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Total Hip Arthroplasty after Treatment of an Atypical Subtrochanteric Femoral Fracture in a Patient with Pycnodysostosis.

Yuasa T, Maeda K, Kaneko K, Yoshikata K - Case Rep Orthop (2015)

Bottom Line: She was of short stature with typical facial features, short stubby hands, and radiological features including open cranial sutures, obtuse mandible, and generalized skeletal sclerosis.The majority of cases of atypical subtrochanteric fractures are associated with long-term use of bisphosphonates; some occur in bisphosphonate-free patients.We performed cementless THA in combination with a plate and cables.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.

ABSTRACT
The authors describe the case of a 51-year-old woman with an osteonecrosis of her right femoral head after treatment of an atypical subtrochanteric fracture caused by pycnodysostosis. She had this fracture after a low-trauma fall. She was of short stature with typical facial features, short stubby hands, and radiological features including open cranial sutures, obtuse mandible, and generalized skeletal sclerosis. The majority of cases of atypical subtrochanteric fractures are associated with long-term use of bisphosphonates; some occur in bisphosphonate-free patients. We report a rare case of total hip arthroplasty (THA) in a patient with pycnodysostosis who developed an osteonecrosis of the femoral head after treatment of an atypical subtrochanteric femoral fracture. We performed cementless THA in combination with a plate and cables. Cementless THA is a potential intervention in a patient with pycnodysostosis; although the bone quality may have been sclerotic, healing is not a problem in this condition.

No MeSH data available.


Related in: MedlinePlus

Lateral radiograph of the skull showed separated sutures, open fontanelle, and obtuse angle of mandible.
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fig2: Lateral radiograph of the skull showed separated sutures, open fontanelle, and obtuse angle of mandible.

Mentions: Radiographs of the right femur confirmed a noncomminuted, transverse subtrochanteric fracture with both lateral and medial cortical thickening, but without obliteration of the medullary canal, consistent with radiologic features of an atypical subtrochanteric femoral fracture [8] (Figure 1). Pelvic views demonstrated asymptomatic stress fracture in the left femur that involved the lateral cortex. A subsequent skeletal survey revealed cortical thickening of all long bones and an incompletely fused anterior fontanelle (Figure 2).


Total Hip Arthroplasty after Treatment of an Atypical Subtrochanteric Femoral Fracture in a Patient with Pycnodysostosis.

Yuasa T, Maeda K, Kaneko K, Yoshikata K - Case Rep Orthop (2015)

Lateral radiograph of the skull showed separated sutures, open fontanelle, and obtuse angle of mandible.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4581509&req=5

fig2: Lateral radiograph of the skull showed separated sutures, open fontanelle, and obtuse angle of mandible.
Mentions: Radiographs of the right femur confirmed a noncomminuted, transverse subtrochanteric fracture with both lateral and medial cortical thickening, but without obliteration of the medullary canal, consistent with radiologic features of an atypical subtrochanteric femoral fracture [8] (Figure 1). Pelvic views demonstrated asymptomatic stress fracture in the left femur that involved the lateral cortex. A subsequent skeletal survey revealed cortical thickening of all long bones and an incompletely fused anterior fontanelle (Figure 2).

Bottom Line: She was of short stature with typical facial features, short stubby hands, and radiological features including open cranial sutures, obtuse mandible, and generalized skeletal sclerosis.The majority of cases of atypical subtrochanteric fractures are associated with long-term use of bisphosphonates; some occur in bisphosphonate-free patients.We performed cementless THA in combination with a plate and cables.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.

ABSTRACT
The authors describe the case of a 51-year-old woman with an osteonecrosis of her right femoral head after treatment of an atypical subtrochanteric fracture caused by pycnodysostosis. She had this fracture after a low-trauma fall. She was of short stature with typical facial features, short stubby hands, and radiological features including open cranial sutures, obtuse mandible, and generalized skeletal sclerosis. The majority of cases of atypical subtrochanteric fractures are associated with long-term use of bisphosphonates; some occur in bisphosphonate-free patients. We report a rare case of total hip arthroplasty (THA) in a patient with pycnodysostosis who developed an osteonecrosis of the femoral head after treatment of an atypical subtrochanteric femoral fracture. We performed cementless THA in combination with a plate and cables. Cementless THA is a potential intervention in a patient with pycnodysostosis; although the bone quality may have been sclerotic, healing is not a problem in this condition.

No MeSH data available.


Related in: MedlinePlus