Open Fracture of the Femoral Neck in an Adult: Case Report and Surgical Solution.

Autor:	Campos RS; Cirurgião Ortopédico, Serviço de Ortopedia, Hospital Estadual Alberto Torres (HEAT-RJ), Rio de Janeiro, RJ, Brasil., Correia MA; Cirurgião Ortopédico, Centro de Trauma Ortopédico, Instituto Nacional de Traumatologia e Ortopedia (INTO-RJ), Rio de Janeiro, RJ, Brasil., Menezes R; Cirurgião Ortopédico, Serviço de Ortopedia, Hospital Estadual Alberto Torres (HEAT-RJ), Rio de Janeiro, RJ, Brasil., Duarte MEL; Pesquisador, Divisão de Pesquisa, Instituto Nacional de Traumatologia e Ortopedia (INTO-RJ), Rio de Janeiro, RJ, Brasil., Guimarães JAM; Chefe da Divisão de Ensino e Pesquisa do Instituto Nacional de Traumatologia e Ortopedia (INTO-RJ), Rio de Janeiro, RJ, Brasil.
Jazyk:	angličtina
Zdroj:	Revista brasileira de ortopedia [Rev Bras Ortop (Sao Paulo)] 2021 Mar 22; Vol. 58 (4), pp. e662-e666. Date of Electronic Publication: 2021 Mar 22 (Print Publication: 2023).
DOI:	10.1055/s-0040-1721842
Abstrakt:	Intracapsular proximal femoral fracture is a frequent injury in elderly patients, often associated with low-energy trauma and reduced bone mass. In young patient, it is uncommon, usually caused by high-energy trauma and accompanied by damage to the adjacent soft tissues. However, reports of open intracapsular proximal femoral fracture due to indirect trauma are rare in the orthopedic literature. In the present article, we describe a case of this injury in a 35-year-old man involved in a car accident. The proximal femur was exposed at the gluteal region due to a mechanism similar to dislocation of the posterior hip. We describe the initial treatment and subsequent management until achieving a definitive solution using total hip arthroplasty and muscle transfer to reconstruct the abductor mechanism of the hip. At 10 months of follow-up, the patient presented good functional outcome, with gradual recovery of the abductive strength and a Harris Hip Score of 91 points. In addition, a radiographic study showed that the cemented total prosthesis was well-positioned. This therapeutic strategy (total hip arthroplasty with muscle transfer to reconstruct the abductor musculature) was successful to treat an intracapsular proximal femoral fracture with bone exposure. Competing Interests: Conflito de Interesses Os autores declaram não haver conflito de interesses. (Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)
Databáze:	MEDLINE
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