Femoral Fractures: Fractures of the femur.Fracture Healing: The physiological restoration of bone tissue and function after a fracture. It includes BONY CALLUS formation and normal replacement of bone tissue.Hip Fractures: Fractures of the FEMUR HEAD; the FEMUR NECK; (FEMORAL NECK FRACTURES); the trochanters; or the inter- or subtrochanteric region. Excludes fractures of the acetabulum and fractures of the femoral shaft below the subtrochanteric region (FEMORAL FRACTURES).Fracture Fixation, Intramedullary: The use of nails that are inserted into bone cavities in order to keep fractured bones together.Fracture Fixation, Internal: The use of internal devices (metal plates, nails, rods, etc.) to hold the position of a fracture in proper alignment.Fractures, Bone: Breaks in bones.Bone Nails: Rods of bone, metal, or other material used for fixation of the fragments or ends of fractured bones.Femoral Neck Fractures: Fractures of the short, constricted portion of the thigh bone between the femur head and the trochanters. It excludes intertrochanteric fractures which are HIP FRACTURES.Fracture Fixation: The use of metallic devices inserted into or through bone to hold a fracture in a set position and alignment while it heals.Periprosthetic Fractures: Fractures around joint replacement prosthetics or implants. They can occur intraoperatively or postoperatively.Bone Plates: Implantable fracture fixation devices attached to bone fragments with screws to bridge the fracture gap and shield the fracture site from stress as bone heals. (UMDNS, 1999)Fractures, Comminuted: A fracture in which the bone is splintered or crushed. (Dorland, 27th ed)Spinal Fractures: Broken bones in the vertebral column.Traction: The pull on a limb or a part thereof. Skin traction (indirect traction) is applied by using a bandage to pull on the skin and fascia where light traction is required. Skeletal traction (direct traction), however, uses pins or wires inserted through bone and is attached to weights, pulleys, and ropes. (From Blauvelt & Nelson, A Manual of Orthopaedic Terminology, 5th ed)Fractures, Spontaneous: Fractures occurring as a result of disease of a bone or from some undiscoverable cause, and not due to trauma. (Dorland, 27th ed)Bone Screws: Specialized devices used in ORTHOPEDIC SURGERY to repair bone fractures.Osteoporotic Fractures: Breaks in bones resulting from low bone mass and microarchitectural deterioration characteristic of OSTEOPOROSIS.Radius FracturesBony Callus: The bony deposit formed between and around the broken ends of BONE FRACTURES during normal healing.Fractures, Stress: Fractures due to the strain caused by repetitive exercise. They are thought to arise from a combination of MUSCLE FATIGUE and bone failure, and occur in situations where BONE REMODELING predominates over repair. The most common sites of stress fractures are the METATARSUS; FIBULA; TIBIA; and FEMORAL NECK.Fractures, Closed: Fractures in which the break in bone is not accompanied by an external wound.Ulna Fractures: Fractures of the larger bone of the forearm.Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee.Insurance, Long-Term Care: Health insurance to provide full or partial coverage for long-term home care services or for long-term nursing care provided in a residential facility such as a nursing home.Rib FracturesSkull Fractures: Fractures of the skull which may result from penetrating or nonpenetrating head injuries or rarely BONE DISEASES (see also FRACTURES, SPONTANEOUS). Skull fractures may be classified by location (e.g., SKULL FRACTURE, BASILAR), radiographic appearance (e.g., linear), or based upon cranial integrity (e.g., SKULL FRACTURE, DEPRESSED).Internal Fixators: Internal devices used in osteosynthesis to hold the position of the fracture in proper alignment. By applying the principles of biomedical engineering, the surgeon uses metal plates, nails, rods, etc., for the correction of skeletal defects.Diaphyses: The shaft of long bones.Casts, Surgical: Dressings made of fiberglass, plastic, or bandage impregnated with plaster of paris used for immobilization of various parts of the body in cases of fractures, dislocations, and infected wounds. In comparison with plaster casts, casts made of fiberglass or plastic are lightweight, radiolucent, able to withstand moisture, and less rigid.Mandibular Fractures: Fractures of the lower jaw.Hip Prosthesis: Replacement for a hip joint.Leg Length Inequality: A condition in which one of a pair of legs fails to grow as long as the other, which could result from injury or surgery.Arthroplasty, Replacement, Hip: Replacement of the hip joint.Prosthesis Failure: Malfunction of implantation shunts, valves, etc., and prosthesis loosening, migration, and breaking.Bone Wires: Steel wires, often threaded through the skin, soft tissues, and bone, used to fix broken bones. Kirschner wires or apparatus also includes the application of traction to the healing bones through the wires.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Reoperation: A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis (OSTEOPOROSIS, POSTMENOPAUSAL) and age-related or senile osteoporosis.Range of Motion, Articular: The distance and direction to which a bone joint can be extended. Range of motion is a function of the condition of the joints, muscles, and connective tissues involved. Joint flexibility can be improved through appropriate MUSCLE STRETCHING EXERCISES.Tooth Fractures: Break or rupture of a tooth or tooth root.Bone Density Conservation Agents: Agents that inhibit BONE RESORPTION and/or favor BONE MINERALIZATION and BONE REGENERATION. They are used to heal BONE FRACTURES and to treat METABOLIC BONE DISEASES such as OSTEOPOROSIS.Fractures, Compression: Crumbling or smashing of cancellous BONE by forces acting parallel to the long axis of bone. It is applied particularly to vertebral body fractures (SPINAL FRACTURES). (Blauvelt and Nelson, A Manual of Orthopedic Terminology, 1994, p4)Accidental Falls: Falls due to slipping or tripping which may result in injury.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Intra-Articular Fractures: Fractures of the articular surface of a bone.Bone Transplantation: The grafting of bone from a donor site to a recipient site.Bone Cements: Adhesives used to fix prosthetic devices to bones and to cement bone to bone in difficult fractures. Synthetic resins are commonly used as cements. A mixture of monocalcium phosphate, monohydrate, alpha-tricalcium phosphate, and calcium carbonate with a sodium phosphate solution is also a useful bone paste.Prosthesis Design: The plan and delineation of prostheses in general or a specific prosthesis.Alendronate: A nonhormonal medication for the treatment of postmenopausal osteoporosis in women. This drug builds healthy bone, restoring some of the bone loss as a result of osteoporosis.Bone Density: The amount of mineral per square centimeter of BONE. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by X-RAY ABSORPTIOMETRY or TOMOGRAPHY, X RAY COMPUTED. Bone density is an important predictor for OSTEOPOROSIS.Orbital Fractures: Fractures of the bones in the orbit, which include parts of the frontal, ethmoidal, lacrimal, and sphenoid bones and the maxilla and zygoma.Surgical Procedures, Minimally Invasive: Procedures that avoid use of open, invasive surgery in favor of closed or local surgery. These generally involve use of laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device.Colles' Fracture: Fracture of the lower end of the radius in which the lower fragment is displaced posteriorly.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Recovery of Function: A partial or complete return to the normal or proper physiologic activity of an organ or part following disease or trauma.Orthopedics: A surgical specialty which utilizes medical, surgical, and physical methods to treat and correct deformities, diseases, and injuries to the skeletal system, its articulations, and associated structures.Embolism, Fat: Blocking of a blood vessel by fat deposits in the circulation. It is often seen after fractures of large bones or after administration of CORTICOSTEROIDS.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Fractures, Open: Fractures in which there is an external wound communicating with the break of the bone.Orthopedic Procedures: Procedures used to treat and correct deformities, diseases, and injuries to the MUSCULOSKELETAL SYSTEM, its articulations, and associated structures.Injury Severity Score: An anatomic severity scale based on the Abbreviated Injury Scale (AIS) and developed specifically to score multiple traumatic injuries. It has been used as a predictor of mortality.Diphosphonates: Organic compounds which contain P-C-P bonds, where P stands for phosphonates or phosphonic acids. These compounds affect calcium metabolism. They inhibit ectopic calcification and slow down bone resorption and bone turnover. Technetium complexes of diphosphonates have been used successfully as bone scanning agents.Insurance Claim Reporting: The design, completion, and filing of forms with the insurer.Biomechanical Phenomena: The properties, processes, and behavior of biological systems under the action of mechanical forces.AlabamaAccidents, Traffic: Accidents on streets, roads, and highways involving drivers, passengers, pedestrians, or vehicles. Traffic accidents refer to AUTOMOBILES (passenger cars, buses, and trucks), BICYCLING, and MOTORCYCLES but not OFF-ROAD MOTOR VEHICLES; RAILROADS nor snowmobiles.Wrist Injuries: Injuries to the wrist or the wrist joint.Hip Joint: The joint that is formed by the articulation of the head of FEMUR and the ACETABULUM of the PELVIS.Length of Stay: The period of confinement of a patient to a hospital or other health facility.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Weight-Bearing: The physical state of supporting an applied load. This often refers to the weight-bearing bones or joints that support the body's weight, especially those in the spine, hip, knee, and foot.Maxillary Fractures: Fractures of the upper jaw.External Fixators: External devices which hold wires or pins that are placed through one or both cortices of bone in order to hold the position of a fracture in proper alignment. These devices allow easy access to wounds, adjustment during the course of healing, and more functional use of the limbs involved.Zygomatic Fractures: Fractures of the zygoma.Incidence: The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.Tibial FracturesOsteoporosis, Postmenopausal: Metabolic disorder associated with fractures of the femoral neck, vertebrae, and distal forearm. It occurs commonly in women within 15-20 years after menopause, and is caused by factors associated with menopause including estrogen deficiency.Northern IrelandRisk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Forearm Injuries: Injuries to the part of the upper limb of the body between the wrist and elbow.Thoracic Vertebrae: A group of twelve VERTEBRAE connected to the ribs that support the upper trunk region.Surgical Wound Infection: Infection occurring at the site of a surgical incision.Intraoperative Complications: Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.Rotation: Motion of an object in which either one or more points on a line are fixed. It is also the motion of a particle about a fixed point. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed)Clavicle: A bone on the ventral side of the shoulder girdle, which in humans is commonly called the collar bone.Pelvic Bones: Bones that constitute each half of the pelvic girdle in VERTEBRATES, formed by fusion of the ILIUM; ISCHIUM; and PUBIC BONE.Knee Prosthesis: Replacement for a knee joint.Arthroplasty, Replacement, Knee: Replacement of the knee joint.Ankle Injuries: Harm or hurt to the ankle or ankle joint usually inflicted by an external source.

Contralateral fracture of the proximal femur. Implications for planning trials. (1/858)

In three consecutive years 462 patients over the age of 60 years presented at Waikato Hospital, Hamilton, New Zealand, with a fracture of the proximal femur. Within two years, 11 (2.4%) returned with a fracture of the contralateral femur. If the effectiveness of any form of treatment aiming at reducing the incidence of contralateral fracture were subjected to a trial, a sample size of 5000, randomly distributed equally between treatment and placebo groups, would be needed for the trial to have a power of 80% to detect a reduction.  (+info)

Femur osteomyelitis due to a mixed fungal infection in a previously healthy man. (2/858)

We describe a previously healthy, 22-year-old man who, after a closed fracture of the femur and subsequent operation, developed chronic osteomyelitis. Within a few days, infected bone fragments, bone, and wound drainage repeatedly yielded three different filamentous fungi: Aspergillus fumigatus, Aspergillus flavus, and Chalara ellisii. Histologic examination of the bone revealed septate hyphae. After sequential necrotomies of the femur and irrigation-suction drainage with added antimycotic therapy, the infection ceased and the fracture healed. This case is unique in that it is the only known instance in which a long bone was affected in an immunocompetent individual, with no evidence of any systemic infection, by a mixed population of two different Aspergillus spp. and the rare filamentous fungus C. ellisii. Environmental factors that could potentiate the infection include blood and edema fluid resulting from the surgical procedure and the presence of the osteosynthetic plate.  (+info)

Malunion in the lower limb. A nomogram to predict the effects of osteotomy. (3/858)

Nomograms derived from mathematical analysis indicate that the level of malunion is the most important determinant of changes in the moment arm of the knee, the plane of the ankle and alterations in limb length. Testing in five patients undergoing reconstruction showed a mean error of postoperative limb length of 2.2 mm (SD 0.8 mm), knee moment arm of 4.7 mm (SD 3.3 mm) and ankle angle of 2.6 degrees (SD 2.3 degrees). These nomograms provide the information required when assessing whether a particular degree of angulation may be accepted.  (+info)

Stimulation of the inflammatory system by reamed and unreamed nailing of femoral fractures. An analysis of the second hit. (4/858)

It has been suggested that reamed intramedullary nailing of the femur should be avoided in some patients with multiple injuries. We have studied prospectively the effect of femoral reaming on the inflammatory process as implicated in the pathogenesis of acute respiratory distress syndrome (ARDS) and multiple-organ failure (MOF). We studied changes in the levels of serum interleukin-6 (IL-6) (proinflammatory cytokine), neutrophil CD11b (C3) receptor expression (activated neutrophil adhesion molecule), serum soluble intracellular adhesion molecule (s-ICAM-1), serum soluble E-selectin (the soluble products of endothelial adhesion molecules) and plasma elastase (neutrophil protease) in a series of patients with femoral fractures treated by nailing. We have also compared reamed nailing with unreamed nailing. We found that the levels of serum IL-6 and elastase rose significantly during the nailing procedure indicating a measurable 'second hit'. There was no clear response in leukocyte activation and no difference in the release of endothelial adhesion molecule markers. There was no significant difference between groups treated by reamed and unreamed nailing. Although clinically unremarkable, the one patient who died from ARDS was shown to be hyperstimulated after injury and again after nailing, suggesting the importance of an excessive inflammatory reaction in the pathogenesis of these serious problems. Our findings have shown that there is a second hit associated with femoral nailing and suggest that the degree of the inflammatory reaction may be important in the pathogenesis of ARDS and MOF.  (+info)

Spontaneous healing of an atrophic pseudoarthrosis during femoral lengthening. A case report with six-year follow-up. (5/858)

A seven-year old girl developed an atrophic pseudoarthrosis at the midshaft of the femur with 8.5 cm of femoral shortening after an open type II fracture. During a femoral lengthening procedure, the pseudoarthrosis filled with spontaneous callus formation and bone union was obtained.  (+info)

Comparison of quantitative ultrasound in the human calcaneus with mechanical failure loads of the hip and spine. (6/858)

OBJECTIVE: Quantitative ultrasound of the calcaneus is used clinically for evaluating bone fracture risk, but its association with the mechanical properties at other skeletal sites is not well characterized. The objective was therefore to determine its predictive ability of the mechanical failure loads of the proximal femur and lumbar spine. METHOD: In 45 human cadavers (29 males and 16 females, aged 82.5 +/- 9.6 years), we determined the speed of sound, broadband ultrasonic attenuation (BUA) and the empirical stiffness index, using a commercial quantitative ultrasound scanner. The proximal femora and the fourth vertebral body were excised and loaded to failure in a testing machine. RESULTS: Femoral failure loads ranged from 933 to 7000 N and those of the vertebrae from 1000 to 7867 N, their correlation being 0.51 in females and -0.08 in males. Forty percent of the variability of femoral, but only 24% of the variability of the vertebral fracture loads could be predicted with calcaneal speed of sound. In the femur, a combination of speed of sound and BUA improved the prediction (r2 = 50-60%), but not in the spine. CONCLUSIONS: The study provides experimental evidence that calcaneal quantitative ultrasound is capable of predicting mechanical failure at other skeletal sites and has potential to identify patients at risk from osteoporotic fracture. The different association of quantitative ultrasound with femoral and vertebral failure may result from the influence of the cortical bone and a higher microstructure-related similarity of the calcaneus and the femur.  (+info)

Correction of genu recurvatum by the Ilizarov method. (7/858)

The Ilizarov apparatus was used to carry out opening-wedge callotasis of the proximal tibia in ten patients who had suffered premature asymmetrical closure of the proximal tibial physis and subsequent genu recurvatum. In four knees, the genu recurvatum was entirely due to osseous deformity, whereas in six it was associated with capsuloligamentous abnormality. Preoperatively, the angle of recurvatum averaged 19.6 degrees (15 to 26), the angle of tilt of the tibial plateau, 76.6 degrees (62 to 90), and the ipsilateral limb shortening, 2.7 cm (0.5 to 8.7). The average time for correction was 49 days (23 to 85). The average duration of external fixation was 150 days (88 to 210). Three patients suffered complications including patella infera, pin-track infection and transient peroneal nerve palsy. At a mean follow-up of 4.4 years, all patients, except one, had achieved an excellent or good radiological and functional outcome.  (+info)

Transcranial doppler detection of fat emboli. (8/858)

BACKGROUND AND PURPOSE: The fat embolism syndrome (FES) is characterized by the simultaneous occurrence of pulmonary and neurological symptoms as well as skin and mucosal petechiae in the setting of long-bone fractures or their surgical repair. Its pathophysiology is poorly understood, and effective treatments are lacking. We present 5 patients with long-bone fractures in whom in vivo microembolism was detected by transcranial Doppler. METHODS: Five patients with long-bone fractures were monitored with transcranial Doppler for microembolic signals (MESs) after trauma. Two patients also had intraoperative monitoring. A TC-2020 instrument equipped with MES detection software was used. Detected signals were saved for subsequent review. Selected signals satisfied criteria defined previously and were categorized as large or small. RESULTS: Cerebral microembolism was detected in all 5 patients and was transient, resolving within 4 days of injury. Intraoperative monitoring revealed an increase in MESs during intramedullary nail insertion. The characteristics of MESs after injury varied among patients, with large signals being more frequent in the only patient with a patent foramen ovale. CONCLUSIONS: Cerebral microembolism after long-bone fractures can be detected in vivo and monitored over time. These findings may have potential diagnostic and therapeutic implications.  (+info)

  • This study describes the short-term outcome after revision arthroplasty using a modular, titanium, tapered, conical stem for PFF in a series of 38 fractures in 37 patients. (ox.ac.uk)
  • Fractures of the inferior or distal femur may be complicated by separation of the condyles, resulting in misalignment of the articular surfaces of the knee joint, or by hemorrhage from the large popliteal artery that runs directly on the posterior surface of the bone. (wikipedia.org)
  • The purpose of this study was to analyse the cut-out complication with respect to the following variables: patients' age, fracture type, fracture reduction, implant positioning and implant design. (nih.gov)
  • non-anatomical reduction, non-optimal lag screw position and the characteristic fracture pattern found. (nih.gov)
  • A typical cut-out complication in our study is represented by an unstable fracture involving the trochanteric and cervical regions or the combination of both, non-anatomical reduction and non-optimal screw position. (nih.gov)
  • Isolated trochanteric avulsion fractures can result from sudden violent force avulsing the insertion of gluteus medius from the greater trochanter, or iliopsoas from the lesser trochanter. (patient.info)
Femoral Fractures | Profiles RNS
Femoral Fractures | Profiles RNS (profiles.umassmed.edu)
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How One Might Determine Whether The Femur Fracture Is Related To A Bisphosphonate Such As Fosamax - Drug Injury Watch (drug-injury.com)
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Wheeless' Textbook of Orthopaedics (wheelessonline.com)
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October 1980 - Volume 152 - Issue : Clinical Orthopaedics and Related Research® (journals.lww.com)
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Orthopedic Specialty Group - Intermountain Medical Center | Intermountain Medical Center (intermountainhealthcare.org)
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DailyMed - ALENDRONATE- alendronate sodium tablet (dailymed.nlm.nih.gov)
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Fosamax Plus D (Alendronate Sodium and Cholecalciferol): Uses, Dosage, Side Effects, Interactions, Warning (rxlist.com)
Answers about Bone Pain and Fractures
Answers about Bone Pain and Fractures (answers.com)
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Open Reduction and Internal Fixation of Distal Femoral Fractures in Children: Background, Indications, Contraindications (emedicine.medscape.com)
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Femoral Neck Fractures - Choices | Orthogate (orthogate.org)
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Wheeless' Textbook of Orthopaedics (wheelessonline.com)
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Orthopedics | September 2014 Issue (healio.com)
Orthopedic Surgery Clerkship - A Quick Reference Guide for Senior Medical Students | Adam Eltorai | Springer
Orthopedic Surgery Clerkship - A Quick Reference Guide for Senior Medical Students | Adam Eltorai | Springer (springer.com)
Study finds strong link between bisphosphonates use and risk of atypical femoral fractures
Study finds strong link between bisphosphonates use and risk of atypical femoral fractures (news-medical.net)
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Slipped capital femoral epiphysis: MedlinePlus Medical Encyclopedia (medlineplus.gov)
Efficacy and Safety of Intravenous Iron Sucrose in Patients With Hip Fracture to Prevent Perioperative Anemia - Full Text View ...
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