Journal of Orthopedic Education

Nonunion femoral neck fracture with varus deformity can be a difficult problem to treat, particularly in the young patients and they are associated with high complication rates of avascular necrosis due to the precarious blood supply and poor biomechanics. For improving either biology or biomechanics various treatment options include cannulated screws fixation with washers in inverted triangle configuration, rigid internal fixation with or without bone grafting, muscle pedicle bone graft, valgus osteotomy of the proximal femur with or without bone graft, valgus osteotomy or hip arthroplasty. Valgus osteotomy, repositioning and fixation with dynamic hip screw (DHS) achieved good union rates and good functional outcome with minimal complications 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.6 Here we are presenting a case of nonunion fracture neck femur in young patient treated with valgus osteotomy stabilized with 140 degree dynamic hip screw.

Keywords: Nonunion; Fracture; Neck; Femur.

Distal femur fractures are mostly caused by a high-energy injury mechanism. Managing these compound fractures with vascular injury can be a challenging task. Most surgeons agree that distal
femur fractures with vascular injury need to be treated operatively to achieve optimal patient outcomes. The effective surgical methods include external fixation and vascular repair, limb reconstruction
system if there is bone loss, Masquelet technique and Ilizarov distraction osteogenesis. Post traumatic limb reconstructive surgeries, non-union, infection, bone loss, shortening and for deformity correction,
Ilizarov is best operative technique to get excellent results.7 Common treatment for femoral nonunion with large segmental bone defect is difficult and complex.2

Keywords : Compound; Gustilo; Anderson
 

Background: Today, total hip replacement (total hip arthroplasty, THA) is one of the most successful surgical procedures in the field of orthopaedic and trauma surgery. Besides relieving pain, restoration of the hip joint biomechanics with appropriate femoral offset, and leg length is an important goal of THA and facilitates normal gait and function. THA is effective for decreasing pain and improving the function of patients. But like any other surgery. Total Hip Arthroplasty is also associated with few complications. The purpose of our study is to present the common complications associated with total hip arthroplasty. Material and Methods: This longitudinal study was conducted from January 2018 to Jan 2020 in which we have performed a total of 84 total hip replacements (THR) in 64 patients at Sri Aurobindo Institute of Medical Science, Indore. (Table 1) Patient’s age was in the range of 23 to 65 years. Median age of patient was 35 years. (Table 2) Results: Complications were diagnosed in 25 (29.7%) patients. Postoperative complications such as aseptic loosening of the prosthetic components in 1 patient (1.1%), superficial or deep Hematogenous infections in 2 patient (2.3%), prosthetic dislocations in 4 patient (4.6%) and limb length discrepancy in 16 patients (19%) and radicular pain in lower limb in 2 patients (2.3%) were predominant. Conclusion: Complications and adverse events are associated with all medical and surgical treatments. By identifying and defining complications and adverse events associated with THA we can reduce the intra operative and post operative complications of total hip arthroplasty.

Keywords: Hip; Arthroplasty; Complication; Infection.