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Proximal femur fractures

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https://www.readbyqxmd.com/read/28210775/risk-of-fragility-fracture-among-patients-with-sarcoidosis-a-population-based-study-1976-2013
#1
P Ungprasert, C S Crowson, E L Matteson
: Incidence of fragility fracture of a population-based cohort of 345 patients with sarcoidosis was compared with age and sex-matched comparators. The incidence of fragility fracture was higher among patients with sarcoidosis with hazard ratio (HR) of 2.18. INTRODUCTION: Several chronic inflammatory disorders increase the risk of fragility fracture. However, little is known about the risk of fragility fracture in patients with sarcoidosis. METHODS: This study was conducted using a previously identified population-based cohort of 345 patients with incident sarcoidosis from Olmsted County, Minnesota...
February 16, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28192826/the-management-of-bone-defects-in-periarticular-knee-injuries-a-review-article
#2
Brian Buck, Yvonne M Murtha
Traumatic bone defects of the distal femur and proximal tibia present treatment challenges for the orthopaedic traumatologist. In addition to bone loss, significant soft tissue compromise and cartilage defects leave the patient and surgeon with few reconstructive options for proper long-term joint function. These injuries are often complicated by delayed healing, nonunion, malunion, infection, and poor subjective patient outcomes. There are a variety of clinical problems associated with the treatment of periarticular fractures about the knee...
February 13, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28183304/genistein-treatment-improves-fracture-resistance-in-obese-diabetic-mice
#3
Britton Odle, Nathan Dennison, Layla Al-Nakkash, Tom L Broderick, Jeffrey H Plochocki
BACKGROUND: Obese, type two diabetics are at an increased risk for fracturing their limb bones in comparison to the general population. Phytoestrogens like as the soy isoflavone genistein have been shown to protect against bone loss. In this study, we tested the effects of genistein treatment on femurs of ob/ob mice, a model for obesity and type two diabetes mellitus. METHODS: Twenty six-week-old female mice were divided into obese (ob/ob) control, obese genistein-treated, lean (ob/+) control, and lean genistein-treated groups (n = 5 each)...
January 9, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28178228/imaging-evaluation-of-the-safe-region-for-distal-locking-screw-of-proximal-femoral-nail-anti-rotation-in-patients-with-proximal-femoral-fracture
#4
Jinpeng Gong, Pengcheng Liu, Ming Cai
BACKGROUND Proximal femoral nail anti-rotation (PFNA) is a standard femoral intertrochanteric fracture operation. Iatrogenic vascular injury, although uncommon, is a reported complication of PFNA surgery as well as a complication of hip fracture surgery. This study aimed to compare the safety and best use of the distal locking screw in 170 mm PFNA and 240 mm PFNA devices, and to determine the safe region for placement of the distal locking screw in PFNA surgery. MATERIAL AND METHODS A retrospective analysis of 100 patients with 170 mm PFNA and 80 patients with 240 mm PFNA were retrospectively analyzed...
February 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28168640/3d-computer-graphical-anatomy-study-of-the-femur-a-basis-for-a-new-nail-design
#5
Beat Schmutz, Stanley Kmiec, Martin E Wullschleger, Martin Altmann, Michael Schuetz
BACKGROUND: Current intramedullary nails with a radius of curvature (ROC) of 1500-2000 mm sometimes cause distal anterior cortical encroachment. Furthermore, clinical data indicate that the proximal nail end is too long for some Asian patients. The objective of our study was to develop a comprehensive 3D measurement protocol that measures both the anatomy of the canal and the proximal region. The protocol was used to obtain measurements from Caucasian and Asian (Japanese and Thai) specimens...
March 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28166159/fdg-pet-ct-assesses-the-risk-of-femoral-pathological-fractures-in-patients-with-metastatic-breast-cancer
#6
Gary A Ulaner, Alexandra M Zindman, Junting Zheng, Tae Won B Kim, John H Healey
PURPOSE: Assessment of pathological fracture risk is critical to optimize the use of prophylactic orthopedic fixation to prevent pathological fractures. Better prediction of pathological fracture risk is needed. We evaluated if quantitative measures of FDG avidity can assess femoral pathological fracture risk in patients with metastatic breast cancer (MBC). PATIENTS AND METHODS: A Health Insurance Portability and Accountability Act-compliant retrospective case-control study was performed under institutional review board waiver...
February 3, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28166067/ultrasound-guided-femoral-nerve-block-to-provide-analgesia-for-positioning-patients-with-femur-fracture-before-subarachnoid-block-comparison-with-intravenous-fentanyl
#7
S Ranjit, B B Pradhan
Background Positioning patients with fractured femur for subarachnoid block is painful. Intravenous analgesics or peripheral nerve block like femoral nerve block or fascia iliaca compartment block are some of the available techniques to reduce pain. We compared the efficacy of femoral nerve block and intravenous fentanyl in providing effective analgesia before positioning for subarachnoid block. Objective This study was designed to compare between ultrasound guided femoral nerve block with lignocaine and intravenous fentanyl in providing effective analgesia before positioning patient with femur fracture in sitting position for subarachnoid block...
April 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/28164068/fracture-diaphyseal-femur-in-a-case-of-ipsilateral-excision-arthroplasty-of-hip-report-of-two-cases-with-description-of-an-unusual-injury-pattern-mechanism-and-clinical-decision-making-in-management
#8
Kunal Shah, Tushar Ubale, Rahematullah Abdul, Vaibhav Kasodekar, Ashish Assudani, Kiran Makwana
INTRODUCTION: Although fracture diaphyseal femur is commonly seen in orthopedic practice, its association with ipsilateral resection arthroplasty of hip/pseudarthrosis of neck is rare. The technique of excision arthroplasty has undergone modification with emphasis on preserving as much bone as possible. However, it is not always possible to preserve bone while removing the earlier prosthesis and cement. This often leads to extensive proximal bone loss. Associated ipsilateral fracture femur presents a unique scenario...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28157079/treatment-outcomes-and-quality-of-life-after-the-implantation-of-modular-prostheses-of-the-proximal-femur-in-patients-with-cancer-metastases
#9
Grzegorz Guzik
BACKGROUND: Surgical treatment of pathological fractures of the proximal femur with intramedullary rods produces good short-term outcomes, but after some time the fixation often becomes unstable in patients with a good prognosis and a repeat surgery is required. Modular prostheses allow for better long-term outcomes. MATERIAL AND METHODS: A total of 64 surgical resection procedures for metastatic tumours of the proximal femur combined with the implantation of modular prostheses were performed at the Oncological Orthopaedics Department in Brzozów in 2010-2014...
May 5, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28150224/isolated-acetabular-revision-with-femoral-stem-retention-after-bipolar-hip-arthroplasty
#10
Nobuhiro Kaku, Tomonori Tabata, Hiroaki Tagomori, Hiroshi Tsumura
INTRODUCTION: In bipolar hemiarthroplasty, migration of the outer cup component into the acetabular cup, with evidence of severe osteolysis in the acetabulum, commonly occurs without loosening of the femoral component. The merits of retaining the stable femoral component in these cases have been debated. Our study aimed to determine whether revision of the acetabular component in isolation could be successfully performed. MATERIALS AND METHODS: The data of 54 patients (61 hips), 44 women, and 10 men, aged 67...
February 1, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28133707/physical-activity-for-strengthening-fracture-prone-regions-of-the-proximal-femur
#11
REVIEW
Robyn K Fuchs, Mariana E Kersh, Julio Carballido-Gamio, William R Thompson, Joyce H Keyak, Stuart J Warden
PURPOSE OF REVIEW: Physical activity improves proximal femoral bone health; however, it remains unclear whether changes translate into a reduction in fracture risk. To enhance any fracture-protective effects of physical activity, fracture prone regions within the proximal femur need to be targeted. RECENT FINDINGS: The proximal femur is designed to withstand forces in the weight-bearing direction, but less so forces associated with falls in a sideways direction...
January 30, 2017: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/28132729/malnutrition-an-underestimated-factor-in-the-inpatient-treatment-of-traumatology-and-orthopedic-patients-a-prospective-evaluation-of-1055-patients
#12
Christoph Ihle, Thomas Freude, Christian Bahrs, Eva Zehendner, Janick Braunsberger, Hans Konrad Biesalski, Christine Lambert, Ulrich Stöckle, Elke Wintermeyer, Julia Grünwald, Leonard Grünwald, Gunnar Ochs, Ingo Flesch, Andreas Nüssler
INTRODUCTION: Suboptimal nutritional status is often observed among hospitalized patients across all medical specialties. The objective of the present study was to (1) analyze the prevalence of malnutrition in hospitalized orthopedic and trauma patients and (2) to evaluate the relationship between malnutrition and selected clinical outcomes. MATERIALS AND METHODS: The prospective field study was conducted between 06/2014 and 06/2015 in a German level I trauma center (Department of Traumatology, Septic Trauma Surgery and Arthroplasty) with a total number of 1055 patients...
January 22, 2017: Injury
https://www.readbyqxmd.com/read/28130016/cortical-strut-allograft-support-of-modular-femoral-junctions-during-revision-total-hip-arthroplasty
#13
Chin Tat Lim, Derek F Amanatullah, James I Huddleston, Katherine L Hwang, William J Maloney, Stuart B Goodman
BACKGROUND: There is risk of junction failure when using modular femoral stems for revision total hip arthroplasty (THA), especially with loss of bone stock in the proximal femur. Using a cortical strut allograft may provide additional support of a modular femoral construct in revision THA. METHODS: We reviewed prospectively gathered clinical and radiographic data for 28 revision THAs performed from 2004 to 2014 using cementless modular femoral components with cortical strut allograft applied to supplement proximal femoral bone loss: 5 (18%) were fluted taper designs and 23 (82%) were porous cylindrical designs All the patients had a Paprosky grade IIIA or greater femoral defect...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28126418/percutaneous-osteosynthesis-and-cementoplasty-for-stabilization-of-malignant-pathologic-fractures-of-the-proximal-femur
#14
E Mavrovi, J-B Pialat, H Beji, A-C Kalenderian, G Vaz, B Richioud
PURPOSE: To retrospectively evaluate the outcome of patients who underwent radiological percutaneous osteosynthesis and cementoplasty (RPOC) for stabilization of malignant pathological fracture of the proximal femur. MATERIALS AND METHODS: The clinical files of 12 patients who underwent RPOC for stabilization of malignant pathological fracture of the proximal femur were reviewed. There were 9 men and 3 women with a mean age of 56 years±13 (SD) (range: 35-82 years)...
January 23, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28122548/conversion-to-total-hip-arthroplasty-after-failed-proximal-femoral-nail-antirotations-or-dynamic-hip-screw-fixations-for-stable-intertrochanteric-femur-fractures-a-retrospective-study-with-a-minimum-follow-up-of-3%C3%A2-years
#15
Xianshang Zeng, Ke Zhan, Lili Zhang, Dan Zeng, Weiguang Yu, Xinchao Zhang, Mingdong Zhao
BACKGROUND: Conversion to total hip arthroplasty (CTHA) is a relatively common procedure after a failed dynamic hip screw (DHS) or proximal femoral nail anti-rotation (PFNA) fixation of intertrochanteric fractures, but there have been far fewer reports specifically describing the long-term results of CTHA after failed treatments of stable intertrochanteric fractures with DHS or PFNA. The aim of the present study was to compare the clinical and radiological outcomes of CTHA after failed PFNA or DHS fixations of stable intertrochanteric fractures after a minimum follow-up of 3 years...
January 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28116505/total-hip-arthroplasty-after-failed-treatment-of-proximal-femur-fracture
#16
Tomonori Tetsunaga, Kazuo Fujiwara, Hirosuke Endo, Tomoyuki Noda, Tomoko Tetsunaga, Toru Sato, Naofumi Shiota, Toshifumi Ozaki
INTRODUCTION: Total hip arthroplasty (THA) is a good option as a salvage procedure after failed treatment of proximal femur fracture. The anatomy of the proximal femur, however, makes this surgery complicated and challenging. The purpose of this study was to evaluate the radiographic and clinical outcomes of THA after failed treatment of proximal femur fractures. MATERIALS AND METHODS: We retrospectively analysed 50 consecutive THAs (42 women, 8 men; mean age 77 years) after failed treatment of a proximal femur fracture...
January 23, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28108173/broach-handle-design-changes-force-distribution-in-the-femur-during-total-hip-arthroplasty
#17
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/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
#18
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
#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/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
#20
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
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