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Fractured neck of femur

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https://www.readbyqxmd.com/read/28511967/a-sliding-hip-screw-augmented-with-2-screws-is-biomechanically-similar-to-an-inverted-triad-of-cannulated-screws-in-repair-of-a-pauwels-type-iii-fracture
#1
B Kemker, K Magone, J Owen, P Atkinson, S Martin, T Atkinson
OBJECTIVE: Pauwels III femoral neck fractures are highly unstable. These fractures are commonly treated with three cannulated screws or sliding hip screw (SHS) implants, however high rates of non-union persist. A hybrid SHS construct has recently been proposed. The objective of the study was to compare this construct to the familiar inverted triad of cannulated screws and to a single SHS. METHODS: Fourth generation biomechanical femur analogs were used to create a highly repeatable injury model...
May 8, 2017: Injury
https://www.readbyqxmd.com/read/28511947/intraoperative-femur-fracture-risk-during-primary-direct-anterior-approach-cementless-total-hip-arthroplasty-with-and-without-a-fracture-table
#2
Eric M Cohen, Joshua J Vaughn, Scott A Ritterman, Daniel L Eisenson, Lee E Rubin
BACKGROUND: There is no study to date comparing intraoperative femur fractures (IFFs) in the direct anterior approach (DAA) with and without a fracture table. We hypothesize that there is no significant difference in the IFF with and without a fracture table when performed by experienced DAA hip surgeons. METHODS: This study is a 1-year retrospective review of patients who underwent DAA total hip arthroplasty by 2 surgeons: one surgeon uses a flat table and manually elevates the femur with a large bone hook, while the other surgeon uses a fracture table and a mechanical femoral elevator...
April 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28494481/enhanced-hip-fracture-management-use-of-statistical-methods-and-dataset-to-evaluate-a-fractured-neck-of-femur-fast-track-pathway-pilot-study
#3
Nigel Gilchrist, Kristian Dalzell, Scott Pearson, Gary Hooper, Kit Hoeben, Jeremy Hickling, John McKie, Ma Yi, Sandra Chamberlain, Caroline McCullough, Marc Gutenstein
The increasing elderly population and subsequent rise in total hip fracture(s) in this group means more effective management strategies are necessary to improve efficiency. We have changed our patient care strategy from the emergency department (ED), acute orthopaedic wards, operating theatre, post-operation and rehabilitation, and called it Fracture Neck of Femur Fast Track Pathway. All clinical data and actions were captured, integrated and displayed on a weekly basis using 'signalfromnoise' (SFN) software...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28494480/implementation-and-effects-of-enhanced-recovery-after-surgery-for-hip-and-knee-replacements-and-fractured-neck-of-femur-in-new-zealand-orthopaedic-services
#4
Suzanne Proudfoot, Brandon Bennett, Simon Duff, Julie Palmer
AIM: The National Orthopaedic Enhanced Recovery After Surgery (ERAS) Collaborative was launched in November 2013 to implement ERAS protocols for hip and knee total joint arthroplasty (TJA) and fractured neck of femur (NOF) in participating district health boards (DHBs) by December 2014. This paper reports on the results. METHOD: ERAS protocols were developed for hip and knee TJA and fractured NOF. Breakthrough Series collaborative methodology was used to implement the ERAS protocols in 18 DHBs...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28494476/effect-of-the-shorter-stays-in-emergency-departments-time-target-policy-on-key-indicators-of-quality-of-care
#5
MULTICENTER STUDY
Peter Jones, James Le Fevre, Alana Harper, Susan Wells, Joanna Stewart, Elana Curtis, Papaarangi Reid, Shanthi Ameratunga
AIM: To determine whether implementation of a national health target called Shorter Stays in Emergency Departments impacted on clinical markers of quality of care. METHOD: A retrospective pre- and post-intervention study from 2006 to 2012 examined quality of care metrics for five different indicators at different sites in relation to the implementation of the target using a general linear model for times to treatment. Explanatory variables included period (pre- or post-target), ethnicity, age, deprivation and severity of condition...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28482680/optimal-starting-point-for-fifth-metatarsal-zone-ii-fractures-a-cadaveric-study
#6
Geoffrey I Watson, Sydney C Karnovsky, Gabrielle Konin, Mark C Drakos
BACKGROUND: Identifying the optimal starting point for intramedullary fixation of tibia and femur fractures is well described in the literature using a retrograde or anterograde technique. This technique has not been applied to the fifth metatarsal, where screw trajectory can cause iatrogenic malreduction. The generally accepted starting point for the fifth metatarsal is "high and inside" to accommodate the fifth metatarsal's dorsal apex and medial curvature. We used a retrograde technique to identify the optimal starting position for intramedullary fixation of fifth metatarsal fractures...
April 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28469902/reducing-returns-to-theatre-for-neck-of-femur-fracture-patients
#7
Selina Graham, Mark Dahill, Derek Robinson
The Royal United Hospital, Bath, admits approximately 550 patients with neck of femur fractures per year. The risks from returning to theatre for this patient group are often life-threatening. Post-operative wound ooze was noted to cause a significant rate of return to theatre, with increased lengths of stay and patient morbidity. A wound closure protocol was agreed by the consultant body. This information was disseminated by email and teaching sessions to all members of the multidisciplinary team, including surgeons, theatre staff and ortho-geriatricians...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28469720/a-study-of-chronic-obstructive-pulmonary-disease-specific-causes-of-osteoporosis-with-emphasis-on-the-emphysema-phenotype
#8
Mona Ali Fouda, Esam Hamad Alhamad, Mohammed Saleh Al-Hajjaj, Shaffi Ahmed Shaik, Ahmad Amer Alboukai, Feisal Abdulla Al-Kassimi
BACKGROUND: Osteoporosis, the most common extra-pulmonary complication of chronic obstructive pulmonary disease (COPD), may be related to general causes or COPD-specific causes such as low forced expiratory volume in 1 s (FEV1) and hypoxia. A few studies reported that emphysema is an independent risk factor for osteoporosis. However, other workers considered the association to be confounded by low FEV1 and low body mass index (BMI) which cluster with emphysema. AIMS: To study the association between osteoporosis and emphysema in a model that includes these potentially confounding factors...
April 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28459415/frax-based-estimates-of-10-year-probability-of-hip-and-major-osteoporotic-fracture-among-adults-aged-40-and-over-united-states-2013-and-2014
#9
Anne C Looker, Neda Sarafrazi Isfahani, Bo Fan, John A Shepherd
BACKGROUND: The FRAX algorithm estimates the 10-year probability of hip and major osteoporotic (clinical spine, forearm, hip, or humerus) fracture for adults aged 40 and over. An expert panel developed criteria to define elevated FRAX probabilities for U.S. adults aged 50 and over. This report uses FRAX estimates from the National Health and Nutrition Examination Survey 2013-2014 to describe the hip and major osteoporotic fracture probability distribution (for adults aged 40 and over) and prevalence of elevated probabilities (for adults aged 50 and over) in the United States...
March 2017: National Health Statistics Reports
https://www.readbyqxmd.com/read/28450739/comparing-mortality-risk-of-patients-with-acute-hip-fractures-admitted-to-a-major-trauma-centre-on-a-weekday-or-weekend
#10
Rajpal Nandra, Jack Pullan, Jonathan Bishop, Khalid Baloch, Liam Grover, Keith Porter
Proximal femoral fractures are a major public health concern with estimated annual direct and social costs amounting to £2 billion and average 30-day mortality risk of 7.5%. In response to the recent debate over out-of-hours hospital provision we investigated the 'weekend effect' at a major trauma centre, caring for acute injuries. A single centre, multi-surgeon review of 2060 patients performed. The distribution of patient and treatment variables compared in patients admitted on a weekday or the weekend. Fewer patients met performance indicators during weekend admission, time to surgery (63 vs...
April 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28447127/bone-adaptation-of-a-biologically-reconstructed-femur-after-ewing-sarcoma-long-term-morphological-and-densitometric-evolution
#11
Giordano Valente, Fulvia Taddei, Andrea Roncari, Enrico Schileo, Marco Manfrini
Combining bone allografts and vascularized fibular autografts in intercalary reconstructions after resection of bone sarcomas is of particular interest in young patients as it facilitates bone healing and union and helps reduce fractures. However, adverse events related to bone adaptation still occur. Bone adaptation is driven by mechanical loading, but no quantitative biomechanical studies exist that would help surgical planning and rehabilitation. We analyzed the bone adaptation of a successful femoral reconstruction after Ewing sarcoma during 76-month follow-up using a novel methodology that allows CT-based quantification of morphology and density...
April 26, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28443571/numerical-optimization-of-the-position-in-femoral-head-of-proximal-locking-screws-of-proximal-femoral-nail-system-biomechanical-study
#12
Mehmet Nuri Konya, Özgür Verim
BACKGROUND: Proximal femoral fracture rates are increasing due to osteoporosis and traffic accident. Proximal femoral nails are routinely used in the treatment of these fractures on the proximal femur. AIMS: The present study aimed to compare various combination and to determine ideal proximal lag screw (PLS) position on the pertrochanteric fractures (AO classification 31-A1) of femur by using optimised finite element analysis. STUDY DESIGN: Biomechanical Study...
April 6, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28442297/vertebral-and-femoral-bone-mineral-density-and-bone-strength-in-prostate-cancer-patients-assessed-in-phantomless-pet-ct-examinations
#13
Benedikt J Schwaiger, David L Kopperdahl, Lorenzo Nardo, Luca Facchetti, Alexandra S Gersing, Jan Neumann, Kwang J Lee, Tony M Keaveny, Thomas M Link
PURPOSE: Bone fracture risk assessed ancillary to positron emission tomography with computed tomography co-registration (PET/CT) could provide substantial clinical value to oncology patients with elevated fracture risk without introducing additional radiation dose. The purpose of our study was to investigate the feasibility of obtaining valid measurements of bone mineral density (BMD) and finite element analysis-derived bone strength of the hip and spine using PET/CT examinations of prostate cancer patients by comparing against values obtained using routine multidetector-row computed tomography (MDCT) scans-as validated in previous studies-as a reference standard...
April 24, 2017: Bone
https://www.readbyqxmd.com/read/28435578/use-of-an-industrial-tungsten-carbide-drill-in-the-treatment-of-a-complex-fracture-in-a-patient-with-severe-osteopetrosis-a-case-report
#14
R Kunnasegaran, Y H Chan
The treatment of fractures in osteopetrosis can be complicated and difficult. We describe the use of an industrial grade tungsten carbide drill bit in the treatment of one of these complex fractures. An industrial grade tungsten carbide drill bit was used to fashion a medullary canal in the surgical treatment of a left peri-implant fracture of the neck of femur in a patient with osteopetrosis. The patient was successfully treated with a hemiarthroplasty with good functional outcomes. A tungsten carbide drill bit serves as an effective and safe option in the treatment of osteopetrotic femoral neck fractures...
March 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28435566/functional-outcome-of-bipolar-prosthesis-versus-total-hip-replacement-in-the-treatment-of-femoral-neck-fracture-in-elderly-patients
#15
R Shukla, M Singh, R K Jain, P Mahajan, R Kumar
INTRODUCTION: The present study was performed to compare cemented total hip replacement (THR) with cemented bipolar prosthesis in the treatment of displaced fracture neck of femur in elderly patients. MATERIALS AND METHODS: This prospective study included 47 patients of greater than 60 years of age and having fracture of neck of femur, out of which 25 patients were managed by cemented bipolar prosthesis and remaining 22 were managed by cemented THR between June 2011 and June 2013...
March 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28415025/unusual-combination-of-femoral-head-dislocation-associated-acetabular-fracture-with-multipart-femoral-fractures-case-report
#16
Erdal Uzun, Ali Eray Günay, İbrahim Karaman, Abdülhamit Mısır, Turan Bilge Kızkapan, Mustafa Özçamdallı
INTRODUCTION: Traumatic hip dislocation associated with femur intertrocanteric fracture is a rare and severe injury and it frequently occurs following a high energy trauma, Associated acetabular fractures with this injury are even more rare and potentially cause devastating consequences including avascular necrosis of the femoral head and subsequent early secondary osteoarthritis of the hip joint. PRESENTATION OF CASE: In this case report, we present a 20year old polytraumatized patient with traumatic hip dislocation associated with ipsilateral acetabulum fracture and simultaneous fractures of the ipsilateral femur...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28413494/preoperative-qct-assessment-of-femoral-head-for-assessment-of-femoral-head-bone-loss
#17
Chen Yi, Manyi Wang, Jie Wei, Jun Wang, Ling Wang, Xiaoguang Cheng
We quantified differences in trabecular volumetric bone mineral density (BMD) of the femoral head between patients with proximal femoral fractures and healthy subjects in the control group by using quantitative computed tomography (QCT) with the purpose of providing guidance for the choice of head screw in the intramedullary nail fixation. Participants suffering from intertrochanteric fractures (n=536 patients) were recruited. In addition, 497 fracture-free, age-matched cases were considered as the control group...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28407298/spatial-differences-in-the-distribution-of-bone-between-femoral-neck-and-trochanteric-fractures
#18
Aihong Yu, Julio Carballido-Gamio, Ling Wang, Thomas F Lang, Yongbin Su, Xinbao Wu, Manyi Wang, Jie Wei, Chen Yi, Xiaoguang Cheng
There is little knowledge about the spatial distribution differences in volumetric bone mineral density and cortical bone structure at the proximal femur between femoral neck fractures and trochanteric fractures. In this case-control study, a total of 93 women with fragility hip fractures, 72 with femoral neck fractures (mean ± SD age: 70.6 ± 12.7 years) and 21 with trochanteric fractures (75.6 ± 9.3 years), and 50 control subjects (63.7 ± 7.0 years) were included for the comparisons. Differences in the spatial distributions of volumetric bone mineral density, cortical bone thickness, cortical volumetric bone mineral density and volumetric bone mineral density in a layer adjacent to the endosteal surface were investigated using voxel-based morphometry (VBM) and surface-based statistical parametric mapping (SPM)...
April 13, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28405035/safety-and-efficacy-of-transdermal-buprenorphine-versus-oral-tramadol-for-the-treatment-of-post-operative-pain-following-surgery-for-fracture-neck-of-femur-a-prospective-randomised-clinical-study
#19
Sameer N Desai, Santhoshi V Badiger, Shreesha B Tokur, Prashanth A Naik
BACKGROUND: Transdermal buprenorphine, which is used in chronic pain management, has rarely been studied for use in acute pain management. The aim of this study was to compare the safety and efficacy of transdermal buprenorphine patch to oral tramadol for post-operative analgesia, following proximal femur surgeries. METHODOLOGY: Fifty adult patients undergoing surgery for hip fracture under spinal anaesthesia were included in this study. One group (Group TDB) received transdermal buprenorphine 10 mcg/h patch applied a day before the surgery and other group received oral tramadol 50 mg three times a day for analgesia (Group OT)...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28397164/comparison-of-effects-of-different-screw-materials-in-the-triangle-fixation-of-femoral-neck-fractures
#20
Kadir Gok, Sermet Inal, Arif Gok, Eyyup Gulbandilar
In this study, biomechanical behaviors of three different screw materials (stainless steel, titanium and cobalt-chromium) have analyzed to fix with triangle fixation under axial loading in femoral neck fracture and which material is best has been investigated. Point cloud obtained after scanning the human femoral model with the three dimensional (3D) scanner and this point cloud has been converted to 3D femoral model by Geomagic Studio software. Femoral neck fracture was modeled by SolidWorks software for only triangle configuration and computer-aided numerical analyses of three different materials have been carried out by AnsysWorkbench finite element analysis (FEA) software...
May 2017: Journal of Materials Science. Materials in Medicine
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