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Femoral Neck Stress Fracture

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121. 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

122. Intertrochanteric Hip Fractures (Treatment)

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

123. Diaphyseal Femur Fractures (Treatment)

, 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

124. 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

125. Fracture, Hip (Diagnosis)

- Stress fractures or incomplete fractures (see image below) Type 2 - Impacted fractures (see image below) Femoral neck fractures. Top diagram is a nondisplaced, or incomplete, femoral neck fracture. Bottom diagram is an impacted femoral neck fracture. Type 3 - Partially displaced fractures (see image below) Partially displaced femoral neck fracture. Type 4 - Completely displaced or comminuted fractures (see image below) Completely displaced femoral neck fracture. Trochanteric fractures Greater (...) in Emergency Medicine Updated: Feb 28, 2016 Author: Moira Davenport, MD; Chief Editor: Trevor John Mills, MD, MPH Share Email Print Feedback Close Sections Sections Hip Fracture in Emergency Medicine Overview Practice Essentials Hip fracture occurs in approximately 341,000 persons in the United States each year. [ ] The rate of hip fracture increases with age, doubling every 5-6 years after age 60 years. [ ] See the image below. Femoral neck fractures. Top diagram is a nondisplaced, or incomplete, femoral

2014 eMedicine Emergency Medicine

126. 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

127. Periprosthetic Fractures (Overview)

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

128. Subtrochanteric Hip Fractures (Follow-up)

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

129. 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

130. 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

131. 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

132. 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

133. 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

134. Fracture, Hip (Overview)

- Stress fractures or incomplete fractures (see image below) Type 2 - Impacted fractures (see image below) Femoral neck fractures. Top diagram is a nondisplaced, or incomplete, femoral neck fracture. Bottom diagram is an impacted femoral neck fracture. Type 3 - Partially displaced fractures (see image below) Partially displaced femoral neck fracture. Type 4 - Completely displaced or comminuted fractures (see image below) Completely displaced femoral neck fracture. Trochanteric fractures Greater (...) in Emergency Medicine Updated: Feb 28, 2016 Author: Moira Davenport, MD; Chief Editor: Trevor John Mills, MD, MPH Share Email Print Feedback Close Sections Sections Hip Fracture in Emergency Medicine Overview Practice Essentials Hip fracture occurs in approximately 341,000 persons in the United States each year. [ ] The rate of hip fracture increases with age, doubling every 5-6 years after age 60 years. [ ] See the image below. Femoral neck fractures. Top diagram is a nondisplaced, or incomplete, femoral

2014 eMedicine Emergency Medicine

135. Fracture, Hip (Follow-up)

, Perry JJ. Regional Nerve Blocks For Hip and Femoral Neck Fractures in the Emergency Department: A Systematic Review. CJEM . 2016 Jan. 18 (1):37-47. . Dickman E, Pushkar I, Likourezos A, Todd K, Hwang U, Akhter S, et al. Ultrasound-guided nerve blocks for intracapsular and extracapsular hip fractures. Am J Emerg Med . 2015 Dec 14. . Groot L, Dijksman LM, Simons MP, Zwartsenburg MM, Rebel JR. Single Fascia Iliaca Compartment Block is Safe and Effective for Emergency Pain Relief in Hip-fracture (...) . Femoral neck fractures. Top diagram is a nondisplaced, or incomplete, femoral neck fracture. Bottom diagram is an impacted femoral neck fracture. Partially displaced femoral neck fracture. Completely displaced femoral neck fracture. Trochanteric fractures. Top diagram is a nondisplaced trochanteric fracture. Bottom diagram is a displaced trochanteric fracture. Intertrochanteric fractures. Top diagram is a single fracture line intertrochanteric fracture. Bottom diagram is a displaced, or multiple

2014 eMedicine Emergency Medicine

136. Fixation Using Alternative Implants for the Treatment of Hip Fractures (FAITH-2)

(i.e. soft tissue or bone). Stress fracture of the femoral neck. Pathologic fractures secondary to neoplasm or other bone lesion. Patients with known or likely undiagnosed disorders of bone metabolism such as Paget's disease, osteomalacia, osteopetrosis, osteogenesis imperfect, etc. Patients with hyperhomocysteinemia. Patient has an allergy to vitamin D or another contraindication to being prescribed vitamin D. Patient is currently taking an over counter drug and/or food supplement that contains (...) Phase Femoral Neck Fractures Procedure: Sliding Hip Screw Procedure: Cancellous Screws Drug: Vitamin D Drug: Vitamin D Placebo Phase 3 Detailed Description: Femoral neck fractures are a type of hip fracture associated with high complication rates and poor functional outcomes. It is estimated that over 300,000 hip fractures occur in patients under age 50 annually. Hip fractures in younger aged patients are particularly devastating with profound impairments of quality of life and function. Virtually

2013 Clinical Trials

137. Femoral Stem Fracture and In Vivo Corrosion of Retrieved Modular Femoral Hips. (Abstract)

Femoral Stem Fracture and In Vivo Corrosion of Retrieved Modular Femoral Hips. A series of 78 retrieved modular hip devices were assessed for fretting and corrosion. Damage was common at both the head-neck junction (54% showing corrosion; 88% showing fretting) and at the stem-sleeve junction (88% corrosion; 65% fretting). Corrosion correlated to in vivo duration, patient activity, and metal (vs ceramic) femoral heads but did not correlate to head carbon content. Femoral stem fatigue fracture (...) was observed in seven retrievals; all had severe corrosion, were under increased stress, and were in vivo longer than the non-fractured cohort. This study emphasizes the potential for stem fracture when small diameter femoral stems with large offsets are used in heavy and active patients. Designs which reduce fretting and corrosion in modular implants is warranted as patients demand longer lasting implants.Copyright © 2012 Elsevier Inc. All rights reserved.

2011 Journal of Arthroplasty

138. The science of pinning the neck of the femur. Full Text available with Trip Pro

The science of pinning the neck of the femur. Experiments show that the cancellum of some femoral heads and of the trochanteric region is too weak to support a nail. A simple classification of traumatic femoral neck fractures is presented. These are either vertical or, less commonly, transversely disposed. Either type may be undisplaced, impacted, or displaced. For adequate fixation of undisplaced vertical and all displaced fractures a nail plate is essential. For undisplaced transverse (...) fractures and impacted vertical fractures two screws usually suffice. Impacted transverse fractures require no active treatment. Hammering nails into the femoral head can cause fractures of the articular cartilage, split the femoral head in two, lead to avulsion of articular cartilage under the weight-bearing area, and osteoarthrosis. Early weight-bearing on weak implants can be disastrous. For the unsolved fracture a sliding pin compressing the fragments should be used. In a series of 54 displaced

1977 Annals of the Royal College of Surgeons of England

139. Technical considerations and functional results in primary uncemented hip arthroplasty using short femoral stems through mini-invasive techniques Full Text available with Trip Pro

Technical considerations and functional results in primary uncemented hip arthroplasty using short femoral stems through mini-invasive techniques Primary hip arthroplasty is a surgical procedure through which the coxofemoral joint is replaced with a prosthetic implant. Arthroplasties can be total or partial, cemented or uncemented. These procedures are generally indicated as a form of treatment for arthritic pain or in the case of severe trauma, such as femoral neck fractures. The most commonly (...) used approaches are: Smith Peterson, Watson Jones, Hardinge, Moore Southern and Ludloff. Recently, mini-invasive approaches have started being used, while correlated with short femoral stems. Short metaphyseal femoral stems have been introduced as an alternative to conventional stems, having a series of advantages: preservation of bone stock (high cervical osteotomies), preservation of the anatomical anteversion of the femural neck, decrease in cortical stress forces, decrease in the remaining

2014 Journal of medicine and life

140. Impingement between the acetabular cup and the femoral neck after hip resurfacing arthroplasty. (Abstract)

Impingement between the acetabular cup and the femoral neck after hip resurfacing arthroplasty. Loosening, femoral neck fracture, and metal ion release have been well documented after hip resurfacing arthroplasty, but impingement between the acetabular cup and the femoral neck has not. The goal of this study was to analyze radiographic findings that were presumed to represent impingement of the neck after hip resurfacing arthroplasty, and to describe the mechanism of impingement.Of the 635 hips (...) edge of the socket. No significant factors were found to be related to the occurrence of impingement.Femoral-neck impingement should be differentiated from notching, narrowing, stress-shielding, or osteolysis of the femoral neck. Although we found no significant factors to explain the impingement found in the hips in our study, it appears that repetitive extreme motion of the involved hip and malposition of the implants can cause impingement after hip resurfacing arthroplasty.

2011 The Journal of Bone and Joint Surgery. American Volume

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