Clinical History, Examination and Blood Test Results

  • Step 4 case 1 presents a 50 year old gentleman who was diagnosed with a slipped upper femoral epiphysis as a child, and underwent pinning and osteotomy.  He has suffered with a stiff and shortened leg as a result. 

Imaging Results

PRE-OP RADIOGRAPH

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this shows severe deformity of the right hip, with pins in the right femur from previous surgery.

This shows severe deformity of the right hip, with pins in the right femur from previous surgery.

 

PRE-OP LONG LEG

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Pre-op long leg radiograph: helps the surgeon determine the source of the leg length discrepancy and plan the surgery.


Diagnosis

  • Severe right femoral deformity causing a stiff and shortened right leg


Treatment

LONG STEM CORAIL 

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Long stem corail: Indicated for use in revision for Paprosky Type 2 & 3A defects, or primary for osteoporotic bone, or very large femurs.

 

Imaging Outcomes

POST-OP RADIOGRAPH

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ONE-YEAR POST-OP RADIOGRAPH

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This shows satisfactory positioning of the long stem Corail implant.

This one-year post-operative follow up radiograph shows that the implant hasn't moved since the post-operative image was taken.


Clinical Outcomes

  • He has made a good recovery and is much more mobile and pain free as a result.


Learning Points

  • A long non modular femoral stem allows the surgeon to bypass femoral defects to gain stability.

  • Long leg pre-operative radiographs help determine the source of leg length discrepancy.