbert screws. Three months follow up, the wound healed nicely and able to perform his daily activity. CLINICAL DISCUSSION: Malunion that was formed from previous inadequate treatment could make uncomfortable sensation and disturbing daily activities usually treated with large osteotomies. Multiple drill hole (MDH) usage in combination with the Herbert screw to fix the new fracture line had several advantages compared to standard methods that were previously performed. CONCLUSION: The combination of multiple drill hole and Herbert screws could be an alternative procedure with minimal surgical wounds. Without implant removal in the future, the patient can proceed to rehabilitation and return to his daily activities.
