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Femoral Neck Stress Fracture

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101. Scaphoid Proximal Pole Fracture Following Headless Screw Fixation Full Text available with Trip Pro

insertion site in three young male patients with healed scaphoid nonunions. Each fracture was remarkably similar in shape and size, comprised the volar proximal pole, and was contiguous with the screw entry point. Treatment was challenging but successful in all cases. Literature Review Previous reports have posited that stress-raisers secondary to screw orientation may be implicated in subsequent peri-implant fracture of the femoral neck. Repeat scaphoid fracture after screw fixation has also been (...) Scaphoid Proximal Pole Fracture Following Headless Screw Fixation Background Headless screw fixation of scaphoid fractures and nonunions yields predictably excellent outcomes with a relatively low complication profile. However, intramedullary implants affect the load to failure and stress distribution within bone and may be implicated in subsequent fracture. Case Description We describe a posttraumatic fracture pattern of the scaphoid proximal pole originating at the previous headless screw

2015 Journal of wrist surgery

102. Assessment of femur geometrical parameters using EOS™ imaging technology in patients with atypical femur fractures; preliminary results. (Abstract)

Assessment of femur geometrical parameters using EOS™ imaging technology in patients with atypical femur fractures; preliminary results. Atypical femur fractures (AFF) arise in the subtrochanteric and diaphyseal regions. Because of this unique distribution, we hypothesized that patients with AFF demonstrate specific geometrical variations of their lower limb whereby baseline tensile forces applied to the lateral cortex are higher and might favor the appearance of these rare stress fractures (...) Caucasian women with AFF and recruited 16 ethnicity-, sex-, age-, height- and cumulative bisphosphonate exposure-matched controls from local osteoporosis clinics. Compared to controls, those with AFF had more lateral femur bowing (-3.2° SD [3.4] versus -0.8° SD [1.9] p=0.02). In regression analysis, lateral femur bowing was associated with the risk of AFF (aOR 1.54; 95% CI 1.04-2.28, p=0.03). Women who sustained a subtrochanteric AFF demonstrated a lesser femoral neck shaft angle (varus geometry) than

2015 Bone

103. Molecular mechanisms of osteoporotic hip fractures in elderly women. (Abstract)

from elderly osteoporotic women with hip fractures (OP) in comparison to bone samples from age matched women with osteoarthritis of the hip (OA). Femoral heads and adjacent neck tissue were collected from 10 women with low-trauma hip fractures (mean age 83±6) and consecutive surgical hip replacement. Ten bone samples from patients undergoing hip replacement due to osteoarthritis (mean age 80±5) served as controls. One half of each bone sample was subjected to gene expression analysis. The second (...) Molecular mechanisms of osteoporotic hip fractures in elderly women. A common manifestation of age-related bone loss and resultant osteoporosis are fractures of the hip. Age-related osteoporosis is thought to be determined by a number of intrinsic factors including genetics, hormonal changes, changes in levels of oxidative stress, or an inflammatory status associated with the aging process. The aim of this study was to investigate gene expression and bone architecture in bone samples derived

2015 Experimental Gerontology

104. Biplane double-supported screw fixation (F-technique): a method of screw fixation at osteoporotic fractures of the femoral neck Full Text available with Trip Pro

Biplane double-supported screw fixation (F-technique): a method of screw fixation at osteoporotic fractures of the femoral neck The present work introduces a method of screw fixation of femoral neck fractures in the presence of osteoporosis, according to an original concept of the establishment of two supporting points for the implants and their biplane positioning in the femoral neck and head. The provision of two steady supporting points for the implants and the highly increased (obtuse (...) ) angle at which they are positioned allow the body weight to be transferred successfully from the head fragment onto the diaphysis, thanks to the strength of the screws, with the patient's bone quality being of least importance. The position of the screws allows them to slide under stress with a minimal risk of displacement. The method was developed in search of a solution for those patients for whom primary arthroplasty is contraindicated. The method has been analysed in relation to biomechanics

2011 European Journal of Orthopaedic Surgery & Traumatology

105. Isolated Right Ventricular Stress (Takotsubo) Cardiomyopathy Full Text available with Trip Pro

Isolated Right Ventricular Stress (Takotsubo) Cardiomyopathy A 79-year-old woman was admitted with a left femoral neck fracture and she immediately developed circulatory shock. Echocardiography showed a markedly enlarged right ventricle (RV) with systolic ballooning of the mid-ventricular wall and preserved contractility of the apex. The left ventricular (LV) motion was normal. Multi-detector-row computed tomography showed severe congestion of the contrast media in the right atrium (...) with no forward flow to RV, but no pulmonary embolism. She was successfully treated with percutaneous veno-arterial extracorporeal membrane oxygenation. This case presented with acute, profound, but reversible RV dysfunction triggered by acute stress in a manner similar to that seen in LV stress cardiomyopathy.

2017 Internal Medicine

106. Hip Fracture (Overview)

these cumulative forces exceed the structural strength of bone, stress fractures occur. [ , , ] Stress fractures occur mainly at the femoral neck and are classified as either tension (at the superior aspect of the femoral neck) or compression (at the inferior aspect of the femoral neck). See the images below. A subcapital femoral neck fracture. Slight compression of the femoral head onto the femoral neck can be seen. Note the cortical break medially. This fracture could be missed if not closely evaluated (...) . A view of the contralateral hip for comparison. are classified as intracapsular, which includes femoral head and neck fractures, or extracapsular, which includes trochanteric, , and . The location of the fracture and the amount of angulation and comminution play integral roles in the overall morbidity of the patient, as does the preexisting physical condition of the individual. Fractures of the proximal femur are extremely rare in young athletes and are usually caused by high-energy motor vehicle

2014 eMedicine.com

107. Femur Injuries and Fractures (Overview)

of the proximal and middle third of the femur. Fractures in this location occur as a result of the compression forces on the medial femur. [ ] A study suggested that the lateral cortex of the femoral shaft may also be susceptible to stress fracture due to tensile forces. [ ] Stress fractures can also occur on the lateral aspect of the femoral neck in areas of distraction and are less likely to heal non-operatively than compression-side stress fractures on the medial side. Stress fractures occur most often (...) of associated injuries. J Orthop Trauma . 2011 Sep. 25(9):556-9. . Koval KJ, Zuckerman JD. Hip Fractures: I. Overview and Evaluation and Treatment of Femoral-Neck Fractures. J Am Acad Orthop Surg . 1994 May. 2(3):141-149. . Niva MH, Kiuru MJ, Haataja R, Pihlajamäki HK. Fatigue injuries of the femur. J Bone Joint Surg Br . 2005 Oct. 87(10):1385-90. . Koh JS, Goh SK, Png MA, Ng AC, Howe TS. Distribution of atypical fractures and cortical stress lesions in the femur: implications on pathophysiology. Singapore

2014 eMedicine.com

108. Diaphyseal Femur Fractures (Follow-up)

, and higher rate of complications tend to favor other methods of treatment. Healing occurs without callus formation, and the bone is slower to regain strength. Bone under the plate is also prone to stress shielding and may become osteopenic. Compression plating may be used in distal metaphyseal-diaphyseal junction fractures and in certain situations with ipsilateral femoral-neck fractures. Plating is done via a lateral approach in the skin and spitting the vastus lateralis. One should be careful to avoid (...) . Its use has been studied extensively, and it has proved effective in the short and long terms. An unscrubbed assistant surgeon must assist by first examining the radiographs and determining the appropriate direction of force needed to reduce the fracture. After reduction, anteroposterior (AP) and lateral imaging with fluoroscopy should be performed to confirm the reduction. At this time, the femoral neck also can be critically examined with fluoroscopy. The patient is positioned on the fracture

2014 eMedicine Surgery

109. Subtrochanteric Hip Fractures (Treatment)

evolve and improve, applications in high-energy proximal femoral fractures may become feasible and allow for a more biologically favorable approach with less soft-tissue dissection and disruption of native blood supply. There is no literature regarding total hip arthroplasty (THA) for subtrochanteric fractures in patients, and any conclusions must be extrapolated from data regarding THA for femoral neck fractures or intertrochanteric fractures. This body of literature suggests possible functional (...) are probably similar to those with angled blade plates and are reliant on biologically favorable, indirect reduction techniques. Intramedullary nails are emerging as the treatment of choice for subtrochanteric femur fractures. [ , , ] The most widely used nails are either centromedullary (contained within the medullary canal) or cephalomedullary (including those that affix to the femoral neck and head; see the image below). Subtrochanteric femur fracture repaired with cephalomedullary device Essentially

2014 eMedicine Surgery

110. Subtrochanteric Hip Fractures (Overview)

fracture has significantly higher rates of malunion and nonunion than other femoral fractures do. Still, with an improved understanding of this fracture and the specific treatment options, successful results can be obtained. [ , ] Next: Anatomy The subtrochanteric region of the femur, arbitrarily designated as the region between the lesser trochanter and a point 5 cm distal, consists primarily of cortical bone. The femoral head and neck are anteverted approximately 13º with respect to the plane (...) of the femoral shaft. The piriformis fossa lies at the base of the neck and is oriented in line with the femoral shaft. The lesser trochanter is posteromedial, and it is the point of insertion for the psoas and iliacus tendons. The femoral shaft has both an anterior and a lateral bow. The major muscles that surround the hip create significant forces that contribute to fracture deformity. The gluteus medius and minimus tendons attach to the greater trochanter and abduct the proximal fragment. The psoas

2014 eMedicine Surgery

111. Periprosthetic Fractures (Treatment)

hip arthroplasties: a 40-year experience. Bone Joint J . 2016 Apr. 98-B (4):468-74. . Koval KJ, Frankel VH, Kummer F, Green S. Complications of fracture fixation devices. Epps CH, ed. Complications in Orthopaedic Surgery . 3rd ed. Philadelphia: JB Lippincott; 1994. 131-54. Wu CC, Shih CH. Ipsilateral femoral neck and shaft fractures. Retrospective study of 33 cases. Acta Orthop Scand . 1991 Aug. 62(4):346-51. . Azer SN, Rankin EA. Complications of treatment of femoral shaft fractures. Epps CH, ed (...) arthroplasty. J Trauma . 2010 Jun. 68(6):1464-70. . Ozdemir G, Azboy I, Yilmaz B. Bilateral periprosthetic tibial stress fracture after total knee arthroplasty: A case report. Int J Surg Case Rep . 2016. 24:175-8. . Fonseca F, Rebelo E, Completo A. TIBIAL PERIPROSTHETIC FRACTURE COMBINED WITH TIBIAL STEM STRESS FRACTURE FROM TOTAL KNEE ARTHROPLASTY. Rev Bras Ortop . 2011 Nov-Dec. 46 (6):745-50. . Wada M, Imura S, Bo A, Baba H, Miyazaki T. Stress fracture of the femoral component in total knee replacement

2014 eMedicine Surgery

112. Lumbar Spine Fractures and Dislocations (Treatment)

, Hurlbert RJ, Anderson P, Fehlings M, Rampersaud R, Massicotte EM, et al. Neurologic deterioration secondary to unrecognized spinal instability following trauma--a multicenter study. Spine (Phila Pa 1976) . 2006 Feb 15. 31 (4):451-8. . Kinoshita T, Ebara S, Kamimura M, Tateiwa Y, Itoh H, Yuzawa Y, et al. Nontraumatic lumbar vertebral compression fracture as a risk factor for femoral neck fractures in involutional osteoporotic patients. J Bone Miner Metab . 1999. 17 (3):201-5. . Castaño-Betancourt MC (...) Lumbar Spine Fractures and Dislocations (Treatment) Lumbar Spine Fractures and Dislocations Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine Surgery

113. Periprosthetic Fractures (Diagnosis)

original strength. Some 90% of fractures around fracture fixation implants occur through a drill hole (see the image below). [ ] Failed fixation caused by fracture through screw holes. Displacement of unrecognized femoral neck fracture or new fracture occurs in 3% of intramedullary nailings of femoral shaft fractures. [ , ] With any implant, the end of the device becomes a stress riser in which the weaker osteoporotic bone tends to fracture first when excessive load is applied. [ ] Removal of devices (...) , ed. Complications in Orthopaedic Surgery . 3rd ed. Philadelphia: JB Lippincott; 1994. 131-54. Wu CC, Shih CH. Ipsilateral femoral neck and shaft fractures. Retrospective study of 33 cases. Acta Orthop Scand . 1991 Aug. 62(4):346-51. . Azer SN, Rankin EA. Complications of treatment of femoral shaft fractures. Epps CH, ed. Complications in Orthopaedic Surgery . 3rd ed. Philadelphia: JB Lippincott; 1994. 487-524. Chmell MJ, Moran MC, Scott RD. Periarticular Fractures After Total Knee Arthroplasty

2014 eMedicine Surgery

114. General Principles of Fracture Care (Follow-up)

. Stuttgart: Verlag von Ferdinand Enke; 1872. Vol 2: 234-920. Bryant LR, Song WS, Banks KP, Bui-Mansfield LT, Bradley YC. Comparison of planar scintigraphy alone and with SPECT for the initial evaluation of femoral neck stress fracture. AJR Am J Roentgenol . 2008 Oct. 191(4):1010-5. . Yang HL, Wang GL, Niu GQ, Liu JY, Hiltner E, Meng B, et al. Using MRI to determine painful vertebrae to be treated by kyphoplasty in multiple-level vertebral compression fractures: a prospective study. J Int Med Res . 2008 (...) Sep-Oct. 36(5):1056-63. . McManus JG, Morton MJ, Crystal CS, McArthur TJ, Helphenstine JS, Masneri DA, et al. Use of ultrasound to assess acute fracture reduction in emergency care settings. Am J Disaster Med . 2008 Jul-Aug. 3(4):241-7. . Rang M. Children’s Fractures . 2nd ed. Philadelphia: JB Lippincott; 1983. Ly TV, Swiontkowski MF. Treatment of femoral neck fractures in young adults. J Bone Joint Surg Am . 2008 Oct. 90(10):2254-66. . [Guideline] Brox WT, Roberts KC, Taksali S, et al

2014 eMedicine Surgery

115. Subtrochanteric Hip Fractures (Diagnosis)

, subtrochanteric fracture has significantly higher rates of malunion and nonunion than other femoral fractures do. Still, with an improved understanding of this fracture and the specific treatment options, successful results can be obtained. [ , ] Next: Anatomy The subtrochanteric region of the femur, arbitrarily designated as the region between the lesser trochanter and a point 5 cm distal, consists primarily of cortical bone. The femoral head and neck are anteverted approximately 13º with respect (...) to the plane of the femoral shaft. The piriformis fossa lies at the base of the neck and is oriented in line with the femoral shaft. The lesser trochanter is posteromedial, and it is the point of insertion for the psoas and iliacus tendons. The femoral shaft has both an anterior and a lateral bow. The major muscles that surround the hip create significant forces that contribute to fracture deformity. The gluteus medius and minimus tendons attach to the greater trochanter and abduct the proximal fragment

2014 eMedicine Surgery

116. Lumbar Spine Fractures and Dislocations (Follow-up)

, Hurlbert RJ, Anderson P, Fehlings M, Rampersaud R, Massicotte EM, et al. Neurologic deterioration secondary to unrecognized spinal instability following trauma--a multicenter study. Spine (Phila Pa 1976) . 2006 Feb 15. 31 (4):451-8. . Kinoshita T, Ebara S, Kamimura M, Tateiwa Y, Itoh H, Yuzawa Y, et al. Nontraumatic lumbar vertebral compression fracture as a risk factor for femoral neck fractures in involutional osteoporotic patients. J Bone Miner Metab . 1999. 17 (3):201-5. . Castaño-Betancourt MC (...) Lumbar Spine Fractures and Dislocations (Follow-up) Lumbar Spine Fractures and Dislocations Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine Surgery

117. Intertrochanteric Hip Fractures (Follow-up)

trochanter, with a compression hip screw inserted through the proximal portion of the nail into the femoral head, is now being used, especially for unstable fracture patterns. [ , ] (See the image below.) Femur with intramedullary rod and screw. Cephalomedullary fixation may help with reduction of unstable fractures and prevent excessive shortening from collapse, in that the nail acts as a calcar rand lateral wall replacement to support the femoral neck. This percutaneous technique has the potential (...) fracture before fixation [ ] but generally is not indicated in current practice. Arthroplasty Replacement of the hip may be perfomed either by replacing only the femoral side (hemiarthroplasty) or by replacing both the acetabulum and the femoral side (total hip arthroplasty). These two surgical treatment options, though common for displaced femoral neck fractures in the elderly, have not been a popular form of therapy for intertrochanteric fractures. The reluctance to employ these options is due

2014 eMedicine Surgery

118. General Principles of Fracture Care (Diagnosis)

for the initial evaluation of femoral neck stress fracture. AJR Am J Roentgenol . 2008 Oct. 191(4):1010-5. . Yang HL, Wang GL, Niu GQ, Liu JY, Hiltner E, Meng B, et al. Using MRI to determine painful vertebrae to be treated by kyphoplasty in multiple-level vertebral compression fractures: a prospective study. J Int Med Res . 2008 Sep-Oct. 36(5):1056-63. . McManus JG, Morton MJ, Crystal CS, McArthur TJ, Helphenstine JS, Masneri DA, et al. Use of ultrasound to assess acute fracture reduction in emergency care (...) settings. Am J Disaster Med . 2008 Jul-Aug. 3(4):241-7. . Rang M. Children’s Fractures . 2nd ed. Philadelphia: JB Lippincott; 1983. Ly TV, Swiontkowski MF. Treatment of femoral neck fractures in young adults. J Bone Joint Surg Am . 2008 Oct. 90(10):2254-66. . [Guideline] Brox WT, Roberts KC, Taksali S, et al. The American Academy of Orthopaedic Surgeons Evidence-Based Guideline on Management of Hip Fractures in the Elderly. J Bone Joint Surg Am . 2015 Jul 15. 97 (14):1196-9. . Bhandari M. Evidence

2014 eMedicine Surgery

119. Diaphyseal Femur Fractures (Diagnosis)

. Rockwood and Green's Fractures in Adults . 8th ed. Philadelphia: Wolters Kluwer; 2015. Vol 2: 2149-228. Kanlic E, Cruz M. Current concepts in pediatric femur fracture treatment. Orthopedics . 2007 Dec. 30(12):1015-9. . Poolman RW, Kocher MS, Bhandari M. Pediatric femoral fractures: a systematic review of 2422 cases. J Orthop Trauma . 2006 Oct. 20(9):648-54. . Lee SH, Baek JR, Han SB, Park SW. Stress fractures of the femoral diaphysis in children: a report of 5 cases and review of literature. J Pediatr (...) fractures. J Pediatr Orthop . 2000 May-Jun. 20(3):405-10. . Baumgaertner, M, Tornetta III, P. Orthopaedic Knowlodge Update, Trauma 3. Book . 2005. 93-106, 387-395. O'toole RV, Dancy L, Dietz AR, Pollak AN, Johnson AJ, Osgood G. Diagnosis of femoral neck fracture associated with femoral shaft fracture: blinded comparison of computed tomography and plain radiography. J Orthop Trauma . 2013 Jun. 27(6):325-30. . Hwang JS, Gibson PD, Koury KL, Stekas N, Sirkin MS, Reilly MC, et al. The role of computed

2014 eMedicine Surgery

120. Periprosthetic Fractures (Follow-up)

hip arthroplasties: a 40-year experience. Bone Joint J . 2016 Apr. 98-B (4):468-74. . Koval KJ, Frankel VH, Kummer F, Green S. Complications of fracture fixation devices. Epps CH, ed. Complications in Orthopaedic Surgery . 3rd ed. Philadelphia: JB Lippincott; 1994. 131-54. Wu CC, Shih CH. Ipsilateral femoral neck and shaft fractures. Retrospective study of 33 cases. Acta Orthop Scand . 1991 Aug. 62(4):346-51. . Azer SN, Rankin EA. Complications of treatment of femoral shaft fractures. Epps CH, ed (...) arthroplasty. J Trauma . 2010 Jun. 68(6):1464-70. . Ozdemir G, Azboy I, Yilmaz B. Bilateral periprosthetic tibial stress fracture after total knee arthroplasty: A case report. Int J Surg Case Rep . 2016. 24:175-8. . Fonseca F, Rebelo E, Completo A. TIBIAL PERIPROSTHETIC FRACTURE COMBINED WITH TIBIAL STEM STRESS FRACTURE FROM TOTAL KNEE ARTHROPLASTY. Rev Bras Ortop . 2011 Nov-Dec. 46 (6):745-50. . Wada M, Imura S, Bo A, Baba H, Miyazaki T. Stress fracture of the femoral component in total knee replacement

2014 eMedicine Surgery

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