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Transcript of Adult Hepatoblastoma
Dr. Eyad alakkas
* Orthopeadic Resident
General assessment and clinical case discussion
5 - 18 % of total hip arthroplasties performed in US
20,000 per year
Then we realized , that we might be free falling
without a parachute
Review of orthopaedics sixth edition
MARK D. MILLER
Apley's System of orthopeadics and fractures
campbells operative orthopeadics
Rockwood and Greens Fractures in Adults, 7th edition
4 = 1
50 % bilateral
coagulation of intraosseous
retrograde arterial occlusion
decrease blood flow tofemoral head
ischemia and necrosis tissue
reactive new bone formation around necrotic bone
over necrosed bne
( sclerosis )
structural failure - subchondral fracture
femoral neck fractures resulting in avascular necrosis can be predicted by using:
Type I ___ transphyseal fractures
very high risk of AVN ( approaches100%)
Type II ___ transcervical fractures
moderate risk of AVN (50%)
Type III ___ basicervical or cervicothoracic fractures
low risk of AVN (20% _ 30% )
Type IV ___ intertrochanteric fractures
very low risk of AVN (10% _ 15% )
- most common risk factor : post traumatic .
- Fify percent rate of bilateral involvement
( always image other hip )
- treatment based on age and whether the head is collapsed
- core decompression is contraindicated if on chronic steroids .
- Transient osteoprosis of the hip
middle age men , pregnant women
increased signal throught the head
conservative mangment .
- femoral neck fracture ??
- transtrochanteric rotational osteotomy
not envolved all femur head surface