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Femoral fracture

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https://www.readbyqxmd.com/read/28938339/reduction-techniques-for-diaphyseal-femur-fractures
#1
Philip R Wolinsky, Justin F Lucas
Achieving and maintaining reduction in patients with a diaphyseal femur fracture may be difficult; therefore, thorough preoperative planning is required. To fully prepare for successful surgical management of diaphyseal femur fractures, surgeons must consider appropriate patient positioning and necessary tools, including surgical tables, traction devices, and instruments. Principles of acceptable reduction rely on the restoration of length, alignment, and rotation. Reduction of diaphyseal femur fractures should be attained in the least invasive manner, via percutaneous reduction techniques, if possible, to preserve fracture biology and promote successful fracture healing...
September 21, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28935593/factors-affecting-peri-implant-fracture-following-locking-plate-for-osteoporotic-distal-femur-fractures
#2
Ki-Chul Park, Seung-Jae Lim, Young Sik Song, Kyu-Tae Hwang
INTRODUCTION: The purpose of this study is to evaluate the outcomes and to analyze the risk factors for the occurrence of peri-implant fracture after treatment of osteoporotic distal femoral fracturesusing a locking plate. HYPOTHESIS: Risk factors affecting peri-implant fracture exist after locking plate fixation in osteoporotic distal femur fracture. MATERIALS AND METHODS: Eighty nine(88 patients) with osteoporotic distal femoral fractures were evaluated between January2006 and January2014...
September 18, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28934540/safe-positioning-for-sexual-intercourse-after-proximal-femoral-replacement
#3
Cory G Couch, Richard W Nicholas, Corey O Montgomery
Hip arthroplasty is a common procedure used for the treatment of fractures and degenerative processes affecting the hip. Proximal femoral replacement is an uncommon type of hip arthroplasty used for reconstruction after extensive bone loss. Proximal femoral replacement is used most commonly after the resection of the proximal femur for malignancies and for extensive bone loss encountered in revision hip arthroplasty and occasionally for extensive bone loss after fractures. The authors present a case of a female patient who sustained a prosthetic dislocation of her proximal femoral replacement during sexual intercourse...
September 21, 2017: Orthopedics
https://www.readbyqxmd.com/read/28929003/fatal-cobalt-toxicity-after-a-non-metal-on-metal-total-hip-arthroplasty
#4
Rinne M Peters, Pax Willemse, Paul C Rijk, Mels Hoogendoorn, Wierd P Zijlstra
This case illustrates the potential for systemic cobalt toxicity in non-metal-on-metal bearings and its potentially devastating consequences. We present a 71-year-old male with grinding sensations in his right hip following ceramic-on-ceramic total hip arthroplasty (THA). After diagnosing a fractured ceramic liner, the hip prosthesis was revised into a metal-on-polyethylene bearing. At one year postoperatively, X-rays and MARS-MRI showed a fixed reversed hybrid THA, with periarticular densities, flattening of the femoral head component, and a pattern of periarticular metal wear debris and pseudotumor formation...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28928953/treatment-of-femoral-shaft-fractures-with-monoaxial-external-fixation-in-polytrauma-patients
#5
Gianluca Testa, Domenico Aloj, Alessandro Ghirri, Eraclite Petruccelli, Vito Pavone, Alessandro Massé
Background: Femoral shaft fractures, typical in younger people, are often associated with polytrauma followed by traumatic shock. In these situations, despite intramedullary nailing being the treatment of choice, external fixation could be used as the definitive treatment. The aim of this study is to report evidence regarding definitive treatment of femoral shaft fractures with monoaxial external fixation. Methods: Between January 2006 and December 2015, 83 patients with 87 fractures were treated at the Department of Orthopaedics and Traumatology CTO of Turin, with a monoaxial external fixation device...
2017: F1000Research
https://www.readbyqxmd.com/read/28927455/eight-orthopedic-surgeons-achieved-moderate-to-excellent-reliability-measuring-the-preoperative-posterior-tilt-angle-in-50-garden-i-and-garden-ii-femoral-neck-fractures
#6
Filip C Dolatowski, Sigurd Erik Hoelsbrekken
BACKGROUND: Studies of elderly patients with Garden-I and Garden-II femoral neck fractures (FNFs) suggest that a preoperative posterior tilt of the femoral head of at least 20° increases the risk of fixation failure. A recently published treatment algorithm recommended hemiarthroplasty over internal fixation for elderly patients with Garden-I and Garden-II FNFs and a preoperative posterior tilt of at least 20°. However, the reliability of the method used to measure the posterior tilt has not been assessed according to recommended standards for reliability trials...
September 19, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28924690/lateral-fixation-an-alternative-surgical-approach-in-the-prevention-of-complete-atypical-femoral-fractures
#7
Mohammad Kharazmi, Karl Michaëlsson, Pär Hallberg, Jörg Schilcher
Little evidence is available on how to treat incomplete atypical fractures of the femur. When surgery is chosen, intramedullary nailing is the most common invasive technique. However, this approach is adopted from the treatment of other types of ordinary femoral fracture and does not aim to prevent the impending complete fracture by interrupting the mechanism underlying the pathology. We suggest a different surgical approach that intends to counteract the underlying biomechanical conditions leading to a complete atypical fracture and thus could be better suited in selected cases...
September 18, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28924360/the-correct-implant-choice-for-transtrochanteric-fracture-in-brazil
#8
Diogo Fernandes Torquato, André Figueiredo Bordini, Gustavo Ferreira, Edmilson Takehiro Takata, Gustavo Trigueiro, Ricardo Basile
OBJECTIVE: To assess the adequacy to the Brazilian population of orthopedic implants used for treatment of proximal femoral fractures. METHODS: The neck-shaft angle of the femur of 101 patients was measured in anteroposterior pelvis radiographs and these measurements were correlated to gender, age, height, weight and ethnicity. In addition, we compared the values of the neck -shaft angle with the angulation of the main implants available in the Brazilian market for the treatment of transtrochanteric fractures...
November 2016: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28922726/chronic-arsenicosis-and-cadmium-exposure-in-wild-snowshoe-hares-lepus-americanus-breeding-near-yellowknife-northwest-territories-canada-part-2-manifestation-of-bone-abnormalities-and-osteoporosis
#9
S Amuno, A Al Kaissi, A Jamwal, S Niyogi, C E Quenneville
Various bone abnormalities, including osteoporosis, have been associated with chronic arsenic and cadmium exposure in experimental animal models, but information regarding the bone pathology of wild population of small mammals breeding in contaminated environment is limited. This present study was conducted to comparatively assess the prevalence and pattern of skeletal abnormalities in free ranging snowshoe hares inhabiting an area heavily contaminated by arsenic and other trace metals, near the vicinity of the abandoned Giant mine, and in a reference location approximately 20km from the city of Yellowknife, Northwest Territories, Canada...
September 13, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28921820/systematic-review-and-network-meta-analysis-on-the-relative-efficacy-of-osteoporotic-medications-men-with-prostate-cancer-on-continuous-androgen-deprivation-therapy%C3%A2-to-reduce-risk-of-fragility-fractures
#10
REVIEW
Yeesha Poon, Petros Pechlivanoglou, Shabbir M H Alibhai, David Naimark, Jeffrey S Hoch, Emmanuel Papadimitropoulos, Mary-Ellen Hogan, Murray Krahn
BACKGROUND: Androgen deprivation therapy (ADT) is an effective treatment for men with advanced prostate cancer, but loss of bone mineral density (BMD) is a major risk factor for fractures. This analysis evaluated the relative effectiveness of osteoporosis treatments using BMD as a surrogate endpoint for fragility fractures in men on continuous ADT. METHOD: We included randomized controlled trials studying bisphosphonates, denosumab, toremifene, and raloxifene in patients with non-metastatic prostate cancer on ADT for review...
September 18, 2017: BJU International
https://www.readbyqxmd.com/read/28921338/the-effect-of-high-dose-vitamin-d3-supplementation-on-bone-mineral-density-in-subjects-with-prediabetes
#11
A U Larsen, G Grimnes, R Jorde
The rationale of this study was to determine the effect of high-dose vitamin D3 supplementation on bone mineral density (BMD). Prediabetic males given vitamin D had significantly less reduction in BMD at the femoral neck compared to the controls. The clinical implications of our findings require further investigation. INTRODUCTION: Type 2 diabetes mellitus is associated with increased fracture risk, and recent studies show crosstalk between bone and glucose metabolism. Few studies have investigated the effect of vitamin D supplementation on the bone without additional calcium...
September 18, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28921003/mortality-and-cardiorespiratory-complications-in-trochanteric-femoral-fractures-a-ten-year-retrospective-analysis
#12
Juliane Carow, John Bennet Carow, Mark Coburn, Bong-Sung Kim, Benjamin Bücking, Christopher Bliemel, Leo Cornelius Bollheimer, Cornelius Johannes Werner, Jan Philipp Bach, Matthias Knobe
PURPOSE: Despite intense research and innovations in peri-operative management, a high mortality rate and frequent systemic complications in trochanteric femoral fractures persist. The aim of the present study was to identify predictive factors for mortality and cardio-respiratory complications after different treatment methods in a ten year period at a level I trauma centre. METHODS: Retrospectively, all patients above 60 years of age with trochanteric femoral fracture between January 2000 and May 2011 were analyzed at a level I trauma centre...
September 18, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28920547/decreased-postoperative-gluteus-medius-muscle-cross-sectional-area-measured-by-computed-tomography-scan-in-patients-with-intertrochanteric-fractures-nailing
#13
Mitsuaki Noda, Yasuhiro Saegusa, Masayasu Takahashi, Yuma Takada, Masahiro Fujita, Issei Shinohara
BACKGROUND: In patients with femoral intertrochanteric fractures treated by cephalomedullary (CM) nailing, abduction force reportedly decreased by 25-30% during the postoperative follow-up period. The purpose of the current study is to evaluate the cross-sectional area (CSA) and adipose tissue ratio (ATR) of the gluteus medius muscle on the postoperative computed tomography (CT) view, expecting this graphic study will support clinical results. MATERIALS AND METHODS: A total of 27 patients with femoral intertrochanteric fractures treated by CM femoral nail implants completed the study...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28919813/a-prospective-double-blinded-randomized-comparison-of-ultrasound-guided-femoral-nerve-block-with-lateral-femoral-cutaneous-nerve-block-versus-standard-anesthetic-management-for-pain-control-during-and-after-traumatic-femur-fracture-repair-in-the-pediatric-population
#14
Nicole M Elsey, Joseph D Tobias, Kevin E Klingele, Ralph J Beltran, Tarun Bhalla, David Martin, Giorgio Veneziano, Julie Rice, Dmitry Tumin
BACKGROUND: Traumatic injury of the femur resulting in femoral fracture may result in significant postoperative pain. As with other causes of acute pain, regional anesthesia may offer a benefit over conventional therapy with intravenous opioids. This study prospectively assesses the effects of femoral nerve blockade with a lateral femoral cutaneous nerve block (FN-LFCN) on intraoperative anesthetic requirements, postoperative pain scores, and opioid requirements. MATERIALS AND METHODS: Seventeen pediatric patients (age 2-18 years) undergoing surgical repair of a traumatic femur fracture fulfilled the study criteria and were randomly assigned to general anesthesia with either an FN-LFCN block (n = 10) or intravenous opioids (n = 7)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28919366/prevalence-and-risk-factors-for-fragility-fracture-in-systemic-mastocytosis
#15
Yannick Degboé, Marine Eischen, Delphine Nigon, Pol-André Apoil, Claire Mailhol, Emilie Tournier, Camille Laurent, Katia Hanssens, Olivier Hermine, Carle Paul, Michel Laroche, Cristina Bulai-Livideanu
OBJECTIVES: Systemic mastocytosis (SM) is characterized by the accumulation of mast cells in tissues other than the skin. Bone involvement although frequent has not been thoroughly evaluated. Primary objective was to determine risk factors associated with fragility fractures (FF) in SM. Secondary objectives were to evaluate the ability of bone marrow tryptase (BMT) level to identify patients with FF, and to describe bone involvement in SM. METHODS: We analyzed retrospectively all consecutive patients seen in our expert center, with a diagnosis of SM according to the 2001 WHO criteria, and with complete bone assessment...
September 14, 2017: Bone
https://www.readbyqxmd.com/read/28918874/the-outcome-of-intracapsular-hip-fracture-fixation-using-the-targon-femoral-neck-tfn-locking-plate-system-or-cannulated-cancellous-screws-a-comparative-study-involving-2004-patients
#16
Zeiad Alshameeri, Mohamed Elbashir, Martyn J Parker
AIM: This study compares the outcome of intracapsular hip fracture fixation using the Targon Femoral Neck (TFN) locking plate system with the standard fixation using cannulated cancellous screws (CCS). PATIENTS AND METHOD: Analyses of a prospectively collected data of all patients treated for intracapsular hip fractures using the TFN system and CCS at our department over a period of 28 years. Baseline characteristics and specific outcome measures where compared...
September 1, 2017: Injury
https://www.readbyqxmd.com/read/28918227/bone-remodeling-of-the-distal-femur-after-uncemented-total-knee-arthroplasty-a-2-year-prospective-dxa-study
#17
Mikkel Rathsach Andersen, Nikolaj S Winther, Thomas Lind, Henrik M Schrøder, Michael Mørk Petersen
Loss of bone stock as a response to the bone trauma, immobilization, and stress shielding related to joint replacement surgery increases the risk of fracture of the distal femur after total knee arthroplasty. Previous studies of uncemented femoral components have reported very high levels of bone loss in the distal femur. This study investigates the adaptive bone remodeling of the distal femur after uncemented total knee arthroplasty. We performed a 2-year follow-up of 53 patients (mean age 61.5 [38-70] years, F/M = 27/26, body mass index 29...
September 13, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28917605/outcomes-using-wedge-stem-with-full-hydroxiapatite-coverage-with-a-minimum-of-5-years-follow-up
#18
D Godoy-Monzon, M Buttaro, F Comba, G Zanotti, F Piccaluga, I Neira-Borrajo
INTRODUCTION: Total Hip Arthroplsty (THA) using uncemented stems is a popular practice in the last decades. The implant survivorship is crtitical and a less than 10% revision at 10 years is been propesed for commercialization and use. OBJECTIVE: To analyse the clinicoradiological results of an uncemented hydroxiapatite covered wedge stem with a 5 years minimum follow up. MATERIAL AND METHODS: Prospective study, patients aged from 21-75years were included...
September 13, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28917003/effects-of-obesity-and-diabetes-on-rate-of-bone-density-loss
#19
W D Leslie, S N Morin, S R Majumdar, L M Lix
In this large registry-based study, women with diabetes had marginally greater bone mineral density (BMD) loss at the femoral neck but not at other measurement sites, whereas obesity was not associated with greater BMD loss. Our data do not support the hypothesis that rapid BMD loss explains the increased fracture risk associated with type 2 diabetes and obesity observed in prior studies. INTRODUCTION: Type 2 diabetes and obesity are associated with higher bone mineral density (BMD) which may be less protective against fracture than previously assumed...
September 15, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28916134/novel-technique-to-accurately-measure-femoral-diameter-using-a-thomas-splint
#20
Ignatius Liew, Mobeen Qureshi, Jibu Joseph, Oliver Bailey
INTRODUCTION: During surgical management of femoral shaft fractures, difficulties arise when treating patients with narrow femoral diaphyseal canals, such as young patients and those with dysplastic femurs secondary to underlying pathology. Accurate pre-operative assessment of the femoral diaphyseal canal diameter would allow the surgeon to plan surgical technique and ensure appropriate equipment was available, such as narrow, unreamed or paediatric sized nails. TECHNIQUE: When secured to the patient both longitudinal rods of the main Thomas Splint component lie parallel with the femoral shaft and horizontal to the radiographic x-ray plate...
September 6, 2017: Injury
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