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Proximal femur fractures

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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
#1
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
https://www.readbyqxmd.com/read/27918708/patient-specific-hip-fracture-strength-assessment-with-microstructural-mr-imaging-based-finite-element-modeling
#2
Chamith S Rajapakse, Alexandra Hotca, Benjamin T Newman, Austin Ramme, Shaleen Vira, Elizabeth A Kobe, Rhiannon Miller, Stephen Honig, Gregory Chang
Purpose To describe a nonlinear finite element analysis method by using magnetic resonance (MR) images for the assessment of the mechanical competence of the hip and to demonstrate the reproducibility of the tool. Materials and Methods This prospective study received institutional review board approval and fully complied with HIPAA regulations for patient data. Written informed consent was obtained from all subjects. A nonlinear finite element analysis method was developed to estimate mechanical parameters that relate to hip fracture resistance by using MR images...
December 2, 2016: Radiology
https://www.readbyqxmd.com/read/27915448/bone-mineral-content-and-areal-density-but-not-bone-area-predict-an-incident-fracture-risk-a-comparative-study-in-a-uk-prospective-cohort
#3
E M Curtis, N C Harvey, S D'Angelo, C S Cooper, K A Ward, P Taylor, G Pearson, C Cooper
: We studied a prospective UK cohort of women aged 20 to 80 years, assessed by dual-energy X-ray absorptiometry (DXA) at baseline. Bone mineral content (BMC) and areal bone mineral density (aBMD), but not bone area (BA), at femoral neck, lumbar spine and the whole body sites were similarly predictive of incident fractures. BACKGROUND: Low aBMD, measured by DXA, is a well-established risk factor for future fracture, but little is known about the performance characteristics of other DXA measures such as BA and BMC in fracture prediction...
December 2016: Archives of Osteoporosis
https://www.readbyqxmd.com/read/27915374/long-term-functional-and-radiological-outcomes-of-allograft-hip-prosthesis-composite-a-fourteen%C3%A2-year-follow-up-study
#4
Arnaud Dubory, Eric Mascard, Méryl Dahan, Philippe Anract, Charles Court, Stéphane Boisgard, Brice Viard, Gilles Missenard
PURPOSE: Allograft hip composite prosthesis (APC) is a type of reconstruction after resection of the proximal femur. This study aimed to assess long-term outcomes after an APC reconstruction. MATERIALS AND METHODS: Forty-six patients were retrospectively included (14 revision total hip replacements, 30 primary malignant bone tumors, two metastasis). RESULTS: The mean length of femoral bone resection was 16.4 cm (7 to 27). With a mean follow-up of 14...
December 3, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27909788/dedifferentiated-liposarcoma-of-the-lower-extremity-with-low-grade-dedifferentiation-and-low-grade-osteosarcomatous-component
#5
Anna K Zajicek, Julia A Bridge, Joshua W Akers, Sean V McGarry, Craig W Walker
Dedifferentiated liposarcoma can arise de novo or as a complication of a preexisting well-differentiated liposarcoma. We describe the radiologic and pathologic features of a long-standing liposarcoma with multiple recurrences in a 59-year-old male. Imaging demonstrated a heterogeneous fat-containing mass in the anterior thigh. The adjacent proximal femur showed irregular cortical new bone, eventually followed by intramedullary osteoblastic involvement and pathologic fracture. Histologic assessment at resection revealed dedifferentiated liposarcoma with low-grade osteosarcomatous component...
December 1, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27903406/morphology-of-the-posteromedial-fragment-in-pertrochanteric-fractures-a-three-dimensional-computed-tomography-analysis
#6
Gaurav Sharma, Kiran Kumar Gn, Kavin Khatri, Ravijot Singh, Shivanand Gamanagatti, Vijay Sharma
BACKGROUND: In this study we describe the morphology of the posteromedial fragment in pertrochanteric fractures using 3D CT scans and answer two questions 1) Do differences exist between the 3D CT appearances of posteromedial fragments and the depictions made in the AO classification 2) Does the posteromedial fragment affect stability in pertrochanteric fractures, in terms of fracture collapse? METHODS: Preoperative CT scans of eight 31-A1 and fifty 31-A2 fractures were analysed...
November 17, 2016: Injury
https://www.readbyqxmd.com/read/27889112/risk-factors-for-cut-out-of-double-lag-screw-fixation-in-proximal-femoral-fractures
#7
Kadir Buyukdogan, Omur Caglar, Samet Isik, Mazhar Tokgozoglu, Bulent Atilla
OBJECTIVE: We assessed factors associated with cut-out after internal fixation of proximal femoral fractures using double lag screw nails. DESIGN: Retrospective cohort study. SETTING: A university hospital. PATIENTS AND METHODS: Patients with non-pathological intertrochanteric femur fractures and a minumum 90days follow-up who underwent internal fixation with dual lag screw nails were included. Potential risk factors for lag screw cut-out investigated by our study were: age, gender, body mass index, comorbidities (American Society of Anesthesiologists [ASA] classification), type of fracture (AO/OTA classification), fracture stability, side, operation time, implant length, reduction quality, tip-apex distance (TAD), and lag screw configuration...
November 19, 2016: Injury
https://www.readbyqxmd.com/read/27882811/the-ao-pediatric-comprehensive-classification-of-long-bone-fractures-pccf-part-ii
#8
Alexander Joeris, Nicolas Lutz, Andrea Blumenthal, Theddy Slongo, Laurent Audigé
Background and purpose - To achieve a common understanding when dealing with long bone fractures in children, the AO Pediatric Comprehensive Classification of Long Bone Fractures (AO PCCF) was introduced in 2007. As part of its final validation, we present the most relevant fracture patterns in the lower extremities of a representative population of children classified according to the PCCF. Patients and methods - We included patients up to the age of 17 who were diagnosed with 1 or more long bone fractures between January 2009 and December 2011 at either of 2 tertiary care university hospitals in Switzerland...
November 24, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27874909/risk-factors-for-intraoperative-proximal-femoral-fracture-during-primary-cementless-tha
#9
Ran Zhao, Hong Cai, Yanqing Liu, Hua Tian, Ke Zhang, Zhongjun Liu
Intraoperative proximal femoral fracture, one of the most common complications of total hip arthroplasty (THA), occurs more often in cementless procedures and can affect rehabilitation, hospitalization time, and cost of treatment. The goal of this study was to identify risk factors for intraoperative proximal femoral fracture in THA to identify high-risk groups preoperatively and minimize the incidence of this complication. This nested case-control study included 904 primary cementless THA procedures (769 patients) performed between January 2009 and July 2015...
November 22, 2016: Orthopedics
https://www.readbyqxmd.com/read/27871553/fascia-iliaca-block-associated-only-with-deep-sedation-in-high-risk-patients-taking-p2y12-receptor-inhibitors-for-intramedullary-femoral-fixation-in-intertrochanteric-hip-fracture-a-series-of-3-cases
#10
Carlos Rodrigues Almeida, Emília Milheiro Francisco, Vítor Pinho-Oliveira, José Pedro Assunção
OBJECTIVE: We present a series of 3 cases in which the impact in outcome was, first of all, related to the capacity to offer early and safer treatment to some hip fracture high-risk patients using a fascia iliaca block (FIB; ropivacaine 0,5% 20 cc and mepivacaine 1,3% 15 cc, given 30 minutes before incision) associated only with deep sedation, contributing to better practice and outcome. CASE REPORTS: All elderly patients were American Society of Anesthesiologists IV patients, under P2Y12 receptor inhibitors, suffering from an intertrochanteric fracture, and purposed for intramedullary femoral fixation (IMF)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27858121/trends-in-hip-fracture-rates-in-taiwan-a-nationwide-study-from-1996-to-2010
#11
T Y Wu, H Y Hu, S Y Lin, W C Chie, R S Yang, C K Liaw
: There was an initial increase and a later decrease in hip fracture rates in Taiwan between 1996 and 2010 (457.9 to 390.0 fractures per 100,000 people per year). Mortality rates decreased but re-emerged later (2.26 to 1.91 deaths per 100 hip fracture admissions). The turning point for change in trends was 2003. INTRODUCTION: Fractures of the proximal femur remain a major cause of mortality and morbidity. We aimed to examine recent trends in hip fracture rates, in-hospital mortality rates, and length of hospital stay (LOS) due to hip fractures in people aged 55 and over in Taiwan...
November 17, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27846358/-subtrochanteric-fracture-in-children-treated-with-minimally-invasive-surgery-case-report
#12
R Guzmán-Vargas, D F Rincón-Cardozo, J A Camacho-Casas
Subtrochanteric fractures in children are rare events that occur in only 4% of all femur fractures; most injuries occur as a result of high-energy trauma, being young male patients the most affected. The management of this type of injury is controversial; there are many forms of treatment, including the use of plaster spica 90-90, closed reduction and use of elastic or rigid intramedullary nails, open reduction and plate placement, and the use of external fixators. Most suggest that for children under 10 a nonoperative approach should be preferred and that older ones should be managed surgically, but it is between six and 12-year-olds that most of the controversy exists...
March 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/27843357/proximal-femoral-fracture-surgery-in-a-patient-with-osteopetrosis-tarda-complications-and-treatment-strategy
#13
Fırat Seyfettinoglu, Ümit Tuhanioğlu, Hasan Ulas Ogur, Hakan Cicek
Osteopetrosis is a rare, inherited disease characterized by defects in osteoclastic function that results in defective bone resorption. When fractures are encountered, fixation is extremely difficult. Osteopetrosis patients have an increased predisposition to infection. If infection develops after a fracture, treatment is more difficult. In this paper, treatment is presented of a 49-year old female to whom proximal femoral nailing was applied for fixation of an osteopetrotic proximal femur fracture; and when it was unsuccessful, revision was made with a locked anatomic plate, which subsequently led to development of infection...
2016: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/27830385/atypical-femoral-fractures-in-italy-a-retrospective-analysis-in-a-large-urban-emergency-department-during-a-7-year-period-2007-2013
#14
Mario Pedrazzoni, Andrea Giusti, Giuseppe Girasole, Barbara Abbate, Ignazio Verzicco, Gianfranco Cervellin
The aim of this study was to determine the incidence of atypical femoral fractures (AFFs) seen in a large emergency department in Italy. It was a retrospective study of all men and women aged 40 years or older admitted to the Emergency Department of Parma University Hospital for a femoral fracture. Cases were identified in the hospital database with use of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 820 or 821 or text strings. All the radiographic images of fractures not clearly identified as proximal or condylar were retrieved and evaluated by three independent reviewers...
November 9, 2016: Journal of Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/27830101/low-energy-traumatic-obturator-hip-dislocation-with-ipsilateral-femoral-shaft-fracture-in-a-patient-with-omolateral-knee-arthroplasty
#15
G Gazzotti, L Patrizio, S Dall'Aglio, E Sabetta
Ipsilateral obturator hip dislocation and femoral shaft fracture are rare. We report such a case in an older woman after a low-energy injury. She had a knee prostheses in the same limb. The patient was treated by open manipulative reduction of the luxation without opening joint and open reduction and internal fixation of the femur with angular stability plate and screws. We could not find a similar case in the literature. An early diagnosis of the dislocation is crucial in order to obtain good results. Great awareness and radiologic examination are fundamental to achieve precocious diagnosis of both these rare combined injuries, as treatment in these cases is considered an emergency...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27821999/early-results-of-the-lps%C3%A2-limb-preservation-system-in-the-management-of-periprosthetic-femoral-fractures
#16
M Curtin, C Bryan, E Murphy, C G Murphy, W Curtin
INTRODUCTION: Achieving skeletal fixation in the presence of progressive bone loss is a surgical challenge, especially in cases of periprosthetic fracture (PPF). Unpredictable fracture patterns and preexisting bone loss frequently combine in this patient group. Megaprosthetic arthroplasty allows for immediate mobilisation and shorter periods of rehabilitation. We describe the clinical outcomes of a cohort of LPS™ megaprostheses performed for PPF by a single surgeon at our institution...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27818743/the-clinical-contribution-of-cortical-porosity-to-fragility-fractures
#17
REVIEW
Åshild Bjørnerem
Cortical bone is not compact; rather it is penetrated by many Haversian and Volkmann canals for blood supply. The lining of these canals are the intracortical bone surfaces available for bone remodeling. Increasing intracortical bone remodeling increases cortical porosity. However, cortical bone loss occurs more slowly than trabecular loss due to the fact that less surface per unit of bone matrix volume is available for bone remodeling. Nevertheless, most of the bone loss over time is cortical because cortical bone constitutes 80% of the skeleton, and the relative proportion of trabecular bone diminishes with advancing age...
2016: BoneKEy Reports
https://www.readbyqxmd.com/read/27815914/patient-factors-associated-with-increased-acute-care-costs-of-hip-fractures-a-detailed-analysis-of-402-patients
#18
R Aigner, T Meier Fedeler, D Eschbach, J Hack, C Bliemel, S Ruchholtz, B Bücking
: The aim of the present study was to identify patient factors associated with higher costs in hip fracture patients. The mean costs of a prospectively observed sample of 402 patients were 8853 €. The ASA score, Charlson comorbidity index, and fracture location were associated with increased costs. PURPOSE: Fractures of the proximal end of the femur (hip fractures) are of increasing incidence due to demographic changes. Relevant co-morbidities often present in these patients cause high complication rates and prolonged hospital stays, thus leading to high costs of acute care...
December 2016: Archives of Osteoporosis
https://www.readbyqxmd.com/read/27810151/markers-of-muscle-damage-for-comparing-soft-tissue-injury-following-proximal-femur-nail-and-dynamic-hip-screw-operations-for-intertrochanteric-hip-fractures
#19
Yonathan Wagman, Ortal Segal, Israel Dudkiewicz, Ely Steinberg
BACKGROUND: Femoral neck fractures are the most common fractures among the elderly. The two operative approaches used for the treatment of AO/OTA 31 intertrochanteric fractures include an intramedullary device (proximal femoral nail [PFN]) or an extramedullary device (sliding/dynamic hip screw [DHS]). The aim of this study was to provide objective evidence of local soft tissue injury by measuring serum creatine phosphokinase (CPK), a biochemical marker, to quantify muscle damage and inflammation in patients treated by the two approaches...
December 2016: Injury
https://www.readbyqxmd.com/read/27803216/a-randomised-feasibility-study-comparing-total-hip-arthroplasty-with-and-without-dual-mobility-acetabular-component-in-the-treatment-of-displaced-intracapsular-fractures-of-the-proximal-femur-the-warwick-hip-trauma-evaluation-two-white-two
#20
X L Griffin, N Parsons, J Achten, M L Costa
AIMS: The optimal treatment for independent patients with a displaced intracapsular fracture of the hip remains controversial. The recognised alternatives are hemiarthroplasty and total hip arthroplasty. At present there is no established standard of care, with both types of arthroplasty being used in many centres. PATIENTS AND METHODS: We conducted a feasibility study comparing the clinical effectiveness of a dual mobility acetabular component compared with standard polyethylene component in total hip arthroplasty for independent patients with a displaced intracapsular fracture of the hip, for a 12-month period beginning in June 2013...
November 2016: Bone & Joint Journal
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