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Proximal femur fractures

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https://www.readbyqxmd.com/read/28918227/bone-remodeling-of-the-distal-femur-after-uncemented-total-knee-arthroplasty-a-2-year-prospective-dxa-study
#1
Mikkel Rathsach Andersen, Nikolaj S Winther, Thomas Lind, Henrik M Schrøder, Michael Mørk Petersen
Loss of bone stock as a response to the bone trauma, immobilization, and stress shielding related to joint replacement surgery increases the risk of fracture of the distal femur after total knee arthroplasty. Previous studies of uncemented femoral components have reported very high levels of bone loss in the distal femur. This study investigates the adaptive bone remodeling of the distal femur after uncemented total knee arthroplasty. We performed a 2-year follow-up of 53 patients (mean age 61.5 [38-70] years, F/M = 27/26, body mass index 29...
September 13, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28904663/-direct-medical-costs-of-hospital-treatment-of-fractures-of-the-upper-extremity-of-the-femur
#2
Abdelghani El Ayoubi, Kevin Parfait Bienvenu Bouhelo, Hachem Chafik, Mohammed Nasri, Mohammed El Idrissi, Mohammed Shimi, Abdelhalim El Ibrahimi, Abdelmajid Elmrini
Fractures of the upper extremity of the femur are serious because of their morbidity and social and/or economic consequences. They have been the subject of several studies of world literature concerning their hospital treatment, evolution and prevention. The increase in the incidence of this pathology seems unavoidable due to population ageing and to the lengthening life expectancy; it is posing a real long-term public health problem whose importance will be further increased by the need to control health care costs...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28902085/proximal-screw-configuration-alters-peak-plate-strain-without-changing-construct-stiffness-in-comminuted-supracondylar-femur-fractures
#3
Stewart McLachlin, Hans Kreder, Matthew Ng, Richard Jenkinson, Cari Whyne, Jeremie Larouche
OBJECTIVES: Assess the effect of proximal screw configuration on the strain in lateral plating of a simulated comminuted supracondylar femur fracture. METHODS: Fractures were simulated in twelve synthetic femurs by removing a 20mm section of bone, located 60mm from the intercondylar fossa and repaired via a 16-hole locked lateral plate instrumented with eight uniaxial strain gauges. Three proximal screw type configurations were evaluated: (1) four non-locking screws, (2) four locking screws, and (3) a hybrid configuration of two non-locking screws flanked by a locking screw at each end of the proximal fragment...
August 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28890120/fascia-iliaca-block-for-pain-control-in-hip-fracture-patients
#4
P Castillón, M Veloso, O Gómez, J Salvador, A Bartra, F Anglés
INTRODUCTION: Pain treatment for patients with hip fracture has been based on the use of nonsteroidal anti-inflammatories and opioid derived drugs. These medications have been associated with multiple adverse effects. Fascia iliaca block is a recent pain management alternative for these patients. The objective of this study was to evaluate the effectiveness of fascia iliaca block performed in the emergency room (ER) for patients over 65years of age with hip fracture. MATERIALS AND METHODS: A cohort of 216 patients, from January to December 2016, was studied prospectively...
September 7, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28889934/working-length-and-proximal-screw-constructs-in-plate-osteosynthesis-of-distal-femur-fractures
#5
William H Harvin, Lasun O Oladeji, Gregory J Della Rocca, Yvonne M Murtha, David A Volgas, James P Stannard, Brett D Crist
BACKGROUND: The study purpose is to evaluate the working length, proximal screw density, and diaphyseal fixation mode and the correlation to fracture union after locking plate osteosynthesis of distal femoral fractures using bridge-plating technique. METHODS: A four-year retrospective review was performed to identify patients undergoing operative fixation of distal femur fractures with a distal femoral locking plate using bridge-plating technique for the metadiaphyseal region...
September 1, 2017: Injury
https://www.readbyqxmd.com/read/28884107/giant-cell-tumor-locally-advanced-around-the-knee-treatment-and-literature-review
#6
REVIEW
Ana Valeria Rigollino, Thiago Santos Fernando, Marcos Hajime Tanaka, Marcello Martins Souza
Giant cell tumor (GCT) is a benign bone tumor with aggressive characteristics. They are more prevalent in the third decade of life and demonstrate a preference for locating in the epiphyseal region of long bones. They have a high local recurrence rate, which depends on the type of treatment and initial tumor presentation. The risk of lung metastases is around 3%. Between October 2010 and August 2014, nine patients diagnosed with locally advanced GCT or with pathological fracture to the knee level underwent surgical treatment...
June 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28859846/the-influence-of-the-hips-position-on-measurements-of-posterior-tilt-in-a-valgus-impacted-femoral-neck-fracture
#7
Sigurd Erik Hoelsbrekken, Filip C Dolatowski
INTRODUCTION: Lateral radiographs are important for the evaluation of Garden I and II femoral neck fractures. These fractures appear undisplaced in the anteroposterior view, but posterior tilt of the femoral head may still be present in the lateral view. The influence of posterior tilt is, however, debated, which could be caused by the use of non-standardized cross-table radiographs in the conflicting reports. The aim of this bone-model study was therefore to evaluate the influence of the hips position on measurements of posterior tilt...
August 26, 2017: Injury
https://www.readbyqxmd.com/read/28859264/adefovir-induced-fanconi-syndrome-associated-with-osteomalacia
#8
Samel Park, Woo-Il Kim, Dai-Hyun Cho, Yeo-Joo Kim, Hong-Soo Kim, Ji-Hee Kim, Seung-Kuy Cha, Kyu-Sang Park, Ji-Hye Lee, Sang Mi Lee, Eun Young Lee
Fanconi syndrome is a dysfunction of the proximal renal tubules that results in impaired reabsorption and increased urinary loss of phosphate and other solutes. The pathophysiology of drug-induced Fanconi syndrome is unclear. Here we report the case of a 36-year-old woman who presented with pain in multiple bones and proteinuria. She had a 7-year history of taking adefovir at 10 mg/day for chronic hepatitis B. Three years previously she had received surgery for a nontraumatic right femur neck fracture, after which she continued to complain of pain in multiple bones, and proteinuria, glycosuria, and phosphaturia were noted...
September 1, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28852331/conversion-total-hip-arthroplasty-after-failed-basicervical-hip-fracture-fixation-a-case-report-and-review-of-literature
#9
Vineet Tyagi, Oluwaseun Akinbo
Proximal femur fractures are a common orthopedic injury, and it is estimated that their prevalence will continue to increase over the next twenty years. There has been much debate over the optimal management of basicervical fractures, which can be difficult to identify radiographically. There is also a role for conversion total hip arthroplasty in patients where fracture fixation fails. We present a case report of a proximal femur fracture managed as a basicervical fracture, and subsequently needing a conversion arthroplasty and revision surgery...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28852330/femoral-iatrogenic-subtrochanteric-fatigue-fracture-risk-is-not-increased-by-placing-drill-holes-below-the-level-of-the-lesser-trochanter
#10
Andrew G Tsai, Timothy J Ashworth, Randall Marcus, Ozan Akkus
BACKGROUND: Iatrogenic subtrochanteric fractures of the femur can occur postoperatively following placement of screws in the lateral femoral cortex. Drilling holes below the lesser trochanter is generally avoided to prevent fatigue failure; however, there is little biomechanical evidence to support this recommendation. We hypothesized that hole placement below the level of the lesser trochanter will not accelerate fatigue failure compared to holes at the level of the lesser trochanter...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28852329/fascia-iliaca-block-for-reduction-of-anterior-native-hip-dislocation-a-case-report
#11
Christopher West, Yatish Ranganath, Michael Willey
Native hip dislocations require urgent reduction in a setting where adequate sedation and analgesia is essential. We have recently implemented the use of fascia iliaca blocks at our institution for preoperative pain management for patients with proximal femur fractures. In the setting of limited resources, alternate modalities for sedation and analgesia may need to be implemented to obtain a timely reduction for hip dislocations. We present a case report where of the use of a fascia iliaca block along with light sedation to obtain a successful, atraumatic reduction of an anterior dislocation of a native hip joint...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28851523/hip-osteoarthritis-as-a-predictor-of-the-fracture-pattern-in-proximal-femur-fractures
#12
I Aguado-Maestro, M Panteli, M García-Alonso, I García-Cepeda, P V Giannoudis
INTRODUCTION: Several authors have suggested a correlation between the fracture patterns of proximal femur fractures and the degree of hip osteoarthritis (HOA), but the current evidence to support this are insufficient. The aim of our study was to demonstrate whether there is an association between the grade of HOA and fracture pattern observed, in patients presenting with a fragility fracture of the proximal femur. MATERIALS AND METHODS: We contacted a retrospective review of all patients presenting to our institution with fragility fractures involving the proximal femur, between March 2012 and October 2013...
August 26, 2017: Injury
https://www.readbyqxmd.com/read/28851521/incidence-of-bone-protection-and-associated-fragility-injuries-in-patients-with-proximal-femur-fractures
#13
I Aguado-Maestro, M Panteli, M García-Alonso, A Bañuelos-Díaz, P V Giannoudis
OBJECTIVES: Our aim was to investigate whether patients presenting with fragility fractures of the proximal femur are receiving osteoporosis treatment and to assess the number of other fragility fractures they have sustained prior to admission. METHODS: All patients presenting to our institution with fragility fractures of the proximal femur within an 18-month period (January 2012-August 2013) were included. Patient demographics; fracture classification (AO/OTA); American Society of Anesthesiologists (ASA) grade; Abbreviated Mental Test Score (AMTS) on admission; type of operation; time to operation; peri-operative complications; length of hospital stay (LOS); walking status; osteoporotic medication; Dual-energy X-ray absorptiometry (DEXA) results; additional fragility fractures; and mortality were collected and analysed...
August 26, 2017: Injury
https://www.readbyqxmd.com/read/28837455/revision-total-knee-arthroplasty-for-the-management-of-periprosthetic-fractures
#14
Paul R T Kuzyk, Evan Watts, David Backstein
Periprosthetic fractures after total knee arthroplasty (TKA) can present reconstructive challenges. Not only is the procedure technically complex, but patients with these fractures may have multiple comorbidities, making them prone to postoperative complications. Early mobilization is particularly beneficial in patients with multiple comorbidities. Certain patient factors and fracture types may make revision TKA the ideal management option. Periprosthetic fractures around the knee implant occur most frequently in the distal femur, followed by the tibia and the patella...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28836493/developing-a-multidisciplinary-rehabilitation-package-following-hip-fracture-and-testing-in-a-randomised-feasibility-study-fracture-in-the-elderly-multidisciplinary-rehabilitation-femur
#15
Nefyn H Williams, Jessica L Roberts, Nafees Ud Din, Joanna M Charles, Nicola Totton, Michelle Williams, Kevin Mawdesley, Claire A Hawkes, Val Morrison, Andrew Lemmey, Rhiannon T Edwards, Zoe Hoare, Aaron W Pritchard, Robert T Woods, Swapna Alexander, Catherine Sackley, Pip Logan, Clare Wilkinson, Jo Rycroft-Malone
BACKGROUND: Proximal femoral fracture is a major health problem in old age, with annual UK health and social care costs of £2.3B. Rehabilitation has the potential to maximise functional recovery and maintain independent living, but evidence of clinical effectiveness and cost-effectiveness is lacking. OBJECTIVES: To develop an enhanced community-based rehabilitation package following surgical treatment for proximal femoral fracture and to assess acceptability and feasibility for a future definitive randomised controlled trial (RCT) and economic evaluation...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28835046/-evaluation-of-the-proximal-femur-geometry-in-patients-with-elderly-osteoporotic-hip-fractures
#16
J X Fan, N Li, X F Gong, M H Yang, S W Zhu, X B Wu, L He
Objective: To investigate the relationship between the proximal femur geometry and elderly osteoporotic hip fractures. Methods: From May 2015 to December 2015, 137 patients with elderly osteoporotic hip fractures were involved.69 cases were in the fracture group and 68 cases were in the control group.CT scan were performed on all patients and the proximal femur geometry parameters were measured, including the neck width (NW), neck length (NL), neck shaft angle (NSA), femur head diameter (FHD), head height (HH) and Offset...
August 15, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28822791/acute-unilateral-hip-pain-in-fibrodysplasia-ossificans-progressiva-fop
#17
Frederick S Kaplan, Mona Al Mukaddam, Robert J Pignolo
BACKGROUND: Flare-ups of the hips are among the most feared and disabling complications of fibrodysplasia ossificans progressiva (FOP) and are poorly understood. In order to better understand the nature of hip flare-ups in FOP, we evaluated 25 consecutive individuals with classic FOP (14 males, 11 females; 3-56years old, median age, 17years old) who presented with acute unilateral hip pain. RESULTS: All 25 individuals were suspected of having a flare-up of the hip based on clinical history and a favorable response to a four day course of high-dose oral prednisone...
August 16, 2017: Bone
https://www.readbyqxmd.com/read/28819612/uncommon-floating-knee-in-a-teenager-a-case-report-of-ipsilateral-physeal-fractures-in-distal-femur-and-proximal-tibia
#18
Youssef Othman, Lassaad Hassini, Aymen Fekih, Issam Aloui, Abderrazek Abid
INTRODUCTION: The concomitance of ipsilateral physeal fractures of the distal femur and the proximal tibia is an extremely scarce entity. It is conceptually similar to floating knee in the pediatric population. CASE REPORT: One case with this injury is reported in a 16-year-old teenager. He was treated surgically by close reduction and internal fixation. The diagnosis of the tibial fracture was initially missed, and the fracture was seen on the post-operative radiographs...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28819601/carcinoma-of-unknown-primary-mimicking-multiple-myeloma
#19
Vanamali B Seetharamaiah, B Sunil, M K Padmanabha, N Sparsha
INTRODUCTION: Pathological fractures due to secondaries in the bone are common with carcinoma of lung, breast, prostate, and in multiple myeloma. Multiple pathological fractures after a trivial fall, indicating metastases warrants detailed investigations for the search of primary. Skeletal secondaries should be strongly suspected in addition to obvious diagnosis of multiple myeloma in such cases. CASE REPORT: We report a case of pathological fractures at multiple sites: The vertebral column, proximal shaft of femur, and contralateral fracture neck of femur...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28808627/non-ossifying-fibromas-case-series-including-in-uncommon-upper-extremity-sites
#20
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
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