Periprosthetic distal fractures comminuted. Medical search. Frequent questions

The use of reverse total shoulder arthroplasty for the management of complex proximal humerus fractures has gained popularity in the last five to ten years. (scielo.org.za)
We present a concise review of conservative and surgical treatment of proximal humerus fractures and a more detailed review of published series of reverse shoulder arthroplasty for fracture treatment. (scielo.org.za)
performed a prospective observational study of 76 patients with complex proximal humerus fractures managed non-operatively. (scielo.org.za)
However, there is conflicting evidence regarding the outcomes when used for proximal humerus fractures. (scielo.org.za)
Intra-articular Fractures of the Distal Humerus in the Adult. (uth.edu)
Fractures of the distal HUMERUS and the proximal ULNA and the RADIUS at the ELBOW JOINT, including the head, anatomic and surgical necks, and tuberosities. (bvsalud.org)
Diaphyseal humerus fractures (AO/OTA 12) have traditionally been managed nonoperatively with splinting and functional bracing 1 . (researchsquare.com)

Supracondylar femur fractures require anatomically stable internal fixation for best results. (medscape.com)
however, fixation is difficult because of the wide canal, the thin cortex, and the relatively poor bone quality of the distal femur. (medscape.com)
Most surgical failures are caused by inadequate fixation of fracture fragments. (medscape.com)
The more comminuted the fracture and the poorer the quality of bone, fixation, or reduction, the worse the prognosis. (medscape.com)
The mainstay of surgical management for distal femur fractures is retrograde nailing or open reduction internal fixation (ORIF). (teachmesurgery.com)
In certain cases, external fixation may be used in severe comminuted or open fractures. (teachmesurgery.com)
The management of a peri-prosthetic distal femur fracture is more complex, and may require intramedullary nailing, open reduction internal fixation, revision to a long stem prosthesis, or a distal femoral replacement. (teachmesurgery.com)
Open reduction internal fixation is often the preferred method in the presence of an intact and stable prosthesis, while long stem revision or distal femoral replacement is more commonly employed when the femoral component is loose. (teachmesurgery.com)
Patella Fracture Fixation With Novel Wagon Wheel Construct Versus Tension-Band Construct: A Technical Trick. (mayoclinic.org)
Pain Management following Open Reduction and Internal Fixation of Distal Radius Fractures. (mayoclinic.org)
Although the concept of internal fixation dates back to the mid-1800s, Lister introduced open reduction, internal fixation (ORIF) of patella fractures in the 1860s. (medscape.com)
Early surgical fixation initially was complicated by many obstacles, such as infection, poorly conceived implants and techniques, metal allergy, and a limited understanding of the biology and mechanics of fracture healing. (medscape.com)
Fractures with less than an anatomic reduction and less rigid fixation (ie, those with large gaps and low strain via external fixator, casting, and intramedullary [IM] nailing) heal with callous formation or secondary healing with progression through several different tissue types and eventual remodeling. (medscape.com)
Anatomic reduction and absolute stabilization of a fracture by internal fixation alter the biology of fracture healing by diminishing strain (elongation force) on the healing tissue at the fracture site. (medscape.com)
Absolute stability with no fracture gap (eg, via open reduction and internal fixation using interfragmental compression and plating) presents a low strain and results in primary healing (cutting cone) without the production of callus. (medscape.com)
Supplemental medial small fragment fixation adds stability to distal femur fixation: A biomechanical study. (stanford.edu)
INTRODUCTION: Bridge plating of distal femur fractures with lateral locking plates is susceptible to varus collapse, fixation failure, and nonunion. (stanford.edu)
Locked plate technology for fixation of fractures associated with poor bone quality has expanded in recent years. (scielo.org.za)
In a recent prospective randomised control trial (PRCT) of 50 patients comparing non-operative management and locked-plate fixation for complex displaced fractures, it was reported that at 12 months the functional scores (American Shoulder and Elbow Score ASES, and Constant Score CS) were similar, and that the only significant difference was better radiographs in the operated group. (scielo.org.za)
Femoral neck fractures are at risk of non-union with/without mechanical collapse due to insufficient fixation and/or avascular necrosis of the femoral head. (musculoskeletalkey.com)
Extra-capsular fractures are at risk of mechanical collapse and non-union due to insufficient fixation. (musculoskeletalkey.com)
It should be reserved for multifragmentary fractures that require multiplanar fixation. (aofoundation.org)
Locking fixation in these plates is helpful considering the significant forces across the patella fracture and the need for unicortical fixation. (aofoundation.org)
This study analyzes risk factors associated with mechanical failure following plate fixation of humeral shaft fractures in order to further elucidate the mode and location of failure. (researchsquare.com)
Eleven of eighty-five humeral shaft fractures had aseptic mechanical failure requiring revision (12.9%), following initial plate fixation. (researchsquare.com)
Fracture characteristics (AO type, comminution, location) and fracture fixation (plate type, multiplanar, number of screws proximal and distal to the fracture) were compared between aseptic mechanical failure and those without failure. (researchsquare.com)
There was significant differences in fixation between the aseptic mechanical failure group and those without failure, specifically in the number of screws for proximal fixation (p=0.008) and distal fixation (p=0.040). (researchsquare.com)
In contrast, constructs with 4 bicortical screws or more of fixation on either side of the fracture had lower failure rates and may help to reduce the risk of mechanical failure. (researchsquare.com)
Common complications for open reduction internal fixation (ORIF) of humeral shaft fractures include radial nerve injury, infection, and hardware failure 3 . (researchsquare.com)
Ideal plate and screw fixation construct for open reduction and internal fixation of humeral shaft fractures remains controversial. (researchsquare.com)
Although 6-8 cortices of proximal and distal fixation have been recommended based on expert opinion 1 , there is considerable variation in plating techniques and fixation constructs to match the variability in patient and fracture characteristics. (researchsquare.com)
We reviewed all patients who underwent humeral shaft ORIF over a 9-year period to evaluate modes and location of failure by fracture type and fixation construct, as well as to determine the risk factors contributing to failure. (researchsquare.com)

In more severe cases, the bone may be broken into several fragments, known as a comminuted fracture. (wikipedia.org)
The fracture-line is anatomically located laterally to the nutrient vessels to the femoral head, so avascular necrosis is rarely seen, but muscle attachments often dislocate the fragments and bleeding into surrounding muscles can be severe and life-threatening. (musculoskeletalkey.com)
Classification systems are primarily based on fracture-line location and number of fragments. (musculoskeletalkey.com)
Fracture was grossly exposed with several free bony fragments. (biocomposites.com)
This can be cut and contoured to precisely outline the fracture fragments of the patella. (aofoundation.org)

Periprosthetic patella fractures occur typically through fall onto a bent knee. (aofoundation.org)

Proximal humeral fractures account for around 5% of humeral fractures. (scielo.org.za)
The Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association (AO/OTA) classification together with the Neer classification is one of the most frequently used systems for classifying proximal humeral fractures . (radiopaedia.org)
Like fractures in other bone segments, proximal humeral fractures are divided into three groups subject to the severity and complexity of the respective injury 1 . (radiopaedia.org)
2. Marongiu G, Leinardi L, Congia S, Frigau L, Mola F, Capone A. Reliability and Reproducibility of the New AO/OTA 2018 Classification System for Proximal Humeral Fractures: A Comparison of Three Different Classification Systems. (radiopaedia.org)
3. Brorson S, Eckardt H, Audigé L, Rolauffs B, Bahrs C. Translation Between the Neer- and the AO/OTA-Classification for Proximal Humeral Fractures: Do We Need to Be Bilingual to Interpret the Scientific Literature? (radiopaedia.org)

Octogenarian and Nonagenarians Are at a Higher Risk for Experiencing Adverse 30-Day Outcomes Following ORIF of Ankle Fractures. (mayoclinic.org)

Patients with open fractures fare worse than those with closed fractures. (medscape.com)
BACKGROUND: Open fractures of the ankle are complex injuries requiring multidisciplinary input and are associated with significant morbidity and mortality. (bvsalud.org)

Complications following a distal femur fracture include malunion (more common for fractures that have been plated), non-union (can occur in up to 19%, most common in the metaphyseal area), and secondary osteoarthritis , especially those with intraarticular extension of the fracture. (teachmesurgery.com)
Some fractures may lead to serious complications including a condition known as compartment syndrome. (wikipedia.org)
Other complications may include non-union, where the fractured bone fails to heal, or malunion, where the fractured bone heals in a deformed manner. (wikipedia.org)
Complications of fractures may be classified into three broad groups, depending upon their time of occurrence. (wikipedia.org)
These are as follows - Immediate complications - occurs at the time of the fracture. (wikipedia.org)
Early complications - occurring in the initial few days after the fracture. (wikipedia.org)
Late complications - occurring a long time after the fracture. (wikipedia.org)
Immediate complications - occurs at the time of the fracture. (wikipedia.org)

There is also an increasing number of whom have a distal femur fracture related to a knee replacement (known as a peri-prosthetic fracture ). (teachmesurgery.com)

His clinical interests include nonunions, periarticular fractures, fractures of the pelvis and acetabulum, and infections. (stanford.edu)

The goal in treating supracondylar femur fractures, as in treating any periarticular fracture in a weightbearing bone, is restoration of a stable limb for functional, pain-free ambulation. (medscape.com)
The distal femur is funnel-shaped, and the area where the stronger diaphyseal bone meets the thinner and weaker metaphyseal bone is prone to fracture with direct or indirect trauma. (medscape.com)
Supracondylar femur fractures usually occur as a result of low-energy trauma in osteoporotic bone in elderly persons or high-energy trauma in young patients. (medscape.com)
Fractures proximal to knee replacements may be caused by notching of the anterior cortex when the surgeon placed the prosthesis or may be secondary to the stress riser effect of the interface between the rigid metal and soft bone. (medscape.com)
[ 18 , 19 ] The treating physician must also be aware of the potential for pathologic fractures through metastatic lesions or primary bone tumors in this area. (medscape.com)
A bone fracture (abbreviated FRX or Fx, Fx, or #) is a medical condition in which there is a partial or complete break in the continuity of any bone in the body. (wikipedia.org)
A bone fracture may be the result of high force impact or stress, or a minimal trauma injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, osteopenia, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathologic fracture. (wikipedia.org)
Although bone tissue contains no pain receptors, a bone fracture is painful for several reasons: Breaking in the continuity of the periosteum, with or without similar discontinuity in endosteum, as both contain multiple pain receptors. (wikipedia.org)
One form of malunion is the malrotation of a bone, which is especially common after femoral and tibial fractures. (wikipedia.org)
The natural process of healing a fracture starts when the injured bone and surrounding tissues bleed, forming a fracture hematoma. (wikipedia.org)
Smokers generally have lower bone density than non-smokers, so they have a much higher risk of fractures. (wikipedia.org)
A bone fracture may be diagnosed based on the history given and the physical examination performed. (wikipedia.org)
Iliac Crest Allograft with Plate Osteosynthesis for a Bone-Patellar Tendon-Bone Anterior Cruciate Ligament Donor-Site Fracture: A Case Report. (mayoclinic.org)
Every bone in the human body is susceptible to a fracture, this is especially the case as we get older and degenerative joint disease sets in or if a patient suffers a traumatic injury or undergoes a severe life-threatening accident with multiple broken bones. (englewoodortho.com)
Methods A 45-degree oblique fracture line was created in artificial bone samples. (bvsalud.org)
Immobilization by casting, bracing, or splinting a joint above and below the fracture was used for most long bone fractures - except femur fractures, for which traction was the mainstay of treatment. (medscape.com)
Although this process has been called secondary bone union or indirect fracture repair, it is the natural and expected way fractures heal. (medscape.com)
In this model, cutter heads of the osteons reach the fracture and cross it where bone-to-bone contact exists. (medscape.com)
A bone fracture (abbreviated FRX or Fx , F x , or # ) is a medical condition in which there is a partial or complete break in the continuity of any bone in the body. (wikipedia.org)
Stages in Fracture Repair: The healing of a bone fracture follows a series of progressive steps: (a) A fracture hematoma forms. (wikipedia.org)
This is a disease that has surgical management and in the presence of diffuse bone demineralization, a nondisplaced fracture may be less visible on x-ray. (podiatry.com)
STIMULAN beads were used to fill the bone deficit at the fracture site. (biocomposites.com)
Fractures of the skull, as with fractures of any bone, occur when biomechanical stresses exceed the bone's tolerance. (radiopaedia.org)
It is essential that a bone algorithm is used if undisplaced fractures are to be visualized. (radiopaedia.org)
Fractures will appear as discontinuities in the bone and may or may not be displaced. (radiopaedia.org)

Non-operative management requires a long period of immobilisation and non-weight bearing, however is sometimes indicated for fractures with minimal displacement in a non-ambulatory or very co-morbid patient. (teachmesurgery.com)
So fracture detection actually requires a minimal degree of displacement. (podiatry.com)
Femoral neck fracture classification has historically been contentious with several different systems, primarily based on fracture displacement seen in the anterior-posterior radiographs. (musculoskeletalkey.com)
If the extensor mechanism is disrupted due to displacement of the fracture, then the patellar button is likely also unstable. (aofoundation.org)

As most cases present following a fall or trauma , differentials include tibial plateau fractures , haemarthrosis , or tibial shaft fractures . (teachmesurgery.com)
Operative treatment of humeral shaft fractures (AO/OTA 12) is being performed more frequently. (researchsquare.com)
A retrospective review of 351 humeral shaft fractures was completed at a single level I trauma center. (researchsquare.com)

In adults, the femoral head is primarily supplied by the distal recurrent vessels entering the femur on the shaft side of the fracture. (musculoskeletalkey.com)

Partial articular fractures can be further classified into sagittal fractures of lateral condyle, sagittal fractures of medial condyle, and coronal fractures. (teachmesurgery.com)
While medial and lateral dual plating has been described in clinical series, the biomechanical effects of dual plating of distal femur fractures have yet to be clearly defined. (stanford.edu)
31-A3 covers fracture lines through the lateral femoral wall - defined as the lateral cortex distal to the greater trochanter - in which the subgroup 31-A3.1 represent the reverse fracture and 31-A3.2 the transversal, while the most comminuted 31-A3.3 fracture demands both a fractured lateral femoral wall and a detached lesser trochanter. (musculoskeletalkey.com)
26-year-old male with shotgun wound to the right shoulder presented with right distal open comminuted lateral third clavicle fracture with intact AC joint and large overlying skin defect. (biocomposites.com)

The replacement of hematoma by this structural network adds stability to the fracture site. (medscape.com)
Avascular necrosis is caused by ischaemia hypothetically due to either a direct trauma to the arterial supply crossing the fracture-line or by a temporary arterial impingement, caused by vessel stretching or intra-capsular hematoma. (musculoskeletalkey.com)
Skull fractures, if closed and undisplaced, rarely need any direct management, with treatment being aimed at any associated injury (e.g. extradural hematoma). (radiopaedia.org)

They are the third most common non-vertebral fragility fracture after the hip and distal radius. (scielo.org.za)
In a fragility fracture context, intra-capsular hip fractures are in fact through the femoral neck, as femoral head fractures are uncommon in the elderly. (musculoskeletalkey.com)

Distal femur fractures are fractures extending from the distal metaphyseal-diaphyseal junction of the femur to the articular surface of the femoral condyles. (teachmesurgery.com)
A Hoffa fracture is a specific type of type B articular distal femoral fracture in which there is a fracture of the posterior aspect of the femoral condyles in the coronal plane. (teachmesurgery.com)
Use of an Intraoperative Limb Positioner for Adjustable Distraction in Acetabulum Fractures with Femoral Head Protrusion: A Case Report. (mayoclinic.org)
The hip joint capsule divides fractures into two main categories with an almost equal patient distribution: (1) Intra-capsular femoral neck fractures and (2) Extra-capsular basicervical, trochanteric and sub-trochanteric fractures. (musculoskeletalkey.com)
Conclusions: Proximal femoral nailing can be one of the primary treatment options for intertrochanteric hip fractures in the elderly. (journaltocs.ac.uk)

Fully-threaded screws could, therefore, be more useful in diaphyseal fracture treatment. (bvsalud.org)

Outcomes of Surgical Management of Closed Periprosthetic Distal Femur Fractures above Total Knee Arthroplasties: A Case Series Orthoplastic Surgery. (mayoclinic.org)

Cephalomedullary Nailing of Unstable Geriatric Intertrochanteric Fractures on a Traction Table Combined With Percutaneous Reduction Techniques Is Safe and Results in a Low Rate of Cutout. (mayoclinic.org)
DeBaun MR, Goodnough LH, Hidden KA , Nork SE, Kleweno CP, Hebert-Davies J. Type III Open Tibia Fractures Treated With Single-Stage Immediate Medullary Nailing and Attempted Primary Closure Yield Low Rates of Flap Coverage. (mayoclinic.org)

Trans-ulnar Fracture Dislocations of the Elbow: A Systematic Review and Clarification of Classification Systems. (mayoclinic.org)
The constrained prosthesis has increased stress at the elbow joint with high rates of osteolysis, loosening, and periprosthetic fractures. (medapparatus.com)

Open (compound) fracture will usually require debridement to reduce the risk of subsequent infection 1 . (radiopaedia.org)

Wound healing occurred 3 months after treatment, and at 6 months there was full consolidation of the clavicle fracture with complete absorption of STIMULAN beads. (biocomposites.com)

to simulate comminuted extraarticular distal femur fractures (AO/OTA 33A). (stanford.edu)

They occur both in younger patients (as the result of high energy trauma) or in older patients (from low energy trauma as a pathological fracture secondary to osteoporosis or malignancy). (teachmesurgery.com)
We provide expert orthopedic trauma care for patients with complex fractures throughout the body as well as treating nonunions (fractures that do not heal post-operatively), malunions (improper alignment after a fracture) and in correcting orthopedic deformities. (englewoodortho.com)
Disruption of the endosteal and periosteal blood supply occurs with the initial trauma, and maintaining adequate blood supply to the fracture site is essential for healing. (medscape.com)

Avascular necrosis (AVN) complicates between 21 and 75% of three- and four-part fractures, and is related to the initial injury, the fracture pattern, the integrity and size of the medial cortical hinge, and surgical dissection. (scielo.org.za)

Antero-posterior radiograph of right side proximal femur showing the anatomy and fracture positions. (musculoskeletalkey.com)

In frontal/coronal (transverse) fractures, the reduction is easier with the knee extended. (aofoundation.org)

Current CORIT research programs include: (1) Development new mitigation strategies for prevention of prosthetic joint infections, (2) The prevention and treatment of periprosthetic fractures, (3) Quantifying and enhancing surgical skills through computer-assisted and robotic technologies, and (4) Biomechanical simulation and optimization of orthopaedic procedures. (uth.edu)
Previous biomechanical work on optimal screw configurations, plate type and the use of locking constructs have been studied as a result, but they investigate a very narrow range of fracture patterns and configurations 4 , 5 . (researchsquare.com)

Radial head replacement is now more common and is used to treat complex radial head fractures. (medapparatus.com)

If the fracture extends intra-articular, then a knee effusion may be present (from haemarthrosis). (teachmesurgery.com)
The knee joint and fracture lines must be irrigated and cleared of the blood clot and small debris to allow exact reconstruction. (aofoundation.org)
Sagittal fractures are more easily reduced with the knee flexed. (aofoundation.org)

However, data on the clinical outcomes of open ankle fracture management in patients older than 70 is minimal. (bvsalud.org)
AIM: To evaluate the clinical outcomes following open ankle fracture management in patients older than 70. (bvsalud.org)
While most simple, minimally or non-displaced fractures can be managed successfully with non-operative means, the more complex three- and four-part displaced fractures remain difficult to treat and have worse outcomes. (scielo.org.za)
In order to evaluate the benefits and risks of the various surgical techniques, it is important first to understand the natural history of non-operatively managed fractures, and to know the outcomes of the different surgical options. (scielo.org.za)

The classification is commonly used to classify distal femur fractures into extra-articular (type A), partial articular (type B), and complete articular (type C). (teachmesurgery.com)
A coronoid-centric classification system of proximal trans-ulnar fracture-dislocations has almost perfect intraobserver and interobserver agreement. (mayoclinic.org)
Patients were grouped according to a 3D classification of fracture pattern. (scielo.org.za)
The AO/OTA classification covers most fractures within previous classification systems, except the few trochanteric fractures with a detached greater trochanter and an intact lesser trochanter. (musculoskeletalkey.com)

All patients older than 70 years of age with an open ankle fracture requiring surgical intervention were identified. (bvsalud.org)
Methods: The study included a total of 77 patients aged over 70 years with an AO type 31-A1 or 31-A2 fracture. (journaltocs.ac.uk)

Damage to adjacent structures such as nerves, muscles or blood vessels, spinal cord, and nerve roots (for spine fractures), or cranial contents (for skull fractures) may cause other specific signs and symptoms. (wikipedia.org)
Skull fractures are common in the setting of both closed traumatic brain injury and penetrating brain injury . (radiopaedia.org)
This article will focus on the general terminology of fractures and delegate discussion of particular fracture patterns to separate articles (e.g. base of skull fractures ). (radiopaedia.org)
The pattern of fracturing depends on the location, direction and kinetic properties of the impact as well as intrinsic features of the skull 2-4 . (radiopaedia.org)
Skull fractures are best imaged with CT of the brain. (radiopaedia.org)

Basicervical fractures are a few percent of borderline cases between the intra- and extra-capsular fractures, anatomically positioned on the capsular attachment line. (musculoskeletalkey.com)

Under certain circumstances, radiographic examination of the nearby joints is indicated in order to exclude dislocations and fracture-dislocations. (wikipedia.org)

The current dogma of humeral shaft fracture stabilization is to use a minimum of 3 screws proximal and distal to the fracture, however the current study demonstrates this is associated with higher rates of mechanical failure. (researchsquare.com)

citation needed] In orthopedic medicine, fractures are classified in various ways. (wikipedia.org)
The main goal of Englewood Orthopedic Associates is the healing of the fractured bones, as well as restoring the anatomic alignment of the joint surfaces to allow for recovery and return to maximum function and movement of the injured body part. (englewoodortho.com)

The complexity of these injuries is a function of fracture severity (and the associated risk of avascular necrosis), and the difficulty in attaining union of the greater and lesser tuberosities in anatomical position. (scielo.org.za)

The reduction of this fracture requires careful planning. (aofoundation.org)
In contrast, depressed fractures will often require surgical intervention for cosmesis and reduction in the incidence of post-traumatic epilepsy 1 . (radiopaedia.org)

Results: The two groups were found to be similar in respect of age, gender, comorbidities, AO fracture type and type of anaesthesia. (journaltocs.ac.uk)

Anatomy46

Diseases72

Chemicals and Drugs25

Analytical, Diagnostic and Therapeutic Techniques and Equipment81

Phenomena and Processes20

Disciplines and Occupations1

Anthropology, Education, Sociology and Social Phenomena1

Technology, Industry, Agriculture9

Humanities1

Information Science4

Health Care23

Geographicals2

Humerus7

Fixation32

Fragments5

Patella Fractures1

Humeral Fractures5

ORIF1

Open fractures2

Complications8

Femur fracture1

Periarticular Fractures1

Bone25

Displacement4

Shaft fractures3

Side of the fracture1

Lateral4

Hematoma3

Fragility fracture2

Femoral5

Diaphyseal fracture1

Surgical management1

Nailing2

Elbow2

Compound Fracture1

Clavicle Fracture1

Extraarticular1

Trauma3

Medial1

Proximal femur1

Coronal1

Biomechanical2

Radial1

Knee3

Outcomes4

Classification4

Patients2

Skull5

Anatomically1

Dislocations1

Stabilization1

Orthopedic2

Avascular1

Reduction2

Comorbidities1