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Atypical fracture

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https://www.readbyqxmd.com/read/28644936/the-deltoid-lift-a-comparison-study-of-exposure-area-in-proximal-humeral-approaches
#1
Michael Ting, Nicholas Kusnezov, John Dunn, Alok K Dwivedi, Miguel A Pirela-Cruz
BACKGROUND: Adequate exposure of the proximal humerus is necessary to address atypical or complex proximal humerus fractures and orthopedic tumors. Surgical management may be difficult through existing approaches due to their limited nature and the delicate neurovascular anatomy of the shoulder. The deltoid lift, a previously described extensile approach, can be incorporated into the surgeon's armamentarium as an alternative exposure to the proximal humerus. The objective of this study was to quantify and compare the humeral exposure achieved through the deltoid lift with the standard direct lateral deltoid-splitting, anterolateral acromial, and deltopectoral approaches in terms of surface area and exposure of key anatomic landmarks...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28632660/clinical-experience-with-the-use-of-low-intensity-pulsed-ultrasound-lipus-in-the-treatment-of-atypical-femoral-fractures
#2
Sang Yang Lee, Takahiro Niikura, Takashi Iwakura, Tomoaki Fukui, Ryosuke Kuroda
OBJECTIVE: The aim of this study was to report the clinical results of atypical femoral fractures (AFFs) treated with low-intensity pulsed ultrasound (LIPUS). MATERIALS AND METHODS: The data on AFFs that were surgically treated in our hospital from 2010 to 2016 was retrospectively analyzed. AFF was diagnosed based on the criteria defined by the second report of an ASBMR task force. RESULTS: Seven fractures in 6 cases were included in this study...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28632656/intramedullary-nail-fixation-of-atypical-femur-fractures-with-bone-marrow-aspirate-concentrate-leads-to-faster-union-a-case-control-study
#3
Andrew J Lovy, Jun S Kim, John Di Capua, Sulaiman Somani, Stephanie Shim, Aakash Keswani, Rohit Hasija, Yangguan Wu, David Joseph, Richard Ghillani
OBJECTIVES: 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 antegrade intramedullary nails...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28625337/osteogenesis-imperfecta-a-clinical-update
#4
Symeon Tournis, Anastasia D Dede
Osteogenesis imperfecta (OI) is the most common inherited form of bone fragility and includes a heterogenous group of genetic disorders which most commonly result from defects associated with type 1 collagen. 85%-90% of cases are inherited in an autosomal dominant manner and are caused by mutations in the COL1A1 and COL1A2 genes, leading to quantitative or qualitative defects in type 1 collagen. In the last decade, defects in several other proteins involved in the normal processing of type 1 collagen have been described...
June 8, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28612307/atypical-subtrochanteric-fractures-in-korean-hip-fracture-study
#5
Y-K Lee, T-Y Kim, Y-C Ha, S-H Song, J W Kim, H C Shon, J S Chang, K-H Koo
In Korean, atypical subtrochanteric fractures (ASF) were rare. Higher BMI and use of bisphosphonate were significant risk factors of ASF. INTRODUCTION: Recently, ASF have been reported to increase among patients on bisphosphonate. However, the incidence of ASF and the association between ASF and bisphosphonate use have not been well defined in Asian population. Our purposes are (1) to estimate the proportion of ASF among Korean patients with proximal femur fracture and (2) to determine the associated risk factors of ASF in the Korean patients...
June 14, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28611964/lateral-femoral-bowing-and-the-location-of-atypical-femoral-fractures
#6
Hyunseung Yoo, Youngho Cho, Youngbo Park, Sungsoo Ha
PURPOSE: Atypical femoral fractures (AFFs) occur in two distinct part, subtrochanter and diaphysis. The aim of this study was to investigate the relationship between the lateral femoral bowing angle and the location of AFF. MATERIALS AND METHODS: This study included a total of 56 cases in 45 patients who underwent surgical treatment between January 2010 and December 2015. For the diaphyseal and subtrochanteric AFFs, we evaluated the relationship between the anatomic location and lateral femoral bowing angle...
June 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28607787/ipsilateral-rupture-of-quadriceps-tendon-with-distal-tibia-fracture-a-case-report-and-review-of-the-literature
#7
Samik Banerjee, Timothy P Dooley, James R Parkinson
Traumatic rupture of the quadriceps tendon by itself is not an uncommon clinical condition. However, its association with concurrent ipsilateral closed distal tibia oblique fracture is exceedingly rare with only one previously reported case in English literature. The dual diagnosis of this atypical combination of injury may be masked by pain and immobilization of the more obvious fracture and may be missed, unless the treating physician maintains a high index of suspicion. Suprapatellar knee pain with or without a palpable gap in the quadriceps tendon and inability to straight leg raise in the setting of a distal tibia fracture should raise concern, but if initial treatment employs a long-leg splint the knee symptoms may be muted...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28595841/an-atypical-variant-of-superolateral-dislocation-of-the-mandibular-condyle-a-case-report
#8
Kapil Malik, Subhas C Debnath, Apurba K Adhyapok, Kriti Hazarika
Dislocation of the mandibular condyle from the glenoid fossa can occur in anterior, posterior, lateral, and superior directions. Posterior, lateral, and superior dislocations are rare. Superolateral dislocation is seldom encountered in clinical practice. It is generally associated with fracture of the anterior or contralateral side of the mandible. The occurrence of superolateral dislocation of the condyle hooked above the zygomatic arch with an associated fracture of the medial pole of the condyle is rare and has been reported only once in the literature...
May 15, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28578439/long-term-use-of-bisphosphonates-in-osteoporosis
#9
Basmah K Alwahhabi, Basil A Alsuwaine
To report and describe the management and response to treatment of patients referred to the osteoporosis clinic after prolonged use of bisphosphonate BPs) (4 years and more) with and without new fracture (any site) or any other new skeletal symptoms.  Methods: This is a single center observational retrospective cohort study conducted from January 2009 to May 2016 in a tertiary center. We describe cause of referral, X-rays findings, management, and response to treatment. Results: Thirty-four patients, aged 46-89 years, were collected...
June 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28571705/factors-affecting-fracture-location-in-atypical-femoral-fractures-a-cross-sectional-study-with-147-patients
#10
Ji Wan Kim, Jung Jae Kim, Young-Soo Byun, Oog-Jin Shon, Hyoung Keun Oh, Ki Chul Park, Joon-Woo Kim, Chang-Wug Oh
INTRODUCTION: Many studies have tried to determine the characteristics of atypical femoral fractures (AFFs) through age-, sex-, and ethnicity-matched comparison with non-AFFs. However, we hypothesized that diaphyseal AFFs would have characteristics different from those of subtrochanteric AFFs. The aim of this study was to evaluate the clinical features of diaphyseal/subtrochanteric AFFs and determine the factors related to fracture location. PATIENTS AND METHODS: One hundred forty-seven patients with AFF were enrolled, 114 patients (78%) had a history of bisphosphonate use...
May 25, 2017: Injury
https://www.readbyqxmd.com/read/28549530/the-incidence-of-atypical-femoral-fractures-in-breast-cancer-patients-with-bone-metastases-who-received-bisphosphonate-treatment
#11
Eiji Nakata, Shinsuke Sugihara, Natsumi Yamashita, Shozo Osumi
BACKGROUND: Atypical femoral fractures (AFFs) have been reported to occur in patients with bone metastases who received long-term bisphosphonate treatment. However, the incidence of AFFs in breast cancer patients with bone metastases who received intravenous bisphosphonate is unclear. The purpose of this study is to examine the incidence of AFFs in breast cancer patients with bone metastases who received intravenous bisphosphonate. In addition, we estimated the number of dose and duration of intravenous bisphosphonate at the time of occurrence of AFFs...
May 23, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28546097/10-years-of-denosumab-treatment-in-postmenopausal-women-with-osteoporosis-results-from-the-phase-3-randomised-freedom-trial-and-open-label-extension
#12
Henry G Bone, Rachel B Wagman, Maria L Brandi, Jacques P Brown, Roland Chapurlat, Steven R Cummings, Edward Czerwiński, Astrid Fahrleitner-Pammer, David L Kendler, Kurt Lippuner, Jean-Yves Reginster, Christian Roux, Jorge Malouf, Michelle N Bradley, Nadia S Daizadeh, Andrea Wang, Paula Dakin, Nicola Pannacciulli, David W Dempster, Socrates Papapoulos
BACKGROUND: Long-term safety and efficacy of osteoporosis treatment are important because of the chronic nature of the disease. We aimed to assess the long-term safety and efficacy of denosumab, which is widely used for the treatment of postmenopausal women with osteoporosis. METHODS: In the multicentre, randomised, double-blind, placebo-controlled, phase 3 FREEDOM trial, postmenopausal women aged 60-90 years with osteoporosis were enrolled in 214 centres in North America, Europe, Latin America, and Australasia and were randomly assigned (1:1) to receive 60 mg subcutaneous denosumab or placebo every 6 months for 3 years...
July 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28539165/drug-holidays-from-bisphosphonates-and-denosumab-in-postmenopausal-osteoporosis-emas-position-statement
#13
REVIEW
Panagiotis Anagnostis, Stavroula A Paschou, Gesthimani Mintziori, Iuliana Ceausu, Herman Depypere, Irene Lambrinoudaki, Alfred Mueck, Faustino R Pérez-López, Margaret Rees, Levent M Senturk, Tommaso Simoncini, John C Stevenson, Petra Stute, Florence A Trémollieres, Dimitrios G Goulis
BACKGROUND: Bisphosphonates and denosumab are used extensively in the treatment of postmenopausal osteoporosis. Despite their proven efficacy in the reduction of vertebral and non-vertebral fractures, their optimal duration of use has not been determined. The occurrence of adverse effects, such as osteonecrosis of the jaw (ONJ) and atypical femoral fractures (AFF), has raised the issue of bisphosphonate or denosumab discontinuation ("drug holiday") after a certain treatment period. AIM: To assess the effect of bisphosphonate and denosumab discontinuation on fracture risk, as well as its possible benefits in reducing the risk of adverse effects...
July 2017: Maturitas
https://www.readbyqxmd.com/read/28535898/treatment-of-postmenopausal-osteoporosis-a-literature-based-algorithm-for-use-in-the-public-health-care-system
#14
Ellen Luz Pereira Caires, Mailze Campos Bezerra, Ana Flávia Torquato de Araújo Junqueira, Sheila Márcia de Araújo Fontenele, Silvana Cristina de Albuquerque Andrade, Catarina Brasil d'Alva
Bisphosphonates are considered first-line agents in the treatment of postmenopausal osteoporosis based on extensive experience of use, safety, and proven efficacy in reducing vertebral, non-vertebral and femur fractures. However, post-marketing reports based on the treatment of millions of patients/year over lengthy periods of time have revealed the occurrence of initially unexpected adverse effects, such as osteonecrosis of the jaw and atypical femoral fracture, leading to the restriction of treatment duration with bisphosphonates by global regulatory agencies...
May 2017: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/28490036/fractured-penis-not-so-rare
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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