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femur fractures

Sebastian Lotzien, Clemens Hoberg, Martin F Hoffmann, Thomas A Schildhauer
PURPOSE: The number of total knee arthroplasties (TKA) increased rapidly. In conjunction with higher implantation rates, periprosthetic femur fractures following TKA are also gradually increasing. Purpose of this study was to evaluate polyaxial locking plate treatment of periprosthetic femoral fractures with retained total knee replacement using polyaxial locking plates in regard to quality of life, functional outcome and complications. METHODS: The Study design is a single-center retrospective cohort analysis...
June 22, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Victoria Schlanser, Andrew Dennis, Katarina Ivkovic, Kimberly Joseph, Matthew Kaminsky, Thomas Messer, Stathis Poulakidas, Frederic Starr, Faran Bokhari
Reconstruction of skin and soft tissue wounds can pose a unique surgical challenge. This is especially true for cases of exposed bone and tendon where soft tissue loss is extensive and opportunities for tissue advancement or rotation are limited. A clinical case is presented describing an experience with dehydrated human amnion/chorion membrane (dHACM, EpiFix®/AmnioFix®, MiMedx Group, Marietta, GA) graft to obtain granulation over an open fracture with desiccated bone. The 22-year-old female trauma patient presented with high-grade bilateral lower extremity soft tissue loss after being run over and dragged by a semitruck...
December 5, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Philip Ashley, Shawn R Gilbert
Obese children with high-energy injuries present with more severe injuries, more extremity injuries, and higher Injury Severity Scores. They are at increased risk for complications, prolonged ventilation, and ICU stay and have increased mortality. Obesity is associated with altered bone mass accrual and higher fracture rates. Obese patients have a higher risk of loss of reduction of forearm fractures, more severe supracondylar fractures, and a higher likelihood of lateral condyle fractures. Obese patients are more likely to have complications with femur fractures and have higher rates of foot and ankle fracture...
July 2018: Orthopedic Clinics of North America
Marie Anneberg, Ole Brink
The aim for this review is to present general considerations in relation to malalignment after osteosynthesis with plate fixation and its consequences after fractures in adults in each of the following anatomical locations: humerus, forearm, femur, tibia. Recommendations for accepted malalignment in humerus diaphyseal fracture is varus <20 degrees, valgus <15 degrees, sagittal deformity <5 degrees and rotation <30 degrees. Recommendations when treating fractures of the forearm is anatomical reduction...
June 2018: Injury
Andrew H Schmidt
Periprosthetic fractures are typically defined as fractures occurring adjacent to a total joint arthroplasty. However, fractures may occur adjacent to a previous internal fixation device used to treat a prior fracture in the same patient, or between implants (the interprosthetic fracture). All of these injuries tend to occur in frail patients with severe osteopenia, and therefore are very challenging to treat. This article provides a brief but thorough review of the current state of the art regarding the treatment of these challenging problems...
June 2018: Injury
Utku Kandemir
With advances in osteosynthesis technology providing improved stability of fixation and better outcomes, surgical treatment has become the standard of care for distal femur fractures. Pre-contoured distal femoral locking plates are the most commonly used implants for fixation. However, healing problems such as delayed union, failure of fixation, and /or nonunion are not uncommon. The fixation construct being "too stiff" is a commonly quoted reason when nonunion/failure of fixation occurs on distal femur fractures fixed with a plate...
June 2018: Injury
Aakash Mugalur
Equalizing limb length is of paramount importance for optimal outcome in patients undergoing hip arthroplasty(HA). Numerous techniques have been described for avoiding limb length discrepancy (LLD) in patients undergoing HA. However their applicability in patients undergoing HA for neck of femur(NOF) fractures remains questionable due to dissociation between the femur and the head. I hereby describe a novel yet simple technique for better utilization of already established techniques to avoid LLD in NOF fractures undergoing HA...
June 2018: Journal of Clinical Orthopaedics and Trauma
Toru Nishiwaki, Shinichi Uchikawa, Hiroshi Kusakabe, Atsuhito Seki, Yoshitaka Eguchi, Shinichiro Takayama, Akihito Oya, Masaya Nakamura, Morio Matsumoto, Arihiko Kanaji
BACKGROUND: Although a simple bone cyst carries the risk of pathological fractures, it rarely causes severe deformity. Here we report a case of severe femoral deformity after multiple pathological fractures due to simple bone cysts, and consider the reason for the progression of malunion despite multiple previous treatments. Finally, we propose a treatment option for malunion correction. CASE PRESENTATION: A 9-year, 7-month-old Japanese girl was referred to our facility with obvious deformity of her right femur, caused by multiple simple bone cyst-related pathological fractures...
June 21, 2018: Journal of Medical Case Reports
Claudia Beaudoin, Sonia Jean, Lynne Moore, Philippe Gamache, Louis Bessette, Louis-Georges Ste-Marie, Jacques P Brown
Prognostic tools are available to identify individuals at high risk of osteoporotic fracture and assist physicians in management decisions. Some authors have suggested improving the predictive ability of current tools by integrating characteristics of prior fractures (number, location and time since prior fracture). The objectives of this study were i) to evaluate the sex-age-specific association between characteristics of prior fractures and the occurrence of a future osteoporotic fracture and ii) to assess whether the characteristics of prior fractures could increase the discriminative ability of fracture risk prediction tools...
June 20, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Pamela S Hinton, Laura C Ortinau, Rebecca K Dirkes, Emily L Shaw, Matthew W Richard, Terese Z Zidon, Steven L Britton, Lauren G Koch, Victoria J Vieira-Potter
Background: Osteoporosis and related fractures, decreased physical activity, and metabolic dysfunction are serious health concerns for postmenopausal women. Soy protein might counter the negative effects of menopause on bone and metabolic health due to the additive or synergistic effects of its bioactive components. Objective: To evaluate the effects of ovariectomy (OVX) and a soy-protein diet (SOY) on bone outcomes in female, low-capacity running (LCR) rats selectively bred for low aerobic fitness as a model of menopause...
June 2018: Bone Reports
M N Baig, Abdul Halim Dzufar, Colin G Murphy, Bill Curtin
Lateral femoral prosthesis perforation is an uncommon periprosthetic fracture. Periprosthetic fractures may be fixed with open reduction and internal fixation, or with revision arthroplasty, depending on the type of fracture, the condition of the host bone in the proximal femur, the stability of the implant, and occasionally the medical co-morbidities of the patient. Proximal femoral replacement is a complex and challenging procedure but provides a better chance of early mobilisation. We describe a case of treating a 71-year-old woman who presented with an unusual type of periprosthetic fracture, treated with a revision arthroplasty procedure using a proximal femur replacement...
April 17, 2018: Curēus
Shinya Abe, Nathaniel Narra, Riku Nikander, Jari Hyttinen, Reijo Kouhia, Harri Sievänen
Sideways falls impose high stress on the thin superolateral cortical bone of the femoral neck, the region regarded as a fracture-prone region of the hip. Exercise training is a natural mode of mechanical loading to make bone more robust. Exercise-induced adaptation of cortical bone along the femoral neck has been previously demonstrated. However, it is unknown whether this adaption modulates hip fracture behavior. The purpose of this study was to investigate the influence of specific exercise loading history on fall-induced hip fracture behavior by estimating fracture load and location with proximal femur finite element (FE) models created from magnetic resonance images (MRI) of 111 women with distinct exercise histories: 91 athletes (aged 24...
June 8, 2018: Journal of Biomechanics
Mariana E Kersh, Saulo Martelli, Roger Zebaze, Ego Seeman, Marcus G Pandy
Advancing age and reduced loading are associated with a reduction in bone formation. Conversely, loading increases periosteal apposition and may reduce remodeling imbalance and slow age-related bone loss, an important outcome for the proximal femur which is a common site of fracture. The ability to take advantage of bone's adaptive response to increase bone strength has been hampered by a lack of knowledge of which exercises and specific leg muscles load the superior femoral neck: a common region of microcrack initiation and progression following a sideways fall...
June 19, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
T Zafeiris, M Gothner, C Hempel Overhage, G Heil, B Roetman
Chronic lymphatic leukaemia (CLL) is one of the most common leukaemic diseases in middle Europe. Pathological fractures are rare findings in patients with CLL. The diagnosis of CLL is in most cases an incidental finding as it often stays asymptomatic for years. This article presents an interesting case of a 65-year-old male patient with known asymptomatic CLL for 5 years and fractures of the proximal femur and proximal radius after trauma. During the hospital stay the patient suffered multiple pathological fractures with histological findings of bony infiltration of the CLL and an acute phase, which was treated by combination chemotherapy...
June 18, 2018: Der Unfallchirurg
Ariana Lott, Rebekah Belayneh, Jack Haglin, Sanjit Konda, Kenneth A Egol
OBJECTIVES: Analyze the effectiveness of a BPCI (Bundle Payments for Care Improvement) initiative for patients who would be included in a future potential Surgical Hip and Femur Fracture Treatment (SHFFT) bundle. DESIGN: Retrospective cohort SETTING:: Single Academic Institution PATIENTS/PARTICIPANTS:: Patients discharged with operative fixation of a hip or femur fracture (DRG codes 480-482) between 1/2015-10/2016 were included. A BPCI initiative based upon an established program for BPCI Total Joint Arthroplasty (TJA) was initiated for patients with hip and femur fractures in January 2016...
May 28, 2018: Journal of Orthopaedic Trauma
R Dimock, D Elliott
No abstract text is available yet for this article.
June 18, 2018: Annals of the Royal College of Surgeons of England
Kyun-Ho Shin, Seung-Beom Han
INTRODUCTION: Acute kidney injury (AKI) is a common and serious complication after hip fracture surgery in older adults. Hypoalbuminemia is a known independent risk factor for AKI. However, few studies have investigated the relationship between early postoperative hypoalbuminemia and AKI after hip fracture surgery. Therefore, we sought to determine the incidence of and risk factors for AKI and the effects of early postoperative hypoalbuminemia on AKI incidence after surgery for hip fractures, especially intertrochanteric fractures of the proximal femur...
May 2, 2018: Injury
Antoine Morice, Florian Ducellier, Pascal Bizot
INTRODUCTION: The indications for total hip arthroplasty (THA) after failed internal fixation of a proximal femur fracture vary. Published studies on this topic are broad-ranging and do not distinguish between intracapsular and extracapsular fractures. This led us to conduct a retrospective analysis comparing the clinical outcomes, radiological outcomes, technical problems and complications between these two types of fractures. HYPOTHESIS: The functional outcomes of THA after an extracapsular fracture will be worse than the ones after an intracapsular fracture...
June 13, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Y Arlachov, R Ibrahem Adam
Acute hip pain is a common presenting complaint among patients attending Emergency Departments particularly following a traumatic event. A proximal femoral fracture is the main consideration, which requires urgent confirmation and treatment; however, there are a number of conditions, which could mimic neck of femur fracture and the causes may not be directly related to the hip, so systematic and careful observation of pelvic MRI could shed light on the true culprit of acute hip pain.
June 11, 2018: Clinical Radiology
Jaewon Yang, Namki Hong, Jee-Seon Shim, Yumie Rhee, Hyeon Chang Kim
Background: Type 2 diabetes mellitus is associated with an increased risk of osteoporotic fracture despite relatively preserved bone mineral density (BMD). Although this paradox might be attributed to the influence of insulin resistance (IR) on bone structure and material properties, the association of IR with femur bone geometry and strength indices remains unclear. Methods: Using data from the Cardiovascular and Metabolic Disease Etiology Research Center cohort study, we conducted a cross-sectional analysis among nondiabetic postmenopausal women...
May 2018: Journal of Bone Metabolism
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