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Unusual bilateral rim fracture in femoroacetabular impingement.

Rafols C, Monckeberg JE, Numair J - Case Rep Orthop (2015)

Bottom Line: With this technique the head of the screw lays hidden by the reattached labrum.We removed partially the fractured rim fragment and the internal fixation of the remaining portion was achieved with a screw.We believe that this bilateral case helps establish the efficacy and reproducibility of the technique described by Larson.

View Article: PubMed Central - PubMed

Affiliation: MEDS Clinical Sport Center, 8320000 Santiago, Chile.

ABSTRACT
This is a report of one case of bilateral acetabular rim fracture in association with femoroacetabular impingement (FAI), which was treated with a hip arthroscopic procedure, performing a partial resection, a labral reinsertion, and a subsequential internal fixation with cannulated screws. Up to date, there are in the literature only two reports of rim fracture and "os acetabuli" in association with FAI. In the case we present, the pincer and cam resection were performed without complications; the technique used was published previously. With this technique the head of the screw lays hidden by the reattached labrum. We removed partially the fractured rim fragment and the internal fixation of the remaining portion was achieved with a screw. In the event of a complete resection of the fragment, it would have ended with a LCE angle of 18° and a high probability of hip instability. We believe that this bilateral case helps establish the efficacy and reproducibility of the technique described by Larson.

No MeSH data available.


Related in: MedlinePlus

Under X-ray supervision, the remaining bone fragment was secured with an arthroscopic assisted 3.0 mm cannulated screw in both sides.
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fig3: Under X-ray supervision, the remaining bone fragment was secured with an arthroscopic assisted 3.0 mm cannulated screw in both sides.

Mentions: A magnetic resonance arthrogram showed FAI and an anterosuperior bilateral labral tear (Figure 2). A bilateral hip test with intra-articular lidocaine was positive (showing an intra-articular and labral pain). The patient was then treated with an arthroscopic procedure of each hip, with a three-month gap period in between them both. The out-in hip arthroscopy approach described by Sampson [6] was used in both surgical events. A labral tear associated with a large superior fracture of the bone rim was found; the cartilage at the junction with the labrum was intact in both hips. Pincer resection was performed with power instruments, which included about 30% of the fractured segment. This was performed under X-ray supervision and the remaining bone fragment was secured with an arthroscopic assisted 3.0 mm cannulated screw (Figure 3) in both sides. Finally, the labral fixation was secured with 3 translabral suture anchors and an arthroscopic cam resection of the femoral neck was performed. The final examination of the hip motion under arthroscopic vision probed no impingement at all.


Unusual bilateral rim fracture in femoroacetabular impingement.

Rafols C, Monckeberg JE, Numair J - Case Rep Orthop (2015)

Under X-ray supervision, the remaining bone fragment was secured with an arthroscopic assisted 3.0 mm cannulated screw in both sides.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4334434&req=5

fig3: Under X-ray supervision, the remaining bone fragment was secured with an arthroscopic assisted 3.0 mm cannulated screw in both sides.
Mentions: A magnetic resonance arthrogram showed FAI and an anterosuperior bilateral labral tear (Figure 2). A bilateral hip test with intra-articular lidocaine was positive (showing an intra-articular and labral pain). The patient was then treated with an arthroscopic procedure of each hip, with a three-month gap period in between them both. The out-in hip arthroscopy approach described by Sampson [6] was used in both surgical events. A labral tear associated with a large superior fracture of the bone rim was found; the cartilage at the junction with the labrum was intact in both hips. Pincer resection was performed with power instruments, which included about 30% of the fractured segment. This was performed under X-ray supervision and the remaining bone fragment was secured with an arthroscopic assisted 3.0 mm cannulated screw (Figure 3) in both sides. Finally, the labral fixation was secured with 3 translabral suture anchors and an arthroscopic cam resection of the femoral neck was performed. The final examination of the hip motion under arthroscopic vision probed no impingement at all.

Bottom Line: With this technique the head of the screw lays hidden by the reattached labrum.We removed partially the fractured rim fragment and the internal fixation of the remaining portion was achieved with a screw.We believe that this bilateral case helps establish the efficacy and reproducibility of the technique described by Larson.

View Article: PubMed Central - PubMed

Affiliation: MEDS Clinical Sport Center, 8320000 Santiago, Chile.

ABSTRACT
This is a report of one case of bilateral acetabular rim fracture in association with femoroacetabular impingement (FAI), which was treated with a hip arthroscopic procedure, performing a partial resection, a labral reinsertion, and a subsequential internal fixation with cannulated screws. Up to date, there are in the literature only two reports of rim fracture and "os acetabuli" in association with FAI. In the case we present, the pincer and cam resection were performed without complications; the technique used was published previously. With this technique the head of the screw lays hidden by the reattached labrum. We removed partially the fractured rim fragment and the internal fixation of the remaining portion was achieved with a screw. In the event of a complete resection of the fragment, it would have ended with a LCE angle of 18° and a high probability of hip instability. We believe that this bilateral case helps establish the efficacy and reproducibility of the technique described by Larson.

No MeSH data available.


Related in: MedlinePlus