How to Trip Rapid Review

Step 1: Select articles relevant to your search (remember the system is only optimised for single intervention studies)

Step 2: press

Step 3: review the result, and maybe amend the or if you know better! If we're unsure of the overall sentiment of the trial we will display the conclusion under the article title. We then require you to tell us what the correct sentiment is.

557 results for

Femoral Neck Stress Fracture

by
...
Alerts

Export results

Use check boxes to select individual results below

SmartSearch available

Trip's SmartSearch engine has discovered connected searches & results. Click to show

381. Abdominal Trauma, Blunt (Follow-up)

immobilization on patients with multisystem injuries and on patients with a mechanism of injury that has potential for spinal cord trauma. In the rural setting, the pneumatic antishock garment may have a role for treating shock resulting from a severe pelvic fracture. Promptly notify the destination hospital so that that facility can activate its trauma team and prepare for the patient. Previous Next: Emergency Department Care Upon the patient’s arrival in the emergency department (ED) or trauma center (...) trauma is usually caused by hypovolemia from hemorrhage. Identification of hypovolemia and signs of shock necessitate vigorous resuscitation and attempts to identify the source of blood loss. Effective volume resuscitation is accomplished by controlling external hemorrhage and infusing warmed crystalloid solution via 2 large-bore (eg, 18-gauge) peripheral IV lines. Use central lines (preferably femoral by using a large-bore line such as a Cordis catheter) and cutdowns (eg, saphenous, brachial

2014 eMedicine Emergency Medicine

382. Temporal Arteritis (Diagnosis)

). One school of thought considers GCA and to be different manifestations of the same disease process, while others see them as closely related but different diseases. [ , ] Common signs and symptoms of GCA reflect the involvement of the temporal artery and other medium-sized arteries of the head and the neck and include visual disturbances, headache, jaw claudication, neck pain, and scalp tenderness. Constitutional manifestations, such as fatigue, malaise, and fever, may also be present. (See .) GCA (...) infarction (MI) Less often, the descending aorta and mesenteric, renal, iliac, and femoral arteries can be affected, with attendant complications of intestinal infarction, renal infarction, crural infarction, and ischemic mononeuropathies [ , ] Pulmonary arterial involvement has also been described Some veins may be affected occasionally The most common cause of vision loss in GCA is anterior ischemic optic neuropathy (AION). This results from ischemia of the optic nerve head, which is supplied mainly

2014 eMedicine Emergency Medicine

383. Temporal Arteritis (Follow-up)

). One school of thought considers GCA and to be different manifestations of the same disease process, while others see them as closely related but different diseases. [ , ] Common signs and symptoms of GCA reflect the involvement of the temporal artery and other medium-sized arteries of the head and the neck and include visual disturbances, headache, jaw claudication, neck pain, and scalp tenderness. Constitutional manifestations, such as fatigue, malaise, and fever, may also be present. (See .) GCA (...) infarction (MI) Less often, the descending aorta and mesenteric, renal, iliac, and femoral arteries can be affected, with attendant complications of intestinal infarction, renal infarction, crural infarction, and ischemic mononeuropathies [ , ] Pulmonary arterial involvement has also been described Some veins may be affected occasionally The most common cause of vision loss in GCA is anterior ischemic optic neuropathy (AION). This results from ischemia of the optic nerve head, which is supplied mainly

2014 eMedicine Emergency Medicine

384. Bone Infarct

bones and subtle collapse of the bone surface that is undetected on plain radiographs. The diagnosis of spontaneous osteonecrosis of the knee is being questioned. Current theories suggest that this entity is actually a subchondral stress fracture that most often occurs in the medial femoral condyle. Spontaneous osteonecrosis of the tarsal navicular in adults (ie, Mueller-Weiss syndrome) may occur, especially in women. Plain radiographic features include medial or dorsal protrusion of a portion (...) of the sternum. Unilateral or bilateral femoral neck fractures are reported in 2% of patients who are exposed to pelvic irradiation. These fractures are commonly subcapital. Often, sclerotic changes occur, and trabecular opacity increases in the femoral neck, preceding a fracture. Fractures usually heal normally with abundant callous formation. Protrusio acetabuli is also reported to occur after radiation therapy of the pelvis; this condition may be associated with peritoneal calcification. Changes

2014 eMedicine Radiology

385. Temporal Arteritis (Treatment)

). One school of thought considers GCA and to be different manifestations of the same disease process, while others see them as closely related but different diseases. [ , ] Common signs and symptoms of GCA reflect the involvement of the temporal artery and other medium-sized arteries of the head and the neck and include visual disturbances, headache, jaw claudication, neck pain, and scalp tenderness. Constitutional manifestations, such as fatigue, malaise, and fever, may also be present. (See .) GCA (...) infarction (MI) Less often, the descending aorta and mesenteric, renal, iliac, and femoral arteries can be affected, with attendant complications of intestinal infarction, renal infarction, crural infarction, and ischemic mononeuropathies [ , ] Pulmonary arterial involvement has also been described Some veins may be affected occasionally The most common cause of vision loss in GCA is anterior ischemic optic neuropathy (AION). This results from ischemia of the optic nerve head, which is supplied mainly

2014 eMedicine Emergency Medicine

386. General Principles of Internal Fixation (Treatment)

or an unstable pattern. The working length of the nail is increased when the locking screws are located as close to the ends of the nail as is structurally possible, increasing the potential fracture indications. By the 1980s, examples of second-generation interlocking nails included the Grosse-Kempf nail and, later, the Russell-Taylor nail. Currently, all nail manufacturers include basic interlocking screws and other notable features on third-generation nails, such as proximal femoral head/neck screws (...) and dynamic screw slots. Reconstruction-type nails and gamma-style nails with a reinforced proximal section that allow fixation into the femoral head and neck region are cephalomedullary nails. These nails increase the fixation options for proximal femoral fractures. Recon nails are a variation of a standard piriformis-start antegrade femoral nail, whereas cephalomedullary nails are devices starting at the tip of the greater trochanter, which is not in line with the anatomic axis of the femur

2014 eMedicine Surgery

387. Thoracic Aortic Aneurysm (Follow-up)

cerebrospinal drainage, reimplantation of intercostal arteries, evoked potential monitoring, mild hypothermia, and atrial femoral bypass, spinal cord injury still occurs. Endovascular stent grafting has not eliminated spinal cord paraplegia; the incidence varies widely, with an overall incidence of 2.7%. [ , , , ] Complications specific to endovascular stenting include endoleaks, stent fractures, stent graft migration or thrombosis, iliac artery rupture, retrograde dissection, microembolization (...) artery. Distally, a sufficient landing zone of 2 cm prior to the celiac artery is required. The aortic inner neck diameters in the proximal and distal landing zones must fall within 23-37 mm. In addition, appropriately sized femoral and iliac arteries (typically >8 mm in diameter) that lack tortuosity and calcium are required for implantation. TAAAs, accounting for approximately 10% of thoracic aneurysms, may be repaired with the use of a partial bypass of the left atrium to the femoral artery

2014 eMedicine Surgery

388. Acute Nerve Injury (Overview)

girdle plexuses or to spinal nerve roots can occur in a number of ways. Injuries to the lumbosacral plexus or to the lumbosacral roots commonly are associated with fractures of the pelvis. Displacement of fractures and joint dislocations can result in stretch injury to peripheral nerves. Stretch injury to peripheral nerves may occur during operative or other surgical procedures. [ ] Stretching of the nerve around the radial neck during a closed reduction is an example of procedural etiology (...) relationship between the peripheral nerves and surrounding tissues causes certain nerves to be vulnerable to injury. The peroneal division of the sciatic nerve is affected more commonly in traumatic hip dislocations because the peroneal division is tethered at the fibular neck and at the sciatic notch and the tibial division is tethered only at the sciatic notch. This difference allows the tibial division a greater length over which to dissipate stresses. The funiculi of the peroneal division are fewer

2014 eMedicine Surgery

389. Cerebral Aneurysm (Overview)

at an aneurysm cavity neck. These augmented hemodynamic stresses probably cause the initiation and subsequent progression of most saccular aneurysms. Thrombosis and rupture are also explained by intra-aneurysmal hemodynamic stresses. Studies demonstrate that the geometric relation between an aneurysm and its parent artery is the principal factor that determines intra-aneurysmal flow patterns. In lateral aneurysms, such as those that arise directly from the ICA, blood typically moves into the aneurysm (...) is usually composed of only intima and adventitia. The intima is typically normal, though subintimal cellular proliferation is common. The internal elastic membrane is reduced or absent, and the media ends at the junction of the aneurysm neck with the parent vessel. Lymphocytes and phagocytes may infiltrate the adventitia. The lumen of the aneurysmal sac often contains thrombotic debris. Atherosclerotic changes in the parent vessel are also common. Etiology It was once thought that most saccular

2014 eMedicine Surgery

390. Cerebral Aneurysm (Treatment)

at an aneurysm cavity neck. These augmented hemodynamic stresses probably cause the initiation and subsequent progression of most saccular aneurysms. Thrombosis and rupture are also explained by intra-aneurysmal hemodynamic stresses. Studies demonstrate that the geometric relation between an aneurysm and its parent artery is the principal factor that determines intra-aneurysmal flow patterns. In lateral aneurysms, such as those that arise directly from the ICA, blood typically moves into the aneurysm (...) is usually composed of only intima and adventitia. The intima is typically normal, though subintimal cellular proliferation is common. The internal elastic membrane is reduced or absent, and the media ends at the junction of the aneurysm neck with the parent vessel. Lymphocytes and phagocytes may infiltrate the adventitia. The lumen of the aneurysmal sac often contains thrombotic debris. Atherosclerotic changes in the parent vessel are also common. Etiology It was once thought that most saccular

2014 eMedicine Surgery

391. Freiberg Infraction (Treatment)

or pads, rigid shanks, or a rocker bottom, may be helpful. Activity modification during exacerbations may help to prevent the aggravating symptoms of pain and swelling. [ ] Medications may be helpful for pain but should not be used to allow increased activity. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used commonly for pain, but cautious use is recommended. Although sufficient human studies are lacking, NSAIDs have been shown to delay stress fracture healing in rats. [ ] Hoskinson reported (...) A. Osteochondroses: aseptic necrosis of the foot. Jahss M, ed. Disorders of the Foot and Ankle . 2nd ed. Philadelphia: Saunders; 1991. 617-38. Bayliss NC, Klenerman L. Avascular necrosis of lesser metatarsal heads following forefoot surgery. Foot Ankle . 1989 Dec. 10(3):124-8. . Donahue SW, Sharkey NA. Strains in the metatarsals during the stance phase of gait: implications for stress fractures. J Bone Joint Surg Am . 1999 Sep. 81(9):1236-44. . Smillie IS. Freiberg's infraction (Kohler's second disease). J Bone

2014 eMedicine Surgery

392. Bone Marrow Transplantation, Long-Term Effects (Follow-up)

conditioned with and cyclophosphamide without TBI experienced severe ovarian failure that required estrogen replacement. [ ] This stresses the importance of both TBI and alkylating agents in the etiology of ovarian failure in females undergoing HSCT. Ovarian failure or premature menopause often manifests with high levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) with or without decreased estrogen levels, although all eventually progress to a low-estrogen state. Measurements (...) of antimullerian hormone (AMH) may be useful in assessing ovarian reserve. [ ] Similar to postmenopausal women with low estrogen levels, females who experience acute ovarian failure or premature menopause following HSCT seem to be at risk for early reduced bone mineral density, [ ] bone fractures, [ ] lipid disorders, and ischemic heart disease. [ , , ] Use of steroids and radiotherapy can potentiate the risk of reduced bone mineral density. Ovarian failure after HSCT responds well to estrogen replacement

2014 eMedicine Pediatrics

393. Osteogenesis Imperfecta (Overview)

in the crib and how to hold the child so as to minimize the risk of fractures while maintaining bonding and physical stimulation. Living with ostogenesis imperfecta The following tips have been developed by the for taking care of children with OI: Do not be afraid to touch or hold an infant with OI, but be careful; to lift the infant, spread your fingers apart and put one hand between the legs and under the buttocks, and place the other hand behind the shoulders, neck, and head Never lift a child with OI (...) with callus formation is observed. Beaded ribs. Multiple fractures are seen in long bones of upper extremities. Wormian bones are present in skull. Newborn has bilateral femoral fractures. of 4 Tables Table 1. Adapted Sillence Classification of Osteogenesis Imperfecta Type Genetic Teeth Bone Fragility Bone Deformity Sclera Spine Skull Prognosis IA AD * Normal Variable but less severe than other types Moderate Blue 20% scoliosis and kyphosis Wormian bones Fair IB AD Dentinogenesis imperfecta NA NA NA NA NA

2014 eMedicine Surgery

394. Metallic Alloys (Overview)

to be structurally stiffer than bones. Alloys with elastic moduli closer to bone may cause less stress shielding. Different metals can form a battery effect when in solution in the body. The galvanic series provides electrochemical comparisons that allow prediction of corrosion between two different metals when they are in physical contact in saline solution. [ ] Galvanic corrosion occurs if stainless steel surgical wire is wrapped over a cobalt- or titanium-based alloy femoral component or if a cobalt-chromium (...) femoral head is placed on a titanium alloy femoral stem, so this metal mismatch is not recommended. Cobalt- and titanium-based alloy components may be used in contact with each other, and stainless steel components, such as sutures, may be used with either if actual physical contact is avoided. Previous Next: Surgical Stainless Steel The introduction of steel plates for fracture treatment is credited to Sherman. [ ] Surgical stainless steel alloys (316L) made with varying amounts of iron, chromium

2014 eMedicine Surgery

395. Limping Child (Overview)

Infect Dis . 1986 Nov-Dec. 5(6):669-76. . Chiarapattanakom P, Thanacharoenpanich S, Pakpianpairoj C, Liupolvanish P. The remodeling of the neck-shaft angle after proximal femoral varus osteotomy for the treatment of Legg-Calve-Perthes syndrome. J Med Assoc Thai . 2012 Oct. 95 Suppl 10:S135-41. . Pfeifer R, Zelle BA, Kobbe P, Knobe M, Garrison RL, Ohm S, et al. Impact of isolated acetabular and lower extremity fractures on long-term outcome. J Trauma Acute Care Surg . 2012 Feb. 72(2):467-72. . Media (...) and a true lateral should be obtained. Distal femur fracture due to child abuse. Slipped capital femoral epiphysis. A 5-year-old boy with Legg-Calve-Perthes Disease. A 10-month-old boy with left distal tibia buckle fracture. In very young children or those whose physical examination does not reveal a focal source of pain, radiographs of the entire lower extremity should be obtained. As many as 20% of children have unsuspected fractures. [ , ] A study from Scotland using a protocol that radiographically

2014 eMedicine Surgery

396. General Principles of Internal Fixation (Overview)

or an unstable pattern. The working length of the nail is increased when the locking screws are located as close to the ends of the nail as is structurally possible, increasing the potential fracture indications. By the 1980s, examples of second-generation interlocking nails included the Grosse-Kempf nail and, later, the Russell-Taylor nail. Currently, all nail manufacturers include basic interlocking screws and other notable features on third-generation nails, such as proximal femoral head/neck screws (...) and dynamic screw slots. Reconstruction-type nails and gamma-style nails with a reinforced proximal section that allow fixation into the femoral head and neck region are cephalomedullary nails. These nails increase the fixation options for proximal femoral fractures. Recon nails are a variation of a standard piriformis-start antegrade femoral nail, whereas cephalomedullary nails are devices starting at the tip of the greater trochanter, which is not in line with the anatomic axis of the femur

2014 eMedicine Surgery

397. Osteoporosis (Overview)

, identified on a radiograph alone]) T-score of –2.5 or less at the femoral neck or spine after appropriate evaluation to exclude secondary causes Low bone mass (T-score between –1.0 and –2.5 at the femoral neck or spine) and a 10-year probability of a hip fracture of 3% or greater or a 10-year probability of a major osteoporosis-related fracture of 20% or greater, based on the US-adapted WHO algorithm for calculating fracture risk ( ) Guidelines from the American Association of Clinical Endocrinologists (...) Women 15.8 52.6 Men 3.9 36 Non-Hispanic black Women 7.7 36.2 Men 1.3 21.3 Hispanic Women 20.4 47.8 Men 5.9 38.3 Source: Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randall S, et al. The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res . Nov 2014;29(11):2520-6. . Melton et al reported that the prevalence of hip fractures is higher in white populations, regardless of geographic

2014 eMedicine Surgery

398. Sickle Cell Anemia (Diagnosis)

: Young children present with chest pain, fever, cough, tachypnea, leukocytosis, and pulmonary infiltrates in the upper lobes; adults are usually afebrile, dyspneic with severe chest pain, with multilobar/lower lobe disease Pulmonary hypertension: Increasingly recognized as a serious complication of SCD Avascular necrosis of the femoral or humeral head: This is due to vascular occlusion CNS involvement: Most severe manifestation is stroke Ophthalmologic involvement: Ptosis, retinal vascular changes (...) ) CSF examination: Consider LP in febrile children who appear toxic and in those with neurologic findings (eg, neck stiffness, + Brudzinski/Kernig signs, focal deficits); consider CT scanning before performing LP Blood cultures ABGs Secretory phospholipase A2 (sPLA2) In one study of 38 asymptomatic children with SCD, investigators found that hypertension and abnormal blood pressure patterns were prevalent in children with SCD. [ ] They suggested using 24-hour ambulatory BP monitoring (ABPM

2014 eMedicine Pediatrics

399. Child Abuse and Neglect: Physical Abuse (Diagnosis)

are strong and relatively more resistant to stress than the bone and cartilage, which accounts for less joint dislocations and ligamentous tears in childhood. Finally, bone healing is more rapid in children than in adults, which makes dating of childhood fractures more complicated. Types of fractures While certain types of fractures (eg posterior rib, scapular, classic metaphyseal lesions) are more common in physical abuse than accidental injury, there is no fracture that is pathognomonic for child (...) follow-up film with sclerotic fracture line and periosteal new bone healing. Metaphyseal fractures (also called corner fractures or bucket handle fractures) are microfractures through the immature part of the bone edge and often appear like chips or corner fractures on radiographs. The metaphysis is an area of rapid bone turnover in the growing infant and toddler. Metaphyseal fractures are specific to infants as they involve the immature physis; they are caused by shearing and tensile stress seen

2014 eMedicine Pediatrics

400. Bone Marrow Transplantation, Long-Term Effects (Diagnosis)

conditioned with and cyclophosphamide without TBI experienced severe ovarian failure that required estrogen replacement. [ ] This stresses the importance of both TBI and alkylating agents in the etiology of ovarian failure in females undergoing HSCT. Ovarian failure or premature menopause often manifests with high levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) with or without decreased estrogen levels, although all eventually progress to a low-estrogen state. Measurements (...) of antimullerian hormone (AMH) may be useful in assessing ovarian reserve. [ ] Similar to postmenopausal women with low estrogen levels, females who experience acute ovarian failure or premature menopause following HSCT seem to be at risk for early reduced bone mineral density, [ ] bone fractures, [ ] lipid disorders, and ischemic heart disease. [ , , ] Use of steroids and radiotherapy can potentiate the risk of reduced bone mineral density. Ovarian failure after HSCT responds well to estrogen replacement

2014 eMedicine Pediatrics

To help you find the content you need quickly, you can filter your results via the categories on the right-hand side >>>>