Non-union fracture neck femur in a young patient

100 %
0 %
Information about Non-union fracture neck femur in a young patient
Health & Medicine

Published on February 27, 2014

Author: Apollo_Hospitals

Source: slideshare.net

Description

Fracture neck of femur in young is rare and usually occur
due to severe injuries like road traffic accident (RTA), fall from height etc. If the displaced fractures are not treated early, then it is often associated with complications. Non-union is one of the commonest complications. Treatment of non-union of these fractures in young is quite challenging.

Non-union fracture neck femur in a young patient

a p o l l o m e d i c i n e x x x ( 2 0 1 4 ) 1 e2 Available online at www.sciencedirect.com ScienceDirect journal homepage: www.elsevier.com/locate/apme Interesting Rare Case Pictures Non-union fracture neck femur in a young patient Raju Vaishya a,*, Vipul Vijay b, K.C. Kapil Mani b, Vikas Birla b a b Prof, Department of Orthopaedic Surgery, Indraprastha Apollo Hospitals, New Delhi, India Department of Orthopaedic Surgery, Indraprastha Apollo Hospitals, New Delhi, India 1. Case report An 18-year-old boy fell 1 year ago from a tree and sustained right hip injury, which was treated by traction. At presentation, 15 years ago, he had pain, deformity and 300 shortening and was unable to bear weight on right leg. X-ray of the right hip showed non-union with resorption of neck of femur and proximal migration of femur (Fig. 1), but the head seemed viable. A corrective valgus osteotomy with the fixation of fracture was done using a Dynamic Hip Screw (DHS) with a 135 angle 4 hole plate. The patient did very well and both the osteotomy and fracture united without any avascular necrosis of the femoral head (Fig. 2). At 15 years follow up, the patient came for a routine implant removal (Fig. 3), when he was totally asymptomatic and has had only 1 cm of residual shortening of right hip and almost full range of hip movements. The implants were removed without any significant event (Fig. 4). Fracture neck of femur in young is rare and usually occur due to severe injuries like road traffic accident (RTA), fall from height etc. If the displaced fractures are not treated early then it is often associated with complications. Non-union is one of the commonest complications. Treatment of non-union of these fractures in young is quite challenging. An attempt to save the natural femoral head and hip joint is a priority and hence corrective valgus osteotomy with fixation of the fracture with stable implant is a good choice and may achieve union and preserve the natural hip joint, as it was in our case. Joint replacement may be a secondary choice but considering the young age of these patients, an attempt to fix the fracture along with a corrective osteotomy must be considered first, as it may preserve a natural hip joint. Fig. 1 e Non-union of fracture neck femur with proximal migration of the trochanter. * Corresponding author. E-mail address: raju.vaishya@gmail.com (R. Vaishya). 0976-0016/$ e see front matter Copyright ª 2014, Indraprastha Medical Corporation Ltd. All rights reserved. http://dx.doi.org/10.1016/j.apme.2014.01.005 Please cite this article in press as: Vaishya R, et al., Non-union fracture neck femur in a young patient, Apollo Medicine (2014), http://dx.doi.org/10.1016/j.apme.2014.01.005

2 a p o l l o m e d i c i n e x x x ( 2 0 1 4 ) 1 e2 Fig. 4 e X-ray showing hip joint, with united fracture after removal of implants. 2. Fig. 2 e Early post op radiograph showing well fixed osteotomy and uniting fracture. Learning points  Fracture neck of femur in children are rare injuries and are often caused by severe trauma  Early surgical treatment is essential for better outcomes  Neglected cases may need corrective osteotomy and fixation 3. Image quiz What is diagnosis of this condition? 1. 2. 3. 4. Dislocation of the hip Fresh fracture neck of the femur Non-union of fracture neck of femur Dysplasia of the hip Ans: Non-union of the fracture neck of femur with resorption of neck and proximal migration of the trochanter. Fig. 3 e 15 year follow up X-ray showing well united and remodelled fracture with implants in situ. Please cite this article in press as: Vaishya R, et al., Non-union fracture neck femur in a young patient, Apollo Medicine (2014), http://dx.doi.org/10.1016/j.apme.2014.01.005

A o oh s i l ht:w wa o o o p a . m/ p l o p a : t / w .p l h s i lc l ts p / l ts o T ie: t s / ie. m/o p a A o o wt rht :t t r o H s i l p l t p /w t c ts l Y uu e ht:w wy uu ec m/p l h s i ln i o tb : t / w . tb . a o o o p a i a p/ o o l ts d F c b o : t :w wfc b o . m/h A o o o p a a e o k ht / w . e o k o T e p l H s i l p/ a c l ts Si s ae ht:w wsd s aen t p l _ o p a l e h r: t / w .i h r.e/ o o H s i l d p/ le A l ts L k d : t :w wl k d . m/ mp n /p l -o p a i e i ht / w . e i c c a y o oh s i l n n p/ i n no o a l ts Bo : t :w wl s l e l . / l ht / w . t a h a hi g p/ e tk t n

Add a comment

Related presentations

Related pages

Non-union fracture neck femur - Orthopaedic Principles

Non-union fracture neck femur ... Dissatisfied patient ... Gap Non Union 6 Months Post Accident Doubtful Union of Shaft Femur
Read more

ORTHOPAEDIC TRAUMA BOOTCAMP Femoral Neck Fractures in ...

ORTHOPAEDIC TRAUMA BOOTCAMP . Femoral Neck Fractures in Younger ... Complications of femoral neck fracture in young ... of the neck of the femur in young ...
Read more

Femoral neck fracture | Radiology Reference Article ...

asymmetry of lateral femoral neck/head; sclerosis in fracture ... for young, otherwise fit patient with ... Neck of femur fracture (NOF) Femoral neck ...
Read more

An unusual presentation of femoral neck fracture in a ...

... of neck of femur fracture. ... in young patients can have unusual presentation making ... young patient with an unusual presentation of ...
Read more

Non-union fracture neck femur in a young patient - Apollo ...

Non-union fracture neck femur in a young patient. ... X-ray of the right hip showed non-union with resorption of neck of femur and proximal migration of ...
Read more

Femoral Neck Fracture Treatment & Management: Acute Phase ...

Femoral Neck Fracture Treatment & Management. ... A displaced fracture in a young patient is an orthopedic ... Subcapital fractures of the femur.
Read more

Femoral Neck Non-Union - Wheeless' Textbook of Orthopaedics

Femoral Neck Non-Union ... for neglected femoral neck fractures in young ... after intracapsular fracture of the proximal femur.
Read more

Nonunions-OrthoInfo - AAOS

Neck & Back. Health Centers. Broken ... A "delayed union" is when a fracture takes longer than ... External fixation can treat nonunions in a patient who ...
Read more

Femoral Fractures. Information about Femur ... - Patient

Femoral Fractures are common. Read about Femoral Fractures, and bone fractures affecting the femur on out Femoral Fractures page.
Read more