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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. 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

103. 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

104. Hip Fracture (Diagnosis)

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

105. 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

106. Hip Fracture (Treatment)

& Management Updated: Jan 08, 2019 Author: Naveenpal S Bhatti, MD; Chief Editor: Sherwin SW Ho, MD Share Email Print Feedback Close Sections Sections Hip Fracture Treatment Acute Phase Rehabilitation Program Physical Therapy The treatment of femoral neck fractures, intertrochanteric hip fractures, and most tension femoral neck stress fractures requires surgical intervention. Stress fractures occur most often in the femoral neck and are classified according to the location (ie, inferior or compression (...) is increased signal intensity at the superior femoral neck on T2-weighted and short inversion time inversion recovery (STIR) images. Displaced fractures can be identified on plain radiographs. Complications associated with poorly treated or misdiagnosed stress fractures are considerable. AVN, nonunion, varus deformity, osteonecrosis, and completely displaced femoral neck fractures may occur. These complications can lead to serious, life-altering changes in function and the patient's ability to ambulate

2014 eMedicine.com

107. Femur Injuries and Fractures (Treatment)

program/phase is completed. The progression can include (1) cycling, (2) swimming, and (3) running in chest-deep water before resuming more intensive weight-bearing training. Patients must maintain upper extremity and cardiovascular fitness and avoid lower extremity exercise early in the healing process. Compression sided femoral neck stress fractures are typically treated conservatively with a period of protected crutch-assisted weight bearing until symptoms resolve. Tension-sided (lateral) femoral (...) by not only location, but also tumor type. In primary bone tumors, the goal of surgical treatment is curative where as in metastatic tumors the goal is palliative. In the case of femoral shaft stress fracture, operative treatment is reserved for those infrequent cases that have been recalcitrant to a long course of conservative treatment. Intramedullary nailing, whether antegrade or retrograde, is the treatment of choice for these cases. Tension sided femoral neck stress fractures are typically treated

2014 eMedicine.com

108. 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

109. Hip Fracture (Follow-up)

are considerable. AVN, nonunion, varus deformity, chronic pain, and completely displaced femoral neck fractures may occur and may lead to serious life-altering changes in function and the patient's ability to ambulate efficiently. Previous Next: Prognosis The prognosis for hip fractures is dependent on the age and condition of the patient and on the location and type of fracture. Athletes who sustain femoral neck stress fractures may or may not be able to return to their sport. Tension stress fractures (...) of Orthopaedic Surgeons. Management of Hip Fractures in the Elderly: Evidence- Based Clinical Practice Guideline. Available at . Accessed: September 14, 2014. Shin AY, Gillingham BL. Fatigue fractures of the femoral neck in athletes. J Am Acad Orthop Surg . 1997 Nov. 5(6):293-302. . Pincus D, Ravi B, Wasserstein D, Huang A, Paterson JM, Nathens AB, et al. Association Between Wait Time and 30-Day Mortality in Adults Undergoing Hip Fracture Surgery. JAMA . 2017 Nov 28. 318 (20):1994-2003. . Bischoff-Ferrari HA

2014 eMedicine.com

110. 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

111. 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

112. 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

113. Diaphyseal Femur Fractures (Overview)

. 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

114. General Principles of Fracture Care (Overview)

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

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. Femur Injuries and Fractures (Follow-up)

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 Med J . 2011 Feb. 52(2):77-80. . Oh Y, Fujita K, Wakabayashi Y, Kurosa Y, Okawa A. 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. Injury . 2017 Dec. 48 (12):2736-2743. . DeFranco MJ, Recht M, Schils J, Parker RD. Stress fractures of the femur in athletes. Clin Sports Med . 2006 Jan. 25(1):89-103, ix. . Fitch KD. Stress fractures of the lower limbs in runners. Aust Fam Physician . 1984 Jul. 13(7):511-5. . Schnackenburg KE

2014 eMedicine.com

117. Femur Injuries and Fractures (Diagnosis)

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

118. 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

119. General Principles of Fracture Care (Treatment)

. 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

120. 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

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