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femoral fractures

Ahmed Mohamed El Ghoneimy, Magdy El Sherbiny, Nehal Kamal
BACKGROUND:  Most reports on skeletal reconstruction using vascularized fibular free flap include patients with varying age groups and anatomic locations. This study has limited the inclusion criteria to pediatric and adolescent patients diagnosed with bone sarcoma of the femoral shaft. METHODS:  Forty-one patients, diagnosed with a malignant bone tumor of the femoral shaft (21 Ewing's sarcomas and 20 osteosarcomas), were locally treated by joint sparing wide resection and reconstruction using a vascularized fibular free flap...
August 18, 2018: Journal of Reconstructive Microsurgery
Claude Schwartz
BACKGROUND: Osteopenia of the front half of the distal femur is a well-known problem after total knee arthroplasty (TKA) with secondary issues after years, especially when must be addressed fractures or revisions for loosening. Stress shielding has been recognized as a cause in different biomechanical studies of the bone. QUESTION/PURPOSES: It was logical to look for a solution by changing the design to minimize stress shielding behind the femoral shield. PATIENTS AND METHODS: It was proved that radiological measure of bone density was reliable although not so early and accurate as densitometry...
August 16, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Jiantao Li, Licheng Zhang, Hao Zhang, Peng Yin, Mingxing Lei, Guoqi Wang, Song Wang, Peifu Tang
PURPOSE: To determine how the reduction of medial and anteromedial cortices using CT findings in 31-A2 intertrochanteric fractures treated with the intramedullary nail could affect the clinical outcomes and complication rates of the fractures. METHODS: We retrospectively analyzed the data of 43 patients with 31-A2 intertrochanteric fractures who underwent closed reduction and intramedullary internal fixation (CRIF) between January 2010 and December 2013. Patients were classified into two groups based on the post-operative CT scans taken from the sagittal and coronal planes, respectively...
August 16, 2018: International Orthopaedics
Andreas Roth, Johannes Beckmann, Klaus Bohndorf, Christian Heiß, Marcus Jäger, Stefan Landgraeber, Uwe Maus, Ulrich Nöth, Klaus M Peters, Christof Rader, Stephan Reppenhagen, Ulrich Smolenski, Ina Kopp, Markus Tingart
The update of the German S3 guideline on atraumatic femoral head necrosis in adults aims to provide an overview of diagnosis and treatment. All clinical studies, systematic reviews, and meta-analyses published in German or English between 01.05.2013 and 30.04.2017 were included. Of 427 studies, 28 were suitable for analysis. Risk factors are corticosteroids, chemotherapy, kidney transplants, hemoglobinopathies, and alcoholism. Differential diagnoses are for example bone marrow edema, insufficiency fracture, and destructive arthropathy...
August 16, 2018: Der Orthopäde
Marcos Guilherme Cunha Cruvinel, Fabiano Soares Carneiro, Roberto Cardoso Bessa Junior
OBJECTIVE: The aim of this report is to exemplify the role of the use of bedside ultrasound by the anesthesiologist, offering an individualized approach to the specific condition of the patient, without unnecessary postponement of femur fracture surgical repair in the elderly. CASE REPORT: Female patient, 86 years old, hypertensive, victim of trochanteric fracture of the femur, taken to the operating room after being released by cardiology. Bedside ultrasound allowed the identification of aortic stenosis, left ventricular hypertrophy, carotid stenosis, and signs of hypovolemia...
August 13, 2018: Revista Brasileira de Anestesiologia
Vicente Mosquera, Carlota Fernández, Amer Zanabili, Jose A Del Castro, Mónica G Pandavenes, Manuel Alonso
BACKGROUND: Iliac vein injury associated with pelvic fracture due to blunt trauma is an uncommon and difficult diagnosis but a life-threatening condition which often requires an emergent management. Although open repair has been traditionally used as the treatment of choice in unstable patients, it is controversial, given the difficulty injured vessel exposure in patients with significant retroperitoneal hematoma as well as tamponade effect loss associated to laparotomy. We present a challenging case of iliac vein laceration successfully treated by placement of a self-expanding covered stent...
August 13, 2018: Annals of Vascular Surgery
Ingmar Fleps, William S Enns-Bray, Pierre Guy, Stephen J Ferguson, Peter A Cripton, Benedikt Helgason
The majority of hip fractures have been reported to occur as a result of a fall with impact to the greater trochanter of the femur. Recently, we developed a novel cadaveric pendulum-based hip impact model and tested two cadaveric femur-pelvis constructs, embedded in a soft tissue surrogate. The outcome was a femoral neck fracture in a male specimen while a female specimen had no fracture. The aim of the present study was, first, to develop a methodology for constructing and assessing the accuracy of explicit Finite Element Models (FEMs) for simulation of sideways falls to the hip based on the experimental model...
2018: PloS One
Alessandro Vidoni, Rachit Shah, Davina Mak, David Beale, Sioned Beale, Steven James, Rajesh Botchu
INTRODUCTION: To describe a novel secondary sign of subchondral insufficiency fracture of the knee, metaphyseal burst sign (soft tissue oedema in the meta-epiphyseal region of the affected condyle). METHODS: An electronic database research of 7926 knee MRI examinations was performed. Forty-eight scans were included in the study. The diagnosis of subchondral insufficiency fracture (SIF) was confirmed in a consensus review by one fellowship trained musculoskeletal (MSK) radiologist and one radiology fellow...
August 16, 2018: Journal of Medical Imaging and Radiation Oncology
Robert C Marchand, Nipun Sodhi, Manoshi Bhowmik-Stoker, Laura Scholl, Caitlin Condrey, Anton Khlopas, Assem A Sultan, Jared M Newman, Michael A Mont
Although several studies highlight the advantages of robotic arm-assisted total knee arthroplasty (RA-TKA), few investigate its intraoperative outcome. Therefore, the purpose of this study was to analyze the RA-TKA's ability to assist with intraoperative correction of: (1) flexion and (2) extension gaps, as well as its ability to (3) accurately predict implant sizes. Additionally, in this RA-TKA cohort, length of stay, complications, and readmissions were assessed. A total of 335 patients who underwent RA-TKA were included...
August 15, 2018: Journal of Knee Surgery
Haiwei Shi, Long Xiao, Zhifang Wang
Curative effect of artificial femoral head replacement on hip joint function and complications of elderly patients with femoral intertrochanteric fracture were investigated. Eighty patients who were operated for femoral intertrochanteric fractures operation were randomly divided into observation group (n=40) and control group (n=40). The observation group was treated with artificial femoral head replacement, while the control group received internal proximal femur locking plate fixation. In the observation group, the operation time was shorter than that in the control group (P<0...
August 2018: Experimental and Therapeutic Medicine
Nicholas Pulos, Kathleen M Kollitz, Allen T Bishop, Alexander Y Shin
BACKGROUND: Outcomes following revision surgery for scaphoid nonunions with osteonecrosis are guarded. We hypothesized that use of free vascularized medial femoral condyle (MFC) bone grafts can lead to healing of the nonunion, increase vascularity of the proximal pole, and restore scaphoid architecture, resulting in acceptable functional outcomes. METHODS: We performed a retrospective review of 49 patients who were treated with an MFC bone graft, between May 2005 and September 2016, after prior failure of operative treatment for scaphoid nonunion...
August 15, 2018: Journal of Bone and Joint Surgery. American Volume
H Tsuchie, N Miyakoshi, K Iba, Y Kasukawa, K Nozaka, T Dohke, I Kosukegawa, T Aizawa, S Maekawa, H Abe, M Takeshima, T Tomite, T Segawa, K Ouchi, H Kinoshita, M Suzuki, T Yamashita, Y Shimada
We compared the effectiveness of promoting bone healing between two teriparatide preparations for atypical femoral fracture (AFF). A total of 45 AFFs were included in this study, and we compared the duration of bone union. Teriparatide administered by daily injection enhanced bone union more than weekly administration in complete AFFs. INTRODUCTION: The efficacy of teriparatide for atypical femoral fracture (AFF) has been recently reported. Although two different teriparatide preparations can be used to treat osteoporosis in Japan, daily or weekly injection, all previous reports on the effectiveness of teriparatide for AFF only examined daily injection formulations...
August 13, 2018: Osteoporosis International
Giorgio Berlot, Rossana Bussani, Vennus Shafiei, Nadia Zarrillo
The release of fat and bone marrow fragments is a common occurrence following traumatic and nontraumatic events. In most cases, they go symptomless or cause only minor disturbances, but occasionally they can determine a multiorgan dysfunction whose severity ranges from mild to fatal. The authors describe the case of a patient who became deeply comatose and ultimately died after a traffic accident in which he suffered the exposed right femoral and tibial fracture in the absence of other injuries. He underwent the external fixation of the fractured bones 2 hours after the admission under general anesthesia...
2018: Case Reports in Critical Care
Michael Willey, Matthew L Welsh, Travis S Roth, Kenneth J Koval, James V Nepola
Recent estimates suggest an annual incidence of greater than 125,000 femoral neck fractures. Surgical treatment is indicated for the majority of these fractures, which are estimated to double by the year 2050. Most displaced femoral neck fractures in elderly patients are treated with arthroplasty secondary to high complication rates associated with internal fixation. Traditional implants used for internal fixation, typically in elderly patients with stable fracture morphology and younger patients regardless of morphology, include the sliding hip screw (SHS), with or without a supplemental anti-rotation screw, and multiple cancellous lag screws...
2018: Iowa Orthopaedic Journal
Nathan R Hendrickson, Perry J Pickhardt, Alejandro Munoz Del Rio, Humberto G Rosas, Paul A Anderson
Background: Clinical computed tomography (CT) studies performed for other indications can be used to opportunistically assess vertebral bone without additional radiation or cost. Reference values for young women are needed to evaluate diagnostic accuracy and track changes in CT bone mineral density values across the lifespan. The purpose of this study was to determine reference values for lumbar trabecular CT attenuation (Hounsfield units [HU]) and determine the diagnostic accuracy of HU T-scores (T-scoreHU ) for identifying individuals with osteoporosis...
2018: Iowa Orthopaedic Journal
Jie-Feng Huang, Xian-Jun Jiang, Jian-Jian Shen, Ying Zhong, Pei-Jian Tong, Xiao-Hong Fan
BACKGROUND: The Unified Classification System (UCS) for Periprosthetic femoral fractures (PPFF) still has some limitations. METHODS: We retrieved 18 previous classifications for PPFF based on systematic review of the literature, and also retrospectively analyzed 402 cases with PPFF. 46 cases (11.4%) were identified as beyond the classification scope of the original UCS. RESULTS: We modified the UCS as follows: (1) add two new B2 subtypes: B2PALT/B2PAGT (i...
August 10, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Zhiqiang Wang, Yi Yin, Qingshan Li, Guanjun Sun, Xu Peng, Hua Yin, Yongjie Ye
BACKGROUND: The incidence of early postoperative complications of displaced intracapsular hip fractures is high. The purpose of this study was to compare the early postoperative complications and assess the incidence of femoral neck shortening on using a newly designed proximal femoral cannulated screw locking plate (CSLP) versus multiple cancellous screws (MCS) in the treatment of displaced intracapsular hip fractures in young adults. METHODS: Sixty-eight young adult patients with displaced intracapsular hip fractures were randomly assigned to either the CSLP group or the MCS group and treated routinely by internal fixation with either the CSLP or the MCS...
August 13, 2018: Journal of Orthopaedic Surgery and Research
Agnieszka Matuszewska, Beata Nowak, Diana Jędrzejuk, Marcin Landwójtowicz, Ewa Sadanowicz, Tomasz Sozański, Joanna Kwiatkowska, Małgorzata Pieśniewska, Marek Bolanowski, Adam Szeląg
BACKGROUND: Histamine regulates function of osteoclasts and osteoblasts, however data regarding the influence of histamine H2 receptors antagonists on bone tissue are ambiguous. Factors that influence growing skeleton may have an important impact on the peak bone mass and future risk of fractures. The aim of our study was the assessment of influence of ranitidine, on growing bones. METHODS: The experiment was carried out on young male Wistar rats divided into two groups receiving either ranitidine (10 mg/kg ip) or vehicle...
March 16, 2018: Pharmacological Reports: PR
Chang-Hee Lee, Seung Hyun Son, Chae Moon Hong, Ju Hye Jeong, Shin Young Jeong, Sang-Woo Lee, Jaetae Lee, Tae-Geon Kwon, Byeong-Cheol Ahn
Purpose: Bisphosphonate (BP) is the first-line therapy for the management of osteoporosis. BP-related osteonecrosis of the jaw (BRONJ) and atypical femoral fracture (AFF) are increasingly common comorbidities in patients with osteoporosis under long-term BP treatment. The aim of this study was to evaluate the incidence and risk factors for AFF features on bone scintigraphy in patients with BRONJ. Methods: Among total of 373 BRONJ patients treated between September 2005 and July 2014, 237 (220 women, 17 men; median age 73 years) who underwent three-phase bone scintigraphy were enrolled for this retrospective study...
August 2018: Nuclear Medicine and Molecular Imaging
J Ramalho, I D B Marques, Didier Hans, David Dempster, Hua Zhou, Parth Patel, R M R Pereira, V Jorgetti, R M A Moyses, Thomas L Nickolas
The trabecular bone score (TBS) is a novel tool using grayscale variograms of the lumbar spine bone mineral density (BMD) to assess trabecular bone microarchitecture. Studies in patients with chronic kidney disease (CKD) suggest it may be helpful in assessing fracture risk. However, TBS has not been validated as a measure of trabecular architecture against transiliac bone biopsy with histomorphometry in CKD patients. We hypothesized that TBS would reflect trabecular architecture at the iliac crest in CKD patients...
August 8, 2018: Bone
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