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causes of pathological fracture in femur

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https://www.readbyqxmd.com/read/29690812/analysis-of-orthopedic-surgery-of-patients-with-metastatic-bone-tumors-and-pathological-fractures
#1
Resit Sevimli, Mehmet Fatih Korkmaz
Objective This study was performed to determine the most common causes, locations, and treatments of metastasizing primary tumors through evaluation of patients with metastatic bone tumors who were admitted to our clinic. Methods In total, 96 patients with metastatic bone tumors who were admitted to our clinic from 2000 to 2016 were included in the study. Results The breast (30 patients, 31.3%) and lung (18 patients, 18.8%) were the most commonly metastasized primary organs. The femur was the most commonly metastasized bone...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29629144/label-free-raman-spectroscopy-provides-early-determination-and-precise-localization-of-breast-cancer-colonized-bone-alterations
#2
Chi Zhang, Paul T Winnard, Sidarth Dasari, Scott L Kominsky, Michele Doucet, Swaathi Jayaraman, Venu Raman, Ishan Barman
Breast neoplasms frequently colonize bone and induce development of osteolytic bone lesions by disrupting the homeostasis of the bone microenvironment. This degenerative process can lead to bone pain and pathological bone fracture, a major cause of cancer morbidity and diminished quality of life, which is exacerbated by our limited ability to monitor early metastatic disease in bone and assess fracture risk. Spurred by its label-free, real-time nature and its exquisite molecular specificity, we employed spontaneous Raman spectroscopy to assess and quantify early metastasis driven biochemical alterations to bone composition...
January 21, 2018: Chemical Science
https://www.readbyqxmd.com/read/29581916/hip-fracture-in-a-patient-with-primary-hyperparathyroidism-medical-and-surgical-lessons
#3
M N Baig, Cathal Mac Dhaibheid, Fintan J Shannon
Hyperparathyroidism is a condition which can be primary, secondary or tertiary and is characterized by increased calcium levels, low phosphate levels, and elevated parathyroid hormone (PTH) levels. Primary hyperthyroidism can cause severe bone resorption leading to bone pains and pathological fracture. We present the case of a patient with severe primary hyperparathyroidism with an atraumatic fracture at the neck of the femur and multiple medical comorbidities presenting a surgical challenge. While primary hyperparathyroidism is rare, it should be considered during differential diagnoses...
January 23, 2018: Curēus
https://www.readbyqxmd.com/read/29516238/healing-nonunion-and-re-operation-after-internal-fixation-of-diaphyseal-and-distal-femoral-fractures-a-systematic-review-and-meta-analysis
#4
Riikka E Koso, Cristina Terhoeve, R Grant Steen, Robert Zura
PURPOSE: Nonunion is a highly morbid complication that exacerbates the pain, disability and financial burden of distal and diaphyseal femur fractures. This study examined the modern rates of healing, nonunion, and other complications requiring reoperation of different fixation methods for distal and diaphyseal femur fractures. METHODS: A systematic review and meta-analysis of all records from PubMed, Embase and the Cochrane Review system was performed. Included studies had >20 acute, non-pathologic distal or diaphyseal femur fractures treated with primary internal fixation...
March 8, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29499640/grade-iii-bone-cement-implantation-syndrome-in-malignant-lung-cancer-patient-a-case-report
#5
Pawan Kumar Hamal, Puspa Raj Poudel, Janith Singh
BACKGROUND: Bone cement implantation syndrome is a known complication causing mortality during perioperative period particularly in patients with malignancy. With rise in aging population with malignancy in low income country, the syndrome is more likely to be encountered. CASE PRESENTATION: We present a case of 66 years old male patient with metastatic bronchogenic carcinoma of lung with pathological proximal femur fracture of left hip that underwent a cemented endoprosthesis under combined spinal epidural anesthesia who succumbed to intraoperative mortality due to grade III bone cement implantation syndrome even after aggressive fluid resuscitation, vasopressor use, and mechanical ventilation...
March 2, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29442350/occult-phosphaturic-mesenchymal-tumor-of-femur-cortex-causing-oncogenic-osteomalacia-diagnostic-challenges-and-clinical-outcomes
#6
Deep Dutta, Raghuvansh Kumar Pandey, Rakhee Gogoi, Nagender Solanki, Renu Madan, Anupam Mondal, Shruti Dogra, Pradeep Thapa
BACKGROUND: Tumor induced osteomalacia (TIO) are extremely rare paraneoplastic syndrome with less than 300 reported cases. This report highlights the pitfalls and challenges in diagnosing and localizing TIO in patients with refractory and resistant osteomalacia. PATIENT AND METHODS: 41- year gentleman with 4-year history of musculoskeletal weakness and pathologic fractures presented in wheelchair bound incapacitated state of 1-year duration. Investigations were significant for severe hypophosphatemia, severe phosphaturia, normal serum calcium, reduced 1,25-dihydroxy vitamin-D, elevated ALP, elevated intact parathyroid hormone (iPTH), and pseudo-fractures involving pelvis and bilateral femur...
February 14, 2018: Endokrynologia Polska
https://www.readbyqxmd.com/read/29072235/reconstruction-of-lower-extremity-primary-malignant-and-metastatic-bone-tumours-with-modular-endoprosthesis
#7
H Sezgin, A Çıraklı, H Göçer, N Dabak
INTRODUCTION: This study is aimed to assess the functional results of cases with lower extremity malignant and metastatic bone tumours that were treated with modular tumour resection prostheses. MATERIALS AND METHODS: 49 patients were retrospectively examined. 27 (55.1%) patients had a primary bone tumour, and 22 (44.9%) had a metastatic bone tumour. Although most tumours located in the proximal femur were metastatic, tumours located around the knee were mostly primary malignant bone tumours...
September 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29051895/chronic-lymphocytic-leukemia-a-rare-cause-of-pathological-fracture-of-the-femur
#8
Parita Soni, Nidhi Aggarwal, Anand Rai, Vivek Kumar, Kamholz Stephan, Yoon Taek, Kupfer Yizhak
The incidence rate of chronic lymphocytic leukemia (CLL) in the United States is approximately 0.005%; men are at slightly higher risk than women. Bony involvement or pathological fracture rarely occurs in CLL, and it may be the initial presentation. An 85-year-old woman presented with acute respiratory failure secondary to pneumonia. Symptomatology included dyspnea. She was found to have pathological fracture of the femur caused by CLL. The diagnosis of CLL had been made 6 years previously, but the patient had refused therapy...
October 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28992299/fracture-after-radiation-therapy-for-femoral-metastasis-incidence-timing-and-clinical-features
#9
Tetsuo Shimoyama, Hirohisa Katagiri, Hideyuki Harada, Hideki Murata, Junji Wasa, Seiichi Hosaka, Takayoshi Suzuki, Mitsuru Takahashi, Hirofumi Asakura, Tetsuo Nishimura, Harumoto Yamada
We analyzed 428 femoral metastases initially treated with radiotherapy between 2002 and 2011 to clarify the clinical details of post-irradiation fractures of femoral metastasis. Patients included 161 men and 167 women, with a mean age of 62 years. Fracture incidence, fracture site, fracture risk based on X-ray images before radiotherapy, and interval from completion of radiotherapy to fracture occurrence were assessed. In addition, 24 pathological specimens obtained during 27 surgeries for these fractures were examined...
September 1, 2017: Journal of Radiation Research
https://www.readbyqxmd.com/read/28840055/one-year-readmission-risk-and-mortality-after-hip-fracture-surgery-a-national-population-based-study-in-taiwan
#10
Tien-Ching Lee, Pei-Shan Ho, Hui-Tzu Lin, Mei-Ling Ho, Hsuan-Ti Huang, Je-Ken Chang
Early readmission following hip fracture (HFx) is associated with high morbidity and mortality. We conducted a survival analysis of patients with readmission within 1 year after HFx to elucidate the trend and predictors for readmission. We used Taiwan National Health Insurance Database to recruit HFx patients who underwent operations between 2000 and 2009. Patients < 60 years; with pathological fractures; involved in major traffic accidents; with previous pelvis, femur, and hip operations; or who died during the index admission were excluded...
July 2017: Aging and Disease
https://www.readbyqxmd.com/read/28741325/continuous-pain-and-swelling-after-humerus-fracture-in-an-86-years-old-woman
#11
M Herrera-Pérez, J Boluda-Mengod, R Muñoz-Ortus, M J Gutiérrez-Morales, J Pais-Brito
Metastases to bone are the most frequent cause of destructive lesions to the skeleton in adults . The tumours that are most likely to metastasize to bone are prostate (32%), breast (22%), kidney (16%), lung and thyroid. The typical distribution of metastatic lesions are to the spine, ribs, pelvis, and proximal limb girdles. The humerus is the second most common site for long bone metastases, behind only the femur in its frequency of involvement . It represents the 20% of all bony metastases. We present a clinical case of an 86 yo woman with a previous diagnosis of myofibroblastic sarcoma of the maxillaris who suffers a pathological fracture of the humeral shaft secondary to metastasis and was misdiagnosed and treated for a typical humeral fracture using and intramedullary pinning (Hackethal technique), producing the progression of the disease within the humeral shaft...
January 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28642858/pathological-fracture-of-femoral-neck-leading-to-a-diagnosis-of-wilson-s-disease-a-case-report-and-review-of-literature
#12
Nishit Bhatnagar, Purushotham Lingaiah, Jeetendra Singh Lodhi, Yugal Karkhur
Wilson's disease (WD) is a rare inherited disorder of copper metabolism. It chiefly has hepatic, neurological and ophthalmic manifestations. Although osteoporosis, rickets and early arthritis are common features of WD, they are under-recognized. Musculoskeletal manifestations very rarely lead to diagnosis of the disease. Here we present a case of a 12-year-old girl who presented with a 3-month-old pathological fracture of neck of femur. WD was diagnosed on investigating the cause of the pathological fracture, which was managed by performing a conventional McMurray's intertrochanteric osteotomy...
May 2017: Journal of Bone Metabolism
https://www.readbyqxmd.com/read/28630838/a-case-report-of-an-unusual-case-of-tuberculous-osteomyelitis-causing-spontaneous-pathological-fracture-of-humerus-in-a-middle-aged-female
#13
Umesh Birole, Ashish Ranade, Mahesh Mone
INTRODUCTION: Tuberculosis is a major health problem worldwide. Extrapulmonary tuberculosis is often secondary to some primary foci in lungs. There are reports of tuberculous osteomyelitis involving maxilla, ulna, femur, and shoulder joint but none have reported pathological fracture in humeral diaphysis due to tuberculosis osteomyelitis without shoulder joint involvement. We report a case of pathological fracture of humerus diaphysis due to tuberculous osteomyelitis with normal articular space...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28629828/factors-associated-with-the-decision-of-operative-procedure-for-proximal-femoral-bone-metastasis-questionnaire-survey-to-institutions-participating-the-bone-and-soft-tissue-tumor-study-group-of-the-japan-clinical-oncology-group
#14
Nobuhito Araki, Hirokazu Chuman, Tomoya Matsunobu, Kazuhiro Tanaka, Hirohisa Katagiri, Toshiyuki Kunisada, Toru Hiruma, Hiroaki Hiraga, Hideo Morioka, Hiroshi Hatano, Kunihiro Asanuma, Yoshihiro Nishida, Koji Hiraoka, Takeshi Okamoto, Satoshi Abe, Munenori Watanuki, Takeshi Morii, Hideshi Sugiura, Yukihiro Yoshida, Takatoshi Ohno, Hidetatsu Outani, Koichiro Yokoyama, Shoji Shimose, Haruhiko Fukuda, Yukihide Iwamoto
BACKGROUND: Pathological fracture of the proximal femur is a main cause of cancer patients losing their ability to walk. Although both osteosynthetic devices (predominantly intramedullary nails) and prosthetic replacement have been widely performed for treatment, controversies exist regarding which procedure should be used for the various conditions. In order to decide the eligibility criteria of a planned randomized prospective study about the treatment of pathological fractures of the proximal femur, we assessed the factors affecting the selection of operative procedures using questionnaires sent to the members of the Bone and Soft Tissue Tumor Study Group (BSTTSG) of the Japan Clinical Oncology Group (JCOG)...
September 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28538416/case-report-of-2-sudden-deaths-after-surgery-for-bone-fracture-usefulness-of-immunohistochemical-analysis-of-coronary-artery-for-identifying-acute-myocardial-infarction
#15
Atsushi Kurata, Jun Nishida, Takashi Koyama, Tamotsu Miki, Hirotsugu Hashimoto, Kengo Yamamoto, Masahiko Kuroda
RATIONALE: Death following orthopedic surgery has become rare, but does occur. Acute myocardial infarction (AMI) can be a cause of such death, but diagnosis of AMI is often challenging, even by autopsy. PATIENT CONCERNS: We have recently experienced 2 cases of sudden death after bone fracture surgery, in which AMI and pulmonary thromboembolism were clinically suspected as causes of death. Case 1 was a 60-year-old male with a history of diabetes mellitus who died 7 days after surgery for Lisfranc dislocation fracture...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28469049/spontaneous-fracture-of-the-femur-due-to-osteomyelitis-caused-by-the-streptococcus-anginosus-group
#16
E H C C Janssen, L C J de Bree, K M Kant, P van Wijngaarden
A 57-year-old man was admitted because of pain in the right upper leg due to an osteolytic lesion of the femoral bone which was complicated by a spontaneous fracture. At first a malignancy was suspected. However, blood and bone cultures revealed the Streptococcus anginosus group. A diagnosis of acute osteomyelitis was made. In spite of extensive antibiotic and surgical treatment the patient developed severe septic shock with multiple organ failure and died. In the case of a pathological fracture, one should consider the broad differential diagnosis, including osteomyelitis, which should lead to a laboratory work-up and imaging studies...
April 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28240373/effect-of-simulated-metastatic-lesions-on-the-biomechanical-behavior-of-the-proximal-femur
#17
Emir Benca, Andreas Reisinger, Janina M Patsch, Lena Hirtler, Alexander Synek, Sandra Stenicka, Reinhard Windhager, Winfried Mayr, Dieter H Pahr
Pathologic fractures of femora in patients with metastatic cancer are associated with high morbidity and mortality. Prediction of impending fractures is based on unspecific clinical criteria or past clinician's experience, which leads to underestimation or overtreatment. The aim of this study was to investigate the effect of the site of metastatic lesions on biomechanical behavior of the proximal femur. Sixteen pairs of human femora were scanned with quantitative computed tomography (QCT) to asses bone mineral density...
November 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/27777921/pathologic-fracture-of-the-femur-in-brown-tumor-induced-in-parathyroid-carcinoma-a-case-report
#18
Sang-Hyun Park, Gyu-Min Kong, Yong-Uk Kwon, Jun-Ho Park
Brown tumor refers to a change of skeletones that develops as a complication of hyperparathyroidism. As osteoclast is activated to stimulate reabsorption and fibrosis of bone, it causes a cystic change of the bone. Parathyroid carcinoma is being reported as a tumor that induces primary hyperparathyroidism. It causes excessive secretion of the parathyroid hormone and increases the blood parathyroid hormone and calcium. Bone deformation due to brown tumor is known to be naturally recovered through the treatment for hyperparathyroidism...
September 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/27541832/a-novel-ano5-mutation-causing-gnathodiaphyseal-dysplasia-with-high-bone-turnover-osteosclerosis
#19
Tim Rolvien, Till Koehne, Uwe Kornak, Wolfgang Lehmann, Michael Amling, Thorsten Schinke, Ralf Oheim
Gnathodiaphyseal dysplasia (GDD) is a rare skeletal syndrome that involves an osteopetrosis-like sclerosis of the long bones and fibrous dysplasia-like cemento-osseous lesions of the jawbone. Although the genetic analysis of the respective patients has revealed mutations in the ANO5 gene as an underlying cause, there is still no established consensus regarding the bone status of GDD patients. We report a new case of GDD in a 13-year-old boy with recurrent diaphyseal fractures of the femur, in whom we identified a novel de novo missense mutation in the ANO5 gene, causing a p...
February 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/27389120/ct-guided-percutaneous-femoroplasty-pfp-for-the-treatment-of-proximal-femoral-metastases
#20
Helin Feng, Jin Wang, Peng Guo, Jianfa Xu, Wei Chen, Yingze Zhang
BACKGROUND: The spine, pelvis, skull, and femur are the most common sites of bone metastases, and pain is the main symptom of metastatic tumors. Percutaneous femoroplasty (PFP) is becoming increasingly popular for treating proximal femoral metastases. OBJECTIVES: To assess the clinical value and feasibility of PFP performed under the guidance of computed tomography (CT). STUDY DESIGN: A retrospective clinical review comparing pain intensity and the ability to perform activities of daily living before and after treatment with PFP...
2016: Pain Physician
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