distal femur fracture

INTRODUCTION: The concomitance of ipsilateral physeal fractures of the distal femur and the proximal tibia is an extremely scarce entity. It is conceptually similar to floating knee in the pediatric population. CASE REPORT: One case with this injury is reported in a 16-year-old teenager. He was treated surgically by close reduction and internal fixation. The diagnosis of the tibial fracture was initially missed, and the fracture was seen on the post-operative radiographs...

INTRODUCTION: Although periprosthetic fractures of the femur have been well documented, insufficiency fractures following total hip arthroplasty (THA) have been rarely described. We report a case of an insufficiency fracture in the distal tibia and fibula that occurred after THA. CASE REPORT: A 54-year-old woman presented with severe pain in the bilateral hip joints and was diagnosed with end-stage osteoarthritis. She underwent THA on the right side. Although the postoperative course was uneventful, she suddenly experienced severe pain and swelling in the right leg without any history of trauma 22 weeks after the surgery...

Complex joint fractures often require an open surgical procedure, which is associated with extensive soft tissue damages and longer hospitalization and rehabilitation time. Percutaneous techniques can potentially mitigate these risks but their application to joint fractures is limited by the current sub-optimal 2D intra-operative imaging (fluoroscopy) and by the high forces involved in the fragment manipulation (due to the presence of soft tissue, e.g., muscles) which might result in fracture malreduction. Integration of robotic assistance and 3D image guidance can potentially overcome these issues...

AIM: To investigate non-ossifying fibromas (NOFs) common fibrous bone lesions in children that occur in bones of the lower extremities. METHODS: We analyzed 44 cases of NOF including 47 lesions, which were referred with a working diagnosis of neoplastic lesions. Lesions were located in the upper extremities (1 proximal humerus, 1 distal radius) and the lower extremities (25 distal femurs, 12 proximal and 4 distal tibias, and 4 proximal fibulas). RESULTS: Three cases had NOFs in multiple anatomical locations (femur and fibula in 1 case, femur and tibia in 2 cases)...

BACKGROUND: Non-union of neck femur is a common but difficult situation to manage especially in young adults. There are two main options of arthroplasty or osteotomy. The aim of this study was to assess the results of intertrochanteric valgus osteotomy in non-union femoral neck fractures. PATIENTS AND METHODS: We present a study of 44 cases of neck femur non-union including untreated fractures, late presentations (more than 3 weeks), treated with compression screw, DHS...

Exposure to high-dose ionizing radiation during medical treatment exerts well-documented deleterious effects on bone health, reducing bone density and contributing to bone growth retardation in young patients and spontaneous fracture in postmenopausal women. However, the majority of human radiation exposures occur in a much lower dose range than that used in the radiation oncology clinic. Furthermore, very few studies have examined the effects of low-dose ionizing radiation on bone integrity and results have been inconsistent...

BACKGROUND: Locked plating is one of the latest innovative options for treating supracondylar femur fractures with relatively low failure rates. Single lateral plating was often found to have a relative higher failure rate. No clinical studies of double-plating distal femur fixation have thus far been reported. The aim of this study is to present our clinical experience with this surgical approach. PATIENTS AND METHODS: Thirty-two patients (26 females and 6 males, mean age 76 years, range 44-101) were included in the study...

Femoral shaft fractures are common injuries with an incidence of 37.1 per 100,000 person-years in the United States. Retrograde femoral nailing is an increasingly used treatment strategy to manage these injuries, particularly in fractures below stemmed hip prostheses, in supracondylar or distal femur fractures, in fractures in pregnant or obese patients, and when concomitant ipsilateral acetabular/pelvic ring fractures are present. Retrograde fixation has been shown to be a viable option with union rates comparable to antegrade intramedullary nailing...

INTRODUCTION: The distal articular femur fracture is a serious injury that for years has been a problem in traumatology. It is often believed that produced varying degrees of permanent disability in the knee and that the fate of the joint was determined by the injury rather than treatment. OBJECTIVES: Present the results of surgical treatment of articular distal femur fractures type C2 with three treatment modalities: dynamic condylar screw (TDC), condylar buttress plate (PSC) and periarticular plate (PPA)...

BACKGROUND: Ample evidence on etiological and pathological differences between femoral neck and trochanteric fracture cases suggests the possibility of individualized treatment. There are many issues related to areal bone mineral density and other quantitative computed tomography parameters of the proximal femur. Although osteoporosis is a systemic problem, little has been reported regarding differences in bone structural parameters, including bone mineral density, between them in regions other than the proximal femur...

Osteoporosis is related to more than 2 million fractures and $19 billion in healthcare costs each year (). A fragility fracture (FF) is a low-energy fracture of the distal radius, proximal humerus, ankle, or proximal femur (hip) from minimal trauma such as a fall from a standing height. In addition to cost, FFs often result in the loss of independence and productivity (). In 2015, our orthopaedic unit received the first certification ever awarded for FFs. Fragility fracture certification is a new certification demonstrating that a healthcare facility complies with national patient care standards and uses evidence-based practice guidelines to deliver quality outcomes...

Those with type 1 diabetes (T1D) are more likely to suffer a fracture than age- and sex-matched individuals without diabetes, despite daily insulin therapy. In rodent studies examining the effect of bone- or glucose-targeting therapies on preventing the T1D-related decrease in bone strength, insulin co-therapy is often not included, despite the known importance of insulin signaling to bone mass accrual. Therefore, working toward a relevant pre-clinical model of diabetic bone disease, we assessed the effect of continuous subcutaneous insulin infusion (CSII) therapy at escalating doses on preserving bone and the effect of delayed CSII on rescuing the T1D-related bone deterioration in an established murine model of T1D...

Identification of atypical femoral fractures (AFFs) can be challenging. To assist in the radiological assessment, an American Society for Bone and Mineral Research (ASBMR) Task Force developed a case definition for AFFs in 2010, revising it in 2013. How the revised definition performs in a community setting compared with the 2010 definition is unknown. We applied the 2013 criteria to 372 femoral fractures that occurred between January 1, 1996, and June 30, 2009, employing two independent expert physician reviewers...

PURPOSE: The Hoffa fracture is a rare fracture pattern consisting of a unicondylar posterior fracture of the distal femur. This video demonstrates a case of Hoffa fracture repair using headless screw compression. METHODS: Hoffa fractures are intra-articular in nature. Given that isolated Hoffa fractures are rare, there is little information available as to the best management of this injury. However, several small studies have demonstrated good-to-excellent functional results after anatomical reduction and rigid fixation of the Hoffa fracture, followed by early mobilization...

Distal femur fractures (DFFs) in elderly patients historically were difficult to treat because of osteoporotic bone, comminution, and intra-articular involvement. Current surgical treatment options, including intramedullary nailing, internal fixation, and external fixation, are complicated by prolonged immobility, malunion, and nonunion. Furthermore, fixation increases the complexity of subsequent arthroplasty. Primary total knee arthroplasty (TKA) is a rarely used treatment for acute DFF but may be of benefit in select patients...

OBJECTIVES: The objectives of this study were (1) to compare the axial and torsional stiffness of a dynamic hip screw with a two- and four-hole side-plate in a synthetic model of a healed and stable intertrochanteric femur fracture and (2) to evaluate the load to failure, as well as propensity to peri-implant fracture. METHODS: Fourth-generation synthetic composite femur models, simulating osteoporotic bone, were implanted with 135° dynamic hip screws (DHS) with either a two- or four-hole side-plate with or without a stable intertrochanteric fracture...

AIMS: Fractures of the distal femur can be challenging to manage and are on the increase in the elderly osteoporotic population. Management with casting or bracing can unacceptably limit a patient's ability to bear weight, but historically, operative fixation has been associated with a high rate of re-operation. In this study, we describe the outcomes of fixation using modern implants within a strategy of early return to function. PATIENTS AND METHODS: All patients treated at our centre with lateral distal femoral locking plates (LDFLP) between 2009 and 2014 were identified...

Spinal cord injury (SCI) is characterized by marked bone loss at the knee, and there is a need for established dual-energy X-ray absorptiometry (DXA) protocols to examine bone mineral density (BMD) at this location to track therapeutic progress and to monitor fracture risk. The purpose of this study was to quantify the precision and reliability of a DXA protocol for BMD assessment at the distal femur and the proximal tibia in individuals with SCI. The protocol was subsequently used to investigate the relationship between BMD and duration of SCI...

INTRODUCTION: Despite recent evolution in the operating techniques and surgical implants, debate continues around the choice of implant for management of distal femur fractures. High rates of complications and union difficulties continues to make them a momentous therapeutic challenge. AIM: To compare the outcome of locked compressive plating versus retrograde nailing in the management of extra articular supracondylar femur fractures. MATERIALS AND METHODS: In this randomized prospective study, 42 patients with extra-articular distal femur fractures were segregated into two groups based on internal fixation with distal femoral locking plate (n=22) and retrograde nail (n=20)...

BACKGROUND: Decreasing the stiffness of locked plating constructs can promote natural fracture healing by controlled dynamization of the fracture. This biomechanical study compared the effect of four different stiffness reduction methods on interfragmentary motion by measuring axial motion and shear motion at the fracture site. METHODS: Distal femur locking plates were applied to bridge a metadiaphyseal fracture in femur surrogates. A locked construct with a short bridge span served as the non-dynamized control group (LOCKED)...