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causes of pathological fracture in femur

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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
#1
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
#2
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
#3
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)...
June 16, 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
#4
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
#5
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
#6
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...
February 27, 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
#7
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
#8
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...
August 19, 2016: 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
#9
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
https://www.readbyqxmd.com/read/27261972/detection-of-femoral-neck-fractures-in-pediatric-patients-with-femoral-shaft-fractures
#10
Lindsey Caldwell, Charles M Chan, James O Sanders, John T Gorczyca
BACKGROUND: Ipsilateral femoral neck fractures occur in 1% to 9% of adult trauma patients with femoral shaft fractures making dedicated imaging important. This is not as clear in children. Our purpose is to establish the incidence of ipsilateral femoral neck fractures in children with femoral shaft fractures and to provide recommendations regarding diagnostic imaging protocols. METHODS: A retrospective analysis of medical records was performed for pediatric patients (below 18 y) with femoral shaft fractures seen at our trauma center over a 10-year period...
April 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27020436/what-is-the-role-of-allogeneic-cortical-strut-grafts-in-the-treatment-of-fibrous-dysplasia-of-the-proximal-femur
#11
Bastiaan C J Majoor, Marleen J M Peeters-Boef, Michiel A J van de Sande, Natasha M Appelman-Dijkstra, Neveen A T Hamdy, P D S Dijkstra
BACKGROUND: Management of fibrous dysplasia of the proximal femur is a progressive, often recurrent condition of bone that can cause skeletal deformity, fractures, and pain. Allogeneic cortical strut grafting to minimize the risk of fracture or as part of fracture treatment is a promising treatment option, but evidence is scarce on the intermediate- to long-term results of this procedure and there are no data on factors associated with graft failure. QUESTIONS/PURPOSES: The purposes of this study were (1) to evaluate the revision-free survivorship; (2) radiographic findings; (3) factors associated with failure; and (4) complications associated with cortical strut allograft to prevent or treat fractures of the proximal femur in patients with fibrous dysplasia...
March 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/26983184/-epidemiology-morbidity-mortality-cost-to-society-and-the-individual-and-main-causes-for-falls
#12
Régis Gonthier
Falls are the leading cause of accidental death among the elderly, accounting for about 12 000 deaths per year. The risk of falls increases with age: one-third of subjects over 65 years old living in the community and half of those over 85 fall at least once a year. Despite their frequency, falls should not be trivialized, as they are associated with significant morbidity and care expenditure: 10% of falls have severe traumatic consequences, and30 % of hospital admissions for traumatic injury among elderly individuals are due to falls...
June 2014: Bulletin de L'Académie Nationale de Médecine
https://www.readbyqxmd.com/read/26918216/fibrocartilaginous-dysplasia-of-the-bone-a-rare-variant-of-fibrous-dysplasia
#13
Raju Vaishya, Amit Kumar Agarwal, Nishint Gupta, Vipul Vijay
Fibrocartilaginous dysplasia (FCD) is a rare variant of fibrous dysplasia (FD) which frequently involves the long bones, and the proximal femur is the most commonly affected site. This benign, lytic, and expansile bone lesion causes progressive deformity in the bones and may lead to pathological fracture. Radiologically, this lesion may mimic cartilaginous benign and malignant bone tumors. Therefore, histopathological differentiation of FCD from other cartilaginous tumors is of the utmost importance. The treatment is often surgical, in the form of curettage and bone grafting or corrective osteotomy, to treat progressive deformity in the long bones...
2016: Curēus
https://www.readbyqxmd.com/read/26783325/improper-use-of-a-plant-based-vitamin-c-deficient-beverage-causes-scurvy-in-an-infant
#14
Isidro Vitoria, Berta López, Jacinto Gómez, Carolina Torres, María Guasp, Inmaculada Calvo, Jaime Dalmau
Scurvy is a rare disease in developed countries. Risk groups include children with restricted diets, mainly patients who are autistic or have cerebral palsy. Furthermore, consumption of plant-based beverages has increased in recent years, especially in developed countries. When plant-based beverages are the exclusive diet in the first year of life and not consumed as a supplement to formula or breastfeeding, it can result in severe nutritional problems. We report a case of scurvy after exclusive intake of almond beverages and almond flour from 2...
February 2016: Pediatrics
https://www.readbyqxmd.com/read/26630472/maffucci-syndrome-an-interesting-case-and-a-review-of-the-literature
#15
REVIEW
Calvin Ngai, David Y Ding, Timothy B Rapp
Maffucci syndrome, a rare sporadic form of enchondromatosis, is characterized by hemangiomas and multiple enchondromas, benign cartilaginous tumors that arise near growth plates. Previous studies demonstrate that individuals diagnosed with Maffucci syndrome have approximately 100% lifetime risk of malignant transformation. Identification of Maffucci syndrome by surgical excision and pathological diagnosis can be life-saving due to its high malignant potential relative to other subtypes of enchondromatosis such as Ollier's disease...
December 2015: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/26515168/-pathological-and-metabolic-bone-diseases-clinical-importance-for-fracture-treatment
#16
REVIEW
R Oheim
Pathological and metabolic bone diseases are common and relevant occurrences in orthopedics and trauma surgery; however, fractures are often treated as being the illness itself and not seen as the symptom of an underlying bone disease. This is why further diagnostics and systemic treatment options are often insufficiently considered in the routine treatment of fractures. This review focuses on osteoporosis, osteopetrosis, hypophosphatasia and Paget's disease of bone.In patients with osteoporotic vertebral or proximal femur fractures, pharmaceutical treatment to prevent subsequent fractures is an integral part of fracture therapy together with surgical treatment...
December 2015: Der Unfallchirurg
https://www.readbyqxmd.com/read/26488793/use-of-massive-allografts-to-manage-hydatid-bone-disease-of-the-femur
#17
Domingo L Muscolo, Ezequiel E Zaidenberg, German L Farfalli, Luis A Aponte-Tinao, Miguel A Ayerza
Hydatid disease is caused by the parasitic tapeworm Echinococcus granulosus. Osseous involvement accounts for 0.5% to 4% of cases in humans. Patients usually are from endemic zones and are initially asymptomatic, presenting with pain and edema at a later stage of disease. However, large lesions may present initially as pathologic fractures. Standard radiographs usually show expansive osteolytic lesions associated with initial cortical thinning, with compromise of the metaphysis or epiphysis, and may involve the diaphysis...
October 2015: Orthopedics
https://www.readbyqxmd.com/read/26316813/regional-anesthesia-for-the-trauma-patient-improving-patient-outcomes
#18
REVIEW
Jeff Gadsden, Alicia Warlick
Trauma is a significant health problem and a leading cause of death in all age groups. Pain related to trauma is frequently severe, but is often undertreated in the trauma population. Opioids are widely used to treat pain in injured patients but have a broad range of undesirable effects in a multitrauma patient such as neurologic and respiratory impairment and delirium. In contrast, regional analgesia confers excellent site-specific pain relief that is free from major side effects, reduces opioid requirement in trauma patients, and is safe and easy to perform...
2015: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/26248631/pathological-subtrochanteric-femoral-fracture-due-to-extensive-arterio-venous-malformation-a-case-study
#19
Jakub Jończyk, Wojciech Szubert, Michał Panasiuk
Despite the case of a 19-year-old male with a pathological subtrochanteric left femoral fracture in the course of an extensive arteriovenous malformation of the left thigh. The arteriovenous malformation was diagnosed when the patient was 16 years old. He has undergone several embolization procedures. The fracture was caused by a fall from the patient's own height. Before the patient was qualified for surgery of the fracture, a left lower limb angiography confirmed the presence of extensive pathological vascularity (arteriovenous malformation), and an embolization procedure was performed on the branches and trunk of the left deep femoral artery, several vessels branching off of the proximal and distal segment of the superficial femoral artery and one branch of the internal iliac artery...
May 2015: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/26173585/dysregulated-tgf-%C3%AE-signaling-alters-bone-microstructure-in-a-mouse-model-of-loeys-dietz-syndrome
#20
Ashvin K Dewan, Ryan E Tomlinson, Stuart Mitchell, Brian C Goh, Rachel M Yung, Sarvesh Kumar, Eric W Tan, Marie-Claude Faugere, Harry C Dietz, Thomas L Clemens, Paul D Sponseller
Loeys-Dietz syndrome (LDS) is a connective tissue disorder characterized by vascular and skeletal abnormalities resembling Marfan syndrome, including a predisposition for pathologic fracture. LDS is caused by heterozygous mutations in the genes encoding transforming growth factor-β (TGF-β) type 1 and type 2 receptors. In this study, we characterized the skeletal phenotype of mice carrying a mutation in the TGF-β type 2 receptor associated with severe LDS in humans. Cortical bone in LDS mice showed significantly reduced tissue area, bone area, and cortical thickness with increased eccentricity...
October 2015: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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