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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

Radiograph after open reduction of the fractures with a plate and screws.
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fig3: Radiograph after open reduction of the fractures with a plate and screws.

Mentions: For the treatment of fracture, open reduction and internal fixation with a plate and screws were performed. Drilling, particularly in the femoral neck, was quite difficult as bone was sclerotic. For the opposite sided stress fracture, prophylactic operation, an internal fixation with a plate and screws, was performed (Figure 3). 10 days after operation of the left femur, fracture occurred at the distal screw and reoperation was performed using a long plate (Figure 4). Fracture healed well in 3 months and then the patient was able to bear full weight.


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)

Radiograph after open reduction of the fractures with a plate and screws.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig3: Radiograph after open reduction of the fractures with a plate and screws.
Mentions: For the treatment of fracture, open reduction and internal fixation with a plate and screws were performed. Drilling, particularly in the femoral neck, was quite difficult as bone was sclerotic. For the opposite sided stress fracture, prophylactic operation, an internal fixation with a plate and screws, was performed (Figure 3). 10 days after operation of the left femur, fracture occurred at the distal screw and reoperation was performed using a long plate (Figure 4). Fracture healed well in 3 months and then the patient was able to bear full weight.

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