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distal femoral fracture

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
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
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
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
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
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
Connie Y Chang, Daniel I Rosenthal, Deborah M Mitchell, Atsuhiko Handa, Susan V Kattapuram, Ambrose J Huang
Metabolic bone diseases are a diverse group of diseases that result in abnormalities of (a) bone mass, (b) structure mineral homeostasis, (c) bone turnover, or (d) growth. Osteoporosis, the most common metabolic bone disease, results in generalized loss of bone mass and deterioration in the bone microarchitecture. Impaired chondrocyte development and failure to mineralize growth plate cartilage in rickets lead to widened growth plates and frayed metaphyses at sites of greatest growth. Osteomalacia is the result of impaired mineralization of newly formed osteoid, which leads to characteristic Looser zones...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Mark Lenz, Karl Stoffel, Heike Kielstein, Keith Mayo, Gunther O Hofmann, Boyko Gueorguiev
INTRODUCTION: Proximal plate fixation in periprosthetic femur fractures can be improved by plate anchorage in the greater trochanter (lateral tension band principle) or bicortical locking screw placement beside the prosthesis stem in an embracement configuration. Both concepts were compared in a biomechanical test using a femoral hook plate (hook) or a locking attachment plate (LAP). METHODS: After bone mineral density (BMD) measurement in the greater trochanter, six pairs of fresh frozen human femora were assigned to two groups and instrumented with cemented hip endoprostheses...
September 30, 2016: Injury
M Javed Shaikh, C Rex, R Vignesh, Madhav Chavan
INTRODUCTION: Congenital insensitivity to pain (CIP) is a rare disorder, and often presents to an orthopaedic surgeon as recurrent fractures, dislocations, pseudoarthrosis, osteomyelitis etc. Here, we report a case of congenital insensitivity to pain presenting with distal femoral physeal separation in a child. CASE REPORT: A 12-year-old girl child came with complaints of limp while walking and swelling in the left knee for past 5 weeks. Mother gave a history that the girl is a known case of congenital insensitivity to pain with clear history of no pain on intramuscular injection since birth...
April 2016: Journal of Orthopaedic Case Reports
Ahmed El-Bakoury, Hazem Hosny, Mark Williams, Jonathan Keenan, Rathan Yarlagadda
BACKGROUND: Periprosthetic fracture following total hip arthroplasty is a significant problem faced by hip surgeons, and its management in elderly patients remains a considerable challenge. METHODS: We retrospectively reviewed 28 Vancouver B2 and B3 periprosthetic femoral fractures (PFF) treated with revision of the femoral stems by distally locked, hydroxyapatite-coated uncemented stems (Cannulok). Patients were aged 75 years or older at the time of surgery. RESULTS: The mean follow-up was 44...
August 12, 2016: Journal of Arthroplasty
Tracy Y Zhu, Vivian W Y Hung, Wing-Hoi Cheung, Jack C Y Cheng, Ling Qin, Kwok-Sui Leung
We aimed to determine whether loss of volumetric bone mineral density (vBMD) and deterioration of microarchitecture imaged by high-resolution peripheral quantitative computed tomography at the distal radius/tibia provided additional information in fracture discrimination in postmenopausal women with recent hip fracture. This case-control study involved 24 postmenopausal Chinese women with unilateral femoral neck fracture (average [SD] age: 79.6[5.6]) and 24 age-matched women without any history of fracture...
September 27, 2016: Scientific Reports
Dong Ren, Yueju Liu, Ming Li, Zhaohui Song, Shuangquan Yao, Pengcheng Wang
BACKGROUND: Cephalomedullary Nail (CMN) is seen as the mainstay of internal fixation in femoral fractures. The purpose of the study was to present an accurate calculation method by simulating diverse anterior bow femoral models with finite element software. We hypothesized that anterior cortical penetration in distal femur would occur in patients whose femoral anterior bow was identified as too large for nailing by preoperative measurement of contralateral X-ray. METHODS: A 31-year healthy male was selected for building 3D bone model through computed tomography (CT) scan of right femoral femur...
September 26, 2016: BMC Surgery
J Schmolders, S Koob, P Schepers, S Gravius, D C Wirtz, C Burger, P H Pennekamp, A C Strauss
Introduction/Background: With extended life expectancy, the number of primary joint arthroplasties has also increased. Revision surgery is also more often necessary, due to aseptic or septic loosening of the prosthesis or periprosthetic fracture. Large bone defects often occur in these patients and several non-modular, conventional implants are available to handle this difficult situation. Custom made implants offer an individually designed and defect-adapted shape with perfect covering of the lesion, but may delay the operation...
September 15, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Axel Somersalo, Juha Paloneva, Hannu Kautiainen, Eija LÖNnroos, Mikko HEinÄNen, Ilkka Kiviranta
Background and purpose - The association between mortality and lower extremity fractures (other than hip fractures in older individuals) is unclear. We therefore investigated mortality in adults of all ages after lower extremity fractures that required inpatient care. Patients and methods - Diagnosis code (ICD10), procedure code (NOMESCO), and 7 additional characteristics of patients admitted to the trauma ward at Central Finland Hospital were collected between 2002 and 2008 (n = 3,567). Patients were followed up until the end of 2012...
September 12, 2016: Acta Orthopaedica
Cuixia Tian, Brenda L Wong, Lindsey Hornung, Jane C Khoury, Lauren Miller, Jean Bange, Irina Rybalsky, Meilan M Rutter
Osteoporosis is a major problem in boys with Duchenne Muscular Dystrophy (DMD), attributable to muscle weakness and glucocorticoid therapy. Consensus regarding bone health assessment and management is lacking. Lumbar spine areal bone mineral density by dual-energy X-ray absorptiometry (DXA) is frequently the primary measure used, but has limitations for boys with DMD. We retrospectively studied 292 ambulant glucocorticoid-treated boys with DMD categorized by functional mobility score, FMS 1, 2 or 3. We assessed DXA whole body and lumbar spine areal bone mineral density and content Z-scores adjusted for age and height, lateral distal femur areal bone mineral density Z-scores, frequency of fractures, and osteoporosis by International Society for Clinical Densitometry 2013 criteria...
August 22, 2016: Neuromuscular Disorders: NMD
Rhianna M Little, Matthew D Milewski
While some fractures may be managed similarly in adults and children, physeal fractures are uniquely limited to the pediatric population and require special consideration. Although physeal fractures about the knee are relatively rare, they are occurring more frequently due to increasing youth participation in sports and high-energy recreational activities. The evaluation and management of distal femoral and proximal tibial physeal fractures are similar to one another, but fractures of the tibial spine and tibial tubercle are approached somewhat differently...
September 7, 2016: Current Reviews in Musculoskeletal Medicine
Filippo Maffezzoni, Michele Maddalo, Stefano Frara, Monica Mezzone, Ivan Zorza, Fabio Baruffaldi, Francesco Doglietto, Gherardo Mazziotti, Roberto Maroldi, Andrea Giustina
Vertebral fractures are an emerging complication of acromegaly but their prediction is still difficult occurring even in patients with normal bone mineral density. In this study we evaluated the ability of high-resolution cone-beam computed tomography to provide information on skeletal abnormalities associated with vertebral fractures in acromegaly. 40 patients (24 females, 16 males; median age 57 years, range 25-72) and 21 healthy volunteers (10 females, 11 males; median age 60 years, range: 25-68) were evaluated for trabecular (bone volume/trabecular volume ratio, mean trabecular separation, and mean trabecular thickness) and cortical (thickness and porosity) parameters at distal radius using a high-resolution cone-beam computed tomography system...
September 6, 2016: Endocrine
Nicholas M Desy, Joshua D Johnson, Rafael J Sierra
BACKGROUND: The Exeter cemented femoral stem has demonstrated excellent clinical and radiographic outcomes as well as long-term survivorship free from aseptic loosening. A shorter revision stem (125 mm) with a 44 offset became available for the purpose of cement-in-cement revision situations. In certain cases, this shorter revision stem may be used for various primary total hip arthroplasties (THAs) where the standard length stem would require distally reaming the femoral canal. We sought to report on the early to midterm results of this specific stem when used for primary THA regarding (1) clinical and radiographic outcomes, (2) complications, and (3) survivorship...
August 10, 2016: Journal of Arthroplasty
Hyung Suk Choi, Jae Hwi Nho, Chung Hyun Kim, Sai Won Kwon, Jong Seok Park, You Sung Suh
Periprosthetic fractures after total knee arthroplasty (TKA) are gradually increasing, reflecting extended lifespan, osteoporosis, and the increasing proportion of the elderly during the past decade. Supracondylar periprosthetic femoral fracture is a potential complication after TKA. Generally, open reduction and internal fixation are the conventional option for periprosthetic fracture after TKA. However, the presence of severe comminution with component loosening can cause failure of internal fixation. Although the current concept for periprosthetic fracture is open reduction and internal fixation, we introduce an unusual case of revision arthroplasty using a MUTARS® prosthesis for a comminuted periprosthetic fracture in the distal femur after TKA, with technical tips...
November 2016: Yonsei Medical Journal
Swapnil B Shah, Theodore T Manson, Jason W Nascone, Marcus F Sciadini, Robert V O'Toole
A retrospective review was conducted at an academic trauma center to determine whether fracture characteristics or aspects of native anatomy are predictive of early failure after fixation of posterior wall acetabular fractures. A chart review of posterior wall acetabular fractures treated from 2004 to 2009 yielded the study group that met the inclusion criteria. The study group included 18 consecutive patients who had clinical failure. The control group included 27 patients who did not have clinical failure...
August 30, 2016: Orthopedics
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