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injury femur fracture

Ryan Urchek, Eric Miller
The typical injury pattern of a posterior hip dislocation includes posterior wall fracture, capsular injury, and muscular strain. This report presents an example of a posterior wall acetabulum fracture-dislocation associated with complete hip abductor tendon and capsular avulsion from the femur. The patient was found to have an unstable hip despite a small posterior wall fragment due to the extensive soft tissue injury. This was repaired. The patient had improvement in function initially, but ultimately required repair of the hip abductor tendons...
October 13, 2016: Orthopedics
David Lidwell, Colin A Meghoo
Skeletal traction is a useful technique for managing proximal femur fractures in austere environments where fracture stabilization for this injury is difficult. We present a technique and a construct appropriate for field use that facilitates patient evacuation, and we provide guidelines for the use of this technique by an advanced medical provider managing these injuries. The objectives of this article are to enable to reader to (1) recognize the role of skeletal traction in managing proximal femur fractures in an austere environment, (2) identify the key steps in placing transfemoral skeletal traction pins, and (3) identify options and requirements for building a traction construct in resource-limited environments...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Ahmad S Alobaidi, Ammar Al-Hassani, Ayman El-Menyar, Husham Abdelrahman, Mazin Tuma, Hassan Al-Thani, Mohammed A Aldosari
BACKGROUND: Femur fracture (FF) is a common injury, and intramedullary nailing (IMN) is the standard surgical fixation. However, the time of intervention remains controversial. We aimed to describe the reamed IMN (rIMN) timing and hospital outcomes in trauma patients presenting with FF. MATERIALS AND METHODS: A retrospective analysis was conducted for all patients admitted with FF and they underwent fixation at level 1 trauma unit between January 2010 and January 2012...
July 2016: International Journal of Critical Illness and Injury Science
Shabnam Samsami, Sadegh Saberi, Nima Bagheri, Gholamreza Rouhi
BACKGROUND: Vertical femoral neck fractures in the youth could be happened in high-energy accidents, and because of dominant shearing forces, this fracture is considered as a troublesome injury with a controversy regarding selection of the best fixation method. OBJECTIVE: The long term goal of this quasi-experimental study was to find the more stable fixation method among cannulated screws (CSs), proximal femoral locking plate (PFLP), and dynamic hip screw with derotational screw (DHS+DS) for this kind of fracture...
September 28, 2016: Bio-medical Materials and Engineering
S Subramanian, M J Parker
Atypical femoral fractures have been associated with long term use of bisphosphonates. Our study plan was to report the outcome of treatment for a series of -patients with an atypical femoral fracture and to compare the characteristics of those patients with a proximal femoral fracture. 21 atypical fractures were identified over a seven year period and these were compared with those of 2.547 hip fracture patients treated over the same time period at a single centre. The mean age of patients with an atypical fracture was on average nine years less than that for the hip fracture patients (72 as against 81 years, p = 0...
August 2016: Acta Orthopaedica Belgica
M S Reich, A J Dolenc, T A Moore, H A Vallier
BACKGROUND: Previous work established resuscitation parameters that minimize complications with early fracture management. This Early Appropriate Care (EAC) protocol was applied to patients with advanced age to determine if they require unique parameters to mitigate complications. METHODS: Between October 2010 and March 2013, 376 consecutive skeletally mature patients with unstable fractures of the pelvis, acetabulum, thoracolumbar spine, and/or proximal or diaphyseal femur fractures were treated at a level I trauma center and were prospectively studied...
September 26, 2016: Journal of Orthopaedic Surgery and Research
Xiaowu Wu, Michael A Dubick, Martin G Schwacha, Andrew P Cap, Daniel N Darlington
INTRODUCTION: Severe trauma, hemorrhage and resuscitation can lead to a trauma related acute lung injury that involves rapid infiltration of immune cells and platelets. This infiltration involves exymatic degradation of matrix proteins, including plasmin, and causes loss of barrier function. Since tranexamic acid (TXA) inhibits plasminogen/ plasmin binding to target substrates, it may attenuate loss of barrier function after severe trauma, hemorrhage and resuscitation. METHODS: Sprague-Dawley rats were subjected to polytrauma (laparotomy, and trauma to intestines, liver, right leg skeletal muscle and right femur fracture), then bled 40% of their blood volume...
September 19, 2016: Shock
Rebecca Bradford, Alice Munro, Bhavdeep R Jani, Surendra Singham, Kate O'Loughlin, Janette Cansick
: Pseudomonas aeruginosa (P.aeruginosa) and Candida albicans (C.albicans) are opportunistic pathogens that cause systemic infections in immune-suppressed patients. They show important bacterial-fungal interactions including quorum sensing. This involves cell-signaling to communicate between the cells of their own colony as well as the cells of rival microbes or the host. It is thought that this phenomenon is vital in the potential competition and virulence of the organisms. We report a case of a previously healthy 2 year old boy, where an accidental injury had been sustained resulting in a closed fracture of femur...
September 15, 2016: Pediatric Infectious Disease Journal
R Guzmán-Vargas, D F Rincón-Cardozo, J A Camacho-Casas
Subtrochanteric fractures in children are rare events, occur in only 4% of all femur fractures, most injuries occur as a result of high energy trauma, being young males patient the most affected. The management of this type of injury is controversial, there are many forms of treatment, including the use of plaster spica 90-90, closed reduction and use of elastic or rigid intramedullary nails, open reduction and plate placement and external fixators. Most suggest that children under 10 should be preferred non-operative and for older than 12 surgical management is indicated, but the discussion is between 6 and 12 years old...
January 2016: Acta Ortopédica Mexicana
Nabil A Ebraheim, Grant S Buchanan, Xiaochen Liu, Maxwell E Cooper, Nicholas Peters, Jacob A Hessey, Jiayong Liu
OBJECTIVE: To report and evaluate the outcomes of patients undergoing definitive treatment for distal femur nonunion after initial treatment with a locking plate. METHODS: Fourteen patients who had undergone definitive treatment at an academic Level 1 trauma center from May 2007 to December 2013 for distal femur nonunion were identified from a fracture database. Thirteen of them were female; the average age was 65 years (range, 50-84 years). Ten patients had sustained their injuries in falls at ground level, and four in motor vehicle accidents...
August 2016: Orthopaedic Surgery
Robert Zura, Ze Xiong, Thomas Einhorn, J Tracy Watson, Robert F Ostrum, Michael J Prayson, Gregory J Della Rocca, Samir Mehta, Todd McKinley, Zhe Wang, R Grant Steen
Importance: Failure of bone fracture healing occurs in 5% to 10% of all patients. Nonunion risk is associated with the severity of injury and with the surgical treatment technique, yet progression to nonunion is not fully explained by these risk factors. Objective: To test a hypothesis that fracture characteristics and patient-related risk factors assessable by the clinician at patient presentation can indicate the probability of fracture nonunion. Design, Setting, and Participants: An inception cohort study in a large payer database of patients with fracture in the United States was conducted using patient-level health claims for medical and drug expenses compiled for approximately 90...
September 7, 2016: JAMA Surgery
John E Lawrence, Daniel M Fountain, Duncan J Cundall-Curry, Andrew D Carrothers
BACKGROUND: Patients sustaining a fractured neck of the femur are typically of advanced age with multiple comorbidities. As a consequence, the proportion of these patients receiving warfarin therapy is approximately 10%. There are currently few studies investigating outcomes in this subset of patients. QUESTIONS/PURPOSES: The purpose of this study was to assess the association between warfarin therapy and time to surgery, length of hospital stay, and survival in patients sustaining a fractured neck of the femur...
September 1, 2016: Clinical Orthopaedics and related Research
Derek A Jones, James P Gaewsky, Mireille E Kelley, Ashley A Weaver, Anna N Miller, Joel D Stitzel
INTRODUCTION: The objective of this study was to reconstruct 4 real-world motor vehicle crashes (MVCs), 2 with lumbar vertebral fractures and 2 without vertebral fractures in order to elucidate the MVC and/or restraint variables that increase this injury risk. METHODS: A finite element (FE) simplified vehicle model (SVM) was used in conjunction with a previously developed semi-automated tuning method to arrive at 4 SVMs that were tuned to mimic frontal crash responses of a 2006 Chevrolet Cobalt, 2012 Ford Escape, 2007 Hummer H3, and 2002 Chevrolet Cavalier...
September 2016: Traffic Injury Prevention
Sven Schmidt, Ronald Schulz, Heidi Pfeiffer, Andreas Schmeling, Gunther Geserick
A pedestrian was killed in a road traffic accident by collision with a car coming from the right. The victim's right femur was observed to have sustained a wedge-shaped fracture with biconcave side edges (so-called Messerer fracture), with the apex of the wedge pointing in the direction opposite to the direction of travel of the car. The absence of skin or soft tissue injuries in the area of the fracture means that it is reasonable to assume that this 'reverse wedge fracture' is an indirect fracture. The mechanism by which characteristic wedge-shaped fractures are produced through compression along the longitudinal axis of the bone has long been known...
November 2016: International Journal of Legal Medicine
Xiaoxuan Li, Zhe Yun, Xiaoxiang Li, Yucai Wang, Tongtao Yang, Lianhe Zheng, Jixian Qian
OBJECTIVE: Although electric bicycle related injuries have become the most common reason for hospitalization from a road crash in China, no study has comprehensively investigated electric bicycle collisions and their impact on orthopedic injuries; such a study may provide evidence to support a new road safety policy. METHODS: A retrospective review of orthopedic injuries from electric bicycle collisions was performed in an urban trauma center. We collected variables including age, gender, location of fracture, presence of open or closed fractures, concomitant vascular, and neurologic injuries...
August 30, 2016: Traffic Injury Prevention
Josh Vaughn, Heather Gotha, Eric Cohen, Amanda J Fantry, Ross J Feller, Jake Van Meter, Roman Hayda, Christopher T Born
Femoral and tibial shaft fractures are common injuries in the United States. Since their introduction, reamed intramedullary nails have become the treatment of choice for most of these fractures. However, delayed union and nonunion can complicate treatment in up to 10% of patients. Removal of interlocking screws, or dynamization, can promote fracture healing in cases of delayed union or nonunion. The efficacy of nail dynamization has been reported to range from 19% to 82%. This study was conducted to evaluate the efficacy of dynamization, identify the factors associated with its success or failure, and analyze the cost compared with exchange nailing...
August 30, 2016: Orthopedics
M Thaeter, M Knobe, M Vande Kerckhove, F Böhle, J Herold, E Verhaven, H-C Pape
PURPOSE: Interleukin-6 is a mainly proinflammatory interleukin and an indicator for the magnitude of surgery. The IL-6 serum concentration correlates with injury severity, the extent of tissue trauma and has negative impact on prognosis. To date it is unclear whether the immunologic changes assessed are age dependent. The aim of this study is to compare the surgical inflammatory response in different age groups. METHODS: Data were collected at a level-1 university trauma center in a prospective, consecutive cohort study...
October 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Han Kook Yoon, Hyun Cheol Oh, Junyoung Park, Choidog Oyunbat, Taehwan Kim
Recently, we experienced a case where the diagnosis and management of a deep femoral artery rupture was delayed. This vascular complication occurred during the insertion of a distal interlocking screw of a proximal femoral nail for the fixation of an intertrochanteric femur fracture. A 79-year-old male patient was diagnosed with a right intertrochanteric fracture after a fall. We fixed the fracture with a proximal femoral nail (Zimmer® Natural Nail™ System). One day after the procedure, the patient complained of pain and swelling on the anteromedial side of his middle thigh followed by hypotension, anemia and prolonged thigh swelling...
March 2016: Hip Pelvis
Bong-Ju Park, Hong-Man Cho, Woong-Bae Min
PURPOSE: People with dementia have poor mobility and discharge outcomes following hip fractures. The purpose of this study was to evaluate the clinical and radiological results of internal fixation of undisplaced femur neck fractures (Garden types 1 and 2) by proximal femoral nail antirotation (PFNA) in dementia patients. MATERIALS AND METHODS: We studied retrospectively 19 patients with undisplaced femur neck fracture. All patients were over 70 years of age, walked independently with a cane or crutches and suffered moderate-to-severe dementia...
September 2015: Hip Pelvis
Christian D Weber, Rolf Lefering, Thomas Dienstknecht, Philipp Kobbe, Richard M Sellei, Frank Hildebrand, Hans-Christoph Pape
BACKGROUND: A broad range of systemic complications has been described to occur in patients with open major fractures. Various causes have been claimed to play a role. We therefore surveyed a nationwide trauma registry to assess risk factors associated with closed and various types of open femur fractures. METHODS: Cohort study in a nationwide population-based prospective database. Inclusion criteria for selection from database: individuals with femur fracture, age ≥16 years, and survival until primary admission...
August 16, 2016: Journal of Trauma and Acute Care Surgery
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