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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/27882814/the-ao-pediatric-comprehensive-classification-of-long-bone-fractures-pccf-part-iii
#2
Laurent Audigé, Theddy Slongo, Nicolas Lutz, Andrea Blumenthal, Alexander Joeris
Background and purpose - The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF) describes the localization and morphology of fractures, and considers severity in 2 categories: (1) simple, and (2) multifragmentary. We evaluated simple and multifragmentary fractures in a large consecutive cohort of children diagnosed with long bone fractures in Switzerland. Patients and methods - Children and adolescents treated for fractures between 2009 and 2011 at 2 tertiary pediatric surgery hospitals were retrospectively included...
November 24, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27879185/-an-integrated-approach-including-paediatric-and-forensic-medical-expertise-on-suspicion-of-child-abuse
#3
M C M Schouten, W A Karst, H F van der Stel, A H Teeuw, E M van de Putte
A false accusation of child abuse has a major impact on child and family. Conversely, a missed diagnosis of child abuse may have significant and lifelong consequences for the child. For health professionals the assessment of the nature of the injury and differentiating between accidental and inflicted injury, disease manifestation or a physiological phenomenon can be challenging. For adequate determination of the cause of injury, an integrated approach including paediatric knowledge and forensic medical expertise is essential...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27869327/the-selective-serotonin-re-uptake-inhibitor-fluoxetine-directly-inhibits-osteoblast-differentiation-and-mineralization-during-fracture-healing-in-mice
#4
V Bradaschia-Correa, A M Josephson, D Mehta, M Mizrahi, S S Neibart, C Liu, O D Kennedy, A B Castillo, K A Egol, P Leucht
Chronic use of selective serotonin re-uptake inhibitors (SSRI) for the treatment of depression has been linked to osteoporosis. In this study, we investigated the effect of chronic SSRI use on fracture healing in two murine models of bone regeneration. First, we performed a comprehensive analysis of endochondral bone healing in a femur fracture model. C57/BL6 mice treated with fluoxetine, the most commonly prescribed SSRI, developed a normal cartilaginous soft-callus at 14 days after fracture and demonstrated a significantly smaller and biomechanically weaker bony hard-callus at 28 days...
November 21, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/27851666/factors-associated-with-nonaccidental-trauma-evaluation-among-patients-below-36-months-old-presenting-with-femur-fractures-at-a-level-1-pediatric-trauma-center
#5
Allison M Blatz, Catherine W Gillespie, Arielle Katcher, Allison Matthews, Matthew E Oetgen
BACKGROUND: In 2009, the American Academy of Orthopedic Surgeons published clinical practice guidelines (CPGs) on the treatment of pediatric diaphyseal femur fractures, which recommended a nonaccidental trauma (NAT) evaluation for all patients below 36 months of age. A recent study of these guidelines found <50% clinical compliance with this treatment recommendation. We aimed to identify areas for improvement in compliance with this guideline. METHODS: A retrospective review was performed of all patients presenting to a single pediatric tertiary care hospital with a diaphyseal femur fracture from January 2007 to June 2013 who were below 36 months old...
November 15, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27846358/-subtrochanteric-fracture-in-children-treated-with-minimally-invasive-surgery-case-report
#6
R Guzmán-Vargas, D F Rincón-Cardozo, J A Camacho-Casas
Subtrochanteric fractures in children are rare events that occur in only 4% of all femur fractures; most injuries occur as a result of high-energy trauma, being young male patients 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 the use of external fixators. Most suggest that for children under 10 a nonoperative approach should be preferred and that older ones should be managed surgically, but it is between six and 12-year-olds that most of the controversy exists...
March 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/27844134/high-mortality-in-younger-patients-with-major-osteoporotic-fractures
#7
R Ray, N D Clement, S A Aitken, M M McQueen, C M Court-Brown, S H Ralston
: Data were gathered with regard to mortality after fractures in 1006 younger patients. Results revealed that major osteoporotic fractures of the hip and humerus and drinking alcohol to excess were related to an increased risk of mortality. INTRODUCTION: Major osteoporotic fractures are known to be associated with increased mortality in older individuals. It is less clear whether this also applies to younger patients. METHODS: Date were gathered regarding patient demographics, fracture pattern, mechanism of injury, as well as smoking and alcohol intake at the time of injury in consecutive patients aged between 40 and 55 who presented to a UK trauma centre over a 12-month period...
November 14, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27843272/open-intramedullary-nailing-for-segmental-long-bone-fractures-an-effective-alternative-in-a-resource-restricted-environment
#8
Olasunkanmi M Babalola, Gbadebo Hakeem Ibraheem, Bola A Ahmed, Ayokunle Olawepo, Samuel B Agaja, Adebowale Adeniyi
BACKGROUND: Closed, locked intramedullary nailing has been accepted as the gold standard in the care of femoral fractures, with reported union rates as high as 98-100%. Closed, locked intramedullary nailing often requires expensive equipment which is a challenge in developing countries. Segmental long bone fractures are often a result of high-energy trauma and hence often associated with a lot of injuries to the surrounding soft tissues. This consequently results in higher rates of delayed or nonunion...
July 2016: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/27830101/low-energy-traumatic-obturator-hip-dislocation-with-ipsilateral-femoral-shaft-fracture-in-a-patient-with-omolateral-knee-arthroplasty
#9
G Gazzotti, L Patrizio, S Dall'Aglio, E Sabetta
Ipsilateral obturator hip dislocation and femoral shaft fracture are rare. We report such a case in an older woman after a low-energy injury. She had a knee prostheses in the same limb. The patient was treated by open manipulative reduction of the luxation without opening joint and open reduction and internal fixation of the femur with angular stability plate and screws. We could not find a similar case in the literature. An early diagnosis of the dislocation is crucial in order to obtain good results. Great awareness and radiologic examination are fundamental to achieve precocious diagnosis of both these rare combined injuries, as treatment in these cases is considered an emergency...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27810151/markers-of-muscle-damage-for-comparing-soft-tissue-injury-following-proximal-femur-nail-and-dynamic-hip-screw-operations-for-intertrochanteric-hip-fractures
#10
Yonathan Wagman, Ortal Segal, Israel Dudkiewicz, Ely Steinberg
BACKGROUND: Femoral neck fractures are the most common fractures among the elderly. The two operative approaches used for the treatment of AO/OTA 31 intertrochanteric fractures include an intramedullary device (proximal femoral nail [PFN]) or an extramedullary device (sliding/dynamic hip screw [DHS]). The aim of this study was to provide objective evidence of local soft tissue injury by measuring serum creatine phosphokinase (CPK), a biochemical marker, to quantify muscle damage and inflammation in patients treated by the two approaches...
December 2016: Injury
https://www.readbyqxmd.com/read/27779977/anticipated-transfusion-requirements-and-mortality-in-patients-with-orthopedic-and-solid-organ-injuries
#11
Devon S Callahan, Zane Ashman, Dennis Y Kim, David S Plurad
Long bone fractures are cited as an etiology for significant blood loss; however, there is scant supporting literature. We examined the relationship between long bone fractures, blood transfusions, and solid organ injuries. We hypothesize that transfusions are rare with long bone fractures in the absence of a liver or splenic injury. We performed a retrospective analysis of patients admitted with femur, tibia, and humerus fractures. Outcomes included transfusion requirements and mortality. A total of 1837 patients were included...
October 2016: American Surgeon
https://www.readbyqxmd.com/read/27763962/the-role-of-radiographs-and-office-visits-in-the-follow-up-of-healed-intertrochanteric-hip-fractures-an-economic-analysis
#12
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Abby M Howenstein, Erik N Kubiak, Michael Suk, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to evaluate the role and the necessity of radiographs and office visits obtained during follow-up of intertrochanteric hip injuries. DESIGN: Retrospective study. SETTING: Two level I trauma centers. PATIENTS: Four hundred sixty-five elderly patients who were surgically treated for an intertrochanteric fracture of the femur at 2 level I trauma centers between January 2009 and August 2014 were retrospectively identified from orthopaedic trauma databases...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27763958/a-multi-centre-randomized-control-trial-comparing-a-novel-intramedullary-device-intertan-versus-conventional-treatment-sliding-hip-screw-of-geriatric-hip-fractures
#13
David Sanders, Dianne Bryant, Christina Tieszer, Abdel Lawendy, Mark MacLeod, Steven Papp, Liew Allan, Viskontas Darius, Coles Chad, Gurr Kevin, Carey Tim, Gofton Wade, Bailey Chris, Bartley Debra, Andrew Trenholm, Stone Trevor, Leighton Ross, Julia Foxall, Mauri Zomar, Kelly Trask
OBJECTIVES: To compare outcomes in elderly patients with intertrochanteric hip fractures treated with either the sliding hip screw (SHS) or InterTAN intramedullary device (IT). DESIGN: Prospective, randomized, multi-centre clinical trial SETTING:: Five level 1 trauma centresPatients/Participants: 249 patients aged 55 years or older with AO/OTA 31A1 (43) and OA/OTA 31A2 (206) fractures were prospectively enrolled and followed for 12 months. INTERVENTION: Computer generated randomization to either IT (n=123) or SHS (n=126)...
September 30, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27763957/limited-blood-transfusions-are-safe-in-orthopaedic-trauma-patients
#14
Andrea J Dolenc, William Z Morris, John J Como, Karl G Wagner, Heather A Vallier
OBJECTIVES: Controversy exists over association of blood transfusions with complications. The purpose was to assess effects of limited transfusions on complication rates and hospital course. SETTING: Level 1 trauma center. PATIENTS AND METHODS: Three hundred seventy-one consecutive patients with Injury Severity Score ≥16 underwent fixation of fractures of spine (n = 111), pelvis (n = 72), acetabulum (n = 57), and/or femur (n = 179). Those receiving >3 units of packed red blood cell were excluded...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27760408/a-finite-element-model-of-a-six-year-old-child-for-simulating-pedestrian-accidents
#15
Yunzhu Meng, Wansoo Pak, Berkan Guleyupoglu, Bharath Koya, F Scott Gayzik, Costin D Untaroiu
Child pedestrian protection deserves more attention in vehicle safety design since they are the most vulnerable road users who face the highest mortality rate. Pediatric Finite Element (FE) models could be used to simulate and understand the pedestrian injury mechanisms during crashes in order to mitigate them. Thus, the objective of the study was to develop a computationally efficient (simplified) six-year-old (6YO-PS) pedestrian FE model and validate it based on the latest published pediatric data. The 6YO-PS FE model was developed by morphing the existing GHBMC adult pedestrian model...
October 16, 2016: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/27735975/posterior-wall-fracture-dislocation-with-traumatic-abductor-avulsion
#16
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
https://www.readbyqxmd.com/read/27734434/a-skeletal-traction-technique-for-proximal-femur-fracture-management-in-an-austere-environment
#17
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
https://www.readbyqxmd.com/read/27722116/early-and-late-intramedullary-nailing-of-femur-fracture-a-single-center-experience
#18
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
https://www.readbyqxmd.com/read/27689572/interfragmentary-motion-assessment-for-three-different-fixation-techniques-of-femoral-neck%C3%A2-fractures-in-young-adults
#19
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
https://www.readbyqxmd.com/read/27682303/atypical-femur-fractures-patient-characteristics-and-results-of-intramedullary-nailing-for-a-series-of-21-patients
#20
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
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