Discusión entre pares / 36 yrs. Male having pain for 5 months in rt hip
- Posted by victor valdes
- Posted on mayo 23, 2014
- Uncategorized
- Comentarios desactivados en Discusión entre pares / 36 yrs. Male having pain for 5 months in rt hip

36 yrs. Male having pain for 5 months in rt hip . Felt by itself and presented with this picture.
I did curatage and filled cancellous bone graft and fixed.
Curated material send for biopsy.
Opinion please regarding my attempt.
I did curatage and filled cancellous bone graft and fixed.
Curated material send for biopsy.
Opinion please regarding my attempt.
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Mohammed Ahmed Refay Your attempt is very good. But I want to know what was the pathology, curettage done through window in the trochanter or you opened the capsule and did direct curettage and what approach you used?
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Sanjay Ganorkar attempt good ..but for the patient leaves behind a feeling that something is missing ..if your curettage shows a benign lesion you are through with your effort but what about the vascularity of the head and the ultimate healing ..good procedure anyway
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Baher Samy If the biospy came out with a malignant lesion then this is a catastrophy, and if it’s benign then non-union or fixation failure is likely to occur. Better have well investigated and biposied first then manage accordingly
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Anup Msf Lesion extendin well into the head
Osteosynthesis chances r very less
Uncemented thr wud b btr option with excissiin biopsy -
Yogesh Gaikwad Most probably benign lesion like ABC.You should be proceed after biopsy report.You preserved his own head I think is good but fibula r strut graft in addition to DHS is better.
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Santosh Singh In this whatever lesion it will collapse& derot screw is going to prevent, this chances of osteosynthes is less
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DrAkhilesh Singh I curated it through trochanter(reamed hole made for Richard screw) and filled the graft through same.
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DrDilawar Khan Mahsud How was the hold of the screws ?? It may loose (back) or cut out into the joint
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Harish Makker dear ur intention of saving neck and attempt is good but graft is insfficient,it could be benign is my gut feeling but if pt.could afford-mri could have made some clearity-/
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Shyamlal Mukhi Graft is insufficient iliac and fibula and dhs u can pull on for 6 to 10 years this is benign bone cyst later one can do THR COC
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Sikthireak Kluesik It is better to make clear diagnosis of pathology first by MRI and Biopsy, then management accordingly.
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Abhijit Khade If u hav cureted through trochanter then it is insuficient … U hav to 1st do mri then needle biopsy and then anterior aproach curetage wth lateral dhs plate wth bone graft… V had done same kind of case wth sp aproach
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Ravi Shankar Good attempt. Curettage&bg through the dhs entry hole is good enough. It really works. Additional Valgus osteotomy would improve the outcome
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Ramesh Kumar Gupta Very nice job, u have done. Almost same I have done 6- 7 yrs before, I got very good result. Biopsy report was benign lesion.
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Yogesh Gaikwad Good job, at least you try to preserve normal head.
Done similar case 4 yr back .Turn out ABC.Keep non wt bearing till at least 3 month.Thomos splint for earlier post op period.
Attaching similar case.will post follow up x ray. -
Ashish Gupta Many of us are saying fibula . & most likely non vascularized ( nagi’s) .one of my friend frm PGI chd told me they followed these pt by CT & these fibula were not incorporated even after 2-3 years . so believing that non vascularized fibula is a good option may not be very wise
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Ashish Gupta Regarding this case there r few issues as mentioned earlier , preop biopsy, quantity of graft , and quality of purchase lag screw is having as there is not much bone present in head. But a decent attempt. If succeed ,then nothing better . i did 3 cases like this ( non of them were this big lesions ). 2 healed & one is just 2 months follow up.
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