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distal femoral fracture

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https://www.readbyqxmd.com/read/27891409/distal-femur-locking-plate-the-answer-to-all-distal-femoral-fractures
#1
Jagandeep Singh Virk, Sudhir Kumar Garg, Parmanand Gupta, Vivek Jangira, Jagdeep Singh, Sudhir Rana
INTRODUCTION: Good results have been published by researchers with distal femur nail, dynamic condylar screw and even addition of a medial plate to a distal femur locking plate for treating distal femur fractures. By this study, we explore the capability of a distal femur locking plate to counter distal femur fractures of extra- articular, partial or intra- articular nature. Positive results have been published by various groups from all over the world. AIM: To study the functional and radiological outcome of distal femoral fractures in skeletally mature patients treated by open reduction and internal fixation with distal femur locking plate...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27871553/fascia-iliaca-block-associated-only-with-deep-sedation-in-high-risk-patients-taking-p2y12-receptor-inhibitors-for-intramedullary-femoral-fixation-in-intertrochanteric-hip-fracture-a-series-of-3-cases
#2
Carlos Rodrigues Almeida, Emília Milheiro Francisco, Vítor Pinho-Oliveira, José Pedro Assunção
OBJECTIVE: We present a series of 3 cases in which the impact in outcome was, first of all, related to the capacity to offer early and safer treatment to some hip fracture high-risk patients using a fascia iliaca block (FIB; ropivacaine 0,5% 20 cc and mepivacaine 1,3% 15 cc, given 30 minutes before incision) associated only with deep sedation, contributing to better practice and outcome. CASE REPORTS: All elderly patients were American Society of Anesthesiologists IV patients, under P2Y12 receptor inhibitors, suffering from an intertrochanteric fracture, and purposed for intramedullary femoral fixation (IMF)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27857483/megaprostheses-in-the-management-of-trauma-of-the-knee
#3
Scott Evans, Edward Laugharne, Amit Kotecha, Laura Hadley, Arul Ramasamy, Lee Jeys
OBJECTIVE: Review the outcome of patients with complex fractures around the knee treated with megaprosthesis. METHOD: Retrospective observational study of 10 patients was undertaken. RESULTS: Six patients were treated with a distal femoral endoprosthesis (DEFPR) and four with an augmented rotating hinge knee replacement (RHK). The mean post-operative Toronto Extremity Salvage Score (TESS) was 62.5 for the whole cohort (RHK group 79.3, compared with 49...
December 2016: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27844306/biocompatibility-of-calcium-phosphate-bone-cement-with-optimised-mechanical-properties-an-in-vivo-study
#4
Iwan Palmer, John Nelson, Wolfgang Schatton, Nicholas J Dunne, Fraser Buchanan, Susan A Clarke
This work establishes the in vivo performance of modified calcium phosphate bone cements for vertebroplasty of spinal fractures using a lapine model. A non-modified calcium phosphate bone cement and collagen-calcium phosphate bone cements composites with enhanced mechanical properties, utilising either bovine collagen or collagen from a marine sponge, were compared to a commercial poly(methyl methacrylate) cement. Conical cement samples (8 mm height × 4 mm base diameter) were press-fit into distal femoral condyle defects in New Zealand White rabbits and assessed after 5 and 10 weeks...
December 2016: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/27830384/comparison-of-the-effects-of-denosumab-between-a-native-vitamin-d-combination-and-an-active-vitamin-d-combination-in-patients-with-postmenopausal-osteoporosis
#5
Kosuke Ebina, Masafumi Kashii, Makoto Hirao, Jun Hashimoto, Takaaki Noguchi, Kota Koizumi, Kazuma Kitaguchi, Hozo Matsuoka, Toru Iwahashi, Yasunori Tsukamoto, Hideki Yoshikawa
The aim of this 12-month, retrospective study was to compare the effects of denosumab (DMAb; 60 mg subcutaneously every 6 months) plus native vitamin D (VD) (cholecalciferol) combination therapy with DMAb plus active VD analog (alfacalcidol) combination therapy in patients with postmenopausal osteoporosis. Patients [N = 127; mean age 75.6 years (range 58-93 years); 28 treatment-naïve patients, 59 patients treated with oral bisphosphonate therapy, 40 patients treated with teriparatide daily] were allocated to either (1) the DMAb plus native VD group (n = 60; cholecalciferol, 10 μg, plus calcium, 610 mg/day; 13 treatment-naïve patients, 28 patients treated with oral bisphosphonate therapy, and 19 patients treated with teriparatide daily) or (2) the DMAb plus active VD group [n = 67; alfacalcidol, 0...
November 9, 2016: Journal of Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/27818985/bilateral-distal-femoral-fracture-after-total-knee-arthroplasty
#6
Fabrício Bolpato Loures, Jorge Rafael Wenck Motta, Rodrigo Sattamini Pires E Albuquerque, João Maurício Barretto, Naason Trindade Cavanellas
The number of total knee arthroplasties has increased exponentially and their indications have been expanded. This procedure presents challenging complications for orthopedic surgeons that are potentially catastrophic for patients. Here, a rare case of simultaneous bilateral periprosthetic fracture of the knee is reported, with discussion of the causal factors, possible management and prophylaxis.
September 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/27818743/the-clinical-contribution-of-cortical-porosity-to-fragility-fractures
#7
REVIEW
Åshild Bjørnerem
Cortical bone is not compact; rather it is penetrated by many Haversian and Volkmann canals for blood supply. The lining of these canals are the intracortical bone surfaces available for bone remodeling. Increasing intracortical bone remodeling increases cortical porosity. However, cortical bone loss occurs more slowly than trabecular loss due to the fact that less surface per unit of bone matrix volume is available for bone remodeling. Nevertheless, most of the bone loss over time is cortical because cortical bone constitutes 80% of the skeleton, and the relative proportion of trabecular bone diminishes with advancing age...
2016: BoneKEy Reports
https://www.readbyqxmd.com/read/27815952/incidence-of-distal-femoral-periprosthetic-fractures-after-total-knee-arthroplasty
#8
Tyler Welch, Richard Iorio, Andrew J Marcantonio, Michael S H Kain, John F Tilzey, Lawrence M Specht, William L Healy
BACKGROUND: The incidence of distal femoral periprosthetic fractures associated with total knee arthroplasty (TKA) has been reported as 0.3% to 2.5%. This study examined the incidence of distal femoral periprosthetic fractures at one hospital over a 16-year period. We hypothesized that the incidence of these fractures would be lowered after the introduction of lugged femoral implants and insertion of a distal femoral intramedullary bone graft during TKA. METHODS: From 1994 to 2010, 4,943 primary TKAs were performed...
November 2016: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/27812774/optimum-stem-length-for-mitigation-of-periprosthetic-fracture-risk-following-primary-total-knee-arthroplasty-a-finite-element-study
#9
Noel Conlisk, Colin R Howie, Pankaj Pankaj
PURPOSE: Due to age-related changes to the material properties and thinning of the cortical bone structure, older patients with osteoporosis may be at greater risk of femoral fracture following total knee arthroplasty. This study investigates whether there is a potential role for stemmed prostheses in such scenarios to help mitigate peri-implant fracture risk, and if so what should the optimum stem length be to balance surgical bone loss with reduced fracture risk. METHODS: Finite element models of the distal femur implanted with four different implant types: a posterior stabilising implant, a total stabilising implant with short stem (12 mm × 50 mm), a TS implant with medium stem (12 mm × 75 mm), and a TS implant with long stem (12 mm × 100 mm), were developed and analysed in this study...
November 3, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27802890/the-use-of-interfragmentary-positional-screw-in-minimally-invasive-plate-osteosynthesis-for-simple-distal-femur-fractures-in-elderly-patients-a-retrospective-single-centre-pilot-study
#10
Jun Young Chung, Jae Ho Cho, Heon Ju Kweon, Hyung Keun Song
INTRODUCTION: Minimally invasive plate osteosynthesis (MIPO) using locking plates has been used in distal femur fractures, but various problems, such as nonunion, malalignment, and implant failure, have been reported. Simple fractures sometimes have poorer outcomes than complex fractures. We studied elderly patients with simple fracture patterns who underwent open reduction followed by placement of a single positional screw to hold the reduced interfragmentary gap, and compared these cases with patients who underwent surgery using conventional MIPO techniques...
October 29, 2016: Injury
https://www.readbyqxmd.com/read/27802795/femoral-fracture-following-acute-trauma-in-a-female-collegiate-swimmer
#11
Jonathan Hernandez, Seth Gamradt, Drew Morcos
The patient was a 20-year-old Division I female collegiate swimmer who presented to the athletic training room following a traumatic onset of right knee pain. She was immediately transferred to the hospital for diagnostic imaging. Knee radiographs revealed a minimally displaced fracture of her right distal femur that extended from her intercondylar notch to the lateral aspect of her distal femoral metaphysis, while computed tomography and magnetic resonance imaging scans revealed the intra-articular nature of the fracture...
November 2016: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/27802093/prepubertal-impact-of-protein-intake-and-physical-activity-on-weight-bearing-peak-bone-mass-and-strength-in-males
#12
Thierry Chevalley, Jean-Philippe Bonjour, Marie-Claude Audet, Fanny Merminod, Bert van Rietbergen, Rene Rizzoli, Serge Ferrari
CONTEXT: Peak bone mass (PBM) and strength are important determinants of fragility fracture risk in later life. During growth bone is responsive to changes in nutrition and physical activity (PA), particularly when occuring before pubertal maturation. OBJECTIVE: In prepubertal healthy boys, protein intake (Prot-Int) enhances the impact of PA on weight-bearing bone. We hypothesized that the synergism between Prot-Int and PA on proximal femur as recorded at mean age of 7...
November 1, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27790391/a-case-of-distal-femur-medial-condyle-hoffa-type-ii-c-fracture-treated-with-headless-screws
#13
Chirag Kapoor, Aditya Merh, Malkesh Shah, Paresh Golwala
Coronal plane fractures of the distal femur are less frequent compared to sagittal plane fractures. They were described by Hoffa in 1904 and are known as Hoffa fractures (AO type B3). They are isolated fractures of the femoral condyle and rare in occurrence. The objective in the treatment of these fractures is to achieve anatomical reduction of the articular surface and a stable fixation to prevent joint damage in future and prevent post-traumatic arthritis of the joint. We report the case of a young male patient who had a rare type of medial Hoffa fracture which was treated by open reduction and internal fixation using headless Herbert screws using a posterior approach...
September 23, 2016: Curēus
https://www.readbyqxmd.com/read/27789875/biomechanical-analysis-of-the-cephalomedullary-nail-versus-the-trochanteric-stabilizing-plate-for-unstable-intertrochanteric-femur-fractures
#14
David Walmsley, Bruce Nicayenzi, Paul Rt Kuzyk, Alan Machin, Habiba Bougherara, Emil H Schemitsch, Radovan Zdero
Unstable intertrochanteric fractures are commonly treated with a cephalomedullary nail due to high failure rates with a sliding hip screw. The Omega3 Trochanteric Stabilizing Plate is a relatively new device that functions like a modified sliding hip screw with a proximal extension; however, its mechanical properties have not been evaluated. This study biomechanically compared a cephalomedullary nail, that is, Gamma3 Nail against the Omega3 plate. Unstable intertrochanteric fractures were created in 24 artificial femurs...
October 26, 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/27780504/treatment-of-osteoporotic-intertrochanteric-fractures-by-zoledronic-acid-injection-combined-with-proximal-femoral-nail-anti-rotation
#15
Yong Li, Wen-Bo Zhao, De-Li Wang, Qing He, Qin Li, Fu-Xing Pei, Lei Liu
OBJECTIVE: To observe the clinical results of proximal femoral nail anti-rotation (PFNA) combined with zoledronic acid injection in the treatment of osteoporotic intertrochanteric fractures in the elderly. METHODS: 60 elderly patients with osteoporotic intertrochanteric fractures were diagnosed using a dual energy X-ray bone density instrument. Patients were randomly divided into treatment or control groups (30 cases in each group). Patients in both groups were treated by closed/open reduction and internal fixation using PFNA...
October 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/27779272/effect-of-monocortical-and-bicortical-screw-numbers-on-the-properties-of-a-locking-plate-intramedullary-rod-configuration-an-in-vitro-study-on-a-canine-femoral-fracture-gap-model
#16
Elinor J Field, Kevin Parsons, Julie A Etches, Katie Hamilton, Neil J Burton
OBJECTIVES: To evaluate the effect of varying the number and configuration of locking bicortical and monocortical screws on a plate-rod construct using a mid-diaphyseal femoral ostectomy model. METHODS: Thirty Greyhound femurs were assigned to six groups (A-F). An intramedullary pin was placed in each bone following which a 3.5 mm locking plate was applied with six differing locking screw configurations. Groups A to C had one bicortical screw in the most proximal and distal plate holes and one to three monocortical locking screws in the proximal and distal fragments...
October 25, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/27773369/impact-of-cement-augmented-condylar-screws-in-locking-plate-osteosynthesis-for-distal-femoral-fractures-a-biomechanical-analysis
#17
Christopher Bliemel, Ludwig Oberkircher, Benjamin Bockmann, Eric Petzold, Rene Aigner, Thomas Jan Heyse, Steffen Ruchholtz, Benjamin Buecking
INTRODUCTION: Compromised bone quality and the need for early mobilization continue to lead to implant failure in elderly patients with distal femoral fractures. The cement augmentation of screws might facilitate improving implant anchorage. The aim of this study was to analyse the impact of cement augmentation of the condylar screws on implant fixation in a human cadaveric bone model. MATERIAL AND METHODS: Ten pairs of osteoporotic femora (mean age: 90 years, range: 84-99 years) were used...
October 18, 2016: Injury
https://www.readbyqxmd.com/read/27768679/medial-knee-approach-an-anatomical-study-of-minimally-invasive-plate-osteosynthesis-in-medial-femoral-condylar-fracture
#18
Norachart Sirisreetreerux, Babar Shafiq, Greg M Osgood, Erik A Hasenboehler
OBJECTIVES: To determine the location of distal medial neurovascular structures, identifying a medial "safe zone" for minimally invasive plate osteosynthesis to treat displaced femoral condylar fractures. METHODS: Eleven uninjured lower-half torsos were dissected on the bilateral medial lower thigh. A longitudinal incision was made at the midsagittal plane of the medial thigh starting 1 cm proximal to the knee joint and extending to the proximal one-third of the femur...
November 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27755333/biomechanical-evaluation-of-the-femoral-neck-system-in-unstable-pauwels-iii-femoral-neck-fractures-a-comparison-to-the-dynamic-hip-screw-and-cannulated-screws
#19
Karl Stoffel, Ivan Zderic, Florian Gras, Christoph Sommer, Ursula Eberli, David Mueller, Martin Oswald, Boyko Gueorguiev
OBJECTIVES: To evaluate the biomechanical performance of Femoral Neck System (FNS) in comparison to established methods for fixation of femoral neck fractures in a cadaveric model. METHODS: Twenty pairs of fresh-frozen human cadaveric femora were instrumented either with DHS-Screw, DHS-Blade, 3CS or with FNS in a partially paired design. The specimens were randomized to two paired treatment groups based on the BMD, namely DHS-Screw/DHS-Blade and FNS/3CS. A reduced unstable femoral neck fracture with postero-caudal comminution, AO/OTA 31-B2...
October 13, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27732335/teriparatide-treatment-in-patients-with-wnt1-or-pls3-mutation-related-early-onset-osteoporosis-a-pilot-study
#20
Ville-Valtteri Välimäki, Outi Mäkitie, Renata Pereira, Christine Laine, Katherine Wesseling-Perry, Jorma Määttä, Mikko Kirjavainen, Heli Viljakainen, Matti J Välimäki
CONTEXT: We previously identified two Finnish families with dominantly inherited, low-turnover osteoporosis caused by mutations in WNT1 or PLS3. OBJECTIVE: Design and Setting: This prospective, longitudinal, uncontrolled study was undertaken to evaluate whether patients with these mutations respond to teriparatide treatment. PATIENTS AND INTERVENTION: We recruited six adults (median age 54); three with a WNT1 missense mutation c.652T>G and three with a PLS3 splice mutation c...
October 12, 2016: Journal of Clinical Endocrinology and Metabolism
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