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Fractured neck of femur

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https://www.readbyqxmd.com/read/29666099/collapse-in-the-elderly-rivastigmine-induced-heart-block-and-a-literature-review-of-the-pharmacology-of-acetylcholinesterase-inhibitors-used-in-alzheimer-s-disease
#1
Olushola Alonge, Fahad Mujtaba Iqbal, Elzbieta Cifonelli
Falls resulting in neck of femur fractures are common in the elderly. Often multiple comorbidities can make management and diagnosis of such a polyfactorial condition difficult, particularly with Alzheimer's dementia (AD). Indeed, poorly managed AD may contribute to falls. We present our management of an 87-year-old woman, on rivastigmine for AD, who presented with a collapse episode-attributed to rivastigmine-resulting in a neck of femur fracture. Furthermore, we perform a literature review of the pharmacology of acetylcholinesterase inhibitors and how their use in AD may contribute to bradyarrhythmias...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29664885/the-effect-of-hip-positioning-on-the-projected-femoral-neck-shaft-angle-a-modeling-study
#2
Abhiram R Bhashyam, Edward K Rodriguez, Paul Appleton, John J Wixted
OBJECTIVES: The femoral neck-shaft angle (NSA) is used to restore normal hip geometry during hip fracture repair. Femoral rotation is known to affect NSA measurement, but the effect of hip flexion-extension is unknown. The goals of this study were to determine and test mathematical models of the relationship between hip flexion-extension, femoral rotation and NSA. We hypothesized that hip flexion-extension and femoral rotation would result in NSA measurement error. METHODS: Two mathematical models were developed to predict NSA in varying degrees of hip flexion-extension and femoral rotation...
April 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29661684/trabecular-bone-score-and-hip-structural-analysis-in-patients-with-atypical-femur-fractures
#3
Sanne K C Buitendijk, Denise M van de Laarschot, Alexandra A A Smits, Fjorda Koromani, Fernando Rivadeneira, Thomas J Beck, M Carola Zillikens
Bisphosphonate use has declined dramatically in recent years, partly because of fear of rare side effects like atypical femur fractures (AFFs). It is therefore desirable to have a diagnostic method to identify those at risk of AFF to prevent this serious complication. We compared trabecular microarchitecture and hip geometry between 30 patients with AFF and 141 controls of similar age and sex, using bisphosphonates. Trabecular bone score (TBS) and hip structural analysis (HSA) were used to assess trabecular microarchitecture and macroscopic hip geometry from dual-energy X-ray absorptiometry images of the lumbar spine and hip, respectively...
March 22, 2018: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/29658534/the-influence-of-osteoporotic-bone-structures-of-the-pelvic-hip-complex-on-stress-distribution-under-impact-load
#4
Katarzyna Arkusz, Tomasz Klekiel, Niezgoda Niezgoda, Romuald Będziński
PURPOSE: The aim of this study was to determine the effect of bone mineral density (BMD) on the stress distribution in pelvic-hip complex (PHC) model which included bone structures and soft tissues. Bone mass changes in osteoporosis and osteopenia were considered in this analysis. In addition, the relations between force direction and stress distribution causing PHC fractures were determined. METHODS: This paper presents the development and validation of a detailed 3D finite element model with high anatomical fidelity of the PHC and BMD changes in trabecular and cortical bones, modelled based on CT scans...
2018: Acta of Bioengineering and Biomechanics
https://www.readbyqxmd.com/read/29653317/increased-torsional-stability-by-a-novel-femoral-neck-locking-plate-the-role-of-plate-design-and-pin-configuration-in-a-synthetic-bone-block-model
#5
Jan Egil Brattgjerd, Martin Loferer, Sanyalak Niratisairak, Harald Steen, Knut Strømsøe
BACKGROUND: In undisplaced femoral neck fractures, internal fixation remains the main treatment, with mechanical failure as a frequent complication. As torsional stable fixation promotes femoral neck fracture healing, the Hansson Pinloc® System with a plate interlocking pins, was developed from the original hook pins. Since its effect on torsional stability is undocumented, the novel implant was compared with the original configurations. METHODS: Forty-two proximal femur models custom made of two blocks of polyurethane foam were tested...
March 27, 2018: Clinical Biomechanics
https://www.readbyqxmd.com/read/29649099/functional-and-radiological-results-of-proximal-femoral-nail-antirotation-pfna-osteosynthesis-in-the-treatment-of-unstable-pertrochanteric-fractures
#6
Ahmad M Radaideh, Hashem A Qudah, Ziad A Audat, Rami A Jahmani, Ibraheem R Yousef, Abed Allah A Saleh
Pertrochanteric femur fractures are considered amongst the most commonly encountered fractures in the geriatric age group. We evaluated radiographic and functional outcomes of patients with unstable pertrochanteric fractures treated with the proximal femur nail antirotation (PFNA). Between March 2013 and December 2015, fifty patients (28 male and 22 females with a mean age of 72.8 years (range, 20-94)) with unstable pertrochanteric fractures (AO 31.A2 and 31.A3) were fixed with the PFNA at our institution, and they were retrospectively evaluated...
April 12, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29643155/femoral-nerve-block-intervention-in-neck-of-femur-fracture-finof-a-randomised-controlled-trial
#7
Martin Rowlands, Gerrie van de Walt, Jim Bradley, Alexa Mannings, Sarah Armstrong, Nigel Bedforth, Iain K Moppett, Opinder Sahota
OBJECTIVE: Fractured neck of femur is a severely painful condition with significant mortality and morbidity. We investigated whether early and continuous use of femoral nerve block can improve pain on movement and mobility after surgery in older participants with fragility neck of femur fracture. DESIGN: Prospective single-centre, randomised controlled pragmatic trial. SETTING: Secondary care, acute National Health Service Trust, UK. PARTICIPANTS: Participants admitted with a history and examination suggesting fractured neck of femur...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29618344/introduction-of-a-guide-based-on-a-femoral-neck-section-for-fixation-with-multiple-screws-a-cadaveric-study
#8
Qiuliang Zhu, Bin Xu, Jinzhu Lv, Maohua Yan
BACKGROUND: The design and application of assisted instrumentation for internal fixation of femoral neck fractures with multiple screws are still evolving. A novel guide based on a femoral neck section was designed to improve the accuracy of screw placement, and its efficacy was evaluated. METHODS: A guide based on a femoral neck section was designed for assisted fixation of femoral neck fractures with multiple screws. Femoral specimens from 10 adults (20 femurs) underwent assisted internal fixation for a femoral neck fracture with 3 cannulated screws using the new guide technique or conventional technique...
April 4, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29606486/augmented-reality-fluoroscopy-simulation-of-the-guide-wire-insertion-in-dhs-surgery-a-proof-of-concept-study
#9
B H van Duren, K Sugand, R Wescott, R Carrington, A Hart
BACKGROUND: Hip fractures contribute to a significant clinical burden globally with over 1.6 million cases per annum and up to 30% mortality rate within the first year. Insertion of a dynamic hip screw (DHS) is a frequently performed procedure to treat extracapsular neck of femur fractures. Poorly performed DHS fixation of extracapsular neck of femur fractures can result in poor mobilisation, chronic pain, and increased cut-out rate requiring revision surgery. A realistic, affordable, and portable fluoroscopic simulation system can improve performance metrics in trainees, including the tip-apex distance (the only clinically validated outcome), and improve outcomes...
March 29, 2018: Medical Engineering & Physics
https://www.readbyqxmd.com/read/29605113/disuse-osteopenia-following-leg-fracture-in-postmenopausal-women-implications-for-hip-fracture-risk-and-fracture-liaison-services
#10
S J Hopkins, A D Toms, M Brown, A Appleboam, K M Knapp
INTRODUCTION: Disuse osteopenia is a known consequence of reduced weight-bearing and has been demonstrated at the hip following leg injury but has not been specifically studied in postmenopausal women. METHOD: Bilateral DXA (GE Lunar Prodigy) bone mineral density (BMD) measurements were taken at the neck of femur (NOF), total hip region (TH) and lumbar spine in postmenopausal female groups comprising controls (N = 43), new leg fractures (#<3wks) (N = 9), and participants who had sustained a leg fracture more than one year previously (#>1yr) (N = 24)...
May 2018: Radiography
https://www.readbyqxmd.com/read/29581916/hip-fracture-in-a-patient-with-primary-hyperparathyroidism-medical-and-surgical-lessons
#11
M N Baig, Cathal Mac Dhaibheid, Fintan J Shannon
Hyperparathyroidism is a condition which can be primary, secondary or tertiary and is characterized by increased calcium levels, low phosphate levels, and elevated parathyroid hormone (PTH) levels. Primary hyperthyroidism can cause severe bone resorption leading to bone pains and pathological fracture. We present the case of a patient with severe primary hyperparathyroidism with an atraumatic fracture at the neck of the femur and multiple medical comorbidities presenting a surgical challenge. While primary hyperparathyroidism is rare, it should be considered during differential diagnoses...
January 23, 2018: Curēus
https://www.readbyqxmd.com/read/29572365/a-rare-presentation-of-haematuria-hip-prosthesis-in-the-bladder
#12
Yih Chyn Phan, Nnaemeka Eli, Praveen Pillai, Jonathan O'Dair
An 80-year-old woman presented to our department with visible haematuria and stage II acute kidney injury (AKI). She had stage IIB cervical cancer, for which she received chemotherapy and external beam radiotherapy in 2003. Four years later, she had a left dynamic hip screw for an extracapsular neck of femur fracture following a fall. In 2010, she underwent a right total hip replacement owing to osteoarthritis, and it was subsequently revised in 2012 owing to a right acetabular component failure. In this admission, her AKI improved with intravenous fluid administration and her haematuria settled following catheterisation with a three-way catheter and bladder irrigation with saline...
March 22, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29564292/short-term-outcomes-of-ceramic-coated-metal-on-metal-large-head-in-total-hip-replacement-arthroplasty
#13
Weon-Yoo Kim, Myung-Sup Ko, Se-Won Lee, Kwang-Sub Kim
Purpose: This study characterizes the short-term outcomes of ceramic coated metal-on-metal (MoM) large head total hip arthroplasty (THA) in prospectively selected patients aged 70 to 75 years. Materials and Methods: Eighteen patients (18 hips) between the ages of 70 and 75-years old with THA using ceramic-coated MoM large heads between June 2014 and December 2014 were evaluated. We prospectively selected patients younger than 70 years for bipolar hemiarthroplasty and older than 75 years for conventional THA...
March 2018: Hip & Pelvis
https://www.readbyqxmd.com/read/29549969/reliability-of-the-classification-of-proximal-femur-fractures-does-clinical-experience-matter
#14
Tom J Crijns, Stein J Janssen, Jacob T Davis, David Ring, Hugo B Sanchez
BACKGROUND: Radiographic fracture classification helps with research on prognosis and treatment. AO/OTA classification into fracture type has shown to be reliable, but further classification of fractures into subgroups reduces the interobserver agreement and takes a considerable amount of practice and experience in order to master. QUESTIONS/PURPOSES: We assessed: (1) differences between more and less experienced trauma surgeons based on hip fractures treated per year, years of experience, and the percentage of their time dedicated to trauma, (2) differences in the interobserver agreement between classification into fracture type, group, and subgroup, and (3) differences in the interobserver agreement when assessing fracture stability compared to classifying fractures into type, group and subgroup...
March 14, 2018: Injury
https://www.readbyqxmd.com/read/29548016/overuse-injuries-among-female-combat-warriors-in-the-israeli-defense-forces-a-cross-sectional-study
#15
Oren Schwartz, Itzik Malka, Cara H Olsen, Israel Dudkiewicz, Tarif Bader
Introduction: Integration of females in combat units poses a unique challenge for army commanders around the world. The purpose of this study is to provide a detailed up-to-date situation report regarding overuse injuries among combat female warriors in the IDF (Israeli Defense Forces) in order to enable evidence-based decision-making, prevention policy, and further research of this highly significant military public health issue. Methods: A cross-sectional descriptive study was conducted including 2,519 females recruited to combat duties during the year of 2013...
March 14, 2018: Military Medicine
https://www.readbyqxmd.com/read/29541272/is-head-and-neck-resection-of-the-femur-girdlestone-s-procedure-still-relevant-indications-and-results-about-24-cases
#16
Mamoudou Sawadogo, Hamado Kafando, Salam Ouedraogo, Alexandre Stanislas Korsaga, Souleymane Ouedraogo, Sayouba Tinto, Anatole Jean Innocent Ouedraogo, Mohamed Tall, Songahir Christophe DA
Introduction: Head and neck resection of the femur was described by Girdlestone in 1928 in the treatment of coxalgia. Very invasive at the beginning, this intervention is much less so today, but the term of "Girdlestone's operation" or "Girdlestone's procedure" has remained in use. The reported results are controversial. In resource-limited countries, Girdlestone's procedure is often indicated for lack of a better one. In this context, we report the results of a series of 24 patients operated in a regional hospital (Ouahigouya, Burkina Faso) with the aim of showing that this technique remains valid and can be benefit...
2018: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29536682/-application-of-tri-lock-bone-preservation-stem-in-acetabular-protrusion-combined-with-shorten-defect-of-femoral-head-and-neck
#17
Jun Liu, Ping Zhen, Sheng-Hu Zhou, Qi Tian, Hui Chen, Wei Wang, Xiao-le He, Xu-Sheng Li
OBJECTIVE: To evaluate the manipulation technique and clinical outcome of Tri-Lock bone preservation stem for acetabular protrusion combined with shorten defect of femoral head and neck. METHODS: From January 2013 to December 2015, 10 patients(12 hips) with acetabular protrusion combined with shorten defect of femoral head and neck were treated with total hip arthroplasty(THA) including 5 males and 5 female with an average age of(51.6±3.0) years old ranging from 42...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29529595/rankl-opg-system-regulation-by-endogenous-pth-and-pth1r-atf4-axis-in-bone-implications-for-bone-accrual-and-strength-in-growing-rats-with-mild-uremia
#18
Beata Znorko, Dariusz Pawlak, Ewa Oksztulska-Kolanek, Tomasz Domaniewski, Anna Pryczynicz, Alicja Roszczenko, Joanna Rogalska, Paweł Lipowicz, Michał Doroszko, Malgorzata Michalina Brzoska, Krystyna Pawlak
Osteoprotegerin (OPG), receptor activator of NF-κB ligand (RANKL), and parathyroid hormone (PTH) play a central role in the regulation of bone turnover in chronic kidney disease (CKD), but their influence on bone mineral density (BMD) and strength remains unclear, particularly in children. We studied the clinical significance of OPG and RANKL in relation to PTH, femur weight, BMD, and bone biomechanical properties in growing rats after one month (CKD-1) and three months (CKD-3) of surgically-induced mild CKD...
March 9, 2018: Cytokine
https://www.readbyqxmd.com/read/29526781/comparison-of-femoral-strength-and-fracture-risk-index-derived-from-dxa-based-finite-element-analysis-for-stratifying-hip-fracture-risk-a-cross-sectional-study
#19
Shuman Yang, Yunhua Luo, Lang Yang, Enrico Dall'Ara, Richard Eastell, Andrew L Goertzen, Eugene V McCloskey, William D Leslie, Lisa M Lix
BACKGROUND: Dual-energy X-ray absorptiometry (DXA)-based finite element analysis (FEA) has been studied for assessment of hip fracture risk. Femoral strength (FS) is the maximum force that the femur can sustain before its weakest region reaches the yielding limit. Fracture risk index (FRI), which also considers subject-specific impact force, is defined as the ratio of von Mises stress induced by a sideways fall to the bone yield stress over the proximal femur. We compared risk stratification for prior hip fracture using FS and FRI derived from DXA-based FEA...
March 8, 2018: Bone
https://www.readbyqxmd.com/read/29526160/basic-principles-of-fracture-treatment-in-children
#20
Hakan Ömeroğlu
This review aims to summarize the basic treatment principles of fractures according to their types and general management principles of special conditions including physeal fractures, multiple fractures, open fractures, and pathologic fractures in children. Definition of the fracture is needed for better understanding the injury mechanism, planning a proper treatment strategy, and estimating the prognosis. As the healing process is less complicated, remodeling capacity is higher and non-union is rare, the fractures in children are commonly treated by non-surgical methods...
April 2018: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
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