Avascular Necrosis following fracture Neck of femur _______________________________ |
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| This 20 year old
chartered accountancy student developed Avascular Necrosis after fracture of
the neck of femur and had cystic changes in the femoral head and trendelenberg lurch
as well as a shortening of 4 cm.
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Double level osteotomy was done in the femur through small puncture incisions--Upper femoral osteotomy was done with medial displacement of the distal fragment at subtrochanteric level to decrease loading in the hip joint. At the same time the proximal fragment was rotated to bring a better area of the femoral head under the weight bearing area of acetabulum. The trochanter was also rotated downwards to improve the lever arm of the abductors. At the lower level, lengthening has been performed and the mechanical axis has been normalized to ensure that the knee remains horizontal.
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| The results at the end of
5 months of treatment show that limb lengths are equal and there is no more Trendelenberg
lurch. The pain relief has lasted for more than 5 years, at last follow-up.
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