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femoral fractures

Matthew Jian-Qiao Peng, Hai-Yan Chen, XiangYang Ju, Yong Hu, Ashraf Ayoub, Balvinder Khambay, ZiQing Liu, Bo Bai
BACKGROUND: Little is known about how biomechanics govern the five fixtures such as DHS, MLS, DHS + LS, LP, and HA are accepted as common therapeutic techniques. AIMS AND OBJECTIVES: A series of numerical models for a femoral neck fracture of Pauwels-I will be constructed by innovative approach of finite element in order to determine the most optimized option in comparison with biomechanical performance. METHOD: Twenty sets of computer tomography scanned femora were imported onto Mimics to extract 3 D models; these specimens were transferred to Geomagic-Studio for a simulative osteotomy and kyrtograph; then, they underwent UG to fit simulative solid models; 5 sorts of fixture were then expressed by Pro-Engineer virtually...
December 5, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Paul Bonnevialle, Pierre-Sylvain Marcheix, Xavier Nicolau, Marine Arboucalot, Marie Lebaron, Christophe Chantelot, Didier Mainard, Matthieu Ehlinger
INTRODUCTION: Interprosthetic femoral fractures (IFF) are becoming more frequent; however they have not been the subject of many publications and the largest study on this topic includes only 30 cases. The complication rate and clinical outcomes have only been evaluated in small case series. This led us to conduct a retrospective, multicenter, observational study in IFF patients with at least 12 months' follow-up to (1) determine the mortality and morbidity (2) determine the clinical and radiological outcomes and (3) identify elements of the treatment indications...
December 1, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Rui Wang, Yi Liu, Yi-Yi Zhou, Jia-Ying Wang, Zhu-Jie Xu, Sha-Yang Chen, Qi-Qi Wang, Peng Yuan
Pelvic osteotomy is commonly used to adjust acetabula dysplasia for congenital dislocation of the hip, whereas congenital insensitivity to pain with anhidrosis (CIPA) is a rare hereditary disease that often has the characteristics of joint development deformity and easy fracture. This article reports the case involving a CIPA patient who was surgically treated by Chiari pelvic osteotomy and proximal femoral rotation osteotomy for congenital dislocation of the left hip joint and was provided long-term follow-up for redislocation and bilateral femoral head absorption...
November 26, 2018: World Journal of Clinical Cases
E Michael Lewiecki, Rajani V Dinavahi, Marise Lazaretti-Castro, Peter R Ebeling, Jonathan D Adachi, Akimitsu Miyauchi, Evelien Gielen, Cassandra E Milmont, Cesar Libanati, Andreas Grauer
Romosozumab, a humanized monoclonal antibody that binds and inhibits sclerostin, has the dual effect of increasing bone formation and decreasing bone resorption. As previously reported in the pivotal FRActure study in postmenopausal woMen with ostEoporosis (FRAME), women with a T-score of ≤ -2.5 at the total hip or femoral neck received subcutaneous placebo or romosozumab once monthly for 12 months, followed by open-label subcutaneous denosumab every 6 months for an additional 12 months. Upon completion of the 24-month primary analysis period, eligible women entered the extension phase and received denosumab for an additional 12 months...
December 3, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Zhao Zhe, Zhu Jianjin, Song Fei, He Dawei, Deng Jiuzheng, Chen Fang, Pan Yongwei
OBJECTIVES: Intramedullary (IM) nailing is the preferred method for treatment of femoral shaft fractures. However, for the surgical staff and the patients, exposure to large dose of X-rays is inevitable during the procedure. In this paper, a new technique based on ultrasound is proposed to guide the reduction of femoral fractures, reducing radiation exposure. METHODS AND RESULTS: By means of particular continuous transverse and multiplanar longitudinal scanning, the deformity pattern information of the fracture could be efficiently acquired...
December 3, 2018: Archives of Orthopaedic and Trauma Surgery
Elizabeth J Samelson, Kerry E Broe, Hanfei Xu, Laiji Yang, Steven Boyd, Emmanuel Biver, Pawel Szulc, Jonathan Adachi, Shreyasee Amin, Elizabeth Atkinson, Claudie Berger, Lauren Burt, Roland Chapurlat, Thierry Chevalley, Serge Ferrari, David Goltzman, David A Hanley, Marian T Hannan, Sundeep Khosla, Ching-Ti Liu, Mattias Lorentzon, Dan Mellstrom, Blandine Merle, Maria Nethander, René Rizzoli, Elisabeth Sornay-Rendu, Bert Van Rietbergen, Daniel Sundh, Andy Kin On Wong, Claes Ohlsson, Serkalem Demissie, Douglas P Kiel, Mary L Bouxsein
BACKGROUND: Although areal bone mineral density (aBMD) assessed by dual-energy x-ray absorptiometry (DXA) is the clinical standard for determining fracture risk, most older adults who sustain a fracture have T scores greater than -2·5 and thus do not meet the clinical criteria for osteoporosis. Importantly, bone fragility is due to low BMD and deterioration in bone structure. We assessed whether indices of high-resolution peripheral quantitative CT (HR-pQCT) were associated with fracture risk independently of femoral neck aBMD and the Fracture Risk Assessment Tool (FRAX) score...
November 28, 2018: Lancet Diabetes & Endocrinology
E J Dickenson, P D H Wall, C E Hutchinson, D R Griffin
OBJECTIVE: Cam hip morphology is associated with femoroacetabular impingement (FAI) syndrome and causes hip osteoarthritis. We aimed to assess the prevalence of cam hip morphology in a sample representative of the general population, using a measure with a predefined diagnostic accuracy. DESIGN: Patients aged 16-65, who were admitted to a major trauma centre and received a CT pelvis were retrospectively screened for eligibility. Subjects with proximal femoral, acetabular or pelvic fractures and those who were deceased were excluded...
November 28, 2018: Osteoarthritis and Cartilage
Justin Roth, Brian Goldman, Lewis Zirkle, John Schlechter, John Ibrahim, David Shearer
BACKGROUND: As the population ages, the developing world industrializes, and more urban centers emerge, the burden of orthopedic trauma will steadily increase. SIGN Fracture Care International has developed a unique intramedullary device for fixation of hip fractures in low-resource settings lacking fluoroscopy. The purpose of this study is to report the safety profile and complication rate for a consecutive series of hip fracture patients managed using this implant. METHODS: We conducted a retrospective analysis of the first 170 patients treated with the SIGN Hip Construct (SHC) from 2009 to 2014 using the SIGN Online Surgical Database (SOSD)...
2018: SICOT-J
T B Kristensen, E Dybvik, O Furnes, L B Engesæter, J-E Gjertsen
AIMS: The aim of this large registry-based study was to compare mid-term survival rates of cemented femoral stems of different designs used in hemiarthroplasty for a fracture of the femoral neck. PATIENTS AND METHODS: From the Norwegian Hip Fracture Register (NHFR), 20 532 primary cemented bipolar hemiarthroplasties, which were undertaken in patients aged > 70 years with a femoral neck fracture between 2005 and 2016, were included. Polished tapered stems (n = 12 065) (Exeter and CPT), straight stems (n = 5545) (Charnley, Charnley Modular, and Spectron EF), and anatomical stems (n = 2922) (Lubinus SP2) were included...
December 2018: Bone & Joint Journal
Karen Dombestein Elde, Ole Rintek Madsen
OBJECTIVES: FRAX is a computer-based algorithm developed by the World Health Organisation for estimation of the 10-yr risk of a hip or major osteoporotic fracture. Inclusion of femoral neck bone mineral density (BMD) in the estimation is optional. The study aimed to investigate the intra-individual agreement between FRAX fracture risk calculated with and without BMD in patients with rheumatoid arthritis (RA). METHODS: Clinical data and BMD results from 50 RA patients registered in the Danish rheumatology registry (DANBIO) were used for analysis...
October 31, 2018: Journal of Clinical Densitometry
Ji H Son, Aviram M Giladi, James P Higgins
No abstract text is available yet for this article.
November 29, 2018: Journal of Hand Surgery, European Volume
Alex Ireland, Fiona R Saunders, Stella G Muthuri, Anastasia V Pavlova, Rebecca J Hardy, Kathryn R Martin, Rebecca J Barr, Judith E Adams, Diana Kuh, Richard M Aspden, Jennifer S Gregory, Rachel Cooper
Bones' shapes and structures adapt to the muscle and reaction forces they experience during everyday movements. Onset of independent walking, at approximately 12 months, represents the first postnatal exposure of the lower limbs to the large forces associated with bipedal movements, and, accordingly, earlier walking is associated with greater bone strength. However, associations between early life loading and joint shape have not been explored. We therefore examined associations between walking age and hip shape at age 60-64y in 1423 individuals (740 women) from the MRC National Survey of Health and Development, a nationally-representative British birth cohort...
November 29, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Emma L Duncan
No abstract text is available yet for this article.
December 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Frank R Avilucea, David Joyce, Hassan R Mir
OBJECTIVES: To report on the use of dynamic stress fluoroscopy (DSF) for detection of occult fractures of the femoral neck associated with femoral shaft fractures. To compare DSF with a fully static imaging protocol in detecting occult femoral neck fractures. DESIGN: Multicenter retrospective cohort study SETTING:: Two urban level I trauma centers PARTICIPANTS/INTERVENTION:: A consecutive series of 1273 femoral shaft fractures were included. Inclusion criteria were patients treated with an intramedullary rod (antegrade/retrograde), age ≥ 18, a fine-cut (2 mm) pre-operative CT and hip radiographs, intraoperative AP/lateral fluoroscopic view of the femoral neck prior to femoral nailing, and a minimum follow up of three months...
October 8, 2018: Journal of Orthopaedic Trauma
Sudipta Kumar Patra, Ajoy Prasad Shetty, Dheenadhayalan Jayaramaraju, S Rajasekaran
OBJECTIVES: To assess radiation exposure (RE) to the surgical team and fluoroscopy time (FT) during closed nailing of long bone fractures performed under fluoroscopic guidance with regard to surgeons experience. DESIGN: Prospective observational study SETTING:: Level-1 Trauma Centre PARTICIPANTS:: Surgical team, comprising surgeon, surgical assistant and scrub nurse, for closed nailings done in 202 consecutive closed tibial and femoral diaphyseal fractures. INTERVENTION: Dosimeter provided to each member of surgical team; Surgeon experience-level (Trainee, Senior registrar, Consultant) MAIN OUTCOME MEASUREMENTS:: RE (microsieverts) to the surgical team and FT (minutes) were recorded from the dosimeter and fluoroscopic unit respectively and correlated with surgeons experience...
October 8, 2018: Journal of Orthopaedic Trauma
Basem Attum, Diana G Douleh, Paul S Whiting, Ashley C Dodd, Michelle S Shen, Nikita Lakomkin, William T Obremskey, Manish K Sethi
This study sought to evaluate the outcomes of patients with osseous defects exceeding 5 cm following open femur fractures. Size of the osseous defect, method of internal fixation (plate vs. intramedullary nail), patient demographics, medical comorbidities, and surgical complications were collected. Twenty-seven of the 832 open femur fracture patients had osseous defects exceeding 5 cm. Mean osseous defect size was 8 cm, and each patient had an average of four operations including initial debridement. Average time from injury to bone grafting was 123...
2018: Journal of Surgical Orthopaedic Advances
E M Stein, A Dash, M Bucovsky, S Agarwal, J Fu, S Lentzsch, E Shane
Patients with monoclonal gammopathy of undetermined significance (MGUS) had abnormalities in volumetric BMD (vBMD), microarchitecture, and stiffness at both the radius and tibia by high-resolution peripheral quantitative CT compared to matched controls. This is the first report demonstrating that patients with MGUS have microarchitectural deficits at multiple skeletal sites. INTRODUCTION: Fracture risk is elevated in patients with monoclonal gammopathy of undetermined significance (MGUS)...
November 28, 2018: Osteoporosis International
Giovanni Vicenti, Massimiliano Carrozzo, Vincenzo Caiaffa, Antonella Abate, Giuseppe Solarino, Davide Bizzoca, Roberto Maddalena, Giulia Colasuonno, Vittorio Nappi, Francesco Rifino, Biagio Moretti
INTRODUCTION: Femoral shaft fractures with third fragments have a high non-union rate, which may reach 14%. This study aims to assess the impact of the radiological features of the third fragment, evaluated on post-operative X-rays, on the outcome of femoral shaft fractures type 32-B managed with intramedullary nailing, in order to obtain an algorithm which could predict the fracture healing time. MATERIALS AND METHODS: We have retrospectively evaluated a series of 52 patients...
November 17, 2018: International Orthopaedics
Abbas Jafari, Adiba Isa, Li Chen, Nicholas Ditzel, Walid Zaher, Linda Harkness, Hans E Johnsen, Basem M Abdallah, Christian Clausen, Moustapha Kassem
Understanding the mechanisms regulating recruitment of human skeletal (stromal or mesenchymal) stem cells (hMSC) to sites of tissue injury is a prerequisite for their successful use in cell replacement therapy. Chemokine-like protein TAFA2 is a recently discovered neurokine involved in neuronal cell migration and neurite outgrowth. Here, we demonstrate a possible role for TAFA2 in regulating recruitment of hMSC to bone fracture sites. TAFA2 increased the in vitro trans-well migration and motility of hMSC in a dose-dependent fashion and induced significant morphological changes including formation of lamellipodia as revealed by high content image analysis at single cell level...
November 28, 2018: Stem Cells
Elsa A Spaans, Koen L M Koenraadt, Robert Wagenmakers, Leon H G J Elmans, Joost A A M van den Hout, D Eygendaal, Stefan B T Bolder
INTRODUCTION: Surgeon volume of hip arthroplasties is of importance with regard to complication and revision rates in total hip arthroplasty. For hip hemiarthroplasty, the effect of surgeon volume on outcome is far less studied. We analyzed the outcome of hip hemiarthroplasties performed by orthopedic surgeons in a retrospective cohort in different volume categories, focusing on early survival of the prosthesis and complications. METHODS: Between March 2009 and January 2014, 752 hemiarthroplasties were performed for intracapsular femoral neck fracture by 27 orthopedic surgeons in a large Dutch teaching hospital...
November 27, 2018: Archives of Orthopaedic and Trauma Surgery
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