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World Journal of Orthopedics 2019年第6期10卷 247-254页

作者： Saisunder Shashank Chaganty Deeptiman James Faculty of Medicine and Dentistry University of PlymouthPlymouth PL6 8BUUnited Kingdom Assistant Professor Department of OrthopedicsChristian Medical CollegeVelloreVellore 632004Tamil NaduIndia

BACKGROUND femoral neck stress fractures are rarely encountered among young adults and are often associated with either repetitive excessive loading or underlying bone *** research has indicated human immunodeficiency virus(HIV)/antiretroviral therapy(ART)as predisposing agents to osteopenia and osteoporosis related *** report a case of HIV/ART induced insufficiency fracture in a resource limited setting in Central *** aim is to increase awareness and promote screening of HIV/ART related osteopenia and osteoporosis in order to prevent catastrophic orthopaedic *** SUMMARY A 35-year-old HIV positive male presented with a stress fracture of left femoral *** patient was on ART and reported no *** went on to be successfully managed ***,during work-up osteopenia of the contralateral proximal femur was recognised using Singh’s *** months post-op the patient presented with right-sided femoral-neck stress *** this stage the patient was nonconcordant with ART and denied surgical *** In the absence of co-morbidities,several mechanisms of HIV/antiretroviral therapy may have played a role in predisposing our patient towards such a *** recommend routine screening all HIV-infected patients for osteopenia,especially in younger *** low resource settings and district hospitals,pelvis radiograph&Singh’s index can be used for screening.

关键词： Bilateral femoral neck stress fracture Human immunodeficiency virusantiretroviral therapy related osteopenia Osteoporosis in resource limited setting Human immunodeficiency virus related fragility fractures

Systematic review of dynamization vs exchange nailing for delayed/non-union femoral fractures

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World Journal of Orthopedics 2018年第7期9卷 92-99页

作者： Jacob E Vaughn Ronit V Shah Tarek Samman Jacob Stirton Jiayong Liu Nabil A Ebraheim College of Medicine and Life Sciences University of Toledo Department of Orthopedic Surgery University of Toledo Medical Center

AIM To analyze the literature on efficacy of dynamamization vs exchange nailing in treatment of delayed and nonunion femur *** Ultimately, 31 peer-reviewed articles with 644 exchanged nailing patients and 131 dynamization patients were identified and analyzed. The following key words were inputted in different combinations in order to search the field of publications in its entirety: "nonunion", "delayed union", "ununited", "femur fracture", "femoral fracture", "exchange nailing", "dynaiz(s)ation", "secondary nailing", "dynamic", "static", and "nail revision". The initial search yielded over 150 results, and was refined based on the inclusion criteria: Only studies reporting on humans, non-unions and delayed unions, and the usage of exchange nailing and/or dynamization as a secondary treatment after failed IM nailing. The resulting 66 articles were obtained through online journal access. The results were filtered further based on the exclusion criteria: No articles that failed to report overall union rates, differentiate between success rates of their reported techniques, or articles that analyzed less than 5 patients. RESULTS Exchange nailing lead to fracture union in 84.785% of patients compared to the 66.412% of dynamization with statistically comparable durations until union(5.193 ± 2.310 mo and 4.769 ± 1.986 mo respectively). Dynamically locking exchange nails resulted in an average union time of 5.208 ± 2.475 mo compared to 5.149 ± 2.366 mo(P = 0.8682) in statically locked exchange nails. The overall union rate of the two procedures, statically and dynamically locked exchange nailing yielded union rates of 84.259% and 82.381% respectively. Therefore, there was no significant difference between the different locking methods of exchange nailing for union rate or time to union at a significance value of P femoral non-unions in respect to its higher succ

关键词： Non-union Delayed union Dynamization femoral fracture Exchange nailing

Open surgical treatment for rare epithelioid hemangioendothelioma of the common femoral vein

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Journal of Interventional Medicine 2019年第4期2卷 178-180页

作者： Xiangjiang Guo Shuo fei Yang Guan hua Xue Jia quan Chen Hao Zhang Lan Zhang Department of Vascular Surgery Renji HospitalSchool of MedicineShanghai Jiaotong UniversityShanghai200127China

Epithelioid hemangioendothelioma is a very rare disease affecting big blood vessels,especially *** have been very few articles describing the *** hereby present the case of a 56-year-old woman presenting with lower limb edema,who was initially being treated for residual thrombus in the common femoral vein but was eventually diagnosed with epithelioid hemangioendothelioma(EHE).The common femoral vein was resected and reconstructed using the external jugular *** additional therapy was *** this article,previous literature about EHE has been reviewed and oncologic principles have been discussed.

关键词： Open surgical treatment rare epithelioid hemangioendothelioma common femoral vein

Managing extremely distal periprosthetic femoral supracondylar fractures of total knee replacements-a new PHILOS-ophy

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World Journal of Orthopedics 2017年第10期8卷 809-813页

作者： Kevin J Donnelly Adam Tucker Angel Ruiz Neville W Thompson Department of Trauma and Orthopaedic Surgery Altnagelvin Hospital

We report two cases where a proximal humeral locking plate was used for the fixation of an extremely distal, type Ⅲ peri-prosthetic femoral fractures in relation to a total knee replacement(TKR). In each case there was concern regarding the fixation that could be achieved using the available anatomic distal femoral plates due to the size and bone quality of distal fragment. The design of the Proximal Humeral Internal Locking System(PHILOS) allows nine 3.5-mm locking screws to be placed over a small area in multiple directions. This allowed a greater number of fixation points to be achieved in the distal fragment. Clinical and radiological short-term follow-up(6-12 mo) has been satisfactory in both cases with no complications. We suggest the use of this implant for extremely distal femoral fractures arising in relation to the femoral component of a TKR.

关键词： Distal femoral Periprosthetic Fracture PHILOS Open reduction and internal fixation

Profunda femoris artery pseudoaneurysm following revision for femoral shaft fracture nonunion

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World Journal of Orthopedics 2013年第3期4卷 154-156页

作者： Federico Valli Marco GA Teli Marco Innocenti Ruggero Vercelli Domenico Prestamburgo Department of Orthopaedic Surgery Civile Regional Hospital20025 LegnanoItaly Department of Diagnostic and Interventional Radiology Niguarda Cà Granda Regional Hospital20162 MilanoItaly

femoral artery pseudoaneurysms(FAPs) have been described following internal fixation of intertrocantheric, subtrocantheric and intracapsular femoral neck fractures as well as core decompression of the femoral head. The diagnosis of FAP is usually delayed because of non-specific clinical features like pain, haematoma,swelling, occasional fever and unexplained *** of the insidious onset and of the possible delayed presentation of pseudoaneurysms, orthopaedic and trauma surgeons should be aware of this complication. We report a case of Profunda Femoris arterial branch pseudoaneurysm, diagnosed in a 40-year-old male 4 wk after revision with Kuntscher intramedullary nail of a femoral shaft nonunion. The diagnosis was achieved by computed tomography angiography and the lesion was effectively managed by endovascular repair. The specific literature and suggestions for treatment are discussed in the paper.

关键词： Arterial injury Pseudoaneurysm Nonunion femoral shaft Endovascular repair

Bipolar hemiarthroplasty for femoral neck fracture using the direct anterior approach

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World Journal of Orthopedics 2013年第2期4卷 85-89页

作者： Tomonori Baba Katsuo Shitoto Kazuo Kaneko Department of Orthopedic Surgery Juntendo University School of Medicine Tokyo 113-8421 Japan Department of Orthopedic Surgery Juntendo University Urayasu Hospital Chiba 279-0021Japan

AIM: To evaluate whether walking ability recovers early after bipolar hemiarthroplasty(BHA) using a direct anterior ***: Between 2008 and 2010, 81 patients with femoral neck fracture underwent BHA using the direct anterior approach(DAA) or the posterior approach(PA). The mean observation period was 36 mo. The age, sex, body mass index(BMI), time from admission to surgery, length of hospitalization, outcome after discharge, walking ability, duration of surgery, blood loss and complications were compared. RESULTS: There was no significant difference in the age, sex, BMI, time from admission to surgery, length of hospitalization, outcome after discharge, duration of surgery and blood loss between the two groups. Two weeks after the operation, assistance was not necessary for walking in the hospital in 65.0% of the patients in the DAA group and in 33.3% in the PA group(P femoral greater trochanter developed in 1 patient in the DAA group and calcar crack and dislocation in 1 patient each in the PA ***: DAA is an approach more useful for BHA for femoral neck fracture in elderly patients than total hip arthroplasty in terms of the early acquisition of walking ability.

关键词： Direct anterior approach Bipolar hemiarthroplasty Posterior approach femoral neck fracture Muscle presentation Walking ability

Arterioureteral fistula:An unusual cause of haematuria 10 years after the implantation of a synthetic iliac-femoral stent

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Asian Journal of Urology 2023年第4期10卷 563-564页

作者： Luca Ongaro Michele Rizzo Francesco Claps Ottavia Runti Andrea Piasentin Carlo Trombetta Giovanni Liguori Department of Urology Cattinara HospitalASUGIUniversity of TriesteTriesteItaly

Dear Editor,The patient had a history of intermittent self-resolving episodes of gross haematuria and was referred to our department for a massive *** presentation,haemoglobin was 8.6 g/dL and creatinine was 1.37 mg/*** was hemodynamically stable,but suffered an important anemization in the subsequent days requiring multiple blood *** his medical history,it was reported that he had type II diabetes mellitus and the implantation of a right iliac-femoral stent 10 years before.

关键词： iliac femoral transfusion

Clinical features of the femoral head necrosis caused by gross teres ligament after reduction for the developmental dislocation of the hip

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Chinese Medical Journal 1998年第11期000卷 39-41页

作者：马瑞雪吉士俊刘卫东周永德 Department of Pediatric Orthopedics 2nd Clinical CollegeChina Medical UniversityShengyang 110003China

Abstract Objective To observe the clinical features of the femoral head necrosis caused by a gross teres ligament after reduction of developmental dislocation of the hip and study its pathological causes. Methods Ten hips with necrosis of the femoral head after reduction of developmental dislocation of the hip were observed. X ray images of the hip were retrospectively reviewed with regard to the acetabular index, the acetabular head index, the shapes and the development of the femoral heads. The operative findings were analyzed. Results No growth or delayed growth of the femoral head and the acetabular index was found after reduction. The recovery of acetabulum was very slow. All of the cases showed the same features: femoral head necrosis, subluxation, and acetabular dysplasia. A gross teres ligament was proved during surgical operation. The femoral head recovered gradually after the operation. Conclusions The gross tissue interposed (a gross teres ligament) is another important pathogenesis of femoral head necrosis after the reduction of developmental dislocation of the hip. It is necessary to recognize it before reduction by imaging examinations.

关键词： features the femoral head Clinical after

Hip survival rate in the patients with avascular necrosis of femoral head after transtrochanteric rotational osteotomy: a systematic review and meta-analysis

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Chinese Medical Journal 2019年第24期132卷 2960-2971页

作者： Ying-Xing Xu Yuan-Zhong Ren Zhi-Ping Zhao Ying-Zhen Wang Teng Wang Tao Li Department of Joint Surgery The Affiliated Hospital of Qingdao UniversityQingdaoShandong 266003China Qingdao University QingdaoShandong 266071China Medical Department Qingdao UniversityQingdaoShandong 266071China

Background:The clinical outcome of transtrochanteric rotational osteotomy(TRO)for osteonecrosis of the femoral head(ONFH)remains controversial,and the promising clinical results of several Japanese studies could not be reproduced in American and European *** to solve controversies on TRO for ONFH rising from apparently conflicting studies,a meta-analysis was conducted to assess the 5-and 10-year hip survival rates(with conversion to artificial joint replacement and radiographic failure as endpoints)after ***:All eligible studies were searched in seven comprehensive databases including PubMed,Web of Science,Embase,Cochrane Library,VIP Database,China Knowledge Resource Integrated Database,and Wan Fang Database prior to June *** outcomes evaluated were 5-and 10-year hip survival rates after *** odds ratio and risk difference for the noncomparative binary data with the 95%confidence intervals(CIs)were calculated for each *** included studies were assessed for methodologic bias and potential reasons for heterogeneity were ***:Nineteen studies of TRO for ONFH were eligible for this meta-analysis according to inclusion *** on the previous report,two calculation methods(Methods 1 and 2)were adopted in this ***,we performed a subgroup analysis of the 5-and 10-year hip survival rates(Method 1)after TRO for ONFH:Asian sub-population and non-Asian *** conversion to artificial joint replacement as the endpoint,5-and 10-year hip survival rates(Method 1)after TRO for ONFH in the Asian population were 0.86(95%CI=0.82–0.89)and 0.72(95%CI=0.65–0.78),respectively,and 5-and 10-year hip survival rates after TRO for ONFH in the non-Asian population were 0.55(95%CI=0.43–0.67)and 0.42(95%CI=0.28–0.55),*** 5-and 10-year hip survival rates(Method 2)after TRO for ONFH were 0.90(95%CI=0.79–0.95)and 0.89(95%CI=0.81–0.94),*** radiographic failure as the endpoint,5-and 1

关键词： Meta-analysis Osteonecrosis femoral head Hip osteoarthritis Joint preserving treatments Transtrochanteric rotational osteotomy Survival rate

DIAGNOSIS AND TREATMENT OF IDIOPATHIC NECROSIS OF THE femoral HEAD

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Chinese Medical Sciences Journal 1990年第2期8卷 88-92页

作者：李毅中乐铜 PUMC Hospital CAMSBeijing

Fifteen cases,27 hips,of idiopathic necrosis of the femoral head (INFH) were included iour *** role of radiography,isotopic bone scanning,intraosseous pressure measure-ment and intraosseous venography in the diagnosis of INFH were *** could not reveal early cases,while isotopic bone scanning was more *** was an increase of intraosseous pressure in most of the diseased *** intraos-seous venography showed abnormalities in all examined *** latter two tests couldtherefore detect early *** decompression was performed in 23 hips,21 of whichwere followed for 7 to 27 *** evaluation was good or excellent in 18 *** re-examination remained unchanged in 19 *** intraosseouspressure measurement and intraosseous venography revealed a decrease of intraosseous pres-sure and improvement of venous *** decompression is therefore an ideal methodof treatment for early INFH.

关键词： idiopathic necrosis femoral head intraosseous pressure intraosseous venography isotopic bone scanning core decompression