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Sung Bum Park - One of the best experts on this subject based on the ideXlab platform.
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a validation study for estimation of femoral anteversion using the posterior Lesser Trochanter line an analysis of computed tomography measurement
Journal of Arthroplasty, 2013Co-Authors: Jung Ro Yoon, Jae Hyuk Yang, Seung Yeop Song, Sung Bum ParkAbstract:Abstract The aim of this study was to introduce a simple and reliable intraoperative reference guide to reproduce the normal femoral anteversion during total hip arthroplasty (THA). We hypothesized that the posterior Lesser Trochanter line (PLTL) could be a useful guide for estimating femoral anteversion during THA. We conducted a study of 56 men (112 hips) to evaluate the relationship between the PLTL and the femoral anteversion using computed tomography scans. The mean femoral anteversion was 9.0° ± 8.1° (range, − 16.2° to 32.9°). The PLTL angle correlated (r 2 = 0.12, P
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the use of the posterior Lesser Trochanter line to estimate femoral neck version an analysis of computed tomography measurements
Journal of Arthroplasty, 2013Co-Authors: Won Yong Shon, Jae Hyuk Yang, Seung Yeop Song, Sung Bum ParkAbstract:Abstract We hypothesized that the Lesser Trochanter could be a useful guide for estimating femoral component version during total hip arthroplasty. We conducted a study of 88 patients to evaluate the relationship between the posterior Lesser Trochanter line (PLTL) and the femoral neck axis (FNA) using computed tomographic scans. The mean angle between the PLTL and the FNA was 17.4° ± 7.1° (range, −1.6° to 36.5°). The PLTL angle correlated ( r 2 = 0.67-0.72) with the FNA angle. Intraclass correlation coefficient values showed a high level of intraobserver and interobserver agreement in the angles between the PLTL and the FNA. We found a constant relationship between the Lesser Trochanter and the FNA, and femoral neck version can be estimated, using the PLTL, with reasonable reliability.
David E Hartigan - One of the best experts on this subject based on the ideXlab platform.
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Lesser Trochanter osteoplasty for ischiofemoral impingement
Arthroscopy techniques, 2017Co-Authors: Jill A Goodwin, Anikar Chhabra, Karan A Patel, David E HartiganAbstract:Abstract Ischiofemoral impingement is a newly recognized cause of extra-articular hip pain, and is caused by contact between the Lesser Trochanter and ischium. Surgical intervention has been proven successful for patients with persistent pain and disability after failure of nonoperative management. This technique article provides a reliable method for endoscopic Lesser Trochanter osteoplasty using an anterior approach.
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arthroscopic iliopsoas release at the level of the Lesser Trochanter following total hip arthroplasty
Arthroscopy techniques, 2017Co-Authors: Karan A Patel, Jill A Goodwin, Anikar Chhabra, Jaycen C Brown, David E HartiganAbstract:Abstract Iliopsoas impingement is an uncommon cause of pain after total hip arthroplasty. If pain persists after a trial of conservative treatment, surgical intervention can alleviate the patient's symptoms. Multiple advantages exist to release the iliopsoas tendon at the level of the Lesser Trochanter. The purpose of this Technical Note is to demonstrate a technique for arthroscopic release of the iliopsoas tendon at the Lesser Trochanter after total hip arthroplasty.
Travis G. Maak - One of the best experts on this subject based on the ideXlab platform.
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arthroscopic reduction and fixation of a Lesser Trochanter avulsion nonunion
Arthroscopy techniques, 2019Co-Authors: Alex G Dukas, Temitope F. Adeyemi, Taylor L King, Travis G. MaakAbstract:Abstract Identifying and treating avulsion fractures of the pelvis and proximal femur in adolescent athletes has become increasingly more important as the rate of competitive sports participation has grown. The majority of these fractures can be treated conservatively, with most returning to full activity. Surgical treatment of these injuries has been traditionally indicated for >2 cm displacement, painful nonunion, symptomatic exostosis formation, or persistent pain and symptoms. Lesser Trochanter avulsion injuries are extremely rare and literature outlining their surgical treatment lacking. We present our method of arthroscopic reduction and fixation of Lesser Trochanter avulsion nonunions.
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Is the Lesser Trochanter Profile a Reliable Means of Restoring Anatomic Rotation After Femur Fracture Fixation
Clinical Orthopaedics and Related Research, 2018Co-Authors: Lucas S. Marchand, Dane C. Todd, Patrick Kellam, Temitope F. Adeyemi, David L. Rothberg, Travis G. MaakAbstract:Restoring normal femoral rotation is an important consideration when managing femur fractures. Femoral malrotation after fixation is common and several preventive techniques have been described. Use of the Lesser Trochanter profile is a simple method to prevent malrotation, because the profile changes with femoral rotation, but the accuracy of this method is unclear. The purposes of this study were (1) to report the rotational profiles of uninjured femora in an adult population; and (2) to determine if the Lesser Trochanter profile was associated with variability in femoral rotation. One hundred fifty-five consecutive patients (72% female and 28% male) with a mean age of 32 years (range, 12-56 years) with a CT scanogram were retrospectively evaluated. Patients were included if CT scanograms had adequate cuts of the proximal and distal femur. Patients were excluded if they had prior hip/femur surgery or anatomic abnormalities of the proximal femur. CT scanogram measurements of femoral rotation were compared with the Lesser Trochanter profile (distance from the tip of the Lesser Trochanter to the medial cortex of the femur) measured on weightbearing AP radiographs. These measurements were made by a single fellowship-trained orthopaedic surgeon and repeated for intraobserver reliability testing. Presence of rotational differences based on sex and laterality was assessed and correlation of the difference in Lesser Trochanter profile to the difference in femoral rotation was determined using a coefficient of determination (r). The mean femoral rotation was 10.9° (SD ± 8.8°) of anteversion. Mean right femoral rotation was 11.0° (SD ± 8.9°) and mean left femoral rotation was 10.7° (SD ± 8.7°) with a mean difference of 0.3° (95% confidence interval [CI], -1.7° to 2.3°; p = 0.76). Males had a mean rotation of 9.4°(SD ± 7.7°) and females had a mean rotation of 11.5° (SD ± 9.1°) with a mean difference of 2.1° (95% CI, -0.1° to 4.3°; p = 0.06). Mean Lesser Trochanter profile was 6.6 mm (SD ± 4.0 mm). Mean right Lesser Trochanter profile was 6.6 mm (SD ± 3.9 mm) and mean left Lesser Trochanter profile was 6.5 mm (SD ± 4.0 mm) with a mean difference of 0.1 mm (-0.8 mm to 1.0 mm, p = 0.86). The Lesser Trochanter profile varied between the sexes; males had a mean of 8.3 mm (SD ± 3.4), and females had a mean of 5.9 mm (SD ± 4.0). The mean difference between sexes was 2.5 mm (1.5-3.4 mm; p < 0.001). The magnitude of the Lesser Trochanter profile measurement and degree of femoral rotation were positively correlated such that increasing measures of the Lesser Trochanter profile were associated with increasing amounts of femoral anteversion. The Lesser Trochanter profile was associated with femoral version in a linear regression model (r = 0.64; p < 0.001). Thus, 64% of the difference in femoral rotation can be explained by the difference in the Lesser Trochanter profile. Intraobserver reliability for both the femoral version and Lesser Trochanter profile was noted to be excellent with intraclass correlation coefficients of 0.94 and 0.95, respectively. This study helps define the normal femoral rotation profile among adults without femoral injury or bone deformity and demonstrated no rotational differences between sexes. The Lesser Trochanter profile was found to be positively associated with femoral rotation. Increasing and decreasing Lesser Trochanter profile measurements are associated with increasing and decreasing amounts of femoral rotation, respectively. The Lesser Trochanter profile can determine the position of the femur in both anteversion and retroversion, supporting its use as a method to restore preinjury femoral rotation after fracture fixation. Although some variability in the rotation between sides may exist, matching the Lesser Trochanter profile between injured and uninjured femora can help reestablish native rotation.
S P Hodgson - One of the best experts on this subject based on the ideXlab platform.
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isolated Lesser Trochanter fractures in elderly a case for prophylactic dhs fixation a case series
Injury-international Journal of The Care of The Injured, 2004Co-Authors: A Y Bonshahi, D Knowles, S P HodgsonAbstract:Isolated Lesser Trochanter fractures are a rare presentation of hip fractures in the elderly. Classically, Lesser Trochanter fractures in adults are associated with tumours and result from little or no trauma. We present three elderly osteoporotic ladies who sustained isolated fractures of the Lesser Trochanter secondary to a definite history of trauma. Radiologically, none of them showed any evidence of pathological lesions or interTrochanteric fracture at presentation. Two patients subsequently developed displaced interTrochanteric fractures, which necessitated internal fixation. In the third patient, a dynamic hip screw (DHS) was inserted before mobilisation. Based on this experience, we recommend careful observation and follow-up of such cases and suggest that isolated Lesser Trochanteric fractures in the elderly osteoporotic population may be an indication for prophylactic DHS fixation.
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Isolated Lesser Trochanter fractures in elderly—a case for prophylactic DHS fixation: A case series
Injury-international Journal of The Care of The Injured, 2004Co-Authors: A Y Bonshahi, D Knowles, S P HodgsonAbstract:Isolated Lesser Trochanter fractures are a rare presentation of hip fractures in the elderly. Classically, Lesser Trochanter fractures in adults are associated with tumours and result from little or no trauma. We present three elderly osteoporotic ladies who sustained isolated fractures of the Lesser Trochanter secondary to a definite history of trauma. Radiologically, none of them showed any evidence of pathological lesions or interTrochanteric fracture at presentation. Two patients subsequently developed displaced interTrochanteric fractures, which necessitated internal fixation. In the third patient, a dynamic hip screw (DHS) was inserted before mobilisation. Based on this experience, we recommend careful observation and follow-up of such cases and suggest that isolated Lesser Trochanteric fractures in the elderly osteoporotic population may be an indication for prophylactic DHS fixation.
Jae Hyuk Yang - One of the best experts on this subject based on the ideXlab platform.
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a validation study for estimation of femoral anteversion using the posterior Lesser Trochanter line an analysis of computed tomography measurement
Journal of Arthroplasty, 2013Co-Authors: Jung Ro Yoon, Jae Hyuk Yang, Seung Yeop Song, Sung Bum ParkAbstract:Abstract The aim of this study was to introduce a simple and reliable intraoperative reference guide to reproduce the normal femoral anteversion during total hip arthroplasty (THA). We hypothesized that the posterior Lesser Trochanter line (PLTL) could be a useful guide for estimating femoral anteversion during THA. We conducted a study of 56 men (112 hips) to evaluate the relationship between the PLTL and the femoral anteversion using computed tomography scans. The mean femoral anteversion was 9.0° ± 8.1° (range, − 16.2° to 32.9°). The PLTL angle correlated (r 2 = 0.12, P
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the use of the posterior Lesser Trochanter line to estimate femoral neck version an analysis of computed tomography measurements
Journal of Arthroplasty, 2013Co-Authors: Won Yong Shon, Jae Hyuk Yang, Seung Yeop Song, Sung Bum ParkAbstract:Abstract We hypothesized that the Lesser Trochanter could be a useful guide for estimating femoral component version during total hip arthroplasty. We conducted a study of 88 patients to evaluate the relationship between the posterior Lesser Trochanter line (PLTL) and the femoral neck axis (FNA) using computed tomographic scans. The mean angle between the PLTL and the FNA was 17.4° ± 7.1° (range, −1.6° to 36.5°). The PLTL angle correlated ( r 2 = 0.67-0.72) with the FNA angle. Intraclass correlation coefficient values showed a high level of intraobserver and interobserver agreement in the angles between the PLTL and the FNA. We found a constant relationship between the Lesser Trochanter and the FNA, and femoral neck version can be estimated, using the PLTL, with reasonable reliability.