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Journal of Medical Case Reports

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Open Access 01-12-2015 | Case report

Combined bilateral femoral head necrosis and pertrochanteric fracture: a case report

Authors: Bogdan Deleanu, Radu Prejbeanu, Dan Crisan, Dinu Vermesan, Vlad Predescu, Eleftherios Tsiridis

Published in: Journal of Medical Case Reports | Issue 1/2015

Abstract

Introduction

Modular femoral implants have become a regular feature of revision hip surgery. However, for a primary hip arthroplasty, such as a femoral neck fracture case, the implant of choice is a standard femoral component, while compelling literature evidence have made osteosynthesis the standard procedure for the vast majority of trochanteric fractures.

Case presentation

We present the case of a 66-year-old Caucasian woman presenting with two trochanteric fractures associated with primary and secondary hip osteoarthritis that were treated with an uncemented total hip replacement with a modular femoral component.

Conclusions

We found that a modular femoral component can address the issues of stability and, in our case, proved to be a viable solution for treating cases that are complicated by concomitant acetabular or femoral head and neck pathology.

De Bellis UG, Legnani C, Calori GM: Acute total hip replacement for acetabular fractures: A systematic review of the literature.Injury 2013, 45:356–361.CrossRefPubMed

Bonnaire F, Lein T, Bula P: Trochanteric femoral fractures: anatomy, biomechanics and choice of implants.Unfallchirurg 2011, 114:491–500. 10.1007/s00113-011-1973-2CrossRefPubMed

Boisgard S, Descamps S, Bouillet B: Complex primary total hip arthroplasty.Orthop Traumatol Surg Res 2013, 99:S34-S42. 10.1016/j.otsr.2012.11.008CrossRefPubMed

Antapur P, Mahomed N, Gandhi R: Fractures in the elderly: when is hip replacement a necessity?CIA 2011, 6:1–7.

Liu X-Z, Yang W, Yang S-H, Xu W-H, Ye S-N: Total hip arthroplasty for treatment of elderly patients with comminuted intertrochanteric fracture accompanied by femoral head necrosis.Chin J Traumatol 2008, 11:359–363.CrossRefPubMed

Lyman JR, Kelley SS, Lachiewicz PF: Hip arthroplasty after extracapsular hip fracture: a matched pair cohort analysis.J Surg Orthop Adv 2004, 13:38–41.PubMed

Weiss RJ, Kärrholm J, Hailer NP, Beckman MO, Stark A: Salvage of failed trochanteric and subtrochanteric fractures using a distally fixed, modular, uncemented hip revision stem.Acta Orthop 2012, 83:488–492. 10.3109/17453674.2012.733917CrossRefPubMedPubMedCentral

Marsland D, Mears SC: A review of periprosthetic femoral fractures associated with total hip arthroplasty.Geriatr Orthop Surg Rehabil 2012, 3:107–120. 10.1177/2151458512462870CrossRefPubMedPubMedCentral

de Menezes DFA, Le Béguec P, Sieber H-P, Goldschild M: Stem and osteotomy length are critical for success of the transfemoral approach and cementless stem revision.Clin Orthop Relat Res 2012, 470:883–888. 10.1007/s11999-011-1998-4CrossRefPubMed

10.

Müller T, Topp T, Kühne CA, Gebhart G, Ruchholtz S, Zettl R: The benefit of wire cerclage stabilisation of the medial hinge in intramedullary nailing for the treatment of subtrochanteric femoral fractures: a biomechanical study.Int Orthop 2011, 35:1237–1243. 10.1007/s00264-010-1204-4CrossRefPubMedPubMedCentral

11.

Wu L-D, Bernasek TL: Treatment of comminuted trochanteric fractures and non-union of trochanteric osteotomy in revision total hip arthroplasty.Chin J Traumatol 2003, 6:265–269.PubMed

12.

Glassman AH: Complications of trochanteric osteotomy.Orthop Clin North Am 1992, 23:321–333.PubMed

13.

Zarin JS, Zurakowski D, Burke DW: Claw plate fixation of the greater trochanter in revision total hip arthroplasty.J Arthroplasty 2009, 24:272–280. 10.1016/j.arth.2007.09.016CrossRefPubMed

14.

Laflamme GY, Leduc S, Petit Y: Reattachment of complex femoral greater trochanteric nonunions with dual locking plates.J Arthroplasty 2012, 27:638–642. 10.1016/j.arth.2011.08.004CrossRefPubMed

15.

Hamadouche M, Zniber B, Dumaine V, Kerboull M, Courpied JP: Reattachment of the ununited greater trochanter following total hip arthroplasty. The use of a trochanteric claw plate.J Bone Joint Surg Am 2003, 85-A:1330–1337.CrossRefPubMed

16.

Calderazzi F, Groppi G, Ricotta A, Ceccarelli F: Does hip osteoarthritis have a protective effect against proximal femoral fractures? A retrospective study.Hip Int 2014, 24:231–236.PubMed

17.

Robstad B, Frihagen F, Nordsletten L: The rate of hip osteoarthritis in patients with proximal femoral fractures versus hip contusion.Osteoporos Int 2011, 23:901–905.CrossRefPubMedPubMedCentral

18.

Franklin J, Englund M, Ingvarsson T, Lohmander S: The association between hip fracture and hip osteoarthritis: a case–control study.BMC Musculoskelet Disord 2010, 11:274. 10.1186/1471-2474-11-274CrossRefPubMedPubMedCentral

19.

Kaplan K, Miyamoto R, Levine BR, Egol KA, Zuckerman JD: Surgical management of hip fractures: an evidence-based review of the literature. II: intertrochanteric fractures.J Am Acad Orthop Surg 2008, 16:665–673.CrossRefPubMed

20.

Stern R: Are there advances in the treatment of extracapsular hip fractures in the elderly?Injury 2006, 38:77–87.CrossRef

21.

Haidukewych GJ, Berry DJ: Hip arthroplasty for salvage of failed treatment of intertrochanteric hip fractures.Clin Orthop Relat Res 2003, 85:899–904.

22.

Haentjens P, Lamraski G: Endoprosthetic replacement of unstable, comminuted intertrochanteric fracture of the femur in the elderly, osteoporotic patient: a review.Disabil Rehabil 2005, 27:1167–1180. 10.1080/09638280500055966CrossRefPubMed

23.

Dean BJF, Matthews JJ, Price A, Stubbs D, Whitwell D, Gibbons CMLH: Modular endoprosthetic replacement for failed internal fixation of the proximal femur following trauma.Int Orthop 2011, 36:731–734.CrossRefPubMedPubMedCentral

24.

Liu M, Yang Z, Pei F, Huang F, Chen S, Xiang Z: A meta-analysis of the Gamma nail and dynamic hip screw in treating peritrochanteric fractures.Int Orthop 2009, 34:323–328.CrossRefPubMedPubMedCentral

25.

Pui CM, Bostrom MP, Westrich GH, Valle CJD, Macaulay W, Mont MA, Padgett DE: Increased complication rate following conversion total hip arthroplasty after cephalomedullary fixation for intertrochanteric hip fractures: a multi-center study.J Arthroplasty 2013, 28:45–47. 10.1016/j.arth.2013.04.048CrossRefPubMed

26.

Sathappan SS, Strauss EJ, Ginat D, Upasani V, Di Cesare PE: Surgical challenges in complex primary total hip arthroplasty.Am J Orthop 2007, 36:534–541.PubMed

27.

McKinley JC, Robinson CM: Treatment of displaced intracapsular hip fractures with total hip arthroplasty: comparison of primary arthroplasty with early salvage arthroplasty after failed internal fixation.J Bone Joint Surg Am 2002, 84-A:2010–2015.CrossRefPubMed

Title: Combined bilateral femoral head necrosis and pertrochanteric fracture: a case report
Authors: Bogdan Deleanu
Radu Prejbeanu
Dan Crisan
Dinu Vermesan
Vlad Predescu
Eleftherios Tsiridis
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2015
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/1752-1947-9-25

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Combined bilateral femoral head necrosis and pertrochanteric fracture: a case report

Abstract

Introduction

Case presentation

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Case presentation

Conclusions

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