Orthopedic Care and Consultation
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 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).
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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.
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.
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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
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.
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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.
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.
Exposed Head From Another Angle
The patient was also in septicemia and was critical when admitted.
Another Look At Jutting Out Femur
Patient did not survive because of multi organ failure.
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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...]
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A post fixation xray of fractureneck femur, fixed with dynamic hip screw system and another cancellous screw acting as derotation screw.
Dynamic Hip Screw and Cancellous Screew Acting As Derotation Screw
Derotation screw is used to counter rotational insability [Rotaion of the proximal fragment might occur in spite of the dynamic hip screw]
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