10,234 results match your criteria Femoral Head Avascular Necrosis


Evaluation of avascular necrosis risk factors after closed reduction for developmental dysplasia of the hip before walking age.

J Pediatr Orthop B 2021 Jun 9. Epub 2021 Jun 9.

Department of Orthopaedics and Traumatology Department of Radiology, Harran University Faculty of Medicine, Şanliurfa/Turkey Department of Orthopaedics and Traumatology, Dr. Sami Ulus Maternity and Child Health Training and Research Hospital, Ankara/Turkey.

Avascular necrosis (AVN) of the femoral head is one of the most important complications after closed reduction and spica cast application in developmental dysplasia of the hip (DDH) treatment. This study aims to put forth the impact of closed reduction age and other factors which can cause AVN. Inclusion criteria of the study were: closed reduction and spica cast application before walking age (12 months) and minimum 2 years duration of follow-up. Read More

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Evaluation of the clinical efficacy of 3D Printing technology assisted surgery combined with early postoperative comprehensive rehabilitation in the treatment of Senile Intertrochanteric Fractures.

Pak J Med Sci 2021 May-Jun;37(3):740-745

Xin-xin Zhang, Department of Orthopedics, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, Henan 471000, P.R.China.

Objectives: To observe the clinical value of 3D printing technology assisted surgery combined with early postoperative comprehensive rehabilitation in elderly patients with intertrochanteric fractures.

Methods: Sixty elderly patients with intertrochanteric fractures of the femur who were treated in our hospital from January 2018 to January 2020 were selected and randomly divided into two groups. In the experimental group, 3D printing technology assisted surgery combined with early postoperative comprehensive rehabilitation was used for treatment. Read More

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METHODS OF TREATMENT OF LEGG-СALVÉ-PERTHES DISEASE (REVIEW).

Georgian Med News 2021 Apr(313):127-134

1NСJSC "Semey Medical University", Department of children's surgery and orthopedics; 2NСJSC "Astana Medical University", Department of children's surgery, Nur-Sultan, Republic of Kazakhstan; 3Republican Scientific and Practical Center of Traumatology and Orthopedics, Minsk, Belarus.

This Literature Review presents various treatments, including operative and conservative therapies, of Legg - Calvé - Perthes Disease. The problem is relevant because of the prevalence of the disease. The authors presented a review of literature, which managed to classify the main methods of treatment by the principles of action, practical application, and presented the interpretation of the effectiveness of modern research from the point of view of evidence-based medicine. Read More

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A novel mutation of COL2A1 in a large Chinese family with avascular necrosis of the femoral head.

BMC Med Genomics 2021 Jun 4;14(1):147. Epub 2021 Jun 4.

Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated the Sixth People's Hospital, 600 Yi-Shan Rd., Shanghai, 200233, People's Republic of China.

Avascular necrosis of the femoral head (ANFH) is a debilitating bone disease, characterized by collapse of the femoral head and subsequent loss of hip joint function. Heterozygous mutations in COL2A1 have been identified to cause familial ANFH. Here we report on a large Chinese family with ANFH and a novel heterozygous mutation (c. Read More

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The efficacy of acupuncture and moxibustion for early and middle-stage osteonecrosis of the femeral head: A systematic review and meta-analysis of randomized controlled trials.

Medicine (Baltimore) 2021 Jun;100(22):e26210

Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang City, Jiangxi Province, China.

Background: Osteonecrosis of the femeral head (ONFH) occurs predominantly in young- and middle-aged people, and the disability rate is high in the late stage of the disease and most patients have to undergo total hip replacement. Clinically, increasing attention is paid to intervening early and middle-stage ONFH so as to delay its progress. Acupuncture and moxibustion (AM) is a unique method for treating ONFH in China. Read More

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Recombinant human FGF-2 for the treatment of early-stage osteonecrosis of the femoral head: TRION, a single-arm, multicenter, Phase II trial.

Regen Med 2021 Jun 2. Epub 2021 Jun 2.

Department of Orthopedic Surgery, Gifu University, Gifu, 501-1194, Japan.

This study aimed to evaluate the 2-year outcomes from a clinical trial of recombinant human FGF-2 (rhFGF-2) for osteonecrosis of the femoral head (ONFH). Sixty-four patients with nontraumatic, precollapse and large ONFHs were percutaneously administered with 800 μg rhFGF-2 contained in gelatin hydrogel. Setting the end point of radiological collapse, we analyzed the joint preservation period of the historical control. Read More

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Open reduction, Dega osteotomy and proximal femoral osteotomy in delayed diagnosis of developmental hip dislocation: outcome at 40-year follow-up.

J Child Orthop 2021 Apr;15(2):171-177

Department of Pediatric Orthopaedics and Traumatology, Poznan University of Medical Sciences (Dega Hospital), Poznan, Poland.

Purpose: Late-diagnosed dislocated hips underwent open reduction, Dega osteotomy, and proximal femoral osteotomy between 1968 and 1988. The objectives of this study are to assess the survival of hips into adulthood, clinical and radiological outcome, patients' life perspectives and the risk factors of failure.

Methods: An assessment of 67 hips treated when younger than five years (Read More

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Dexamethasone promotes the endoplasmic reticulum stress response of bone marrow mesenchymal stem cells by activating the PERK-Nrf2 signaling pathway.

Pharmacol Res Perspect 2021 May;9(3):e00791

Department of Orthopaedics, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.

The pathogenesis of steroid-induced avascular necrosis of femoral head (SANFH) is complex, and there is a lack of effective early prevention method. The aim of the present study was to evaluate the effect of dexamethasone (DEX) on the biological behavior of bone marrow mesenchymal stem cells (BMSCs) and to explore the possibility of DEX in the clinical treatment of SANFH. The effect of DEX on the proliferation of BMSCs was evaluated by Counting Kit-8 assay, western blot assay, and enzyme-linked immunosorbent assay. Read More

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Avascular femoral necrosis as part of Cushing syndrome presentation: a case report.

J Med Case Rep 2021 May 26;15(1):287. Epub 2021 May 26.

Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, 4200-319, Porto, Portugal.

Background: The clinical characteristics and complications of Cushing syndrome (CS) are well known and described in the literature. Nevertheless, rare, atypical presentations may go unnoticed. Osteonecrosis is a well-documented complication of glucocorticoid therapy. Read More

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[Expression of Ras-Associated Protein 1 in the Vascular Endothelium of Bone Tissue with Non-Traumatic Osteonecrosis of Femoral Head].

Sichuan Da Xue Xue Bao Yi Xue Ban 2021 05;52(3):452-457

Gansu University of Chinese Medicine, Lanzhou 730000, China.

Objective: To investigate the difference in the expression of Ras-associated protein 1 (Rap1) in necrotic and healthy areas of non-traumatic osteonecrosis of femoral head (NONFH) patients.

Methods: Femoral head tissue samples from 30 cases of NONFH and 30 cases of traumatic osteonecrosis of the femoral head (TONFH) were collected after hip replacement surgery, respectively. No significant difference of Association Research Circulation Osseous (ARCO) staging was found between the NONFH and the TONFH groups ( =-0. Read More

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Pediatric skeletal diffusion-weighted magnetic resonance imaging, part 2: current and emerging applications.

Pediatr Radiol 2021 May 21. Epub 2021 May 21.

Division of Pediatric Radiology, Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY, 14642, USA.

Diffusion-weighted imaging (DWI) complements the more established T1, fluid-sensitive and gadolinium-enhanced magnetic resonance pulse sequences used to assess several pediatric skeletal pathologies. There is optimism that the technique might not just be complementary but could serve as an alternative to gadolinium and radiopharmaceuticals for several indications. As a non-contrast, free-breathing and noninvasive technique, DWI is especially valuable in children and is readily incorporated into existing MRI protocols. Read More

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Targeting DKK1 prevents development of alcohol-induced osteonecrosis of the femoral head in rats.

Am J Transl Res 2021 15;13(4):2320-2330. Epub 2021 Apr 15.

Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities Baise 533000, Guangxi, China.

Osteonecrosis of the femoral head (ONFH) is a devastating bone disease characterized by avascular or aseptic necrosis of the femoral head, and alcohol consumption is reported one of the leading risks to this disease. Previous studies have linked Dickkopf-1 (DKK1) to the occurrence of ONFH, but the role of DKK1 in alcohol-induced ONFH (AONFH) has not been fully discussed. In this study, we found that the expression level of DKK1 was dramatically increased in serum and bone samples from AONFH patients, experimental AONFH rats, and cultured bone marrow mesenchymal stem cells (BMMSCs) with ethanol stimulation. Read More

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Total Hip Arthroplasty in a Patient with Mucopolysaccharidosis Type IVB.

Case Rep Orthop 2021 28;2021:5584408. Epub 2021 Apr 28.

Department of Orthopedic Surgery, ENDO-Klinik Hamburg, Holstenstr. 2, 22767 Hamburg, Germany.

. Morquio syndrome or mucopolysaccharidosis (MPS) type IV is a rare autosomal recessive lysosomal storage disease, characterized by abnormal metabolism of glycosaminoglycans associated with specific skeletal deformities, also known as dysostosis multiplex. . Read More

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[Short-term effectiveness of femoral neck system in the treatment of femoral neck fracture].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 May;35(5):539-543

Orthopedics Center, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan Ningxia, 750001, P.R.China.

Objective: To investigate the short-term effectiveness of femoral neck system (FNS) in the treatment of femoral neck fracture.

Methods: The clinical data of 34 patients with femoral neck fracture admitted between January 2019 and April 2020 who met the selection criteria were retrospectively analyzed and divided into group A (19 patients were treated with conventional cannulated screw internal fixation) and group B (15 patients were treated with FNS internal fixation) according to the different methods of internal fixation. There was no significant difference between the two groups in general data such as gender, age, affected side, cause of injury, fracture type, and time from injury to operation ( >0. Read More

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Treatment of Traumatic Femoral Neck Fractures with an Intramedullary Nail in Osteoporotic Bones.

Indian J Orthop 2021 Jun 11;55(3):621-628. Epub 2021 Mar 11.

ATORG-Aschaffenburg Trauma and Orthopaedic Research Group, Center for Orthopaedics, Trauma Surgery and Sports Medicine, Hospital Aschaffenburg-Alzenau, Am Hasenkopf 1, 63739 Aschaffenburg, Germany.

Purpose: Sufficient anchoring of intramedullary osteosynthesis in the femoral head in a femoral neck fracture is a challenge with increasing age of the patients and decreasing bone quality. For older patients with inferior bone quality, it has not been investigated whether the application of an intramedullary force carrier, as a minimally invasive and rapid intervention, can provide a considerable benefit and reduce the postoperative complication and lethality rate. This retrospective study aimed to investigate the stability and functionality after the acute treatment of a femoral neck fracture in osteoporotic bone using an intramedullary force carrier even with higher grade fracture types. Read More

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Atorvastatin Upregulates microRNA-186 and Inhibits the TLR4-Mediated MAPKs/NF-κB Pathway to Relieve Steroid-Induced Avascular Necrosis of the Femoral Head.

Front Pharmacol 2021 16;12:583975. Epub 2021 Apr 16.

Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Medical Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.

Steroid-induced avascular necrosis of the femoral head (SANFH) is caused by the death of active components of the femoral head owing to hormone overdoses. The use of lipid-lowering drugs to prevent SANFH in animals inspired us to identify the mechanisms involving Atorvastatin (Ato) in SANFH. However, it is still not well understood how and to what extent Ato affects SANFH. Read More

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Efficacy of orthobiologic adjuvants to core decompression for hip preservation in avascular necrosis hip.

J Hip Preserv Surg 2020 Aug 22;7(3):423-438. Epub 2020 Nov 22.

Department of Orthopaedics, PGIMER, Chandigarh 160012, India.

Head preserving modalities in avascular necrosis (AVN) hip are variably effective in early stages, and further options that could prevent head distortion and osteoarthritis are needed. Core decompression (CD) is the most commonly used surgery in the early stages of osteonecrosis with variable rates of success. The present review aimed to determine the effectiveness of bone marrow aspirate concentrate (BMAC), platelet-rich plasma (PRP), bone morphogenetic proteins (BMP) or their combination with CD in early stages of AVN hip, prior to collapse of femoral head. Read More

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Alendronate Alleviated Femoral Head Necrosis and Upregulated BMP2/EIF2AK3/EIF2A/ATF4 Pathway in Liquid Nitrogen Treated Rats.

Drug Des Devel Ther 2021 23;15:1717-1724. Epub 2021 Apr 23.

Department of Orthopedics, Minhang Hospital, Fudan University, Shanghai, 201199, People's Republic of China.

Background: Osteonecrosis of the femoral head (ONFH) seriously affects the quality of life and labor ability of patients. It is urgent and vital to find the methods for necrosis clinical treatment.

Objective: This study aims to study the potential protective effects of Alendronate in the early stage of femur head necrosis. Read More

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Morphological variants to predict outcome of avascular necrosis in developmental dysplasia of the hip.

Bone Joint J 2021 May;103-B(5):999-1004

Department of Orthopaedic Surgery, Sophia's Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands.

Aims: The most important complication of treatment of developmental dysplasia of the hip (DDH) is avascular necrosis (AVN) of the femoral head, which can result in proximal femoral growth disturbances leading to pain, dysfunction, and eventually to early onset osteoarthritis. In this study, we aimed to identify morphological variants in hip joint development that are predictive of a poor outcome.

Methods: We retrospectively reviewed all patients who developed AVN after DDH treatment, either by closed and/or open reduction, at a single institution between 1984 and 2007 with a minimal follow-up of eight years. Read More

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Exosomes Secreted from Hypoxia-Preconditioned Mesenchymal Stem Cells Prevent Steroid-Induced Osteonecrosis of the Femoral Head by Promoting Angiogenesis in Rats.

Biomed Res Int 2021 7;2021:6655225. Epub 2021 Apr 7.

Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710061, China.

Recent studies have suggested that exosomes exert similar therapeutic effects to those of mesenchymal stem cells (MSCs) in regenerative medicine and MSCs-derived exosomes exhibit therapeutic effects on steroid-induced osteonecrosis of the femoral head (ONFH). Furthermore, reparative functions of exosomes from MSCs are enhanced by hypoxia treatment of the cells. However, there are no related reports about whether exosomes derived from hypoxia-preconditioned MSCs could show better therapeutic effects on steroid-induced ONFH. Read More

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Autologous stem cell implantation with core decompression for avascular necrosis of the femoral head using a new device.

Ann R Coll Surg Engl 2021 Apr 29. Epub 2021 Apr 29.

Southampton University Hospitals NHS Trust, UK.

Introduction: Autologous stem cell progenitor implantation into necrotic lesions of the femoral head has previously been described as a potential treatment for avascular necrosis (AVN), on the basis that there is a reduced number of functioning stem cells in the marrow within the necrotic segment. We present a case series of patients with AVN that underwent core decompression with autologous stem cell implantation using a new device.

Methods: The records and imaging of patients with AVN of the femoral head treated by a single surgeon were retrospectively reviewed. Read More

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Dual-construct fixation is recommended in ipsilateral femoral neck fractures with infra-isthmus shaft fracture: A STROBE compliant study.

Medicine (Baltimore) 2021 Apr;100(17):e25708

Department of Orthopedic, Kaohsiung veteran general hospital, Kaohsiung, Taiwan.

Abstract: The aim of this study was to evaluate the risk factors related to osteosynthesis failure in patients with concomitant ipsilateral femoral neck and shaft fractures, including old age; smoking habit; comminuted fragments; infra-isthmus fracture; angular malreduction; unsatisfactory reduction (fracture gap >5 mm); and treatment with single construct.Patients over the age of 20 with concomitant ipsilateral femoral neck and shaft fractures diagnosed at a level one medical center between 2003 and 2019 were included. Treatment modalities included single construct with/without an antirotational screw for the neck and dual constructs. Read More

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More than 20° posterior tilt of the femoral head in undisplaced femoral neck fractures results in a four times higher risk of treatment failure.

Eur J Trauma Emerg Surg 2021 Apr 26. Epub 2021 Apr 26.

Department of Trauma Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

Purpose: In this study, we aimed to determine the correlation between the preoperative posterior tilt of the femoral head and treatment failure in patients with a Garden type I and II femoral neck fracture (FNF) treated with the dynamic locking blade plate (DLBP).

Methods: Preoperative posterior tilt was measured in a prospective documented cohort of 193 patients with a Garden type I and II FNF treated with the DLBP. The correlation between preoperative posterior tilt and failure, defined as revision surgery because of avascular necrosis, non-union, or cut-out, was analyzed. Read More

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Selective pathological examination following hip arthroplasty: A retrospective cohort study.

Orthop Traumatol Surg Res 2021 Apr 22:102942. Epub 2021 Apr 22.

Department of Orthopaedic Surgery, Alrijne Healthcare Group, Leiderdorp, The Netherlands.

Background: Pathological examination of the femoral head after hip arthroplasty is often performed routinely. The cost-effectiveness of the examination with regard to identifying clinically relevant diagnoses has been a point of discussion. To date, recommendations on performing pathological examination based on patient characteristics, disease history or radiographic findings are scarce. Read More

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Incarcerated Cannulated Cancellous Screw Removal during Total Hip Arthroplasty with a Novel Trick: A Case Report.

Malays Orthop J 2021 Mar;15(1):128-131

Department of Orthopaedics, Max Super Speciality Hospital Patparganj, Delhi, India.

Salvage total hip arthroplasty (THA) may be required to manage femoral neck fracture implant failures, avascular necrosis and secondary hip arthritis. Cannulated cancellous screws can become stripped or incarcerated during the initial implantation and pose hardware removal issues. We present a novel technique for safe screw removal in a 62-year-old female patient with a painful right hip. Read More

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Clinical analysis of 11 cases of nocardiosis.

Open Med (Wars) 2021 8;16(1):610-617. Epub 2021 Apr 8.

Department of Hematology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetic and Gene Regulation, Sun Yat-Sen University, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong 510120, People's Republic of China.

Nocardiosis is a rare, life-threatening, opportunistic, and suppurative infection. Its clinical manifestation lacks specificity, which makes early diagnosis difficult. A retrospective analysis of the clinical records of 11 patients with nocardiosis admitted to our hospital from January 2013 to November 2018 was conducted. Read More

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Qualitative and quantitative magnetic resonance imaging evaluation of bone tissue vaso-occlusive events in patients with sickle cell disease.

Bone 2021 Jul 16;148:115961. Epub 2021 Apr 16.

Ribeirão Preto Medical School, USP Ribeirão Preto, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Campus Universitário s/n - Monte Alegre, Ribeirão Preto, SP, Brazil; Ribeirão Preto Medical School Musculoskeletal Imaging Research Laboratory, Brazil; Department of Orthopedic Surgery, University of Missouri Health Care, Columbia, MO, United States.

Objective: To evaluate the association between bone changes due to vaso-occlusive events in sickle cell disease (SCD) revealed by conventional MRI sequences and the fat fraction obtained using a 6-point DIXON technique (FFdix), in an attempt to use quantitative data as a biomarker for bone complications.

Methods: Cross-sectional study, with 48 SCD patients, 26-homozygous (HbSS), and 22-compound heterozygous (HbSC). Forty-eight healthy individuals paired by age, weight, and sex with SCD patients. Read More

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Associations between glucocorticoids, antiphospholipid antibodies and femur head necrosis in patients with SLE: a directed acyclic graph-based multicentre study.

Ther Adv Musculoskelet Dis 2021 29;13:1759720X211002677. Epub 2021 Mar 29.

Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, NO 600, Yishan Road, Xuhui district, Shanghai 200233, China.

Background: Osteonecrosis of the femoral head (ONFH) remains a major cause of disability in patients with systemic lupus erythematosus (SLE) and seriously impairs quality of life. This study aimed to investigate associations between glucocorticoids (GCs), antiphospholipid antibodies (aPLs), and ONFH in patients with SLE.

Methods: We conducted a multicentre cohort study on patients with SLE and used a directed acyclic graph-based analysis strategy. Read More

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Combination of hyperbaric oxygen and core decompression therapies improve outcomes in the treatment of hip osteonecrosis.

Hip Int 2021 Apr 12:11207000211003285. Epub 2021 Apr 12.

Fora Hyperbaric Centre, Balgat, Ankara, Turkey.

Introduction: To investigate whether combined treatment of hyperbaric oxygen (HBO) and core decompression (CD) result with better outcomes and have an additional influence on health quality scores when compared with HBO alone.

Methods: 63 consecutive patients' 80 hips (43 male, 20 female, 17 bilateral), diagnosed with Stage II Osteonecrosis of the femoral head were included in our study. The mean age at presentation in the HBO and CD + HBO groups were 39. Read More

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Core Decompression with Non Vascularized Fibular Graft as Modern Surgical Treatment of Early Hip Avascular Necrosis.

Mymensingh Med J 2021 Apr;30(2):323-328

Dr Mohammad Tariqul Alam, Assistant Professor, Paediatric Orthopaedics, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:

Cellular death of bone due to impairment of the blood supply leading to collapse resulting in pain, and loss of joint function is known as avascular necrosis (AVN). The head of femur is the most common bone affected by avascular necrosis followed by talus and scaphoid. We evaluate the results of core decompression with non-vascularized fibular graft in avascular necrosis of femoral head. Read More

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