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https://www.readbyqxmd.com/read/28529662/femoral-and-acetabular-re-alignment-in-slipped-capital-femoral-epiphysis
#1
M Leunig, H M Manner, L Turchetto, R Ganz
NEW PATHOPHYSIOLOGICAL INSIGHTS: Based on improved knowledge of the vascular supply of the proximal femur, a safe surgical dislocation of the hip joint was established allowing direct insights to the pathomorphological malfunctioning of the joint. One insight was that slipped capital femoral epiphysis (SCFE) impingement leads to substantial damage of the chondrolabral rim area, even in the presence of minor slips. A further surgical development was the extended retinacular flap allowing for correction of the deformity with calculable risk for iatrogenic necrosis...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28511967/a-sliding-hip-screw-augmented-with-2-screws-is-biomechanically-similar-to-an-inverted-triad-of-cannulated-screws-in-repair-of-a-pauwels-type-iii-fracture
#2
B Kemker, K Magone, J Owen, P Atkinson, S Martin, T Atkinson
OBJECTIVE: Pauwels III femoral neck fractures are highly unstable. These fractures are commonly treated with three cannulated screws or sliding hip screw (SHS) implants, however high rates of non-union persist. A hybrid SHS construct has recently been proposed. The objective of the study was to compare this construct to the familiar inverted triad of cannulated screws and to a single SHS. METHODS: Fourth generation biomechanical femur analogs were used to create a highly repeatable injury model...
May 8, 2017: Injury
https://www.readbyqxmd.com/read/28511947/intraoperative-femur-fracture-risk-during-primary-direct-anterior-approach-cementless-total-hip-arthroplasty-with-and-without-a-fracture-table
#3
Eric M Cohen, Joshua J Vaughn, Scott A Ritterman, Daniel L Eisenson, Lee E Rubin
BACKGROUND: There is no study to date comparing intraoperative femur fractures (IFFs) in the direct anterior approach (DAA) with and without a fracture table. We hypothesize that there is no significant difference in the IFF with and without a fracture table when performed by experienced DAA hip surgeons. METHODS: This study is a 1-year retrospective review of patients who underwent DAA total hip arthroplasty by 2 surgeons: one surgeon uses a flat table and manually elevates the femur with a large bone hook, while the other surgeon uses a fracture table and a mechanical femoral elevator...
April 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28496308/atorvastatin-a-double-weapon-in-osteoporosis-treatment-an-experimental-and-clinical-study
#4
Naglaa El-Nabarawi, Mohamed El-Wakd, Mostafa Salem
OBJECTIVE: The aim of this study was to evaluate the effect of atorvastatin on the bone formation and resorption markers in ovariectomized rats (experimental study), and to study its effect on the bone mineral density (BMD) in postmenopausal osteoporotic women (clinical study). MATERIALS AND METHODS: The study involved experimental and clinical aspects. In the experimental aspect, 42 female Wistar rats were divided into five groups: Group I (n=6; sham-operated), Group II (n=6; 1 mL of carboxymethyl cellulose [CMC] was administered orally), Group III (n=6; 20 mg/kg orally of atorvastatin was administered), Group IV (n=12; untreated ovariectomized [OVX] rats and served as a model of osteoporosis [OP]) and Group V (n=12; 20 mg/kg orally of atorvastatin was administered to ovariectomized rats)...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28494481/enhanced-hip-fracture-management-use-of-statistical-methods-and-dataset-to-evaluate-a-fractured-neck-of-femur-fast-track-pathway-pilot-study
#5
Nigel Gilchrist, Kristian Dalzell, Scott Pearson, Gary Hooper, Kit Hoeben, Jeremy Hickling, John McKie, Ma Yi, Sandra Chamberlain, Caroline McCullough, Marc Gutenstein
The increasing elderly population and subsequent rise in total hip fracture(s) in this group means more effective management strategies are necessary to improve efficiency. We have changed our patient care strategy from the emergency department (ED), acute orthopaedic wards, operating theatre, post-operation and rehabilitation, and called it Fracture Neck of Femur Fast Track Pathway. All clinical data and actions were captured, integrated and displayed on a weekly basis using 'signalfromnoise' (SFN) software...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28494480/implementation-and-effects-of-enhanced-recovery-after-surgery-for-hip-and-knee-replacements-and-fractured-neck-of-femur-in-new-zealand-orthopaedic-services
#6
Suzanne Proudfoot, Brandon Bennett, Simon Duff, Julie Palmer
AIM: The National Orthopaedic Enhanced Recovery After Surgery (ERAS) Collaborative was launched in November 2013 to implement ERAS protocols for hip and knee total joint arthroplasty (TJA) and fractured neck of femur (NOF) in participating district health boards (DHBs) by December 2014. This paper reports on the results. METHOD: ERAS protocols were developed for hip and knee TJA and fractured NOF. Breakthrough Series collaborative methodology was used to implement the ERAS protocols in 18 DHBs...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28494476/effect-of-the-shorter-stays-in-emergency-departments-time-target-policy-on-key-indicators-of-quality-of-care
#7
MULTICENTER STUDY
Peter Jones, James Le Fevre, Alana Harper, Susan Wells, Joanna Stewart, Elana Curtis, Papaarangi Reid, Shanthi Ameratunga
AIM: To determine whether implementation of a national health target called Shorter Stays in Emergency Departments impacted on clinical markers of quality of care. METHOD: A retrospective pre- and post-intervention study from 2006 to 2012 examined quality of care metrics for five different indicators at different sites in relation to the implementation of the target using a general linear model for times to treatment. Explanatory variables included period (pre- or post-target), ethnicity, age, deprivation and severity of condition...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28491189/asymmetric-bone-mineral-density-in-the-bilateral-femoral-necks-due-to-gluteal-implants-a-case-report
#8
Jennifer L Favinger, Charles H Chesnut, Felix S Chew
Interpreting asymmetric bone mineral density in the bilateral hips on dual energy x-ray absorptiometry requires investigation into the potential causes, both real and artifactual. Silicone gluteal implants have been reported to cause abnormally elevated bone mineral density. We report a case of abnormally low bone mineral density in a patient with bilateral gluteal implants. This is likely due to patient positioning and inability of the computer to identify the superior margin of the proximal femur and the femoral neck...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28488162/can-the-metaphyseal-anchored-metha-short-stem-safely-be-revised-with-a-standard-cls-stem-a-biomechanical-analysis
#9
Shuang G Yan, Matthias Woiczinski, Tobias F Schmidutz, Patrick Weber, Alexander C Paulus, Arnd Steinbrück, Volkmar Jansson, Florian Schmidutz
PURPOSE: Short stem total hip arthroplasty (SHA) has gained increasing popularity as it conserves bone stock and is supposed to allow revision with a conventional stem. However, no study has evaluated whether the revision of a SHA with a standard total hip arthroplasty (THA) stem provides sufficient primary stability to allow osseous integration. METHODS: A neck preserving SHA (Metha) and a standard THA (CLS) stem were implanted into six composite femurs respectively and dynamically loaded (300-1700 N, 1 Hz)...
May 9, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28482680/optimal-starting-point-for-fifth-metatarsal-zone-ii-fractures-a-cadaveric-study
#10
Geoffrey I Watson, Sydney C Karnovsky, Gabrielle Konin, Mark C Drakos
BACKGROUND: Identifying the optimal starting point for intramedullary fixation of tibia and femur fractures is well described in the literature using a retrograde or anterograde technique. This technique has not been applied to the fifth metatarsal, where screw trajectory can cause iatrogenic malreduction. The generally accepted starting point for the fifth metatarsal is "high and inside" to accommodate the fifth metatarsal's dorsal apex and medial curvature. We used a retrograde technique to identify the optimal starting position for intramedullary fixation of fifth metatarsal fractures...
April 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28474728/pelvic-limb-alignment-measured-by-computed-tomography-in-purebred-english-bulldogs-with-medial-patellar-luxation
#11
Filippo Lusetti, Andrea Bonardi, Chadi Eid, Anna Brandstetter De Bellesini, Filippo Maria Martini
OBJECTIVES: The aim of the study was to describe the differences in pelvic limb alignment between healthy purebred English Bulldogs and those with medial patellar luxation through the measurement of femoral and tibial angles on computed tomography images in multiplanar reconstruction modality (MPR-CT). METHODS: Twenty-one purebred English Bulldogs were included and divided into two groups: one including healthy dogs (15 limbs) and the other including those with medial patellar luxation (24 limbs)...
May 5, 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/28469902/reducing-returns-to-theatre-for-neck-of-femur-fracture-patients
#12
Selina Graham, Mark Dahill, Derek Robinson
The Royal United Hospital, Bath, admits approximately 550 patients with neck of femur fractures per year. The risks from returning to theatre for this patient group are often life-threatening. Post-operative wound ooze was noted to cause a significant rate of return to theatre, with increased lengths of stay and patient morbidity. A wound closure protocol was agreed by the consultant body. This information was disseminated by email and teaching sessions to all members of the multidisciplinary team, including surgeons, theatre staff and ortho-geriatricians...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28469720/a-study-of-chronic-obstructive-pulmonary-disease-specific-causes-of-osteoporosis-with-emphasis-on-the-emphysema-phenotype
#13
Mona Ali Fouda, Esam Hamad Alhamad, Mohammed Saleh Al-Hajjaj, Shaffi Ahmed Shaik, Ahmad Amer Alboukai, Feisal Abdulla Al-Kassimi
BACKGROUND: Osteoporosis, the most common extra-pulmonary complication of chronic obstructive pulmonary disease (COPD), may be related to general causes or COPD-specific causes such as low forced expiratory volume in 1 s (FEV1) and hypoxia. A few studies reported that emphysema is an independent risk factor for osteoporosis. However, other workers considered the association to be confounded by low FEV1 and low body mass index (BMI) which cluster with emphysema. AIMS: To study the association between osteoporosis and emphysema in a model that includes these potentially confounding factors...
April 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28459415/frax-based-estimates-of-10-year-probability-of-hip-and-major-osteoporotic-fracture-among-adults-aged-40-and-over-united-states-2013-and-2014
#14
Anne C Looker, Neda Sarafrazi Isfahani, Bo Fan, John A Shepherd
BACKGROUND: The FRAX algorithm estimates the 10-year probability of hip and major osteoporotic (clinical spine, forearm, hip, or humerus) fracture for adults aged 40 and over. An expert panel developed criteria to define elevated FRAX probabilities for U.S. adults aged 50 and over. This report uses FRAX estimates from the National Health and Nutrition Examination Survey 2013-2014 to describe the hip and major osteoporotic fracture probability distribution (for adults aged 40 and over) and prevalence of elevated probabilities (for adults aged 50 and over) in the United States...
March 2017: National Health Statistics Reports
https://www.readbyqxmd.com/read/28450739/comparing-mortality-risk-of-patients-with-acute-hip-fractures-admitted-to-a-major-trauma-centre-on-a-weekday-or-weekend
#15
Rajpal Nandra, Jack Pullan, Jonathan Bishop, Khalid Baloch, Liam Grover, Keith Porter
Proximal femoral fractures are a major public health concern with estimated annual direct and social costs amounting to £2 billion and average 30-day mortality risk of 7.5%. In response to the recent debate over out-of-hours hospital provision we investigated the 'weekend effect' at a major trauma centre, caring for acute injuries. A single centre, multi-surgeon review of 2060 patients performed. The distribution of patient and treatment variables compared in patients admitted on a weekday or the weekend. Fewer patients met performance indicators during weekend admission, time to surgery (63 vs...
April 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28447127/bone-adaptation-of-a-biologically-reconstructed-femur-after-ewing-sarcoma-long-term-morphological-and-densitometric-evolution
#16
Giordano Valente, Fulvia Taddei, Andrea Roncari, Enrico Schileo, Marco Manfrini
Combining bone allografts and vascularized fibular autografts in intercalary reconstructions after resection of bone sarcomas is of particular interest in young patients as it facilitates bone healing and union and helps reduce fractures. However, adverse events related to bone adaptation still occur. Bone adaptation is driven by mechanical loading, but no quantitative biomechanical studies exist that would help surgical planning and rehabilitation. We analyzed the bone adaptation of a successful femoral reconstruction after Ewing sarcoma during 76-month follow-up using a novel methodology that allows CT-based quantification of morphology and density...
April 26, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28443571/numerical-optimization-of-the-position-in-femoral-head-of-proximal-locking-screws-of-proximal-femoral-nail-system-biomechanical-study
#17
Mehmet Nuri Konya, Özgür Verim
BACKGROUND: Proximal femoral fracture rates are increasing due to osteoporosis and traffic accident. Proximal femoral nails are routinely used in the treatment of these fractures on the proximal femur. AIMS: The present study aimed to compare various combination and to determine ideal proximal lag screw (PLS) position on the pertrochanteric fractures (AO classification 31-A1) of femur by using optimised finite element analysis. STUDY DESIGN: Biomechanical Study...
April 6, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28442297/vertebral-and-femoral-bone-mineral-density-and-bone-strength-in-prostate-cancer-patients-assessed-in-phantomless-pet-ct-examinations
#18
Benedikt J Schwaiger, David L Kopperdahl, Lorenzo Nardo, Luca Facchetti, Alexandra S Gersing, Jan Neumann, Kwang J Lee, Tony M Keaveny, Thomas M Link
PURPOSE: Bone fracture risk assessed ancillary to positron emission tomography with computed tomography co-registration (PET/CT) could provide substantial clinical value to oncology patients with elevated fracture risk without introducing additional radiation dose. The purpose of our study was to investigate the feasibility of obtaining valid measurements of bone mineral density (BMD) and finite element analysis-derived bone strength of the hip and spine using PET/CT examinations of prostate cancer patients by comparing against values obtained using routine multidetector-row computed tomography (MDCT) scans-as validated in previous studies-as a reference standard...
April 24, 2017: Bone
https://www.readbyqxmd.com/read/28438455/lesser-trochanter-size-on-plain-anteroposterior-radiographs-correlates-with-native-femoral-anteversion
#19
Michael C Worlicek, Michael L Wörner, Benjamin S Craiovan, Florian Zeman, Joachim Grifka, Tobias F Renkawitz, Markus Weber
BACKGROUND: Assessing femoral version in orthopedic surgery is important for preoperative planning of total hip arthroplasty, especially for recognizing excessive anteversion or retroversion. The present study addressed the following: (1) Is the position of the lesser trochanter correlated to the femoral neck axis? (2) If so, may femoral version be assessed by means of plain pelvic radiographs? METHODS: Three-dimensional computed tomography scans of 60 patients undergoing minimally invasive cement-free total hip arthroplasty were retrospectively analyzed, particularly with regard to the relation between the femoral neck axis and the lesser trochanter, the femoral version, and the size of the projected lesser trochanter in different rotational positions...
April 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28435578/use-of-an-industrial-tungsten-carbide-drill-in-the-treatment-of-a-complex-fracture-in-a-patient-with-severe-osteopetrosis-a-case-report
#20
R Kunnasegaran, Y H Chan
The treatment of fractures in osteopetrosis can be complicated and difficult. We describe the use of an industrial grade tungsten carbide drill bit in the treatment of one of these complex fractures. An industrial grade tungsten carbide drill bit was used to fashion a medullary canal in the surgical treatment of a left peri-implant fracture of the neck of femur in a patient with osteopetrosis. The patient was successfully treated with a hemiarthroplasty with good functional outcomes. A tungsten carbide drill bit serves as an effective and safe option in the treatment of osteopetrotic femoral neck fractures...
March 2017: Malaysian Orthopaedic Journal
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