| Autor: |
Yaser E. Khalifa, Hesham A. Elkady, Ahmad M. Abdel-Aal, Ali M. Khalil |
| Rok vydání: |
2010 |
| Předmět: |
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| Zdroj: |
Current Orthopaedic Practice. 21:390-395 |
| ISSN: |
1940-7041 |
| DOI: |
10.1097/bco.0b013e3181dade5a |
| Popis: |
Pathologic proximal femoral fracture complicating an aneurysmal bone cyst is a situation sometimes met in clinical practice. It combines the difficulties of tumor eradication, reconstruction of the created bone defect and rigid fixation of the fracture with preservation of the femoral head in young patients. This study included eight patients who presented with pathologic proximal femoral fractures that proved to be aneurysmal bone cysts. There were six women and two men. The ages ranged from 18–28 years. Surgical treatment consisted of curettage and grafting of the lesion and internal fixation of the fracture. Four internal fixation devices were used. A dynamic hip screw was used in three patients, a 130°-angled blade plate in two patients, a condylar blade-plate in two patients and in one patient with severe bone loss, a barrel plate (150°) was used with a fibular graft inserted inside the barrel and impacted into the femoral head. Follow-up ranged from 6–42 months. All fractures united. No recurrence of the tumor was seen until the latest follow-up. Failure of fixation occurred in one patient after fracture collapse and migration of the dynamic hip screw. Overall results were excellent in six patients and good in two patients (using modified Hospital for Special Surgery score). The ideal treatment plan includes effective curettage through a wide exposure in addition to cancellous bone grafting and rigid internal fixation with the optional use of a fibular strut graft in difficult cases. All devices designed for the proximal femur can be used provided that there is anatomical reduction and rigid fixation. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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