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Atypical fracture

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https://www.readbyqxmd.com/read/29457424/-progress-on-diagnosis-and-treatment-of-proximal-tibiofibular-joint-dislocation
#1
REVIEW
Bin Yuan, Bao-Jian Ge, Bai-Yi Meng
Dislocation of proximal tibiofibular joint(PTFJ) is relatively infrequent in clinic, it can be either isolated or associated with tibia fracture, fibular fracture and ankle injury and so on. Chronic symptomatic PTFJ instability are easily mixed with meniscal tears. It was easily neglected because of the mild clinical presentation and atypical change on radiography. Early diagnosis and treatment are crucial to prevent chronic knee pain and instability. The paper concluded the anatomy, classification, complication, diagnosis, treatment, clinical effect and insufficient of the dislocation of PTFJ, to direct the diagnosis and treatment of proximal tibiofibular joint dislocation in clinical work...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29437070/outcomes-after-extensive-manual-curettage-and-limited-burring-for-atypical-cartilaginous-tumour-of-long-bone
#2
W Kim, J S Lee, H W Chung
AIMS: Adjuvant treatment after intralesional curettage for atypical cartilaginous tumours (ACTs) of long bones is widely accepted for extending surgical margins. However, evaluating the isolated effect of adjuvant treatment is difficult, and it is unclear whether not using such adjuvants provides poor oncological outcomes. Hence, we analyzed whether intralesional curettage without cryosurgery or chemical adjuvants provides poor oncological outcomes in patients with an ACT. PATIENTS AND METHODS: A total of 24 patients (nine men, 15 women) (mean age 45 years; 18 to 62) were treated for ACTs of long bones and followed up for a median of 66 months (interquartile range 50 to 84)...
February 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29379075/atypical-changes-in-drg-neuron-excitability-and-complex-pain-phenotype-associated-with-a-nav1-7-mutation-that-massively-hyperpolarizes-activation
#3
Jianying Huang, Malgorzata A Mis, Brian Tanaka, Talia Adi, Mark Estacion, Shujun Liu, Suellen Walker, Sulayman D Dib-Hajj, Stephen G Waxman
Sodium channel Nav1.7 plays a central role in pain-signaling: gain-of-function Nav1.7 mutations usually cause severe pain and loss-of-function mutations produce insensitivity to pain. The Nav1.7 I234T gain-of-function mutation, however, is linked to a dual clinical presentation of episodic pain, together with absence of pain following fractures, and corneal anesthesia. How a Nav1.7 mutation that produces gain-of-function at the channel level causes clinical loss-of-function has remained enigmatic. We show by current-clamp that expression of I234T in dorsal root ganglion (DRG) neurons produces a range of membrane depolarizations including a massive shift to >-40 mV that reduces excitability in a small number of neurons...
January 29, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29354170/subtrochanteric-femoral-stress-fracture-with-features-of-atypical-femoral-fracture-in-patient-with-paget-s-disease-a-case-report
#4
Young-Kyun Lee, Hong Seok Kim, Hwan Seong Cho, Kyung-Hoi Koo
Atypical femoral fracture (AFF) has been widely issued since the American Society for Bone and Mineral Research (ASBMR) taskforce stated a possible association with long-term use of bisphosphonate in 2010. ASBMR taskforce recommended to include Paget's disease as one of variables to investigate the AFF in 2010. On the other hand, the ASBMR taskforce in 2014 excluded Paget's disease in the definition of AFF. Still, any rationale has been barely documented about this change. We described the rationale by reporting an 85-year-old man who had a subtrochanteric fracture with features of atypical femoral fracture which turned out to be Paget's disease of bone in the pathology...
September 2017: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/29354166/adult-onset-hypophosphatasia-diagnosed-following-bilateral-atypical-femoral-fractures-in-a-55-year-old-woman
#5
John E Lawrence, Danish Saeed, Jonathan Bartlett, Andrew D Carrothers
We report the case of a 55-year-old woman who presented to the emergency department having woken from sleep with right sided thigh swelling. Pelvic radiographs revealed bilateral atypical subtrochanteric femoral fractures (ASFFs). In the two years leading up to this admission, the patient had experienced gradually increasing pain and weakness in her legs which had resulted in a decrease in her mobility from fully mobile to bed-bound. During this time a neurologist had organised a magnetic-resonance imaging (MRI) scan of the brain and spine which was normal...
September 2017: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/29354161/atypical-femur-fractures-a-distinctive-tract-of-adult-hypophosphatasia
#6
REVIEW
Francesca Marini, Maria Luisa Brandi
Hypophosphatasia (HPP) is a congenital, rare and heterogeneous bone disorder, characterized by a deficit of calcified tissue mineralization, leading to skeletal deformities and osteomalacia in adults, rickets in infants and children, and fragility fractures and premature loss of dentition in children and adults. The disease is caused by a reduced or absent expression and activity of the tissue non-specific alkaline phosphatase (TNSALP) enzyme, derived from inactivating mutations of the alkaline phosphatase (ALPL) gene...
September 2017: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/29349947/incidence-rate-of-atypical-femoral-fracture-after-bisphosphonates-treatment-in-korea
#7
Young Kyun Lee, Soyeon Ahn, Kyoung Min Kim, Chang Suk Suh, Kyung Hoi Koo
BACKGROUND: Atypical femoral fracture (AFF) has been high-lightened, because it was associated with the long-term use of bisphosphonate. Comparing western countries, the incidence rate of AFF was unclear in East Asian patients. Our purposes were to estimate the incidence rate of radiologically defined AFF in Korea, and to determine the association between occurrence of AFF and long-term use of bisphosphonate. METHODS: We conducted a hospital-based, retrospective cohort study in patients aged ≥ 45 years, who took bisphosphonate...
January 29, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29339529/management-of-endocrine-disease-atypical-femoral-fractures-risks-and-benefits-of-long-term-treatment-of-osteoporosis-with-anti-resorptive-therapy
#8
REVIEW
Robert A Adler
Modern osteoporosis treatment began in the mid-1990s with the approval of amino-bisphosphonates, anti-resorptive agents that have been shown to decrease osteoporotic fracture risk by about half. In 2005, the first cases of atypical femoral fractures (AFF), occurring in the shaft of the femur, were reported. Since then, more cases have been found, leading to great concern among patients and a dramatic decrease in bisphosphonate prescribing. The pathogenesis and incidence of AFF are reviewed herein. Management and an approach to prevention or early detection of AFF are also provided...
March 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29338853/atypical-fractures-an-issue-of-concern-or-a-myth
#9
Mohammad Al-Ashqar, Michalis Panteli, Gautam Chakrabarty, Peter V Giannoudis
Atypical Femoral Fractures (AFF) represent fractures located between the lesser trochanter and the supracondylar flare of a femur. An increasing pool of evidence supports their association with the prolonged use of bisphosphonates, even though a direct correlation is yet to be proved. The purpose of this review is to encapsulate the current evidence associating bisphosphonate use and the development of AFFs, the clinical features related to their presentation, as well as to report the armamentarium of strategies available in the prevention and treatment of AFFs...
December 16, 2017: Injury
https://www.readbyqxmd.com/read/29337454/-osteoporosis
#10
Brigitte Uebelhart, Serge Ferrari
The risk for a second fracture within two years after a first one is high. Ten years denosumab treatment show favorable results with a risk of early vertebral fractures in patients with prevalent vertebral fractures when treatment is stopped. Teriparatide is more effective than risedronate to prevent vertebral and clinical fractures in high risk patients. Romosozumab acts as an anabolic agent in osteoporosis. Atypical femoral fractures associated with bisphosphonate treatment could be more frequent in patients with particular anatomical features...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29323712/paradoxical-side-effects-of-bisphosphonates-on-the-skeleton-what-do-we-know-and-what-can-we-do
#11
REVIEW
Jorge William Vargas-Franco, Beatriz Castaneda, Françoise Rédiní, David Francisco Gómez, Dominique Heymann, Frédéric Lézot
Bisphosphonates are considered the most effective drugs for controlling adult and pediatric osteolytic diseases. Although they have been used successfully for many years, several side effects, such as osteonecrosis of the jaw, delayed dental eruption, atypical femoral fracture and alterations to the bone growth system, have been described. After an overview of nitrogenous bisphosphonate, the purpose of this article is to describe their mechanisms of action and current applications, review the preclinical and clinical evidence of their side effects in the skeleton ("what we know"), and describe current recommendations for preventing and managing these effects ("what we can do")...
January 11, 2018: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/29299492/economic-analysis-of-bisphosphonate-use-after-distal-radius-fracture-for-prevention-of-hip-fracture
#12
Suneel B Bhat, Asif M Ilyas
Background: Osteoporosis is a common condition among the elderly population, and is associated with an increased risk of fracture. One of the most common fragility fractures involve the distal radius, and are associated with risk of subsequent fragility fracture. Early treatment with bisphosphonates has been suggested to decrease the population hip fracture burden. However, there have been no prior economic evaluations of the routine treatment of distal radius fracture patients with bisphosphonates, or the implications on hip fracture rate reduction...
November 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29289389/tubb3-e410k-syndrome-with-osteoporosis-and-cough-syncope-in-a-patient-previously-diagnosed-with-atypical-moebius-syndrome
#13
Yasuko Nakamura, Hiroshi Matsumoto, Kiyotaka Zaha, Kenji Uematsu, Shigeaki Nonoyama
BACKGROUND: A heterozygous c.1228G > A p.E410K mutation in TUBB3 encoding neuronal-specific β-tubulin isotype 3 causes TUBB3 E410K syndrome, which exhibits a wide range of neurological and endocrinological abnormalities. CASE DESCRIPTION: The patient is a 31-year-old Japanese woman who was diagnosed with atypical Moebius syndrome because of congenital facial weakness and extraocular ophthalmoplegia sparing abduction. She suffered a femoral neck fracture at 23 years of age, and radiological and endocrinological studies revealed osteoporosis because of hypogonadotropic hypogonadism...
December 27, 2017: Brain & Development
https://www.readbyqxmd.com/read/29273918/a-review-of-atypical-subtrochanteric-femoral-fractures-in-northern-ireland-between-2010-and-2014
#14
K J Donnelly, A Tucker, B Kerr, S McDonald, D S O'Longain, J D Acton
The term atypical femoral fractures most commonly occur in the subtrochanteric area. Concerns exist regarding the role of bisphosphonate treatment in their aetiology. Which surgical intervention provides the best outcome remains contentious. We reviewed all atypical subtrochanteric femoral fractures treated in Northern Ireland over 5 years, specifically investigating incidence, prodromal symptoms, association with bisphosphonates and optimal fixation methods. All subtrochanteric fractures treated in the region were identified and reviewed for atypical features...
December 22, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29250504/acetabular-insufficiency-fracture-following-prolonged-alendronate-use-and-the-failure-of-total-hip-arthroplasty-in-frozen-bone-two-cases-report
#15
Sang-Joon Kwak, Yoon-Je Cho, Gwang-Young Jung, Joo-Hyun Lee, Young-Soo Chun, Kee-Hyung Rhyu
Atypical insufficiency fracture of the femur following prolonged bisphosphonate use is well described. Regardless of the cause, insufficiency fracture of the acetabulum is extremely rare, and no reports have described insufficiency fractures of the acetabulum that are associated with prolonged bisphosphonate use. This report demonstrates the possibility of insufficiency fracture at the acetabulum following long-term alendronate use and the necessity of particular care in managing insufficiency fractures in "frozen" bone...
December 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/29246529/teriparatide-treatment-in-an-adult-patient-with-hypophosphatasia-exposed-to-bisphosphonate-and-revealed-by-bilateral-atypical-fractures
#16
Morgane Righetti, Jean Wach, Romain Desmarchelier, Fabienne Coury
Atypical femoral fractures are defined as atraumatic fractures located in the subtrochanteric region or femoral shaft. They have been mainly reported in patients taking bisphosphonates. We report the case of a 67-year-old female with osteoporosis treated by alendronate during ten years. Radiographies showed atypical femoral fractures. Serum levels of total and bone-specific alkaline phosphatase were low. In order to accelerate bone healing, teriparatide was introduced. After one year of teriparatide treatment, pain and functional difficulty have decreased, and alkaline phosphatase levels were normalized...
December 12, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/29242786/radius-and-ulna-stress-fractures-in-a-patient-with-neuromyelitis-optica-a-case-report
#17
George J M Hourston, Hadyn K N Kankam, Phillip Johnston
Introduction: Stress fractures are more common in the weight-bearing bones of the lower limb and are particularly prevalent in athletes. Whereas, those of the upper limb are usually reported as unique events in rare circumstances. Case Report: We present a case of a 40-year-old White British female with neuromyelitis optica (NMO) who mobilized in a wheelchair and presented to our center in April 2016 with a week-long history of a hot, swollen, and unstable right forearm...
September 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29237448/surgical-outcome-of-atypical-subtrochanteric-and-femoral-fracture-related-to-bisphosphonates-use-in-osteoporotic-patients-with-or-without-teriparatide-treatment
#18
Wen-Ling Yeh, Chun-Yi Su, Chia-Wei Chang, Chien-Hao Chen, Tsai-Sheng Fu, Lih-Huei Chen, Tung-Yi Lin
BACKGROUND: Atypical subtrochanteric fracture and femoral fracture have been considered to be rare complications related to long-term bisphosphonates use. A reduced bone turnover rate may lead to delayed bone healing. Limited data have revealed that teriparatide treatment may reverse the effect of bisphosphonates and be effective in bone healing. METHODS: We reviewed patients with atypical subtrochanteric and femoral fracture related to bisphosphonates use between January 2008 and December 2014...
December 13, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29230287/kyphoplasty-for-the-treatment-of-an-atypical-osteoporotic-vertebral-compression-fracture-of-the-lumbar-spine-a-case-report
#19
Sanjeev Kumar, Leon Anijar, Rishi Agarwal
Vertebral augmentation is a minimally invasive but sometimes technically challenging intervention typically reserved for the treatment of older patients with painful vertebral compression fractures due to osteoporosis or neoplasms. We report the successful treatment of osteoporotic vertebral compression fractures of the first lumbar vertebral body (L1) using kyphoplasty in a paraplegic young patient with multiple comorbidities. Despite the unusual and complicated clinical scenario, kyphoplasty was nonetheless performed with immediate and lasting pain relief...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29229501/proceedings-of-the-2017-santa-fe-bone-symposium-insights-and-emerging-concepts-in-the-management-of-osteoporosis
#20
REVIEW
E Michael Lewiecki, John P Bilezikian, John J Carey, Richard M Dell, Catherine M Gordon, Steven T Harris, Michael R McClung, Paul D Miller, Michael Rosenblatt
The 18th Annual Santa Fe Bone Symposium was held on August 4-5, 2017, in Santa Fe, New Mexico, USA. The symposium convenes health-care providers and clinical researchers to present and discuss clinical applications of recent advances in research of skeletal diseases. The program includes lectures, oral presentations by endocrinology fellows, case-based panel discussions, and breakout sessions on topics of interest, with emphasis on participation and interaction of all participants. Topics included the evaluation and treatment of adult survivors with pediatric bone diseases, risk assessment and management of atypical femur fractures, nonpharmacologic strategies in the care of osteoporosis, and skeletal effects of parathyroid hormone with opportunities for therapeutic intervention...
November 20, 2017: Journal of Clinical Densitometry
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