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P Y Mathonet, S Willems, J F Ciornohac
Bisphosphonates have frequently shown their efficacy in the treatment of osteoporosis, including ibandronate and alendronate. But more and more mention is made in the literature of patients taking a long-term bisphosphonate and undergoing an atypical fracture associated with this therapy. These complications are most often femoral fractures in the proximal part of the femoral diaphysis. We report the case of a 73-year-old patient who had a subtrochanteric pathological fracture after a prolonged intake of alendronate followed by ibandronate...
February 2018: Revue Médicale de Liège
Ifaz T Haider, Prism Schneider, Andrew Michalski, W Brent Edwards
INTRODUCTION: Atypical femoral fractures (AFF) are characterized as low-energy fractures of the femoral shaft or subtrochanteric region. Femoral geometry is known to play a role in AFF risk; it is hypothesized that high-risk geometries are associated with elevated femoral shaft strain. However, it is not well known which geometric parameters have the greatest effect on strain, or whether interaction between parameters is significant. The purpose of this study was to thoroughly quantify the relationship between femoral geometry and diaphyseal strain, using patient specific finite element (FE) modelling in concert with parametric mesh morphing...
February 23, 2018: Bone
Vivek Trikha, Saubhik Das, Prabhat Agrawal, Arkesh M, Sunil Kumar Dhaka
PURPOSE: Cerclage wire application has emerged as a potential therapeutic adjunct to intramedullary nailing for subtrochanteric fractures. But its popularity is plagued by the concern of possible negative effect on fracture zone biology. This study was intended to analyze the clinico-radiological outcome and complications associated with cerclage wire application. METHODS: Retrospective analysis was performed on all the subtrochanteric fractures operated with intramedullary nailing between January 2012 and January 2016...
February 6, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Lei Han, Yun-Gen Hu, Wei-Li Fang, Bo Jin, Shi-Chao Xu
OBJECTIVE: To study clinical effects of inversive LISS(less invasive stabilization system, LISS) plate for the treatment of intertrochanteric and subtrochanteric fractures combined with femoral shaft fractures. METHODS: From January 2012 to January 2015, 24 patients with intertrochanteric and subtrochanteric fractures combined with femoral shaft fractures were treated with inversive LISS plate, included 16 males and 8 females with an average age of 62.5 years old ranged from 35 to 81 years old...
July 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Bin-Fei Zhang, Yu-Xuan Cong, Peng-Fei Wang, Hai Huang, Hu Wang, Yan Zhuang
INTRODUCTION: Complications involving vascular injuries after hip fracture are rare, and the diagnosis and management of deep femoral artery (DFA) injuries are challenging. We reported 4 cases of DFA injuries after hip fracture surgery and aimed to discuss their early detection, treatment, and prevention. METHODS: We reviewed 4 cases of deep femoral injury after hip fracture. Case 1: a 71-year-old woman suffered a fracture around a prosthesis. Cases 2-4: 2 men and 1 woman suffered subtrochanteric or intertrochanteric fracture...
February 2018: Medicine (Baltimore)
Young-Kyun Lee, Hong Seok Kim, Hwan Seong Cho, Kyung-Hoi Koo
Atypical femoral fracture (AFF) has been widely issued since the American Society for Bone and Mineral Research (ASBMR) taskforce stated a possible association with long-term use of bisphosphonate in 2010. ASBMR taskforce recommended to include Paget's disease as one of variables to investigate the AFF in 2010. On the other hand, the ASBMR taskforce in 2014 excluded Paget's disease in the definition of AFF. Still, any rationale has been barely documented about this change. We described the rationale by reporting an 85-year-old man who had a subtrochanteric fracture with features of atypical femoral fracture which turned out to be Paget's disease of bone in the pathology...
September 2017: Clinical Cases in Mineral and Bone Metabolism
Elias Mazzawi, Daniela Militianu, Mark Eidelman, Yaniv Keren
Introduction: Radiofrequency ablation is an effective modality in treating osteoid osteoma while avoiding the complications of an open procedure. Its complications are usually self-limited consisting mostly of local skin burns. This report presents a major complication, a femur shaft fracture following an osteoid osteoma radiofrequency ablation. The fracture occurred approximately one year after the ablation at the site of the osteoid osteoma. Discussion: Few case reports have been published regarding subtrochanteric femur fracture after ablation of an osteoid osteoma...
September 2017: Clinical Cases in Mineral and Bone Metabolism
John E Lawrence, Danish Saeed, Jonathan Bartlett, Andrew D Carrothers
We report the case of a 55-year-old woman who presented to the emergency department having woken from sleep with right sided thigh swelling. Pelvic radiographs revealed bilateral atypical subtrochanteric femoral fractures (ASFFs). In the two years leading up to this admission, the patient had experienced gradually increasing pain and weakness in her legs which had resulted in a decrease in her mobility from fully mobile to bed-bound. During this time a neurologist had organised a magnetic-resonance imaging (MRI) scan of the brain and spine which was normal...
September 2017: Clinical Cases in Mineral and Bone Metabolism
Hu-Cheng Tan, Wei-Min Su, Cai-Sheng Zhou
OBJECTIVE: To explore curative effects of external fixation combined with single hip plaster in treating children with femoral subtrochanteric fracture. METHODS: Form March 2009 to July 2016, 15 children with femoral subtrochanteric fracture were treated with external fixation combined with single hip plaster, including 9 males and 6 females with a mean age of 8.5 years old ranging from 5 to 14 years old. According to fracture classification of Seinsheimer, 3 cases were type IIA, 4 cases were type IIB, 3 cases were type IIC, 2 cases were type IIIA, 1 case was type IIIB, 1 case was type IV, 1 case was type V...
March 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
M Kumar, V Akshat, A Kanwariya, M Gandhi
Introduction: Sub-trochanteric fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. This study was done to analyse the management and complications of sub-trochanteric fractures using long proximal femoral nail (PFN). Materials and Methods: This was a prospective study of 50 patients with sub-trochanteric fractures of femur who were treated with long PFN at a tertiary care center from July 2012 to June 2016. The fractures were classified according to Seinsheimer classification...
November 2017: Malaysian Orthopaedic Journal
Katharine D Harper, Paul Navo, Frederick Ramsey, Sainabou Jallow, Saqib Rehman
Purpose: Excessive blood loss with hip fracture management has been shown to result in increased rates of complications. Our goal is to compare blood loss and transfusion rates between patients with intracapsular and extracapsular (both intertrochanteric (IT) and subtrochanteric (ST)) hip fractures. Methods: 472 patients were evaluated over a five-year period. Those who presented to the hospital with a proximal femur fracture (femoral neck, IT or ST) were considered for the study...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
K J Donnelly, A Tucker, B Kerr, S McDonald, D S O'Longain, J D Acton
The term atypical femoral fractures most commonly occur in the subtrochanteric area. Concerns exist regarding the role of bisphosphonate treatment in their aetiology. Which surgical intervention provides the best outcome remains contentious. We reviewed all atypical subtrochanteric femoral fractures treated in Northern Ireland over 5 years, specifically investigating incidence, prodromal symptoms, association with bisphosphonates and optimal fixation methods. All subtrochanteric fractures treated in the region were identified and reviewed for atypical features...
December 22, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Morgane Righetti, Jean Wach, Romain Desmarchelier, Fabienne Coury
Atypical femoral fractures are defined as atraumatic fractures located in the subtrochanteric region or femoral shaft. They have been mainly reported in patients taking bisphosphonates. We report the case of a 67-year-old female with osteoporosis treated by alendronate during ten years. Radiographies showed atypical femoral fractures. Serum levels of total and bone-specific alkaline phosphatase were low. In order to accelerate bone healing, teriparatide was introduced. After one year of teriparatide treatment, pain and functional difficulty have decreased, and alkaline phosphatase levels were normalized...
December 12, 2017: Joint, Bone, Spine: Revue du Rhumatisme
Wen-Ling Yeh, Chun-Yi Su, Chia-Wei Chang, Chien-Hao Chen, Tsai-Sheng Fu, Lih-Huei Chen, Tung-Yi Lin
BACKGROUND: Atypical subtrochanteric fracture and femoral fracture have been considered to be rare complications related to long-term bisphosphonates use. A reduced bone turnover rate may lead to delayed bone healing. Limited data have revealed that teriparatide treatment may reverse the effect of bisphosphonates and be effective in bone healing. METHODS: We reviewed patients with atypical subtrochanteric and femoral fracture related to bisphosphonates use between January 2008 and December 2014...
December 13, 2017: BMC Musculoskeletal Disorders
Syed Ibrahim, Jimmy Joseph Meleppuram
Objective: Analyze the outcomes of proximal femoral locking compression plate (PF-LCP) in these complex fractures. Methods: This study retrospectively analyzed 21 proximal femoral fractures treated with PF-LCP from June 2013 to February 2015. There were 15 females (71%) and six males (29%) with an average age of 61.4 years (range: 34-80 years). The peritrochanteric fractures constituted by intertrochanteric and subtrochanteric fractures were classified by the Boyd and Griffin classification and Seinshemier's classification, respectively...
November 2017: Revista Brasileira de Ortopedia
Naoki Kondo, Tomomi Fukuhara, Yo Watanabe, Dai Miyasaka, Noriaki Yamamoto, Hiroe Sato, Yoko Wada, Takeshi Nakatsue, Junichi Fujisawa, Mayumi Sakuma, Norio Imai, Takuya Yoda, Ichiei Narita, Naoto Endo
Atypical femoral fractures (AFFs) are defined as atraumatic or low-trauma fractures located in the subtrochanteric or diaphyseal sites. Long-term bisphosphonates (BPs) are administered to prevent fragility fractures in patients with primary osteoporosis or collagen diseases who are already taking glucocorticoids (GCs). Long-term BP use is one of the most important risk factors for AFFs. Its pathogenesis is characterized by severely suppressed bone turnover (SSBT), but whether the characteristics of patients are different regarding to location of fracture site remains unknown...
December 2017: Tohoku Journal of Experimental Medicine
J Gómez-Álvarez, S González-Escobar, E Gil-Garay
INTRODUCTION: Some patients with a hip fracture also present a concomitant upper limb fracture. We want to know whether these patients have a worse functional level and whether they have any differences in various clinical parameters compared with patients with an isolated hip fracture. MATERIAL AND METHODS: We retrospectively reviewed 1061 discharge reports from the Orthogeriatrics Unit. We collected information on several clinical parameters of the fractures. Subsequently, we performed a statistical analysis of the data by comparing the associated fracture group with the isolated fracture group...
November 28, 2017: Revista Española de Cirugía Ortopédica y Traumatología
S Frik
In daily clinical practice most orthopedic surgeons suffer from doubt about treatment of rare injuries. The aim of this study is to enlighten the management of birth related femoral subtrochanteric fractures of neonates. Four birth-related femoral subtrochanteric fractures of neonates were treated and followed up. Difficult caesarian breech delivery seems to be a risk factor. All patients were treated with Pavlik harness and union was achieved by the fourth week. None of the patients suffer any angulation or limb length discrepancy...
December 2016: Acta Orthopaedica Belgica
Sanjay Agarwala, Aditya Menon, Sameer Chaudhari
Introduction: Cerclage wiring has been used in the past for osteosynthesis of femoral fractures. However, the technique went into disrepute as extensive soft tissue dissection, and periosteal stripping increased the risk of bone necrosis and delayed union. Advent of new instrumentation and minimally invasive technique has significantly reduced these complications. In spite of the limited indications for its application, reduction and stabilization with cerclage wiring can supplement osteosynthesis especially in spiral or oblique fracture morphology or those with a butterfly fragment instead of interfragmentary screw fixation...
July 2017: Journal of Orthopaedic Case Reports
Duan Wang, De-Hua Li, Qi Li, Hao-Yang Wang, Ze-Yu Luo, Yang Yang, Fu-Xing Pei, Zong-Ke Zhou
BACKGROUND: This retrospective study was designed to determine complications, functional and radiographic results of transverse subtrochanteric osteotomy during cementless, modular total hip arthroplasty (THA) in a series of active patients younger than 45 years with Crowe Type-III or IV developmental dysplasia of the hip (DDH). METHODS: We followed 49 patients (56 hips) with DDH who were treated with cementless THA, where the acetabular cup was positioned in the anatomic hip center and where a simultaneous transverse femoral osteotomy was performed...
November 25, 2017: BMC Musculoskeletal Disorders
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