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Fractured femurs

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https://www.readbyqxmd.com/read/28108173/broach-handle-design-changes-force-distribution-in-the-femur-during-total-hip-arthroplasty
#1
Dustin A Greenhill, Pooyan Abbasi, Kurosh Darvish, Andrew M Star
BACKGROUND: Curved broach handles were developed to overcome limited surgical exposures during total hip arthroplasty. Some authors report increased intraoperative fracture rates during limited exposures. This study evaluates mechanical force ratios transmitted to the bone while broaching with curved vs straight handles. METHODS: An experimental model utilized a 6-axis load cell to measure force distributions produced by 4 different broach handles, each with increasing offset and curvature...
December 29, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28105580/pixel-based-dxa-derived-structural-properties-strongly-correlate-with-pqct-measures-at-the-one-third-distal-femur-site
#2
Alexander M Baker, David W Wagner, B Jenny Kiratli, Gary S Beaupre
While bone mineral density has been traditionally used to quantify fracture risk for individuals with spinal cord injuries, recent studies are including engineering measurements such as section modulus and cross sectional moment of inertia. These are almost exclusively calculated by peripheral QCT scanners which, unlike DXA scanners, are rarely found in clinical settings. Using fifty-four fresh frozen femora, we developed and validated a pixel-by-pixel method to calculate engineering properties at the distal femur using a Hologic QDR-1000 W DXA scanner and compared them against similar parameters measured using a Stratec XCT-3000 peripheral QCT scanner...
January 19, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28103859/treatment-with-soluble-activin-type-iib-receptor-improves-bone-mass-and-strength-in-a-mouse-model-of-duchenne-muscular-dystrophy
#3
Tero Puolakkainen, Hongqian Ma, Heikki Kainulainen, Arja Pasternack, Timo Rantalainen, Olli Ritvos, Kristiina Heikinheimo, Juha J Hulmi, Riku Kiviranta
BACKGROUND: Inhibition of activin/myostatin pathway has emerged as a novel approach to increase muscle mass and bone strength. Duchenne muscular dystrophy (DMD) is a neuromuscular disorder that leads to progressive muscle degeneration and also high incidence of fractures. The aim of our study was to test whether inhibition of activin receptor IIB ligands with or without exercise could improve bone strength in the mdx mouse model for DMD. METHODS: Thirty-two mdx mice were divided to running and non-running groups and to receive either PBS control or soluble activin type IIB-receptor (ActRIIB-Fc) once weekly for 7 weeks...
January 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28103852/stiffness-of-the-locking-compression-plate-as-an-external-fixator-for-treating-distal-tibial-fractures-a-biomechanics-study
#4
Wei Liu, Lihui Yang, Xiaochuan Kong, Likun An, Gang Hong, Zicheng Guo, Lei Zang
BACKGROUND: Locking compress plate, as external fixator, is an attractive technique for distal tibial fracture treatment. But it still remains unclear whether the external LCP has sufficient stiffness. Thus, the present study aims to make a comprehensive evaluation of the stiffness of external locking compress plate when it is used as an external fixator in distal tibial fractures treatment. METHODS: Composite tibia was used to simulate distal tibia fracture (Orthopedic Trauma Association type 43 A3 fracture)...
January 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28099754/addressing-the-crisis-in-the-treatment-of-osteoporosis-a-path-forward
#5
Sundeep Khosla, Jane A Cauley, Juliet Compston, Douglas P Kiel, Clifford Rosen, Kenneth G Saag, Elizabeth Shane
Considerable data and media attention have highlighted a potential "crisis" in the treatment of osteoporosis. Specifically, despite the availability of several effective drugs to prevent fractures, many patients who need pharmacological therapy are either not being prescribed these medications or if prescribed a medication, are simply not taking it. Although there are many reasons for this "gap" in the treatment of osteoporosis, a major factor is physician and patient concerns over the risk of side effects, especially atypical femur fractures (AFFs) related to bisphosphonate (and perhaps other antiresorptive) drug therapy...
December 29, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28097413/when-surgical-resources-are-severely-constrained-who-receives-care-determinants-of-access-to-orthopaedic-trauma-surgery-in-uganda
#6
Trina Stephens, Alexander Mezei, Nathan N O'Hara, Jeffrey Potter, Rodney Mugarura, Piotr A Blachut, Peter J O'Brien, Tito Beyeza, Gerard P Slobogean
BACKGROUND: In low- and middle-income countries, the volume of traumatic injuries requiring orthopaedic intervention routinely exceeds the capacity of available surgical resources. The objective of this study was to identify predictors of surgical care for lower extremity fracture patients at a high-demand, resource-limited public hospital in Uganda. METHODS: Skeletally mature patients admitted with the intention of definitive surgical treatment of an isolated tibia or femur fractures to the national referral hospital in Uganda were recruited to participate in this study...
January 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28097118/femur-neck-fracture-in-a-young-marfan-syndrome-patient
#7
Yong-Uk Kwon, Gyu-Min Kong, Jun-Ho Park
Marfan syndrome is an autosomal dominant and could decrease bone mineral density. So patients with Marfan syndrome could vulnerable to trauma in old ages. We present the first report, to the best of our knowledge, of a rare fracture of the femoral neck with a minor traumatic history in a juvenile Marfan syndrome patient whose physis is still open. Although the patient is young, her bone mineral density was low and the geometry of femur is changed like old ages. The femur neck fracture in children is very rare and only caused by high energy trauma, we concluded that the Marfan syndrome makes the bone weaker in young age and preventative medications to avoid fractures in younger Marfan syndrome patients are necessary in early ages...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28097113/clinical-and-functional-outcomes-of-treatment-for-type-a1-intertrochanteric-femoral-fracture-in-elderly-patients-comparison-of-dynamic-hip-screw-and-proximal-femoral-nail-antirotation
#8
Hong Man Cho, Kyujung Lee
PURPOSE: We aimed to evaluate and compare the clinical and functional outcomes of dynamic hip screw (DHS) and proximal femoral nail antirotation (PFNA) treatment of AO type 1 intertrochanteric fractures in elderly patients. MATERIALS AND METHODS: We retrospectively reviewed 194 consecutive patients with type A1 intertrochanteric femoral fractures who were treated with DHS (n=113) or PFNA (n=81). We evaluated operation time, intraoperative blood loss, and functional outcomes, walking ability, and the Barthel activities index...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28097110/comparative-study-of-bipolar-hemiarthroplasty-for-femur-neck-fractures-treated-with-cemented-versus-cementless-stem
#9
Jung-Yun Choi, Yerl-Bo Sung, Joo-Hyung Kim
PURPOSE: To compare and analyze clinical and radiologic outcomes of cemented versus cementless bipolar hemiarthroplasty for treatment of femur neck fractures. MATERIALS AND METHODS: A total of 180 patients aged 65 years and over older who underwent bipolar hemiarthroplasty for treatment of displaced femur neck fractures (Garden stage III, IV) from March 2009 to February 2014 were included in this study. Among the 180 patients, 115 were treated with cemented stems and 65 patients with cementless stems...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28096579/intrathecal-ropivacaine-with-or-without-tramadol-for-lower-limb-orthopedic-surgeries
#10
Rashmi Salhotra, Medha Mohta, Deepti Agarwal, Ashok K Sethi
BACKGROUND AND AIM: Preservative free tramadol has been used as an adjuvant to intrathecal bupivacaine. However, the effect of the addition of tramadol on intrathecal isobaric ropivacaine has never been studied. MATERIAL AND METHODS: This prospective, randomized, double-blind study was conducted in 50 adult male American Society of Anesthesiologists grade I or II patients, aged 18-60 years, being operated for unilateral femur fractures. An epidural catheter was inserted in L2-L3 interspace and subarachnoid block was given in L3-L4 space...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28095896/screening-for-potential-genes-associated-with-bone-overgrowth-after-mid-shaft-femur-fracture-in-a-rat-model
#11
Chibing Liu, Yanting Liu, Weizhong Zhang, Xiuxin Liu
BACKGROUND: We investigated the underlying molecular mechanisms of bone overgrowth after femoral fracture by using high-throughput bioinformatics approaches. METHODS: The gene expression profile of GSE3298 (accession number) was obtained from the Gene Expression Omnibus database. Sixteen femoral growth plate samples, including nine samples without fracture and seven fracture samples for seven time points, were used for analysis. The Limma package was applied to identify differentially expressed genes (DEGs) between fractured and intact samples...
January 17, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28093251/malalignment-after-minimally-invasive-plate-osteosynthesis-in-distal-femoral-fractures
#12
Joon-Woo Kim, Chang-Wug Oh, Jong-Keon Oh, Il-Hyung Park, Hee-Soo Kyung, Kyeong-Hyeon Park, Seong-Dae Yoon, Seong-Min Kim
INTRODUCTION: Although minimally invasive plate osteosynthesis (MIPO) is a preferred operative treatment for fractures of the distal femur, malalignment is a significant concern because of indirect reduction of the fracture. The purpose of this study, therefore, was to evaluate radiologic alignment after MIPO for distal femoral fractures. PATIENTS AND METHODS: Of the 138 patients with fracture of the distal femur who underwent MIPO, we enrolled 51 patients in whom bilateral rotational alignment could be assessed by postoperative computed tomography (CT)...
January 10, 2017: Injury
https://www.readbyqxmd.com/read/28089667/periprosthetic-fractures-of-the-distal-femur-after-total-knee-arthroplasty-plate-versus-nail-fixation
#13
REVIEW
Sara Shippee Wallace, Daniel Bechtold, Adam Sassoon
: The incidence of periprosthetic fractures about a TKA is increasing. Traditionally these fractures are classified by their location and prosthesis integrity. In the setting of a supracondyar fracture about a well-fixed prosthesis, both plate and nail fixation of the fracture present themselves as options, each with unique benefits and pitfalls. Through review and discussion of the literature, we aim to describe some of the patient, fracture, and implant related factors that should be considered when planning fixation of periprosthetic fractures about a TKA...
January 12, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28089085/the-timing-of-bone-spect-to-predict-osteonecrosis-after-internal-fixation-of-femur-neck-fractures
#14
Ji Wan Kim, Jin-Sook Ryu, Sora Baek, Seong-Eun Byun, Jae Suk Chang
BACKGROUND: Bone SPECT can be used after a femur neck fracture to assess the circulation of the femoral head in the immediate postoperative period because the blood supply is one of the major factors affecting bone uptake of radiotracer on bone scintigraphy. The purpose of our present study was to investigate whether osteonecrosis of the femoral head (OFH) after internal fixation of femoral neck fracture could be predicted by early and late bone SPECT. METHODS: This retrospective cohort study enrolled 44 patients (33 women; mean age, 66...
January 6, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28088810/leptin-influences-healing-in-the-sprague-dawley-rat-fracture-model
#15
Pengcheng Liu, Ming Cai
BACKGROUND Leptin plays a crucial role in bone metabolism, and its level is related to bone callus formation in the fracture repair process. The objective of this study was to evaluate the effect of recombinant leptin on the healing process of femoral fractures in rats. MATERIAL AND METHODS Forty-eight male Sprague Dawley (SD) rats with an average body weight of 389 g (range: 376-398 g) and an average age of 10 weeks were included in this animal research, and all rats were randomly divided into two major groups...
January 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28087409/thioredoxin-a-novel-biomarker-of-post-injury-sepsis
#16
Jesper Eriksson, Andreas Gidlöf, Mikael Eriksson, Emma Larsson, Olof Brattström, Anders Oldner
BACKGROUND: Thioredoxin (TRX), an endogenous anti-oxidant protein induced in inflammatory conditions, has been shown to increase in plasma and to be associated with outcome in septic patients. This biomarker has never been studied in a trauma setting. We hypothesized that TRX would be increased after trauma and associated with post-injury sepsis. METHODS: Single-centre prospective observational study conducted at the intensive care unit (ICU) at the Karolinska University Hospital, Stockholm, Sweden, a level-1 trauma centre...
January 10, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28087211/the-effect-of-bone-growth-onto-massive-prostheses-collars-in-protecting-the-implant-from-fracture
#17
Paul Fromme, Gordon W Blunn, William J Aston, Tasneem Abdoola, Jacob Koris, Melanie J Coathup
Limb-sparing distal femoral endoprotheses used in cancer patients have a high risk of aseptic loosening. It had been reported that young adolescent patients have a higher rate of loosening and fatigue fracture of intramedullary stems because the implant becomes undersized as patients grow. Extracortical bone growth into the grooved hydroxyapatite-coated collar had been shown to reduce failure rates. The stresses in the implant and femur have been calculated from Finite Element models for different stages of bone growth onto the collar...
January 10, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28087118/open-lower-limb-fractures-in-major-trauma-centers-a-loss-leader
#18
Elizabeth K Tissingh, Arman Memarzadeh, Joseph Queally, Peter Hull
PURPOSE: Open lower limb fractures are resource intensive injuries. Regardless of the financing model, the cost of treatment is an important consideration for any healthcare provider. METHODS: Open lower limb fractures treated at our centre were identified over a six-month period. Isolated open femur or tibia fractures were included as well as cases with multiple fractures. Direct inpatient care costs were calculated and income was reviewed for each case according to 'Healthcare Resource Group' (HRG) cost codes...
December 28, 2016: Injury
https://www.readbyqxmd.com/read/28073094/the-role-of-lesser-trochanter-fragment-in-unstable-pertrochanteric-a2-proximal-femur-fractures-is-refixation-of-the-lesser-trochanter-worth-the-effort
#19
Christian Ehrnthaller, Alain Christoph Olivier, Florian Gebhard, Lutz Dürselen
BACKGROUND: Instability of osteoporotic pertrochanteric fractures is defined by loss of medial/lateral cortical integrity with the posteromedial fragment including the lesser trochanter being pivotal for load distribution. Literature addressing the importance of lesser trochanter refixation is scarce. To clarify the effect of lesser trochanter refixation on primary stability in these fractures, following study was performed. METHODS: 21 femora were match-paired in 3 groups and osteotomized, creating pertrochanteric fractures (AO-31A2)...
December 30, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/28071874/medicare-program-advancing-care-coordination-through-episode-payment-models-epms-cardiac-rehabilitation-incentive-payment-model-and-changes-to-the-comprehensive-care-for-joint-replacement-model-cjr-final-rule
#20
(no author information available yet)
This final rule implements three new Medicare Parts A and B episode payment models, a Cardiac Rehabilitation (CR) Incentive Payment model and modifications to the existing Comprehensive Care for Joint Replacement model under section 1115A of the Social Security Act. Acute care hospitals in certain selected geographic areas will participate in retrospective episode payment models targeting care for Medicare fee-forservice beneficiaries receiving services during acute myocardial infarction, coronary artery bypass graft, and surgical hip/femur fracture treatment episodes...
3, 2017: Federal Register
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