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Proximal femur fractures

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https://www.readbyqxmd.com/read/29777918/sex-differences-in-the-spatial-distribution-of-bone-in-relation-to-incident-hip-fracture-findings-from-the-ages-reykjavik-study
#1
Elisa A Marques, Julio Carballido-Gamio, Vilmundur Gudnason, Gunnar Sigurdsson, Sigurdur Sigurdsson, Thor Aspelund, Kristin Siggeirsdottir, Lenore Launer, Gudny Eiriksdottir, Thomas Lang, Tamara B Harris
In this case-cohort study, we used data-driven computational anatomy approaches to assess within and between sex spatial differences in proximal femoral bone characteristics in relation to incident hip fracture. One hundred male and 234 female incident hip fracture cases, and 1047 randomly selected noncase subcohort participants (562 female) were chosen from the population-based AGES-Reykjavik study (mean age of 77 years). The baseline -i.e. before hip fracture- hip quantitative computed tomography scans of these subjects were analyzed using voxel-based morphometry, tensor-based morphometry, and surface-based statistical parametric mapping to assess the spatial distribution of volumetric bone mineral density (vBMD), internal structure, and cortical bone properties (thickness, vBMD and trabecular vBMD adjacent to the endosteal surface) of the proximal femur, respectively, in relation to incident hip fracture...
May 16, 2018: Bone
https://www.readbyqxmd.com/read/29776736/trabecular-bone-score-at-the-distal-femur-and-proximal-tibia-in-individuals-with-spinal-cord-injury
#2
Stacey Lobos, Anne Cooke, Gillian Simonett, Chester Ho, Steven K Boyd, W Brent Edwards
Rapid declines in bone mineral density (BMD) at the knee after spinal cord injury (SCI) are associated with an increased risk of fracture. Evaluation of bone quality using the trabecular bone score (TBS) may provide a complimentary measure to BMD assessment to examine bone health and fracture risk after SCI. The purpose of this study was to assess bone mineral density (BMD) and trabecular bone score (TBS) at the knee in individuals with and without SCI. Nine individuals with complete SCI (mean time since SCI 2...
April 24, 2018: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/29776439/concurrence-of-symmetrical-peripheral-gangrene-and-venous-limb-gangrene-following-polytrauma-a-case-report
#3
Jih Huei Tan, Yuzaidi Mohamad, Chor Lip Henry Tan, Mahazir Kassim, Theodore E Warkentin
BACKGROUND: Symmetrical peripheral gangrene is characterized as acral (distal extremity) ischemic limb injury affecting two or more extremities, without large vessel obstruction, typically in a symmetrical fashion. Risk factors include hypotension, disseminated intravascular coagulation, and acute ischemic hepatitis ("shock liver"). In contrast, venous limb gangrene is characterized by acral ischemic injury occurring in a limb with deep vein thrombosis. Both symmetrical peripheral gangrene and venous limb gangrene present as acral limb ischemic necrosis despite presence of arterial pulses...
May 19, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29770880/intraoperative-periprosthetic-femur-fracture-during-bipolar-hemiarthroplasty-for-displaced-femoral-neck-fractures
#4
Choon Chiet Hong, Nazrul Nashi, Jiong Hao Tan, Ruben Manohara, Wei Ting Lee, Diarmuid Paul Murphy
INTRODUCTION: We aim to review the incidence and risk factors for the development of intraoperative periprosthetic femur fractures while performing a bipolar hemiarthroplasty for displaced neck of femur fractures. Our secondary aim is to characterize the types of intraoperative periprosthetic fractures, the steps leading to the fractures, and the salvage treatments instituted. MATERIALS AND METHODS: 271 patients treated with bipolar hemiarthroplasty after traumatic displaced femoral neck fractures were retrospectively analyzed...
May 17, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29751273/age-related-mechanical-strength-evolution-of-trabecular-bone-under-fatigue-damage-for-both-genders-fracture-risk-evaluation
#5
Rabeb Ben Kahla, Abdelwahed Barkaoui, Tarek Merzouki
Bone tissue is a living composite material, providing mechanical and homeostatic functions, and able to constantly adapt its microstructure to changes in long term loading. This adaptation is conducted by a physiological process, known as "bone remodeling". This latter is manifested by interactions between osteoclasts and osteoblasts, and can be influenced by many local factors, via effects on bone cell differentiation and proliferation. In the current work, age and gender effects on damage rate evolution, throughout life, have been investigated using a mechanobiological finite element modeling...
May 4, 2018: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29739257/obtuse-triangle-screw-configuration-for-optimal-internal-fixation-of-femoral-neck-fracture-an-anatomical-analysis
#6
Qiuliang Zhu, Bengong Shi, Bin Xu, Jianfeng Yuan
OBJECTIVES: To identify the optimal screw configuration for internal fixation of femoral neck fractures based on anatomic analysis on radiologic imaging. METHODS: Thirty proximal femurs of 15 adults were constructed by CT. Three femoral neck sections (FNS), the subcapital, medial, and the fundus, were projected on the lateral femoral trochanteric wall. The simulated three screw configurations in the projection of FNS include: two inverted equilateral triangles symmetrized to the axis of the FNS (IET-FNS group) or the coronal axis of the proximal femur (IET-PR group) and an obtuse triangle (OT group)...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29738596/relatively-high-complication-and-revision-rates-of-the-mayo-%C3%A2-metaphysical-conservative-femoral-stem-in-young-patients
#7
Tal Frenkel Rutenberg, Yaniv Warshevski, Aviram Gold, Nadav Shasha, Nimrod Snir, Ofir Chechik, Oleg Dolkart, Dynai Eilig, Amir Herman, Ehud Rath, Moti Kramer, Michael Drexler
The Mayo metaphysical conservative femoral stem (Zimmer, Warsaw, Indiana) is a wedge-shaped implant designed to transfer loads proximally, reduce femoral destruction, and enable the preservation of bone stock in the proximal femur. Thus, it is a potentially preferred prosthesis for active, non-elderly patients who may require additional future surgeries. This retrospective case study analyzed the outcomes of consecutive patients who underwent total hip replacements with this stem between May 2001 and February 2013...
May 8, 2018: Orthopedics
https://www.readbyqxmd.com/read/29737103/-therapeutic-effect-of-uncemented-allograft-prosthetic-composite-for-the-reconstruction-of-tumorous-bone-defect
#8
Yan-Ling Wang, Li Min, Hong Duan, Yong Zhou, Wei-Li Zhang, Rui Shi, Yi Luo, Chong-Qi Tu
OBJECTIVE: To investigate the surgical techniques and mid-term efficacy of reconstruction for proximal femur with allograft-prosthetic composite (APC) . METHODS: Fifteen patients who underwent uncemented APC reconstruction of proximal femur after bone tumor resection were retrospectively evaluated. Image and physical examinations were taken on the 1st,3rd,6th,9th and 12th month after surgery and every 6 months thereafter to assess union condition,greater trochanteric bone absorption and myodynamia of abductors...
January 2018: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/29729819/one-year-after-proximal-or-distal-periprosthetic-fracture-of-the-femur-two-conditions-with-divergent-outcomes
#9
D Eschbach, B Buecking, H Kivioja, M Fischer, T Wiesmann, R Zettl, L Oberkircher, J Barthel, R Aigner, S Ruchholtz, C Bliemel
INTRODUCTION: Arthroplasty of the hip and knee is 1 of the 20 most frequent operations in Germany. Periprosthetic fracture is one of the most feared complications following primary or revision arthroplasty. Present publication aims to analyse differences between patients with periprosthetic fracture around total knee arthroplasty (PFTKA) and patients with periprosthetic fracture around total hip arthroplasty (PFTHA) concerning demographics, clinical course, complications and return to pre-fracture mobility...
April 24, 2018: Injury
https://www.readbyqxmd.com/read/29726286/risk-of-subsidence-and-peri-prosthetic-fractures-using-collared-hydroxyapatite-coated-stem-for-hip-arthroplasty-in-the-elderly
#10
Farhan Syed, Amr Hussein, Krishnaiah Katam, Paul Saunders, Stephen K Young, Mohammad Faisal
INTRODUCTION: Subsidence has been noted with both cemented and uncemented stems in hip arthroplasty. On most occasions, it's minimal (i.e. less than 2 mm) and stabilises at 1 year. However, when its progressive and significant, it causes loss of length and horizontal offset, and when symptomatic warrants a revision. Patients/Materials & Methods: A retrospective radiological review of the patient database was carried out to identify all patients with age ≥ 70 years who underwent elective hip arthroplasty using uncemented HA coated collared stem and had radiographs at 1 year follow up...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29725512/bilateral-proximal-femur-fractures-in-a-patient-with-renal-tubular-acidosis-a-case-report
#11
S S Charl, S Shahrul-Hisham, S Mohamad-Sha
The diagnosis of pathological fractures is on the rise. The morbidity involved does not only burden the patient and their families but it has a great toll on the healthcare system as well. Early identification of the patient at risk is an invaluable tool to cut cost and improve the patient's quality of life. Multiple renal pathologies have been highlighted in relation to the risk of pathological fractures; however, complications in renal tubular acidosis have been rarely documented. Nevertheless, prompt action with adequate and relevant patient education ultimately can reduce the associated morbidity...
March 2018: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29720961/osteoporosis-therapy-with-denosumab-in-organ-transplant-recipients
#12
Jana Brunova, Simona Kratochvilova, Jitka Stepankova
Objective: Osteoporosis and fragility fractures represent serious complications for the solid organ transplant population. The recommended osteoporosis therapy for organ recipients involves supplementation with calcium and vitamin D and bisphosphonate administration. However, these options can prove limited for patients with impaired renal function. An alternative therapy option is offered by denosumab, a monoclonal antibody that targets receptor activator of nuclear factor kappa-B ligand...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29720212/individualized-approach-to-the-surgical-management-of-fibrous-dysplasia-of-the-proximal-femur
#13
Bas C J Majoor, Andreas Leithner, Michiel A J van de Sande, Natasha M Appelman-Dijkstra, Neveen A T Hamdy, P D Sander Dijkstra
BACKGROUND: Fibrous dysplasia of the proximal femur presents with heterogeneous clinical manifestations dictating different surgical approaches. However, to date there are no clear recommendations to guide the choice of surgical approach and no general guidelines for the optimal orthopedic management of these lesions. The objective of this study was to evaluate treatment outcomes of angled blade plates and intramedullary nails, using as outcome indicators revision-free survival, pain, function and femoral neck-shaft-angle...
May 2, 2018: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29710852/association-of-insulin-resistance-with-bone-strength-and-bone-turnover-in-menopausal-chinese-singaporean-women-without-diabetes
#14
Maria Kalimeri, Francesca Leek, Nan Xin Wang, Huann Rong Koh, Nicole C Roy, David Cameron-Smith, Marlena C Kruger, Christiani Jeyakumar Henry, John J Totman
Insulin resistance (IR) is accompanied by increased areal or volumetric bone mineral density (aBMD or vBMD), but also higher fracture risk. Meanwhile, imbalances in bone health biomarkers affect insulin production. This study investigates the effect of IR on proximal femur and lumbar spine BMD, femoral neck bending, compressive and impact strength indices (Composite Strength Indices) and circulating levels of parathyroid hormone (PTH), C-telopeptide of Type I collagen (CTx-1) and 25(OH) Vitamin D₃, in a cohort of 97 healthy, non-obese, menopausal Chinese-Singaporean women...
April 30, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29700856/defining-the-width-of-the-normal-tibial-plateau-relative-to-the-distal-femur-critical-normative-data-for-identifying-pathologic-widening-in-tibial-plateau-fractures
#15
Adam M Johannsen, Austin M Cook, Michael Gardner, Julius A Bishop
INTRODUCTION: Tibial plateau widening in the setting of fracture is an indication for surgical treatment, and restoring width is an important goal of surgery. In order to identify and correct pathological widening, the width of the normal tibial plateau must first be defined. The aim of this study was to establish normative data for the width of the tibial plateau relative to the distal femur to enable surgeons to identify and correct pathological widening in the setting of tibial plateau fracture...
April 26, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29698292/does-the-watson-jones-or-modified-smith-petersen-approach-provide-superior-exposure-for-femoral-neck-fracture-fixation
#16
Paul M Lichstein, John P Kleimeyer, Michael Githens, John S Vorhies, Michael J Gardner, Michael Bellino, Julius Bishop
BACKGROUND: A well-reduced femoral neck fracture is more likely to heal than a poorly reduced one, and increasing the quality of the surgical exposure makes it easier to achieve anatomic fracture reduction. Two open approaches are in common use for femoral neck fractures, the modified Smith-Petersen and Watson-Jones; however, to our knowledge, the quality of exposure of the femoral neck exposure provided by each approach has not been investigated. QUESTIONS/PURPOSES: (1) What is the respective area of exposed femoral neck afforded by the Watson-Jones and modified Smith-Petersen approaches? (2) Is there a difference in the ability to visualize and/or palpate important anatomic landmarks provided by the Watson-Jones and modified Smith-Petersen approaches? METHODS: Ten fresh-frozen human pelvi underwent both modified Smith-Petersen (utilizing the caudal extent of the standard Smith-Petersen interval distal to the anterosuperior iliac spine and parallel to the palpable interval between the tensor fascia lata and the sartorius) and Watson-Jones approaches...
April 24, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29681707/pediatric-proximal-femur-fractures
#17
REVIEW
Brian L Dial, Robert K Lark
Pediatric proximal femur fractures are rare injuries resulting from high-energy trauma. The Delbet classification is used when describing these injuries, and associates fracture type to the development of avascular necrosis. Historically, casting was utilized in the treatment of these injuries, but high complication rates following this approach have changed the treatment modality to early and anatomic fixation. Complications associated with these injuries including avascular necrosis, non-union, coxa-vara, and premature physeal fusion...
June 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29680494/femur-loading-in-feet-first-fall-experiments-using-an-anthropomorphic-test-device
#18
Angela Thompson, Gina Bertocci, Craig Smalley
BACKGROUND: Femur fractures are a common orthopedic injury in young children. Falls account for a large portion of accidental femur fractures in young children, but there is also a high prevalence of femur fractures in child abuse, with falls often provided as false histories. Objective information regarding fracture potential in short distance fall scenarios may aid in assessing whether a child's injuries are the result of abuse or an accidental fall. Knowledge of femur loading is the first step towards understanding likelihood of fracture in a fall...
March 31, 2018: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/29671044/comparison-of-femur-stiffness-measured-from-dxa-and-qct-for-assessment-of-hip-fracture-risk
#19
Yunhua Luo, Huijuan Yang
Femur stiffness, for example axial and bending stiffness, integrates both geometric and material information of the bone, and thus can be an effective indicator of bone strength and hip fracture risk. Femur stiffness is ideally measured from quantitative computed tomography (QCT), but QCT is not recommended for routine clinical use due to the public concern about exposure to high-dosage radiation. Dual energy X-ray absorptiometry (DXA) is currently the primary imaging modality in clinic. However, DXA is two-dimensional and it is not clear whether DXA-estimated stiffness has adequate accuracy to replace its QCT counterpart for clinical application...
April 18, 2018: Journal of Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/29668448/tranexamic-acid-in-pertrochanteric-femoral-fracture-is-it-a-safe-drug-or-not
#20
Andrea Schiavone, Michele Bisaccia, Ivan Inkov, Giuseppe Rinonapoli, Mattia Manni, Giuseppe Rollo, Luigi Meccariello, Cristina Ibáñez Vicente, Paolo Ceccarini, Carmelinda Ruggiero, Auro Caraffa
BACKGROUND: There is a high incidence of blood transfusion following hip fractures in elderly patients. AIM: The aim of this study is to evaluate the effectiveness and complications of use of tranexamic acid in proximal femur nailing surgery. MATERIALS AND METHODS: Our sample group consisted of 90 patients suffering from pertrochanteric fractures surgically treated with osteosynthesis with SupernailGT(LimaCorporate). The classification system AO/OTA was used to divide the fractures into 31A1 (n=45) and 31A2 (n=45)...
March 1, 2018: Folia Medica
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