– Measurement of Length: – its essential to plan ahead to achieve proper leg length; – w/ comminuted frx, use opposite leg to determine leg length; – one method is to obtain long cassette radiograph of opposite side w/ radiographic ruler included on the film; … Read more
– Discussion: – performed to correct either anteversion / valgus deformity of femoral neck in patients w/ dysplasia that reduces w/ abduction and medial rotation; – if hip is not reducible, then open reduction is performed prior to osteotomy; – the procedure is most useful when the acetabular dyspasia … Read more
– Discussion: – goal: ream close to endosteal cortex, which has strongest cancellous bone; – enter medullary canal w/ curet, & ensure that there are no perforations; – this is esp important w/ osteoporotic bone; – to enlarge medullary canal of diaphysis, use … Read more
(see: Synthes Femoral Products) Workup for Femoral Shaft Frx (trauma workup) assessment of perfusion: damage control orthopaedics timing of surgery in orthopaedic patients with brain injury surgical timing and prevention of ARDS in patients with femur frx IM Nailing Technique Anatomy of Femur Arterial supply Canal Entry Point Comminuted Femoral Shaft Fractures Distal Femoral Physeal … Read more
– See: – x-rays for femoral neck fractures – technique of closed reduction – Acceptable Reduction: – poor reduction of femoral neck frx interferes w/ blood supply to femoral head & decreases apposition of bone between bone fragments; – reduction should leave neck-shaft angle between … Read more
– See: Accetable Reduction Parameters – Discussion: – always attempt closed reduction before open reduction; – evaluation of the lateral x-ray after reduction to evaluate posterior comminution of the femoral neck is critical; – posterior comminution leads to the loss of a butressing effect posteriorly, w/ subsequent loss of reduction … Read more
– See: Avascular Necrosis following Femoral Neck Fracture – Discussion: – usually non unions are apparent w/in one year of femoral neck frx; – incidence ranges from 10 to 30%; – only 1/3 of pts w/ AVN will require additional surgery where as – 3/4 patients with … Read more
– See: – Total Hip Replacement Menu: – Acetabular Bone Grafting: – Allografts – Discussion: – indicated for pts w/ severe osteolysis or for femoral shaft fractures; – in younger pts, structural allografting may eventually allow some … Read more
– See: Total Hip Replacement Menu – Discussion: – design considerations – femoral stem collar – cemented femoral stems (radiology of cemented femoral stems) – press fit femoral stems – femoral component offset – modular neck: – … Read more
– Discussion: – see acetabular component, reestablishment of acetabular floor, and component position; – see: preoperative and post operative radiographic eval – femoral offset is measured from the distance between the center of the femoral head and a line drawn down center of femoral shaft; – note that increasing … Read more