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J Orthop Traumatol 2022 Jun 28;23(1):27. Epub 2022 Jun 28.

Academic Department of Trauma & Orthopaedics, School of Medicine, University of Leeds, Clarendon Wing, Level D, Great George Street, Leeds, LS1 3EX, West Yorkshire, UK.

Introduction: Intramedullary (IM) nails are considered the 'gold' standard treatment for subtrochanteric femoral fractures. The incidence and risk factors for re-operation in subtrochanteric fractures remain unclear. Furthermore, no studies have compared the outcomes of different nailing systems used to treat subtrochanteric fractures in the same study population. Read More

Pediatr Rheumatol Online J 2022 Jun 18;20(1):44. Epub 2022 Jun 18.

NW Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK.

Background: Juvenile idiopathic arthritis is the most common chronic rheumatic disease of childhood. The term JIA encompasses a heterogenous group of diseases. The variability in phenotype of patients affected by the disease means it is not uncommon for mimics of JIA to be misdiagnosed. Read More

Radiol Case Rep 2022 Aug 8;17(8):2815-2819. Epub 2022 Jun 8.

Department of Trauma and Orthopaedics, Diana Princess of Wales Hospital, DN33 2BA, Grimsby, United Kingdom.

We report the unorthodox use of a retrograde intramedullary nail via antegrade technique for the treatment of a subtrochanteric pathological femur fracture in the presence of significant coxa vara. No similar use has been documented previously in literature. A standard approach to the proximal right femur was performed and standard antegrade technique used to introduce a guide wire into the proximal femur after which the femoral shaft was reamed. Read More

J Pediatr Orthop 2022 Jul 10;42(6):e661-e666. Epub 2022 Mar 10.

Children's Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, CA.

Background: The proximal femur is a common location for pathologic fractures in children, yet there is little published information regarding this injury. The purpose of this study was to investigate the outcomes of pediatric pathologic proximal femur fractures due to benign bone tumors.

Methods: A retrospective review of patients treated for pathologic proximal femur fractures from 2004 to 2018 was conducted. Read More

Int J Mol Sci 2022 Apr 12;23(8). Epub 2022 Apr 12.

School of Engineering, Brown University, Providence, RI 02912, USA.

Camptodactyly-arthropathy-coxa vara-pericarditis (CACP) syndrome leads to diarthrodial joint arthropathy and is caused by the absence of lubricin (proteoglycan 4-PRG4), a surface-active mucinous glycoprotein responsible for lubricating articular cartilage. In this study, mice lacking the orthologous gene served as a model that recapitulates the destructive arthrosis that involves biofouling of cartilage by serum proteins in lieu of Prg4. This study hypothesized that Prg4-deficient mice would demonstrate a quadruped gait change and decreased markers of mitochondrial dyscrasia, following intra-articular injection of both hindlimbs with recombinant human PRG4 (rhPRG4). Read More

Children (Basel) 2022 Mar 28;9(4). Epub 2022 Mar 28.

Pediatric Orthopedic Surgeon, Department of Pediatric Orthopedic Surgery, Emergency Hospital for Children "Grigore Alexandrescu", 011743 Bucharest, Romania.

Background: Slipped capital femoral epiphysis is due to proximal femur physis failure in adolescent patients. Early iatrogenic closure of proximal growth cartilage in children with significant residual growth potential causes complications such as coxa breva, coxa vara, and lower limb length inequalities. The Free-Gliding SCFE Screw System is a self-extending cannulated screw used in Slipped Capital Femoral Epiphysis (SCFE) fixation and femoral neck fractures. Read More

J Orthop Case Rep 2021 Dec;11(12):69-72

Department of Trauma and Emergency, Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Introduction: Hypokalemic periodic paralysis (HPP) is an important and a reversible but rare cause of paralysis. Periodic paralyses are of two types. The first one is primary which is also known as familial type and the second one is secondary periodic paralysis which is due to other underlying pathologies [1]. Read More

Clin Imaging 2022 Jun 30;86:94-97. Epub 2022 Mar 30.

Dept. of Orthopedics, Phoenix Children's Hospital, 1919 E. Thomas Rd., Phoenix, AZ 85016, United States of America. Electronic address:

We present a case of spondyloepiphyseal dysplasia congenita (SEDC), a rare autosomal dominant genetic disorder that results in short stature and skeletal anomalies. Children with SEDC have disproportionate short-trunked short stature, platyspondyly, coxa vara, and epiphyseal involvement. Those with coxa vara can develop osteoarthritis of the hip early and a valgus hip osteotomy is recommended to preserve hip function and delay progression to osteoarthritis. Read More

World J Orthop 2022 Mar 18;13(3):329-338. Epub 2022 Mar 18.

Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Section of Orthopaedics and Traumatology, Tor Vergata Hospital, Rome 00133, Italy.

Background: Surgical correction of femoral deformities in polyostotic fibrous dysplasia (PFD) or McCune-Albright syndrome (MAS), such as coxa vara or shepherd's crook deformity, is a challenge.

Aim: To evaluate the treatment of patients with femoral deformities caused by PDF or MAS treated by osteotomies and stabilized with different methods, by analyzing the most relevant studies on the topic.

Methods: A literature search was performed in Medline database (PubMed). Read More

Eur J Trauma Emerg Surg 2022 Mar 15. Epub 2022 Mar 15.

Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong, People's Republic of China.

Purpose: This study is aimed to evaluate the clinical effects of anteromedial support plate combined with three cannulated screws on Pauwels type III femoral neck fractures in young adults.

Methods: We conducted a retrospective study of 27 patients with Pauwels type III femoral neck fracture treated by anteromedial support plate combined with three cannulated screws. The results of fracture healing and complications for all patients were assessed by postoperative imaging examination. Read More

Cureus 2022 Jan 22;14(1):e21496. Epub 2022 Jan 22.

Orthopedics and Traumatology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, IND.

Fibrous dysplasia is a rare benign intramedullary fibro-osseous lesion characterized by fibro-osseous proliferation with intervening areas of normal or immature bone. It can either be a monostotic or a polyostotic presentation. The etiology of fibrous dysplasia has been linked with a missense mutation in the GNAS1 gene on chromosome 20. Read More

Acta Biomater 2022 03 7;141:233-243. Epub 2022 Jan 7.

Department of Trauma and Orthopaedic Surgery, Division of Orthopaedics, University Medical Center Hamburg-Eppendorf, Germany. Electronic address:

Skeletal adaptation is substantially influenced by mechanical loads. Osteocytes and their lacuno-canalicular network have been identified as a key player in load sensation and bone quality regulation. In the femoral neck, one of the most common fracture sites, a complex loading pattern with lower habitual loading in the superolateral neck and higher compressive stresses in the inferomedial neck is present. Read More

Ulus Travma Acil Cerrahi Derg 2022 Jan;28(1):107-112

Department of Orthopedics and Traumatology, Dicle University Faculty of Medicine, Diyarbakır-Turkey.

Background: Fractures of proximal femur are rarely seen in childhood. These fractures can result in serious complications such as avascular necrosis (AVN), coxa vara, and early closure of the femoral epiphysis. The aim of this study is to investigate retrospectively the Delbet type 2 fractures that are commonly seen and has high rates of AVN. Read More

Am J Case Rep 2021 Dec 19;22:e933919. Epub 2021 Dec 19.

Department of Paediatric Endocrine, Parc Taulí University Hospital, Parc Taulí I3PT Research and Innovation Institute, Autonomous University of Barcelona, Sabadell, Spain.

BACKGROUND Moyamoya syndrome is a rare cerebrovascular condition caused by blockage of the arteries of the basal ganglia. The Japanese word "moyamoya" means "a puff of smoke" which describes the appearance of the collateral compensatory vessels that develop over time. Microcephalic osteodysplastic primordial dwarfism type II (MOPD II) is a rare genetic syndrome characterized by microcephaly and short stature. Read More

Ther Clin Risk Manag 2021 19;17:1199-1207. Epub 2021 Nov 19.

Medical School of Chinese PLA, Beijing, 100853, People's Republic of China.

Objective: We aimed to demonstrate the methods of treatment for coxa vara with modular total hip arthroplasty (THA) and evaluate clinical and radiographic outcomes, and further survivorship at the midterm follow-up.

Methods: We retrospectively reviewed 33 patients (42 hips) who underwent modular THA for coxa vara deformity from May 2008 to December 2019. The clinical and radiographic results, including Harris Hip Score (HHS), leg length discrepancy (LLD), greater trochanteric height, femoral offset, abductor lever arm, stem alignment and limp, and complications, were evaluated. Read More

Medicine (Baltimore) 2021 Nov;100(45):e26829

Department of Orthopaedics, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, Hebei, People's Republic of China.

Abstract: To investigate the clinical effects of a new intertrochanteric valgus osteotomy technique designed by the authors for treatment of post-traumatic coxa varus after proximal femur fractures. Retrospectively analyzed 11 patients who developed coxa vara after sustaining proximal femoral fractures were treated with intertrochanteric valgus osteotomy from December 2005 to December 2018 in our hospital. This study included 6 cases of intertrochanteric fracture deformity union, 3 cases of subtrochanteric fracture nonunion and 2 cases of femoral neck fracture nonunion. Read More

J Bone Joint Surg Am 2022 04;104(Suppl 2):61-67

Department of Orthopaedic Trauma and Microsurgery, Zhongnan Hospital of Wuhan University.

Background: Old femoral neck fracture (OFNF) generally refers to fractures for more than 3 weeks. Corticoperiosteal pedicle flap of greater trochanter (CPPF-GT) was designed to restore blood supply and donor bone for OFNF. This study aimed to assess the efficacy and radiographic results of CPPF-GT for treatment of OFNF in children after a minimum 5 years follow-up. Read More

Injury 2022 Mar 1;53(3):1196-1201. Epub 2021 Oct 1.

Department of Orthopedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India. Electronic address:

Neck of femur fractures have often been termed as "The Unsolved Fractures", since they have a guarded outcome even after improved understanding of biomechanics and biology of this area. Gap-nonunion is one such dreaded complication of this fracture, especially in younger (<60 years) population, where arthroplasty may not be the best go-to option. We have earlier described "The AIIMS BOX" technique to manage such cases of gap non-union in neglected neck femur fractures [1]. Read More

BMJ Case Rep 2021 Oct 5;14(10). Epub 2021 Oct 5.

Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospital, New Delhi, India.

A 23-year-old female-treated patient of osteomalacia and secondary hyperparathyroidism with hypophosphatemia presented with a 5-year history of bilateral groin pain and stiffness of both hips and difficulty in walking. Plain radiographs of the pelvis showed bilateral coxa vara deformity. She was managed surgically by a single-stage bilateral subtrochanteric corrective osteotomy with the internal fixation. Read More

Eur J Orthop Surg Traumatol 2021 Sep 20. Epub 2021 Sep 20.

Department of Orthopedic and Traumatology, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey.

Objective: Pediatric proximal femur fracture is extremely rare trauma comparing to other fractures. The proximal femur fracture is 1% of all pediatric fractures. The aim of current study is to compare the incidence of early complications and outcomes of pediatric proximal femur fractures regarding fracture types retrospectively. Read More

Cureus 2021 Jul 31;13(7):e16776. Epub 2021 Jul 31.

Orthopaedics, All India Institute of Medical Sciences, Rishikesh, IND.

Introduction A neck of femur fracture is a rare injury in the pediatric population and is of foremost importance, as it is associated with a high rate of complications. It usually occurs due to high-velocity trauma or a fall from a height. There is a scarcity of data on risk factors and their role in the prognostication of avascular necrosis. Read More

Clin Orthop Relat Res 2021 Oct;479(10):2169-2180

The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway.

Background: The Corail® cementless stem (DePuy Synthes) has been used in Norway since 1987 and is one of the most frequently used stems in THA worldwide. Although the published survival results of the standard Corail stem have been good, little is known about the long-term (more than 20 years) survival of other stem design variants. Further, some changes were made to the extramedullary part of the stem in 2003, and the effect of these changes on survival is unknown. Read More

Calcif Tissue Int 2021 09 21;109(3):291-302. Epub 2021 Aug 21.

Lancaster Medical School, Faculty of Health & Medicine, Lancaster University, Lancaster, UK.

Osteoarthritis (OA) is one of the most prevalent conditions in the world, particularly in the developed world with a significant increase in cases and their predicted impact as we move through the twenty-first century and this will be exacerbated by the covid pandemic. The degeneration of cartilage and bone as part of this condition is becoming better understood but there are still significant challenges in painting a complete picture to recognise all aspects of the condition and what treatment(s) are most appropriate in individual causes. OA encompasses many different types and this causes some of the challenges in fully understanding the condition. Read More

Afr J Paediatr Surg 2021 Oct-Dec;18(4):224-230

Center of Pathobiochemistry and Genetics, Medical University of Vienna, Austria.

Background: Infantile systemic hyalinosis (ISH) is an autosomal recessively inherited disorder. The classical natural history of the disease is characterised by hypotonia, multiple contractures, skin lesions, osteopenia, joint pain, bone fractures, persistent diarrhoea and growth deficiency.

Materials And Methods: Two children manifested the severe type of ISH underwent genotypic confirmation. Read More

Int J Burns Trauma 2021 15;11(3):207-219. Epub 2021 Jun 15.

Department of Orthopaedic Surgery, J. N. Medical College, Faculty of Medicine, A.M.U. Aligarh, India.

Background: Optimum treatment of pathological fractures following benign bone tumours in paediatric population is controversial. The usual difficulties encountered while dealing such cases is to establish a correct pre-operative diagnosis and to choose between conservative vs operative management. The aim of the work is to highlight the difficult aspects of diagnosis and management of pathological fractures following benign bone tumours in paediatric population. Read More

Indian J Orthop 2021 Jul 18;55(Suppl 2):501-507. Epub 2021 Mar 18.

B J Medical College, Civil hospital, Ahmedabad, Gujarat India.

A bilateral neck of femur fracture in children is a rare occurrence with only twelve cases reported till the date. We report a case of a 3-year-old schoolgirl with bilateral Delbet type 2 fracture neck femur after a fall from height. She was managed elsewhere by bilateral closed reduction and screw fixation within 24 h. Read More

Children (Basel) 2021 Jun 10;8(6). Epub 2021 Jun 10.

Joint Preservation and Limb Reconstruction Center, Jupiter, FL 33477, USA.

Congenital femoral deficiency (CFD) Paley type 1b is characterized by severe bony deformity of the upper femur, extra-articular contractures of the hip, and delayed ossification of the femoral neck and/or subtrochanteric region. The Systematic Utilitarian Procedure for Extremity Reconstruction of the hip (SUPERhip) procedure for the correction of CFD deformities was developed in 1997. Initially, a non-fixed angle device (rush rod) was used for fixation. Read More

J Hip Preserv Surg 2021 Jun 23;8(Suppl 1):i4-i8. Epub 2021 Jun 23.

Department of Orthopaedic Surgery, McMaster University, 1200 Main St W, Hamilton, ON L8N 3Z5, Canada.

There is a lack of consensus around optimal surgical management for Legg-Calvé-Perthes Disease (LCPD). This case report discusses the benefits of combining arthroscopic femoral neck osteochondroplasty and labral repair with Morscher's Osteotomy (MO) for LCPD. S. Read More

Mol Syndromol 2021 Apr 1;12(2):112-117. Epub 2021 Feb 1.

Department of Medical Genetics, AGENTEM, Cukurova University Faculty of Medicine, Adana, Turkey.

Camptodactyly-arthropathy-coxa vara-pericarditis (CACP) syndrome, caused by biallelic pathogenic mutations in the gene, is characterized by early-onset camptodactyly, noninflammatory arthropathy, coxa vara deformity, and rarely, pericardial effusion. Herein, we report 3 patients with CACP syndrome from 2 unrelated families. All patients are female, born to consanguineous parents, and had camptodactyly since the first years of their lives. Read More