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Atypical fracture

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https://www.readbyqxmd.com/read/27900455/bilateral-atypical-femur-fractures-without-bisphosphonate-exposure
#1
Lauren K Szolomayer, Izuchukwu K Ibe, Dieter M Lindskog
Atypical femur fractures have common radiographic features that set them apart from more typical higher-energy subtrochanteric femur fractures. They are noncomminuted, transverse fractures with medial spiking of the femoral cortex and increased lateral cortical thickness. These fractures have been associated in the literature with the use of bisphosphonate medications. This case describes bilateral atypical femur fractures in a patient with a medical history devoid of bisphosphonate use. We present his history, co-morbidities, and subsequent treatment...
November 30, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27898628/fracture-and-nonaccidental-injury-a-case-report-of-a-lateral-condylar-fracture-in-a-13-month-old
#2
Helen Levin, Gurinder Sangha, Timothy P Carey, Rodrick Lim
Pediatric nonaccidental injury (NAI) is an important entity that is commonly seen in a variety of medical settings. These children often present to the emergency department or primary care physicians as the first point of contact after an NAI. There is a major risk associated with nonrecognition of an NAI, including a 35% chance of subsequent injury and a 5% to 10% risk of mortality. Therefore, it is essential for physicians to be vigilant when assessing injuries compatible with NAI, especially in infants and young children who are not able to independently express themselves...
December 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27866217/osteonecrosis-of-the-jaw-onj-and-atypical-femoral-fracture-aff-in-an-osteoporotic-patient-chronically-treated-with-bisphosphonates
#3
A Sánchez, R Blanco
The aim of the study is to report the rare association of two complications of long-term treatment of osteoporosis with bisphosphonates in the same Caucasian elderly patient. A female patient of Italian descent, age 87 years, consulted in February 2013. She had a history of osteoporosis and had taken alendronate weekly for 7 years (1999-2006). Due to low back pain, an orthopedist had indicated i.v. zoledronic acid, 5 mg/year for 3 years (2006-2008). She received occasional supplements of ergocalciferol...
November 20, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27862983/denosumab-prevention-and-management-of-hypocalcemia-osteonecrosis-of-the-jaw-and-atypical-fractures
#4
REVIEW
Kenneth Pittman, Yoland C Antill, Amanda Goldrick, Jeffrey Goh, Richard H de Boer
Denosumab, a bone-modifying agent, reduces the risk of skeletal-related events in patients with bone metastases from solid tumors and is generally well tolerated. However, hypocalcemia, osteonecrosis of the jaw (ONJ) and atypical fracture are potential and important toxicities of denosumab therapy that require attention. In pivotal phase III trials in patients with bone metastases from solid tumors, the incidence of hypocalcemia was 9.6% in denosumab-treated patients, with most events being asymptomatic, grade 2 and resolving by week 4...
November 10, 2016: Asia-Pacific Journal of Clinical Oncology
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
#5
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/27825568/osteoarticular-manifestations-of-celiac-disease-and-non-celiac-gluten-hypersensitivity
#6
Stéphanie Dos Santos, Frédéric Lioté
Celiac disease is a chronic inflammatory autoimmune enteropathy based disorder that is triggered by the ingestion of gluten in genetically susceptible individuals. The global prevalence of 1% to 2% represents only the tip of the iceberg. The diagnosis is confirmed by positive specific antibody, anti-transglutaminase or anti-endomysium, specific lesions of the small intestine and a response to strict gluten-free diet. The diagnosis is difficult and often delayed because the clinical variability is very large, ranging from digestive clinical presentation "classic" to "atypical" symptoms, often extra-intestinal, that are sometimes attributed to a concomitant disease or a complication...
November 4, 2016: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/27824547/atypical-femur-fractures-in-patients-treated-with-bisphosphonates-identification-management-and-prevention
#7
REVIEW
Judith Sarah Bubbear
Osteoporosis is a common condition with significant health care costs. First-line therapy is with bisphosphonates, which have proven anti-fracture efficacy. Around 10 years after the introduction of bisphosphonates reports began to be published of atypical femoral fractures (AFFs) that may be associated with this therapy. These fractures are associated with significant morbidity although lower mortality than the more common osteoporotic neck-of-femur fractures. A case definition has been described to allow identification of this class of fracture...
October 31, 2016: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/27818818/total-hip-arthroplasty-for-implant-rupture-after-surgery-for-atypical-subtrochanteric-femoral-fracture
#8
Yu Ozaki, Tomonori Baba, Hironori Ochi, Yasuhiro Homma, Taiji Watari, Mikio Matsumoto, Kazuo Kaneko
Treatment methods for delayed union and nonunion of atypical femoral fracture are still controversial. Moreover, no treatment method has been established for implant rupture caused by delayed union and nonunion. We encountered a 74-year-old female in whom nonunion-induced implant rupture occurred after treatment of atypical subtrochanteric femoral fracture with internal fixation using a long femoral nail. It was unlikely that sufficient fixation could be obtained by repeating osteosynthesis alone. Moreover, the patient was elderly and early weight-bearing activity was essential for early recovery of ADL...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27812994/a-review-of-adverse-outcomes-associated-with-psychoactive-drug-use-in-nursing-home-residents-with-dementia
#9
REVIEW
Maryse Lapeyre-Mestre
Treatment guidelines generally recommend careful assessment and non-pharmacological treatment approaches for behavioural and psychological symptoms of dementia. However, the inappropriate use of psychoactive drugs in patients with dementia in nursing homes is still prevalent. The aim of this narrative review is to summarise and criticize the most recent data investigating the adverse outcomes related to psychoactive drug use, specifically antipsychotics, antidepressants and benzodiazepines, in patients with dementia living in nursing homes...
November 4, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27812727/-atypical-subtrochanteric-femur-fracture-under-alendronate-therapy-in-spite-of-an-intramedullar-implant
#10
H-P Sobotta, T Gösling
There are a number of case reports about women undergoing long-term bisphosphonate therapy who have suffered an atypical subtrochanteric or femoral shaft fracture due to an inadequate trauma.The present case reports on a patient who underwent a subtrochanteric femur fracture with the inserted AO femur interlocking nail.
November 3, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27810549/technical-modifications-for-intraoral-quadrangular-le-fort-ii-osteotomy
#11
Clemens Klug, Julia Cede
PURPOSE: The intraoral quadrangular Le Fort II osteotomy (IQLFIIO) represents a reliable surgical method in cases of midfacial deficiency with good functional, esthetic, and stable long-term results. PATIENTS AND METHODS: In this technical note, we present 3 surgical modifications to previous reports: 1) inferior orbital rim osteotomy by angulated piezosurgical instruments, thereby avoiding the use of chisels in the orbital region; 2) osteosynthetic fixation only laterally at the zygomatic buttress with 2 L-shaped miniplates, thus avoiding paranasal osteosynthesis; and 3) advancement step camouflage in the lateral infraorbital region with a compound mass of autologous bone chips and fibrin glue with the intention to reduce bone block-associated side effects...
October 6, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27802096/novel-scoring-system-for-identifying-impending-complete-fractures-in-incomplete-atypical-femoral-fractures
#12
Byung-Woo Min, Kyung-Hoi Koo, Youn-Soo Park, Chang-Wug Oh, Seung-Jae Lim, Joon-Woo Kim, Kyung-Jae Lee, Young-Kyun Lee
CONTEXT: Although impending incomplete atypical femoral fractures (AFFs) require prophylactic fixation, there is still a lack of study on predicting complete fracture among the incomplete AFFs. OBJECTIVE: Our purposes are (1) to develop a scoring system to predict progression into complete fracture and (2) to evaluate its reliability and validity. DESIGN, SETTING, AND PATIENTS: We reviewed 46 incomplete AFFs in 44 patients, who did not undergo prophylactic fixation...
November 1, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27789416/compound-heterozygous-variants-in-nbas-as-a-cause-of-atypical-osteogenesis-imperfecta
#13
M Balasubramanian, J Hurst, S Brown, N J Bishop, P Arundel, C DeVile, R C Pollitt, L Crooks, D Longman, J F Caceres, F Shackley, S Connolly, J H Payne, A C Offiah, D Hughes, M J Parker, W Hide, T M Skerry
BACKGROUND: Osteogenesis imperfecta (OI), the commonest inherited bone fragility disorder, affects 1 in 15,000 live births resulting in frequent fractures and reduced mobility, with significant impact on quality of life. Early diagnosis is important, as therapeutic advances can lead to improved clinical outcome and patient benefit. REPORT: Whole exome sequencing in patients with OI identified, in two patients with a multi-system phenotype, compound heterozygous variants in NBAS (neuroblastoma amplified sequence)...
January 2017: Bone
https://www.readbyqxmd.com/read/27777917/adjuvant-teriparatide-therapy-for-surgical-treatment-of-femoral-fractures-does-it-work
#14
Jung Taek Kim, Hyung Jun Jeong, Soong Joon Lee, Hee Joong Kim, Jeong Joon Yoo
PURPOSE: Atypical femoral fracture (AFF), periprosthetic femoral fracture (PPFF) and femoral nonunion (FNU) are recalcitrant challenges for orthopedic surgeons. Teriparatide (TPTD) had been demonstrated to have anabolic effects on bone in various studies. We postulated that adjuvant TPTD after operation would enhance biologic stimulation for bone formation. We investigated (1) whether the adjuvant TPTD could achieve satisfactory union rate of surgically challenging cases such as displaced AFF, PPFF and FNU; (2) whether the adjuvant TPTD could promote development of abundant callus after surgical fixation; (3) whether the adjuvant TPTD had medically serious adverse effects...
September 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/27774356/ewing-sarcoma-of-the-pelvis-with-an-atypical-radiographic-appearance-a-mimicker-of-non-malignant-etiologies
#15
Miguel Flores, Anthony Caram, Edward Derrick, John D Reith, Laura Bancroft, Kurt Scherer
Ewing sarcoma (ES) is a primary malignant bone tumor which most commonly arises in children and young adults. The common clinical presentation with ES includes nighttime pain or pain related to activity, though patients may also present with a combination of localized swelling, a palpable mass, pathologic fracture, and constitutional symptoms. Clinical diagnosis may be delayed when a patient presents with clinical or imaging findings that overlap with non-malignant etiologies, such as fibrous dysplasia (FD) or osteomyelitis...
September 18, 2016: Curēus
https://www.readbyqxmd.com/read/27773495/atypical-vertebral-column-fracture-at-the-middle-of-fused-area-after-instrumented-posterior-decompression-and-fusion-surgery-for-beak-type-thoracic-ossification-of-the-posterior-longitudinal-ligament
#16
Shiro Imagama, Kei Ando, Kazuyoshi Kobayashi, Tetsuro Hida, Kenyu Ito, Mikito Tsushima, Yoshimoto Ishikawa, Akiyuki Matsumoto, Yoshihiro Nishida, Naoki Ishiguro
No abstract text is available yet for this article.
October 20, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27766369/sensitivity-and-specificity-of-radiographic-characteristics-in-atypical-femoral-fractures
#17
A L Adams, F Xue, J Q Chantra, R M Dell, S M Ott, S Silverman, J C Giaconi, C Critchlow
: Using the American Society for Bone and Mineral Research Task Force case definition for atypical femoral fractures, sensitivity and specificity of radiographic fracture characteristics were calculated. Fracture pattern was the most sensitive and specific characteristic. This suggests that some characteristics should be weighted more heavily when identifying these fractures. INTRODUCTION: To estimate the sensitivity and specificity of each radiographic criterion in the 2013 ASBMR atypical femoral fracture (AFF) case definition for distinguishing AFF from other subtrochanteric/diaphyseal fractures (non-AFF) among women enrolled in a large integrated health care organization...
October 21, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27731487/sequential-administration-of-alendronate-and-strontium-ranelate-histomorphometry-and-bone-biomechanics-in-ovariectomized-animals
#18
Diego H Díaz, Julieta A Rodas, Clarisa E Bozzini, Patricia M Mandalunis, Natalia D Escudero
Bisphosphonates are the first choice therapy for the pharmaco logical treatment of osteoporosis. Following reports of cases of bisphosphonaterelated osteonecrosis of the jaw and atypical femur fracture, the safety of longterm use of bisphosphonates has been evaluated, resulting in the proposal of strontium as an alternative drug. No experimental study using a sequential administration design has been reported to date. Hence, the aim of this study was to evaluate the effect on bone tissue of ovariectomized rats of administration of alendronate followed by strontium ranelate...
September 2016: Acta Odontológica Latinoamericana: AOL
https://www.readbyqxmd.com/read/27720510/anterolateral-femoral-bowing-and-loss-of-thigh-muscle-are-associated-with-occurrence-of-atypical-femoral-fracture-effect-of-failed-tension-band-mechanism-in-mid-thigh
#19
W C Shin, N H Moon, J H Jang, K Y Park, K T Suh
BACKGROUND: The purpose of this study was to characterize anterolateral bowing of the femur using X-rays and muscular atrophy in the mid-thigh using computed tomography (CT) in patients with atypical femoral fractures (AFFs). We then compared the results with those of an intertrochanteric fracture to understand whether these measures act as causative factors of AFFs. METHODS: From January 2009 to December 2015, 37 patients with complete AFF and 12 patients with incomplete AFF were enrolled in this study...
October 6, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27708978/teriparatide-for-the-rapid-resolution-of-delayed-healing-of-atypical-fractures-associated-with-long-term-bisphosphonate-use
#20
Silvina R Mastaglia, Gabriel Aguilar, Beatriz Oliveri
Bisphosphonates (BPs) are the most widely used drugs to treat osteoporosis. However, recent reports associated to long-term BPs use with atypical low-impact fractures and prodromal pain. It is estimated that 26% of the cases of atypical fractures associated with the long-term use of BPs show delayed healing or nonunion. Teriparatide [PTH1-34] (TPTD) is an anabolic drug shown to be effective in stimulating bone formation. The aim was to describe the course of a right diaphyseal femoral fracture sustained by a patient on long-term BPs treatment...
June 2016: Eur J Rheumatol
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