Fracture du col fémoral compliquant la réduction orthopédique d’une luxation de hanche

Sy, Mouhamadou Habib; Kinkpé, C.V.A.; Dakouré, Patrick Wendpouiré Hamed; Diémé, C; Sané, A.; Ndiaye, A.; Dansokho, A V; Seye, S.

doi:10.1016/s0035-1040(05)84297-7

Cited by 7 publications

(9 citation statements)

References 8 publications

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“…In the past decade, a positive role of the position of the femoral head in relation to the acetabulum in iatrogenic FNF prevention was proposed by a small series of studies (Sy et al, 2005;Park et al, 2016). However, this conclusion remained controversial.…”

Section: Discussionmentioning

confidence: 99%

Fractured morphology of femoral head associated with subsequent femoral neck fracture: Injury analyses of 2D and 3D models of femoral head fractures with computed tomography

Wang

et al. 2023

Front. Bioeng. Biotechnol.

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Background: The injury of femoral head varies among femoral head fractures (FHFs). In addition, the injury degree of the femoral head is a significant predictor of femoral neck fracture (FNF) incidence in patients with FHFs. However, the exact measurement methods have yet been clearly defined based on injury models of FHFs. This study aimed to design a new measurement for the injury degree of the femoral head on 2D and 3D models with computed tomography (CT) images and investigate its association with FHFs with FNF.Methods: A consecutive series of 209 patients with FHFs was assessed regarding patient characteristics, CT images, and rate of FNF. New parameters for injury degree of femoral head, including percentage of maximum defect length (PMDL) in the 2D CT model and percentage of fracture area (PFA) in the 3D CT-reconstruction model, were respectively measured. Four 2D parameters included PMDLs in the coronal, cross-sectional and sagittal plane and average PMDL across all three planes. Reliability tests for all parameters were evaluated in 100 randomly selected patients. The PMDL with better reliability and areas under curves (AUCs) was finally defined as the 2D parameter. Factors associated with FNF were determined by binary logistic regression analysis. The sensitivity, specificity, likelihood ratios, and positive and negative predictive values for different cut-off values of the 2D and 3D parameters were employed to test the diagnostic accuracy for FNF prediction.Results: Intra- and inter-class coefficients for all parameters were ≥0.887. AUCs of all parameters ranged from 0.719 to 0.929 (p < 0.05). The average PMDL across all three planes was defined as the 2D parameter. The results of logistic regression analysis showed that average PMDL across all three planes and PFA were the significant predictors of FNF (p < 0.05). The cutoff values of the average PMDL across all three planes and PFA were 91.65% and 29.68%. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, predictive positive value and negative predictive value of 2D (3D) parameters were 91.7% (83.3%), 93.4% (58.4%), 13.8 (2.0), 0.09 (0.29), 45.83% (10.87%), and 99.46% (98.29%).Conclusion: The new measurement on 2D and 3D injury models with CT has been established to assess the fracture risk of femoral neck in patients with FHFs in the clinic practice. 2D and 3D parameters in FHFs were a feasible adjunctive diagnostic tool in identifying FNFs. In addition, this finding might also provide a theoretic basis for the investigation of the convenient digital-model in complex injury analysis.

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Section: Discussionmentioning

confidence: 99%

Fractured morphology of femoral head associated with subsequent femoral neck fracture: Injury analyses of 2D and 3D models of femoral head fractures with computed tomography

Wang

et al. 2023

Front. Bioeng. Biotechnol.

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“…Elle est due le plus souvent, comme dans notre cas, à une invagination capsulo labrale dans l'acétabulum [ 1 , 2 ]. Cette irréductibilité fragilise le col fémoral, et augmente le risque de sa fracture lors des tentatives de réduction surtout en présence d'une fracture de la tête fémorale type II de Pipkin comme l'a rapporté Sy et al [ 3 ]. Dans ce cadre, le diagnostic de cette variété lésionnelle doit être fait initialement par le biais d'un bilan radiologique comportant des incidences du bassin de face, de profil, les ¾ alaire et obturateur, et s'associant idéalement à un scanner, ceci pour adopter des mesures préventives lors de la réduction par des manœuvres douces sur un malade bien curarisé.…”

Section: Discussionunclassified

“…La réduction orthopédique expose au risque de nombreuses complications, d'abord l'irréductibilité rapportée avec un pourcentage de 50% dans la série de Duquennoy et Butler [ 1 ], et de 57% dans celle de Vielpeau [ 4 ]. Ensuite la fracture du col qui est la complication la plus redoutable, celle-ci est souvent décrite dans les fractures de la tête fémorale Pipkin II, son incidence varie selon les auteurs de 12 à 27% [ 3 , 4 ]. Puis, l'incarcération du fragment céphalique qui demeure rare, et qui est l'apanage des fractures céphaliques type I et II comminutives [ 3 , 4 ].…”

Section: Discussionunclassified

“…Ensuite la fracture du col qui est la complication la plus redoutable, celle-ci est souvent décrite dans les fractures de la tête fémorale Pipkin II, son incidence varie selon les auteurs de 12 à 27% [ 3 , 4 ]. Puis, l'incarcération du fragment céphalique qui demeure rare, et qui est l'apanage des fractures céphaliques type I et II comminutives [ 3 , 4 ]. Chez notre patient, la tentative de réduction s'est faite sous anesthésie générale par manœuvre de Bohler sans pour autant qu'elle réussisse.…”

Section: Discussionunclassified

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Traitement chirurgical d’une luxation fracture parcellaire de la tete femorale pipkin ii irreductible: à propos d’un cas

Abid¹,

Mechchat²,

Idrissi³

et al. 2014

Pan Afr Med J

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L'irréductibilité d'une luxation-fracture parcellaire de la tête fémorale est une entité pathologique rare dont le traitement est chirurgical. Dans la littérature, les avis des auteurs divergent concernant le choix de la voie d'abord, mais la conservation du fragment céphalique est la règle. Indépendamment de la qualité de la prise en charge, les résultats mauvais et passables sont très importants estimés à 50% au bout de 10 ans, et l’évolution arthrosique à long terme semble être inéluctable.

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“…Reduction attempt in such irreducible cases may cause femoral neck fracture, and, therefore, reduction should not be attempted. The femoral neck fractures found in Pipkin type III lesions are often the result of an orthopaedic reduction accident, as reported in three cases for Duquennoy et al [2], two cases for Epstein [11], two cases for Pipkin [10], three cases for Roeder and Delee [4], two cases for Zehi et al [12], and four cases for Sy et al [13]. In their literature review of iatrogenic type III fractures, Sy et al [13] noted that 13 of 14 cases were due to reduction attempts on fractures that were initially classified as Pipkin type II.…”

Section: Discussionmentioning

confidence: 99%

Hip subluxation associated with Pipkin II fracture: an injury to look for before reduction

Uzel¹,

Mazzola²,

Lebreton³

et al. 2009

Musculoskelet Surg

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Fractures of the femoral head are rare. They usually occur in association with a posterior hip dislocation secondary to a high-energy trauma (motor vehicle accident). We report a case of Pipkin II fracture associated with an irreducible hip subluxation. Clinical signs are poor unlike in posterior hip subluxation. CT scan is important to evaluate the traumatism. The Hardinge approach is relevant in this context of irreducible hip subluxation. The clinical, diagnostic, and therapeutic particularities of this lesion type are discussed.

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Fracture du col fémoral compliquant la réduction orthopédique d’une luxation de hanche

Cited by 7 publications

References 8 publications

Fractured morphology of femoral head associated with subsequent femoral neck fracture: Injury analyses of 2D and 3D models of femoral head fractures with computed tomography

Fractured morphology of femoral head associated with subsequent femoral neck fracture: Injury analyses of 2D and 3D models of femoral head fractures with computed tomography

Traitement chirurgical d’une luxation fracture parcellaire de la tete femorale pipkin ii irreductible: à propos d’un cas

Hip subluxation associated with Pipkin II fracture: an injury to look for before reduction

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