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Managementt o f non traumatic A vascular Necrosis off Femoral Head at precollapse stage with Core Decompression and tibial Bone Grafting

Author: Baqer Kadhim Kraidi Senior orthopedic surgeon (F. I. C. M. S. – M. B. Ch. B)a Alwan Hussein Keetan (M. B. Ch. B).b
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2014 Volume: 10 Issue: 1 Pages: 44-47
Publisher: Baghdad University جامعة بغداد

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Abstract

B aa cc kk gg r oo uunn dd : Avascular necrosis have always presented great challenges to orthopedic surgeons and patients, remain in many ways today the unsolved dilemma. Varieties of non-vascularized bone grafting techniques preceded by core decompression have been proposed with varying degrees of success. O bb j ee cc t i vv ee ss : The aim of this study is to review the the value of core decompression and non-vascularized tibial bone strip graft treatment for early stages of non-traumatic osteonecrosis stage II & III according to stein burg staging . M ee t hh oo dd ss : prospectively reviewed 26 patients (32 hips) with osteonecrosis of the femoral head between June 2006 and December 2013 at Imam Ali hospital in Sader city & Al-Wasity teaching hospital. Inclusion criteria were all patients ages 19 years to 50 years and in Stein burg stages II and III . Mean follow-up for 3 year. Exclusion criteria were stage I, IV, V and VI .We used Phemister technique to make a window at the posterior aspect of greater trochanter to remove necrotic bone and packed the excavated area with cortico-cancelloustibial bone strip graft. This study was taking into account ethical evaluation and approval by scientific committee of Arab board. R ee ss uu l t ss: The reported results of treatment for femoral head avascular necrosis was (87.6%) success rate of hips in our cohort of patients with core decompression &non-vascularized tibial bone strip C oo nn cc l uu ss i oo nn ss : None vascularized tibial bone graft effectively reduce donor site morbidity and may defer jointarthroplasty in selected patient stein burg staging


Article
Intracapsular fracture of the neck femur in age group between 20-50 years ,the result of Internal fixation with cannulated screws
كسر داخل عظم الفخذ في الرقبة في الفئة العمرية بين 20-50 سنة ، نتيجة التثبيت الداخلي مع مسامير مقنى

Author: Iskandar Mahdi Saleh اسكندر مهدي صالح
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2016 Volume: 12 Issue: 22 Pages: 33-41
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

Background: Femoral neck fracture represent important subject because it has many complications and followed by morbidity , prospective study was done on (20) patient, The treatment options of femoral neck fracture are many ,we choose treatment with cannulated screws and evaluatethe result of it regarding the union rate and occurrence of the complications. Patients and Methods:This study was performed on 20 patients with femoral neck fractures in period between September 2009 and September 2010 in orthopedic department in the Hospital for Specialized Surgeries in medical city/ Baghdad ,we did preoperative assessment to them and including radiological examination ,laboratory investigations to identify medical diseases and treat them ,classify patient according garden classification and Treated by reduction of displaced fractures and capsulatomy and then fixation with three cannulated secrew Results: Twenty patients with femoral neck fractures 7 females 35%, and 13 males 65%, 12 patients were left-sided 60%, 8 patients were right-sided 40%.11 patients were with undisplaced femoral neck fractures (55%), 9 patients with displaced femoral neck fractures (45%). The age of the patients was ranging from 20 – 50year ,The result of our study was indicated that union rate of 85% , and 25% of vascular necrosis. Conclusions: the cannulated hip screws is a good method of fixation regarding union rate and low complication rate , the result of treatment is influenced mainly by the fracture displacement and quality of reduction and time of surgery.

إن كسر عنق عظم الفخذ يعتبر من المواضيع المهمة وذلك لما تحتويه من مضاعفات خطيرة قد تؤدي إلى موات رأس العظم مما قد يسبب سوفان مبكر لمفصل الورك.هنالك العديد من العوامل التي تسبب المضاعفات التي قد تحصل يمكن التحكم فيها مما قد يقلل حصول تلك المضاعفات ومنها :التشخيص المبكر للكسر,سرعة إجراء عملية تثبيت الكسر بواسطة البراغي ألمثقبه مع الحفاظ على قوام العظم في وضعة الأصلي ما قبل الكسر .و لقد أثبتت هذه الدراسة مدى كفأه تثبيت الكسر بواسطة البراغي المثقبة من خلال النسبة العالية للأتأم الكسر مع قلة حصول المضاعفات مقارنة بالدراسات الأخرى

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