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Proximal femur fractures

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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
#1
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/28073094/the-role-of-lesser-trochanter-fragment-in-unstable-pertrochanteric-a2-proximal-femur-fractures-is-refixation-of-the-lesser-trochanter-worth-the-effort
#2
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/28057631/ultimate-fracture-load-of-cadaver-proximal-humeri-correlates-more-strongly-with-mean-combined-cortical-thickness-than-with-areal-cortical-index-dexa-density-or-canal-to-calcar-ratio
#3
J G Skedros, C S Mears, W Z Burkhead
OBJECTIVES: This investigation sought to advance the work published in our prior biomechanical study (Journal of Orthopaedic Research, 2016). We specifically sought to determine whether there are additional easy-to-measure parameters on plain radiographs of the proximal humerus that correlate more strongly with ultimate fracture load, and whether a parameter resembling the Dorr strength/quality characterisation of proximal femurs can be applied to humeri. MATERIALS AND METHODS: A total of 33 adult humeri were used from a previous study where we quantified bone mineral density of the proximal humerus using radiographs and dual-energy x-ray absorptiometry (DEXA), and regional mean cortical thickness and cortical index using radiographs...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28057011/functional-and-radiological-outcomes-of-a-minimally-invasive-surgical-approach-to-monostotic-fibrous-dysplasia
#4
Mamer S Rosario, Katsuhiro Hayashi, Norio Yamamoto, Akihiko Takeuchi, Shinji Miwa, Yuta Taniguchi, Hiroyuki Tsuchiya
BACKGROUND: Reports showing high recurrence rates for intralesional curettage and bone grafting have made the current treatment principle for fibrous dysplasia controversial. This study aimed to report the postoperative clinical outcomes from three minimally invasive surgical strategies we use for monostotic fibrous dysplasia (MFD). PATIENTS AND METHODS: Twelve patients with MFD presenting with no pathologic fracture or deformity and treated with one of three surgical strategies-plain open biopsy, plain alpha-tricalcium phosphate (ATP) reconstruction, and prophylactic bridge plating-were included...
January 5, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28053268/implant-options-for-the-treatment-of-intertrochanteric-fractures-of-the-hip-rationale-evidence-and-recommendations
#5
A R Socci, N E Casemyr, M P Leslie, M R Baumgaertner
AIMS: The aim of this paper is to review the evidence relating to the anatomy of the proximal femur, the geometry of the fracture and the characteristics of implants and methods of fixation of intertrochanteric fractures of the hip. MATERIALS AND METHODS: Relevant papers were identified from appropriate clinical databases and a narrative review was undertaken. RESULTS: Stable, unstable, and subtrochanteric intertrochanteric fractures vary widely in their anatomical and biomechanical characteristics, as do the implants used for their fixation...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28051829/apophyseal-and-epiphyseal-knee-injuries-in-the-adolescent-athlete
#6
P Persiani, F M Ranaldi, A Formica, M Mariani, O Mazza, M Crostelli, C Villani
OBJECTIVES: In the context of pediatric sports injuries, the epiphyseal and apophyseal knee fractures represent rather peculiar lesions. The most frequently involved anatomical area is the knee. The peculiar function of the physis and the need to preserve their integrity, makes choosing what treatment methods to employ very important. Objective of this study is to assess the kind and the effectiveness of the most suitable treatment in the apophyseal and epiphyseal knee lesions occurring in the adolescents...
November 2016: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28050546/medial-migration-of-the-intramedullary-gamma-3-nail-a-case-report
#7
Ana Costa Pinheiro, Bruno Alpoim, António Félix, Carlos Alves, Cristina Sousa, António Rodrigues
Intertrochanteric femur fractures are very common in patients over 65 years old, and are often associated with osteoporosis. Proximal femoral nails are preferred because of their biomechanical advantages in the treatment of these fractures, especially if the fracture is unstable. However, many complications associated with intramedullary fracture fixation have been described. The medial migration of the intramedullary gamma nail is a rare complication. The authors report an uncommon but potentially fatal complication, medial and intrapelvic migration of the intramedullary Gamma 3 nails, recorded after one month of osteosynthesis...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28050531/femoroacetabular-impingement
#8
REVIEW
José Batista Volpon
The femoroacetabular impingement (FAI) is as condition recently characterized that results from the abnormal anatomic and functional relation between the proximal femur and the acetabular border, associated with repetitive movements, which lead labrum and acetabular cartilage injuries. Such alterations result from anatomical variations such as acetabular retroversion or decrease of the femoroacetabular offset. In addition, FAI may result from acquired conditions as malunited femoral neck fractures, or retroverted acetabulum after pelvic osteotomies...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28040349/-effect-of-drugs-for-osteoporosis-on-cardiovascular-diseases-and-effect-of-cardio-vascular-drugs-on-osteoporosis
#9
Michel Laroche, Yannick Degboe, Hubert Blain, Véronique Breuil, Roland Chapurlat, Bernard Cortet, Bruno Sutter
Osteoporosis and cardiovascular diseases are epidemiologically associated. Calcification phenomena of atherosclerotic plaque involve cytokines and growth factors also involved in bone remodeling. Drugs given for either of these two conditions could act on these mechanisms. Can osteoporosis drugs have an influence on the occurrence of cardiovascular events? Conversely, can the treatment of hypertension alter the course of osteoporosis? It is possible that administration of high doses of calcium (1g/day) in patients who already have important dietary intake can increase the risk of myocardial infarction...
December 28, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/28040091/reconstruction-of-patellar-tendon-following-implantation-of-proximal-tibia-megaprosthesis-for-the-treatment-of-post-traumatic-septic-bone-defects
#10
Giorgio M Calori, Emilio Luigi Mazza, Luca Vaienti, Simone Mazzola, Alessandra Colombo, Luca Gala, Massimiliano Colombo
INTRODUCTION: Latest advances made in joint replacement implants allows reconstruction of entire limbs. These special prostheses or megaprostheses were originally designed for the treatment of severe oncological bone loss. Nowadays, however, the indications and applications of these devices are expanding to other orthopaedic and trauma clinical conditions. Since 2008 we have implanted 152 megaprostheses in non-oncological conditions: 87 were implanted for post-traumatic failures aseptic/septic (represented by complex non-unions and critical size bone defects); 26 total femur, 52 distal femur and 9 proximal tibia...
December 2016: Injury
https://www.readbyqxmd.com/read/28032707/surgical-technique-for-subtrochanteric-fracture-of-femur
#11
Peng-Cheng Wang, Dong Ren, Chao-Hui Song, Bing Zhou
A 56-year-old woman had fell over herself 4 h prior to her presentation to our hospital. The diagnosis was a subtrochanteric fracture of the right femur (AO-32-A3). The patient was placed in a supine position was set up on a fracture traction table after general anesthesia. The right leg was placed in abduction while the left leg was positioned so that there was flexion of the knee and hip joint. The C-arm was placed on the left side. The surgical field was sterilized and draped. Deformity and external rotation are always present for this type of fracture, so the first step was to place a joystick in the proximal fragment to correct the external rotation...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28026728/-influence-of-the-weather-on-the-incidence-of-fractures-in-the-elderly
#12
F Burget, O Foltán, J Kraus, K Kudrna, M Novák, J Ulrych
PURPOSE OF THE STUDY The incidence of geriatric fractures (proximal femur, distal radius, proximal humerus and thoracolumbar spine injuries) in the population increases with ageing. However, the role of weather conditions, such as icy and slippery winter, should not be overlooked. A deeper insight into this relationship may bring about a better understanding of the fracture aetiology and thus allow for improvement in the prevention of fractures in elderly people. MATERIAL AND METHODS This prospective study included 676 patients (469 women and 207 men) aged 65 and over...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28026203/sexual-dimorphism-in-bone-muscle-relationship-in-young-adults
#13
Vera Zymbal, Kathleen F Janz, Fátima Baptista
The purpose of this study was to analyse associations between lean soft tissue (LST), a surrogate of skeletal muscle mass and key fracture-related geometric characteristics of the proximal femur. Moreover, we examined the role that muscle played on the proximal femur geometry in response to physical activity (PA). Participants were 83 young adults. Leg LST (exposure) was assessed by dual energy X-ray absorptiometry (DXA). Proximal femur geometry was derived from a left hip DXA scan. Geometric variables (outcomes) included the femoral neck axis length (FNAL), the femoral neck width (FNW), the neck-shaft angle and FNW|FNAL (an index of robustness)...
December 27, 2016: Journal of Sports Sciences
https://www.readbyqxmd.com/read/28019683/effect-of-teriparatide-or-risedronate-in-elderly-patients-with-a-recent-pertrochanteric-hip-fracture-final-results-of-a-78-week-randomized-clinical-trial
#14
Jorge Malouf-Sierra, Umberto Tarantino, Pedro A García-Hernández, Costantino Corradini, Søren Overgaard, Jan J Stepan, Lars Borris, Eric Lespessailles, Frede Frihagen, Kyriakos Papavasiliou, Helmut Petto, Per Aspenberg, José Ramón Caeiro, Fernando Marin
We present final results of a study comparing teriparatide 20 µg QD with risedronate 35 mg QW started within 2 weeks after surgery for a pertrochanteric hip fracture. Patients with BMD T-score ≤-2.0 and 25OHD >9.2 ng/mL were randomized to receive 26-week double-dummy treatment plus calcium and vitamin D, followed by 52-week open-label treatment with the same assigned active drug. Primary endpoint was change from baseline in lumbar spine (LS) BMD at 78 weeks. Secondary and exploratory endpoints were change in BMD at the proximal femur, function, hip pain (Charnley score and 100 mm Visual Analog Scale [VAS]), quality of life (short form-36), radiology outcomes, and safety...
December 26, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28018586/prophylactic-augmentation-of-the-osteoporotic-proximal-femur-mission-impossible
#15
REVIEW
Peter Varga, Ladina Hofmann-Fliri, Michael Blauth, Markus Windolf
The high incidence of secondary hip fractures and the associated markedly increased mortality call for preventive actions that could help to avoid these injuries. By providing immediate strengthening and not relying on patient compliance, internal prophylactic augmentation of the osteoporotic proximal femur may overcome the main limitations of systemic bone drugs and wearable protective pads. However, such a method would have to provide sufficient and reliable strengthening effect with minimal risks and side effects to justify the need of an invasive treatment...
2016: BoneKEy Reports
https://www.readbyqxmd.com/read/28009614/factors-associated-with-patient-initiated-telephone-calls-after-orthopaedic-trauma-surgery
#16
Michael M Hadeed, Abdurrahman Kandil, Vandan Patel, Avery Morrison, Wendy M Novicoff, Seth Yarboro
OBJECTIVES: The primary aim of this study is to investigate the incidence of early patient-initiated postoperative telephone calls and reasons for those calls. Secondary goals are to determine perioperative predictive factors for calls including the procedures most frequently associated with them. DESIGN: Retrospective chart review SETTING:: Academic Level 1 Trauma Center PATIENTS/PARTICIPANTS:: 684 patients who underwent surgical treatment by our orthopaedic trauma division between January 1, 2014 and December 31, 2014...
November 7, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28005099/a-new-technique-for-obtaining-bone-graft-in-cases-of-distal-femur-nonunion-passing-a-reamer-irrigator-aspirator-retrograde-through-the-nonunion-site
#17
Emmanuel D Eisenstein, Brian R Waterman, Enes M Kanlic, Amr A Abdelgawad
Bone grafting is one of the most common orthopedic procedures. We conducted a study to assess the possibility of passing a Reamer/Irrigator/Aspirator (RIA; DePuy Synthes) retrograde through the nonunion site in distal femur cases. This technique would avoid the complications and discomfort associated with a separate entry site for RIA. All patients with a distal femur nonunion treated with RIA bone grafting between 2009 and 2013 were included in the study. Nonunions were mobilized with excision of fibrous tissues...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28002918/the-correlation-between-preoperative-levels-of-albumin-and-tlc-and-mortality-in-patients-with-femoral-neck-fracture
#18
F Niccolai, P D Parchi, A Vigorito, G Pasqualetti, F Monzani, M Lisanti
A femoral neck fracture in an elderly patient often represents a major challenge for the orthopaedic surgeon who has to face not only the fracture, but also all the multiple issues related to age. Among others, malnutrition has been recognised as an important factor associated with severe aggravation in these patients. One-hundred-and-forty-seven patients were enrolled to investigate the use of two markers of patient nutritional status, i.e. serum albumin level and total leukocyte count (TLC), as predictors of mortality in the elderly patient suffering from proximal femur fracture...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/27955656/means-of-enhancing-bone-fracture-healing-optimal-cell-source-isolation-methods-and-acoustic-stimulation
#19
Corina Adriana Ghebes, Maaike Vera Jasmijn Braham, Adelgunde Veronica Clemens Maria Zeegers, Auke Jan Sijbe Renard, Hugo Fernandes, Daniel B F Saris
BACKGROUND: The human body has an extensive capacity to regenerate bone tissue after trauma. However large defects such as long bone fractures of the lower limbs cannot be restored without intervention and often lead to nonunion. Therefore, the aim of the present study was to assess the pool and biological functions of human mesenchymal stromal cells (hMSCs) isolated from different bone marrow locations of the lower limbs and to identify novel strategies to prime the cells prior to their use in bone fracture healing...
December 12, 2016: BMC Biotechnology
https://www.readbyqxmd.com/read/27921146/bone-loss-at-the-distal-femur-and-proximal-tibia-in-persons-with-spinal-cord-injury-imaging-approaches-risk-of-fracture-and-potential-treatment-options
#20
REVIEW
C M Cirnigliaro, M J Myslinski, M F La Fountaine, S C Kirshblum, G F Forrest, W A Bauman
Persons with spinal cord injury (SCI) undergo immediate unloading of the skeleton and, as a result, have severe bone loss below the level of lesion associated with increased risk of long-bone fractures. The pattern of bone loss in individuals with SCI differs from other forms of secondary osteoporosis because the skeleton above the level of lesion remains unaffected, while marked bone loss occurs in the regions of neurological impairment. Striking demineralization of the trabecular epiphyses of the distal femur (supracondylar) and proximal tibia occurs, with the knee region being highly vulnerable to fracture because many accidents occur while sitting in a wheelchair, making the knee region the first point of contact to any applied force...
December 5, 2016: Osteoporosis International
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