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A L Adams, F Xue, J Q Chantra, R M Dell, S M Ott, S Silverman, J C Giaconi, C Critchlow
: Using the American Society for Bone and Mineral Research Task Force case definition for atypical femoral fractures, sensitivity and specificity of radiographic fracture characteristics were calculated. Fracture pattern was the most sensitive and specific characteristic. This suggests that some characteristics should be weighted more heavily when identifying these fractures. INTRODUCTION: To estimate the sensitivity and specificity of each radiographic criterion in the 2013 ASBMR atypical femoral fracture (AFF) case definition for distinguishing AFF from other subtrochanteric/diaphyseal fractures (non-AFF) among women enrolled in a large integrated health care organization...
October 21, 2016: Osteoporosis International
Sherif Galal
: Developmental coxa vara (DCV) develops during early childhood between the age of independent walking and 6 years. The deformity includes a decrease in the neck-shaft angle and femoral retroversion. Recently, good results have been reported using external fixator systems for the correction of proximal femoral deformities secondary to slipped capital femoral epiphysis, Perthes' disease in children, and percutaneous proximal femoral osteotomy for coxa vara. This preliminary study was performed to evaluate the results of percutaneous subtrochanteric osteotomy in restoring the normal alignment and orientation (radiographic outcome), thereby restoring the normal mechanics of the hip joint, overcoming shortening of the limb, and re-establishing the length-tension relationship of the abductor muscles (functional outcome)...
September 29, 2016: Journal of Pediatric Orthopedics. Part B
Daniel J Wescott, Lauren Rockhold Zephro
Over the past two centuries there have been documented secular changes in stature, weight, body proportions, and skeletal maturation rates in the United States. These changes along with a more sedentary lifestyle are likely reflected in femur morphology. Here we examine secular changes in diaphyseal cross-sectional size, shape, area, robusticity, and rigidity at midshaft and subtrochanteric of the femur using 395 adult white females and males from the United States born between the 1850s and the 1970s. The effect of secular change was controlled for an age effect...
January 2016: Human Biology
Richard L Jantz, Lee Meadows Jantz, Joanne L Devlin
Secular change in height has been extensively investigated, but size and shape of the postcranial skeleton much less so. The availability of large, documented collections of nineteenth- and twentieth-century skeletons makes it possible to examine changes in skeletal structure over the past 150 years. We examined secular changes in long bone lengths and proportions, their allometric relationship to stature, and crosssectional properties of long bone shafts. Bone measurements and stature were organized into 10-year birth cohorts, ranging from 1840 to 1989...
January 2016: Human Biology
Mark Lenz, Karl Stoffel, Heike Kielstein, Keith Mayo, Gunther O Hofmann, Boyko Gueorguiev
INTRODUCTION: Proximal plate fixation in periprosthetic femur fractures can be improved by plate anchorage in the greater trochanter (lateral tension band principle) or bicortical locking screw placement beside the prosthesis stem in an embracement configuration. Both concepts were compared in a biomechanical test using a femoral hook plate (hook) or a locking attachment plate (LAP). METHODS: After bone mineral density (BMD) measurement in the greater trochanter, six pairs of fresh frozen human femora were assigned to two groups and instrumented with cemented hip endoprostheses...
September 30, 2016: Injury
Yoichi Iizuka, Haku Iizuka, Tetsuya Kaneko, Tokue Mieda, Rumi Takechi, Hideki Suzuki, Yasunori Sorimachi, Takahito Suto, Masahiro Tachibana, Tomotaka Yoneyama, Takuya Omodaka, Shogo Hashimoto, Noritaka Hamano, Hideo Sakane, Daisuke Shimoyama, Isaku Kohama, Atsufumi Ohshima, Tatsuya Nozaki, Masataka Kamiyama, Tomohiko Moteki, Asuka Ohshima, Shuhei Takamine, Akira Honda, Akira Ueno, Tsuyoshi Tajika, Koichi Okamura, Toshiro Warita, Yukio Yonemoto, Hitoshi Shitara, Takashi Ohsawa, Kenji Takagishi
Many previous reports have indicated that atypical femur fractures (AFFs) are associated with the administration of bisphosphonates (BPs). A number of risk factors and hypotheses regarding the pathogenesis of AFFs have been reported to date. The purpose of the present study was to identify the factors associated with AFFs in Japanese individuals and to elucidate the association between bone metabolism and AFFs by evaluating bone turnover markers (BTMs). We prospectively reviewed all patients with femur fractures and identified the patients with AFFs and typical femur fractures (TFFs)...
September 20, 2016: Injury
N A Johnson, C Uzoigwe, M Venkatesan, V Burgula, A Kulkarni, J N Davison, R U Ashford
INTRODUCTION Intramedullary nailing is a common treatment for proximal femoral fractures. Fracture of the nail is a rare but devastating complication that exposes often frail patients to complex revision surgery. We investigated which risk factors predict nail failure. METHODS We reviewed all cases of nail breakage seen over a 10-year period in a single busy trauma unit; 22 nail fractures were seen in 19 patients. Comparison was made with a group of 209 consecutive patients who underwent intramedullary fixation of a proximal femur fracture with no nail breakage over a 2-year period...
September 23, 2016: Annals of the Royal College of Surgeons of England
Hiroaki Kijima, Shin Yamada, Natsuo Konishi, Hitoshi Kubota, Hiroshi Tazawa, Takayuki Tani, Norio Suzuki, Keiji Kamo, Yoshihiko Okudera, Ken Sasaki, Tetsuya Kawano, Naohisa Miyakoshi, Yoichi Shimada
PURPOSE: In femoral trochanteric fractures, fractures whose fracture lines extend to the basal neck or to the subtrochanteric part have high instability. Area classification can identify such instable fractures. The best choices of internal fixators for femoral trochanteric fractures were investigated according to area classification. METHODS: Femoral trochanteric fractures were investigated with respect to area classification. In area classification, the proximal femur is divided into 4 areas with 3 boundary lines: Line-1 is the center of the neck; Line-2 is the border between the neck and the trochanteric zone; and Line-3 links the inferior borders of the greater and lesser trochanters...
2016: SpringerPlus
Yukichi Zenke, Satoshi Ikeda, Fumio Fukuda, Masahiro Tanaka, Hidetoshi Tanaka, Fumitaka Hirano, Akinori Sakai
UNLABELLED: There are several causes of atypical femoral fractures (AFF) in elderly Japanese patients, including longterm bisphosphonate (BP) use or bowed femoral shaft stress fractures, but the available sample size for examining AFF etiology in a single institution is limited. The purpose of this study was to categorize the characteristics of AFF by analyzing the data compiled on patients treated at our hospital and at affiliated institutes. This multicenter, retrospective, observational study included 34 AFF cases (bilateral AFF 10) in one male and 23 female patients (age range 30-90 years, mean age 73...
September 2016: Journal of UOEH
R Guzmán-Vargas, D F Rincón-Cardozo, J A Camacho-Casas
Subtrochanteric fractures in children are rare events, occur in only 4% of all femur fractures, most injuries occur as a result of high energy trauma, being young males patient the most affected. The management of this type of injury is controversial, there are many forms of treatment, including the use of plaster spica 90-90, closed reduction and use of elastic or rigid intramedullary nails, open reduction and plate placement and external fixators. Most suggest that children under 10 should be preferred non-operative and for older than 12 surgical management is indicated, but the discussion is between 6 and 12 years old...
January 2016: Acta Ortopédica Mexicana
Jedidiah E Schlung, Tracey P Bastrom, Joanna H Roocroft, Peter O Newton, Scott J Mubarak, Vidyadhar V Upasani
BACKGROUND: The role of femoral aspiration (FA) in the treatment of septic arthritis of the hip is controversial. The purpose of this study was to determine if FA conducted concomitantly with irrigation and debridement (I&D) of the septic hip aids in microorganism and osteomyelitis identification and alters the treatment plan, or if the risks of the procedure outweigh its potential benefit. We also compare preoperative magnetic resonance imaging (MRI) with FA for diagnosis of osteomyelitis cooccurring with septic arthritis...
September 3, 2016: Journal of Pediatric Orthopedics
Jae Hyuk Yang, Tae Gon Jung, Arjun Rupanagudi Honnurappa, Jae Min Cha, Chang Hwa Ham, Tae Yoon Kim, Seung Woo Suh
Introduction. To compare the biomechanical stability of the femur following the removal of proximal femoral nail antirotation (PFNA-II) and dynamic hip screw (DHS). Material and Methods. 56 paired cadaveric femurs were used as experimental and control groups. In the experimental group, PFNA-II and DHS were randomly inserted into femurs on both sides and then removed. Thereafter, compression load was applied until fracture occurred; biomechanical stability of the femurs and associated fracture patterns were studied...
2016: Applied Bionics and Biomechanics
Xigong Li, Yang Lu, Junying Sun, Xiangjin Lin, Tiansi Tang
BACKGROUND: The purpose of this study was to evaluate the functional and radiographic results of patients with Crowe type-IV hip dysplasia treated by cementless total hip arthroplasty and double chevron subtrochanteric osteotomy. METHODS: From January 2000 to February 2006, cementless total hip arthroplasty with a double chevron subtrochanteric shortening osteotomy was performed on 18 patients (22 hips) with Crowe type-IV dysplasia. The acetabular cup was placed in the position of the anatomic hip center, and subtrochanteric femoral shortening osteotomy was performed with the use of a double chevron design...
August 10, 2016: Journal of Arthroplasty
Mohamed Mansour Elzohairy, Hosam Mohamed Khairy
BACKGROUND: Although the valgus subtrochanteric osteotomy is considered as a standard surgical treatment for coxa vara, there is no consensus on the optimal method of fixation and osteotomy technique. Fixation of the osteotomy has been achieved by various methods including external fixation and internal fixation with pins and cerclage and a variety of plates. The aim of this study is the evaluation of the results of developmental coxa treated by Y intertrochanteric valgus osteotomy fixed with a T-buttress plate compared with other methods of fixation in the literature...
September 2016: Clinics in Orthopedic Surgery
Shahin Sheibani-Rad
Bisphosphonates are widely used for the prevention of osteoporosis-associated fractures. Femoral fractures associated with bisphosphonate use are increasingly being reported in the literature. Orthopedic surgeons should be aware of this potential association and related implications for patient treatment. Bisphosphonate-associated fractures are characteristically simple, transverse with beaking, and subtrochanteric. Diagnosis is based on a careful history, physical examination, and focused imaging. In the setting of either a complete or partial fracture, it is recommended that bisphosphonate therapy be halted and calcium and vitamin D brought into the therapeutic range...
August 18, 2016: Orthopedics
Byung-Woo Min, Kyung-Jae Lee, Ki-Cheor Bae, Si-Wuk Lee, Seok-Jung Lee, Jung-Hoon Choi
PURPOSE: This study was conducted to evaluate the results of internal fixation for stable femoral neck fractures occurring in patients over 65 years old. MATERIALS AND METHODS: Between 2008 and 2014, we evaluated 25 patients over 65 years old with Garden type 1 and 2 femoral neck fractures that were treated with internal fixation after a minimum follow up of 1 year. There were 5 males and 20 females and the average age was 72.3 years (range, 65-84 years) at the time of surgery...
March 2016: Hip Pelvis
Young Soo Chun, Jung Suk Lee, Yoon Je Cho, Kee Hyung Rhyu
As the osteoporotic patient population grows, various periprosthetic fractures that cannot be classified appropriately can occur around the femur after hip arthroplasty. We experienced two cases of periprosthetic insufficiency fractures at subtrochanteric area of the femurs around radiographically loose cemented femoral stems. The ages of the patients were 75 years and 83 years. Both patients could not recall any history of trauma before the onset of pain. Both were treated non-operatively. Both healed uneventfully and did not recur after two years of follow up...
September 2015: Hip Pelvis
Seyyed Morteza Kazemi, Mohamad Qoreishy, Ali Keipourfard, Mohammadreza Minator Sajjadi, Shahram Shokraneh
BACKGROUND: Some studies have previously shown that geometry of proximal femur can affect the probability of fracture and type of fracture. It happens since the geometry of the proximal femur determines how a force is applied to its different parts. In this study, we have compared proximal femur's geometric characteristics in femoral neck (FNF), intertrochanteric (ITF) and Subtrochanteric (STF) fractures. METHODS: In this study, 60 patients who had hip fractures were studied as case studies...
June 2016: Archives of Bone and Joint Surgery
Sampat S Dumbre Patil, Sachin S Karkamkar, Vaishali S Dumbre Patil, Shailesh S Patil, Abhijeet S Ranaware
BACKGROUND: When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN) or surface implants like Dynamic Condylar Screw (DCS) are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other...
July 2016: Indian Journal of Orthopaedics
Deniz Çankaya, Burak Yoldaş, Elif Çankaya, Yalçın Çakir, Cemal Aydin, Abdullah Yalçın Tabak
BACKGROUND/AIM: Despite the importance of hip fractures, very few studies have assessed their epidemiological characteristics in Turkey. The aim of this study was to evaluate the frequency and demography of hip fractures from the recent data of a central training and research hospital. MATERIALS AND METHODS: In this descriptive study, we identified hip fracture cases between 2009 and 2013. The age, sex, region, injury pattern, and calendar year for all patients were evaluated...
2016: Turkish Journal of Medical Sciences
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