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Posttraumatic Avascular Necrosis Femoral Head With Cannulated Cacellous Screws In Situ

May 7, 2012 By Leave a Comment

Following is an example of avascular necrosis that can occur after trauma. The patient, 53 years old male, suffered fracture neck femur and was operated for the same using cancellous cannulated screws about 7 months prior to this xray.

He presented to OPD with pain in the involved hip and the xray revealed following picture.

Avascular Necrosisof Femoral Head With Cancellous Screws In Situ

Avascular Necrosisof Femoral Head With Cancellous Screws In Situ

The fracture neck femur has united but there is increased radiodensity of the head along with collapse of superomedial portion of the head thus indicating that patient has avascular necrosis of the head of femur.

Filed Under: Hip Fractures, Musculoskeletal Radiology, Orthopaedic Images Tagged With: , , , , ,

United Intertrochanteric Fracture With Dynamic Hip Screw In Situ

April 26, 2012 By Leave a Comment

Xray of 60 years old female who was operated for intertrochanteric fracture on right side. The xray is after four months of surgery.

United Intertrochanteric Fractiure WIth Dynamic Hip Screw In Situ

United Intertrochanteric Fractiure WIth Dynamic Hip Screw In Situ

The xray shows a united fracture and a dynamic hip screw in situ though full profile of the implant is not visible.

Filed Under: Hip Fractures, Musculoskeletal Radiology, Orthopaedic Images Tagged With: , , ,

Fracture Shaft of Femur With Ipsilateral Hip Dislocation

March 8, 2012 By 2 Comments

Young adult with fracture of shaft of femur with dislocation of hip

Fracture of Shaft of Femur With Dislocation of Hip

Fracture of Shaft of Femur With Dislocation of Hip

There is also an associated fracture of acetabulum.

Filed Under: Femoral Fractures, Hip Fractures, Musculoskeletal Radiology, Orthopaedic Images Tagged With: , , , ,

Supracondylar Femur Fracture Fixed With Femoral Condylar Plate In A Patient WIth Dynamic Hip Screw In Situ For Previous Intertrochanteric Fracture

January 21, 2012 By Leave a Comment

A patient with old operated and united intertrochanteric fracture was operated for another injury in the same limb. For suprcondylar fracture of femur.

The following image was taken after 4 weeks of surgery

Femoral Condyalr Plate In Patient With Prevoius DHS

Femoral Condylar Plate In Patient With Prevoius DHS

Though the complete profile is not visible, one can make out the outline of DHS (Dynamic Hip Screw).

Filed Under: Hip Fractures, Knee Injuries, Musculoskeletal Radiology, Orthopaedic Images Tagged With: , , ,

Xray Of Bilateral Fracture Neck Of Femur With Deformed Pelvis In Osteomalacia

January 17, 2012 By Leave a Comment

48 years, mother of five presented to out patient department with inability to walk and pains in all body for past five days. On further probing generalised body pains were present for about a Bilatreral hips were tender on examination.

Xray revealed fracture of neck of femur bilaterally and a deformed pelvis suggesting osteomalacia.

Fracture Neck femur in osteomalacia

Bilateral Fracture Neck femur in osteomalacia

Osteomalacia is a condition that occurs due to Vit D deficiency in adult [ In children the counterpart is rickets].

Osteomalcia leads to softening of bones and pseudofractures in regions like neck of femur, pubic rami etc which may on go to form complete fracture.

This patient was advised surgery [closed/open reduction+fixation] for both the neck of femur fracture but she refused any kind of surgical intervention.

Filed Under: Hip Fractures, Metabolic Diseases, Musculoskeletal Radiology, Orthopaedic Images Tagged With: , , , ,

Intertrochanteric Fracture With Dynamic Hip Screw In Malposition

January 2, 2012 By Leave a Comment

This xray shows a malpositioned lag screw of dynamic hip screw assembly.

Note that screw is almost out of the femoral head shadow.

Malpositioned Lag Screw In Intertrochanteric fracture

Malpositioned Lag Screw In Intertrochanteric fracture

Good thing is that fracture has united in spite of that.

Filed Under: Hip Fractures, Musculoskeletal Radiology, Orthopaedic Images Tagged With: , , , ,

Broken Fixed Angle Blade Plate In Intertrochanteric Fracture

December 27, 2011 By Leave a Comment

The following xray [no actual patient information could be found with this file] shows a broken fixed angle blade plate in a case of intertrochanteric fracture.

Broken Angle blade plate after hip surgery

Broken Angle Blade Plate After Hip Surgery

Probably, the fixed angle blade plate was done as a revision surgery because there are broken screws in addition to screws that are holding the plate.

There was no patient information attached with this file.

Note Fixed angle blade plate was extensively used earlier for treatment of intertrochanteric fractures but with better gadgets available now, it is rarely used.

Filed Under: Hip Fractures, Implants-Instruments Tagged With: , ,

Old Unreduced Open Dislocation of Hip With Exposed Femoral Head and Proximal Femur

October 17, 2011 By Leave a Comment

This patient presented to casualty with a foul smelling wound on left gluteal region. The patient had an accident about 2 months back which probably resulted in an open dislocation of left hip.

Exposed Femoral Head Disclored

Open Dislocation Hip With Exposed Femoral head & Proximal Femur

Over the period, it got infected and these photographs were taken when the patient presented to us. Note that head of femur has discolored indicating dead tissue.

Open dislocation of hip with exposed head

Exposed Head From Another Angle

The patient was also in septicemia and was critical when admitted.

Another Look At Jutting Out Femur

Another Look At Jutting Out Femur

Patient did not survive because of multi organ failure.

 

Filed Under: Hip Fractures, Orthopaedic Images Tagged With: , , ,

Xray of Dynamic Hip Screw Revision Surgery

October 10, 2011 By Leave a Comment

Xray of the patient who underwent a change of side plate after his previous DHS assembly broke.

Revision surgery in broken dynamic hip screw assembly

Revised Side Plate in A Patient With Broken DHS. Broken Screws From Previous Sideplate are Visible

The broken screws from previous surgery are visible.

Filed Under: Hip Fractures, Musculoskeletal Radiology, Orthopaedic Images Tagged With: , ,

Blood Supply of Neck Of Femur

October 9, 2011 By Leave a Comment

Blood supply of proximal part of the femur is derived from following sources

Retinacular Vessels

Ascending cervical vessels arise from the extracapsular ring of anastomosis formed by the medial and lateral circumflex femoral artery at base of neck. Ascending Cervical Branches travel proximally under the hip capsule and continue proximally along neck deep to synovial membrane
toward the femoral head.

These arteries are known as retinacular arteries and are divided into three groups [Read more...]

Filed Under: Basics, Hip Fractures
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