Orthopedics
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Case Reports
Surgical treatment of an acetabular fracture and labral tear with suture anchors in a 10-year-old child.
This article presents a case of a 10-year-old boy with a right acetabular fracture secondary to a direct blow to the pelvis and back. He sustained a right hip dislocation and transverse with posterior wall acetabular fracture with a nonconcentric hip joint after reduction. ⋯ This technique reduced the fracture and labrum, relocated the hip joint, and obviated the need for hardware removal that is typically needed in the pediatric population. This case is distinctive due to the patient's young age and treatment method, which has not been described previously for the treatment of this rare pediatric fracture.
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Case Reports
Acetabular cup malalignment after total hip resurfacing arthroplasty: a case for elective revision?
This article describes the clinical course of a patient with a resurfacing implant in a poor cup position in combination with elevated serum metal ions prior to implant failure. Following resurfacing, the patient had substantial improvement from baseline in pain and functional status. Postoperative radiographs indicated the acetabular cup in an abducted and excessively anteverted position. ⋯ A recent study has shown a correlation between increased cup inclination and increased serum cobalt or chromium levels and this patient's levels were >40 times greater than that typically observed with this device. Early revision should be strongly considered if component malpositioning is noted, and abnormally elevated ion concentrations should signal the need for revision regardless of the patient's clinical status. The relationship of a malpositioned cup and uncharacteristically elevated metal ion levels is related to the metal-on-metal bearing coupling and likely applies to conventional metal-on-metal total hip prostheses as well.