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Fractured neck of femur

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https://www.readbyqxmd.com/read/28073094/the-role-of-lesser-trochanter-fragment-in-unstable-pertrochanteric-a2-proximal-femur-fractures-is-refixation-of-the-lesser-trochanter-worth-the-effort
#1
Christian Ehrnthaller, Alain Christoph Olivier, Florian Gebhard, Lutz Dürselen
BACKGROUND: Instability of osteoporotic pertrochanteric fractures is defined by loss of medial/lateral cortical integrity with the posteromedial fragment including the lesser trochanter being pivotal for load distribution. Literature addressing the importance of lesser trochanter refixation is scarce. To clarify the effect of lesser trochanter refixation on primary stability in these fractures, following study was performed. METHODS: 21 femora were match-paired in 3 groups and osteotomized, creating pertrochanteric fractures (AO-31A2)...
December 30, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/28067568/improving-community-prescribing-of-post-fracture-denosumab-after-discharge
#2
Helen Wood, Harriet Lewis, Rachael Ward, Tarun Solanki, Prabhath Fernando
BACKGROUND: In the UK, denosumab is usually started by hospital clinicians and continued by primary care physicians in the community, but in the authors' region denosumab is a 'green light' drug, only prescribed by the primary care team. The authors suspected that a proportion of patients who were recommended to start the drug after a neck of femur fracture were not receiving this on discharge. They aimed to improve the prescribing of denosumab by implementing a quality improvement project...
January 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28053824/low-normal-tsh-levels-are-associated-with-impaired-bmd-and-hip-geometry-in-the-elderly
#3
Su Jin Lee, Kyoung Min Kim, Eun Young Lee, Mi Kyung Song, Dae Ryong Kang, Hyeon Chang Kim, Yoosik Youm, Young Mi Yun, Hyun-Young Park, Chang Oh Kim, Yumie Rhee
Subclinical hyperthyroidism is known to be associated with the risk of fractures in elderly people. However, there are few studies assessing whether low normal thyroid-stimulating hormone (TSH) levels affect bone density and geometry. Here, we aimed to assess the influence of the TSH level on bone mineral density (BMD) and geometry in elderly euthyroid subjects. This was a cross-sectional cohort study. A total of 343 men and 674 women with euthyroidism were included and analyzed separately. The subjects were divided into tertiles based on the serum TSH level...
December 2016: Aging and Disease
https://www.readbyqxmd.com/read/28050531/femoroacetabular-impingement
#4
REVIEW
José Batista Volpon
The femoroacetabular impingement (FAI) is as condition recently characterized that results from the abnormal anatomic and functional relation between the proximal femur and the acetabular border, associated with repetitive movements, which lead labrum and acetabular cartilage injuries. Such alterations result from anatomical variations such as acetabular retroversion or decrease of the femoroacetabular offset. In addition, FAI may result from acquired conditions as malunited femoral neck fractures, or retroverted acetabulum after pelvic osteotomies...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28043896/marrow-adipose-tissue-composition-in-adults-with-morbid-obesity
#5
Elaine W Yu, Logan Greenblatt, Alireza Eajazi, Martin Torriani, Miriam A Bredella
Patients with type 2 diabetes mellitus (T2DM) have increased fracture risk despite normal or increased bone mineral density (BMD). Elevations in marrow adipose tissue (MAT) and declines in MAT unsaturation are both associated with increased skeletal fragility. The objective of our study was to characterize the quantity and composition of MAT in adults with morbid obesity and T2DM, and to evaluate determinants of MAT. We studied 21 adults with morbid obesity prior to bariatric surgery, 8 of whom had T2DM. All subjects underwent 1H-MR spectroscopy of the lumbar spine and femur for assessment of MAT and dual-energy x-ray absorptiometry (DXA) and quantitative computed tomography (QCT) of the lumbar spine and hip for assessment of areal BMD (aBMD) and volumetric BMD (vBMD)...
December 30, 2016: Bone
https://www.readbyqxmd.com/read/28026203/sexual-dimorphism-in-bone-muscle-relationship-in-young-adults
#6
Vera Zymbal, Kathleen F Janz, Fátima Baptista
The purpose of this study was to analyse associations between lean soft tissue (LST), a surrogate of skeletal muscle mass and key fracture-related geometric characteristics of the proximal femur. Moreover, we examined the role that muscle played on the proximal femur geometry in response to physical activity (PA). Participants were 83 young adults. Leg LST (exposure) was assessed by dual energy X-ray absorptiometry (DXA). Proximal femur geometry was derived from a left hip DXA scan. Geometric variables (outcomes) included the femoral neck axis length (FNAL), the femoral neck width (FNW), the neck-shaft angle and FNW|FNAL (an index of robustness)...
December 27, 2016: Journal of Sports Sciences
https://www.readbyqxmd.com/read/28019683/effect-of-teriparatide-or-risedronate-in-elderly-patients-with-a-recent-pertrochanteric-hip-fracture-final-results-of-a-78-week-randomized-clinical-trial
#7
Jorge Malouf-Sierra, Umberto Tarantino, Pedro A García-Hernández, Costantino Corradini, Søren Overgaard, Jan J Stepan, Lars Borris, Eric Lespessailles, Frede Frihagen, Kyriakos Papavasiliou, Helmut Petto, Per Aspenberg, José Ramón Caeiro, Fernando Marin
We present final results of a study comparing teriparatide 20 µg QD with risedronate 35 mg QW started within 2 weeks after surgery for a pertrochanteric hip fracture. Patients with BMD T-score ≤-2.0 and 25OHD >9.2 ng/mL were randomized to receive 26-week double-dummy treatment plus calcium and vitamin D, followed by 52-week open-label treatment with the same assigned active drug. Primary endpoint was change from baseline in lumbar spine (LS) BMD at 78 weeks. Secondary and exploratory endpoints were change in BMD at the proximal femur, function, hip pain (Charnley score and 100 mm Visual Analog Scale [VAS]), quality of life (short form-36), radiology outcomes, and safety...
December 26, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28018062/non-union-fracture-neck-femur-in-a-toddler-reconstructed-by-valgus-osteotomy-a-minimally-invasive-approach
#8
Amit Sharma, Anurag Tiwari, Tarun Verma, Lalit Maini
BACKGROUND: Non-union is one of the devastating complications of fracture neck of femur. Though a very rarely encountered entity in a toddler (1-3 years paediatric age group), non-united femoral neck fractures are reported in developing countries because of mismanagement by quacks and delay in referrals. For operative treatment, many different procedures have been described, including close/open reduction and internal fixation using K-wires, cannulated screws, fibula or nails. There is no evidence in the literature that one or other implant influences the rate of postoperative complications, such as avascular femoral head necrosis or coxa vara...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28009615/healing-of-atypical-subtrochanteric-femur-fractures-after-cephalomedullary-nailing-which-factors-predict-union
#9
Jae-Woo Cho, Chang-Wug Oh, Frankie Leung, Ki-Chul Park, Merng Koon Wong, Ernest Kwek, Han-Ju Kim, Jong-Keon Oh
OBJECTIVES: The purpose of this study was to determine the healing rate and time-to-union of atypical subtrochanteric fractures treated with cephalomedullary nailing DESIGN: Retrospective review, descriptive and analytic study SETTING: Six level 1 trauma centers PATIENTS/PARTICIPANTS: The study included 42 patients with 48 displaced, atypical, bisphosphonate-associated subtrochanteric femur fractures who underwent surgical intervention. INTERVENTION: Cephalomedullary femur nailing MAIN OUTCOME MEASUREMENT: The main outcome measures were radiologic healing and time to union...
November 7, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28002918/the-correlation-between-preoperative-levels-of-albumin-and-tlc-and-mortality-in-patients-with-femoral-neck-fracture
#10
F Niccolai, P D Parchi, A Vigorito, G Pasqualetti, F Monzani, M Lisanti
A femoral neck fracture in an elderly patient often represents a major challenge for the orthopaedic surgeon who has to face not only the fracture, but also all the multiple issues related to age. Among others, malnutrition has been recognised as an important factor associated with severe aggravation in these patients. One-hundred-and-forty-seven patients were enrolled to investigate the use of two markers of patient nutritional status, i.e. serum albumin level and total leukocyte count (TLC), as predictors of mortality in the elderly patient suffering from proximal femur fracture...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28001017/improvement-of-bone-turnover-markers-and-bone-mineral-density-following-treatment-of-primary-aldosteronism
#11
Huai H Loh, Nor A Kamaruddin, Rozman Zakaria, Norlela Sukor
BACKGROUND: Recent studies showed association between hyperaldosteronism and low bone density among patients with primary aldosteronism (PA) due to secondary hyperparathyroidism. Our objective is to assess bone turnover markers (BTM) and bone mineral density (BMD) of PA patients compared to essential hypertension. METHODS: This was an open-label, prospective, case-controlled study, conducted over 12 months. Fifty-two consecutive patients referred for secondary hypertension were screened...
December 20, 2016: Minerva Endocrinologica
https://www.readbyqxmd.com/read/27996352/lessons-learned-developing-and-piloting-interprofessional-handover-simulations-for-paramedic-nursing-and-physiotherapy-students
#12
Jill Stow, Julia Morphet, Debra Griffiths, Chris Huggins, Prue Morgan
Interprofessional education is an important element in the preparation of healthcare students who can communicate effectively and work collaboratively. A grant from Health Workforce Australia funded a shared nursing, paramedicine, and physiotherapy simulation suite and a staff member dedicated to interprofessional simulation, with the aim of increasing high fidelity simulation within and across the three professions. This article describes the development process and pilot testing of four purpose-designed interprofessional handover scenarios for paramedic, nursing, and physiotherapy students...
January 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/27984687/-three-successive-fractures-of-different-hip-femoral-stems-on-the-same-patient
#13
J Gómez-Robledo
The clinical case of an 80-year-old female who suffered three fractures in uncemented stems implanted in her right hip in a period of three years is presented. A fracture occurred in the prosthetic neck and the other two at the juncture of the conical and cylindrical stem portion, coinciding with the metaphyseal-diaphyseal junction of the femur. The main causes of the failure were an increasing concentration of forces at the level of the implant as a consequence of the increased length of the neck and lateralization of the femur (offset)...
May 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/27926679/factors-associated-with-increased-healing-time-in-complete-femoral-fractures-after-long-term-bisphosphonate-therapy
#14
Hae-Seong Lim, Chong-Kwan Kim, Youn-Soo Park, Young-Wan Moon, Seung-Jae Lim, Sang-Min Kim
BACKGROUND: The purpose of this study was to analyze factors that affect healing time after operative treatment of complete femoral fractures associated with long-term use of bisphosphonates. In particular, we sought to determine surgically controllable factors related to fracture-healing time. METHODS: Ninety-nine consecutive patients (109 fractures) who had been surgically treated for a complete atypical femoral fracture were enrolled. All patients had a documented history of bisphosphonate therapy at the time of presentation, with an average duration of 7...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27917354/results-of-a-hydroxyapatite-coated-femoral-stem-corail-in-chinese-a-minimum-10-year-follow-up
#15
Jianda Xu, Zikang Xie, Jianning Zhao, Yi Gao, Hong Zhao, Libo Peng, Yuxing Qu
BACKGROUND: Due to the adverse effects of cemented hip arthroplasty, uncemented stems with hydroxyapatite (HA) coating reduces these risks and enhanced integration. The concept of an extensive HA coating for the fixation of a tapered femoral stem (Corail(®)) was introduced, which can achieve durable biological fixation and preserve normal periprosthetic bone activity. Here we describe the clinical and radiological outcome in patients with the Corail(®) stem. METHODS: 92 total hip replacements in 81 patients using the Corail(®) stem were followed-up...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27915448/bone-mineral-content-and-areal-density-but-not-bone-area-predict-an-incident-fracture-risk-a-comparative-study-in-a-uk-prospective-cohort
#16
E M Curtis, N C Harvey, S D'Angelo, C S Cooper, K A Ward, P Taylor, G Pearson, C Cooper
: We studied a prospective UK cohort of women aged 20 to 80 years, assessed by dual-energy X-ray absorptiometry (DXA) at baseline. Bone mineral content (BMC) and areal bone mineral density (aBMD), but not bone area (BA), at femoral neck, lumbar spine and the whole body sites were similarly predictive of incident fractures. BACKGROUND: Low aBMD, measured by DXA, is a well-established risk factor for future fracture, but little is known about the performance characteristics of other DXA measures such as BA and BMC in fracture prediction...
December 2016: Archives of Osteoporosis
https://www.readbyqxmd.com/read/27906924/reducing-harm-from-falls
#17
Shelley Jones, Sandy Blake, Richard Hamblin, Carmela Petagna, Carl Shuker, Alan F Merry
Serious adverse event reporting from district health boards (DHBs) brought in-hospital falls to the attention of the Health Quality & Safety Commission (the Commission) when it was incepted in 2010. In 2012, responding to the large numbers reported, the Commission began planning for a three-year programme to reduce harm from falls, initially to run 2013-2015. In this article we discuss the serious consequences of falls, and the challenges and practical considerations involved in reducing the risk of falling and the rate of falls...
December 2, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27895366/intra-operative-implantation-errors-during-austin-moore-hemiarthroplasty
#18
Zohaib Gulzar Naqvi, Javed Ali Markhand, Syed Kamran Ahmed, Amin Chinoy, Mansoor Ali Khan
Austin Moore hemiarthroplasty is an established treatment in elderly patients with neck of femur fractures. Being commonly performed, it is also associated with several technical errors of implantation which results in complications and failure requiring revision surgery. This retrospective pre- and post-operative radiographic study to determine the frequency of technical errors was conducted at the Indus Hospital, Karachi, and comprised data of 50 patients who underwent Austin Moore hemiarthroplasty between January and November 2016...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27866217/osteonecrosis-of-the-jaw-onj-and-atypical-femoral-fracture-aff-in-an-osteoporotic-patient-chronically-treated-with-bisphosphonates
#19
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/27858121/trends-in-hip-fracture-rates-in-taiwan-a-nationwide-study-from-1996-to-2010
#20
T Y Wu, H Y Hu, S Y Lin, W C Chie, R S Yang, C K Liaw
: There was an initial increase and a later decrease in hip fracture rates in Taiwan between 1996 and 2010 (457.9 to 390.0 fractures per 100,000 people per year). Mortality rates decreased but re-emerged later (2.26 to 1.91 deaths per 100 hip fracture admissions). The turning point for change in trends was 2003. INTRODUCTION: Fractures of the proximal femur remain a major cause of mortality and morbidity. We aimed to examine recent trends in hip fracture rates, in-hospital mortality rates, and length of hospital stay (LOS) due to hip fractures in people aged 55 and over in Taiwan...
November 17, 2016: Osteoporosis International
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