Müssbichler, Herbert
June 1970
Angiology;Jun1970, Vol. 21 Issue 6, p385
Academic Journal
Arteriography was performed in 49 patients with fractures of the proximal end of the femur, in which 37 involved the medial part of the neck and 12 the trochanteric region. Of 37 recent fractures examined before osteosynthesis, 25 of them were reexamined after osteosynthesis while 12 were studied postoperatively only. In 17 cases, the contralateral unaffected hip was also examined for comparison with the fractured hip. Arteriography was made by injection of 20 ml of Dijodon, 50 per cent, through a blunt cannula or of 16 ml of Urografin, 76 per cent through a polyethylene catheter inserted into the external iliac artery. The results of the investigation comprise the following findings: (1) Out of 37 recent fractures, the circulation in the posterior collum branch was not disturbed. e.g., normal, in 19 cases. It was arrested in 12 medial neck fractures, and 3 pertrochanteric fractures and delayed only in 3 medial neck fractures. (2) Disturbed circulation occurred only in fractures which were in malrotation position. (3) After reduction of malrotation position by forced manual inward rotation of the leg, arrested circulation in the posterior collum branch improved immediately. (4) After final reduction and osteosynthesis, arrested circulation normalized or improved to '"delayed." (5) The filling of the superior retinacular artery was dependent on normal circulation in the posterior collum branch. (6) Outward rotation of the leg may affect the circulation in the posterior collum branch won after complete reduction and ostoosyntbesis as demonstrated in two pertrochanteric fractures. (7) From angiographic findings in recent unreduced neck fractures, a close relation was found between arrested circulation in the posterior collum branch and the incidence of necrosis of the femoral head as well as between normal circulation and nondevelopment of necrosis. In operated fractures, however, a correlation between delayed and normal circulation and the fate of the femoral head could not be ascertained. (8) In those 7 cases with medial neck fractures in which the superior retinaeular artery was filled, necrosis was not observed. (9) In none of the 7 pertrochanteric fractures followed-up was necrosis noted. In one of the cases the circulation in the posterior collum branch in the recent unreduced fracture had been arrested.


Related Articles

  • INTRAOSSEOUS PRESSURES IN PATIENTS WITH DIFFERENT TYPES OF FRACTURE OF THE FEMORAL NECK. Arnoldi, Carl C.; Lemperg, R.; Linderholm, H. // Angiology;Jun1970, Vol. 21 Issue 6, p403 

    Measurements of intraosseous pressure in the collum and caput femoris were performed on 17 patients with lateral/trochanteric fractures and 29 patients with medial fractures of the femoral neck. In lateral fractures, the pressure tracings were always pulsatile at both points of measurements,...

  • Monoaxial versus polyaxial locking systems: a biomechanical analysis of different locking systems for the fixation of proximal humeral fractures. Zettl, Ralph; Müller, Thorben; Topp, Tobias; Lewan, Ulrike; Krüger, Antonio; Kühne, Christian; Ruchholtz, Steffen // International Orthopaedics;Aug2011, Vol. 35 Issue 8, p1245 

    Objective: The development of locking plate systems has led to polyaxial screws and new plate designs. This study compares monoaxial head locking screws (PHILOS© by Synthes) and a new generation of polyaxial locking screws (NCB-LE© by Zimmer) with respect to biomechanical stability....

  • Injury of the Superficial Femoral Artery Secondary to an Unstable Intertrochanteric Fracture. Won Ro Park; Min Soo Kang; Kyung Taek Kim; Kyu Pill Moon // Hip & Pelvis;Dec2012, Vol. 24 Issue 4, p338 

    Injury of the femoral artery with a femoral intertrochanteric fracture is rare, and usually occurs on the deep femoral artery during surgery. We experienced a case of preoperative injury of the superficial femoral artery by a lesser trochanteric fragment. We repaired the femoral artery through...

  • Lymphadenopathy after joint replacement for osteoclastoma. Stewart, A. J.; Southcott, B. M.; Raweily, E. // Journal of the Royal Society of Medicine;Aug2003, Vol. 96 Issue 8, p404 

    The article presents a case of a 46-year-old man with sustained fracture of the right medial femoral condyle in 1995. The man was treated with open reduction and internal fixation. The clinical examination showed the increase swelling and pain of the knee due to the destructive tumor found in...

  • Flexible intramedullary nailing in paediatric femoral fractures. A report of 73 cases.  // Journal of Orthopaedic Surgery & Research;2011, Vol. 6 Issue 1, p64 

    The article presents several case studies of femoral shaft fractures in 69 child patients treated with retrograde flexible intramedullary nailing with a minimum follow up of five years.Final limb length discrepancy and any angular or rotational deformities were examined. It is found that...

  • Closed reduction, internal fixation with quadratus femoris muscle pedicle bone grafting in displaced femoral neck fracture. Chaudhuri, Sibaji // Indian Journal of Orthopaedics;Jan-Mar2008, Vol. 42 Issue 1, p33 

    Background: Management of femoral neck fracture is still considered as an unsolved problem. It is more evident in displaced fractures where this fracture is considered as some sort of vascular insult to the head of the femur. We have used closed reduction, internal fixation and quadratus femoris...

  • Internal fixation and muscle pedicle bone grafting in femoral neck fractures. Gupta, A. K.; Rastogi, Sanjai; Nath, R. // Indian Journal of Orthopaedics;Jan-Mar2008, Vol. 42 Issue 1, p39 

    Background: The treatment of displaced intracapsular femoral neck fracture is still an unsolved problem. Non-union and avascular necrosis are the two main complications of this fracture, especially if patient presents late. Muscle pedicle bone grafting has been advocated to provide additional...

  • Treatment of unstable posterior pelvic ring fracture with percutaneous reconstruction plate and percutaneous sacroiliac screws: a comparative study. Chen, Hong-wei; Liu, Guo-dong; Fei, Jun; Yi, Xian-hong; Pan, Jun; Ou, Shan; Zhou, Ji-hong // Journal of Orthopaedic Science;Sep2012, Vol. 17 Issue 5, p580 

    Objective: The aim of this study is to compare the clinical effects of percutaneous reconstruction plate and percutaneous sacroiliac screws in treatment of unstable posterior pelvic ring fracture. Methods: Fifty-eight patients with unstable posterior pelvic ring fracture treated with two methods...

  • Erectile dysfunction after perineal compression in young men undergoing internal fixation of femur fractures. Rajbabu, K.; Brown, C.; Poulsen, J. // International Journal of Impotence Research;May/Jun2007, Vol. 19 Issue 3, p336 

    Erectile dysfunction (ED) following treatment for lower limb fractures is not uncommon. The mechanism is thought to be a perineal neurovascular traction injury acquired during surgery. Four young men who sustained femur fracture underwent reduction and intramedullary nail fixation....


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics