TY - JOUR. T1 - Surgical outcome of intramedullary nailing in patients with complete atypical femoral fracture. T2 - A multicenter retrospective study. AU - Lee, Kyung Jae. AU - Yoo, Jeong Joon. AU - Oh, Kwang Jun. AU - Yoo, Je Hyun. AU - Rhyu, Kee Hyung. AU - Nam, Kwang Woo. AU - Suh, Dong Hun. PY - 2017/4/1. Y1 - 2017/4/1. N2 - Background Management of atypical femoral fracture on bisphosphonate therapy still remains controversy and is reported high rate of complications. The aim of this study was to evaluate the outcome of intramedullary nailing in patients with atypical femoral fracture who took bisphosphonate more than one year through the multicenter retrospective study. Methods We gathered 75 atypical femoral fractures from seven institutions between 2009 and 2014. Among them 46 atypical femoral fractures which met the inclusion criteria was evaluated in this study. The average age was 70.1 years (53-80) and the average duration of bisphosphonate use was 5.1 years (1-15 years). Medical ...

INTRODUCTION: Femoral shaft fractures are commonly thought to be primarily associated with high-energy trauma in young persons. Only limited attention has been given to low-energy violence as a cause of these fractures among the elderly. National epidemiological data on characteristics of patients with femoral shaft fractures are lacking, so the purpose of this study was to analyse the incidence, admissions, causes of fracture and operations for these fractures on a nationwide basis in Sweden during 1998-2004. PATIENTS AND METHODS: Data on all femoral shaft fractures were extracted from the Swedish National Hospital Discharge Registry. Sex- and age-specific fracture incidence, hospital admissions, mechanisms of injury and surgical procedures were analysed using descriptive analysis, linear-regression analysis and other methods as appropriate. RESULTS: Over a period of 7 years, 6409 patients with femoral shaft fractures were identified, corresponding to an annual incidence of 10 per 100,000 ...

Background: Fractures of the femoral shaft are mostly the result of high-energy accidents that also cause multiple trauma injuries, in particular ipsilateral knee and hip injuries. The purpose of this study was to investigate the incidence of injuries associated with femoral shaft fractures and how many of them were undetected. Methods: We studied 148 patients (150 femoral shaft fractures) with an average age of 52 (range: 18-97). Femoral shaft fractures were treated with antegrade intramedullary nailing in 118 cases (78.7%), and with open reduction and internal fixation in 32 cases (21.3%). Unlocked reamed intramedullary nailing was performed in Winquist type I and type II fractures, while statically locked unreamed intramedullary nailing was carried out in Winquist type III and type IV fractures. Results: There were 70 patients with associated injuries (46.4%). The associated injuries went undetected in 18 out of 70 patients (25.5%). Six femoral nonunions (4%) occurred in patients under 70 years of

We report that a postmenopausal woman with osteoporosis developed bilateral incomplete atypical femoral fractures (AFFs) after seven years of bisphosphonate therapy. Cessation of the bisphosphonate and treatment with teriparatide was associated with near complete radiological resolution of the AFFs. After 12 months without treatment, denosumab was commenced to prevent structural deterioration. Six months later she developed recurrent bilateral AFFs. This case highlights the management dilemma in patients with ongoing bone loss but prone to stress fractures associated with antiresorptive therapy. Stopping the antiresorptive is recommended but structural decay will recur predisposing to fragility fractures. If the antiresorptive is continued, bone material composition will be further compromised predisposing to atypical fractures. Teriparatide may assist healing of stress fractures and improvement in bone matrix composition. Later antiresosrptive therapy to preserve bone microstructure may ...

Background: In children, inappropriate treatment of open femoral fractures may induce several complications. A few studies have compared the external fixator with flexible intramedullary nails in high-grade open femoral fractures of children. The present study aims at comparing results of these two treatment methods in open femoral fractures. Methods: In this descriptive analytical study, 27 patients with open femoral fractures, who were treated using either the external fixator (n=14) or TEN nails (n=13) method from 2006-2011, were studied. Some patients were treated with a combination method of TEN and pin. The results were evaluated considering infection, union, malunion, and refracture and the patients were followed up for two years. Results: Mean time required for fracture union was 3.89 (range: 2-5.8) and 3.61 (range: 2-5.6) months for the external fixator and TEN groups, respectively. The difference was not statistically significant and there was not any significant difference between the two

The possibility that long-term bisphosphonate use increases the risk of atypical femoral fractures is a growing concern in the clinical management of patients w...

M84.754S is a billable code used to specify a medical diagnosis of complete transverse atypical femoral fracture, right leg, sequela. Code valid for the year 2020

Earlier this year, an update to the ASBMR Task Force on Atypical Femoral Fractures (AFF) seminal 2010 report was published on JBMR® Online.

TY - JOUR. T1 - Treatment of open proximal femoral fractures sustained in combat. AU - Mack, Andrew W.. AU - Freedman, Brett. AU - Groth, Adam T.. AU - Kirk, Kevin L.. AU - Keeling, John J.. AU - Andersen, Romney C.. PY - 2013/2/6. Y1 - 2013/2/6. N2 - Background: Open proximal femoral fractures are rare injuries that often result from wartime high-energy causes. Limited data exist regarding the treatment and complications of these injuries. Methods: We retrospectively reviewed the records of combat casualties treated at two institutions between March 2003 and March 2008. The casualty patient databases, medical records, radiographs, and laboratory data were reviewed to determine time to union, complication rates, and patient outcomes. Results: Forty-one patients (thirty-nine men and two women) with a mean age of 25.7 years were identified as receiving treatment for open proximal femoral fractures. The mechanisms of injury for these forty-one patients were blast (twentynine patients [71%]), ...

This technique has been used successfully at King Khalid hospital, Najran, Saudi Arabia since 1995.. This prospective study was prompted by a review of earlier reports by Shakeel [1], Salem Al Zahrani [8], and Ligier and Metazieau [6].. Fracture treatment in children relies on rapid healing and spontaneous correction of angulated fractures; therefore most of the diaphyseal fractures can be treated by plaster alone. Operative treatment of childrens fractures is often looked at critically [2].. Conventional treatment of femoral shaft fractures in children is by traction followed by a hip spica or a Thomas splint. Conservative treatment of femoral shaft fractures gives good results in children under 5 years of age. But above that age, all such fractures cannot be treated by conservative methods. There is a possibility of loss of reduction and malunion. Plaster immobilisation has its own complications like pressure sores, nerve palsies, soiling of the skin and the plaster, breakage of the plaster, ...

Dr. Weaver treats a periprosthetic femur fracture with the patient positioned supine on a fracture table using a cephalomedullary nail. The fracture table

Little evidence is available on how to treat incomplete atypical fractures of the femur. When surgery is chosen, intramedullary nailing is the most common invasive technique. However, this approach is adopted from the treatment of other types of ordinary femoral fracture and does not aim to prevent the impending complete fracture by interrupting the mechanism underlying the pathology. We suggest a different surgical approach that intends to counteract the underlying biomechanical conditions leading to a complete atypical fracture and thus could be better suited in selected cases. Here, we share an alternative surgical approach and present two cases treated accordingly.. ...

BACKGROUND: Femoral shaft fractures are common injuries in adults. Closed locked intramedullary nailing is the recommended treatment for femoral shaft fractures due to its high union rate. OBJECTIVE: The objective of this study is to determine the outcome of management of closed femoral shaft fractures in adult patients, using open locked intramedullary nailing. PATIENTS AND METHODS: This is a prospective study which was carried out on all adult patients aged 16 years and above who presented within 2 weeks of sustaining closed femoral shaft fractures to the accident and emergency unit of a University Teaching Hospital in Nigeria from January 2013 to December 2013 ...

Skiers hip--a new clinical entity? Proximal femur fractures sustained in cross-country skiing.: Ten proximal femur fractures have been seen in patients who wer

Between 1978 and 1982 154 femoral shaft fractures were treated in 145 adults in our department of general surgery and traumatology. 52 fractures were nailed intramedullary. We reserved the intramedullary nailing for ideal cases like the transverse and the short oblique fractures in the middle 3/5 of the shaft. 102 fractures were treated by a dynamic compression plate applying the AO principles correctly. Condylar plates were not included in this study. 88 patients with 95 FSF were followed up. In our prospective study a significant relationship was found between the types of fractures, the consolidation, the rehabilitation (including walking), the hospitalisation time and the full weight-bearing results. The prognosis for simple fractures was better than for comminuted fractures. Polytrauma patients showed a significantly slower limb rehabilitation, a longer hospitalisation and a worse clinical result than patients with isolated fractures. A significant relationship was shown between the ...

Periprosthetic femoral fracture (PFF) is a potentially devastating complication after total hip arthroplasty, with historically high rates of complication and failure because of the technical challenges of surgery, as well as the prevalence of advanced age and comorbidity in the patients at risk. 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. The mean age of the cohort was 77 years (47 to 96). A total of 27 patients had an American Society of Anesthesiologists grade of at least 3. At a mean follow-up of 35 months (4 to 66) the mean Oxford Hip Score (OHS) was 35 (15 to 48) and comorbidity was significantly associated with a poorer OHS. All fractures united and no stem needed to be revised. Three hips in three patients required further surgery for infection, recurrent PFF and recurrent dislocation and three other patients required closed manipulation for a single dislocation. One

Femoral Fractures are common. Read about Femoral Fractures, and bone fractures affecting the femur on out Femoral Fractures page.

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 Pagets disease as one of variables to investigate the AFF in 2010. On the other hand, the ASBMR taskforce in 2014 excluded Pagets 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 Pagets disease of bone in the pathology ...

A femoral fracture is a bone fracture that involves the femur. They are typically sustained in high-impact trauma, such as car crashes, due to the large amount of force needed to break the bone. Fractures of the diaphysis, or middle of the femur, are managed differently from those at the head, neck, and trochanter (see hip fractures). The fracture may be classed as open, which occurs when the bone fragments protrude through the skin, or there is an overlying wound which penetrates to the bone. These types of fracture cause more damage to the surrounding tissue, are less likely to heal properly, and are at much greater risk of infection. Femoral shaft fractures can be classified with the Winquist and Hansen classification, which is based on the amount of comminution. 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 ...

Medical Clues Include Prior Symptoms, Location Of Thigh Bone Break, And Specific Radiology Findings (Posted by Tom Lamb at DrugInjuryWatch.com) For this medical primer about femur fractures which might be associated with Fosamax as well as the several other bisphosphonate osteoporosis medications available in the U.S. we will start with some basic anatomy taken from a document titled Femur Shaft Fractures (Broken Thighbone), published by the American Academy of Orthopaedic Surgeons (AAOS): Your thighbone (femur) is the longest and strongest bone in your body. Because the femur is so strong, it usually takes a lot of force to break it. Car crashes, for example, are the number one cause of femur fractures. The long, straight part of the femur is called the femoral shaft. When there is a break anywhere along this length of bone, it is called a femoral shaft fracture.... Doctors describe fractures to each other using classification systems. Femur fractures are classified depending on: The location of the

2İstanbul Medipol University, Department of Radiology İSTANBUL Bisphosphonates are the most commonly used drugs in the treatment of osteoporosis. Several randomized controlled studies have proved their effectiveness in the treatment of postmenopausal osteoporosis and today BPs are considered a first-line therapy for osteoporosis. Bisphosphonates inhibit osteoclastic activity, decrease bone turnover and increase bone mineral density. Although there is strong evidence that bisphosphonates prevent osteoporotic fractures, in recent years, there have been several reports that show the increasing risk of atypical femoral fractures that is related to prolonged usage (5 years or longer) of bisphosphonates. This may be related to prolonged suppression of bone turnover. By suppressing the bone turnover they impair the ability of bone to repair the microdamages and leads the accumulation of microcracs. In this case we report 67-year-old female who presented with atypical femoral fracture. Keywords : ...

|p|This week we review femoral shaft fractures with a focus on assessment and analgesia|br/||a class=read-more href=https://coreem.net/podcast/episode-154-0/|Read More|/a||/p|

Osteoporosis is associated with significant morbidity and mortality [ 1 , 2 ], and approximately 50 % of women older than 50 years will sustain an …

2012 (English)In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 23, no 12, 2901-2902 p.Article in journal, Letter (Refereed) Published ...

Diagnosis Code M84.752S information, including descriptions, synonyms, code edits, diagnostic related groups, ICD-9 conversion and references to the diseases index.

Free, official coding info for 2021 ICD-10-CM M84.753D - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more.

The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer ...

A fracture is a condition in which there is a break in the continuity of the bone. Dr Magoline in Broadview Heights, Hudson and Akron, OH offers treatment for knee fractures which includes distal femur fracture and femoral shaft fracture.

Short and long nails exhibited similar treatment failure rates when contemporary cephalomedullary implants were used, according to study results.Researchers retrospectively reviewed medical records and radiographs from patients who underwent open reduction and internal fixation of intertrochanteric hip fracture with either a short or long cephalomedullary nail between January 2004 and December

Internal, extramedullary osteosynthesis of distal femoral fractures which are focussed on in this study has been influenced by interesting developments in recent years. Driven by unsatisfying complication rates new fracture treatments have been looked for. Osteosynthesis materials, reduction techniques, techniques of implant placement and implants themselves - where development went to angular stable systems - have changed decisively. This study analyzes in a retrospective setting distal femoral fractures which were treated between 1.1.1995 and 31.9.2000 either with an internal fixator (LISS) or with conventional plate osteosynthesis. In this study 51 patients with 54 distal femoral fractures could be included. The Infection rate was non significantly lower in the LISS group (0% versus 11,1%), the rate of delayed union was non significantly higher. The only delayed union in the LISS group which needed secondary surgical intervention was seen in a patient with considerate bone loss which was not ...

Currently, there are over 100 individual Fosamax femur fracture lawsuits pending against Merck - 36 of these complaints have been filed in federal court. The plaintiffs filing these Fosamax femur fracture lawsuits have alleged that Merck failed to warn consumers that Fosamax use leads to femur fractures. Specifically, plaintiffs allege that their long-term use of Fosamax caused them to sustain atypical femur fractures. If the U.S. Judicial Panel on Multidistrict Litigation grants Mercks request, all of the federal Fosamax femur fracture lawsuits will be consolidated and centralized for pre-trial purposes.. Fosamax cases have also been filed in state courts, including New Jersey and California. All of the Fosamax cases filed in New Jersey state courts have been consolidated into a state mass tort program (MTP). Similar to a federal MDL, this tool transfers, consolidates and coordinates cases before one state court judge. However, unlike the federal MDL in the Southern District of New York, the ...

For young children with diaphyseal femoral fractures, treatment with a single-leg spica cast is safe and effective, and facilitates patient care and function compared with double-leg spica casting.

Background: Bisphosphonate abuse is associated with atypical femur fractures, which despite different fixation methods have increased non-union, delayed union, and re-operation rates. Therefore, there is a need for a surgical technique that may enhance union in such cases. Herein we are introducing a novel technique of sequential multiple vigorous reaming across the fracture site to introduce reaming debris/endosteal bone graft around the fracture site. Materials and Methods: We present a retrospective analysis of five prospectively treated patients with atypical diaphyseal femur fracture who presented to us from January 2015 to August 2019. All the patients were followed up at regular intervals and assessed both clinically and radiologically. Results: All 5 cases operated with our technique showed union at a mean follow-up of 16 weeks (12 - 20 weeks). There were no complications reported in our study at the last mean follow-up of 25 months (12 - 51 months). Conclusion: This technique of multiple

On rare occasions, hip fractures can be missed. Approximately 75,000 neck of femur fractures occur in the United Kingdom per annum. Up to ten percent of hip fractures are occult on plain radiograph. This case demonstrates an usual presentation of an incidental neck of femur fracture, which had been missed one year prior. Case Presentation: A 91 year old gentleman presented with incidental finding of left neck of femur fracture on a routine radiograph. A quick review of the patient notes revealed a fall, with a lengthy hospital admission, approximately one year previously. Despite his initial inability to weight-bear and protracted slow progress with physiotherapy no further imaging of the hip was obtained beyond an initial, negative pelvic radiograph. Conclusion: Doctors must be bold in questioning a radiograph that does not fit with the clinical picture. Clinical suspicion of neck of femur fracture in the face of a negative radiograph necessitates further imaging to obtain a definitive answer.

There is no consensus regarding the proper radiographic protocol following closed or open reduction and internal fixation for intertrochanteric femoral fractures. The objective of this study was to assess the role of early postoperative imaging studies when deciding about weight bear limitations and reoperations. A prospective cohort study of 100 patients (26 men and 74 women, at a mean age of 79.8 years) treated by closed or open reduction and internal fixation for AO31A fractures was conducted. According to the AO classification, there were 25 cases of 31A1, 54 cases of 31A2, and 21 cases of 31A3. For every patient, the intraoperative fluoroscopy studies were recorded and post-operative radiograms were taken during the first week. Excluded were patients for whom the early X-rays were clinically indicated. The intraoperative AP and axial fluoroscopy studies were compared with the radiograms taken during the first post-operative week. The investigators compared the decisions regarding weight-bearing

The findings of this study indicate that internal fixation of femur fractures in less than 24 hours after injury may be associated with a reduction in mortality, infection, and VTE. There was insufficient evidence to comment on the outcomes of amputation or nonunion/malunion. The studies reviewed did not separate outcomes of open from closed fractures. Hence, this recommendation applies to all femur fractures. Unlike the previous EAST PMG on long bone fractures, all other long bones, including tibia, were excluded from this analysis.. A major implication of this study is that early fracture fixation should be considered in all patients with femur fractures. In the absence of a clear contraindication to surgery or anesthesia, the recommendation of this review, although conditional, should prompt early fixation. However, the surgical decision must be individualized to each patients needs. Delayed treatment has been associated with improved survival rates among patients with serious abdominal ...

Free Online Library: Functional outcome of orif of distal femur fracture with intra-articular extension.(ORIGINAL ARTICLE) by Journal of Evolution of Medical and Dental Sciences; Health, general Fractures Comparative analysis Health aspects Fractures (Injuries) Internal fixation Internal fixation in fractures Medical colleges Medical schools

Overview. The femur, commonly known as the thigh bone, is the largest and strongest bone in your body.. Causes. A direct blow to your thigh can fracture your femur, as can a vehicle crash or fall. Conditions that weaken your bones, like osteoporosis, make a fracture more likely.. Types of Fractures. Femur fractures can happen at the top near the hip socket, along the shaft in the middle of the bone, or down near the knee. Your bone may break in a clean line, at an angle, or in a spiral pattern. The fracture may be just crack the bone or break the bone in two or more pieces. A serious break may pierce the skin, greatly increasing the risk of infection.. Symptoms. A femur fracture is unmistakable, as you will feel significant pain and will be unable to put any weight on it.. Treatment. Most femur fractures need surgery to align the bone, often with the use of rods or metal plates and screws. You may need a cast or a brace. Expect to have physical therapy after the bone has healed to help build ...

Background: Ipsilateral intertrochancteric ractures with fracture of shaft of femur are rare injuries. They warrant special diagnostic and therapeutic considerations. The aim was to study the results of operative treatment of ipsilateral intertrochanchteric and shaft femur fractures with dynamic hip screw (DHS) and retrograde nailing (DFN). Emphasis was posed on long- term functional outcome, especially daily activities. Material and Methods: 8 patients (6 male and 2 female) with ipsilateral intertrochancteric and shaft of femur fractures were treated with vari¬ous fixation devices. Functional outcome was assessed using the Friedman and Wyman classification. Results: All the 8 intertrochancteric fractures united in a mean duration of 3 months. Of the femoral shaft fractures 6 united in a mean of 8.5 months, 2 non unions. One patient developed superficial infection, which resolved with debridement and antibiotic treatment. Functional results were good in 4 patients, fair in 2 and poor in 2. ...

A quick overview of Distal Femur Fractures, the complications linked to the fracture, surgery techniques, and the management of the injury.

Cephalomedullary nailing system for the treatment of a wide range of proximal femur fractures as well as associated femoral shaft fractures.

Annual Report 2007, The Swedish Hip Arthroplasty Register, https://shpr.registercentrum.se/. The Lubinus® SP II® hip prosthesis stem also achieved very good safety data in the Swedish Hip Register of a subgroup analysis** studying failure cases for the occurrence of periprosthetic femoral fractures. In the 1,049 complications recorded between 1979 and 2000 the Model Lubinus® was markedly underrepresented in the fracture group. The risk of periprosthetic femoral fractures was evaluated as very low with the anatomical SP II® hip prosthesis system ...

Learn more about Femoral Fracture at Heartland Womens Group DefinitionCausesRisk FactorsSymptomsDiagnosisTreatmentPreventionrevision ...

Associate Professor of Surgery. In another trauma case with UChicago Medicine, Drs. Kent, Jeffries, Straszewski, and Wilson evaluate and treat a patient with a gunshot wound and femoral fracture. An ABI was obtained, CT angiography was evaluated, and proximal tibial traction was performed for pain management ...

This custom medical exhibit reveals a single view of the lower extremties with the dramatic appearance of Severe Bilateral Femoral Fractures (fractured, broken legs).

In this case, Dr. Michael Weaver performs an intramedullary fixation of a reverse oblique trochanteric femoral fracture in a lateral position. Neutralizing

TY - JOUR. T1 - Increased Risk of Periprosthetic Femur Fractures Associated With a Unique Cementless Stem Design. AU - Watts, Chad D.. AU - Abdel, Matthew. AU - Lewallen, David G.. AU - Berry, Daniel J.. AU - Hanssen, Arlen D.. PY - 2015/6/1. Y1 - 2015/6/1. N2 - Background: Postoperative periprosthetic femur fractures are an increasing concern after primary total hip arthroplasty (THA). Identifying and understanding predisposing factors are important to mitigating future risk. Femoral stem design may be one such factor.Questions/purposes: The goals of our study were to compare the (1) frequency of periprosthetic femur fracture and implant survivorship; (2) time to fracture in those patients who experienced periprosthetic femur fracture; and (3) predictive risk factors for periprosthetic femur fracture between a unique stem design with an exaggerated proximal taper angle and other contemporary cementless, proximally fixed, tapered stems.Level of Evidence: Level III, therapeutic study.Methods: We ...

TY - JOUR. T1 - Survivorship After Periprosthetic Femur Fracture. T2 - Factors Affecting Outcome. AU - Drew, Jacob M.. AU - Griffin, William L.. AU - Odum, Susan M.. AU - Van Doren, Bryce. AU - Weston, Brock T.. AU - Stryker, Louis S.. PY - 2015/6/24. Y1 - 2015/6/24. N2 - Background: Data addressing risk factors predictive of mortality and reoperation after periprosthetic femur fractures (PPFxs) are lacking. This study examined survivorship and risk ratios for mortality and reoperation after surgical treatment for PPFx and associated clinical risk factors. Methods: A retrospective review was performed for 291 patients treated surgically for PPFx between 2004 and 2013. Primary outcomes were death and reoperation. Results: Mortality at 1 year was 13%, whereas the rate of reoperation was 12%. Greater span of fixation and revision arthroplasty (vs open reduction internal fixation) trended toward a lower likelihood of reoperation. Conclusion: After PPFx, patients have a 24% risk of either death or ...

Diaphyseal femur fractures are a common occurrence in busy level one trauma centers and even in the age of damage control orthopaedics most of these fractures are fixed definitively within 24 hours. The historical method of temporizing these fractures has been to place a distal femoral or proximal tibial skeletal traction pin. However, in the pediatric population skeletal traction is not utilized due to concern for physeal injury and cutaneous traction has been the gold standard for decades. Reasons for skeletal traction in adults are not well defined and there are no clinical studies showing that skeletal traction provides better outcomes in time of reduction in the operating theater or better pain control than cutaneous traction. With the ever increasing amount of high energy trauma seen by junior residents in the emergency department time constraints have become a large factor in patient care. Long delays for sedation and equipment procurement make stabilizing a diaphyseal femur fracture a ...

This AAOS Clinical Practice Guideline (CPG) and quality programs for pediatric diaphyseal femur fractures provide up-to-date, evidence-based recommendations for diagnostic, treatment, and postoperative procedures.

Fat embolism syndrome is a life-threatening condition that can develop after orthopedic injury and surgery. This syndrome developed in a 19-year-old man after a traumatic femoral fracture that was surgically repaired with intramedullary nailing. The complications experienced by the patient highlight the importance of prevention and early detection of fat embolism syndrome. Although minimization of the syndrome focuses primarily on prehospital care and early stabilization of a patients condition, prevention of the potential consequences requires early detection by bedside nurses who care for trauma and orthopedic patients. Detailed nursing assessment and rapid recognition and reporting of the signs and symptoms associated with fat embolism syndrome are key to improving the outcomes of these patients. ...

TY - JOUR. T1 - Periprosthetic fractures of the humerus. AU - Schmidt, A. H.. PY - 1999/1/1. Y1 - 1999/1/1. N2 - Periprosthetic fractures of the humerus complicate 2-4% of total shoulder arthroplasties. Intraoperative fractures are more common than those that occur after surgery and are usually the result of faulty surgical technique. Patients with osteoporosis are at increased risk for periprosthetic fracture of the humerus, and these injuries are most common in patients with rheumatoid arthritis. Common mechanisms of intraoperative fracture include excessive external rotation forces because of poor operative exposure, improper starting hole location, and too forceful impaction. Intraoperative fractures should be stabilized with cerclage wires, and long- stem implants should be used if the fracture involves the shaft of the humerus. Postoperative fractures frequently compromise the functional abilities of the patient; operative treatment seems to give the best results. Treatment is based on a ...

Atypical Femur Fracture Injury Lawyer - 866.757.6949 Call Toll Free 24 Hours. If you or someone you know has been injured in an accident, know that we are to help you. Atypical Femur Fracture Injury lawsuits can often be long and upsetting, its important to have an experienced Atypical Femur Fracture Injury lawyer to represent you.

We investigated whether a proximal femoral nail (PFN) having two lag screws can be implanted without distal locking screws in AO/OTA 31-A1 and 31-A2 intertrochanteric femur fractures. Twenty-four patients with AO/OTA 31-A1 and 31-A2 fractures were treated with a PFN without distal interlocking by a single surgeon. The mean follow-up was 12 months (range: 7-23). Clinical and functional outcome was assessed according to the Harris hip score and Barthels activity score. The fractures healed in all patients; the average consolidation time was 14 weeks (range: 9-28). Fourteen patients had excellent and good results, nine patients had fair results, and one patient had a poor result according to the Harris hip score; 17 patients had a high range of mobility according to the Barthel activity score. Our results suggested that the PFN can be successfully implanted without distal interlocking in 31-A1 and 31-A2 fractures. ...

INTRODUCTION: There is no consensus yet on the impact of timing of femur fracture (FF) internal fixation on the patient outcomes. This meta-analysis was conducted to evaluate the contemporary data in patients with traumatic FF undergoing intramedullary nail fixation (IMN). METHODS: English language literature was searched with publication limits set from 1994 to 2016 using PubMed, Scopus, MEDLINE (OVID), EMBASE (OVID), Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL). Studies included randomized controlled trials (RCTs), prospective observational or retrospective cohort studies, and case-control studies comparing early versus late femoral shaft fractures IMN fixation. Variable times were used across studies to distinguish between early and late IMN, but 24 h was the most frequently used cutoff. The quality assessment of the reviewed studies was performed with two instruments. Observational studies were assessed with the Newcastle-Ottawa Quality Assessment Scale. RCTs were

Background: Admission hyperglycemia is associated with increased morbidity and mortality in trauma patients. However, admission hyperglycemia is not only associated with stress-induced hyperglycemia (SIH) but also with diabetic hyperglycemia (DH); furthermore, patients with normoglycemia may not only have non-diabetic normoglycemia (NDN) but also have a possibility of diabetic normoglycemia (DN), with the diabetes under control. This study aimed to assess the effects of SIH and DH on the mortality outcomes of traumatic femoral fracture patients with NDN and DN. Methods: Admission hyperglycemia was diagnosed as a serum glucose ≥200 mg/dL upon arrival at the emergency department. Diabetes mellitus (DM) was determined by patient history and/or admission HbA1c ≥ 6.5%. DH and SIH were diagnosed by admission hyperglycemia in patients with and without DM. DN and NDN were determined by absence of admission hyperglycemia in patients with and without DM. These patients were allocated into four groups: SIH (n

Knee surgeons at OrthoNorCal in Morgan Hill, Watsonville, Santa Cruz County and Santa Clara County, CA treats knee fracture include distal femur fracture, femoral shaft fracture, fractures of the proximal tibia and tibial shaft fractures. They also offers knee surgery to treat knee arthritis and knee infection.

This study will be conducted as a prospective cohort study of children and adolescents treated with TEN for a femoral shaft fracture. All children and adolescents presenting to the Emergency department of a participating center with a femur fracture will be approached for inclusion in the study. The primary outcome for this study will be functional recovery, as measured using a pediatric specific generic QOL measurement tool. The clinical outcome measure which will be used will be the performance version of the ASK (ASK-p) which has been previously tested and shown to be valid, reliable, and responsive in children and adolescents with acute and chronic Orthopaedic disorders. The first time point for data collection will be at four months. Clinical data which will be obtained over the course of follow-up will include clinical evaluation of hip and knee range of motion, limb rotation, clinical measurement of limb length, fracture union, and the presence of complications, including the need for ...

The purpose of this study was to determine patients survival after undergoing an early or delayed operation. We retrospectively assessed 1849 files of patients operated for proximal femoral fracture, divided into two diagnostic groups: intracapsular (n = 640) and extracapsular (n = 1209). 1163 (63%) were treated within 48 h from hospital admission and 686 (37%) were treated |48 h afterwards. Delayed operation in patients with intracapsular fractures was associated with a 1.8-fold excess risk for 1-year mortality (HR = 1.83, P = 0.008), while no effect was observed for patients with extracapsular fractures. Males had a higher HR for mortality in both diagnostic groups. Early surgical intervention is beneficial for intra-capsular femoral fractures; male gender and a high ASA score are associated with an increased mortality hazard risk.

Femoral shaft perforation at total hip arthroplasty is a complication that is being noted more frequently, and it is often associated with femoral shaft fracture below the prosthesis. This study...

This study compares results of unreamed Schneider intramedullary nailings with reamed Küntscher intramedullary nailings. Eighty consecutive closed intramedullary roddings of femoral shaft fractures performed at Parkland Memorial Hospital, Dallas, were reviewed. In the first 40 cases, straight, narrow Schneider or Küntscher rods with an average diameter of 10 mm were inserted following closed reduction. No reaming maneuvers and no effort to attain rigid cortical contact with either fracture fragment were made. In the next 40 cases, the standard Küntscher technique with reaming and cortical impingement of the nail on both fragments was employed using Küntscher nails of an average diameter of 13 mm. All patients were followed to fracture union. Analysis of patient and fracture variables (such as anatomic location and degree of comminution) showed no significant differences in the two groups. While both groups demonstrated multiple minor complications, including slight shortening, mild ...

The NCB Periprosthetic Femur Plating System is a system of polyaxial locking plates for the treatment of femur fractures, including periprosthetic fractures.

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Synthes strives for optimal solutions in the treatment of Proximal Femur and Pelvic indications in order to restore quality of life at any given age.. PFNA with Augmentation Option. PFNA has improved rotational and angular stability thanks to the PFNA blade as a single head element. The augmentation option is a unique system of controlled cement application through the blade resulting in a greater load bearing surface and significantly increased resistance to cut-out. LCP Dynamic Hip Screw (DHS) incl. DHS Blade and Locking Trochanter Stabilization Plate (LTSP). LCP DHS incl. DHS Blade and LTSP is designed for the treatment of proximal femoral fractures, and is especially beneficial for patients with poor quality bone (e.g. osteoporosis).. Proximal Femoral (Hook) Plate. The Proximal Femoral (Hook) Plate offers angular stable treatment of proximal femoral fractures.. Low Profile Pelvic System. The Low Profile 3.5 mm Pelvic System features a wide range of redesigned stainless steel plates in a ...

article{1c594d14-54d3-4c6f-bc91-1ba1e49bf259, abstract = {ABSTRACT. Callus formation is a critical step for successful fracture healing. Little is known about the molecular composition and mineral structure of the newly formed tissue in the callus. The aim was to evaluate the feasibility of small angle x-ray scattering (SAXS) to assess mineral structure of callus and cortical bone and if it could provide complementary information with the compositional analyses from Fourier transform infrared (FTIR) microspectroscopy. Femurs of 12 male Sprague-Dawley rats at 9 weeks of age were fractured and fixed with an intramedullary 1.1 mm K-wire. Fractures were treated with the combinations of bone morphogenetic protein-7 and/or zoledronate. Rats were sacrificed after 6 weeks and both femurs were prepared for FTIR and SAXS analysis. Significant differences were found in the molecular composition and mineral structure between the fracture callus, fracture cortex, and control cortex. The degree of ...

TY - JOUR. T1 - CT-measurement predicts shortening of stable intertrochanteric hip fractures. AU - Hecht, Garin. AU - Shelton, Trevor J.. AU - Saiz, Augustine M.. AU - Goodell, Parker B.. AU - Wolinsky, Philip R. PY - 2018/12/1. Y1 - 2018/12/1. N2 - Purpose: Intertrochanteric (IT) hip fractures can be treated with sliding hip screws (SHS) or cephalomedullary nails (CMN) based on the stability of the fracture. This stability is affected by the initial impaction of the fracture which can be difficult to assess. The aim of this paper is to develop specific pre-operative computed tomography (CT) measurements of IT fractures which are predictive of post-operative shortening. Methods: A retrospective review was performed of 141 patients with AO/OTA 31A1 or 31A2 fracture patterns, who had pre-operative radiographs and CT scans, and who were treated with a SHS or a CMN. Pre-operative and post-operative imaging of IT fractures were analyzed for those fractures that shortened ≥15 mm post-fixation. ...

Learn the Cannulated Hip screws (Asnis III - Stryker) for fixation of intracapsular neck of femur fracture surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Cannulated Hip screws (Asnis III - Stryker) for fixation of intracapsular neck of femur fracture surgical procedure.

The purpose of this study was to investigate bone microarchitecture of cadaveric proximal femurs using ultra-high field (UHF) 7-Tesla magnetic resonance imaging (MRI) and to compare the corresponding metrics with failure load assessed during mechanical compression test and areal bone mineral density (ABDM) measured using dual-energy X-ray absorptiometry. Materials and methods: ABDM of ten proximal femurs from five cadavers (5 women; mean age= 86.2 ± 3.8 (SD) years; range : 82.5-90 years) were investigated using dual-energy X-ray absorptiometry and the bone volume fraction, trabecular thickness, trabecular spacing, fractal dimension, Euler characteristics, Connectivity density and degree of anisotropy of each femur was quantified using UHF MRI. The whole set of specimens underwent mechanical compression tests to failure. Associations were searched using correlation tests and multiple regression analysis. ...

According to the National Hip Fracture Database, over 64,000 patients were admitted with a hip fracture across England, Wales, and Northern Ireland in 2013, but very few are bilateral, and there are no current cases in the literature of bilateral neck of femur fractures in a patient with bilateral below-knee amputations. We present a case of a 69-year-old bilateral below-knee amputee male admitted to the emergency department with bilateral hip pain and radiological evidence of bilateral displaced neck of femur fractures. The patient subsequently underwent synchronous bilateral total hip replacements under general anaesthetic and an epidural and then went on to make a full recovery. He was discharged 27 days after arrival in hospital. Outpatient follow-up at 3 months has shown that the patient has returned to a similar level of preinjury function and is still able to carry out his daily activities with walking aids and bilateral leg prostheses.

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TRIGEN INTERTAN is an intertrochanteric antegrade proximal femoral nailing system used to treat hip fractures. TRIGEN INTERTAN can also be used as an intramedullary and cephalomedullary nailing system.

In a retrospective study performed at a Level I trauma center, we considered all adult patients with major trauma (ISS , 15) and femoral shaft fracture admitted between January 2003 and July 2006. Patients were separated into two groups according to the management strategies for the femoral fracture: group 1, no surgery within 72 hours after primary admission; group 2, surgical stabilization within 72 hours (DCO). To compare the two groups we considered age, ISS, RTS, TRISS, SAPS II, GCS, comorbidity, and other associated surgery. Parameters of evaluation were: mortality in the ICU, ICU length of stay, respiratory failure and length of ventilation, and daily SOFA collected for 8 days. Statistics were determined with the Student t and chi-squared tests; P , 0.05 was considered significant. ...

3 Because almost all femur fractures in battle (usually from bullet and shrapnel wounds) were open, the Thomas splint saved lives mostly by controlling bleeding. Even in a closed femur fracture, however, the patient can lose more than a liter of blood internally, so traction splinting is still important. The Thomas splint was made from a 3/8″ steel rod bent to fit on either side of the leg, with a V-notch in the cross piece beyond the foot. The upper ends of the rod were attached to a padded ring, which had to be slid up the leg until it was braced against the perineum and buttocks. This ring made the splint awkward to apply to a fractured leg, so it was soon modified into the Keller-Blake hinged half-ring splint (which can be improvised from two ski poles, with the interlaced wrist straps replacing the half-ring). The half-ring is eased under the crease of the buttocks, and secured by an attached strap that goes over the top of the thigh. A variation on the Thomas splint was also developed ...

It is extremely important to choose the correct therapeutic approach because there are several post-operative complications following surgery for SFF. Even with modern implants, the complication rates in the treatment of the SFF remain high. Screw cut-out, femur fracture, varization, procurvatum malunion or nonunion, lack of consolidation and implant failure are the most common post-operative complications in SFF 1.. In the SFF, screw cut-out is between 1.1 and 6.3% and represents 85% of fixation failures. The main causes of the cut-out are the instability of the fracture and, in particular, incorrect positioning of the lag screw which consists of the distance from the screw tip to the subchondral bone 14. Thus, it is important for the surgeon to position the lag screw in the femoral head, in order to avoid serious implant failure due to screw cut-out 15.. Studies show the diameter and the length of the nail play an important role in the surgery outcomes. Nails with a greater distal diameter ...

Risedronate and even more notably alendronate use is linked to what are called atypical subtrochanteric fractures and femoral shaft fractures, both linked to bone insufficiency (Angthong and Angthong, 2011). More worrying is the fact that a longer duration of the biphosphonate treatment increases the odds of insufficiency fractures (Meier et al., 2012), which certainly raises concerns about how long the patients should be taking these drugs. Other side effects confirm that bone solidity does not necessarily reflect bone density. Dental practitioners should be aware of the increased risk of implant failure associated with oral biphosphonate use in the population (Yip et al., 2012). Practically speaking, it is well known that many dentists specializing in dental implants do not accept patients following these biphosphonate treatments due to the excessive risk of implant failure. Another concern lies in the association between biphosphonate use and jaw osteonecrosis (Arrain and Masud, 2011). ...

Which femur fracture repair surgeons in New Hampshire get the best outcomes? Find/compare surgeons plus their death and complication rates.

Which femur fracture repair surgeons in Ohio get the best outcomes? Find/compare surgeons plus their death and complication rates.

Stress fractures are injuries that occur when repetitive and excessive stress on a bone is combined with limited rest. This leads to muscle weakness and a lower shock absorbing capacity of the leg and in turn can lead to bone damage. Stress fractures of the femur are relatively uncommon, and data from the literature suggest that they constitute only 2.8-7% of all sport related stress fractures. Anatomy The femur is the longest bone in the body, connects the pelvis to the lower limb and is the so

During the conference, Judge Higbee stated that she hopes to try a group, or at the very least, one of the Fosamax femur fracture lawsuits next spring. She noted that while discovery in the Fosamax femur fracture lawsuits is still in its infancy, many of the ONJ documents used in those cases will overlap and are relevant to the Fosamax femur fracture lawsuits. While there is a degree of overlap, counsel involved in the Fosamax femur fracture lawsuits noted that there have been supplemental requests dealing solely with Fosamax and femur fractures. Defense counsel is in the process of responding to those requests. Regarding discovery of documents, Judge Higbee made clear that relevancy is not a basis for withholding documents. Clarifying that statement, Judge Higbee stated that documents that refer to Fosamax are relevant or could lead to relevant information and must be produced. She reminded counsel that New Jersey has very broad discovery rules.. ...

As patients who were afflicted with poliomyelitis during the outbreaks in the past are aging, lower extremity osteoporotic fractures are becoming more freq

A new method for fluoroscopic tracking of a proximal bone fragment in femoral fracture reduction is presented. The proposed method combines 2-D and 3-D image registration from single-view fluoroscopy with tracking of the head center position of the proximal femoral fragment to improve the accuracy of fluoroscopic registration without the need for repeated manual adjustment of the C-arm as required in stereo-view registrations. Kinematic knowledge of the hip joint, which has a positional correspondence with the femoral head center and the pelvis acetabular center, allows the position of the femoral fragment to be determined from pelvis tracking. The stability of the proposed method with respect to fluoroscopic image noise and the desired continuity of the fracture reduction operation is demonstrated, and the accuracy of tracking is shown to be superior to that achievable by single-view image registration, particularly in depth translation.

The Use of Liposomal Bupivacaine in Orthopaedic Trauma - Hank L. Hutchinson, MD. Hank L. Hutchinson, MD, from the Tallahassee Orthopedic Clinic in Tallahassee, Florida, is an orthopaedic trauma surgeon, and he said liposomal bupivacaine has a made a big difference in his ability to provide pain control for a variety of patients.. Dr. Hutchinson shared a number of cases, including the case of a 63-year-old female with history of bisphosphanate use and prior subtrochanteric fracture. The fracture was treated in 2011 with a cephalomedullary nail, but was referred to Dr. Hutchinson for management of fracture nonunion.. When Dr. Hutchinson rounds on patients who have surgery to repair a subtrochanteric fracture, they are usually asleep from the opioids they have taken to control their pain.. With this patient, however, he infiltrated the site with liposomal bupivacaine, and when he saw her 30 hours after surgery, she was able to flex her knee and lift her leg off the bed. That is typical of his ...

A 40-year-old man with no past medical history was riding his bicycle when he rode over a large pothole in the road, fell to the curb, and sustained a closed mid-shaft right femur fracture. He has no other trauma, is neurologically intact with normal distal perfusion. He will need a Steinmann traction pin placed in the ED and will be on call to the OR tomorrow. Your colleague suggests ketofol for sedation for the ED procedure. Which of the following is BEST supported by the current evidence ...

Date Presented 3/30/2017. This study describes a geriatric population at a medical center admitted for femur fracture to determine the impact of a multidisciplinary team specializing in geriatric trauma. Results show a significant increase in utilization of occupational therapy services and cognitive assessment and a decrease in length of stay.. Primary Author and Speaker: Amanda Wilson. Contributing Authors: Traci Norris, Lindsey Foster, Catherine Royal, Heidi Tymkew, Dean Klinkenberg ...

Fosamax femur fracture attorneys at Arentz Law Group can help victims hold Merck accountable for their physical, emotional, and financial damages.

Tibia and Fibula Shaft Fractures. Ed Smith discusses leg fractures resulting from motor vehicle accidents. Evaluation, classification and treatment.

We included seven studies that involved a total of 444 adults with distal femur fractures. Each of the included studies was small and assessed to be at substantial risk of bias, with four studies being quasi-randomised and none of the studies using blinding in outcome assessment. All studies provided an incomplete picture of outcome. Based on GRADE criteria, we assessed the quality of the evidence as very low for all reported outcomes, which means we are very uncertain of the reliability of these results.. One study compared surgical (dynamic condylar screw (DCS) fixation) and non-surgical (skeletal traction) treatment in 42 older adults (mean age 79 years) with displaced fractures of the distal femur. This study, which did not report on PROMs, provided very low quality evidence of little between-group differences in adverse events such as death (2/20 surgical versus 1/20 non-surgical), re-operation or repeat procedures (1/20 versus 3/20) and other adverse effects including delayed union. ...

For people with hip fractures, traction involves either using tapes (skin traction) or pins (skeletal traction) attached to the injured leg and connected to weights via a pulley. The application of traction before surgery is thought to relieve pain and make the subsequent surgery easier. Where traction is not used, the injured limb is usually placed on a pillow and the patient encouraged to adopt a position of greatest comfort.. This review summarising the evidence from randomised controlled trials included 11 trials with 1654 participants. Consistent with the general hip fracture population, most of the trial participants were older persons of around 80 years of age and the majority were female. Ten trials compared traction versus no traction and two trials, including one of the preceding 10 trials, compared skin and skeletal traction. As well as limitations in the trial methods, there were very limited data for pooling and a lack of information about the longer-term consequences of applying or ...

Femoral Diaphysis - Fracture of the femoral shaft treated with the Centronail Titanium Universal Femoral Nailing System. Antegrade insertion.

Oszwald M., Westphal R., Sattler S., Wahl F., Krettek C., Gösling T.. 2010. X-ray based compensation of relative motions for non-invasive robotic reduction of femoral shaft fractures. 18th European Conference on Orthopaedics, the conference of the European Orthopaedic Research Society. ...

Surgical treatment Intact female Sprague Dawley rats at 6, 26 or 52 weeks of age, weighing 154 eleven g, 281 25 g, and 330 thirty g respectively, were anaes thetized with an intraperitoneal injection of ketamine and xylazine as described earlier. The left knee was shaved, scrubbed with Betadine Solution, and draped with sterile sheets. A medial incision was made with the knee, the patella was deflected laterally as well as a Inhibitors,Modulators,Libraries one. 0 mm hole was drilled in to the inter condylar notch. An intramedullary rod was placed retrograde to the left femur. The incision was closed with wound clips. A closed simple transverse mid diaphyseal femoral fracture was induced using a Bonnarens and Einhorn gadget. Ran domly selected rats from amongst those scheduled for sur gery have been used for 0 time no fracture sham controls. Rats had been euthanized at 0, 0.. four, 1, 2, four, and 6 weeks right after frac ture for a complete of six time points at just about every of the 3 ages. ...

Left femur of pig (Sus domesticus)Photo author: Albert Fischer - Date: 27/04/2014.For more information, refer to the presentation of the corpus of the author. - Sus-domesticus-Femur-Left.jpg