distal femur fracture

The historical concept that obesity protects against bone fractures has been questioned. Weight loss appears to reduce bone mineral density (BMD); however, the results in young adults are inconsistent, and data on the effects of weight loss on bone microstructure are limited. This study aimed to evaluate the impact of weight loss using an intragastric balloon (IGB) on bone density and microstructure. Forty obese patients with metabolic syndrome (mean age 35.1 ± 7.3 yr) used an IGB continuously for 6 mo...

OBJECTIVE:  The aim of this article was to describe the surgical re-alignment technique and stabilization of a distal femoral deformity in a 6-week-old, male, Foxhound. METHODS:  A healing metaphyseal fracture, resulting in a valgus deformity with internal rotation, was observed just proximal to the distal femoral physis. The deformity was treated by an opening wedge osteotomy with lateral translation and external rotation of the distal epiphysis using a guide-wire technique; a corticocancellous allograft bridged the defect, which was stabilized with a 2...

Objective: Pediatric femoral shaft fractures are more commonly treated with intramedullary titanium elastic nail system (TENS). Adhering to the principles, most studies had supported excellent results with this instrumentation and attributed the variation in age, weight, immobilization protocols, technical factors like fracture pattern, reduction and complications as reasons to poor outcomes in their individual studies. Hence, we wanted to identify the potential demographic and perioperative parameters that could affect the final outcomes in this cohort...

In this paper, an innovative design of nail, conceived to heal fractures of long bones has been investigated. Its functioning is based essentially on sliding of conical surfaces located in a spindle and in a series of holding pins radially disposed around it. Spindle and holding pins are connected together by means of a sleeve. Medial and distal screws are not necessary. Rotational and longitudinal motions of the spindle are transformed in a radial expansion of the holding pins by the sliding of conical surfaces...

The coronal unicondylar fracture of the distal femur (AO 33-B3) is a rare intraarticular injury within the weight bearing area of the knee, initially described by Albert Hoffa in 1904. We report an unusual combination of a Hoffa fracture with lateral patellar dislocation in a young adult. Our patient sustained the injury by a sudden twist of his leg during sports. He presented clinically with knee swelling, dislocation of the patella, and localized tenderness; unable to bare weight. After plane radiograph confirmed the injury, manual reduction of the patella was done by hyperextension of the knee and medialward pressure...

OBJECTIVE: Lower extremity injuries are the most frequent Abbreviated Injury Scale (AIS) 2 injury for drivers in frontal crashes. The objective was to reconstruct 11 real-world motor vehicle crashes (2 with AIS 2+ distal lower extremity injury and 9 without lower extremity injury) and to analyze the vehicle parameters and driver attributes that affect injury risk. METHODS: Eleven frontal crashes were reconstructed with a finite element simplified vehicle model (SVM) using a semi-automated optimization method...

INTRODUCTION: Computer Assisted Orthopaedic Surgery (CAOS) was introduced in the late 1990's and early 2000's. Since then its application in orthopaedic trauma has been utilized mainly as augmented fluoroscopy for intraoperative navigation. From 2010 our center implemented an advanced system allowing further expansion of this technology. AIMS: The aim of this study was to describe the experience with an advanced fluoroscopic based CAOS system in our center. METHODS: The BrainLabTM Trauma 3...

Distal locking is a challenging subtask of intramedullary nailing fracture fixation due to the nail deformation that makes the proximally mounted targeting systems ineffective. A patient specific finite element model was developed, based on the QCT data of a cadaveric femur, to predict the position of the distal hole of the nail postoperatively. The mechanical interactions of femur and nail (of two sizes) during nail insertion was simulated using ABAQUS in two steps of dynamic pushing and static equilibrium, for the intact and distally fractured bone...

BACKGROUND: Blood loss estimation after trauma (i.e. physical injury) and early identification of potential sources of bleeding are important for planning of investigation and management of trauma. Long bone fractures have been reported to be associated with substantial volumes of blood loss requiring blood transfusion. The aim of this study was to assess rates and amounts of blood transfusion in the setting of isolated extra capsular femur fractures and to determine variables associated with the need for transfusion within the first 48 h of admission...

Pentraxin 3 (PTX3) is an inflammatory mediator acting as a fluid-phase pattern recognition molecule and playing an essential role in innate immunity and matrix remodeling. Inflammatory mediators also contribute to skeletal homeostasis, operating at multiple levels in physiological and pathological conditions. This study was designed to investigate the role of PTX3 in physiological skeletal remodeling and bone healing. Micro-computed tomography (μCT) and bone histomorphometry of distal femur showed that PTX3 gene-targeted female and male mice ( ptx3-/- ) had lower trabecular bone volume than their wild-type ( ptx3+/+ ) littermates (BV/TV by μCT: 3...

PURPOSE: The objective of this study is to investigate healing outcome of lateral locked plating for distal femoral fractures caused by low-energy trauma. In addition, we sought to determine predictable factors associated with fracture healing time. METHODS: Seventy-three patients (73 fractures) with distal femur fractures (AO/OTA type 33) caused by low-energy trauma were recruited. The mean age of patients was 69.8 years (range, 43-87 years). All fractures were stabilized by less invasive osteosynthesis with anatomical periarticular locking system...

BACKGROUND: Distal femur fractures are difficult to manage, and the selection of implant approach for internal fixation remains controversial. This study explores the clinical outcome of treating distal femoral fractures with a locking compression plate using a posteriolateral novel approach. METHODS: Twenty patients with distal femoral fractures were included in our study, and all patients underwent fixation of the fracture using a locking compression plate through a posterolateral approach...

Background: There is evidence that human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) are independent risk factors for osteoporosis and fracture which is not solely explained by changes in bone mineral density. Thus, we hypothesized that the assessment of trabecular microstructure might play an important role for bone quality in this population and might explain the increased fracture risk. In this study, we have assessed bone microstructure in the proximal femur using high-resolution magnetic resonance imaging (MRI) as well as in the extremities using high resolution peripheral quantitative computed tomography (HR-pQCT) in HIV-infected men and healthy controls and compared these findings to those based on areal bone mineral density (aBMD) derived from dual X-ray absorptiometry (DXA) which is the standard clinical parameter for the diagnosis of osteoporosis...

PURPOSE: The cerclage passer instrument was introduced for aiding percutaneous reduction in spiral femur fractures, thereby overcoming the risk of devascularization of the fracture ends commonly associated with traditional open cerclage wiring techniques. This may, however, predispose to iatrogenic vascular injuries owing to the proximity of the vessels and several other factors. We report four cases with femoral artery (superficial and deep) injuries caused by the cerclage passer in proximal femur and distal femur shaft fractures and incidence of these injuries in our institution...

We report our surgical method used to treat type C distal femur fractures accompanied by patella fractures whereby we approach the articular surface of the femur through the already-fractured patella. We treated 10 patients with type C3 distal femur and patella fractures between May 2013 and April 2015. Because the patella was fractured in all cases, we could approach the articular surface of the distal femur through the transverse gap between the retracted patellar fracture fragments, "transpatellar approach...

INTRODUCTION: Short stem femoral components in primary total hip arthroplasty (THA) have increased in popularity since the advent of minimally invasive surgical techniques. The concept of a short stem is particularly compatible with tapered designs where the goal is to offload forces proximally in the femur. The purpose of this retrospective review was to review our early experience with a short, tapered titanium femoral component with updated design features. MATERIALS AND METHODS: Beginning in November 2011 through February 2012, 92 consented patients (93 hips), at a single center, were treated with primary cementless THA using a short stem, tapered femoral component (Taperloc® Complete Microplasty; Zimmer Biomet, Warsaw, Indiana) and were available for review with a minimum two-year follow-up...

BACKGROUND: Preservation of limb function after resection of malignant bone tumors in skeletally immature children is challenging. Resection of bone sarcomas and reconstruction with an allograft in patients younger than 10 years old is one reconstructive alternative. However, long-term studies analyzing late complications and limb length discrepancy at skeletal maturity are scarce; this information would be important, because growth potential is altered in these patients owing to the loss of one physis during tumor resection...

With an aging population, treatment of interprosthetic femur fractures continues to pose a challenge to the orthopedic surgeon. Retrograde IMN combined with open reduction internal fixation utilizing a tissue-preserving plating technique was used in our series of 9 patients with non-comminuted, distal femur fractures. No interfragmentary screws, cables, cerclage wires, or supplemental bone grafts of any type were used. Each patient initiated weight-bearing as tolerated following operative intervention. Every fracture healed at an average of 20 weeks (range 18 to 24 weeks)...

PURPOSE: Nonunion is a highly morbid complication that exacerbates the pain, disability and financial burden of distal and diaphyseal femur fractures. This study examined the modern rates of healing, nonunion, and other complications requiring reoperation of different fixation methods for distal and diaphyseal femur fractures. METHODS: A systematic review and meta-analysis of all records from PubMed, Embase and the Cochrane Review system was performed. Included studies had >20 acute, non-pathologic distal or diaphyseal femur fractures treated with primary internal fixation...

BACKGROUND: Distal femoral fractures constitute a type of lower limb injuries that is rare and difficult to treat. Despite advances in surgical technique and development of implants used for internal fixation of fracture fragments, the treatment continues to result in numerous complications. The Ilizarov External Fixator reduces the risk of complications and allows for bone union. MATERIAL AND METHODS: Six men with distal femoral fractures resulting from multisite and multiorgan injuries were treated at the Department of Orthopaedics and Musculoskeletal Traumatology of the Medical Uni-versity of Warsaw between 2008 and 2016...