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Femoral Neck Stress Fracture

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1. Location of atypical femoral fracture can be determined by tensile stress distribution influenced by femoral bowing and neck-shaft angle: a CT-based nonlinear finite element analysis model for the assessment of femoral shaft loading stress. (PubMed)

Location of atypical femoral fracture can be determined by tensile stress distribution influenced by femoral bowing and neck-shaft angle: a CT-based nonlinear finite element analysis model for the assessment of femoral shaft loading stress. Loading stress due to individual variations in femoral morphology is thought to be strongly associated with the pathogenesis of atypical femoral fracture (AFF). In Japan, studies on AFF regarding pathogenesis in the mid-shaft are well-documented and a key (...) shaft by nonlinear CT/FEA.Femoral bowing in the mid-shaft AFF group was significantly greater (lateral bowing, p<0.0001; anterior bowing, p<0.01). Femoral neck-shaft angle in the subtrochanteric AFF group was significantly smaller (p<0.001). On CT/FEA, both the mid-shaft and subtrochanteric AFF group showed maximum tensile stress located adjacent to the fracture site. Quantitatively, there was a correlation between femoral bowing and the ratio of tensile stress, which was calculated between the mid

2017 Injury

2. Dynamic Stress Fluoroscopy (DSF) For Evaluation of the Femoral Neck after Intramedullary Nails: Improved Sensitivity for Identifying Occult Fractures. (PubMed)

Dynamic Stress Fluoroscopy (DSF) For Evaluation of the Femoral Neck after Intramedullary Nails: Improved Sensitivity for Identifying Occult Fractures. To report on the use of dynamic stress fluoroscopy (DSF) for detection of occult fractures of the femoral neck associated with femoral shaft fractures. To compare DSF with a fully static imaging protocol in detecting occult femoral neck fractures.Multicenter retrospective cohort study.Two urban level I trauma centers.A consecutive series of 1273 (...) femoral shaft fractures were included. Inclusion criteria were patients treated with an intramedullary rod (antegrade/retrograde), age ≥18 years, a fine-cut (2 mm) preoperative computed tomography and hip radiographs, intraoperative anteroposterior (AP)/lateral fluoroscopic view of the femoral neck before femoral nailing, and a minimum follow-up of 3 months. Patients were divided into 2 groups based on the technique used to identify the presence of a femoral neck fracture after intramedullary fixation

2018 Journal of Orthopaedic Trauma

3. Early diagnosis of femoral neck stress fractures may decrease incidence of bilateral progression and surgical interventions: A case report and literature review (PubMed)

Early diagnosis of femoral neck stress fractures may decrease incidence of bilateral progression and surgical interventions: A case report and literature review Early intervention in femoral neck stress fractures (FNSFs) can be self- limiting, but they have an insidious presentation. High index of suspicion for an occult fracture is necessary to avoid bilateral progression and/or operative interventions.A 83-year-old female, non-athlete, presents with multiple comorbidities and progressive (...) bilateral FNSFs. Initially the patient presented with groin pain and radiographs demonstrated a non-displaced compression type fracture of the right femoral neck without any inciting events. Subsequently, during a post-operative visit of her right hip, a work-up for new onset contralateral groin pain revealed a non-displaced tension type fracture on the left femoral neck. Both FNSFs were treated with percutaneous cannulated screw fixation.Vitamin D deficiency, poor nutrition, and osteoporosis have been

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2018 International journal of surgery case reports

4. Femoral Neck Stress Fractures: MRI Risk Factors for Progression. (PubMed)

Femoral Neck Stress Fractures: MRI Risk Factors for Progression. Femoral neck stress fractures are overuse injuries with devastating consequences if not diagnosed and treated appropriately. The aim of this study was to retrospectively review femoral neck stress fractures using a magnetic resonance imaging (MRI)-based protocol and to identify imaging risk factors that could predict fracture progression requiring surgical intervention.We identified all femoral neck stress fractures treated at our (...) institution from 2002 to 2015. Inclusion criteria for the study were unilateral pathology involving either an incomplete femoral neck stress fracture with a visualized fracture line or edema without a distinct fracture line. MRI data were evaluated for edema, fracture line percentage, and hip effusion. A surgical procedure was offered to patients with fractures with interval progression on serial MRI after 6 weeks of nonoperative treatment.We identified 305 patients who met inclusion criteria. Initial MRI

2018 The Journal of Bone and Joint Surgery. American Volume

5. Femoral neck fractures after internal fixation of trochanteric fractures with implants in situ in adults: A systematic review. (PubMed)

Femoral neck fractures after internal fixation of trochanteric fractures with implants in situ in adults: A systematic review. Femoral neck fractures (FNF) after internal fixation of trochanteric fractures (AIFTF) with the implant in situ (WIIS) are uncommon. Publications of FNFAIFTFWIIS are rare. The purpose of this systematic review of the literature is to report on the frequency, risk factors, mechanisms, clinical presentation, diagnostic and therapeutic modalities, outcomes and the eventual (...) ).The prevalent factors for FNFAIFTFWIIS were osteoporosis, and the presence of the implant in the femoral neck and head. A short nail or screw with the tip far from the subchondral bone was of influence as a stress riser factor, but not prevalent because in two thirds of the cases the FNF occurred when the implant was introduced up to the subchondral bone. Other risk factors analysed included varus reduction or nonunion of the TF, and the breakage of the hip screw, which modify the forces exerted over

2018 Injury

6. Effect of Parkinson's Disease on Hemiarthroplasty Outcomes After Femoral Neck Fractures. (PubMed)

Effect of Parkinson's Disease on Hemiarthroplasty Outcomes After Femoral Neck Fractures. The purpose of this study was to evaluate the outcomes following hemiarthroplasty (HA) for femoral neck fractures (FNFs) in patients with Parkinson's disease (PD) compared with patients without PD.This was a retrospective review utilizing the Nationwide Readmissions Database, a national database incorporating inpatient hospitalization information. Using the Nationwide Readmissions Database, patients who (...) underwent HA for FNF between 2010-2014 were identified. International Classification of Diseases, 9th Revision, codes were used to find a subset of patients with PD. Primary outcomes of interest included death, hospital readmission, periprosthetic fracture, postoperative dislocation, any revision surgery, and revision surgery for instability, fracture, or infection.There were a total of 7721 (4%) patients with PD. There was no difference in the risk of death or any postoperative complications during

2019 Journal of Arthroplasty

7. Young man with sudden severe hip pain secondary to femoral neck stress fracture (PubMed)

Young man with sudden severe hip pain secondary to femoral neck stress fracture Femoral neck stress fractures have been described in military recruits and athletes. Early recognition and aggressive treatment are important, as femoral neck stress fractures have a high potential for complications and even uncomplicated fractures require an extensive course of rehabilitation. Tension-side (superolateral) stress fractures of the femoral neck are at high risk for complications such as displacement (...) , non-union and avascular necrosis, and need to be treated surgically, while compression-side (inferomedial) fractures can be treated conservatively. We describe a case illustrating a typical presentation of insidious hip pain culminating in sudden onset of severe hip pain in a healthy young man. We perform a literature review of studies showing epidemiology, treatment algorithms and rehabilitation.2016 BMJ Publishing Group Ltd.

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2016 BMJ case reports

8. Femoral Neck Stress Fracture

Femoral Neck Stress Fracture Femoral Neck Stress Fracture Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Femoral Neck Stress Fracture (...) Femoral Neck Stress Fracture Aka: Femoral Neck Stress Fracture From Related Chapters II. Symptoms: Groin Pain or anterior thigh pain Provoked by activity (weight bearing) Relieved with rest III. Signs Pain on internal hip rotation IV. Imaging XRay changes lag symptoms by 2-4 weeks MRI preferred over nuclear bone scan High (similar to bone scan) High (better than bone scan) V. Management Risk Modification See Image the opposite hip if is found (bilateral s are common) Inferior Femoral Neck Stress

2018 FP Notebook

9. Femoral stress is prominently associated with fracture risk in children: The Generation R Study. (PubMed)

to incident fractures in children. Bone stress was evaluated at the medial femoral neck, a skeletal site subject to large forces during normal locomotion. This study comprises 1840 children from the Generation R Study, with whole body and hip DXA scans at a mean age of 6.01 years. Hip structural analysis (HSA) was used to measure femur geometry for the FS calculation. Data on fractures occurring over the following 4 years after the DXA assessment were obtained by questionnaire. Incident fracture (...) Femoral stress is prominently associated with fracture risk in children: The Generation R Study. Bone modeling is an important process in the growing skeleton. An inadequate bone modeling in response to mechanical loads would lead some children to develop weaker bones than others. The resulting higher stresses in the bones would render them more susceptible to fracture. We aimed to examine the association between femoral stress (FS) derived from structural parameters and BMD in relation

2019 Bone

10. Femoral neck fractures after removal of hardware in healed trochanteric fractures. (PubMed)

Femoral neck fractures after removal of hardware in healed trochanteric fractures. Hardware removal in healed trochanteric fractures (TF) in the absence of infection or significant mechanical complications is rarely indicated. However, in patients with persistent pain, prominent material and discomfort in the activities of daily living, the implant is eventually removed. Publications of ipsilateral femoral neck fracture after removal of implants from healed trochanteric fractures (FNFARIHTF (...) to December 2016 were eligible for inclusion. Relevant information was divided in two parts. Part I included the analysis of cases of FNFARIHTF, with the objective of establishing the eventual risk factors, mechanisms and pathoanatomy, clinical presentation and diagnosis, treatment and prevention. Part II analyzed series of TF which included cases of FNFARIHTF for assessing the incidence of femoral neck fractures in this condition.Overall 24 publications with 45 cases of FNFARIHTF met the inclusion

2017 Injury

11. Femoral neck stress fracture in a young female recruit: case report (PubMed)

Femoral neck stress fracture in a young female recruit: case report Femoral neck stress fractures are uncommon and depending on their location, can be at high risk for non-union and significant morbidity.  Their prevalence is higher among runners and military recruits, and women seem to be at higher risk.A 27-year-old female, who was enrolled in military recruit, reported left side groin pain after a strenuous running exercise. Due to persistent pain an X-Ray was ordered, which revealed (...) no signs of acute lesions. Further imaging studies with CT scan and MRI identified a compression-type femoral neck stress fracture.The patient was submitted to conservative treatment consisting of restricting from full weight-bearing. Six weeks after she initiated partial weight-bearing, becoming asymptomatic at seven months. Follow-up imaging studies revealed union of the fracture.This diagnosis should be considered when evaluating military and athlete populations. Early recognition of these injuries

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2018 SICOT-J

12. Effects of ulinastatin on inflammatory response and cognitive function after hip arthroplasty for the elderly patients with femoral neck fracture. (PubMed)

was earlier than that of control group (p<0.05), and the off-bed walking time was also earlier than that of control group (p<0.05).The combined application of ulinastatin could effectively reduce the oxidative stress and inflammatory response, improve the neurological functions, and promote the postoperative recovery in the elderly patients with femoral neck fracture after hip arthroplasty. (...) Effects of ulinastatin on inflammatory response and cognitive function after hip arthroplasty for the elderly patients with femoral neck fracture. To investigate the effects of ulinastatin on inflammatory response and cognitive function after hip arthroplasty for the elderly patients with femoral neck fracture.A total of 80 patients with femoral neck fracture receiving hip arthroplasty in our hospital from August 2016 to February 2017 were selected and divided into observation group (n=40

2018 European review for medical and pharmacological sciences

13. Femoral neck cortical bone in female and male hip fracture cases: Differential contrasts in cortical width and sub-periosteal porosity in 112 cases and controls. (PubMed)

Femoral neck cortical bone in female and male hip fracture cases: Differential contrasts in cortical width and sub-periosteal porosity in 112 cases and controls. To quantitate differences between cases of hip fracture and controls in cortical width around the mid-femoral neck in men and women.Over 5 years, 64 (14 male) participants over age 55 (mean 79) years, who had never taken bone-active drugs and suffered intra-capsular hip fracture treated by arthroplasty, donated their routinely (...) discarded distal intra-capsular femoral neck bone for histomorphometry. After embedding, complete femoral neck cross sections from the cut surface near the narrowest part of the neck were stained with von Kossa and cortical width was measured radially every 5 degrees of arc. Control material (n = 48, 25 male) was available through consented post mortems prior to the year 2000. Cortical widths were averaged for circumferential octants, each representing 45 degrees of arc. Divergence of individual

2018 Bone

14. Strength Analyses of Screws for Femoral Neck Fractures (PubMed)

Strength Analyses of Screws for Femoral Neck Fractures This article represents a multidisciplinary approach to biomechanics (engineering + medicine) in the field of "collum femoris" fractures. One possible treatment method for femoral neck fractures, especially for young people, is the application of cancellous (i.e. lag or femoral) screws (with full or cannulated cross-section) made of Ti6Al4V or stainless steel. This paper therefore aims to offer our own numerical model of cancellous screws (...) together with an assessment of them. The new, simple numerical model presented here is derived together with inputs and boundary conditions and is characterized by rapid solution. The model is based on the theory of beams on an elastic foundation and on 2nd order theory (set of three differential 4th order equations, combination of pressure and bending stress-deformation states). It presents the process for calculating displacements, slopes, bending moments, stresses etc. Two examples (i.e

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2018 Journal of Medical and Biological Engineering

15. Finite element analysis of different configurations of fully threaded cannulated screw in the treatment of unstable femoral neck fractures (PubMed)

in the middle surface of the screw near the fracture line in each group. Peak stress value of the implants was highest in the model of triangle with posterior single screw. And the lowest stress values were observed in the triangular model. Fully threaded screw in each group underwent the most stress while partially threaded screw underwent a little bit of stress. Lowest displacement was observed in the triangular model. The volume of bone susceptible to yielding in the femoral neck region was the lowest (...) Finite element analysis of different configurations of fully threaded cannulated screw in the treatment of unstable femoral neck fractures In the present study, we evaluated the mechanical outcome of different configurations formed by fully threaded screws and partially threaded screws in the treatment of unstable femoral neck fracture.The Pauwels type III unstable femoral fracture and the models of the fully threaded screw and partially threaded screw were constructed in 3-matic software

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2018 Journal of orthopaedic surgery and research

16. Analysis of the Impact of Configuration of the Stabilisation System for Femoral Diaphyseal Fractures on the State of Stresses and Displacements (PubMed)

Analysis of the Impact of Configuration of the Stabilisation System for Femoral Diaphyseal Fractures on the State of Stresses and Displacements The treatment of femoral diaphyseal fractures by intramedullary nailing has become a common procedure in orthopaedic surgery. The purpose of this numerical simulation was to present how the changes in configuration of the stabilisation system can affect the stress and displacement state in the bone tissue and implanted device.The numerical comparison (...) of the stabilisation variants for the type 32-A2 femoral diaphyseal fracture (according to the AO classification) performed by using the Charfix2 (ChM®) anatomical nail locked in a number of chosen ways. The displacement and the stress distributions both in the bone and implant were obtained and analysed by computational simulation.In all models, there was the same characteristic distribution, which shows there were minimal rotational movements of the bone around the anatomical axis. In all cases, stress

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2018 Applied bionics and biomechanics

17. Bilateral Femoral Neck Stress Fracture Presented with Unilateral Symptoms in a Shipman Laborer: A Case Report (PubMed)

Bilateral Femoral Neck Stress Fracture Presented with Unilateral Symptoms in a Shipman Laborer: A Case Report Femoral neck stress fracture occured commonly in athlete and military recruit populations, some of them are bilateral. Bilateral femoral neck stress fracture that associated with other occupation is very uncommon. We report a bilateral femoral neck stress fracture case that presented with unilateral symptoms in a male shipman laborer. The patient was successfully treated conservatively (...) . Stress fracture sometimes occur associated with an unexpected specific occupation. Consideration of bilateral involvement is highly important in managing stress fracture.

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2017 Hip & pelvis

18. Clinical hip fracture is accompanied by compression induced failure in the superior cortex of the femoral neck. (PubMed)

Clinical hip fracture is accompanied by compression induced failure in the superior cortex of the femoral neck. Hip fractures pose a major health problem throughout the world due to their devastating impact. Current theories for why these injuries are so prevalent in the elderly point to an increased propensity to fall and decreases in bone mass with ageing. However, the fracture mechanisms, particularly the stress and strain conditions leading to bone failure at the hip remain unclear. Here (...) cortex, indicating a greater magnitude of strain in the superior femoral neck during the failure-associated deformation and fracture process. The predominant stress state for each section was reconstructed based on the unique correlation between the microcrack pattern and the stress state. Specifically, we found clear evidence of longitudinal compression and buckling as the primary failure mechanisms in the superior cortex. These findings demonstrate the importance of microcrack analysis in studying

2017 Bone

19. Pathologic Femoral Neck Fracture Due to Fanconi Syndrome Induced by Adefovir Dipivoxil Therapy for Hepatitis B (PubMed)

Pathologic Femoral Neck Fracture Due to Fanconi Syndrome Induced by Adefovir Dipivoxil Therapy for Hepatitis B In Fanconi syndrome, hypophosphatemic osteomalacia is caused by proximal renal tubule dysfunction which leads to impaired reabsorption of amino acids, glucose, urate, and phosphate. We present a rare case of a 43-year-old Korean male who was found to have insufficiency stress fracture of the femoral neck secondary to osteomalacia due to Fanconi syndrome. He had been receiving low-dose (...) adefovir dipivoxil (ADV, 10 mg/day) for the treatment of chronic hepatitis B virus infection for 7 years and he subsequently developed severe hypophosphatemia and proximal renal tubule dysfunction. The incomplete femoral neck fracture was fixed with multiple cannulated screws to prevent further displacement of the initial fracture. After cessation of ADV and correction of hypophosphatemia with oral phosphorus supplementation, the patient's clinical symptoms, such as bone pain, muscle weakness

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2016 Clinics in orthopedic surgery

20. Augmentation by cerclage wire improves fixation of vertical shear femoral neck fractures-A biomechanical analysis. (PubMed)

Augmentation by cerclage wire improves fixation of vertical shear femoral neck fractures-A biomechanical analysis. Femoral neck fractures in young individuals are typically vertical shear fractures. These injuries are difficult to stabilize due to a significant varus displacement force across the hip with weight bearing. The purpose of this study was to evaluate the biomechanical stability offered by the addition of an augmented wire to conventional inverted triangle triple screw fixation (...) for stabilizing vertical shear femoral neck fracture.Sixteen medium 4th-generation synthetic composite femurs (Sawbones Pacific Research Laboratories, Vashon, WA) were divided into two groups. Vertical osteotomy was performed to mimic Pauwels III femoral neck fracture. Group A (n=8) was fixed with three parallel 6.5-mm cannulated screws (Stryker) with washer in inverted triangle configuration. In group B (n=8), all the screws were set using methods identical to group A, with the addition of the cerclage wire

2016 Injury

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