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https://www.readbyqxmd.com/read/29341846/primary-intra-medullary-nailing-of-open-tibia-fractures-caused-by-low-velocity-gunshots-does-operative-debridement-increase-infection-rates
#1
Chester J Donnally, Charles M Lawrie, Jonathan I Sheu, Meredith A Gunder, Stephen M Quinnan
BACKGROUND: Although gunshot-induced extremity fractures are typically not considered open fractures, there is controversy regarding wound management in the setting of operative fixation to limit infection complications. Previous studies have evaluated the need for a formal irrigation and debridement (I&D) prior to intra-medullary nailing (IMN) of gunshot-induced femur fractures but none have specifically evaluated tibias. By comparing primary IMN for tibial shaft fractures caused by low-velocity firearms additionally treated with a formal operative I&D (group 1) with those without an I&D (group 2), we sought to identify whether there are: differences in treatment group infection rates; particular fracture patterns more prone to infection; and patient characteristics more prone to infections...
January 17, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29339529/management-of-endocrine-disease-atypical-femoral-fractures-risks-and-benefits-of-long-term-treatment-of-osteoporosis-with-anti-resorptive-therapy
#2
Robert Adler
Modern osteoporosis treatment began in the mid-1990's with the approval of amino-bisphosphonates, anti-resorptive agents that have been shown to decrease osteoporotic fracture risk by about half. In 2005, the first cases of atypical femoral fractures (AFF), occurring in the shaft of the femur, were reported. Since then, more cases have been found, leading to great concern among patients and a dramatic decrease in bisphosphonate prescribing. The pathogenesis and incidence of AFF are reviewed herein. Management and an approach to prevention or early detection of AFF are also provided...
January 16, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29338853/atypical-fractures-an-issue-of-concern-or-a-myth
#3
Mohammad Al-Ashqar, Michalis Panteli, Gautam Chakrabarty, Peter V Giannoudis
Atypical Femoral Fractures (AFF) represent fractures located between the lesser trochanter and the supracondylar flare of a femur. An increasing pool of evidence supports their association with the prolonged use of bisphosphonates, even though a direct correlation is yet to be proved. The purpose of this review is to encapsulate the current evidence associating bisphosphonate use and the development of AFFs, the clinical features related to their presentation, as well as to report the armamentarium of strategies available in the prevention and treatment of AFFs...
December 16, 2017: Injury
https://www.readbyqxmd.com/read/29332432/spontaneous-fetal-femoral-fracture-a-case-report-and-literature-review
#4
Mingming Yu, Dapeng Xu, Aiguo Zhang, Jun Shen
Spontaneous fetal femoral fractures are uncommon in the paediatric setting. The major clinical presentations of a spontaneous fetal femoral fracture are femoral angulation, shortness of the femur and even a marked fracture line. This case report describes a spontaneous fetal femoral fracture of the right femur, which was detected by routine ultrasonography during the 19th week of gestation in a 24-year-old woman. On routine follow-up visits, the angulation of the right femur in the fetus gradually improved...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29331010/implants-for-extracapsular-neck-of-femur-fracture-dynamic-hip-screw-versus-intramedullary-nailing
#5
Faisal Farooq Butt, Adnan Shabbair Hussain, Ahmed Mushtaq Khan, Maria Sultan
Neck of femur fractures are the most prevalent type of injury in elderly trauma patients. Both intra and extra capsular type of fractures are equally distributed in the given population. Traditionally, Extra capsular fractures are fixed with Dynamic Hip screw or Intra medullary nailing based on the type of fracture. NICE (National Institute of Clinical Excellence) recommends fixing 31-A1 and 31-A2 fractures with DHS (Dynamic Hip Screw) whereas AO recommends fixing 31-A1 with DHS and 31-A2.1 subtype with DHS and 31-A2...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29329171/nonhuman-primate-rhesus-macaque-models-of-severe-pressure-targeted-hemorrhagic-and-polytraumatic-hemorrhagic-shock
#6
Forest R Sheppard, Antoni R Macko, Jacob J Glaser, Philip J Vernon, Alexander J Burdette, Ruth Madelaine Paredes, Craig A Koeller, Anthony E Pusateri, Douglas K Tadaki, Sylvain Cardin
BACKGROUND: We endeavored to develop clinically translatable nonhuman primate (NHP) models of severe polytraumatic hemorrhagic shock. METHODS: NHPs were randomized into five severe pressure-targeted hemorrhagic shock (PTHS) ± additional injuries scenarios: 30-min PTHS (PTHS-30), 60-min PTHS (PTHS-60), PTHS-60 + soft tissue injury (PTHS-60+ST), PTHS-60+ST + femur fracture (PTHS-60+ST+FF), and decompensated PTHS+ST+FF (PTHS-D). Physiologic parameters were recorded and blood samples collected at five time points with animal observation through T = 24 h...
February 2018: Shock
https://www.readbyqxmd.com/read/29328790/hospital-stay-and-blood-transfusion-in-elderly-patients-with-hip-fractures
#7
Efthymios Iliopoulos, Sohail Yousaf, Hazel Watters, Arshad Khaleel
Neck of femur (NOF) fractures in elderly patients are the most frequent condition which an orthopaedic surgeon confronts nowadays. The incidence of these fractures is increasing as the population continues to age. These patients absorb the majority of the resources in the hospitals, as their healthcare demands are increased. This study included all patients who were admitted to our hospital between January and October 2015 following a neck of femur fracture. A total of 336 patients were included (72.3% female)...
December 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29327108/computed-tomography-for-occult-fractures-of-the-proximal-femur-pelvis-and-sacrum-in-clinical-practice-single-institution-dual-site-experience
#8
Jacob C Mandell, Michael J Weaver, Bharti Khurana
PURPOSE: The purpose of this study was to evaluate the diagnostic performance of CT for assessment of occult fractures of the proximal femur, pelvis, and sacrum. MATERIALS AND METHODS: A retrospective review was performed on patients who received a CT of the hip or pelvis for suspected occult fracture after negative or equivocal radiographs performed within 24 h. The official radiology report was utilized for the determination of CT findings and calculation of sensitivity and specificity...
January 11, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29326764/a-prospective-study-to-evaluate-the-management-of-sub-trochanteric-femur-fractures-with-long-proximal-femoral-nail
#9
M Kumar, V Akshat, A Kanwariya, M Gandhi
Introduction: Sub-trochanteric fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. This study was done to analyse the management and complications of sub-trochanteric fractures using long proximal femoral nail (PFN). Materials and Methods: This was a prospective study of 50 patients with sub-trochanteric fractures of femur who were treated with long PFN at a tertiary care center from July 2012 to June 2016. The fractures were classified according to Seinsheimer classification...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29326763/incidence-of-varus-malalignment-post-interlocking-nail-in-proximal-femur-shaft-fractures-comparing-two-types-of-entry-points
#10
A N Sadagatullah, M N Nazeeb, S Ibrahim
Introduction: Osteosynthesis of the femur using an interlocking nail is the gold standard for treating diaphyseal fractures of the femur. There are two established entry points for the antegrade interlocking nails which is the piriformis fossa or the greater trochanter. It has been reported that varus malalignment was frequently seen in proximal femur fracture which were treated with interlocking nail utilizing the greater trochanter entry point. The study was done to find out if the problem was of significance...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29324632/chair-lift-falls-and-injuries-in-children
#11
Eric W Glissmeyer, Ryan R Metzger, Robert Bolte
OBJECTIVE: The objective of this study was to compare demographic injury and treatment characteristics of hospitalized pediatric cases of falls from chair lifts to cases of other ski and snowboarding injuries and identify potential interventions for preventing falls from chair lifts. METHODS: Retrospective query of the trauma registry of Utah's only pediatric trauma center for children younger than 18 years requiring hospitalization for a ski or snowboarding injury from November 2004 to February 2014...
January 11, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29324528/titanium-elastic-nailing-has-superior-value-to-plate-fixation-of-midshaft-femur-fractures-in-children-5-to-11-years
#12
Jerad D Allen, Kevin Murr, Ferras Albitar, Cale Jacobs, Eric S Moghadamian, Ryan Muchow
BACKGROUND: American Academy of Orthopaedic Surgeons (AAOS) Clinical Practice Guidelines for pediatric femoral shaft fractures indicate titanium elastic nails (TENs) for children 5 to 11 years old. Growing evidence suggests these fractures may also be treated with open or submuscular plating. The purpose of this study was to compare estimated blood loss (EBL), operative time, fluoroscopy time, cost, and subjective and objective pain scores between TENs and plating techniques used in 5- to 11-year-old children with midshaft femur fractures based on length stability...
January 10, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29322292/bilateral-symmetrical-comparison-of-the-proximal-femur-using-3d-ct-models
#13
Filip C Dolatowski, Max J Temmesfeld, Claude Pierre-Jerome, Arne Borthne, Sigurd Erik Hoelsbrekken
PURPOSE: Superimposed three-dimensional (3D)-models obtained from CT-images have been used to evaluate displacement of femoral neck fractures, but this method assumes symmetrical anatomy of normal femurs. The present study aimed to compare the spatial orientation of the left and right proximal femur, thus establishing if 3D models can be used as a reference standard for the evaluation of fracture displacement. METHODS: We generated 3D-CT-models of 20 patients with no skeletal pathology of the proximal femurs...
January 10, 2018: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29321359/association-of-lactase-13910-c-t-polymorphism-with-bone-mineral-density-and-fracture-risk-a-meta-analysis
#14
Yougen Wu, Yinghua Li, Yunqing Cui, Yunjiao Zhou, Qingqing Qian, Yang Hong
A number of studies have investigated the association of lactase (LCT,C/T-13910) gene polymorphismwith bonemineral density (BMD) and fracture risk, but previous results were inconclusive. In this study, a meta-analysis was performed to quantify the association of LCT (C/T-13910) polymorphism with BMD and fracture risk. Eligible publications were searched in the PubMed, Web of Science, Embase databases, Google Scholar, Yahoo and Baidu. Pooled weighed mean difference (WMD) or odds ratio (OR) with their 95% confidence interval (CI) were calculated using a fixed-effects or random-effects model...
December 2017: Journal of Genetics
https://www.readbyqxmd.com/read/29320924/a-model-to-evaluate-pauwels-type-iii-femoral-neck-fractures
#15
Kevin M Magone, Jonas K Owen, Bernard P Kemker, Oliver Bloom, Sidney Martin, Patrick Atkinson
While many femoral neck fractures can be reliably treated with surgical intervention, Pauwels III femoral neck fractures in the young adult population continue to be a challenging injury, and there is no consensus on optimal treatment. As such, there are past and ongoing biomechanical studies to evaluate the fixation provided by different constructs for this inherently unstable fracture. While many investigations rely on cadavers to evaluate the biomechanical performance of a construct, significant inter-subject variability can confound the analysis...
January 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/29318091/nerve-blocks-in-the-geriatric-patient-with-hip-fracture-a-review-of-the-current-literature-and-relevant-neuroanatomy
#16
REVIEW
Nirav H Amin, Jacob A West, Travis Farmer, Hrayr G Basmajian
Introduction: Hip fracture is a common occurrence in the elderly population with high morbidity and mortality due to postoperative pain and opioid use. The goal of this article is to review the current literature on the neuroanatomy of the hip and the use of localized nerve block in controlling hip fracture pain. Methods: A thorough search of MEDLINE/PubMed, Embase, and the Cochrane Database of Systematic Reviews was conducted using the search terms "hip fracture" and "fascia iliaca block (FICB)...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318088/hoffa-fragments-in-the-geriatric-distal-femur-fracture-myth-or-reality
#17
Brian W Hill, Lisa K Cannada
Background: Previous research reported the frequency of coronal plane (Hoffa) fractures in high-energy supracondylar femur fractures in a relatively young population. It is the purpose of this study to identify the frequency of coronal plane fractures seen in elderly patients. Methods: All patients over the age of 18 years treated for supracondylar femur fractures at 2 level I trauma centers were reviewed over a 4-year period. The patients were stratified (≥60 years and <60 years) and compared to determine differences in injury characteristics and fracture patterns with special attention to the prevalence of coronal plane fractures...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318081/-hidden-preoperative-blood-loss-with-extracapsular-versus-intracapsular-hip-fractures-what-is-the-difference
#18
Katharine D Harper, Paul Navo, Frederick Ramsey, Sainabou Jallow, Saqib Rehman
Purpose: Excessive blood loss with hip fracture management has been shown to result in increased rates of complications. Our goal is to compare blood loss and transfusion rates between patients with intracapsular and extracapsular (both intertrochanteric (IT) and subtrochanteric (ST)) hip fractures. Methods: 472 patients were evaluated over a five-year period. Those who presented to the hospital with a proximal femur fracture (femoral neck, IT or ST) were considered for the study...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318009/assessment-of-osteoporosis-using-the-frax-method-and-the-importance-of-vitamin-d-levels-in-copd-patients
#19
Ceyda Anar, Melike Yüksel Yavuz, Filiz Güldaval, Yelda Varol, Dilek Kalenci
Background: The aim of this paper was to evaluate the availability of FRAX for assessing osteoporosis risk, and to demonstrate the importance of vitamin D levels in COPD patients. Methods: Fourty-six males who fulfilled the COPD diagnostic criteria defined by GOLD were included. Age, race, BMI, physical activity frequency, smoking and dietary habits, age at COPD diagnosis, disease duration, fractures history, and medications use were determined. Levels of 25(OH)D were detected...
2018: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/29316590/hemiarthroplasty-for-fractures-of-metastatic-bone-disease-have-different-outcomes-compared-to-fractures-without-metastasis-a-matched-pair-analysis
#20
Samuel Rosas, Alejandro Marquez-Lara, Alexander H Jinnah, Martin W Roche, Jeffrey S Willey, Chukwuweike Gwam, Cynthia L Emory
INTRODUCTION: Hemiarthropalsty (HA) for proximal femur fractures (PFF) has shown good results in the elderly patient population. It has also been used to treat fractures of the proximal femur in patients with metastatic bone disease (MBD). Nonetheless, complications still occur in both patient populations and their effect on 90-day costs can be a great burden to the healthcare system. Thus, the purpose of this study was to evaluate and compare the outcomes and costs of HA for PFF in patients with bone metastasis versus those without it...
December 22, 2017: Surgical Technology International
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