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Fractured neck of femur

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https://www.readbyqxmd.com/read/29221656/z-effect-after-intramedullary-nailing-systems-for-trochanteric-femur-fractures
#1
S J M Smeets, G Kuijt, P V van Eerten
PURPOSE: The aim of this study was to investigate the incidence of Z-effect after dual lag screw intramedullary nailing systems and risk factors contributing to this effect. We hypothesized that long nails provide more neck strength due to a longer lever than short nails and are therefore less likely to develop a misbalance of a higher head compressive strength than neck compressive strength. METHODS: In this retrospective cohort study 103 patients treated operatively with a dual lag screw intramedullary nailing device for (sub)trochanteric hip fracture were included...
September 27, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29218502/lower-preoperative-hounsfield-unit-values-are-associated-with-intra-operative-fractures-in-cementless-bipolar-hemiarthroplasty
#2
Seung-Ju Kim, Hyun-Soo Park, Dong-Woo Lee, Jong Hun Kim
The use of Hounsfield units (HU) from CT scanning to assess regional BMD has been described. Therefore, we evaluated whether HU could be used to identify osteoporosis of the proximal part of the femur. The results showed that HU assessment is associated with the presence of intra-operative fracture during arthroplasty. INTRODUCTION: The aim with this study was to determine the association of preoperative Hounsfield unit (HU) in hip computed tomography (CT) with intra-operative osteoporotic fracture during cementless hemiarthroplasty...
December 7, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29200862/association-between-serum-cystatin-c-and-bone-mineral-density-in-korean-adults
#3
Dongwon Yi, Ah Reum Khang, Hye Won Lee, Seok Man Son, Yang Ho Kang
Background: Serum cystatin C has been known as a novel marker of preclinical renal dysfunction, and higher cystatin C levels are associated with increased risks of hip and nonvertebral fractures. However, there are few reports on the association between serum cystatin C and bone mineral density (BMD), especially in the Asian population. We evaluated the association between cystatin C levels and BMD of the spine and hip in Korean adults. Methods: A cross-sectional study was performed in 865 Korean adults (325 men and 540 women) who participated in a comprehensive medical examination program and underwent bone densitometry...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29196879/the-feasibility-of-physiologically-based-pharmacokinetic-modeling-in-forensic-medicine-illustrated-by-the-example-of-morphine
#4
Nadine Schaefer, Daniel Moj, Thorsten Lehr, Peter H Schmidt, Frank Ramsthaler
In forensic medicine, expert opinion is often required concerning dose and time of intake of a substance, especially in the context of fatal intoxications. In the present case, a 98-year-old man died 4 days after admission to a hospital due to a femur neck fracture following a domestic fall in his retirement home. As he had obtained high morphine doses in the context of palliative therapy and a confusion of his supplemental magnesium tablets with a diuretic by the care retirement home was suspected by the relatives, a comprehensive postmortem examination was performed...
December 1, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/29181721/on-the-failure-initiation-in-the-proximal-human-femur-under-simulated-sideways-fall
#5
Hassan Bahaloo, W S Enns-Bray, I Fleps, O Ariza, S Gilchrist, R Widmer Soyka, P Guy, H Palsson, S J Ferguson, P A Cripton, B Helgason
The limitations of areal bone mineral density measurements for identifying at-risk individuals have led to the development of alternative screening methods for hip fracture risk including the use of geometrical measurements from the proximal femur and subject specific finite element analysis (FEA) for predicting femoral strength, based on quantitative CT data (qCT). However, these methods need more development to gain widespread clinical applications. This study had three aims: To investigate whether proximal femur geometrical parameters correlate with obtained femur peak force during the impact testing; to examine whether or not failure of the proximal femur initiates in the cancellous (trabecular) bone; and finally, to examine whether or not surface fracture initiates in the places where holes perforate the cortex of the proximal femur...
November 27, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29172124/material-mapping-strategy-to-improve-the-predicted-response-of-the-proximal-femur-to-a-sideways-fall-impact
#6
W S Enns-Bray, H Bahaloo, I Fleps, O Ariza, S Gilchrist, R Widmer, P Guy, H Pálsson, S J Ferguson, P A Cripton, B Helgason
Sideways falls are largely responsible for the highly prevalent osteoporotic hip fractures in today's society. These injuries are dynamic events, therefore dynamic FE models validated with dynamic ex vivo experiments provide a more realistic simulation than simple quasi-static analysis. Drop tower experiments using cadaveric specimens were used to identify the material mapping strategy that provided the most realistic mechanical response under impact loading. The present study tested the addition of compression-tension asymmetry, tensile bone damage, and cortical-specific strain rate dependency to the material mapping strategy of fifteen dynamic FE models of the proximal femur, and found improved correlations and reduced error for whole bone stiffness (R2 = 0...
October 27, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29167969/association-of-incident-hip-fracture-with-the-estimated-femoral-strength-by-finite-element-analysis-of-dxa-scans-in-the-osteoporotic-fractures-in-men-mros-study
#7
L Yang, N Parimi, E S Orwoll, D M Black, J T Schousboe, R Eastell
Finite element model can estimate bone strength better than BMD. This study used such a model to determine its association with hip fracture risk and found that the strength estimate provided limited improvement over the hip BMDs in predicting femoral neck (FN) fracture risk only. INTRODUCTION: Bone fractures occur only when it is loaded beyond its ultimate strength. The goal of this study was to determine the association of femoral strength, as estimated by finite element (FE) analysis of DXA scans, with incident hip fracture as a single condition or with femoral neck (FN) and trochanter (TR) fractures separately in older men...
November 22, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/29138386/reverse-less-invasive-stabilization-system-liss-plating-for-proximal-femur-fractures-in-poliomyelitis-survivors-a-report-of-two-cases
#8
Chen Yao, Dongxu Jin, Changqing Zhang
BACKGROUND Poliomyelitis is a neuromuscular disease which causes muscle atrophy, skeletal deformities, and disabilities. Treatment of hip fractures on polio-affect limbs is unique and difficult, since routine fixation methods like nailing may not be suitable due to abnormal skeletal structures. CASE REPORT We report one femoral neck fracture and one subtrochanteric fracture in polio survivors successfully treated with reverse less invasive stabilization system (LISS) plating technique. Both fractures were on polio-affected limbs with significant skeletal deformities and low bone density...
November 15, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29134408/glucosamine-reduces-the-inhibition-of-proteoglycan-metabolism-caused-by-local-anaesthetic-solution-in-human-articular-cartilage-an-in-vitro-study
#9
Abhinav Gulihar, Shalin Shaunak, Pinelopi Linardatou Novak, Parthiban Vinayakam, Baljinder Dhinsa, Grahame Taylor
BACKGROUND: We assessed whether local anaesthetics caused inhibition of proteoglycan metabolism in human articular cartilage and whether the addition of Glucosamine sulphate could prevent or allow recovery from this adverse effect on articular cartilage metabolism. METHODS: Cartilage explants obtained from 13 femoral heads from fracture neck of femur patients (average age 80 years, 10 female) were exposed to either 1% Lidocaine, 2% Lidocaine, 0.25% Bupivacaine, 0...
November 13, 2017: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/29134242/serum-parathyroid-hormone-is-associated-with-increased-cortical-porosity-of-the-inner-transitional-zone-at-the-proximal-femur-in-postmenopausal-women-the-troms%C3%A3-study
#10
M Osima, T T Borgen, M Lukic, G Grimnes, R M Joakimsen, E F Eriksen, Å Bjørnerem
Serum parathyroid hormone (PTH) was associated with increased bone turnover markers and cortical porosity of the inner transitional zone at the proximal femur. These results suggest that PTH through increased intracortical bone turnover leads to trabecularisation of inner cortical bone in postmenopausal women. INTRODUCTION: Vitamin D deficiency leads to secondary hyperparathyroidism and increased risk for fractures, whereas its association with cortical porosity is less clear. We tested (i) whether serum 25-hydroxyvitamin D (25(OH)D) and PTH were associated with cortical porosity and (ii) whether the associations of 25(OH)D) and PTH with fracture risk are dependent on cortical porosity...
November 14, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/29125120/canal-to-diaphysis-ratio-as-a-risk-factor-for-hip-fractures-and-hip-fracture-pattern
#11
Prasad Ellanti, Kunal Mohan, Andrew Moriarity, Niall Hogan, Tom McCarthy
INTRODUCTION: Osteoporosis and related fractures constitute a significant burden on modern healthcare. The standard method of diagnosing osteoporosis with a dual-energy X-ray absorptiometry (DXA) scan is limited by accessibility and expense. The thickness of the cortex of the proximal femur on plain radiographs has been suggested to be a method for indicating osteoporosis and as a risk factor of hip fractures in the elderly. METHODS: A retrospective study was undertaken to assess the usefulness of the canal-diaphysis ratio (CDR) as a risk factor for developing a hip fracture, excluding patients presenting under 50 years old, following high-energy trauma or pathological fractures...
2017: SICOT-J
https://www.readbyqxmd.com/read/29114187/use-of-fibular-bone-graft-and-cancellous-screw-fixation-in-the-management-of-neglected-femur-neck-fractures-in-young-patients
#12
Ghulam Mustafa Kaim Khani, Kamran Hafeez, Muhammad Bux, Nusrat Rasheed, Naveed Ahmed, M Perwez Anjum
Objective: To present the clinical outcome of patients with neglected femur neck fracture treated with fibular bone graft. Methods: During May 2010-February 2013, 15 patients younger than 35 years of age with neglected fracture neck of femur were managed with non-vascularized fibular graft and cannulated screws. Fractures were classified according to Sandhu Classification. Hip function was assessed using Harris hip score. Results: Fifteen patients with mean age of 28...
November 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/29107950/a-new-method-to-determine-cortical-bone-thickness-in-ct-images-using-a-hybrid-approach-of-parametric-profile-representation-and-local-adaptive-thresholds-accuracy-results
#13
Oleg Museyko, Bastian Gerner, Klaus Engelke
MOTIVATION: Cortical bone is an important contributor to bone strength and is pivotal to understand the etiology of osteoporotic fractures and the specific mechanisms of antiosteoporotic treatment regimen. 3D computed tomography (CT) can be used to measure cortical thickness, density, and mass in the proximal femur, lumbar vertebrae, and distal forearm. However, the spatial resolution of clinical whole body CT scanners is limited by radiation exposure; partial volume artefacts severely impair the accurate assessment of cortical parameters, in particular in locations where the cortex is thin such as in the lumbar vertebral bodies or in the femoral neck...
2017: PloS One
https://www.readbyqxmd.com/read/29075806/-medial-fracture-of-the-femoral-neck-with-enclosed-k%C3%A3-ntscher-nail
#14
Christian Feil, Robert Spies, Stefan Michalski, Martin Holzgruber, Hans-Joachim Andreß
We report about an 81-year-old male patient who suffered a medial femoral neck fracture after a fall on the left leg. A total hip arthroplasty was planned based on the appropriate indications. The planning was complicated by the presence of an intramedullary Küntscher femoral nail inserted after a motorcycle incident approximately 60 years ago. After fenestration of the proximal lateral femur, the nail was sawn off and a cemented total hip arthroplasty and plate osteosynthesis were performed.
October 26, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29069393/sclerostin-antibody-reverses-bone-loss-by-increasing-bone-formation-and-decreasing-bone-resorption-in-a-rat-model-of-male-osteoporosis
#15
Xiaodong Li, Michael S Ominsky, Kelly S Villasenor, Qing-Tian Niu, Frank J Asuncion, Xuechun Xia, Mario Grisanti, Thomas J Wronski, W Scott Simonet, Hua Zhu Ke
Sclerostin antibody (Scl-Ab) restored bone mass and strength in the ovariectomized rat model of postmenopausal osteoporosis. Increased bone mineral density (BMD) and decreased skeletal fragility fracture risk have been reported in postmenopausal osteoporotic women receiving Scl-Ab. In males, loss of androgen leads to rapid decreases in BMD and increased risk for fragility fractures. We hypothesized that Scl-Ab could reverse the loss of bone mass and strength caused by androgen ablation in the orchiectomized (ORX) rat model of male osteoporosis...
October 20, 2017: Endocrinology
https://www.readbyqxmd.com/read/29062210/evaluation-of-outcome-of-proximal-femur-locking-compression-plate-pflcp-in-unstable-proximal-femur-fractures
#16
Malkesh D Shah, Chirag S Kapoor, Rishit J Soni, Jagdish J Patwa, Paresh P Golwala
INTRODUCTION: Pertrochanteric fractures are most frequent factures of the proximal femur, accounts for nearly 50% of all proximal femur fractures and are most devastating and also a major cause of disability in elderly. The aim and objective of this study was to evaluate the role of proximal femoral locking compression plate in unstable proximal femur fractures. MATERIAL AND METHOD: A total of 20 cases were included in our study (M:F - 16:4), who suffered proximal femur fracture due to various modalities and all of them were operated using proximal femoral locking compression plate...
October 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29061495/femoral-osteochondroplasty-can-be-performed-effectively-without-the-risk-of-avascular-necrosis-or-femoral-neck-fractures-in-an-experimental-ovine-fai-model
#17
F Schmaranzer, L Arendt, T D Lerch, S D Steppacher, K Nuss, N Wolfer, H E Dawson, B von Rechenberg, P R Kircher, M Tannast
OBJECTIVE: The experimental induction of cam-type femoroacetabular impingement (FAI) in sheep is established. To tap the full potential of this ovine model, one should be able to perform a femoral osteochondroplasty safely. This study was based on previous cadaver experiments on the blood supply to the ovine femoral head and on the biomechanical strength of the proximal femur following offset creation. We hypothesized that offset creation in this ovine FAI model does not lead to (1) avascular necrosis (AVN) of the ovine femoral head or (2) iatrogenic femoral neck fractures and (3) can be performed effectively...
October 20, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29058020/-changes-in-the-patient-population-with-proximal-femur-fractures-over-the-last-decade-incidence-age-comorbidities-and-length-of-stay
#18
Markus Muhm, Matthias Amann, Alexander Hofmann, Thomas Ruffing
BACKGROUND: Over the last decade, the percentage of people >65 years has increased from 16.6% to 20.7%. In industrialized countries, the annual incidence in people >65 years with a proximal femur fracture is about 600-900 per 100,000 population. The incidence will increase by 3-5% per year. Guidelines advocate early surgery as soon as possible but within 24 h. External quality control requires surgical treatment within 48 h. In this study, the changes in the patient population with proximal femur fractures and their treatment during the last decade were investigated...
October 20, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29040234/preventing-wedge-deformities-when-treating-intertrochanteric-femur-fractures-with-intramedullary-devices-a-technical-tip
#19
Bennet A Butler, Ryan S Selley, Hobie D Summers, Michael D Stover
Intertrochanteric femur fractures are common injuries associated with significant patient morbidity and mortality and high societal costs. Although intramedullary devices have shown promise for treating a wide range of intertrochanteric femur fractures, improper technique can lead to malalignment, fracture displacement and/or iatrogenic fractures. In particular, a "wedge effect" has been described, in which the passage of conical reamers and the intramedullary nail itself results in distraction of intertrochanteric fragments with lateralization of the shaft from the femoral neck and varus malalignment...
October 7, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29037093/less-periprosthetic-bone-loss-following-the-anterolateral-approach-to-the-hip-compared-with-the-direct-lateral-approach
#20
Terje O Ugland, Glenn Haugeberg, Svein Svenningsen, Stein H Ugland, Øystein H Berg, Are Hugo Pripp, Lars Nordsletten
Background and purpose - The loss of bone mineral in the proximal femur following hip arthroplasty may increase the fracture risk around uncemented stems. We hypothesized that the surgical approach to the hip might influence bone mineral changes around the femoral stem in patients with a femoral neck fracture (FNF). Patients and methods - This was a pre-specified subgroup analysis (n = 51) of an ongoing randomized trial (n = 120) in patients with FNF. Participants were allocated to an uncemented hemiarthroplasty inserted through a direct lateral (Hardinge) approach or an anterolateral (modified Watson-Jones) approach...
October 17, 2017: Acta Orthopaedica
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