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https://www.readbyqxmd.com/read/29326764/a-prospective-study-to-evaluate-the-management-of-sub-trochanteric-femur-fractures-with-long-proximal-femoral-nail
#1
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
https://www.readbyqxmd.com/read/29318081/-hidden-preoperative-blood-loss-with-extracapsular-versus-intracapsular-hip-fractures-what-is-the-difference
#2
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
https://www.readbyqxmd.com/read/29273918/a-review-of-atypical-subtrochanteric-femoral-fractures-in-northern-ireland-between-2010-and-2014
#3
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
https://www.readbyqxmd.com/read/29246529/teriparatide-treatment-in-an-adult-patient-with-hypophosphatasia-exposed-to-bisphosphonate-and-revealed-by-bilateral-atypical-fractures
#4
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 normalised...
December 12, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/29237448/surgical-outcome-of-atypical-subtrochanteric-and-femoral-fracture-related-to-bisphosphonates-use-in-osteoporotic-patients-with-or-without-teriparatide-treatment
#5
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
https://www.readbyqxmd.com/read/29234646/a-retrospective-analysis-of-surgically-treated-complex-proximal-femur-fractures-with-proximal-femoral-locking-compression-plate
#6
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
https://www.readbyqxmd.com/read/29212985/bone-formation-parameters-of-the-biopsied-ilium-differ-between-subtrochanteric-and-diaphyseal-atypical-femoral-fractures-in-bisphosphonate-treated-patients
#7
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...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29196226/clinical-assessment-of-patients-with-isolated-hip-fractures-associated-with-an-upper-limb-fracture
#8
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
https://www.readbyqxmd.com/read/29182128/management-of-birth-associated-subtrochanteric-femur-fractures
#9
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
https://www.readbyqxmd.com/read/29181351/cerclage-wiring-as-an-adjunct-for-the-treatment-of-femur-fractures-series-of-11-cases
#10
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
https://www.readbyqxmd.com/read/29178854/subtrochanteric-shortening-osteotomy-during-cementless-total-hip-arthroplasty-in-young-patients-with-severe-developmental-dysplasia-of-the-hip
#11
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
https://www.readbyqxmd.com/read/29177775/shortening-subtrochanteric-osteotomy-and-cup-placement-at-true-acetabulum-in-total-hip-arthroplasty-of-crowe-iii-iv-developmental-dysplasia-results-of-midterm-follow-up
#12
Alireza Manafi Rasi, Gholamhossein Kazemian, Mohammad Khak, Reza Zarei
INTRODUCTION: The anatomic abnormalities in developmental dysplasia of hip (DDH) often make total hip replacement (THR) inevitable at a younger age. However, there is no universal gold standard technique of THR for high dislocated dysplastic hips. MATERIALS AND METHODS: Here we present the outcomes of midterm follow-up after THR in patients diagnosed with DDH Crowe type III and IV hospitalized in a tertiary center in Iran for whom placement of a cup in true acetabulum and selective transverse subtrochanteric osteotomy was performed...
November 25, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29162265/the-impact-of-antegrade-intramedullary-nailing-start-site-using-the-sign-nail-in-proximal-femoral-fractures-a-prospective-cohort-study
#13
Mohamed Mustafa Diab, Hao-Hua Wu, Edmund Eliezer, Billy Haonga, Saam Morshed, David W Shearer
INTRODUCTION: In many low and middle-income countries (LMICs) SIGN nail is commonly used for antegrade femoral intramedullary (IM) nailing, using a start site either at the tip of the greater trochanter or piriformis fossa. While a correct start site is considered an essential technical step; few studies have evaluated the impact of using an erroneous start site. This is particularly relevant in settings with limited access to fluoroscopy to aid in creating a nail entry point. The purpose of this study was to evaluate the impact of antegrade SIGN IM nailing start site on radiographic alignment and health-related quality of life...
November 18, 2017: Injury
https://www.readbyqxmd.com/read/29162240/influence-of-gap-size-screw-configuration-and-nail-materials-in-the-stability-of-anterograde-reamed-intramedullary-nail-in-femoral-transverse-fractures
#14
Sergio Gabarre, Jorge Albareda, Luis Gracia, Sergio Puértolas, Elena Ibarz, Antonio Herrera
Femoral shaft fractures are among the most severe injuries of the skeleton. They are associated with high morbidity and mortality. The most appropriate treatment depending on the type of fracture and location level should be chosen. A finite element model of the femur has been developed, analyzing various types of fractures in the subtrochanteric and diaphyseal supracondylar area, with several gap sizes, being stabilized with a single combination of screws for the intramedullary nail. The mechanical strength of the nail against bending and compression efforts was studied comparing two materials for the nail: stainless steel and titanium alloy...
November 2017: Injury
https://www.readbyqxmd.com/read/29138386/reverse-less-invasive-stabilization-system-liss-plating-for-proximal-femur-fractures-in-poliomyelitis-survivors-a-report-of-two-cases
#15
Chen Yao, Dongxu Jin, Changqing Zhang
BACKGROUND Poliomyelitis is a neuromuscular disease which causes muscle atrophy, skeletal deformities, and disabilities. Treatment of hip fractures on polio-affect limbs is unique and difficult, since routine fixation methods like nailing may not be suitable due to abnormal skeletal structures. CASE REPORT We report one femoral neck fracture and one subtrochanteric fracture in polio survivors successfully treated with reverse less invasive stabilization system (LISS) plating technique. Both fractures were on polio-affected limbs with significant skeletal deformities and low bone density...
November 15, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29134242/serum-parathyroid-hormone-is-associated-with-increased-cortical-porosity-of-the-inner-transitional-zone-at-the-proximal-femur-in-postmenopausal-women-the-troms%C3%A3-study
#16
M Osima, T T Borgen, M Lukic, G Grimnes, R M Joakimsen, E F Eriksen, Å Bjørnerem
Serum parathyroid hormone (PTH) was associated with increased bone turnover markers and cortical porosity of the inner transitional zone at the proximal femur. These results suggest that PTH through increased intracortical bone turnover leads to trabecularisation of inner cortical bone in postmenopausal women. INTRODUCTION: Vitamin D deficiency leads to secondary hyperparathyroidism and increased risk for fractures, whereas its association with cortical porosity is less clear. We tested (i) whether serum 25-hydroxyvitamin D (25(OH)D) and PTH were associated with cortical porosity and (ii) whether the associations of 25(OH)D) and PTH with fracture risk are dependent on cortical porosity...
November 14, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/29110093/evaluation-of-inter-and-intra-observer-reliability-of-current-classification-systems-for-subtrochanteric-femoral-fractures
#17
Ahmet İmerci, Nevres Hurriyet Aydogan, Kursad Tosun
INTRODUCTION: To evaluate the inter- and intra-observer reliability of the Russell Taylor, Seinsheimer and AO classification systems, and to investigate whether or not the experience of the surgeon had any effect on the classification. PATIENTS AND METHODS: All the radiographs of 35 patients with subtrochanteric femur fracture were classified by 16 observers using the Russell Taylor, Seinsheimer and 31-AO classifications. Two groups of observers were formed of eight orthopedic surgeons, each with at least five-year experience and eight orthopedic assistants, from six different hospitals, who were invited to participate in the study...
November 6, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29065818/antiresorptives-safety-concerns-clinical-perspective
#18
Jacques P Brown
Antiresorptive drugs, such as amino-bisphosphonates and denosumab (Dmab), have dominated osteoporosis therapies for over 20 years. Since osteoporosis is a chronic disease, antifracture therapy could continue for the rest of a patient's life. Phase III clinical trials for antiresorptive drugs assessed relatively small patient populations for short durations and excluded up to 80% of patients who might seek osteoporosis therapy in clinical practice. Postmarketing reports based upon millions of patient-years and long-term (>5 years) clinical administration have associated some previously unknown, rare adverse events with antiresorptive use including osteonecrosis of the jaw (ONJ) and atypical femur fractures (AFFs)...
January 1, 2017: Toxicologic Pathology
https://www.readbyqxmd.com/read/29065038/provisional-plating-of-subtrochanteric-femur-fractures-prior-to-intramedullary-nailing-in-the-lateral-decubitus-position
#19
Ryan Robertson, Michael Tucker, Thomas Jones
Subtrochanteric femur fractures remain a challenge for surgeons to obtain and maintain adequate reduction and stable fixation. For this reason multiple techniques have been described but we are unaware of a detailed contemporary description of the combination of provisional plating prior to intramedullary fixation in the lateral decubitus position. We present our technique as it was used from 2011-2015 to treat 22 fractures and how it compared clinically to the other 48 subtrochanteric femur fractures treated during that period...
October 14, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29062210/evaluation-of-outcome-of-proximal-femur-locking-compression-plate-pflcp-in-unstable-proximal-femur-fractures
#20
Malkesh D Shah, Chirag S Kapoor, Rishit J Soni, Jagdish J Patwa, Paresh P Golwala
INTRODUCTION: Pertrochanteric fractures are most frequent factures of the proximal femur, accounts for nearly 50% of all proximal femur fractures and are most devastating and also a major cause of disability in elderly. The aim and objective of this study was to evaluate the role of proximal femoral locking compression plate in unstable proximal femur fractures. MATERIAL AND METHOD: A total of 20 cases were included in our study (M:F - 16:4), who suffered proximal femur fracture due to various modalities and all of them were operated using proximal femoral locking compression plate...
October 2017: Journal of Clinical Orthopaedics and Trauma
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