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Fractured femurs

Kerrin C DePeter, Stephen M Blumberg, Sarah Dienstag Becker, James A Meltzer
BACKGROUND: Despite being an effective analgesic for children with fractures, some clinicians may avoid prescribing ibuprofen due to its potentially harmful effect on bone healing. OBJECTIVE: To determine if exposure to ibuprofen is associated with an increased risk of bone healing complications in children with fractures. METHODS: We performed a retrospective study of children aged 6 months to 17 years who presented to the pediatric emergency department (PED) with a fracture of the tibia, femur, humerus, scaphoid, or fifth metatarsus and who followed up with the orthopedic service...
October 14, 2016: Journal of Emergency Medicine
Brian M Ilfeld
A continuous peripheral nerve block (CPNB) consists of a percutaneously inserted catheter with its tip adjacent to a target nerve/plexus through which local anesthetic may be administered, providing a prolonged block that may be titrated to the desired effect. In the decades after its first report in 1946, a plethora of data relating to CPNB was published, much of which was examined in a 2011 Anesthesia & Analgesia article. The current update is an evidence-based review of the CPNB literature published in the interim...
October 3, 2016: Anesthesia and Analgesia
Hao Zhang, Hua Yue, Chun Wang, Weiwei Hu, Jiemei Gu, Jinwei He, Wenzhen Fu, Yunqiu Hu, Miao Li, Zhenlin Zhang
Osteogenesis imperfecta (OI) is an inherited connective tissue disorder characterized by brittle bone fractures. The aim of the present study was to investigate the pathogenic gene mutation spectrum and clinical manifestations of mutations in collagen type I, alpha 1 (COL1A1) and collagen type I, alpha 2 (COL1A2) genes in Chinese patients with OI. A total of 61 unrelated Chinese OI patients with COL1A1 and COL1A2 mutations were recruited. All the exons and the exon-intron boundaries of the COL1A1 and COL1A2 genes were amplified and directly sequenced and lumbar spine bone mineral density was measured by dual‑energy X‑ray absorptiometry...
October 12, 2016: Molecular Medicine Reports
H S Choi, J H Park, S H Kim, S Shin, M J Park
: Bone mineral density (BMD) of offspring was significantly associated with their parents' BMD. Parental BMD Z-score ≤-1 was a significant predictor for BMD Z-score ≤-1 in their offspring. Peak bone mass acquisition during early adulthood is more substantially influenced by genetic factors rather than lifestyle or environmental factors. INTRODUCTION: A person's BMD is affected by both genetic and environmental factors. Family history of osteoporosis or fragility fracture is a well-known risk factor for low bone mass or fracture...
October 17, 2016: Osteoporosis International
Luiz Eduardo Imbelloni, Geraldo Borges de Morais Filho
BACKGROUND: The fast-track concept refers to all phases of perioperative care: Preoperative, intraoperative, and postoperative strategies. Although most research has focused on adherence to medication, adherence also encompasses numerous health-related behaviors. The aim of this prospective study was to determine the attitudes and awareness among health professionals involved in the treatment of elderly patients with fractures of the femur and the results of 400 patients. METHODS: The postoperative protocol acceleration was presented to various hospital departments through four seminars...
September 2016: Anesthesia, Essays and Researches
Yiru Lorna Fan, Wilfred C G Peh
Osteoporosis, a systemic metabolic disease of bone, is characterized by low bone mass and altered trabecular pattern, leading to increased risk of fractures. It increases in prevalence with age, especially in postmenopausal women, and can have other secondary causes. Radiologic evaluation of osteoporosis has historically used conventional radiography, which demonstrates cortical thinning, increased radiolucency, and altered trabecular patterns, and also aids in assessing vertebral fractures. Many indexes have been devised, such as the Saville index for the degree of radiolucency, and the Genant grading system for vertebral fractures...
July 2016: Seminars in Musculoskeletal Radiology
Ryan Urchek, Eric Miller
The typical injury pattern of a posterior hip dislocation includes posterior wall fracture, capsular injury, and muscular strain. This report presents an example of a posterior wall acetabulum fracture-dislocation associated with complete hip abductor tendon and capsular avulsion from the femur. The patient was found to have an unstable hip despite a small posterior wall fragment due to the extensive soft tissue injury. This was repaired. The patient had improvement in function initially, but ultimately required repair of the hip abductor tendons...
October 13, 2016: Orthopedics
David Lidwell, Colin A Meghoo
Skeletal traction is a useful technique for managing proximal femur fractures in austere environments where fracture stabilization for this injury is difficult. We present a technique and a construct appropriate for field use that facilitates patient evacuation, and we provide guidelines for the use of this technique by an advanced medical provider managing these injuries. The objectives of this article are to enable to reader to (1) recognize the role of skeletal traction in managing proximal femur fractures in an austere environment, (2) identify the key steps in placing transfemoral skeletal traction pins, and (3) identify options and requirements for building a traction construct in resource-limited environments...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Nikolai Briffa, Raju Karthickeyan, Joshua Jacob, Arshad Khaleel
The aim of this study was to compare the biomechanical properties of medial and lateral plating of a medially comminuted supracondylar femoral fracture. A supracondylar femoral fracture model comparing two fixation methods was tested cyclically in axial loading. One-centimetre supracondylar gap osteotomies were created in six synthetic femurs approximately 6 cm proximal to the knee joint. There were two constructs investigated: group 1 and group 2 were stabilized with an 8-hole LC-DCP, medially and laterally, respectively...
October 12, 2016: Strategies in Trauma and Limb Reconstruction
Diego H Díaz, Julieta A Rodas, Clarisa E Bozzini, Patricia M Mandalunis, Natalia D Escudero
Bisphosphonates are the first choice therapy for the pharmaco logical treatment of osteoporosis. Following reports of cases of bisphosphonaterelated osteonecrosis of the jaw and atypical femur fracture, the safety of longterm use of bisphosphonates has been evaluated, resulting in the proposal of strontium as an alternative drug. No experimental study using a sequential administration design has been reported to date. Hence, the aim of this study was to evaluate the effect on bone tissue of ovariectomized rats of administration of alendronate followed by strontium ranelate...
September 2016: Acta Odontológica Latinoamericana: AOL
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
Gloria Bonaccorsi, Enrica Fila, Carmelo Messina, Elisa Maietti, Fabio Massimo Ulivieri, Renata Caudarella, Pantaleo Greco, Giuseppe Guglielmi
PURPOSE: To evaluate (a) the performance in predicting the presence of bone fractures of trabecular bone score (TBS) and hip structural analysis (HSA) in type 2 diabetic postmenopausal women compared to a control group and (b) the fracture prediction ability of TBS versus Fracture Risk Calculator (FRAX(®)) as well as whether TBS can improve the fracture prediction ability of FRAX(®) in diabetic women. METHODS: Eighty diabetic postmenopausal women were matched with 88 controls without major diseases for age and body mass index...
October 8, 2016: Aging Clinical and Experimental Research
Ahmad S Alobaidi, Ammar Al-Hassani, Ayman El-Menyar, Husham Abdelrahman, Mazin Tuma, Hassan Al-Thani, Mohammed A Aldosari
BACKGROUND: Femur fracture (FF) is a common injury, and intramedullary nailing (IMN) is the standard surgical fixation. However, the time of intervention remains controversial. We aimed to describe the reamed IMN (rIMN) timing and hospital outcomes in trauma patients presenting with FF. MATERIALS AND METHODS: A retrospective analysis was conducted for all patients admitted with FF and they underwent fixation at level 1 trauma unit between January 2010 and January 2012...
July 2016: International Journal of Critical Illness and Injury Science
W C Shin, N H Moon, J H Jang, K Y Park, K T Suh
BACKGROUND: The purpose of this study was to characterize anterolateral bowing of the femur using X-rays and muscular atrophy in the mid-thigh using computed tomography (CT) in patients with atypical femoral fractures (AFFs). We then compared the results with those of an intertrochanteric fracture to understand whether these measures act as causative factors of AFFs. METHODS: From January 2009 to December 2015, 37 patients with complete AFF and 12 patients with incomplete AFF were enrolled in this study...
October 6, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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
Chun-Jui Weng, Chi-Chuan Wu, Kuo-Fun Feng, I-Chuan Tseng, Po-Cheng Lee, Yu-Chih Huang
BACKGROUND: Treatment of supraintercondylar (AO/OTA 33-C) and supracondylar (AO/OTA 33-A) femur fractures is generally challenging. Standard treatments include open reduction and internal fixation. However, optimal implants are now being well-defined. This study focus on the comparison between clinical and functional outcomes of fractures treated with condylar buttress plates (CBPs). METHODS: We treated 87 patients with supraintercondylar or supracondylar femur fracture from 2004 to 2008, including 30 supraintercondylar and 24 supracondylar fractures treated with CBPs...
October 4, 2016: BMC Musculoskeletal Disorders
A J Schreiner, F Stuby, P M de Zwart, B G Ochs
In contrast to periprosthetic fractures of the femur, periprosthetic fractures of the acetabulum are rare complications - both primary fractures and fractures in revision surgery. This topic is largely under-reported in the literature; there are a few case reports and no long term results. Due to an increase in life expectancy, the level of patients' activity and the number of primary joint replacements, one has to expect a rise in periprosthetic complications in general and periprosthetic acetabular fractures in particular...
October 6, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Silvina R Mastaglia, Gabriel Aguilar, Beatriz Oliveri
Bisphosphonates (BPs) are the most widely used drugs to treat osteoporosis. However, recent reports associated to long-term BPs use with atypical low-impact fractures and prodromal pain. It is estimated that 26% of the cases of atypical fractures associated with the long-term use of BPs show delayed healing or nonunion. Teriparatide [PTH1-34] (TPTD) is an anabolic drug shown to be effective in stimulating bone formation. The aim was to describe the course of a right diaphyseal femoral fracture sustained by a patient on long-term BPs treatment...
June 2016: Eur J Rheumatol
William P Hedges, Marwan Bukhari
OBJECTIVE: Low body mass index (BMI) is a known risk factor for osteoporosis and is part of the FRAX™ 10-year fracture risk stratification tool for predicting fragility fractures. Little is known regarding the effects of changing body composition on bone mineral density (BMD). However, increasing fat mass (FM) improves BMD in young women with anorexia nervosa. This study aimed to assess whether changes in FM over time affected BMD in the general population. MATERIAL AND METHODS: Data was collected from patients who underwent dual-energy X-ray absorptiometry (DEXA) assessment between 2004 and 2011...
March 2016: Eur J Rheumatol
Nefyn H Williams, Jessica L Roberts, Nafees Ud Din, Nicola Totton, Joanna M Charles, Claire A Hawkes, Val Morrison, Zoe Hoare, Michelle Williams, Aaron W Pritchard, Swapna Alexander, Andrew Lemmey, Robert T Woods, Catherine Sackley, Pip Logan, Rhiannon T Edwards, Clare Wilkinson
OBJECTIVE: To conduct a rigorous feasibility study for a future definitive parallel-group randomised controlled trial (RCT) and economic evaluation of an enhanced rehabilitation package for hip fracture. SETTING: Recruitment from 3 acute hospitals in North Wales. Intervention delivery in the community. PARTICIPANTS: Older adults (aged ≥65) who received surgical treatment for hip fracture, lived independently prior to fracture, had mental capacity (assessed by clinical team) and received rehabilitation in the North Wales area...
October 5, 2016: BMJ Open
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