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- Atypical Vancouver B1 periprosthetic fracture of the proximal femur in the United Kingdom: a case report challenged by myeloma, osteoporosis, infection, and recurrent implant failures
- Sayantan Saha, Azeem Ahmed, Rama Mohan
- J Trauma Inj. 2024;37(1):89-96. Published online March 18, 2024
- DOI: https://doi.org/10.20408/jti.2023.0069
- 1,940 View
- 61 Download
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Abstract
PDF - The indications for total hip replacement are increasing and not limited to osteoarthritis. Total hip replacement may also be done for trauma and pathological fractures in patients otherwise physiologically fit and active. This trend has led to an inevitable rise in complications such as periprosthetic femoral fracture. Periprosthetic femoral fracture can be challenging due to poor bone quality, osteoporosis, and stress fractures. We present a case of periprosthetic femoral fracture in a 71-year-old woman with some components of an atypical femoral fracture. The fracture was internally fixed but was subsequently complicated by infection, implant failure needing revision, and later stress fracture. She was on a bisphosphonate after her index total hip replacement surgery for an impending pathological left proximal femur fracture, and this may have caused the later stress fracture. Unfortunately, she then experienced implant breakage (nonunion), which was treated with a biplanar locking plate and bone grafting. The patient finally regained her premorbid mobility 13 months after the last surgery and progressed satisfactorily towards bony union.
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Summary
- Surgical Treatment of Ipsilateral Multi-Level Femoral Fracture Treated Using Antegrade Intramedullary Nail
- Beom-Soo Kim, Jae-Woo Cho, Do-Hyun Yeo, Jong-Keon Oh
- J Trauma Inj. 2018;31(2):96-102. Published online August 31, 2018
- DOI: https://doi.org/10.20408/jti.2018.31.2.96
- 13,964 View
- 337 Download
- 1 Citations
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Abstract
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Ipsilateral fractures of proximal femur with shaft and condylar region are very rare. Current concept of management is based on fixation of each fracture as independent entity using separate fixation modalities for proximal and distal parts of femur. However, we considered that antegrade femoral nailing with cephalomedullary screw fixation is a good option for ipsilateral multi-level femoral fractures. Here, we present an experience of satisfactory treatment for ipsilateral femoral neck fracture, subtrochanteric fracture, comminuted shaft fracture with supracondylar fracture following road traffic accident.
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Citations to this article as recorded by
- Multiple fractures of the femur: Case report, literature review, and proposal for a shared algorithm of treatment
Pasquale Sessa, Michele Galluzzo, Edoardo Leone, Schirò Antonio Maria, Giuseppe Giannicola
SAGE Open Medical Case Reports.2024;[Epub] CrossRef
- Rare Imaging of Fat Embolism Seen on Computed Tomography in the Common Iliac Vein after Polytrauma
- Hojun Lee, Jonghwan Moon, Junsik Kwon, John Cook-Jong Lee
- J Trauma Inj. 2018;31(2):103-106. Published online August 31, 2018
- DOI: https://doi.org/10.20408/jti.2018.31.2.103
- 5,963 View
- 75 Download
- 1 Citations
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Abstract
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Fat embolism refers to the presence of fat droplets within the peripheral and lung microcirculation with or without clinical sequelae. However, early diagnosis of fat embolism is very difficult because the embolism usually does not show at the computed tomography as a large fat complex within vessels. Forty-eight-year-old male with pedestrian traffic accident ransferred from a local hospital by helicopter to the regional trauma center by two flight surgeons on board. At the rendezvous point, he had suffered with dyspnea without any airway obstruction sign with 90% of oxygen saturation from pulse oximetry with giving 15 L of oxygen by a reserve bag mask. The patient was intubated at the rendezvous point. The secondary survey of the patient revealed multiple pelvic bone fracture with sacrum fracture, right femur shaft fracture and right tibia head fracture. Abdominal computed tomography was performed in 191 minutes after the injury and fat embolism with Hounsfield unit of ?86 in his right common iliac vein was identified. Here is a very rare case that mass of fat embolism was shown within common iliac vein detected in computed tomography. Early detection of the fat embolus and early stabilization of the fractures are essential to the prevention of sequelae such as cerebral fat embolism.
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Citations
Citations to this article as recorded by- Fat embolism in the popliteal vein detected on CT: Case report and review of the literature
Tucker Burr, Hamza Chaudhry, Cheryl Zhang, Vasilios Vasilopoulos, Emad Allam
Radiology Case Reports.2020; 15(11): 2308. CrossRef
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