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distal femur fracture

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
Murong You, Juehua Jing, Dasheng Tian, Jun Qian, Guangrong Yu
Dioscin has been shown to play important roles in suppression of osteoclast maturation. It is proposed as a potential natural product for the treatment of osteoclast-related diseases. We hypothesized in this study that treatment of dioscin on bone marrow mesenchymal stem cells (BMSCs) could increase the osteo-chondrogenic differentiation of BMSCs and promote endochondral ossification of BMSCs in bone fracture environment. BMSCs were extracted from femur and tibia of male C57b mice. Stemness of BMSCs was studied by performing proliferation assay and multilineage differentiation...
2016: American Journal of Translational Research
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
T Shimizu, M Takahata, H Kimura-Suda, Y Kameda, K Endo, H Hamano, S Hiratsuka, M Ota, D Sato, T Ito, M Todoh, S Tadano, N Iwasaki
: This study showed that autoimmune arthritis induces especially severe osteoporosis in the periarticular region adjacent to inflamed joints, suggesting that arthritis increases the fragility fracture risk near inflamed joints, which is frequently observed in patients with RA. INTRODUCTION: Periarticular osteoporosis near inflamed joints is a hallmark of early rheumatoid arthritis (RA). Here we show that rheumatic inflammation deteriorates the bone quality and bone quantity of periarticular bone, thereby decreasing bone strength and toughness in a mouse model of RA...
October 4, 2016: Osteoporosis International
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
Francyne Kubaski, Heidi H Kecskemethy, H Theodore Harcke, Shunji Tomatsu
To date, the only published reports of bone mineral density (BMD) in MPS IV involve patients with MPS IVA; no reports exist describing BMD for MPS IVB. In this prospective study of BMD in three patients with MPS IVB, BMD was acquired by dual-energy X-ray absorptiometry (DXA) at whole body (WB), lumbar spine (LS), and lateral distal femur (LDF). Functional abilities, ambulatory status, medical history, and height z-score were evaluated. Three patients with MPS IVB (two females), aged 17.7, 31.4 and 31.7 years, were evaluated...
September 2016: Molecular Genetics and Metabolism Reports
Richard Eastell, Terence W O'Neill, Lorenz C Hofbauer, Bente Langdahl, Ian R Reid, Deborah T Gold, Steven R Cummings
Osteoporosis is a metabolic bone disorder that is characterized by low bone mass and micro-architectural deterioration of bone tissue. Fractures of the proximal femur, the vertebrae and the distal radius are the most frequent osteoporotic fractures, although most fractures in the elderly are probably at least partly related to bone fragility. The incidence of fractures varies greatly by country, but on average up to 50% of women >50 years of age are at risk of fractures. Fractures severely affect the quality of life of an individual and are becoming a major public health problem owing to the ageing population...
2016: Nature Reviews. Disease Primers
Hesham Saleh, Stephen Yu, Jonathan Vigdorchik, Ran Schwarzkopf
AIM: To review and report functional outcomes, complications, and survivorship associated with total knee arthroplasty (TKA) in the treatment of post-traumatic arthritis (PTA). METHODS: We conducted a systematic review according to the PRISMA guidelines. We searched PubMed, Cochrane Library, and SCOPUS in December 2015 for English-language clinical research studies, both prospective and retrospective, examining the use of TKA for the treatment of PTA. All relevant articles were accessed in full...
September 18, 2016: World Journal of Orthopedics
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
Liping Wang, Tian-Zhi Guo, Tzuping Wei, Wen-Wu Li, Xiaoyou Shi, J David Clark, Wade S Kingery
BACKGROUND: Bisphosphonates are used to prevent the bone loss and fractures associated with osteoporosis, bone metastases, multiple myeloma, and osteogenesis deformans. Distal limb fractures cause regional bone loss with cutaneous inflammation and pain in the injured limb that can develop into complex regional pain syndrome (CRPS). Clinical trials have reported that antiresorptive bisphosphonates can prevent fracture-induced bone loss, inhibit serum inflammatory cytokine levels, and alleviate CRPS pain...
October 2016: Anesthesia and Analgesia
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
Nabil A Ebraheim, Grant S Buchanan, Xiaochen Liu, Maxwell E Cooper, Nicholas Peters, Jacob A Hessey, Jiayong Liu
OBJECTIVE: To report and evaluate the outcomes of patients undergoing definitive treatment for distal femur nonunion after initial treatment with a locking plate. METHODS: Fourteen patients who had undergone definitive treatment at an academic Level 1 trauma center from May 2007 to December 2013 for distal femur nonunion were identified from a fracture database. Thirteen of them were female; the average age was 65 years (range, 50-84 years). Ten patients had sustained their injuries in falls at ground level, and four in motor vehicle accidents...
August 2016: Orthopaedic Surgery
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
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
Daniel Gittings, Patrick Hesketh, Jonathan Dattilo, Miltiadis Zgonis, John Kelly, Samir Mehta
BACKGROUND: Post-traumatic stiffness after open reduction and internal fixation of fractures about the knee can have dramatic effects on function. Traditionally, open quadricepsplasty has been the treatment of choice, but is associated with significant morbidity. PURPOSE: The purpose of this study is to examine the immediate and sustainable range of motion (ROM) changes after surgical arthroscopic lysis of knee adhesions (SALKA) for post-traumatic knee stiffness after open reduction internal fixation (ORIF)...
August 30, 2016: Archives of Orthopaedic and Trauma Surgery
Yifeng Zhang, Jiankun Xu, Ye Chun Ruan, Mei Kuen Yu, Micheal O'Laughlin, Helen Wise, Di Chen, Li Tian, Dufang Shi, Jiali Wang, Sihui Chen, Jian Q Feng, Dick Ho Kiu Chow, Xinhui Xie, Lizhen Zheng, Le Huang, Shuo Huang, Kwoksui Leung, Na Lu, Lan Zhao, Huafang Li, Dewei Zhao, Xia Guo, Kaiming Chan, Frank Witte, Hsiao Chang Chan, Yufeng Zheng, Ling Qin
Orthopedic implants containing biodegradable magnesium have been used for fracture repair with considerable efficacy; however, the underlying mechanisms by which these implants improve fracture healing remain elusive. Here we show the formation of abundant new bone at peripheral cortical sites after intramedullary implantation of a pin containing ultrapure magnesium into the intact distal femur in rats. This response was accompanied by substantial increases of neuronal calcitonin gene-related polypeptide-α (CGRP) in both the peripheral cortex of the femur and the ipsilateral dorsal root ganglia (DRG)...
October 2016: Nature Medicine
Darren Grimwood, Jane Harvey-Lloyd
BACKGROUND: Intramedullary nailing is the standard surgical treatment for mid-diaphyseal fractures of long bones; however, it is also a high radiation dose procedure. Distal locking is regularly cited as a demanding element of the procedure, and there remains a reliance on X-ray fluoroscopy to locate the distal holes. A recently developed electromagnetic navigation (EMN) system allows radiation-free distal locking, with a virtual on-screen image. OBJECTIVE: To compare operative duration, fluoroscopy time and radiation dose when using EMN over fluoroscopy, for the distal locking of intramedullary nails...
August 25, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
A Trinh, P Wong, J Brown, S Hennel, P R Ebeling, P J Fuller, F Milat
: This study assessed the prevalence and types of fractures in spina bifida and examined risk factors for fracture. Fracture prevalence was highest in childhood and reduced in adolescence and young adulthood. The importance of maintaining mobility is highlighted by the increased risk of fracture in those who are non-ambulatory. INTRODUCTION: The aims of this study are to study the prevalence and types of fractures according to age group in spina bifida and examine risk factors associated with fracture...
August 24, 2016: Osteoporosis International
Tyler C Kreipke, Jacqueline G Garrison, Jeremiah Easley, A Simon Turner, Glen L Niebur
Bone quantity, or density, has insufficient power to discriminate fracture risk in individuals. Additional measures of bone quality, such as microarchitectural characteristics and bone tissue properties, including the presence of damage, may improve the diagnosis of fracture risk. Microdamage and microarchitecture are two aspects of trabecular bone quality that are interdependent, with several microarchitectural changes strongly correlated to damage risk after compensating for bone density. This study aimed to delineate the effects of microarchitecture and estrogen depletion on microdamage susceptibility in trabecular bone using an ovariectomized sheep model to mimic post-menopausal osteoporosis...
October 3, 2016: Journal of Biomechanics
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