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Adult Hepatoblastoma

case report
by

Eyad alakkas

on 25 May 2016

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Transcript of Adult Hepatoblastoma

Hip avscular necrosis
Conclusion
Dr. Eyad alakkas

* Orthopeadic Resident
PGY -2

General assessment and clinical case discussion
Thank
you
Normal AP
CMC dic
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
Louis solomon

campbells operative orthopeadics
Reference
Rockwood and Greens Fractures in Adults, 7th edition

4 = 1
EPIDEMIOLOGY
Introduction
50 % bilateral
anatomy of
blood supply
coagulation of intraosseous
microcirculation

venous thrombosis
retrograde arterial occlusion
intraosseous
hypertension
decrease blood flow tofemoral head
ischemia and necrosis tissue
reactive new bone formation around necrotic bone
granulation tissue
over necrosed bne
( sclerosis )

structural failure - subchondral fracture
Early
2001
Risk factors
presentation
Radiology
Classification
Ficat Classification
Prognosis
Delbet classification
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 .
=
>
differential diagnosis
- Transient osteoprosis of the hip
Age :
middle age men , pregnant women
MRI :
increased signal throught the head
and neck
.
self limiting
conservative mangment .
- femoral neck fracture ??
- transtrochanteric rotational osteotomy
precollapse stage
segmintal defect
not envolved all femur head surface
Full transcript