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Fractured femurs

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https://www.readbyqxmd.com/read/28817157/extent-and-morbidity-of-lateralization-of-a-trochanteric-fixation-nail-blade
#1
Phillip A Sandifer, Robert M Hulick, Matthew L Graves, Clay A Spitler, George V Russell, Josie M Hydrick, LaRita C Jones, Patrick F Bergin
This study examined the incidence and risk factors associated with lateral helical blade migration and trochanteric pain with the trochanteric fixation nail. A retrospective review was performed of 141 cases of pertrochanteric femur fracture treated with a trochanteric fixation nail at a level I trauma center over a period of 42 months. Exclusion criteria included follow-up of less than 60 days, preexisting osteonecrosis of the femoral head, and prophylactic trochanteric fixation nail treatment. Patient demographics, operative findings, and radiographic findings were recorded...
August 17, 2017: Orthopedics
https://www.readbyqxmd.com/read/28815387/image-guided-surgical-robotic-system-for-percutaneous-reduction-of-joint-fractures
#2
Giulio Dagnino, Ioannis Georgilas, Samir Morad, Peter Gibbons, Payam Tarassoli, Roger Atkins, Sanja Dogramadzi
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...
August 16, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28811854/factors-associated-with-psycho-cognitive-functions-in-patients-with-persistent-pain-after-surgery-for-femoral-neck-fracture
#3
Atsushi Kitayama, Mitsumasa Hida, Hidenobu Takami, Naoki Hirata, Yuko Deguchi, Kazuya Miyaguchi, Masako Nakazono, Rie Nakagawa, Noriyuki Fukumoto, Katsumi Hamaoka
BACKGROUND: The aim of the study was to address issues arising from fracture of the femoral neck in elderly individuals, the prevalence of which continues to increase in Japan. The prevalence is increasing in Japan and there have been many reports on physical functions such as prevention of a fall. However, there have been a few studies that focus on psycho-cognitive functions. We must examine factors in patients with fractured femur necks to develop methods to assist affected patients...
September 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28810524/pioglitazone-induced-bone-loss-in-diabetic-rats-and-its-amelioration-by-berberine-a-portrait-of-molecular-crosstalk
#4
Mohammad Adil, Mohd Nizam Mansoori, Divya Singh, Amit Dattatraya Kandhare, Manju Sharma
Diabetes mellitus and osteoporosis both are high prevalence disorders, especially in the elderly population. Pioglitazone, a PPAR-γ agonist associated with bone loss and risk of fracture in type 2 diabetes mellitus patients. In this study, ameliorative effect of berberine against pioglitazone-induced bone loss in diabetic rats and possible mechanisms has been explored. Diabetes was induced in male Wistar albino rats by streptozotocin (65 mg/kg, i.v.) after 15min of nicotinamide (230mg/kg, i.p.) administration...
August 11, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28808745/parathyroid-hormone-1-34-promotes-fracture-healing-in-ovariectomized-rats-with-type-2-diabetes-mellitus
#5
G Y Liu, G L Cao, F M Tian, H P Song, L L Yuan, L D Geng, Z Y Zheng, L Zhang
Ovariectomized (OVX) rats with type 2 diabetes mellitus (T2DM) with femur fracture received vehicle, insulin, or insulin plus parathyroid hormone (PTH) treatment for 2 and 3 weeks. Radiography, histomorphometry, histology, and immunohistochemistry in callus were evaluated. INTRODUCTION: Reports about effects of PTH plus insulin on callus formation of osteoporotic fracture with T2DM were limited. This study was designed to investigate the effects of the combination of PTH and insulin on fracture healing in OVX rats with T2DM...
August 14, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28808627/non-ossifying-fibromas-case-series-including-in-uncommon-upper-extremity-sites
#6
Akio Sakamoto, Ryuzo Arai, Takeshi Okamoto, Shuichi Matsuda
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)...
July 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28807080/a-descriptive-analysis-of-traction-splint-utilization-and-iv-analgesia-by-emergency-medical-services
#7
Joshua Nackenson, Amado A Baez, Jonathan P Meizoso
Study Objectives Traction splinting has been the prehospital treatment of midshaft femur fracture as early as the battlefield of the First World War (1914-1918). This study is the assessment of these injuries and the utilization of a traction splint (TS) in blunt and penetrating trauma, as well as intravenous (IV) analgesia utilization by Emergency Medical Services (EMS) in Miami, Florida (USA). METHODS: This is a retrospective study of patients who sustained a midshaft femur fracture in the absence of multiple other severe injuries or severe physiologic derangement, as defined by an injury severity score (ISS) <20 and a triage revised trauma score (T-RTS)≥10, who presented to an urban, Level 1 trauma center between September 2008 and September 2013...
August 15, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28802425/outcomes-of-dynamic-hip-screw-augmented-with-trochanteric-wiring-for-treatment-of-unstable-type-a2-intertrochanteric-femur-fractures
#8
Chetan Puram, Chetan Pradhan, Atul Patil, Vivek Sodhai, Parag Sancheti, Ashok Shyam
BACKGROUND: Posteromedial and greater trochanteric fragments are a major cause of telescoping and medialization of the femoral shaft in an unstable intertrochanteric fracture. This leads to significant limb shortening, fracture collapse in varus position and implant failure, which can be prevented by trochanteric wiring in addition to dynamic hip screw (DHS) fixation. The purpose of our study is to assess the outcomes of DHS augmented with trochanteric wiring in unstable type A2 intertrochanteric fractures...
August 2017: Injury
https://www.readbyqxmd.com/read/28802423/effectiveness-of-exchange-k-nail-and-augmented-plating-in-aseptic-femoral-diaphyseal-non-union
#9
K H Sancheti, Chetan Pradhan, Atul Patil, Chetan Puram, Parkalp Bharti, Parag Sancheti, Ashok Shyam
BACKGROUND: Femoral diaphyseal non-unions present difficult scenario to manage. There are multiple options but most of them still report varying incidences of failure. We combined the principles of augmented plating and exchange nailing and aim to study the effectiveness of this technique. METHOD: A retrospective study at a tertiary trauma centre was conducted. Seventy patients (60 men, 10 women), average age 40.7±15.27 years (range 18-81 years) with diaphyseal femoral fracture non-unions treated between July 2010 and January 2015 were reviewed...
August 2017: Injury
https://www.readbyqxmd.com/read/28802420/dhs-osteosynthesis-with-internal-bone-grafting-in-unstable-delayed-presented-intracapsular-neck-femur-fractures
#10
Wasudeo M Gadegone, R M Chandak, Vijayanand R Lokhande
OBJECTIVES: The aim of this study was to assess fracture union and complications following use of dynamic hip screw (DHS) with internal bone grafting in treatment of unstable delayed presented intracapsular neck femur fractures in patients younger than 65 years of age. MATERIAL AND METHODS: Thirty two patients with displaced intracapsular neck femur fractures(Garden III and IV, Pauwels III, with comminution) with delayed presentation (15-60 days) in the 45-65 year age group (mean 54...
August 2017: Injury
https://www.readbyqxmd.com/read/28802417/augmentation-plating-in-management-of-failed-femoral-nailing
#11
Rahul Verma, Pulak Sharma, Sanjiv Gaur
INTRODUCTION: Non-union following interlocking nailing is a troubling complication in treatment of shaft femur fractures. There is no clear consensus on the treatment of this problem. This research was undertaken to study the role of augmentation plating combined with exchange nailing in such cases. PATIENTS AND METHODS: A prospective clinical study was undertaken from January 2010 to December 2015. Patients with aseptic femoral shaft non-union, with or without implant failure following intramedullary nailing were included in the study...
August 2017: Injury
https://www.readbyqxmd.com/read/28802416/accuracy-of-valgus-osteotomy-using-dynamic-hip-screw
#12
Sunil G Kulkarni, G S Kulkarni, Sushrut Babhulkar, Milind G Kulkarni, Ruta M Kulkarni
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...
August 2017: Injury
https://www.readbyqxmd.com/read/28801793/robotic-technique-improves-entry-point-alignment-for-intramedullary-nailing-of-femur-fractures-compared-to-the-conventional-technique-a-cadaveric-study
#13
Eduardo M Suero, Ralf Westphal, Musa Citak, Nael Hawi, Emmanouil Liodakis, Christian Krettek, Timo Stuebig
We aimed to test whether a robotic technique would offer more accurate access to the proximal femoral medullary cavity for insertion of an intramedullary nail compared to the conventional manual technique. The medullary cavity of ten femur specimens was accessed in a conventional fashion using fluoroscopic control. In ten additional femur specimens, ISO-C 3D scans were obtained and a computer program calculated the ideal location of the cavity opening based on the trajectory of the medullary canal. In both techniques, the surgeon opened the cavity using a drill and inserted a radiopaque tube that matched the diameter of the cavity...
August 11, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28801202/a-biomechanical-study-comparing-proximal-femur-nail-and-proximal-femur-locking-compression-plate-in-fixation-of-reverse-oblique-proximal-femur-fractures
#14
Ashutosh Kumar Singh, N Narsaria, R K Gupta
BACKGROUND: The reverse oblique trochanteric fractures are common fractures and its treatment poses a challenge. The purpose of this study was to compare the biomechanical parameters of the construct using proximal femoral nail (PFN) and proximal femoral locking compression plates (PFLCP) in these fractures using cadaveric specimens. MATERIALS AND METHODS: Twenty freshly harvested cadaveric femoral specimens were randomly assigned to two groups after measuring bone mineral density, ten of which were implanted with PFN and the other ten with PFLCP...
May 22, 2017: Injury
https://www.readbyqxmd.com/read/28796551/lateral-cortical-thickening-and-bone-heterogeneity-of-the-subtrochanteric-femur-measured-with-quantitative-ct-as-indicators-for-early-detection-of-atypical-femoral-fractures-in-long-term-bisphosphonate-users
#15
Seung Hyun Lee, Young Han Lee, Jin-Suck Suh
OBJECTIVE: The objective of our study was to compare subtrochanteric femur bone mineral density (BMD) and bone quality of long-term bisphosphonate (BP) users who sustained an atypical femoral fracture (AFF) with BP users who did not sustain a femoral fracture and BP-naïve patients with no history of femoral fracture using quantitative CT (QCT). MATERIALS AND METHODS: Fourteen female BP users with an AFF (mean age, 72.6 years; mean duration of BP use, 6.2 years; mean body mass index, 21...
August 10, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28795328/severe-hemorrhagic-shock-leads-to-a-delayed-fracture-healing-and-decreased-bone-callus-strength-in-a-mouse-model
#16
Katrin Bundkirchen, Christian Macke, Janin Reifenrath, Luisa Marilena Schäck, Sandra Noack, Borna Relja, Philipp Naber, Bastian Welke, Michael Fehr, Christian Krettek, Claudia Neunaber
BACKGROUND: Multiple trauma is frequently associated with hemorrhagic shock and fractures of the extremities. Clinically, the rate of impaired fracture healing (delayed healing and nonunion) seems to be increased in patients with multiple injuries compared with patients with isolated fractures. As the underlying pathogenesis remains poorly understood, we aimed to analyze the biomechanical properties during fracture healing in a murine model. QUESTIONS: The aim of this study was to determine whether fracture healing after severe hemorrhagic shock results in (1) delayed bridging as determined by macroscopic and radiographic assessment, (2) altered conditions of callus components as determined by µCT, and (3) decreased maximum bending moment measured by a three-point-bending test compared with ordinary fracture healing...
August 9, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28794370/the-successful-prevention-of-thromboembolism-using-rivaroxaban-in-a-patient-with-antithrombin-deficiency-during-the-perioperative-period
#17
Hidetsugu Kawai, Hiromichi Matsushita, Hiroshi Kawada, Yoshiaki Ogawa, Kiyoshi Ando
Antithrombin (AT) deficiency, a rare disorder of the coagulation system, is a serious risk factor for thromboembolism. Approximately 50-90% of patients with AT deficiency develop thromboembolism during their lifetime. In addition, surgery is a major risk factor for thromboembolism in these patients. We herein report the case of a 90-year-old woman with AT deficiency who was safely and successfully managed using rivaroxaban (a direct oral factor Xa inhibitor) during the perioperative period of surgery for right femur fracture...
August 10, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28793180/when-is-hemiarthroplasty-preferable-to-intramedullary-prophylactic-fixation-of-malignant-lesions-of-the-proximal-femur
#18
James S Lin, Juan E Santiago-Torres, Joshua S Everhart, Nicole E Zayan, Joel L Mayerson, Thomas J Scharschmidt
BACKGROUND: Malignant hip lesions can be managed operatively by intramedullary (IM) nail fixation and hemiarthroplasty. METHODS: A retrospective review was performed on 86 patients who underwent hemiarthroplasty (n = 22) or IM nail fixation (n = 64) for prophylactic treatment of impending pathologic fracture due to malignant lesions of the hip. Cox proportional hazards and logistic regression modeling were performed to determine risk of death, fixation failure, pain relief, and return to ambulation without gait aids...
August 9, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28791971/comparision-of-the-expandable-nail-with-locked-nail-in-the-treatment-of-closed-diaphyseal-fractures-of-femur
#19
S Sipahioglu, S Zehir, B Sarikaya, U E Isikan
BACKGROUND: Expandable nails achieve stability only by hydraulic expansion; therefore suggest less radiation exposure and operation time. In this study, we aimed to compare the results of expandable femoral nails with locked intramedullary nails in the treatment of diaphyseal fractures of femur. MATERIALS AND METHODS: Isolated closed AO = Arbeitsgemeinschaft für Osteosynthesefragen type 32.A or 32.B unilateral femoral shaft fractures operated with expandable or locked nail were evaluated retrospectively...
July 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28790037/a-six-year-retrospective-analysis-of-cut-out-risk-predictors-in-cephalomedullary-nailing-for-pertrochanteric-fractures-can-the-tip-apex-distance-tad-still-be-considered-the-best-parameter
#20
G Caruso, M Bonomo, G Valpiani, G Salvatori, A Gildone, V Lorusso, L Massari
OBJECTIVES: Intramedullary fixation is considered the most stable treatment for pertrochanteric fractures of the proximal femur and cut-out is one of the most frequent mechanical complications. In order to determine the role of clinical variables and radiological parameters in predicting the risk of this complication, we analysed the data pertaining to a group of patients recruited over the course of six years. METHODS: A total of 571 patients were included in this study, which analysed the incidence of cut-out in relation to several clinical variables: age; gender; the AO Foundation and Orthopaedic Trauma Association classification system (AO/OTA); type of nail; cervical-diaphyseal angle; surgical wait times; anti-osteoporotic medication; complete post-operative weight bearing; and radiological parameters (namely the lag-screw position with respect to the femoral head, the Cleveland system, the tip-apex distance (TAD), and the calcar-referenced tip-apex distance (CalTAD))...
August 2017: Bone & Joint Research
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