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Atypical fracture

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https://www.readbyqxmd.com/read/28490036/fractured-penis-not-so-rare
#1
Ashwin S Tamhankar, Prakash W Pawar, Ajit S Sawant, Gaurav V Kasat, Abhishek Savaliya, Shankar Mundhe, Sunil Patil, Sayalee Narwade
INTRODUCTION: Penile fracture is a relatively common phenomenon. The main problem associated with this condition is the lack of patients' awareness on the urgency of the situation. This study reports the different modes of presentations and treatment results. MATERIALS AND METHODS: We reviewed 21 cases of penile fracture over 5 years. Parameters were mode of injury, age group, time interval before presentation, management, site of injury, urethral involvement, results, complications and erectile function at follow-up...
May 11, 2017: Urologia Internationalis
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
#2
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/28476576/non-bmd-dxa-measurements-of-the-hip
#3
Clinten P Edmondson, Elliott N Schwartz
Hip fracture is one of the most serious complications of osteoporosis. More than 50% of hip and other fractures occur in patients without densitometric osteoporosis. Therefore, areal bone mineral density (aBMD) may not be the best way to assess fracture risk. In order to improve assessment of fracture risk, many other approaches have been taken. At the present time, the Fracture Risk Algorithm (FRAX©) is one of the most notable ways to improve assessment of fracture risk. However, since early in the initiation of the dual energy x-ray absorptiometry (DXA) era, several non-BMD DXA approaches to the assessment of hip fracture risk have been proposed...
May 2, 2017: Bone
https://www.readbyqxmd.com/read/28474166/undisturbed-local-bone-formation-capacity-in-patients-with-atypical-femoral-fractures-a-case-series
#4
H P Bögl, P Aspenberg, J Schilcher
We excised the fracture site in 8 patients with incomplete atypical femoral fractures by drilling an 11-mm-diameter hole. New bone formation could be seen in the hole within a normal time frame. Delayed healing of these fractures might be unrelated to an impaired capacity to form bone. INTRODUCTION: Incomplete atypical femoral fractures (undisplaced cracks) heal slowly or not at all, and often progress to a complete fracture with minimal trauma. The impaired healing has been attributed to an impaired biologic healing capacity related to bisphosphonate use, or, alternatively, to the mechanical environment within the fracture crack...
May 4, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28467663/screening-for-atypical-femur-fractures-using-extended-femur-scans-by-dxa
#5
Denise M van de Laarschot, Alexandra A A Smits, Sanne K C Buitendijk, Merel T Stegenga, M Carola Zillikens
Atypical femur fractures (AFFs) are a rare but serious complication associated with the use of antiresorptive drugs such as bisphosphonates. Assessment of incomplete AFFs on extended femur scans by Dual X-ray Absorptiometry (DXA) may prevent the development of complete fractures. The aim of this study was to evaluate the potential of extended femur scans by DXA as a screening tool for incomplete AFFs. From June 2014 until September 2016 extended femur scans were routinely performed in all consecutive patients undergoing DXA scanning who had used bisphosphonates or denosumab at any given moment in the previous year...
May 3, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28463916/intramedullary-nailing-for-atypical-femoral-fracture-with-excessive-anterolateral-bowing
#6
Young-Chang Park, Hyung-Keun Song, Xuan-Lin Zheng, Kyu-Hyun Yang
BACKGROUND: Intramedullary nailing is the treatment of choice for atypical femoral fractures. However, several problems, such as iatrogenic fracture and medial gap opening, can occur during intramedullary nailing when atypical femoral fractures are associated with excessive anterolateral bowing. To overcome these problems, we have developed a new grading system for anterolateral femoral bowing and a new technique for intramedullary nailing. The core of this new technique is matching the anterior curvature of the femoral nail with the anterolateral bowing of the femur when the nail passes the apex of the curvature, by rotating the nail externally...
May 3, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28459066/atypical-femoral-shaft-fractures-in-female-bisphosphonate-users-were-associated-with-an-increased-anterolateral-femoral-bow-and-a-thicker-lateral-cortex-a-case-control-study
#7
Seung Pil Jang, Ingwon Yeo, Sang-Yeon So, Keunbyuel Kim, Young-Wan Moon, Youn-Soo Park, Seung-Jae Lim
The purpose of our study was to investigate the radiographic characteristics of atypical femoral shaft fractures (AFSFs) in females with a particular focus on femoral bow and cortical thickness. We performed a fracture location-, age-, gender-, and ethnicity-matched case-control study. Forty-two AFSFs in 29 patients and 22 typical osteoporotic femoral shaft fractures in 22 patients were enrolled in AFSF group and control group, respectively. With comparing demographics between two groups, radiographically measured femoral bow and cortical thicknesses of AFSF group were compared with control group...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28456365/medication-management-after-intramedullary-nailing-of-atypical-fractures
#8
Jean-Marc Feron, Adeline Cambon-Binder
Long term use of bisphosphonates (BPs) in osteoporotic patients may be associated with stress fractures of the sub-trochanteric and shaft area of the femur, so called "atypical" femoral fractures (AFF). Specific diagnosis criteria have been defined with 5 major features; the presence of four of them characterizes the AFF. Once a complete fracture occurred, the best surgical treatment is closed reduction and intra medullary nailing. The BPs treatment should be stopped immediately after an AFF occurred. Dietary calcium and vitamin D status should be assessed, and adequate supplementation prescribed...
April 26, 2017: Injury
https://www.readbyqxmd.com/read/28454248/primary-bone-mantle-cell-lymphomas-with-multiple-vertebral-compression-fractures-a-case-report
#9
Peng Yang, Jun Lin, Hao Liu, Hao Shen, Hui-Lin Yang
Mantle cell lymphoma (MCL) is a mature B-cell non-Hodgkin lymphoma. Patients with MCL generally present with extensive lymphadenopathy and extranodal involvement. To the best of our knowledge, no cases of primary bone MCL with multiple vertebral compression fractures have been reported in the literature thus far. The current study reports the case of a 75-year-old Chinese male patient presenting with lower back pain for 1 year. B symptoms were not observed in the patient's medical history. X-ray revealed osteoporosis, and mixed osteolytic and osteosclerotic lesions in the T10 and L1 vertebrae with decreased height...
March 2017: Oncology Letters
https://www.readbyqxmd.com/read/28436160/compound-heterozygous-mutations-in-col1a1-associated-with-an-atypical-form-of-type-i-osteogenesis-imperfecta
#10
Amanda M Ackermann, Michael A Levine
Heterozygous mutations in the genes encoding the proα1(I) or proα2(I) chains of type I procollagen (COL1A1 and COL1A2, respectively) account for most cases of osteogenesis imperfecta (OI), a disorder characterized by reduced bone strength and increased fracture risk. COL1A1 mutations can also cause rare cases of Ehlers-Danlos syndrome (EDS), a disorder that primarily affects connective tissue and often includes reduced bone mass. Here we present a kindred of three young siblings ages 1-4 years old whose mother has a history of mild type I OI...
April 24, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28429247/a-review-of-the-novel-application-and-potential-adverse-effects-of-proton-pump-inhibitors
#11
REVIEW
Li-Yuan Yu, Lu-Ning Sun, Xue-Hui Zhang, Yue-Qi Li, Lei Yu, Zi-Qing-Yun Yuan, Ling Meng, Hong-Wen Zhang, Yong-Qing Wang
Proton pump inhibitors (PPIs) are known as a class of pharmaceutical agents that target H(+)/K(+)-ATPase, which is located in gastric parietal cells. PPIs are widely used in the treatment of gastric acid-related diseases including peptic ulcer disease, erosive esophagitis and gastroesophageal reflux disease, and so on. These drugs present an excellent safety profile and have become one of the most commonly prescribed drugs in primary and specialty care. Except for gastric acid-related diseases, PPIs can also be used in the treatment of Helicobacter pylori infection, viral infections, respiratory system diseases, cancer and so on...
May 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28421287/-age-89-years-depression-fall-with-pelvic-fracture-severe-confusion-serotonin-syndrome-differential-diagnosis-importance-of-cyp450-and-economic-considerations
#12
REVIEW
W Weinrebe, A Moutaouakil, K Risz, M Martin, K Jeckelmann, S Goetz
A case study of an 89-year-old patient is reported, who was admitted to hospital because of immobility due to pain. After the cause of the pain could initially be clarified and treated, the further clinical course in this very old woman showed an alarming symptom complex of agitation, confusion and cognitive deterioration, which took on grave forms. The work-up of this case showed a typical constellation of pain and depression in old age; however, the pharmaceutical treatment in this case is not atypical and could lead to a severe serotonin syndrome...
April 18, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28410753/retrospective-review-of-patients-with-atypical-bisphosphonate-related-proximal-femoral-fractures
#13
H K Phillips, S J Harrison, H Akrawi, S A Sidhom
INTRODUCTION: Patients may be at an increased risk of atypical proximal femoral fractures with prolonged bisphosphonate use. PATIENTS AND METHODS: This was a retrospective review of patients who sustained a subtrochanteric fracture of the femur in our department between April 2009 and March 2014. The radiographs were reviewed for features of atypical femoral fractures as described by the American Society of Bone Mineral Research. RESULTS: 185 patients were coded according to the National Hip Fracture Database as having sustained a subtrochanteric fracture of the femur...
April 4, 2017: Injury
https://www.readbyqxmd.com/read/28409215/high-and-pointed-type-of-femoral-localized-reaction-frequently-extends-to-complete-and-incomplete-atypical-femoral-fracture-in-patients-with-autoimmune-diseases-on-long-term-glucocorticoids-and-bisphosphonates
#14
H Sato, N Kondo, T Nakatsue, Y Wada, J Fujisawa, J J Kazama, T Kuroda, Y Suzuki, M Nakano, N Endo, I Narita
Once a localized reaction (beaking) was detected, discontinuation of bisphosphonates (BPs) and switching to vitamin D supplementation or teriparatide therapy effectively improved its shape. When the localized reaction was high, of the pointed type, and/or accompanied by prodromal pain, the risks of complete and incomplete atypical femoral fracture increased and consideration of prophylactic fixation for such patients was required. INTRODUCTION: Femoral localized reaction (localized periosteal thickening of the lateral cortex, beaking) is reported to precede atypical femoral fractures (AFFs) and to develop in 8-10% of patients with autoimmune diseases taking BPs and glucocorticoids...
April 13, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28396331/atypical-femoral-fracture
#15
Aliya Aziz Khan, Stephanie Kaiser
No abstract text is available yet for this article.
April 10, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28394845/im-nail-fixation-of-atypical-femur-fractures-with-bone-marrow-aspirate-concentrate-leads-to-faster-union-a-case-control-study
#16
Andrew J Lovy, Jun S Kim, John Di Capua, Sulaiman Somani, Stephanie Shim, Aakash Keswani, Rohit Hasija, Yangguan Wu, David Joseph, Richard Ghillani
OBJECTIVES: High rates of implant failure and nonunion in atypical femur fractures (AFF) have been reported. The aim of this study was to evaluate bone marrow aspirate concentrate (BMAC) use in the treatment of AFF. DESIGN: Retrospective Case Control SETTING:: Level 1 Trauma Center PATIENTS:: Complete AFF, defined according to American Society of Bone and Mineral Research (ASBMR) criteria, from September 2009 to April 2015 with minimum 1 year follow up. INTERVENTION: Operative treatment with anterograde intramedullary (IM) nails...
April 7, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28389970/osteoporosis-a-discussion-on-the-past-5%C3%A2-years
#17
REVIEW
Kyle M Schweser, Brett D Crist
PURPOSE OF THE REVIEW: The purposes of this study are to examine the literature within the past 5 years regarding osteoporosis and offer a discussion on new topics and controversies. RECENT FINDINGS: Patient compliance with therapy remains an issue. The effectiveness of Vitamin D and calcium are being called into question Atypical femur fractures have been associated with bisphosphonate and denosumab use. Treatment is both surgical and pharmaceutical. A multidisciplinary approach to osteoporotic fractures is important and having some form of fracture liaison service (FLS) improves the efficacy of osteoporotic care and decreases secondary fractures...
April 7, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28385420/less-is-more-efficacy-of-rapid-3d-t2-space-in-ed-patients-with-acute-atypical-low-back-pain
#18
Nicholas A Koontz, Richard H Wiggins, Megan K Mills, Michael S McLaughlin, Elaine C Pigman, Yoshimi Anzai, Lubdha M Shah
RATIONALE AND OBJECTIVES: Emergency department (ED) patients with acute low back pain (LBP) may present with ambiguous clinical findings that pose diagnostic challenges to exclude cauda equina syndrome (CES). As a proof of concept, we aimed to determine the efficacy of a rapid lumbar spine (LS) magnetic resonance imaging (MRI) screening protocol consisting of a single 3D-T2 SPACE FS (3D-T2 Sampling Perfection with Application optimized Contrasts using different flip angle Evolution fat saturated) sequence relative to conventional LS MRI to exclude emergently treatable pathologies in this complex patient population...
April 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28377987/presence-of-pyrophosphate-in-bone-from-an-atypical-femoral-fracture-site-a-case-report
#19
Maziar Shabestari, Erik Fink Eriksen, Eleftherios P Paschalis, Paul Roschger, Sonja Gamsjaeger, Klaus Klaushofer, Andrea Berzlanovich, Xavier Nogues, Lluis Puig, Adolfo Diez-Perez
Long-term antiresorptives use has been linked to atypical subtrochanteric and diaphyseal femoral fractures (AFF), the pathogenesis of which is still unknown. In the present case report we present the results of analysis of bone chips from a 74-year old female patient that had been on alendronate, ibandronate and denosumab treatment, and who sustained an atypical femoral fracture, by histology, quantitative backscattered electron imaging, and Raman spectroscopic analysis. The results indicate ongoing osteoclastic resorption, but also several abnormalities: 1) an altered arrangement of osteons; 2) impaired mineralization; 3) the presence of pyrophosphate, which might contribute to the impaired mineralization evident in the present case...
June 2017: Bone Reports
https://www.readbyqxmd.com/read/28377979/a-new-contralateral-atypical-femoral-fracture-despite-sequential-therapy-with-teriparatide-and-strontium-ranelate
#20
Hanh H Nguyen, Frances Milat, Peter R Ebeling
Atypical femoral fractures (AFFs) are a rare association of anti-resorptive therapy for osteoporosis. Limited evidence-based management guidelines on their optimal treatment exist, with observational studies suggesting a role for teriparatide (TPTD) in AFF healing. We report a case of a 65-year-old woman with postmenopausal osteoporosis who sustained an AFF following long-term bisphosphonate therapy, and who subsequently developed a new contralateral AFF after completion of TPTD therapy and initiation of strontium ranelate (SR) treatment...
June 2017: Bone Reports
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