A rare case of traumatic bilateral anterior and posterior dislocstions of the hip wss occured by autamobile accident as a passenger injury. The right hip was dislocated anteroinferior to the righ scetabulum(neer the right obturator froamen), and the left hip was dislocated posterosuperior to the left acetsbulum with a ipsilateral femur head fracture caudsd to the fovea centralis(Fig. 1).
Dislocations ; Femur Head ; Femur ; Hip

OBJECTIVETo compare emu necrotic femoral head micro structure repaired in two different methods.

METHODSFifteen adult emus were divided into 3 groups (all n=5), and the right femoral head was selected to research. The first group was the control group; in the second group, femoral head necrosis was made by cryogen with liquid nitrogen; and in the third group, femoral head necrosis was made by local pure ethanol injection. Right femurs were taken for micro CT examination,then femoral head micro structures were compared among these three groups.

RESULTSNo infection or unexpected death was found in all groups. Compared with normal group, necrotic femoral heads in cryogen group showed that bone mineral density significantly reduced after repaire (P=0.015), trabecular space significantly reduced (P=0.001), bone volume fraction significantly enlarged (P=0.036), bone surface/volume fraction (P=0.032) and trabecular numbers (P=0.002) significantly enlarged; trabecular thickness showed no significant difference (P=0.060). Compared with control group, necrotic femoral heads in ethanol group showed that bone mineral density significantly enlarged after repaire (P=0.001), trabecular thickness (P=0.003) and bone surface/volume fraction (P=0.022) significantly enlarged, trabecular space (P=0.001) and bone volume fraction (P=0.001) significantly reduced; the trabecular numbers showed no significant difference (P=0.143). Compared with ethanol group, necrotic femoral heads in cryogen group showed significant lower bone mineral density after repair (P=0.001), significantly lower bone volume fraction (P=0.001), significantly lower trabecular thickness (P=0.001), significantly higher bone surface/volume fraction (P=0.022) and higher trabecular numbers (P=0.003); the trabecular space showed no significant difference (P=0.398).

CONCLUSIONDifferent repair methods make reconstructed femoral head weight bearing area have different bone structure and bone mineral density, along with different bone trabecular quality.

With the in-depth understanding of osteonecrosis of femoral head (ONFH), and more and more patients seeking medical treatment in the early stage of the disease, surgical treatment of femoral head necrosis alone is no longer sufficient for the current treatment of patients' demand, how to rationally and effectively apply drugs to strengthen the early prevention and treatment of femoral head necrosis and delay the progression of disease is becoming more and more important. This article combines the latest expert consensus and evidence-based medical evidence on the principles of ONFH diagnosis and treatment in Chinese and Western medicine at home and abroad, combined with domestic actual clinical application experience, and is organized by experts from Association Related to Circulation Osseous Chinese Microcirculation Society (CSM-ARCO) to write this consensus, focusing on the types of ONFH drugs, the characteristics, safety, rationality and basic principles of drug use provide reference opinions for the safe, reasonable, standardized and effective drug use of medical institutions at all levels. This consensus is only an expert guideline based on literature and clinical experience, not as a requirement for mandatory implementation, let alone as a legal basis. The clinical practice could be tailored to the actual local conditions to develop appropriate prevention and treatment measures for patients.
Humans ; Consensus ; Femur Head ; Femur Head Necrosis/prevention & control*

The reconstruction of femoral length (FL) from fragmentary femora is an essential step in estimating stature from fragmentary skeletal remains in forensic investigations. While regression formulae for doing this have been suggested for several populations, such formulae have not been established for Ghanaian skeletal remains. This study, therefore, seeks to derive regression formulae for reconstruction of FL from fragmentary femora of skeletal samples obtained from Ghana. Six measurements (vertical head diameter, transverse head diameter, bicondylar breadth, epicondylar breadth, sub-trochanteric anterior-posterior diameter, and sub-trochanteric transverse diameter) were acquired from different anatomical portions of the femur and the relationship between each acquired measurement and FL was analyzed using linear regression. The results indicated significantly moderate-to-high correlations (r=0.580–0.818) between FL and each acquired measurement. The error estimates of the regression formulae were relatively low (i.e., standard error of estimate, 13.66–19.28 mm), suggesting that the discrepancies between actual and estimated stature were relatively low. Compared with other measurements, sub-trochanteric transverse diameter was the best estimate of FL. In the absence of a complete femur, the regression formulae based on the assessed measurements may be used to infer FL, from which stature can be estimated in forensic investigations.
Femur ; Ghana ; Head ; Linear Models

Diseases involving hip may influence on the anatomy of the proximal femur, especially on the endosteal canal shape. The simple radiographic comparative study was performed between normal and diseased hips. For the diseasd hip group, 74 hips ol' femoral head AVN(avascular necrosis) (average age: 49.3 years old, patients were all male) who had limped for average l9 months were selected and 77 male hips (average age: 48.9 years old) who had no prior hip disease were selected for the normal hip group. The external shape of both group showed no significant differences except for the femoral head dimensions. Statistically significant differences were ohserved hetween two groups in the proximal endosteal canal shape and cortical thickness. The femur of the diseased hip group had wider canal from the level of distal to lesser trochanter to the level of isthmus, with a significant reduction in the metaphyseal index (the ratio hetween the canal width proximal to lesser trochanter and distal to lesser trochanter) and the canal flare index (p<0.001). Theoretically this study suggests that the optimal fit and fill to the proximal endostcal canals of normal and diseased hips cannot be obtained by oneshape cementless femoral stcms.
Femur* ; Head ; Hip* ; Humans ; Male

An experimental study on the effect of the induced avascular necrosis of the femoral head on the femoral anteversion was made in the hips of 74 three to four-week-old rabbits. The results were as follows; l. In 18 of the 74 operated rabbits, a relative increase of anteversion was observed on the operated side, as compared with the nonoperated femur, the differences ranging from 10 to 75°(average increase was 25.9°). 2. Anteversion increase was actually internal rotation of femoral shaft starting from the subtrochanteric level and progressively increasing downward with spiral fashion. 3. The cause of anteversion increase was not proved in this experiment, but anteversion increase was a result of avascular necrosis.
Femur ; Head ; Hip ; Necrosis ; Rabbits

The presence of anterior hip dislocation along with contralateral posterior hip dislocation in the absence of other major traumas is a distinctly rare injury pattern. We report such a case, along with a review of previous cases. A 40-year-old male patient after motorcycle skidding had posterior dislocation of the left hip and anterior dislocation of the right one without other associated injuries. The patient underwent successful closed reduction of both hips. The clinical course and follow-up assessment of the patient was uneventful.
Anemia, Sickle Cell ; Femur Head ; injuries ; Femur Head Necrosis ; Femur Neck ; Fractures, Spontaneous ; Hip Dislocation ; Humans

PURPOSE: Bone density changes of the femoral head in transient synovitis of the hip were investigated by analyzing the PACS pixel value. MATERIALS AND METHODS: Seventy seven patients diagnosed as unilateral transient synovitis of the hip were investigated. Conventional plain anteroposterior (AP) and frog-leg lateral projection films of the hip were studied for pixel value measurements in PACS. The pixel values of the center of femur head, the periphery of femur head, the femur neck, and the intertrochanter of proximal femur were measured. RESULTS: The pixel value ratios for healthy versus involved sites at the center of the femoral head, at periphery of the femur head and at the femur neck were 1:0.967, 1:0.967 and 1:0.967 on AP view, and 1:0.961, 1:0.955 and 1:0.965 on frog-leg lateral view. The relative pixelvalues were maximally decreased around 2 weeks after symptom onset. After 2 months pixel values of the involved side were nearly normal. CONCLUSION: There was a significant decrease in the pixel value of the involved side, which may have been due to disuse atrophy. Also, the pixel value seemed to be useful for quantifying changes of the bone density in transient synovitis of the hip.
Bone Density* ; Femur ; Femur Head ; Femur Neck ; Head* ; Hip* ; Humans ; Muscular Disorders, Atrophic ; Synovitis*

PURPOSE: To evaluate the usefulness of proximal femoral nail in the treatment of intertrochanteric fracture. MATERIALS AND METHODS: The authors investigated the classificaton of fracture, operation time, the amount of intraoperative and postoperative bleeding, the amount of transfusion, postoperative ambulation status, bone union time and the complication among 45 cases who were treated with proximal femoral nail from Jan. 2001 to June 2002. RESULTS: The mean operation time was 116 minutes, and the amount of bleeding was 524 ml in average. The amount of intraoperative transfusion was 1.4 pints and that of postoperative transfusion was 1.1 pints. The complications were the intraoperative penetration of antirotational screw through the femoral neck in 2 cases, separation of the fracture fragment while inserting the nail in 4 cases, irritation of skin by retropulsion of antirotation screw in 2 cases, and penetration of antirotation screw through femoral head in 1 case. CONCLUSION: Proximal femoral nail was effective for the treatment of intertrochanteric fracture, however the surgeon should be carful about collision of the insertion handle against pelvis when the fracture line coincides with the insertion point of nail, especially in obese patients.
Femur ; Femur Neck ; Head ; Hemorrhage ; Humans ; Pelvis ; Skin ; Walking

PURPOSE: Three-dimensional (3D) effects of the single plane osteotomies of the proximal femur are compared and analyzed by the trigonometric method. MATERIALS AND METHODS: The shape of proximal femur was simplified as a bent line. The bent line is the continuation of the three points-the center of the femoral head, the center of femoral neck at the base, and the center of the femoral shaft. Then rotated the proximal femur at the junction of the neck and shaft with the each rotation axis of X, Y, Z, defined the frontal plane as a XY plane, sagittal plane as a YZ plane, and transverse plane as a XZ plane. RESULTS: The varus osteotomy of the proximal femur in the frontal plane with the rotation axis 'Z' that meant the increase of the X coordinate and the decrease of Y coordinate with constant Z coordinate (Deltax>Deltay, Deltaz=0) resulted in decreased anteversion in the transverse plane and increased flexion in the sagittal plane. The derotation osteotomy (Deltax>Deltaz, Deltay=0) resulted in varus in the frontal plane and extension in the sagittal plane. The flexion osteotomy (Deltaz>Deltay, Deltax=0) resulted in increased anteversion in the transverse plane and varus in the frontal plane. CONCLUSION: Single plane osteotomy for the proximal femur results in the angular correction in all three planes and may have the similar 3D effect of the certain double or triple osteotomy. So single plane osteotomy could be enough to correct some complex deformities.
Axis ; Congenital Abnormalities ; Femur Neck ; Femur* ; Head ; Neck ; Osteotomy*