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https://www.readbyqxmd.com/read/29666734/open-reduction-and-internal-fixation-of-a-proximal-femoral-shaft-fracture-in-a-patient-with-bilateral-congenital-hip-disease
#1
Stefania Kanata, Antonios Anastasiadis
We present a rare case of a femoral shaft fracture in a 74-year-old woman with a preexisting untreated bilateral congenital hip dislocation and with concomitant leg length discrepancy. Because of the marked deformity of the upper femur, a derivative of the congenital hip disease, an open reduction and internal fixation was performed, with the use of an anatomic femur plate originally designed for the treatment of periprosthetic fractures. The patient was treated successfully and returned to her previous status of activity...
2018: Case Reports in Orthopedics
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
#2
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
#3
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/29664884/biomechanical-testing-of-a-3-hole-versus-a-4-hole-sliding-hip-screw-in-the-presence-of-a-retrograde-intramedullary-nail-for-ipsilateral-intertrochanteric-and-femur-shaft-fractures
#4
Michael Olsen, Peter Goshulak, Meghan C Crookshank, Joel Moktar, Ignace J Brazda, Emil H Schemitsch, Radovan Zdero
OBJECTIVE: The goal of this study was to compare a 3-hole vs. a 4-hole sliding hip screw (SHS) in the presence of a retrograde intramedullary (RIM) nail for fixing intertrochanteric and comminuted midshaft femur fractures. METHODS: Mechanical tests were performed on 10 matched pairs of human cadaveric femurs that were osteotomized and then fixed using a 3-hole SHS vs. the traditional "gold standard" 4-hole SHS in the presence of a RIM nail. RESULTS: Data showed no differences between the 3-hole SHS with RIM nail vs...
April 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29663560/activation-of-hedgehog-signaling-by-systemic-agonist-improves-fracture-healing-in-aged-mice
#5
Jennifer A McKenzie, Clayton Maschhoff, Xiaochen Liu, Nicole Migotsky, Matthew J Silva, Michael J Gardner
Fracture healing is a complex process of many coordinated biological pathways. This system can go awry resulting in nonunion, which leads to significant patient morbidity. The Hedgehog (Hh) signaling pathway is upregulated in fracture healing. We hypothesized that the Hh signaling pathway can be pharmacologically modulated to positively affect fracture healing. Diaphyseal femur fractures were created in elderly mice (18 months, C57BL/6 females), which have a blunted and delayed healing response compared to younger mice, and were stabilized with intramedullary pins...
April 16, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29661687/impact-of-weight-loss-with-intragastric-balloon-on-bone-density-and-microstructure-in-obese-adults
#6
Eduardo Madeira, Miguel Madeira, Erika Paniago Guedes, Thiago Thomaz Mafort, Rodrigo Oliveira Moreira, Laura Maria Carvalho de Mendonça, Inayá Correa Barbosa Lima, Leonardo Vieira Neto, Paulo Roberto Alves de Pinho, Agnaldo José Lopes, Maria Lucia Fleiuss Farias
The historical concept that obesity protects against bone fractures has been questioned. Weight loss appears to reduce bone mineral density (BMD); however, the results in young adults are inconsistent, and data on the effects of weight loss on bone microstructure are limited. This study aimed to evaluate the impact of weight loss using an intragastric balloon (IGB) on bone density and microstructure. Forty obese patients with metabolic syndrome (mean age 35.1 ± 7.3 yr) used an IGB continuously for 6 mo...
March 21, 2018: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/29661684/trabecular-bone-score-and-hip-structural-analysis-in-patients-with-atypical-femur-fractures
#7
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/29660737/treatment-of-a-paediatric-distal-femoral-malunion-deformity
#8
Greta S Pavarotti, Randy J Boudrieau
OBJECTIVE:  The aim of this article was to describe the surgical re-alignment technique and stabilization of a distal femoral deformity in a 6-week-old, male, Foxhound. METHODS:  A healing metaphyseal fracture, resulting in a valgus deformity with internal rotation, was observed just proximal to the distal femoral physis. The deformity was treated by an opening wedge osteotomy with lateral translation and external rotation of the distal epiphysis using a guide-wire technique; a corticocancellous allograft bridged the defect, which was stabilized with a 2...
April 16, 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/29658534/the-influence-of-osteoporotic-bone-structures-of-the-pelvic-hip-complex-on-stress-distribution-under-impact-load
#9
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/29657845/long-term-bone-remodelling-around-legendary-cementless-femoral-stems
#10
Charles Rivière, Guido Grappiolo, Charles A Engh, Jean-Pierre Vidalain, Antonia-F Chen, Nicolas Boehler, Jihad Matta, Pascal-André Vendittoli
Bone remodelling around a stem is an unavoidable long-term physiological process highly related to implant design. For some predisposed patients, it can lead to periprosthetic bone loss secondary to severe stress-shielding, which is thought to be detrimental by contributing to late loosening, late periprosthetic fracture, and thus rendering revision surgery more complicated.However, these concerns remain theoretical, since late loosening has yet to be documented among bone ingrowth cementless stems demonstrating periprosthetic bone loss associated with stress-shielding...
February 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29657465/do-demographic-and-perioperative-parameters-really-affect-the-final-outcomes-of-pediatric-femur-shaft-fractures-managed-by-elastic-nails-a-prospective-study
#11
Abhinandhan Reddy, Narendran Pushpasekaran, Jitendra Singh, Gokul Chand Verma, Sathyamurthy Palanisamy
Objective: Pediatric femoral shaft fractures are more commonly treated with intramedullary titanium elastic nail system (TENS). Adhering to the principles, most studies had supported excellent results with this instrumentation and attributed the variation in age, weight, immobilization protocols, technical factors like fracture pattern, reduction and complications as reasons to poor outcomes in their individual studies. Hence, we wanted to identify the potential demographic and perioperative parameters that could affect the final outcomes in this cohort...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29657443/healing-of-femoral-fractures-by-the-meaning-of-an-innovative-intramedullary-nail
#12
V Filardi
In this paper, an innovative design of nail, conceived to heal fractures of long bones has been investigated. Its functioning is based essentially on sliding of conical surfaces located in a spindle and in a series of holding pins radially disposed around it. Spindle and holding pins are connected together by means of a sleeve. Medial and distal screws are not necessary. Rotational and longitudinal motions of the spindle are transformed in a radial expansion of the holding pins by the sliding of conical surfaces...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29655780/dietary-flavonoid-kaempferol-inhibits-glucocorticoid-induced-bone-loss-by-promoting-osteoblast-survival
#13
Sulekha Adhikary, Dharmendra Choudhary, Naseer Ahmad, Anirudha Karvande, Avinash Kumar, Venkatesh Teja Banala, Prabhat Ranjan Mishra, Ritu Trivedi
OBJECTIVE: Kaempferol, a dietary flavonoid found in fruits and vegetables, has been reported to reverse osteopenic condition in ovariectomized rats. Because kaempferol is endowed with osteogenic activity, the aim of this study was to determine whether it has a beneficial effect on glucocorticoid (GC)-induced bone loss. METHODS: Adult female rats were divided into four groups as control (vehicle; distilled water), methylprednisolone (MP; 5 mg•kg•d, subcutaneously), MP + kaempferol (5 mg•kg•d, oral), and MP + human parathyroid 1-34 (30 µg/kg, 5 times/wk, subcutaneously) and treated for 4 wk...
February 13, 2018: Nutrition
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
#14
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/29651610/periprosthetic-femoral-fracture-as-cause-of-early-revision-after-short-stem-hip-arthroplasty-a-multicentric-analysis
#15
Sang-Min Kim, Seung-Beom Han, Kee Hyung Rhyu, Jeong Joon Yoo, Kwang-Jun Oh, Je Hyun Yoo, Kyung-Jae Lee, Seung-Jae Lim
BACKGROUND: The objective of this study was to analyze the prevalence and causes of early re-operation after hip replacement surgery using short bone-preserving stems in a large multicentre series. Specifically, we evaluated the clinical features of periprosthetic fractures occurring around short stems. METHODS: A total of 897 patients (1089 hips) who underwent primary total hip arthroplasty or bipolar hemiarthroplasty from January 2011 to February 2015 using short bone-preserving femoral stems were recruited...
April 12, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29650034/complex-fracture-orthopedic-rehabilitation-comfort-real-time-visual-biofeedback-on-weight-bearing-versus-standard-training-methods-in-the-treatment-of-proximal-femur-fractures-in-the-elderly-study-protocol-for-a-multicenter-randomized-controlled-trial
#16
Marco Raaben, Syaiful Redzwan, Robin Augustine, Taco Johan Blokhuis
BACKGROUND: Proximal femur fractures are a common injury after low energy trauma in the elderly. Most rehabilitation programs are based on restoring mobility and early resumption of weight-bearing. However, therapy compliance is low in patients following lower extremity fractures. Moreover, little is known about the relevance of gait parameters and how to steer the rehabilitation after proximal femur fractures in the elderly. Therefore, the aim of this prospective, randomized controlled trial is to gain insight in gait parameters and evaluate if real-time visual biofeedback can improve therapy compliance after proximal femur fractures in the elderly...
April 12, 2018: Trials
https://www.readbyqxmd.com/read/29649099/functional-and-radiological-results-of-proximal-femoral-nail-antirotation-pfna-osteosynthesis-in-the-treatment-of-unstable-pertrochanteric-fractures
#17
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/29645343/activation-of-hedgehog-signaling-by-systemic-agonist-improves-fracture-healing-in-aged-mice
#18
Jennifer A McKenzie, Clayton Maschhoff, Xiaochen Liu, Nicole Migotsky, Matthew J Silva, Michael J Gardner
Fracture healing is a complex process of many coordinated biological pathways. This system can go awry resulting in nonunion, which leads to significant patient morbidity. The Hedgehog (Hh) signaling pathway is upregulated in fracture healing. We hypothesized that the Hh signaling pathway can be pharmacologically modulated to positively affect fracture healing. Diaphyseal femur fractures were created in elderly mice (18 months, C57BL/6 females), which have a blunted and delayed healing response compared to younger mice, and were stabilized with intramedullary pins...
April 12, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29644322/conservative-treatment-of-periprosthetic-femur-fractures-around-metaphyseal-short-stems-a-feasible-option
#19
K Toth, H Gality, K Gion, K Sisak
Periprosthetic femoral fractures are rare but significant events following total hip replacement. Metaphyseal short stems have recently been popularized as a bone preserving alternative to conventional uncemented total hip replacement. We present two periprosthetic femur fractures which occurred around two different metaphyseal uncemented stem designs. Successful conservative treatment was possible in both cases achieving bony union and excellent clinical results.
June 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29644317/a-rare-case-of-hoffa-fracture-combined-with-lateral-patellar-dislocation
#20
Martin C Jordan, Leonie A Bittrich, Kai Fehske, Rainer H Meffert, Hendrik Jansen
The coronal unicondylar fracture of the distal femur (AO 33-B3) is a rare intraarticular injury within the weight bearing area of the knee, initially described by Albert Hoffa in 1904. We report an unusual combination of a Hoffa fracture with lateral patellar dislocation in a young adult. Our patient sustained the injury by a sudden twist of his leg during sports. He presented clinically with knee swelling, dislocation of the patella, and localized tenderness; unable to bare weight. After plane radiograph confirmed the injury, manual reduction of the patella was done by hyperextension of the knee and medialward pressure...
June 2017: Trauma Case Reports
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