Non-Union of Fracture Neck of Femur.pptx

Case of comminuted fracture neck of femur, fibula graft, DHS, Cannulated screw

1. Comminuted Fracture Neck
Femur — Case report

Vinod Naneria
Girish Yeotikar
Arjun Wadhwani
Manish Ladhania

2. Case summary

+ 35 yr M, had RTA in Aug 2022.

* Fixation done with a DHS, additional compression
screw and Fibula graft.

* Non weight bearing for 3 months.

+ Was advised THR.

* Patient decided to wait.

« Weight bearing started.

* Jan 2023, x-rays showing reduction in fracture gap.
+ CT scan done in Aug 2023.

3. RTA Aug 2022 |

4. EN

E

After, 3 months? /

N
E

5. 82:95:21 202/14 /S0 JYOONI ‘avou ‘av 1
LHOEZbZ -:Lvd 6SLSL - SIE Lb

6. Jan 2023

7. AN
June 2023 |

13. problems

+ CT scan report - sclerosis at the fracture lines.
* No loosening of implants.

* No sign of AVN.

* No loss of position in AP and Lateral views.

* Valgus angle at fracture site looks OK:

14. Follow up — Aug 2024

* Two years passed since injury and fixation.
* Patient walking with full weight bearing.

+ No pain.

* Barely perceptible limp.

* Discomfort at trochanteric site.

« Difficulty in sitting cross legged.

15. … } Aug 2024 7
A

16. Aug 2024

19. CT & MRI OF THE LEFT HIP

CLINICAL HISTORY: Follow up study.

TECHNIQUE: Multiplanar multi echo MRI of the left hip joint. Compared with the
prior study dated Isep 2023

IMAGING FINDINGS:

Status post femur neck fracture fixation with dynamic hip screw and plate. Plate and
femoral screws show good osseous integration. The fracture is completely healed.
There is no overt heardware related complication. No joint effusion. No bursal fluid.
No evidence of collection. No evidence of any discharging sinus. An ill defined
serpenginous area of sclerosis and T1 hypointensity is seen in the posterior medial left
femoral head involving less than 25% of the articular surface with subtle marrow
edema. No femoral head collapse.

20. Disclaimer

Information contained and transmitted by this presentation is
based on personal experience and collection of cases at
Choithram Hospital & Research centre, Indore, India, during last
40 years.

It is intended for use only by the students of orthopaedic
surgery.

Views and opinion expressed in this presentation are personal
opinion.

Depending upon the x-rays and clinical presentations, viewers
can make their own opinion.

For any confusion please contact the sole author for clarification.

Every body is allowed to copy or download and use the material
best suited to him. Authors are not responsible for any
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