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Proximal femur fractures

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https://www.readbyqxmd.com/read/28499922/critical-analysis-of-the-lever-test-for-diagnosis-of-anterior-cruciate-ligament-insufficiency
#1
Patrick A Massey, Joshua D Harris, Leland A Winston, David M Lintner, Domenica A Delgado, Patrick C McCulloch
PURPOSE: To critically analyze the "lever test" in detecting anterior cruciate ligament (ACL) tears and to compare its accuracy with the Lachman, anterior drawer (AD), and pivot shift tests. METHODS: From June 2014 to June 2015, 91 subjects were analyzed. Inclusion criteria were subjects aged 16 to 60 years, presenting after a knee injury with subjective swelling, or an objective effusion and an uninjured normal contralateral knee for comparison. Exclusion criteria included previous knee ligamentous reconstruction, fracture of the distal femur or proximal tibia, bilateral knee injuries, or known cruciate ligament tear...
May 9, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28499377/calculating-hospital-length-of-stay-using-the-hospital-episode-statistics-a-comparison-of-methodologies
#2
John Busby, Sarah Purdy, William Hollingworth
BACKGROUND: Accurate calculation of hospital length of stay (LOS) from the English Hospital Episode Statistics (HES) is important for a wide range of audit and research purposes. The two methodologies which are commonly used to achieve this differ in their accuracy and complexity. We compare these methods and make recommendations on when each is most appropriate. METHODS: We calculated LOS using continuous inpatient spells (CIPS), which link care spanning across multiple hospitals, and spells, which do not, for six conditions with short (dyspepsia or other stomach function, ENT infection), medium (dehydration and gastroenteritis, perforated or bleeding ulcer), and long (stroke, fractured proximal femur) average LOS...
May 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28497247/-medial-closed-wedge-osteotomy-of-the-distal-femur-in-biplanar-technique-and-a-specific-plate-fixator
#3
REVIEW
P Lobenhoffer, K Kley, D Freiling, R van Heerwaarden
OBJECTIVE: Correction of distal femur deformity by closed-wedge biplanar osteotomy. INDICATIONS: Metaphyseal frontal plane deformities of the femur. CONTRAINDICATIONS: Osteoarthritis of the contralateral compartment, total loss of the contralateral meniscus, acute/chronic infection, limited range-of-motion, poor soft-tissue conditions at site of surgery. SURGICAL TECHNIQUE: Skin incision at metaphyseal area of femur...
May 11, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28493805/creating-three-dimensional-printed-models-of-acetabular-fractures-for-use-as-educational-tools
#4
Matthew S Manganaro, Yoav Morag, William J Weadock, Corrie M Yablon, Kara Gaetke-Udager, Erica B Stein
Acetabular fractures are frequently encountered in some clinical practices, and the precise classification of these fractures greatly influences treatments and outcomes. The authors identified the need for an educational aid when teaching acetabular fracture classifications, given the complex spatial anatomy and the nonintuitive classification system that is commonly used. Three-dimensional ( 3D three-dimensional ) printing is an evolving technique that has applications as an educational aid, providing the student with a tangible object to interact with and learn from...
May 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28487299/the-first-reported-case-of-atypical-femoral-fracture-caused-by-daily-ibandronate-prescribed-for-bone-metastases-in-breast-cancer
#5
Robert Espey, Stephanie Grimes, Gary Heyburn, William David Kealey
A 55-year-old woman with bony metastatic breast cancer was commenced on daily ibandronic acid to prevent skeletal related events (SREs). Four years later, she began to experience new lower limb and groin pain with investigations leading to the suspicion of further metastatic spread to her left femur. While awaiting radiotherapy for this, she unfortunately tripped and fell sustaining a fracture to the proximal third of her left femur. Radiographic findings of her femur from both before and after the fall were suggestive of an atypical femoral fracture, presumed secondary to her bisphosphonate therapy rather than metastatic spread...
May 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28481811/trochanteric-entry-for-femoral-lengthening-nails-in-children-is-it-safe
#6
Ahmed I Hammouda, Julio J Jauregui, Martin G Gesheff, Shawn C Standard, John E Herzenberg
BACKGROUND: Antegrade intramedullary (IM) nailing for skeletally immature femur fractures can damage the capital femoral epiphysis blood supply, leading to avascular necrosis (AVN) of the femoral head. Reported AVN rates are 2% for piriformis entry and 1.4% for trochanteric entry. None of previous reports described IM lengthening nails for limb lengthening procedures. We have used self-lengthening telescopic nails with a proximal Herzog bend and standard trochanteric entry for femoral lengthening in children...
June 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28473334/the-efficacy-of-rotational-control-designs-in-promoting-torsional-stability-of-hip-fracture-fixation
#7
J D Gosiewski, T P Holsgrove, H S Gill
OBJECTIVES: Fractures of the proximal femur are a common clinical problem, and a number of orthopaedic devices are available for the treatment of such fractures. The objective of this study was to assess the rotational stability, a common failure predictor, of three different rotational control design philosophies: a screw, a helical blade and a deployable crucifix. METHODS: Devices were compared in terms of the mechanical work (W) required to rotate the implant by 6° in a bone substitute material...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28464756/increased-risk-of-early-and-medium-term-revision-after-post-fracture-total-knee-arthroplasty
#8
Anders El-Galaly, Steffen Haldrup, Alma Becic Pedersen, Andreas Kappel, Michael Ulrich Jensen, Poul Torben Nielsen
Background and purpose - Total knee arthroplasty (TKA) due to posttraumatic fracture osteoarthritis (PTFA) may be associated with inferior prosthesis survival. This study is the first registry-based study solely addressing this issue. Both indications and predictors for revision were identified. Patients and methods - 52,518 primary TKAs performed between 1997 and 2013 were retrieved from the Danish Knee Arthroplasty Register (DKR). 1,421 TKAs were inserted due to PTFA and 51,097 due to primary osteoarthritis (OA)...
June 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28459773/cerclage-wiring-through-a-mini-open-approach-to-assist-reduction-of-subtrochanteric-fractures-treated-with-cephalomedullary-fixation-surgical-technique
#9
Pablo Codesido, Ana Mejía, Jonathan Riego, Cristina Ojeda-Thies
In spite of advances in the management of subtrochanteric fractures, in particular the use of cephalomedullary nails, surgical results still remain poorer than other fractures of the proximal femur. Good reduction is key for satisfactory outcomes. Several methods of reduction have been described; recently, good rates of union with open reduction techniques using clamps and wires have been described. Reduction of fractures in elderly patients is especially complicated due to poor bone quality, comorbidities and unfavorable fracture patterns...
April 25, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28459422/how-high-can-you-go-retrograde-nailing-of-proximal-femur-fractures
#10
Kevin M Kuhn, Lisa K Cannada, J Tracy Watson, Ashley Ali, John A Boudreau, Hassan R Mir, Jennifer M Bauer, Brian Mullis, Robert Hymes, Renee Genova, Michael Tucker, Daniel Schlatter
There are no data-supported recommendations on how proximal is too proximal for retrograde nailing (RGN). At six level 1 trauma centers, patients with femur fractures within the proximal one-third of the femur treated with RGN were included. This article describes a proximal segment capture ratio (PSCR) and nail segment capture ratio to evaluate RGN of proximal fractures. The study included 107 patients. The average follow-up was 44 weeks. There were two nonunions and three malunions. There was no significant difference between PSCR of 0...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28457795/pseudoaneurysm-of-the-deep-femoral-artery-caused-by-a-guide-wire-following-femur-intertrochanteric-fracture-with-a-hip-nail-a-case-report
#11
Ji Wan Kim, Jung Il Lee, Ki Chul Park
An 85-year-old woman developed severe swelling and pain in the proximal thigh after internal fixation of an intertrochanteric fracture of the femur with a hip nail. In order to identify the causes and determine the effective treatment, angiography was performed. The results of the angiography revealed a pseudoaneurysm of a branch of deep femoral artery. Endovascular embolization was used to treat the pseudoaneurysm. After reviewing all possible causes, we found a mistake in insertion of a guide wire for hip nail...
April 27, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28452858/primary-bone-anaplastic-large-cell-lymphoma-masquerading-as-ewing-sarcoma-diagnosis-by-anchored-multiplex-pcr
#12
Susan Swee-Shan Hue, Prasad Iyer, Luke Han Wei Toh, Sudhanshi Jain, Enrica Ee Kar Tan, Kesavan Sittampalam, Derrick Wen Quan Lian, Kenneth Tou En Chang
A 3-year-old boy presented with pathologic fracture of the left proximal femur. Magnetic resonance imaging revealed an aggressive expansile bony mass associated with cortical destruction and surrounding myositis. Computed tomography-guided biopsy revealed a monomorphic small round blue cell tumor by histology. CD99 immunoreactivity and low-level EWSR1 gene translocation by break-apart fluorescent in situ hybridization initially favored a diagnosis of Ewing sarcoma and chemotherapy commenced. Subsequent molecular evaluation by an anchored multiplex polymerase chain reaction-based assay (Archer FusionPlex Sarcoma Panel) revealed a nucleophosmin-anaplastic lymphoma kinase (NPM-ALK) gene fusion...
April 27, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28450739/comparing-mortality-risk-of-patients-with-acute-hip-fractures-admitted-to-a-major-trauma-centre-on-a-weekday-or-weekend
#13
Rajpal Nandra, Jack Pullan, Jonathan Bishop, Khalid Baloch, Liam Grover, Keith Porter
Proximal femoral fractures are a major public health concern with estimated annual direct and social costs amounting to £2 billion and average 30-day mortality risk of 7.5%. In response to the recent debate over out-of-hours hospital provision we investigated the 'weekend effect' at a major trauma centre, caring for acute injuries. A single centre, multi-surgeon review of 2060 patients performed. The distribution of patient and treatment variables compared in patients admitted on a weekday or the weekend. Fewer patients met performance indicators during weekend admission, time to surgery (63 vs...
April 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28443571/numerical-optimization-of-the-position-in-femoral-head-of-proximal-locking-screws-of-proximal-femoral-nail-system-biomechanical-study
#14
Mehmet Nuri Konya, Özgür Verim
BACKGROUND: Proximal femoral fracture rates are increasing due to osteoporosis and traffic accident. Proximal femoral nails are routinely used in the treatment of these fractures on the proximal femur. AIMS: The present study aimed to compare various combination and to determine ideal proximal lag screw (PLS) position on the pertrochanteric fractures (AO classification 31-A1) of femur by using optimised finite element analysis. STUDY DESIGN: Biomechanical Study...
April 6, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28439052/-calcium-and-bone-metabolism-across-women-s-life-stages-pathophysiology-adiagnosis-and-treatment-of-post-pregnancy-osteoporosis
#15
Takumi Kurabayashi
Post-pregnancy osteoporosis is a rare condition with little known pathophysiology. Most cases are diagnosed in the late stage of pregnancy or in the post-partum while breastfeeding, particularly in first pregnancy. Vertebral fractures are most commonly observed and characterized by prolonged severe pain and functional limitations. Measurements of bone mineral density(BMD)of the lumbar spine and proximal femur with dual energy X-ray absorptiometry(DXA)are the clinical methods most commonly used for no fracture women...
2017: Clinical Calcium
https://www.readbyqxmd.com/read/28437506/treatment-of-unstable-trochanteric-femur-fractures-proximal-femur-nail-versus-proximal-femur-locking-compression-plate
#16
Ashutosh Kumar Singh, Nidi Narsaria, Arun G R, Vivek Srivastava
Unstable trochanteric femur fractures are common fractures that are difficult to manage. We conducted a prospective study to compare functional outcomes and complications of 2 different implant designs, proximal femur nail (PFN) and proximal femur locking compression plate (PFLCP), used in internal fixation of unstable trochanteric femur fractures. On hospital admission, 48 patients with unstable trochanteric fractures were randomly assigned (using a sealed envelope method) to treatment with either PFN (24 patients) or PFLCP (24 patients)...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28433450/a-retrospective-cohort-study-of-concomitant-ipsilateral-extra-capsular-and-intra-capsular-fractures-of-the-proximal-femur-are-they-casual-findings-or-an-undervalued-reality
#17
Miquel Videla-Cés, José-Miguel Sales-Pérez, Joan Girós-Torres, Rubén Sánchez-Navés, Sebastián Videla
BACKGROUND: Fractures of the proximal femur constitute a major public health problem, with an annual incidence in Spain of 7.6 cases per 1000 inhabitants over 65 years of age. Hip fractures are frequent in elderly patients, related to osteoporosis and with low energy trauma, which means that they can be considered a geriatric syndrome. Simultaneous ipsilateral extra- and intra-articular hip fractures are considered as very rare are, and generally speaking, classified as extra- or intra-capsular fractures...
April 13, 2017: Injury
https://www.readbyqxmd.com/read/28426251/current-concepts-of-the-anterolateral-ligament-of-the-knee-anatomy-biomechanics-and-reconstruction
#18
Matthew J Kraeutler, K Linnea Welton, Jorge Chahla, Robert F LaPrade, Eric C McCarty
In 1879, Paul Segond described an avulsion fracture (now known as a Segond fracture) at the anterolateral proximal tibia with the presence of a fibrous band at the location of this fracture. Although references to this ligament were occasionally made in the anatomy literature after Segond's discovery, it was not until 2012 that Vincent et al named this ligament what we know it as today, the anterolateral ligament (ALL) of the knee. The ALL originates near the lateral epicondyle of the distal femur and inserts on the proximal tibia near Gerdy's tubercle...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28421239/weight-bearing-recommendations-after-operative-fracture-treatment-fact-or-fiction-gait-results-with-and-feasibility-of-a-dynamic-continuous-pedobarography-insole
#19
Benedikt J Braun, Nils T Veith, Mika Rollmann, Marcel Orth, Tobias Fritz, Steven C Herath, Jörg H Holstein, Tim Pohlemann
PURPOSE: Rehabilitation after lower-extremity fractures is based on the physicians' recommendation for non-, partial-, or full weight-bearing. Clinical studies rely on this assumption, but continuous compliance or objective loading rates are unknown. The purpose of this study was to determine the compliance to weight-bearing recommendations by introducing a novel, pedobarography system continuously registering postoperative ground forces into ankle, tibial shaft and proximal femur fracture aftercare and test its feasibility for this purpose...
April 19, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28416924/comparison-of-second-and-third-generation-nails-in-the-treatment-of-intertrochanteric-fracture-screws-versus-helical-blades
#20
Mert Kumbaraci, Levent Karapinar, Ali Turgut
OBJECTIVE: The aim of this study was to compare the radiological and functional outcomes of anti-rotation trochanteric nails (ATNs) with proximal femoral nail anti-rotation (PFNA) in the treatment of intertrochanteric femur fractures in elderly patients. MATERIALS AND METHODS: In total, 165 intertrochanteric fractures were treated between January 2007 and January 2010. One hundred forty patients were included. The operation time, amount of blood loss, fluoroscopy screening time, and length of hospitalization were recorded...
February 2017: Eurasian Journal of Medicine
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