Proximal Femoral Focal Deficiency 3

8/19/2019 Proximal Femoral Focal Deficiency 3

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BRIEF DISSCUSION ON PROXIMAL

FEMORAL FOCAL DEFICIENCY

BRIEF DISSCUSION ON PROXIMAL

FEMORAL FOCAL DEFICIENCY

MODERATORS: DR PREM KOTIAN

DR K R KAMATH

PRESENTER : DR NIKIL JAYASHEELAN

DATE: 16th FEBRUARY 2010

MODERATORS: DR PREM KOTIAN

DR K R KAMATH

PRESENTER : DR NIKIL JAYASHEELAN

DATE: 16th FEBRUARY 2010


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Broad !"#tr$% o&d"&"#t

Mot #o%%o'()* !art+a( ,"("ta(

d"&"#t +' th" !ro-+%a( &"%$r

.+th a /ar+a() $'ta(" h+!

Short"'+'3 a'd ao#+at"d oth"r

a'o%a(+" I'#+d"'#" o& * 1 !"r 403000 (+/"

+rth

Broad !"#tr$% o&d"&"#t

Mot #o%%o'()* !art+a( ,"("ta(

d"&"#t +' th" !ro-+%a( &"%$r

.+th a /ar+a() $'ta(" h+!

Short"'+'3 a'd ao#+at"d oth"r

a'o%a(+" I'#+d"'#" o& * 1 !"r 403000 (+/"

+rth


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F+$(ar h"%+%"(+a

5($&oot

S!+'a( d)!(a+a

Fa#+a( d)!(a+aA"'"+ o& th" #r$#+at"

(+a%"'t o& th" ,'""

F+$(ar h"%+%"(+a

5($&oot

S!+'a( d)!(a+a

Fa#+a( d)!(a+aA"'"+ o& th" #r$#+at"

(+a%"'t o& th" ,'""


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ETIOLOY

Mat"r'a( +'"t+o' o& dr$ ": Tha(+do%+d"

D"&+#+t o& o'"*#art+(a" 3 #("rot"r% $tra#t+o'

D+t$ra'#" +' #"(($(ar '$tr+t+o'

7a#$(ar a'or%a(+t)

Mat"r'a( +'"t+o' o& dr$ ": Tha(+do%+d"

D"&+#+t o& o'"*#art+(a" 3 #("rot"r% $tra#t+o'

D+t$ra'#" +' #"(($(ar '$tr+t+o'

7a#$(ar a'or%a(+t)


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HISTOLOI5AL

A'or%a( !ro(+&"rat+o' o& #ho'dro#)t"

A'or%a( %at$rat+o' o& #ho'dro#)t" +' !ro-+%a(

ro.th 8o'"

D+ora'+8"d %atr+-* +'ad"9$at" !r"!arat+o' o& %atr+-*

d"(a) /a#$(ar +'/a+o'

#art+(a+'o$ '"#ro+ "'(ar"d h)!"rtro!h+# 8o'"3

A'or%a( !ro(+&"rat+o' o& #ho'dro#)t"

A'or%a( %at$rat+o' o& #ho'dro#)t" +' !ro-+%a(

ro.th 8o'"D+ora'+8"d %atr+-* +'ad"9$at" !r"!arat+o' o& %atr+-*

d"(a) /a#$(ar +'/a+o'

#art+(a+'o$ '"#ro+ "'(ar"d h)!"rtro!h+# 8o'"3


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CLASSIFICATIONCLASSIFICATION

1 A+t,"'

2 Pa!!a

; Ka(a%#h+ "t a(


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A+t,"' &o$r*!art #(a+&+#at+o'A+t,"' &o$r*!art #(a+&+#at+o'

• Nor%a( a#"ta$($% a'd

&"%ora( h"ad

•hort"'+' o& th" &"%$r

• No o') #o''"#t+o' "t.""' th"

!ro-+%a( &"%$r a'd th" &"%ora(

h"ad3

• P"$doartho+


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A+t,"' &o$r*!art #(a+&+#at+o'A+t,"' &o$r*!art #(a+&+#at+o'

•D)!(at+# a#"ta$($%3•A"'t &"%ora( h"ad3•Short &"%$r

A#"ta$($%3 &"%ora( h"ad3

a'd !ro-+%a( &"%$r ar"

tota(() a"'t


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PAPPAS NINE CLASSESPAPPAS NINE CLASSES


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KALAM5HI ET AL FI7E ROUPSKALAM5HI ET AL FI7E ROUPS

ro$! I* hort &"%$r a'd +'ta#t h+! =o+'t

ro$! II* hort &"%$r a'd #o-a /ara o& th" h+!

ro$! III* hort &"%$r $t ."((*d"/"(o!"d a#"ta$($%

a'd &"%ora( h"ad

ro$! I7* a"'t h+! =o+'t a'd d)!(at+# &"%ora(

"%"'t

ro$! 7* tota( a"'#" o& th" &"%$r

ro$! I* hort &"%$r a'd +'ta#t h+! =o+'t

ro$! II* hort &"%$r a'd #o-a /ara o& th" h+!

ro$! III* hort &"%$r $t ."((*d"/"(o!"d a#"ta$($%

a'd &"%ora( h"ad

ro$! I7* a"'t h+! =o+'t a'd d)!(at+# &"%ora(

"%"'t

ro$! 7* tota( a"'#" o& th" &"%$r


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Ainstutz (1969) Ainstutz (1969)

T)!" 1 5o'"'+ta( hort &"%$r .+th o.+'3

#o-a /ara a'd 'or%a( a#"ta$($%

T)!" 2 Short &"%$r .+th $tro#ha't"r+#

!"$darthro+3 !ror"+/" #o-a /ara a'd

'or%a( a#"ta$($%


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T)!" ; Short &"%$r .+th a $(o$ !ro-+%a( "'d3

d"(a)"d a!!"ara'#" o& th" &"%ora( #a!+ta(

"!+!h)+ A#"ta$($% + %+(d() d)!(at+#

Type 4. Short &"%ora( "%"'t ta!"r+'

har!() to a !o+'t at !ro-+%a( "'dA#"ta$($% %or" d)!(at+#

Type 5 . S%a(( o') "%"'t r"!r""'t+' d+ta(

&"%ora( ha&t3 .+th 'o "/+d"'#" o& !ro-+%a(

&"%ora( #o%!o'"'t a'd 'o a#"ta$($%


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MANAGEMENTMANAGEMENT

Ba+# !ro("%

1 I'ta+(+t) o& th" h+!

2 Ma(rotat+o'

; I'ad"9$at" !ro-+%a( %$#$(at$r"


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TreatmentTreatment

B+(at"ra( PFFD + "t tr"at"d 'o'*o!"rat+/"()

Tr"at%"'t + h+h() +'d+/+d$a(+8"d *ra'" &ro%

a%!$tat+o' a'd !roth"t+# r"ha+(+tat+o' to (+% a(/a"3("'th"'+'3 > h+! r"#o'tr$#t+o'

$r"r) + "t d"(a)"d $'t+( o+&+#at+o' o& th" &"%ora(

h"ad a'd !ro-+%a( %"ta!h)+ + ad"9$at"

B+(at"ra( PFFD + "t tr"at"d 'o'*o!"rat+/"()

Tr"at%"'t + h+h() +'d+/+d$a(+8"d *ra'" &ro%

a%!$tat+o' a'd !roth"t+# r"ha+(+tat+o' to (+% a(/a"3("'th"'+'3 > h+! r"#o'tr$#t+o'

$r"r) + "t d"(a)"d $'t+( o+&+#at+o' o& th" &"%ora(

h"ad a'd !ro-+%a( %"ta!h)+ + ad"9$at"


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Non O!"#$ti%" "$t'"ntNon O!"#$ti%" "$t'"nt

E-t"'+o' !roth"+E-t"'+o' !roth"+


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O!"#$ti%" "$t'"ntO!"#$ti%" "$t'"nt

H+! Sta+(+t)

– 5(a*A : ot"oto%) at th" +t" o& th" !"$darthro+

– 5(a*B : M"ta!h)"a( "!+!h)"a( )'oto+

$tro#ha't"r+# ot"oto%)

A%!$tat+o'

– Ao/"*th"*K'"" A%!$tat+o'

– B"(o. ,'"" a%!$tat+o'

H+! Sta+(+t)

– 5(a*A : ot"oto%) at th" +t" o& th" !"$darthro+

– 5(a*B : M"ta!h)"a( "!+!h)"a( )'oto+

$tro#ha't"r+# ot"oto%)A%!$tat+o'

– Ao/"*th"*K'"" A%!$tat+o'

– B"(o. ,'"" a%!$tat+o'


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ROTATION PLASTY

D"#r+"d )7a' N" 3Mod+&+"d ) Kot$+, "t a(> (at"r ) +(("!+" > Torod"

Arthrod"+ o& ,'"" .+th rotat+o' o& d+ta( t++a 1?0

d"r"" "-t"r'a(() o that th" a',(" =o+'t "#o%" a

&$'#t+o'a( ,'"" =o+'t

– a',(" !(a'tar &("-+o' "#o%" @,'"" "-t"'+o' a'd

a',(" dor+&("-+o' "#o%" ,'"" &("-+o'

ROTATION PLASTY

D"#r+"d )7a' N" 3Mod+&+"d ) Kot$+, "t a(> (at"r ) +(("!+" > Torod"

Arthrod"+ o& ,'"" .+th rotat+o' o& d+ta( t++a 1?0

d"r"" "-t"r'a(() o that th" a',(" =o+'t "#o%" a

&$'#t+o'a( ,'"" =o+'t

– a',(" !(a'tar &("-+o' "#o%" @,'"" "-t"'+o' a'd

a',(" dor+&("-+o' "#o%" ,'"" &("-+o'


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L+% ("'ht"'+' !ro#"d$r" – I(+8aro/

– Bo'" tra'!ort

L+% ("'ht"'+' !ro#"d$r" – I(+8aro/

– Bo'" tra'!ort


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Iiz$#o%Iiz$#o%


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Knee arthrodesisKnee arthrodesis


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THANK YOUTHANK YOU

Thank you

Proximal Femoral Focal Deficiency 3

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