4. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Treatment and prognosis. Bone fragility due to osteoporosis is considered the most important cause of SIF, similar to compression fracture of vertebral body. Insufficiency subchondral fracture of the femoral head. May be used to reveal associated ligamentous injuries, osteochondral fractures and chondral fractures 7. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Gaillard F, Yap J, Knipe H, et al. Epidemiology These fractures have an incidence 0.4% to 2.7%, and males are affected more-so than females. The Mitchell classificationis commonly used to classify AVN based on MR images. 8. For the same reasons, CT aids in treatment planning as well 6. Br J Sports Med. Groin disruption injuryis another term that has fallen out of favor. Treatment and prognosis. A subchondral fracture is a fracture of the trabecular cancellous bone just beneath the subchondral bone plate without disruption of the articular surface 1. The Weber ankle fracture classification (or Danis-Weber classification) is a simple system for classification of lateral malleolar fractures, relating to the level of the fracture in relation to the ankle joint, specifically the distal tibiofibular syndesmosis. Stelzeneder D, Hingsammer A, Bixby SD, Kim YJ. Epidemiology These fractures have an incidence 0.4% to 2.7%, and males are affected more-so than females. Treatment and prognosis. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. These two conditions result in a decrease of lumbar lordosis, posterior tilt of the pelvis and subsequent a deficiency in the anterior coverage of the acetabulum. Occipital condylar fractures are uncommon injuries usually resulting from high-energy blunt trauma.They are considered a specific type of basilar skull fracture, and importantly can be seen along with craniocervical dissociation.. This type of fracture is considered to be a fractures due to repeated stress on the healthy femoral head (22). American journal of roentgenology. The tectorial membrane and alar ligaments provide most of the stability to the atlanto-occipital joint, and injury to these ligaments results in instability due to low inherent osseous stability 3.. 1. Our mission is to elevate the quality and safety of healthcare worldwide through the advancement of patient care, education and research furthering the art and science of Subchondral insufficiency fracture of the femoral head mainly occurs in the osteoporotic elderly women and in organ transplant recipients . 3C) (13). Subchondral insufficiency fracture of the knee is not thought to be caused by bone death but instead by osteoporosis and insufficiency fractures, with J Bone Joint Surg Am 2004;86-A:19171924. J Bone Joint Surg Am 2009;91:11201129. The term athletic pubalgia refers to a spectrum of injuries that includes tendinopathy of the aponeurosis, separation of the aponeurotic plate from the pubic bone, frank tearing of the aponeurotic plate, myotendinous strain within the rectus abdominis or abductor longus muscles, pubic tubercle apophysitis, and stress reaction/fracture in the parasymphyseal region of the pubic bones ref. Jessel RH, Zurakowski D, Zilkens C, Burstein D, Gray ML, Kim YJ. The controls were selected from patients who had been studied with MRI of the hip due to hip pain or other diseases than SIF. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Classification. LCE angle was between line between lateral edge of acetabular roof and center of femoral head and vertical line of hip. It often leads to a rapid and severe collapse of the femoral head, which necessitates a THR. Other than describing the general appearance of the affected region, the following are necessary to include in the report as they have a bearing on prognosis and treatment: Often more sensitive than plain film in showing subchondral fractures. Iwasaki K, Yamamoto T, Motomura G, Ikemura S, Yamaguchi R, Iwamoto Y. Radiologic measurements associated with the prognosis and need for surgery in patients with subchondral insufficiency fractures of the femoral head. American journal of roentgenology. fracture lines involves 1 to 4 parts; none of the parts are displaced (i.e. Arch Bone Jt Surg. One-part fracture. It is more common in men than in women 1.. Therefore, we considered patient's age, history of trauma and history of organ transplantation as well as radiologic features including MRI findings in making a diagnosis of SIF. Yoon PW, Kwak HS, Yoo JJ, Yoon KS, Kim HJ. Isolated sternal injuries have a very good outcome with conservative management, with most healing in a few months with a very low mortality rate (<1%) 1. Colles fractures are the most common type of distal radial fracture and are seen in all adult age groups and demographics. The results of our study could afford information to diagnose SIF in osteoporotic elderly patients. Typically it affects the superior articular surface (between 10-2 o'clock) and begins in the most anterior part of the hip. 2017;9(5):428-35. For pediatric patients, the condyle-C1 interval (CCI) has been shown to provide the highest diagnostic accuracy 4. condyle-C1 interval (CCI) >4 mm in children, Jefferson fracture: anterior and posterior C1 ring fracture, possible lateral masses displacement, odontoid fracture: type 2 will cause posterior dens displacement and will disrupt Powers ratio, atlanto-axial subluxation:atlantoaxial rotatory fixation will cause C1 lateral mass asymmetry relative to the dens, Down syndrome:atlanto-occipital instability due to laxity of the alar ligament, rheumatoid arthritis: CT/MRI will show atlantooccipital instability due to pannus destabilisation of joints and ligaments, and x-ray will show erosions, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Song WS, Yoo JJ, Koo KH, Yoon KS, Kim YM, Kim HJ. History and etymology. Pathology. These can be split into early and late features: flattening and cystic lesions of the affected metatarsal head, widening of the metatarsophalangeal joint. In the remaining 10 hips, no abnormal findings were noted on MRI. The IOBP procedure treats these pathologies through a core decompression of For radiologic evaluation, the acetabular index (AI), acetabular roof (AR) angle, acetabular head index (AHI), and lateral center-edge (LCE) angle were measured on the hip anteroposterior view. (, Demographic data of SIF patients and controls, Images of the lumbar spine, pelvis, and the hip. Reference article, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-19767. Wiley-Blackwell. It was originally described as a four-part fracture with double fractures through the anterior and posterior arches, but three-part and two-part fractures have also been described. Among the three, one was a board-certified radiologist, who had specialized skeletal radiology, as well as an orthopaedic surgeon. N Engl J Med 1992;326:14731479. 5. Short leg cast or ankle brace is used until signs of union appear. Histologically, Freiberg infraction is characterized by the collapse of the subchondral bone, osteonecrosis, and cartilaginous fissures 1. 6. Arthroscopy 2012;28:619627. Pathology. Although traditionally the mandible and base of skull are thought to form a complete bony ring, interrupted only by the TMJs.This should mean that the mandible should fracture in two places (akin to the bony pelvis) making single fractures uncommon, but this in fact not the case, with ~40% of Pathology. Yamamoto T, Schneider R, Bullough PG. Looser zones are also a type of insufficiency fracture. It is interesting to note that the word chauffeur comes from the French for "someone who warms" the car engine. The following features can be detected on ultrasound examination 7: anechoic defects and/or partial or full-thickness discontinuities of the tendon insertions in case of tears, loss of normal fibrillary architecture, thickening and hypoechogenicity of tendon insertions in case of tendinopathy, spurring and irregularities of the pubic bone, reproduction of symptoms on pressure with the ultrasound transducer, protrusion of pre-peritoneal fat through the Hesselbach triangle during abdominal strain, subchondral bone marrow edema, involving the entire anterior-posterior diameter of the pubic bone as a result of an osseous stress response, subchondral sclerosis and irregularities in chronic or longstanding cases, thickening of tendon insertion sometimes with concomitant signal alterations as a sign of tendinosis, partial or full-thickness tears displayed as fluid-filled defects, with or without tendon retraction, linear fluid signal running along the inferior margin of the inferior pubic ramus known as secondary cleft, injury or tear of the aponeurotic plate: fluid-signal intense subperiosteal cleft running from the symphysis along the inferior margin of the superior pubic ramus also known as superior cleft7,9, or a combination of all with a cleft extension of tears or clefts from the symphyseal joint capsule into the adductor tendons or rectus abdominis muscles 7. Am J Surg Pathol 2000;24:464468. Coordinated sampling and data collection: Chae DS, Yang IH. The AHI was calculated as the ratio of distance between medial tip of femoral head and lateral edge of acetabular roof to the size of femoral head. Although traditionally the mandible and base of skull are thought to form a complete bony ring, interrupted only by the TMJs.This should mean that the mandible should fracture in two places (akin to the bony pelvis) making single fractures uncommon, but this in fact not the 2). If needed, closed or open reduction methods can be performed with the goal of treatment being preservation of normal facial structure, sensory function, globe position and mastication functionality. <1 cm and <45) These non-displaced or minimally displaced fractures account for ~70-80% of all proximal humeral fractures and are almost always treated conservatively 6,7. subchondral sclerosis and irregularities in chronic or longstanding cases. Writing the manuscript: Jo WL, Lee WS, Koo KH. Mechanism. 10) Poole-Wilson PA, Langer GA. Effect of pH on ionic exchange and function in rat and rabbit myocardium. Typically, Monteggia fracture-dislocations occur as the result of a fall onto an outstretched hand (FOOSH) 4.. A low intensity band lesion, which corresponds to the fracture line, is seen at the subchondral region on T1-weighted MR images in both of the two lesions. Unable to process the form. fracture of the lateral orbital rim and/or diastasis of the frontozygomatic suture; Treatment and prognosis. Most of the lateral deficiency is caused by hip dysplasia, which is a developmental abnormality. Yamamoto T, Iwamoto Y, Schneider R, Bullough PG. The authorized source of trusted medical research and education for the Chinese-language medical community. Treatment and prognosis. Clin Orthop Surg 2012;4:173180. Treatment and prognosis. These 37 patients were matched with 37 controls for gender, age, height, weight, body mass index and bone mineral density. It is usually divided into joint preserving or reconstruction options 12. Both of them have similar radiological and clinical features. 2. Yamamoto T. Subchondral insufficiency fractures of the femoral head. WebThe IntraOsseous BioPlasty (IOBP) surgical technique is for the treatment of bone pathologies resulting from acute or chronic injury, including bone marrow lesions associated with insufficiency fractures, persistent bone bruises, osteoarthritis, and early stages of avascular necrosis. The remaining 29 patients, who already had femoral head collapse and intractable pain at the time of presentation, were treated with total hip replacement (THR) (Fig. Pubis (Pubic Bone): Anatomy, Function, and Epidemiology. fracture lines involves 2 to 4 parts Spondylolysis is present in ~5% of the population 2 and higher in the adolescent athletic population. The SIF of the femoral head should be differentiated from femoral head osteonecrosis (18, 19, 20). Check for errors and try again. May be used to reveal associated ligamentous injuries, osteochondral fractures and chondral fractures 7. Riascos R, Bonfante E, Cotes C, Guirguis M, Hakimelahi R, West C. Imaging of Atlanto-Occipital and Atlantoaxial Traumatic Injuries: What the Radiologist Needs to Know. 1988;11 (5): 753-7. Healing of the Segond fracture is associated with a particular bone excrescence arising below the lateral tibial plateau. 3. adductor tendon injury 7,8. thickening of tendon insertion sometimes with concomitant signal alterations as a sign of tendinosis Hips of patients, who were younger than 50 years, were excluded. 229 (3): 570-81. open reduction and internal fixation (ORIF)) or conservative management (e.g. Urgent reduction and surgical repair of disrupted ligaments is required to prevent long-term joint dysfunction. Skeletal Radiol. Mechanism. Binek R, Levinsohn EM, Bersani F et-al. Patients often recall an acute onset of severe pain without significant trauma. Rarely, severe rib injuries (e.g. Nasal bone fractures, when isolated, are most commonly displaced fractures of one of the paired nasal bones. Treatment may be non-operative or operative, with the aim being to have a painless, plantigrade and stable foot 12.. 7. Stevens K, Tao C, Lee SU, Salem N, Vandevenne J, Cheng C, Neumann G, Valentin-Opran A, Lang P. Subchondral fractures in osteonecrosis of the femoral head: comparison of radiography, CT, and MR imaging. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Valuable tools for building a rewarding career in health care. Femoral and acetabular anteversion were evaluated on the axial view of the MRI (14). The AO Spine Other more important causes of groin pain must first be ruled out. Treatment and prognosis. The term "hangman fracture" was introduced by Schneider in 1965 5. These type of fractures are more common in children, especially aged 5-10 years, due to the elasticity of their bones. 2016;4(3):264-268. Treatment and prognosis Rib fractures themselves are treated symptomatically and have a good prognostic outcome. AJR Am J Roentgenol. Radiographic and patient factors associated with pre-radiographic osteoarthritis in hip dysplasia. Spondylolysis is present in ~5% of the population 2 and higher in the adolescent athletic population. Freiberg disease complicating unrelated trauma. 147 (1): 67-71. Although few patients may remain asymptomatic until the late stages. Groin pain is common in the following sports 2,3: The sheetlike inferior aponeurosis of the rectus abdominis muscle is continuous with the proximal aspect of the adductor aponeurosis (especially adductor longus). Intimate partner violence should be considered in patients where the clinical details do not match the fracture, or the injury occurs in an intimate setting 7. Two-part fracture. Indications for non-operative treatment include undisplaced injuries that are stable with weight-bearing or poor surgical candidates such as non-ambulatory patients, patients with significant comorbidities that have Treatment of Freiberg Disease. subchondral bone marrow edema, involving the entire anterior-posterior diameter of the pubic bone as a result of an osseous stress response. These type of fractures are more common in children, especially aged 5-10 years, due to the elasticity of their bones. Treatment, whether operative or non-operative will typically be followed by a period of non-weight bearing on the affected side (or both). The AR angle was between the horizontal line between pelvic teardrops and the line between lateral edge of acetabular roof and intersection of horizontal and vertical components of acetabulum. Glossary of Terms for Musculoskeletal Radiology. Elsevier Health Sciences. Ombregt L, Bisschop P, Veer HJ. The tectorial membrane and alar ligaments provide most of the stability to the atlanto-occipital joint, and injury to these ligaments results in instability due to low inherent osseous stability 3.. Published online: November Foot Ankle. 2008;190 (3): 570-5. The Traynelis classification describes injuries according to the displacement of the occipital condyles relative to the atlas.. Case 6: affecting 4th and 5th metatarsals. The preferential imaging modality for the diagnostic workup of groin pain in athletes is MRI, however, some helpful imaging features can be observed in other imaging modalities. fracture lines involves 1 to 4 parts; none of the parts are displaced (i.e. Two-part fracture. An undisplaced fracture, particularly in the non-dominant arm of a non-athlete can be treated conservatively (three weeks in Tibial tuberosity avulsion fractures are uncommon. We investigated 37 patients with SIF. Our mission is to elevate the quality and safety of healthcare worldwide through the advancement of patient care, education and research furthering the art and science of oral and Information, resources, and support needed to approach rotations - and life as a resident. Proc (Bayl Univ Med Cent). Radiology. A 59-year-old woman had a pain on the right hip. AOSpine-Spine Trauma Classification System: The Value of Modifiers: A Narrative Review With Commentary on Evolving Descriptive Principles. Prepare to become a physician, build your knowledge, lead a health care organization, and advance your career with NEJM Group information and services. Posterior cruciate ligament (PCL) avulsion fractures are a type of avulsion fracture of the knee that represent the most common isolated PCL lesion. Supported collecting the data: Jo WL, Lee KM. 5. Subscribe now. Patients often recall an acute onset of severe pain without significant trauma. Clin Sports Med. It has a role in determining treatment. Failure to recognize the SIF may lead to a misdiagnosis and erroneous treatment. 1988;169 (1): 213-5. In advanced stages, surgery can be considered. (1975) The American journal of physiology. 1992;16 (5): 727-30. Who's Who in Orthopedics. Katcherian DA. Hence surgical treatment of displaced fractures or angulation. Hence surgical treatment of displaced fractures or angulation. For the same reasons, CT aids in treatment planning as well 6. Treatment is dependent on several factors taking into account both patient factors and fracture characteristics. 6. (2005). Patients often recall an acute onset of severe pain without significant trauma. 2016 Oct;31(10):1650-1655. Furthermore, the objective of MRI in the evaluation of groin pain is not only to demonstrate pathologic findings of the pubic bone, the rectus abdominis-adductor longus aponeurotic plate and the adductor insertions but also to rule out or identify potential other causes of groin pain 7,e.g. In early stages of the disease, it can be managed with lifestyle modifications, immobilzation and NSAID therapy. Thus, the diagnosis of SIF was made using MRI in our patients. Spondylolysis is present in ~5% of the population 2 and higher in the adolescent athletic population. Scartozzi G, Schram A, Janigian J. Freiberg's infraction of the second metatarsal head with formation of multiple loose bodies. Torriani M, Thomas BJ, Bredella MA et-al. The Weber ankle fracture classification (or Danis-Weber classification) is a simple system for classification of lateral malleolar fractures, relating to the level of the fracture in relation to the ankle joint, specifically the distal tibiofibular syndesmosis. If needed, closed or open reduction methods can be performed with the goal of treatment being preservation of normal facial structure, sensory function, globe position and mastication functionality. Murphy G, Foran P, Murphy D, Tobin O, Moynagh M, Eustace S. "Superior Cleft Sign" as a Marker of Rectus Abdominus/Adductor Longus Tear in Patients with Suspected Sportsman's Hernia. 2016 The Korean Academy of Medical Sciences. Yamamoto T, Schneider R, Bullough PG. A subchondral fracture is a fracture of the trabecular cancellous bone just beneath the subchondral bone plate without disruption of the articular surface 1. Treatment. Treatment and prognosis. There were 33 women and 4 men. It is either a musculotendinous or osseous injury that involves the insertion of abdominal muscles on the pubis and the upper aponeurotic insertion of the adductor muscles. DISCLOSURE:The authors have no potential conflicts of interest to disclose. Unable to process the form. Treatment options comprise of surgery (e.g. 7. Management depends not only on the type of fracture but also importantly on the functional status and living situation of the patient. Subchondral insufficiency fracture (SIF) of the femoral head occurs mainly in the elderly women or renal transplantation recipients (1, 2). Histopathological prevalence of subchondral insufficiency fracture of the femoral head. In most of the subchondral fatigue fractures, the extent of fracture is small and the depression is focal usually less than 2 mm. 157 (3): 751-6. Nasal bone fractures, when isolated, are most commonly displaced fractures of one of the paired nasal bones. Another type of subchondral fracture of the femoral head, so called subchondral fatigue fracture, has been observed mainly in young military trainees who are not osteoporotic. J Bone Joint Surg Am 2006;88:11171132. Information and tools for librarians about site license offerings. scapular fracture; clavicle fracture; distal radial fracture (especially Colles fracture) Treatment and prognosis. 2015;35(7):2121-34. Subchondral insufficiency fracture of the femoral head mainly occurs in the osteoporotic elderly women and in organ transplant recipients (15). Treatment and prognosis. 3. The tectorial membrane and alar ligaments provide most of the stability to the atlanto-occipital joint, and injury to these ligaments results in instability due to low inherent osseous stability 3. From the Department of Internal Medicine, Division of Rheumatology, University of Nebraska Medical Center, and the VA NebraskaWestern Iowa Health Care System both in Omaha. 1914; 19:191. Treatment of Freiberg's disease. fracture of metatarsal head or neck. Treatment and prognosis. Hammoud S, Bedi A, Magennis E, Meyers W, Kelly B. Secondary Cleft Sign as a Marker of Injury in Athletes with Groin Pain: MR Image Appearance and Interpretation. Clin. 4 (3): 173-80. We note several limitations of the current study. 2015;49(12):768-74. Treatment and prognosis. For example, someone who lives alone may not be able to do so without the use of one arm. Avascular necrosis of the hip (AVN) is more common than in other sites, presumably due to a combination of precarious blood supply and high loading when standing. NEW! Treatment and prognosis. Associations ~65% of patients with spondylolysis will progress to spondylolisthesis 2, which is seen radiographically in ~25% 4; in most patients this occurs before the age of 16; spina bifida occulta Mankin HJ. Subchondral insufficiency fracture of the femoral head: a differential diagnosis in acute onset of coxarthrosis in the elderly. World J Orthop. Early MR imaging findings include low-signal-intensity changes in the metatarsal head on T1-weighted images with increased signal intensity on corresponding T2-weighted and STIR images. Extension of the fracture to the transverse foramina should be sought, raising the possibility of vertebral artery injury. American Jewish Archives. We also considered the presence of risk factors for osteonecrosis, involvement of the opposite femoral head and histological findings in operated cases. Freiberg AH. Treatment and prognosis Rib fractures themselves are treated symptomatically and have a good prognostic outcome. From March 2005 to May 2014, 37 patients were diagnosed as having a SIF of the femoral head at two institutions. If there is non-union, then excision of the fragment is undertaken. Epidemiology. 2007;28(9):1819-23. Sign in. Close radiographic follow-up is required. It can be bilateral in up to 10% of cases. The International Association of Oral and Maxillofacial Surgeons (IAOMS) is the largest not-for-profit professional association representing oral and maxillofacial surgeons worldwide. Pathology. In late reparative stage, fibrous tissue and fracture callus are seen around the fracture site. For example, someone who lives alone may not be able to do so without the use of one arm. However, sternal fractures associated with other injuries have a higher mortality rate. 3. 2. Yamamoto T, Bullough PG. The term "hangman fracture" was introduced by Schneider in 1965 5. Lee S, Endo Y, Potter H. Imaging of Groin Pain: Magnetic Resonance and Ultrasound Imaging Features. 10. This study showed that anterior deficiency of the acetabulum and decrease of lumbar lordosis are risk factors of SIF as well as lateral deficiency of the acetabulum. Despite treatment, there remains a high risk of future degenerative arthritis and wrist instability. Fractures of the entire posterior process of the talus are extremely rare. Approval of final manuscript: all authors. Tsuchie H, Yamada S, Tazawa H, Kijima H, Shimada Y. Anterior hip subluxation due to lumbar degenerative kyphosis and posterior pelvic tilt. Figure 2: base of skull lines (annotated images), Case 10: with vertebral artery transection, AO Spine classification of upper cervical injuries, Gustilo Anderson classification (compound fracture), Anderson and Montesano classification of occipital condyle fractures, Traynelis classification of atlanto-occipital dissociation, longitudinal versus transverse petrous temporal bone fracture, naso-orbitoethmoid (NOE) complex fracture, cervical spine fracture classification systems, AO classification of upper cervical injuries, subaxial cervical spine injury classification (SLIC), thoracolumbar spinal fracture classification systems, AO classification of thoracolumbar injuries, thoracolumbar injury classification and severity score (TLICS), Rockwood classification (acromioclavicular joint injury), Neer classification (proximal humeral fracture), AO classification (proximal humeral fracture), AO/OTA classification of distal humeral fractures, Milch classification (lateral humeral condyle fracture), Weiss classification (lateral humeral condyle fracture), Bado classification of Monteggia fracture-dislocations (radius-ulna), Mason classification (radial head fracture), Frykman classification (distal radial fracture), Hintermann classification (gamekeeper's thumb), Eaton classification (volar plate avulsion injury), Keifhaber-Stern classification (volar plate avulsion injury), Judet and Letournel classification (acetabular fracture), Harris classification (acetebular fracture), Young and Burgess classification of pelvic ring fractures, Pipkin classification (femoral head fracture), American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture), Cooke and Newman classification (periprosthetic hip fracture), Johansson classification (periprosthetic hip fracture), Vancouver classification (periprosthetic hip fracture), Winquist classification (femoral shaft fracture), Schatzker classification (tibial plateau fracture), AO classification of distal femur fractures, Lauge-Hansen classification (ankle injury), Danis-Weber classification (ankle fracture), Berndt and Harty classification (osteochondral lesions of the talus), Sanders CT classification (calcaneal fracture), Hawkins classification (talar neck fracture), anterior superior iliac spine (ASIS) avulsion, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, avulsion fracture of the proximal 5th metatarsal. Close radiographic follow-up is required. Mechanism. The most advanced way to teach, practice, and assess clinical reasoning skills. Mandibular fractures are relatively common especially among young men. Since Offierski and MacNab described mechanical interactions between the spine and pelvis, the association between lumbar spine and hip lesions, so called hip-spine syndrome has been investigated (16). Colles fractures are the most common type of distal radial fracture and are seen in all adult age groups and demographics. 2. Arch Bone Jt Surg. In early stage, the band lesion is surrounded by bone marrow edema. Ikemura S, Yamamoto T, Nakashima Y, Shuto T, Jingushi S, Iwamoto Y. Check for errors and try again. Hence surgical treatment of displaced fractures or angulation. Mont MA, Jones LC, Hungerford DS. MRI is the most sensitive modality, with a sensitivity of 71-100% and specificity of 94-100% 1. J Korean Med Sci. Treatment and prognosis Treatment depends on both the particulars of the fracture and the patient. Albert H Freiberg(1868-1940), was an American orthopedic surgeon, who first described his eponymous condition in 1914 8,9,11. normal variant: metatarsal head flattening is described in ~10% of the asymptomatic population, including subchondral insufficiency fracture, lesser metatarsal head instability (only identified on MRI): due to plantar plate tear. 21 (6): 1425-40. Treatment is broadly classified into non-surgical management with a stabilizing brace or orthotic or surgical management, usually by posterior fusion +/- anterior fusion. Unable to process the form. North Am. Femoral head avascular necrosis: CT assessment with multiplanar reconstruction. In our patients, none had coronal pelvic obliquity more than 10. J Comput Assist Tomogr. Epidemiology. Freiberg disease. Deficient anterior coverage of the acetabulum as well as deficient lateral coverage induces a decrease in the acetabular coverage. We performed a multivariate analysis to identify risk factors for SIF. 1. WebSubchondral insufficiency fracture of the femoral head mainly occurs in the osteoporotic elderly women and in organ transplant recipients .
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