femoral fractures

INTRODUCTION: Hip fractures cause severe pain during positioning for spinal anesthesia (SA). Intravenous systemic analgesics can lead to various complications in elderly patients, hence peripheral nerve blocks are emerging as a standard of care in pain management for hip fractures, among which femoral nerve block (FNB) is widely known and practiced. Pericapsular nerve group (PENG) block is a recently described technique that blocks the articular nerves of the hip with motor-sparing effects and is used to manage positional pain in hip fractures...

BACKGROUND: The proximal femoral nail anti-rotation (PFNA) with cement enhancement enhances the anchorage ability of internal fixation in elderly with osteoporotic intertrochanteric fracture. However, whether it is superior to hemiarthroplasty is still controversial. The present study aimed to determine which treatment has better clinical outcomes among older patients. METHODS: We retrospectively analyzed 102 elderly patients with osteoporosis who developed intertrochanteric fractures and underwent PFNA combined with cement-enhanced internal fixation (n = 52, CE group), and hemiarthroplasty (n = 50, HA group) from September 2012 to October 2018...

BACKGROUND: 3D multi-spectral imaging (MSI) of metal implants necessitates relatively long scan times. OBJECTIVE: We implemented a fast isotropic 3D MSI technique at 3 T and compared its image quality and clinical utility to non-isotropic MSI in the evaluation of hip implants. METHODS: Two musculoskeletal radiologists scored images from coronal proton density-weighted conventional MAVRIC-SL and an isotropic MAVRIC-SL sequence accelerated with robust-component-analysis on a 3-point scale (3: diagnostic, 2: moderately diagnostic, 1: non-diagnostic) for overall image quality, metal artifact, and visualization around femoral and acetabular components...

BACKGROUND: Spinal anesthesia is used for femoral trochanteric fracture surgery, but frequently induces hypotension and the causative factors remain unclear. We examined background factors for the use of an intraoperative vasopressor in elderly patients receiving spinal anesthesia for femoral trochanteric fracture surgery. METHODS: We retrospectively analyzed 203 patients >75 years (mean age, 87.9 years) with femoral trochanteric fractures who underwent short nail fixation under orthopedically managed spinal anesthesia at our hospital between April 2020 and July 2023...

UNLABELLED: Osteoporosis treatment following arthroplasty for femoral neck fracture (FNF) is associated with lower rates of periprosthetic fracture (PPF). Our study evaluated the economic viability of treatment in patients following arthroplasty and demonstrates that treatment with oral bisphosphonates can be cost-effective in preventing PPF. INTRODUCTION: Osteoporosis treatment following arthroplasty for femoral neck fracture (FNF) is associated with lower rates of periprosthetic fracture (PPF)...

Compromised vascular supply and insufficient neovascularization impede bone repair, increasing risk of non-union. Cyr61, Cysteine-rich angiogenic inducer of 61kD (also known as CCN1), is a matricellular growth factor that is regulated by mechanical cues during fracture repair. Here, we map the distribution of endogenous Cyr61 during bone repair and evaluate the effects of recombinant Cyr61 delivery on vascularized bone regeneration. In vitro, Cyr61 treatment did not alter chondrogenesis or osteogenic gene expression, but significantly enhanced angiogenesis...

BACKGROUND: Teriparatide, a recombinant parathyroid hormone, is pivotal in osteoporosis treatment, particularly in post-surgical recovery for hip fractures. This study investigates its efficacy in functional recovery post-hip fracture surgery in elderly patients, a demographic particularly susceptible to osteoporotic fractures. METHODS: In this retrospective cohort study, 150 elderly patients with proximal femoral fractures undergoing open reduction and internal fixation were enrolled...

OBJECTIVE: Femoral neck fractures (FNFs) are among the most common fractures in elderly individuals. Surgery is the main treatment for FNFs, and osteonecrosis of the femoral head (ONFH) is one of the unacceptable complications. This study aimed to assess both the clinical and radiological outcomes in patients with FNFs treated with three parallel cannulated screws and to identify relationship between screws position and ONFH. PATIENTS AND METHODS: A total of 100 patients who were treated with closed reduction and fixed with 3 parallel cannulated screws met the inclusion criteria between January 2014 and December 2020 at authors' institution...

INTRODUCTION: Evidence on the effects of Vitamin D, omega-3 s and exercise on aBMD in healthy older adults is limited. We examined whether vitamin D3, omega-3 s, or a simple home-based exercise program (SHEP), alone or in combination, over three years, improve lumbar spine (LS), femoral neck (FN) or total hip (TH) aBMD assessed by DXA. METHODS: aBMD was a secondary outcome in DO-HEALTH, a 3-year, multicenter, double-blind, randomized 2 × 2 × 2 factorial design trial in generally healthy older adults age ≥ 70 years...

Fracture healing is a complex series of events that requires a local inflammatory reaction to initiate the reparative process. This inflammatory reaction is important for stimulating the migration and proliferation of mesenchymal progenitor cells from the periosteum and surrounding tissues to form the cartilaginous and bony calluses. The proinflammatory cytokine interleukin (IL)-17 family has gained attention for its potential regenerative effects; however, the requirement of IL-17 signaling within mesenchymal progenitor cells for normal secondary fracture healing remains unknown...

Background: Femoral neck fractures (FNFs) are frequent orthopedic injuries in elderly patients. Despite improvements in clinical monitoring and advances in surgical procedures, 1-year mortality remains between 15% and 30%. The aim of this study is to identify variables that lead to better outcomes in patients treated with total hip arthroplasty (THA) for FNFs. Methods: All patients who underwent cementless THA for FNF from January 2018 to December 2022 were identified. Patients aged more than 80 years old and with other post-traumatic lesions were excluded...

BACKGROUND: Femoral stem fracture following total hip arthroplasty (THA) is an infrequent but nevertheless devastating complication, with an increasing worldwide prevalence as demand for primary THA continues to increase. The aim of this study was to perform a systematic review and meta-analysis of risk factors for femoral stem fracture to help identify at risk patients. METHODS: A systematic search was conducted on EMBASE, MEDLINE and AMED to identify relevant studies...

Traditionally, it was believed that both proximal and distal locking are essential for achieving stability during intra-medullary fixation for extra-capsular hip fractures. However, recent literature has presented varying perspectives on the necessity of distal locking. Distal locking plays a significant role in managing hip fractures with uncertainties regarding longitudinal and rotational stability. This includes cases of comminuted intertrochanteric fractures with subtrochanteric extension, reverse oblique and high oblique fractures, broad medullary canals, comminution of the lateral wall, diaphyseal fractures, and large posteromedial fragments extending below the level of the lesser trochanter...

The well preserved skeleton of Joseph Huber, a very well-known historical character of the 19th century Munich, also nicknamed "Finessen-Sepperl", is the starting point of the reconstruction of life and death of this historical individual. He was known as a postilion d´amour (love's messenger) of the Royal Bavarian capital with numerous comments and anecdotes and a few biographical sketches that indicate he remained well until the last few years of his life where requests for his duties lessened. The skeleton shows a small-sized male individual with almost complete loss of teeth, but otherwise very well-mineralized bone, having suffered from three episodes of trauma - an old-healed incomplete femoral neck fracture leading to severe osteoarthrosis, a clavicle fracture of the medial third with a few weeks old callus formation, and fresh serial rib fractures along with severe skull trauma with fractures of the os temporale and petrosum, presumably leading to intracranial bleeding and finally death...

UNLABELLED: A retrospective analysis was conducted using data from the NHANES. Bone mineral density (BMD) was compared in different thyroid-specific autoantibodies groups. Strengths of associations were calculated by using binary logistic regression models. Higher titers of thyroid-specific autoantibodies (TgAb and/or TPOAb) may lead to decreased BMD. Higher prevalence of TgAb and TPOAb significantly associated with fractures in females but not in males. PURPOSE: Hashimoto's thyroiditis is characterized by elevated thyroid-specific autoantibodies...

OBJECTIVE: Cemented total hip arthroplasty (THA) demonstrates superior survival rates compared to uncemented procedures. Nevertheless, most younger patients opt for uncemented THA, as removing well-fixed bone cement in the femur during revisions is complex, particularly the distal cement plug. This removal procedure often increases the risk of femoral fracture or perforation, haemorrhage and weakening bone due to poor drill control and positioning. Aim of this study was to design a novel drill guide to improve drill positioning...

Objective  To evaluate the stability of osteotomies created in the subtrochanteric and trochanteric regions in a pediatric femur model fixed by flexible intramedullary rods. Method  Tomographic sections were obtained from a pediatric femur model with two elastic titanium rods and converted to a three-dimensional model. This model created a mesh with tetrahedral elements according to the finite element method. Three virtual models were obtained, and osteotomies were performed in different regions: mediodiaphyseal, subtrochanteric, and trochanteric...

CONTEXT: Hyponatremia is associated with increased risk of osteoporosis and fractures. The impact of hyponatremia on non-invasive indices of bone quality, however, is unknown. OBJECTIVE: To evaluate whether trabecular bone microarchitecture, assessed non-invasively by trabecular bone score (TBS), is altered in patients with hyponatremia. METHODS: We conducted a cross-sectional analysis of the population-based 2005-2008 cycles of the National Health and Nutrition Examination Survey (NHANES), in which TBS measurement was performed...

INTRODUCTION: Femoral neck fractures (FNF) in elderly patients are associated with major morbidity and mortality. The influence of postoperative discharge location on recovery and outcomes after arthroplasty for hip fractures is not well understood. METHODS: A multi-site retrospective cohort from nine academic centers identified patients who had FNF treated with hemiarthroplasty (HA) or total hip arthroplasty (THA) between 2010 and 2019. Patients who had diagnoses of dementia, stroke, age > 80 years, or high energy fracture were excluded...

OBJECTIVES: The aim of this study was to compare the radiological and clinical results of femoral diaphyseal fractures operated in the lateral decubitus position with those operated in the supine position on a traction table and to detail the perioperative surgical technique. PATIENTS AND METHODS: Between October 2018 and January 2022, in this prospective, randomized, and single-blind comparative study, 75 patients diagnosed with adult femoral diaphyseal fractures to whom intramedullary nails were applied were operated in the lateral decubitus position without a traction table (Group 1, 37 patients) and in the supine position with a traction table (Group 2, 38 patients)...