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Atypical fracture

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https://www.readbyqxmd.com/read/29923980/thoracolumbar-traumatic-nucleus-pulposus-sequestration-combined-with-a-slight-flexion-distraction-fracture-a-rare-case-report-and-literature-review
#1
Ruofeng Yin, Pengyu Chang, Qingsan Zhu, Fei Cheng, Baolin Zhao, Rui Gu, Bo-Yin Zhang
RATIONALE: Traumatic nucleus pulposus sequestration (TNPS) usually occurs concurrently with severe destruction of bone. TNPS combined with a slight thoracolumbar flexion- distraction fracture, triggering a disastrous nerve injury, has rarely been reported. Due to the atypical radiologic manifestations, such a patient can easily be overlooked. PATIENT CONCERNS: Hereby, we present a TNPS patient as well as a slight thoracolumbar flexion-distraction fracture and serious neurologic symptoms...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29916982/late-complication-associated-with-the-treatment-of-orbital-floor-fracture-with-titanium-mesh
#2
Pedro Jorge Cavalcante Costa, Johnny Holanda de Gauw, José Zenou Costa Filho, Raphael Teixeira Moreira, Paulo Domingos Ribeiro Júnior
Treatment of orbital fractures involves restoration of lost bone anatomy and orbital volume. Among the materials used for this purpose, the titanium mesh is widely used due to its effectiveness and low complication rate related to distortion especially in non-traumatic events. This study shows an atypical and late complication involving the deformation of the titanium mesh used during reconstruction of the orbital floor in a patient with orbital zygomatic complex fracture 5 months after the procedure and without traumatic etiology...
June 18, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29889260/pulmonary-infarction-right-upper-quadrant-pain-as-a-presenting-symptom-with-review-of-typical-computed-tomography-imaging-features
#3
Steven T Fosmire, Guy N Gibson, John C Copeland, Marcus S Maydew, Christian Eggers
The purpose of this case presentation is to discuss right upper quadrant pain as an atypical presenting symptom in pulmonary infarction and review the typical computed tomography (CT) imaging features of pulmonary infarction to improve diagnostic accuracy. Pulmonary infarction results from occlusion of distal arterial vasculature within the lung parenchyma leading to ischemia, hemorrhage, and ultimately necrosis. Patients with lung infarction typically present with pleuritic chest pain and may have associated signs or symptoms of pulmonary thromboembolism or deep vein thrombosis...
June 8, 2018: Military Medicine
https://www.readbyqxmd.com/read/29887503/incidence-and-risk-factors-of-knee-injuries-associated-with-ipsilateral-femoral-shaft-fractures-a-multicentre-retrospective-analysis-of-429-femoral-shaft-injuries
#4
Seong-Eun Byun, Hyun-Chul Shon, Jai Hyung Park, Hyoung Keun Oh, Young-Ho Cho, Ji Wan Kim, Jae-Ang Sim
A femoral shaft fracture is usually a high-energy injury and, thus, is likely to be accompanied by an injury of adjacent joints such as a knee ligament injury. However, these associated injuries are often neglected because of severe pain and deformity. The purpose of the current study is to evaluate the incidence, type and risk factors of ipsilateral knee injuries associated with femoral shaft fractures. A total of 429 femoral shaft fractures were included in this study from January 2010 to September 2015. There were 320 males and 109 females, with mean age of 40...
June 4, 2018: Injury
https://www.readbyqxmd.com/read/29880624/unexpected-early-complication-of-implantable-cardioverter-defibrillator
#5
Ahmed Abdelhafez, Nancy Wassef, Kai Hogrefe, Mohsin Farooq
A 41-year-old woman was visiting Oxford, where she had a sudden cardiac arrest. Cardiopulmonary resuscitation was started by a bystander until the paramedics arrived, who found her in ventricular fibrillation, and delivered three shocks. After 28 min she had return of spontaneous circulation. Emergency coronary angiography revealed normal coronary arteries. Echocardiography followed by a cardiac MRI showed non-dilated left ventricles with no evidence of late gadolinium enhancement. She had a single-chamber implantable-cardioverter defibrillator (ICD)...
June 6, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29862085/comparison-of-atypical-and-osteoporotic-femoral-shaft-fractures-in-the-elderly-a-multicenter-study
#6
Takanori Miura, Hiroaki Kijima, Noriyuki Ishikawa, Toshihito Ebina, Takayuki Tani, Shuichi Chida, Tetsuya Suzuki, Satoshi Yumto, Hiroshi Tazawa, Naohisa Miyakoshi, Yoichi Shimada
Background: In atypical femoral fractures, owing to the high rates of complications and delayed healing that accompany the plate fixation, the most favorable treatment is intramedullary nailing. Although there is insufficient evidence, plate fixation is chosen due to anterolateral bowing of the femur. This study compared the bone healing time and rates of complications in atypical femoral shaft fractures and osteoporotic femoral shaft fractures. Methods: We searched the medical records of 3 institutions in Japan for patients with femoral shaft fractures who visited between 1 January 2010 and 31 December 2015...
2018: Advances in Orthopedics
https://www.readbyqxmd.com/read/29805339/low-positive-predictive-value-of-bone-scan-to-predict-impending-complete-fracture-among-incomplete-atypical-femoral-fracture
#7
Young-Kyun Lee, You Jin Lee, Na Kyoung Lee, Jae-Hwi Nho, Kyung-Hoi Koo
Background: Although bone scan might be useful to detect incomplete atypical femoral fractures (AFFs) earlier than radiographs, there is no study on predicting further progression to a complete fracture among incomplete AFFs. Our purposes are to determine whether bone scan detects impending complete fracture among incomplete AFFs. Methods: We reviewed 18 patients (20 AFFs) who underwent bone scan at the diagnosis of incomplete AFF and were not treated with prophylactic fixation...
May 28, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29801171/interaction-of-microcracks-and-tissue-compositional-heterogeneity-in-determining-fracture-resistance-of-human-cortical-bone
#8
Ahmet Demirtas, Ani Ural
Recent studies demonstrated an association between atypical femoral fracture (AFF) and long-term bisphosphonate (BP) use for osteoporosis treatment. Due to BP treatment, bone undergoes alterations including increased microcrack density and reduced tissue compositional heterogeneity. However, the effect of these changes on the fracture response of bone is not well understood. As a result, the goal of the current study is to evaluate the individual and combined effects of microcracks and tissue compositional heterogeneity on fracture resistance of cortical bone using finite element modeling (FEM) of compact tension (CT) specimen tests with varying microcrack density, location, and clustering, and material heterogeneity in three different bone samples...
September 1, 2018: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29785160/observational-study-of-the-bisphosphonate-related-osteonecrosis-of-jaws
#9
Andreea Elena Lungu, Madalina Anca Lazar, Andrada Tonea, Horatiu Rotaru, Rares Calin Roman, Mindra Eugenia Badea
Introduction: The bisphosphonate-related osteonecrosis of the jaw was first referred to in 2003. Bisphosphonates action is focused on the osteoclasts. The drastic inhibition of the osteoclastic function is harmful for the jaws which are the only bones of the human skeleton in relative contact with the external environment. The adverse effects of the bisphosphonate-related therapy include the pathology for which they are prescribed, the atypical fractures in pathological bone. Method: The aim of this research was to analyze the risk factors and the treatment methods in case of osteonecrosis of the jaws...
2018: Clujul Medical (1957)
https://www.readbyqxmd.com/read/29785116/myopathy-due-to-hmgcr-antibodies-in-adult-mimicking-muscular-dystrophy-associated-with-cancer-and-statin-exposure-narrative-review-of-the-literature-case-report
#10
Alzira Alves de Siqueira Carvalho, Vinicius Gomes da Silva, Edmar Zanoteli, David Feder
Necrotizing autoimmune myopathy is characterized by predominant muscle fiber necrosis and regeneration with little or no inflammation. We describe a 58-year-old woman with previous breast cancer and statin use who complained of rapidly progressive weakness of lower limbs without pain, making walking, running and climbing stairs difficult. The creatine kinase level was 2,843 U/L, and muscle biopsy showed a dystrophic pattern. The genetic test for muscular dystrophies was negative and for anti-3-hydroxy-3-methylglutaryl coenzyme A reductase was positive...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29774402/subtrochanteric-and-diaphyseal-femoral-fractures-in-hypophosphatasia-not-atypical-at-all
#11
F Genest, L Seefried
Risk for subtrochanteric and diaphyseal femoral fractures is considered increased in patients with hypophosphatasia (HPP). Evaluating a large cohort of HPP patients, we could for the first time quantify the prevalcence and identify both morphometric features as well as predisposing factors for this complication of severe HPP. INTRODUCTION: Subtrochanteric and diaphyseal femoral fractures have been associated with both, long-term antiresorptive treatment and metabolic bone disorders, specifically Hypophosphatasia (HPP)...
May 17, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29771927/computer-assisted-surgery-compared-to-fluoroscopy-in-curettage-of-atypical-cartilaginous-tumors-chondrosarcoma-grade-1-in-the-long-bones
#12
J G Gerbers, E F Dierselhuis, M Stevens, J J W Ploegmakers, S K Bulstra, P C Jutte
INTRODUCTION: Fluoroscopy is currently the standard imaging modality for curettage of atypical cartilaginous tumors/chondrosarcoma grade 1 (ACT/CS1). Computer-assisted surgery (CAS) is a possible alternative, offering higher resolution imaging and continuous three-dimensional feedback without ionizing radiation use. CAS hypothetically makes curettage more accurate, thereby decreasing residue or recurrence rate. This study aims to compare CAS and fluoroscopy in curettage of ACT/CS1. PATIENTS AND METHODS: A single center retrospective cohort study was performed...
2018: PloS One
https://www.readbyqxmd.com/read/29762110/surgical-complications-associated-with-atypical-femur-fractures-attributed-to-bisphosphonate-use
#13
Douglas S Schultz, Henry M Gass, William R Barfield, Harry A Demos, Langdon A Hartsock
Complications of atypical femur fractures (AFFs) are common. AFFs often receive the same treatment as other femoral fractures; however, there appears to be a higher rate of adverse outcomes. Nine patients sustained a total of 13 AFFs, had documented bisphosphonate use before fracture, and had surgery between 2006 and 2012. Complications included continued pain, surgical revision, nonunion, malunion, deformity, or heterotopic ossification. The overall complication rate was 33.3%, with four of the 12 surgeries performed at this institution resulting in one nonunion and three minor complications...
2018: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29755856/the-guiding-role-of-bone-metabolism-test-in-osteoporosis-treatment
#14
REVIEW
Wei Zhang, Guo-Ji Yang, Shi-Xian Wu, Dong-Qing Li, Ying-Bo Xu, Cheng-Hong Ma, Jun-Ling Wang, Wei-Wen Chen
Osteoporosis (OP) and osteoporotic fractures are becoming a serious health care issue in the world. Calcium and vitamin D are the basic treatment for osteoporosis. Nonetheless, they do not effectively reduce the incidences of fracture. Currently approved treatments for osteoporosis include selective estrogen receptor modulators (SERMs), bisphosphonates, denosumab, teriparatide, calcitonin and others. However, the appearance of some adverse effects including atypical fracture and breast cancer has limited long-term treatments above mentioned...
2018: American Journal of Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/29725848/breakdown-of-demarcated-opacities-related-to-molar-incisor-hypomineralization-a-longitudinal-study
#15
Aline Borburema Neves, Gabriela Caldeira Andrade Americano, Daniella Varela Soares, Vera Mendes Soviero
OBJECTIVES: This prospective longitudinal study aimed to evaluate if the occurrence of post-eruptive breakdown of demarcated opacities in hypomineralized teeth is influenced by the color or location of the opacity. MATERIALS AND METHODS: Patients diagnosed with molar-incisor hypomineralization (MIH) between 2012 and 2014 were eligible. Two calibrated examiners performed the initial and follow-up evaluations according to European Academy of Paediatric Dentistry (EAPD) criteria...
May 3, 2018: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29725835/critical-differences-between-subtrochanteric-and-diaphyseal-atypical-femoral-fractures-analyses-of-51-cases-at-a-single-institution-in-korean-population
#16
Yoon-Je Cho, Kyung-Chung Kang, Young-Soo Chun, Kee Hyung Rhyu, Sang-Jun Kim, Tae-Su Jang
There still remains controversy on the pathomechanism of atypical femoral fracture (AFF). The angle of lateral bowing and bone mineral density showed significant differences between subtrochanteric and diaphyseal atypical fracture groups. In addition to the use of bisphosphonate, mechanical factors might play important roles in the occurrence of AFFs. INTRODUCTION: Although AFF could be divided into subtrochanteric and diaphyseal fracture according to the location of fractures, there is a lack of evidence regarding differences between two fractures and etiology of the occurrence...
May 3, 2018: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29713181/minodronate-for-the-treatment-of-osteoporosis
#17
REVIEW
Tsuyoshi Ohishi, Yukihiro Matsuyama
Minodronate is a third-generation bisphosphonate that was developed and approved for clinical use in osteoporosis therapy in Japan. The mechanism of action for suppressing bone resorption is the inhibition of farnesyl pyrophosphate synthase, a key enzyme in the mevalonic acid metabolic pathway of osteoclasts, to induce apoptosis of the cells. Minodronate is the strongest inhibitor of bone resorption among the currently available oral bisphosphonates. Large randomized, placebo-controlled, double-blind clinical trials have revealed an increase in bone mineral density of both the lumbar spine and femoral neck over 3 years of daily minodronate therapy and risk reduction in vertebral fractures over 2 years of therapy...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29691303/therapy-of-endocrine-disease-denosumab-vs-bisphosphonates-for-the-treatment-of-postmenopausal-osteoporosis
#18
REVIEW
Athanasios D Anastasilakis, Stergios A Polyzos, Polyzois Makras
The most widely used medications for the treatment of osteoporosis are currently bisphosphonates (BPs) and denosumab (Dmab). Both are antiresorptives, thus targeting the osteoclast and inhibiting bone resorption. Dmab achieves greater suppression of bone turnover and greater increases of bone mineral density (BMD) at all skeletal sites, both in naïve and pretreated patients. No superiority on fracture risk reduction has been documented so far. In long-term administration, BPs reach a plateau in BMD response after 2-3 years, especially at the hip, while BMD increases progressively for as long as Dmab is administered...
July 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29675745/a-proposal-for-an-atypical-femur-fracture-treatment-and-prevention-clinical-practice-guideline
#19
REVIEW
R Dell, D Greene
The prevention as well as the treatment of atypical femur fractures (AFFs) remains controversial but there have been many clinical recommendations suggested. We have summarized these recommendations as well as expanded upon them in this paper. INTRODUCTION: The purpose of the paper was to develop a clinical practice guideline that both treats AFF and decreases the risk of AFF in patients requiring antiresorptive medications. Examples of these medications include bisphosphonates and denosumab for the treatment of osteoporosis...
April 19, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29674832/atypical-radiographic-presentation-of-a-horizontal-mid-root-fracture-in-a-maxillary-central-incisor-tooth
#20
Amandeep Kaur, Ajay Logani, Manish Chahar
Prognosis of a horizontal mid-root fracture is favorable, primarily because the dental pulp tends to maintain its vitality and the fracture segments are completely intraalveolar. Healing usually occurs with deposition of calcified tissue. However, if the segment coronal to the fracture becomes nonvital and infected, healing occurs by interposition of granulation tissue. This report describes a case of a horizontal mid-root fracture in a right maxillary central incisor tooth, where the apical fractured segment was significantly displaced in a linear direction...
March 2018: Journal of Conservative Dentistry: JCD
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