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neck stress fracture

Brian R Waterman, Baris Gun, Julia O Bader, Justin D Orr, Philip J Belmont
PURPOSE: To comprehensively quantify established risk factors for the development of lower extremity stress fractures within a contemporary U.S. military cohort. METHODS: Using the Defense Medical Epidemiological Database, all U.S. service members diagnosed with tibia/fibula, metatarsal, other bone, femoral neck, and femoral shaft stress fractures were identified based on International Classification of Diseases, 9th Revision, Clinical Modification code from 2009 to 2012...
October 2016: Military Medicine
Mitsuru Saito, Keishi Marumo
Chronic obstructive pulmonary disease(COPD)is a chronic inflammatory disease associated with an increase of fracture risk. Bone strength is determined by bone mass and quality.Bone quality is thought to encompass the structural and material properties of bone. Bone collagen crosslinking plays important roles in bone strength. The quantitative and qualitative deterioration of lysyl oxidase control and non enzymatic cross-links(advanced glycation end products, AGEs, pentosidine)of collagen in patients with osteoporotic femoral neck fracture and diabetes, and COPD might be affected by increased oxidative stress and glycation...
2016: Clinical Calcium
Ilias Katsougrakis, Alexandros P Apostolopoulos, Samantha Z Tross
UNLABELLED: Femoral-neck stress fractures are relatively rare and may present as sports-related injuries. The presentation is variable, and prompt diagnosis facilitates the earliest return to pre-morbid functional activity levels. Delayed detection may precipitate femoral non-union or avascular necrosis, resulting in long-term functional deficit. AIMS: We describe the clinical, diagnostic and therapeutic approach of a femoral-neck stress fracture that occurred in a 28-year-old female recreational runner...
2016: Journal of Long-term Effects of Medical Implants
Nicola Veronese, Sara Carraro, Giulia Bano, Caterina Trevisan, Marco Solmi, Claudio Luchini, Enzo Manzato, Riccardo Caccialanza, Giuseppe Sergi, Davide Nicetto, Emanuele Cereda
BACKGROUND: Serum uric acid (SUA) accounts for about 50% of extracellular antioxidant activity, suggesting that hyperuricemia may have a protective role in diseases characterized by high levels of oxidative stress, such as osteoporosis. We aimed to meta-analyse data regarding bone mineral density (BMD), osteoporosis and fractures in people with higher SUA vs. lower SUA concentrations. MATERIALS AND METHODS: Two investigators conducted a literature search using PubMed and Scopus, without language restrictions...
October 5, 2016: European Journal of Clinical Investigation
Bong-Jin Lee, Jyewon Song
Stress fractures may occur at various sites in the femur including the head, neck, shaft, supracondylar and condylar regions. To the best of our knowledge, stress fracture occurring in the trochanteric region has not been previously reported. We report here a case of trochanteric stress fracture in a 53-year-old female window cleaner treated with hip nailing without adverse consequences. Careful consideration of this entity is needed when evaluating patients who have repetitive jumping up and down.
March 2016: Hip Pelvis
Shinya Abe, Nathaniel Narra, Riku Nikander, Jari Hyttinen, Reijo Kouhia, Harri Sievänen
Over 90% of hip fractures are caused by falls. Due to a fall-induced impact on the greater trochanter, the posterior part of the thin superolateral cortex of the femoral neck is known to experience the highest stress, making it a fracture-prone region. Cortical geometry of the proximal femur, in turn, reflects a mechanically appropriate form with respect to habitual exercise loading. In this finite element (FE) modeling study, we investigated whether specific exercise loading history is associated with femoral neck structural strength and estimated fall-induced stresses along the femoral neck...
November 2016: Bone
Fa-Chuan Kuan, Ming-Long Yeh, Chih-Kai Hong, Florence L Chiang, I-Ming Jou, Ping-Hui Wang, Wei-Ren Su
BACKGROUND: Femoral neck fractures in young individuals are typically vertical shear fractures. These injuries are difficult to stabilize due to a significant varus displacement force across the hip with weight bearing. The purpose of this study was to evaluate the biomechanical stability offered by the addition of an augmented wire to conventional inverted triangle triple screw fixation for stabilizing vertical shear femoral neck fracture. METHODS: Sixteen medium 4th-generation synthetic composite femurs (Sawbones Pacific Research Laboratories, Vashon, WA) were divided into two groups...
October 2016: Injury
Michael Brückner, Martin Unger, Markus Spies
OBJECTIVE: To describe early clinical experience with a newly designed interlocking nail system (Targon(®) Vet) in diaphyseal fractures in cats and small dogs. STUDY DESIGN: Retrospective case series. ANIMALS: Client-owned cats (n=49) and dogs (n=8). METHODS: Fifty-seven consecutive cases (49 cats, 8 dogs) with 60 long bone fractures were included in the study. Follow-up radiographs were scheduled at 4 and 8 weeks and again 6 months postoperatively...
August 2016: Veterinary Surgery: VS
Saurabh Vitalkar, Ashmi S Manglunia, Arvind Kulkarni, Ameya D Puranik
Stress insufficiency fracture is usually diagnosed clinically and on the basis of routine X-ray imaging findings. However, the absence of any known predisposing factors and negative or occult radiographic findings pose diagnostic challenges. We report the case of an elderly male patient who presented with a chief complaint of trivial left hip pain and with equivocal radiographic findings. Triphasic (99m)Tc-methylene diphosphonate bone scan and single-photon emission computed tomography/computed tomography helped in arriving at the diagnosis of stress insufficiency fracture involving femoral neck...
July 2016: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Murray T Wong, G Daniel G Langohr, George S Athwal, James A Johnson
BACKGROUND: Acromial fractures after reverse shoulder arthroplasty (RSA) have been reported to occur in up to 7% of patients. Whereas RSA implant parameters can be configured to alter stability, range of motion, and deltoid mechanical advantage, little is known about the effect of these changes on acromial stresses. The purpose of this finite element study, therefore, was to evaluate the effect of RSA humeral and glenoid implant position on acromial stresses. METHODS: Solid body models of 10 RSA reconstructed cadaveric shoulders (38-mm glenosphere, 155° neck-shaft angle) were input into custom software that calculated the deltoid force required to achieve an abduction arc of motion (0°-120°)...
June 30, 2016: Journal of Shoulder and Elbow Surgery
Christopher M Larson, John C Clohisy, Paul E Beaulé, Bryan T Kelly, M Russell Giveans, Rebecca M Stone, Kathryn M Samuelson
BACKGROUND: There is limited literature looking at comprehensive complication rates after arthroscopic hip procedures. PURPOSE: To prospectively report complication rates for a consecutive series of hips undergoing arthroscopic procedures. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Over a 29-month period, 1615 consecutive hips in patients with a mean age of 30.5 years underwent arthroscopic hip procedures at 4 institutions...
September 2016: American Journal of Sports Medicine
Stephan Brand, Michael Bauer, Maximilian Petri, Julian Schrader, Hans J Maier, Christian Krettek, Thomas Hassel
Treatment of periprosthetic femur fractures after total hip arthroplasty remains a major challenge in orthopedic surgery. Recently, a novel surgical technique using intraprosthetic screw fixation has been suggested. The purpose of this study was to evaluate the influence of drilling the femoral hip stem on integrity and strength of the implant. The hypothesis was that intraprosthetic drilling and screw fixation would not cause the load limit of the prosthesis to be exceeded and that deformation would remain within the elastic limit...
July 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Thomas Neubauer, Julian Brand, Surjit Lidder, Manfred Krawany
A systematic review, following strict inclusion criteria, identified 32/48 low and 16/48 high-performance runners with stress fractures of the femoral neck. Surgical treatment was performed in 33/48 cases and was significantly higher (p = 0.009) in high-performance runners. Among the 28/48 runners who resumed running, there were significantly more lower-performance runners (23/32) than higher-performing runners (5/16) (p = 0.012) and significantly more non-displaced (22/30) than displaced fractures (6/18) (p = 0...
July 2016: Research in Sports Medicine
Lindsay N Ramey, Kelly C McInnis, William E Palmer
BACKGROUND: Limited research is available regarding return-to-running (RTR) time after femoral neck stress fractures. While studies have shown the prognostic value of image-based grading scales for stress fractures at other sites, few have included femoral neck stress fractures. PURPOSE: To determine if the grade of femoral neck stress fractures based on magnetic resonance imaging (MRI) characteristics correlates with RTR time. STUDY DESIGN: Cohort study; Level of evidence, 3...
August 2016: American Journal of Sports Medicine
Yoon-Suk Lee, Byung-Kook Kim, Ho-Jae Lee, Jinmyoung Dan
In Fanconi syndrome, hypophosphatemic osteomalacia is caused by proximal renal tubule dysfunction which leads to impaired reabsorption of amino acids, glucose, urate, and phosphate. We present a rare case of a 43-year-old Korean male who was found to have insufficiency stress fracture of the femoral neck secondary to osteomalacia due to Fanconi syndrome. He had been receiving low-dose adefovir dipivoxil (ADV, 10 mg/day) for the treatment of chronic hepatitis B virus infection for 7 years and he subsequently developed severe hypophosphatemia and proximal renal tubule dysfunction...
June 2016: Clinics in Orthopedic Surgery
A I Dubikov, M A Kabalyk, T Yu Koretskaya
AIM: To estimate the rate of articular cartilage microcrystallization in osteoarthritis (OA). SUBJECTS AND METHODS: The investigation included 110 people who had undergone total endoprosthetic replacement for coxarthrosis. A total of 50 patients with total hip endoprosthetic replacement for femoral neck fractures were recruited as a comparison group. An X-ray diffractometer was used to detect crystals. RESULTS: Cartilage mineralization was seen in 72% of the patients with late-stage OA...
2016: Terapevticheskiĭ Arkhiv
Angela E Li, Shari T Jawetz, Harry G Greditzer, Alissa J Burge, Danyal H Nawabi, Hollis G Potter
OBJECTIVE: This article reviews the surgical treatment options for femoroacetabular impingement (FAI), including labral repair and osteochondroplasty, and the expected postoperative appearance on MRI. Complications, including residual osseous deformities, chondral injury, adhesions, femoral neck stress fractures, osteonecrosis, instability, malpositioned suture anchors, and infection, will also be discussed. CONCLUSION: Knowledge of the surgical treatment of FAI can assist in improving our understanding of the expected postoperative MRI appearance and in evaluating surgical complications...
August 2016: AJR. American Journal of Roentgenology
Tanvir R Faisal, Yunhua Luo
Image-based finite element analysis (FEA) has been considered an effective computational tool to predict hip fracture risk. The patient specific FEA gives an insight into the inclusive effect of three-dimensional (3D) complex bone geometry, and the distribution of inhomogeneous isotropic material properties in conjunction with loading conditions. The neck region of a femur is primarily the weakest in which fracture is likely to happen, when someone falls. A sideways fall results in the development of greater tensile and compressive stresses, respectively, in the inferior and superior aspects of the femoral neck, whereas the state of stress is reversed in usual gait or stance configuration...
May 12, 2016: Bio-medical Materials and Engineering
Haruhiko Machida, Toshiyuki Yuhara, Mieko Tamura, Takuya Ishikawa, Etsuko Tate, Eiko Ueno, Katelyn Nye, John M Sabol
With flat-panel detector mammography, radiography, and fluoroscopy systems, digital tomosynthesis (DT) has been recently introduced as an advanced clinical application that removes overlying structures, enhances local tissue separation, and provides depth information about structures of interest by providing high-quality tomographic images. DT images are generated from projection image data, typically using filtered back-projection or iterative reconstruction. These low-dose x-ray projection images are easily and swiftly acquired over a range of angles during a single linear or arc sweep of the x-ray tube assembly...
May 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
James J Yue, Paul C Ivancic, David L Scott
BACKGROUND: We report a case of a young male athlete who sustained a three column displaced teardrop fracture of the C5 vertebra due to a head-first impact in hockey, suffered neurapraxia, yet made full neurological recovery. This full recovery was in sharp contrast to multiple case series which reported permanent quadriplegia in the vast majority of teardrop fracture patients. We investigate the etiology and biomechanical mechanisms of injury. METHODS: Admission imaging revealed the teardrop fracture which consisted of: a frontal plane fracture which separated an anterior quadrilateral-shaped fragment from the posterior vertebral body; a vertical fracture of the posterior vertebral body in the sagittal plane; and incomplete fractures of the neural arch that initiated superiorly at the anterior aspect of the spinous process and left lamina adjacent to the superior facet...
2016: International Journal of Spine Surgery
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