Triple attack technique for non-union of femoral neck fractures

Abdelazeem, Hazem; Abdelazeem, Ahmed Hazem; Al-Dars, Ahmed Mounir; Hegazy, Mohamed; Abdellatif, Nasef

doi:10.1007/s00264-015-2808-5

Cited by 8 publications

(4 citation statements)

References 17 publications

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“…His Harris hip score was 83 a single angled blade plate/sliding hip screw. Pre-bent doubleangled DCS and contoured dynamic compression plates have also been reported in with successful results [23,24].…”

Section: Choice Of Implantmentioning

confidence: 98%

Valgus intertrochanteric osteotomy for femur neck pseudoarthrosis: a simple solution to a complex problem that has stood the test of time

Gavaskar¹,

Jeyakumar²,

Raj³

2019

International Orthopaedics (SICOT)

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Femoral neck nonunion in young patients has always been a difficult problem to deal with for surgeons. Numerous surgical procedures to address either the biological or mechanical issues at the nonunion have been described and most of them have been associated with variable results. Isolated biological augmentation is often associated with poor results and some techniques like vascularized grafting may require not so commonly available expertise. Valgus osteotomy is aimed to correct the abnormal fracture biomechanics associated with femoral neck fractures. By altering the nature of force transmission across the nonunion, shear forces are converted into compressive forces that lead to rapid osseous union without the need for bone grafting. Though the principles are sound and were described a long time ago, the technical aspects have evolved over time. Various modifications have been described to overcome shortcomings such as limb length discrepancy, reduction of femoral offset, alteration in mechanical axis, and the overall proximal femur anatomy. In this review, we look back at the fundamental principles and recent literature on the results of valgus intertrochanteric osteotomy for femoral neck pseudoarthrosis. We also highlight the important need for accurate preoperative planning and surgical execution. Lastly, we elaborate on the technical improvisations that have happened over time in order to improve functional results and to minimize complications and poor outcome after a valgus osteotomy.

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Section: Choice Of Implantmentioning

confidence: 98%

Valgus intertrochanteric osteotomy for femur neck pseudoarthrosis: a simple solution to a complex problem that has stood the test of time

Gavaskar¹,

Jeyakumar²,

Raj³

2019

International Orthopaedics (SICOT)

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“…The above information suggested that blindly increasing stability would not bring benefits to fracture healing, which was also demonstrated in this study. With the persist assistance of BS, the mechanical strength of IMN increased [40]. But the average union time of the BS group (88.5 vs. 97 min, p < 0.001) was significantly longer than that of the BP group.…”

Section: Discussionmentioning

confidence: 89%

Blocking Pins Instead of Blocking Screws in the Treatment of Distal Tibial Fractures with Intramedullary Nail

Bai

Song

Yao

et al. 2020

Preprint

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Background: Distal tibial fractures have a high risk of malalignment when treated with intramedullary nails. The use of blocking screws can aid in achieving satisfactory alignment. The aim of this study was to compare the clinical and radiographic outcomes of temporary blocking pins with those of blocking screws for distal tibial fractures. Methods: From June 2011 through November 2018, a total of 90 patients with distal tibial fractures were enrolled in this prospective randomized controlled study. The patients were randomly received either blocking pins or blocking screws reduction during nailing. After reduction, 5 points at the distal fragment were effectively fixed. Results: The operating time in the BP group was 73.77±6.25 min, which was significantly shorter than 80.05±8.51 min in the BS group (P<0.001). The time to healing in the BP group was shorter than that in the BS group (18.52±4.57 vs. 21.51±3.17 weeks; P=0.001). The coronal and sagittal plane deformities at any time points were comparable (all P＞0.05). During the 12-month follow-up period, patients had an average change in the coronal plane of 1.34 degrees in the BP group and 1.00 degrees in the BS group (P=0.120), as well as an average change in the sagittal plane of 1.09 degrees and 0.81 degrees (P=0.110), respectively. Malunion was seen in two patients (5%) in the BP group and one patient (2%) in the BS group ( P＞0.05). Conclusion: The blocking pins can help achieve satisfactory alignment for distal tibial fractures during nailing. Intramedullary nails without blocking screws can afford adequate stability to maintain the reduction during the healing process when an effective five-point anchoring fixation is achieved.

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“…Surgical management of such a case was challenging due to the patient's young age, bone quality, and underlying GD. The surgical options included fixation of the femoral neck fracture with or without subtrochanteric valgus femoral osteotomy and grafting, 3 but the poor bone quality was concerning in view of a probable delayed or failed union. Also, this surgery would not address the leg-length discrepancy and limping.…”

Section: Case Descriptionmentioning

confidence: 99%

Skeletal Manifestations of Gaucher's Disease: A Case Report and Literature Review

Mohamed,

Elnahal,

Furtado

et al. 2024

Semin Musculoskelet Radiol

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Gaucher's disease (GD) is a lysosomal storage disorder characterized by the storage of glucosylceramide in macrophages (“Gaucher cells”), mainly in the reticuloendothelial system. GD type 1 (GD1) is the most common phenotype that usually manifests with hepatosplenomegaly, cytopenias, and bone involvement. Skeletal manifestations are the most debilitating characteristic and result in significant morbidities. We describe a case of GD1, first presented by a nontraumatic bone fracture. The case presentation highlights the importance of considering GD among the differential diagnosis of nontraumatic fractures, avascular necrosis, and infarcts of the bones. Early diagnosis and treatment improve the course of disease and avoid irreversible sequelae.

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Triple attack technique for non-union of femoral neck fractures

Abstract: The present study provides encouraging clinical and functional results to suggest that this newly described procedure ('triple attack') might be a valuable option in the management of non-united femoral neck fractures.

Cited by 8 publications

References 17 publications

Valgus intertrochanteric osteotomy for femur neck pseudoarthrosis: a simple solution to a complex problem that has stood the test of time

Valgus intertrochanteric osteotomy for femur neck pseudoarthrosis: a simple solution to a complex problem that has stood the test of time

Blocking Pins Instead of Blocking Screws in the Treatment of Distal Tibial Fractures with Intramedullary Nail

Skeletal Manifestations of Gaucher's Disease: A Case Report and Literature Review

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