ABSTRACT
Introduction: Aseptic and septic loosening by mechanical failure is one of the main causes of proximal femur endoprosthesis failure with different clinical consequences such as pain, inflammation, progressive loosening of muscular volume, and strength with functional limitation. We present a case series of four patients with aseptic and septic loosening of femur endoprosthesis that was treated with a novel technique that combines different methods to achieve primary stability. Case Report: Four patients with an average age of 49.5 years (35-70 years), two women and two men, were referred to the Orthopedic Surgery Department of the San Ignacio University Hospital of Bogota. Two of them with a history of oncological disease, ruling out a tumor relapse through local images and extension examinations; another patient with a history of firearm injury to the left thigh with multiple secondary complications, which required various reconstructive procedures; and the oldest patient with a history of total hip replacement. The main complaint of the four patients was thigh pain not caused by trauma and initial assessment radiographs of all of them showed signs of loosening of the prosthetic material, with septic etiology in two of the patients and aseptic etiology in the other two. Therefore, they were scheduled for revision surgery of prosthetic components. These patients recover functional status and resolved pain in the early post-operative period and during long-term follow-up. Only one of the patients, time after the surgical procedure, required removal of the osteosynthesis material due to persistent bone infectious process. Conclusion: Septic and aseptic loosening is one of the most common complications of proximal femur endoprosthesis, resulting in significant pain and functional decline in patients. We present a novel surgical technique that allows primary stabilization of the construct that allows early rehabilitation, improvement of functionality, and no signs of new loosening.
ABSTRACT
Describimos los anclajes óseos y el cable de acero como un nuevo método para la fijación de las fracturas del acetábulo. Comparamos sus características mecánicas frente al método tradicional de pacas y tornillos en un modelo experimental en pelvis de cerdos, encontrando que el nuevo método provee mejores propiedades a la fijación
Subject(s)
Animals , Acetabulum/surgery , Fracture Fixation , Orthotic DevicesABSTRACT
Las fracturas traumáticas intracapsulares del cuello del femúr en el adulto joven son de muy pobre pronóstico por la alta incidencia de no unión y necrosis aséptica.De otra parte, es muy escasa la bibliografía dedicada estrictamente a este tema. Se revisan los resultados de 20 pacientes entre los 15 y 42 años de edad de fracturas grado III y IV de Garden, siguiendo un protocolo de 8 años, basado en el tratamiento con muy firme osteosíntesis e injerto óseo pediculado de glúteo medio, colocado sobre la cara anterior del cuello del femúr, en el foco, no permitiendo el apoyo del peso del cuerpo hasta lograr conolidación muy firme, radiológica y clínicamente. Se estudia la correlación de la necrosis y la consolidación de la fractura y la razón del fracaso en 3 de los 20 pacientes. Se obtuvo consolidación en 17, y en 2 de éstas con fractura ipsilateral de diáfisis de femúr asociada