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Sample records for femur liss system

  1. Osteosynthesis of a periprosthetic fracture of the proximal femur with the distal femur LISS system

    DEFF Research Database (Denmark)

    Tarnowski, Jan Robert; Holck, Kim

    2008-01-01

    In this case report, we show how it is possible to perform osteosynthesis using minimal invasive techniques instead of conventional methods. In this instance the osteosynthesis was performed on a patient in poor general condition who had presented a periprosthetic fracture of the proximal femur....... For the osteosynthesis the Less invasive Stabilization System intended for distal femur fractures was used with success....

  2. 倒置LISS与弹性钉治疗大龄儿童股骨转子下骨折的比较%Less invasive stabilization system (LISS) versus elastic nailing for children with subtrochanteric femur fractures

    Institute of Scientific and Technical Information of China (English)

    杨杰; 黄高; 田乃锋; 孙辽军; 郭晓山

    2013-01-01

    Objective To compare the complications and clinical outcome of reverse less invasive stabilization system (LISS) and elastic nailing for the treatment of subtrochanteric femur fractures in older children.Methods Fifteen children aged from 9 to 15 years old were admitted in this hospital for the treatment of subtrochanteric fractures.The 15 patients subtrochanteric fractures were fixed with reverse LISS.The other 26 patients,who underwent elastic nail fixation for the treatment of subtrochanteric fractures in the same period,were taken as controls.Operative indications,hip joint function and complications of these 2 groups were retrospectively analyzed.Results The average follow-up period of the patients was 30.5 months in LISS group,and 36.2 months in the elastic nail group.No significant difference between these 2 groups was found in fracture healing time,full weight-bearing time and average hospital stay.However,the patients of the LISS group had longer operation time (60.0 ± 10.6 min vs.40.5 ± 7.4 min,P<0.05),less intraoperative blood loss (130.0 ± 55.0 ml vs.30.5 ± 15.0 ml,P<0.05) and more hospital costs (25 000-± 800 RMB vs.12 000 ± 500 RMB,P<0.05).The postoperative complication of these 2 groups was no statistically different,but the patients of the LISS group had a higher incidence of incisional pain,and the elastic nail group had a higher incidence of misalignment.Average Sanders hip function score of LISS group was not significantly different from that of elastic nail group (58.20 vs.58.77,P>0.05).Conclusions The clinical outcome of LISS is comparable with elastic nailing for the treatment of subtrochanteric femur fractures in older children.The fixation device should be selected according to the associated injury,severity of soft tissue injuries and family economic status.%目的 比较倒置LISS及弹性钉固定大龄儿童股骨转子下骨折的临床疗效及并发症.方法 采用LISS倒置固定15例年龄9~15岁的股骨转子下

  3. Estimation of LISS(local input-to-state stability) properties for nonlinear systems

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Compared with input-to-state stability(ISS) in global version,the concept of local input-to-state stability(LISS) is more relevant and meaningful in practice.The key of assessing LISS properties lies in investigating three main ingredients,the local region of initial states,the local region of external inputs and the asymptotic gain.It is the objective of this paper to propose a numerical algorithm for estimating LISS properties on the theoretical foundation of quadratic form LISS-Lyapunov function.Given developments of linear matrix inequality(LMI) methods,this algorithm is effective and powerful.A typical power electronics based system with common DC bus is served as a demonstration for quantitative results.

  4. A comparative study of less invasive stabilization system and titanium elastic nailing for subtrochanteric femur fractures in older children.

    Science.gov (United States)

    Sun, Liao-Jun; Wu, Zhi-Peng; Dai, Cheng-Qian; Guo, Xiao-Shan; Chen, Hua

    2015-03-01

    The objective of this study was to compare prospectively the complications and the radiographic and clinical outcomes of reverse less invasive stabilization system (LISS) and titanium elastic nailing (TEN) for the treatment of subtrochanteric femur fractures in older children. From April 2004 to February 2012, 52 children aged from 10 to 15 years old with subtrochanteric fractures were included in this study. 26 patients were treated with reverse LISS (LISS group) and 26 children treated with titanium elastic nails (TEN group) respectively. Perioperative care was standardized. Surgical time, blood loss, length of hospitalization, hospital costs, fracture union time, full weight-bearing time and complications were analyzed. The radiologic results as well as hip functional outcomes were evaluated. The average follow-up time of LISS group was 36.5±9.3 months and TEN group was 40.2±10.6 months. No significant difference between these two groups was found in union time, full weight-bearing time and average length of hospitalization. However, the patients of LISS group had longer operation time (60.0±10.6 min vs. 40.5±7.4 min, psubtrochanteric femur fractures in older children was associated with better function scores and a lower overall complication rate when compared with reverse LISS.

  5. Large solar heating system with seasonal storage for buld drying in Lisse, the Netherlands

    NARCIS (Netherlands)

    Bokhoven, T.P.; Geus, A.C. de

    1996-01-01

    Within IEA Task 14 (Advanced Solar Systems) of the IEA Solar Heating and Cooling Programme a working group was established dealing with large advanced solar energy systems (the Large Systems Working group). The goal of this working group was to generate a common base of experiences for the design an

  6. Systemic treatment with telmisartan improves femur fracture healing in mice.

    Directory of Open Access Journals (Sweden)

    Xiong Zhao

    Full Text Available Recent clinical studies indicated that angiotensin receptor blockers (ARBs would decrease the risk of bone fractures in the elderly populations. There is little known about the role of the ARBs in the process of fracture healing. The purpose of the present study was to verify the hypothesis that systemic treatment with telmisartan has the ability to promote fracture healing. In this study, femur fractures were produced in 96 mature male BALB/c mice. Animals were treated with the ARBs telmisartan or vehicle. Fracture healing was analysed after 2, 5 and 10 weeks postoperatively using X-ray, biomechanical testing, histomorphometry, immunohistochemistry and micro-computed tomography (micro-CT. Radiological analysis showed the diameter of the callus in the telmisartan treated animals was significantly increased when compared with that of vehicle treated controls after two weeks of fracture healing. The radiologically observed promotion of callus formation was confirmed by histomorphometric analyses, which revealed a significantly increased amount of bone formation when compared with vehicle-treated controls. Biomechanical testing further showed a significantly greater peak torque at failure, and a higher torsional stiffness in telmisartan-treated animals compared with controls. There was an increased fraction of PCNA-positive cells and VEGF-positive cells in telmisartan-treated group compared with vehicle-treated controls. From the three-dimensional reconstruction of the bony callus, telmisartan-treated group significantly increased the values of BV/TV by 21.7% and CsAr by 26.0% compared to the vehicle-treated controls at 5 weeks post-fracture. In summary, we demonstrate in the current study that telmisartan could promote fracture healing in a mice model via increasing mechanical strength and improving microstructure. The most mechanism is probably by an increase of cell proliferation and neovascularization associated with a decreased VEGF expression

  7. Femur-mounted navigation system for the arthroscopic treatment of femoroacetabular impingement

    Science.gov (United States)

    Park, S. H.; Hwang, D. S.; Yoon, Y. S.

    2013-07-01

    Femoroacetabular impingement stems from an abnormal shape of the acetabulum and proximal femur. It is treated by resection of damaged soft tissue and by the shaping of bone to resemble normal features. The arthroscopic treatment of femoroacetabular impingement has many advantages, including minimal incisions, rapid recovery, and less pain. However, in some cases, revision is needed owing to the insufficient resection of damaged bone from a misreading of the surgical site. The limited view of arthroscopy is the major reason for the complications. In this research, a navigation method for the arthroscopic treatment of femoroacetabular impingement is developed. The proposed navigation system consists of femur attachable measurement device and user interface. The bone mounted measurement devices measure points on head-neck junction for registration and position of surgical instrument. User interface shows the three-dimensional model of patient's femur and surgical instrument position that is tracked by measurement device. Surgeon can know the three-dimensional anatomical structure of hip joint and surgical instrument position on surgical site using navigation system. Surface registration was used to obtain relation between patient's coordinate at the surgical site and coordinate of three-dimensional model of femur. In this research, we evaluated the proposed navigation system using plastic model bone. It is expected that the surgical tool tracking position accuracy will be less than 1 mm.

  8. Der umgedrehte Plattenfixateur zur osteosynthetischen Stabilisierung bei erschwerter Frakturheilung am proximalen Femur

    DEFF Research Database (Denmark)

    Mehlhorn, A T; Strohm, P C; Müller, C A

    2009-01-01

    AIM: The aim of the study was to evaluate the application of a locked internal fixator in complex fractures of the proximal femur, in which the internal fixation with standard implants was not possible due to poor quality of bone or already failed internal fixation in the past. METHOD: Ten patients...... suffering from a pertrochanteric (n = 5), periprosthetic (n = 1) or subtrochanteric (n = 4) femural fracture between 2003 and 2008 were prospectively registered, underwent open reduction and internal fixation with an "upside-down" femur LISS (less invasive stabilisation system) and were followed up. In all...... of the implant. CONCLUSIONS: The "reversed" locked internal fixator could be a successful alternative implant for stabilisation of proximal femur fractures which could not be fixated by standard implants due to poor bone quality and circulation. It can also be used as a salvage procedure after internal failed...

  9. Asymmetry and structural system analysis of the proximal femur meta-epiphysis: osteoarticular anatomical pathology

    Directory of Open Access Journals (Sweden)

    Baydoun Safaa

    2008-02-01

    Full Text Available Abstract Background The human femur is commonly considered as a subsystem of the locomotor apparatus with four conspicuous levels of organization. This phenomenon is the result of the evolution of the locomotor apparatus, which encompasses both constitutional and individual variability. The work therein reported, therefore, underlies the significance of observing anatomical system analysis of the proximal femur meta-epiphysis in normal conditions, according to the anatomic positioning with respect to the right or left side of the body, and the presence of system asymmetry in the meta-epiphysis structure, thus indicating structural and functional asymmetry. Methods A total of 160 femur bones of both sexes were compiled and a morphological study of 15 linear and angulated parameters of proximal femur epiphysis was produced, thus defining the linear/angulated size of tubular bones. The parameters were divided into linear and angulated groups, while maintaining the motion of the hip joint and transmission of stress to the unwanted parts of the limb. Furthermore, the straight and vertical diameters of the femoral head and the length of the femoral neck were also studied. The angle between the neck and diaphysis, the neck antiversion and angle of rotation of the femoral neck were subsequently measured. Finally, the condylo-diaphyseal angle with respect to the axis of extremity was determined. To visualize the force of intersystem ties, we have used the method of correlation galaxy construction. Results The absolute numeral values of each linear parameter were transformed to relative values. The values of superfluity coefficient for each parameter in the right and left femoral bone groups were estimated and Pearson's correlation coefficient has been calculated (> 0.60. Retrospectively, the observed results have confirmed the presence of functional asymmetry in the proximal femur meta-epiphysis. On the basis of compliance or insignificant difference in

  10. Reverse LISS plating for intertrochanteric Hip Fractures in elderly patients

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    Chen SB

    2010-07-01

    Full Text Available Abstract Background Fractures of the intertrochanteric hip are common and the treatment of unstable fractures generally requires an operative approach. In elderly patients, osteoporosis makes internal fixation problematic and frequently contributes to failed fixation and poor clinical results. We have attempted to apply the Less Invasive Stabilization System (LISS in reverse position for the repair of intertrochanteric hip fractures in elderly patients with osteoporotic bones. A retrospective review is presented of the cases of 28 elderly patients with stable and unstable fractures of the intertrochanteric hip treated using the reverse LISS. Methods We treated 28 elderly patients with a mean age of 82.3 years. According to the Evens classification, there were 2 Type I fractures, 2 Type II fractures, 3 Type III fractures, 13 Type IV fractures, 6 Type V fractures and 2 Type R fractures. All fractures were treated using the reverse LISS. Radiographic and clinical evidence of functional outcome and complications were evaluated. Results Mean perioperative blood loss was 92.4 milliliters (range 35 to 245 milliliters, and the mean postoperative hospital stay was 8.7 days (range 3 to 14 days. Complications included one minor wound hematoma. Radiographically, no collapses, screw cutouts, or head penetrations were seen. All surviving patients (28 of 28; 100 percent had uneventful fracture healing with union achieved by six months in all patients. Conclusions Use of the Reverse LISS plating for intertrochanteric hip fractures resulted in event-free fracture healing.

  11. Intramedullary nailing of the femur and the systemic activation of monocytes and neutrophils

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    Koenderman Leo

    2011-10-01

    Full Text Available Abstract Background Trauma such as found patients with femur fractures, induces a systemic inflammatory response, which ranges from mild SIRS to ARDS. Neutrophils (i.e. PMN play an important role in the pathogenesis of this inflammatory condition. Additional activation of PMNs during intramedullary nailing (IMN is thought to act as a second immunological hit. Damage control orthopedics has been developed to limit this putative exacerbation of the inflammatory response. The hypothesis is tested that IMN exacerbates systemic inflammation, thereby increasing the risk for ARDS. Methods Thirty-eight trauma patients who required IMN for femur fracture were included. The development of SIRS and ARDS was recorded. Blood samples were taken prior and 18 hours after IMN. Inflammatory response was analyzed by changes in plasma IL-6 levels, monocyte (HLA-DR and PMN phenotype (MAC-1 and responsiveness for the innate immune stimulus fMLP in the context of active FcγRII. Results Plasma IL-6 was significantly enhanced in severely injured patients compared to patients with isolated femur fractures and matched controls (P = 0.005; P = 0.018. This enhanced inflammatory tone was associated with a lower percentage HLA-DR positive monocytes (P = 0.002. The systemic PMN compartment was activated, characterized by an increased MAC-1 expression and a significantly decreased sensitivity for the innate stimulus fMLP Interestingly the PMN compartment was not affected by IMN. Conclusions Multitrauma patients were characterized by a marked activation of the systemic inflammatory response, associated with a systemic activation of the monocyte and PMN compartments. IMN particularly affected the monocyte arm of the systemic innate immune system.

  12. Comparison of citrus orchard inventory using LISS-III and LISS-IV data

    Science.gov (United States)

    Singh, Niti; Chaudhari, K. N.; Manjunath, K. R.

    2016-04-01

    In India, in terms of area under cultivation, citrus is the third most cultivated fruit crop after Banana and Mango. Among citrus group, lime is one of the most important horticultural crops in India as the demand for its consumption is very high. Hence, preparing citrus crop inventories using remote sensing techniques would help in maintaining a record of its area and production statistics. This study shows how accurately citrus orchard can be classified using both IRS Resourcesat-2 LISS-III and LISS-IV data and depicts the optimum bio-widow for procuring satellite data to achieve high classification accuracy required for maintaining inventory of crop. Findings of the study show classification accuracy increased from 55% (using LISS-III) to 77% (using LISS-IV). Also, according to classified outputs and NDVI values obtained, April and May months were identified as optimum bio-window for citrus crop identification.

  13. Banana orchard inventory using IRS LISS sensors

    Science.gov (United States)

    Nishant, Nilay; Upadhayay, Gargi; Vyas, S. P.; Manjunath, K. R.

    2016-04-01

    Banana is one of the major crops of India with increasing export potential. It is important to estimate the production and acreage of the crop. Thus, the present study was carried out to evolve a suitable methodology for estimating banana acreage. Area estimation methodology was devised around the fact that unlike other crops, the time of plantation of banana is different for different farmers as per their local practices or conditions. Thus in order to capture the peak signatures, biowindow of 6 months was considered, its NDVI pattern studied and the optimum two months were considered when banana could be distinguished from other competing crops. The final area of banana for the particular growing cycle was computed by integrating the areas of these two months using LISS III data with spatial resolution of 23m. Estimated banana acreage in the three districts were 11857Ha, 15202ha and 11373Ha for Bharuch, Anand and Vadodara respectively with corresponding accuracy of 91.8%, 90% and 88.16%. Study further compared the use of LISS IV data of 5.8m spatial resolution for estimation of banana using object based as well as per-pixel classification and the results were compared with statistical reports for both the approaches. In the current paper we depict the various methodologies to accurately estimate the banana acreage.

  14. Biomechanics of distal femoral fracture fixed with an angular stable LISS plate.

    Science.gov (United States)

    Pakuła, Grzegorz; Słowiński, Jakub; Scigała, Krzysztof

    2013-01-01

    Fractures of the distal end of the femur are infrequent and constitute less than 1% of all fractures. Only 3% to 6% of femoral fractures occur at the distal end. The two groups most at risk of the said fractures are young men and older women. The aim of treatment of fractures of the distal femur is to restore normal function of the knee joint. The authors asked themselves whether, following fixation of a 33-C2 fracture (according to the AO classification) with a LISS plate, a rehabilitation program can be undertaken immediately after surgery with the implementation of active movements in the knee joint of the operated limb. In order to answer this question, we created a digital model of a fractured femur fixed with the LISS method. The model was subjected to loads corresponding to the loads generated during active lifting of a limb extended in the knee joint and during flexing of a limb in the knee joint to the 90° angle. Interfragmentary movement (IFM) is one of the key parameters taken into account in the treatment of bone fractures. It allows classification of the treatment in terms of its quality both from the mechanical and histological points of view. We analyzed interfragmentary movement in all fracture gaps. The largest recorded displacement reached in our model was 243 μm, which, in the light of the literature data, should not interfere with bone consolidation, and thus implementation of active movement in the operated knee joint (keeping in mind the simplifications of the experimental method used) is possible in the early postoperative period.

  15. Paediatric diaphyseal femur fracture treated with intramedullary titanium elastic nail system

    Directory of Open Access Journals (Sweden)

    Shrawan Kumar Thapa

    2015-11-01

    Full Text Available noBackground & Objectives: Over the few years there has been a marked increase in the use of intramedullary fixation in the management of fracture of shaft of femur in children. The goals should be to stabilize the fracture, to control length and alignment, to promote bone healing and to minimize the morbidity and complications for the child. In this prospective study we intend to evaluate the functional and radiological outcome of diaphyseal fracture of shaft of femur treated with elastic intramedullary nail.Materials & Methods: All 56 patients with diaphyseal fracture shaft of femur were treated with titanium elastic nail and followed for period of 32 weeks.Results: The In this study, outcome was assessed by using Flynn’s criteria of titanium flexible nail outcome score and we found excellent result in 49 cases, satisfactory in six cases and poor in one case. We faced one major complication in form of implant failure and six minor complications inform of superficial wound infection.Conclusion: Elastic intramedullary nail used in treatment of diaphyseal fracture shaft of femur yield excellent functional and radiological outcome. It is easy and simple procedure has low rate of complication. It is physeal-protective, cost effective, does not involve heavy instrumentation and can be performed in small set up. It has minimal risk of infection and no risk of injury to the neurovascular structure.JCMS Nepal. 2015; 11(2:20-22

  16. Systemic Inflammatory Effects of Traumatic Brain Injury, Femur Fracture, and Shock: An Experimental Murine Polytrauma Model

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    C. Probst

    2012-01-01

    Full Text Available Objective. Despite broad research in neurotrauma and shock, little is known on systemic inflammatory effects of the clinically most relevant combined polytrauma. Experimental investigation in an animal model may provide relevant insight for therapeutic strategies. We describe the effects of a combined injury with respect to lymphocyte population and cytokine activation. Methods. 45 male C57BL/6J mice (mean weight 27 g were anesthetized with ketamine/xylazine. Animals were subjected to a weight drop closed traumatic brain injury (WD-TBI, a femoral fracture and hemorrhagic shock (FX-SH. Animals were subdivided into WD-TBI, FX-SH and combined trauma (CO-TX groups. Subjects were sacrificed at 96 h. Blood was analysed for cytokines and by flow cytometry for lymphocyte populations. Results. Mortality was 8%, 13% and 47% for FX-SH, WD-TBI and CO-TX groups (P<0.05. TNFα (11/13/139 for FX-SH/WD-TBI/CO-TX; P<0.05, CCL2 (78/96/227; P<0.05 and IL-6 (16/48/281; P=0.05 showed significant increases in the CO-TX group. Lymphocyte populations results for FX-SH, WD-TBI and CO-TX were: CD-4 (31/21/22; P= n.s., CD-8 (7/28/34, P<0.05, CD-4-CD-8 (11/12/18; P= n.s., CD-56 (36/7/8; P<0.05. Conclusion. This study shows that a combination of closed TBI and femur-fracture/ shock results in an increase of the humoral inflammation. More attention to combined injury models in inflammation research is indicated.

  17. Classification of Liss IV Imagery Using Decision Tree Methods

    Science.gov (United States)

    Verma, Amit Kumar; Garg, P. K.; Prasad, K. S. Hari; Dadhwal, V. K.

    2016-06-01

    Image classification is a compulsory step in any remote sensing research. Classification uses the spectral information represented by the digital numbers in one or more spectral bands and attempts to classify each individual pixel based on this spectral information. Crop classification is the main concern of remote sensing applications for developing sustainable agriculture system. Vegetation indices computed from satellite images gives a good indication of the presence of vegetation. It is an indicator that describes the greenness, density and health of vegetation. Texture is also an important characteristics which is used to identifying objects or region of interest is an image. This paper illustrate the use of decision tree method to classify the land in to crop land and non-crop land and to classify different crops. In this paper we evaluate the possibility of crop classification using an integrated approach methods based on texture property with different vegetation indices for single date LISS IV sensor 5.8 meter high spatial resolution data. Eleven vegetation indices (NDVI, DVI, GEMI, GNDVI, MSAVI2, NDWI, NG, NR, NNIR, OSAVI and VI green) has been generated using green, red and NIR band and then image is classified using decision tree method. The other approach is used integration of texture feature (mean, variance, kurtosis and skewness) with these vegetation indices. A comparison has been done between these two methods. The results indicate that inclusion of textural feature with vegetation indices can be effectively implemented to produce classifiedmaps with 8.33% higher accuracy for Indian satellite IRS-P6, LISS IV sensor images.

  18. CLASSIFICATION OF LISS IV IMAGERY USING DECISION TREE METHODS

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    A. K. Verma

    2016-06-01

    Full Text Available Image classification is a compulsory step in any remote sensing research. Classification uses the spectral information represented by the digital numbers in one or more spectral bands and attempts to classify each individual pixel based on this spectral information. Crop classification is the main concern of remote sensing applications for developing sustainable agriculture system. Vegetation indices computed from satellite images gives a good indication of the presence of vegetation. It is an indicator that describes the greenness, density and health of vegetation. Texture is also an important characteristics which is used to identifying objects or region of interest is an image. This paper illustrate the use of decision tree method to classify the land in to crop land and non-crop land and to classify different crops. In this paper we evaluate the possibility of crop classification using an integrated approach methods based on texture property with different vegetation indices for single date LISS IV sensor 5.8 meter high spatial resolution data. Eleven vegetation indices (NDVI, DVI, GEMI, GNDVI, MSAVI2, NDWI, NG, NR, NNIR, OSAVI and VI green has been generated using green, red and NIR band and then image is classified using decision tree method. The other approach is used integration of texture feature (mean, variance, kurtosis and skewness with these vegetation indices. A comparison has been done between these two methods. The results indicate that inclusion of textural feature with vegetation indices can be effectively implemented to produce classifiedmaps with 8.33% higher accuracy for Indian satellite IRS-P6, LISS IV sensor images.

  19. Quasi-lisse vertex algebras and modular linear differential equations

    CERN Document Server

    Arakawa, Tomoyuki

    2016-01-01

    We introduce a notion of quasi-lisse vertex algebras, which generalizes admissible affine vertex algebras. We show that the normalized character of an ordinary module over a quasi-lisse vertex operator algebra has a modular invariance property, in the sense that it satisfies a modular linear differential equation. As an application we obtain the explicit character formulas of simple affine vertex algebras associated with the Deligne exceptional series at level $-h^{\\vee}/6-1$, which expresses the homogeneous Schur limit of the superconformal index of 4d SCFTs studied by Beem, Lemos, Liendo, Peelaers, Rastelli and van Rees, as quasi-modular forms.

  20. Biomechanical evaluation of fracture fixation constructs using a variable-angle locked periprosthetic femur plate system.

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    Hoffmann, Martin F; Burgers, Travis A; Mason, James J; Williams, Bart O; Sietsema, Debra L; Jones, Clifford B

    2014-07-01

    In the United States there are more than 230,000 total hip replacements annually, and periprosthetic femoral fractures occur in 0.1-4.5% of those patients. The majority of these fractures occur at the tip of the stem (Vancouver type B1). The purpose of this study was to compare the biomechanically stability and strength of three fixation constructs and identify the most desirable construct. Fifteen medium adult synthetic femurs were implanted with a hip prosthesis and were osteotomized in an oblique plane at the level of the implant tip to simulate a Vancouver type B1 periprosthetic fracture. Fractures were fixed with a non-contact bridging periprosthetic proximal femur plate (Zimmer Inc., Warsaw, IN). Three proximal fixation methods were used: Group 1, bicortical screws; Group 2, unicortical screws and one cerclage cable; and Group 3, three cerclage cables. Distally, all groups had bicortical screws. Biomechanical testing was performed using an axial-torsional testing machine in three different loading modalities (axial compression, lateral bending, and torsional/sagittal bending), next in axial cyclic loading to 10,000 cycles, again in the three loading modalities, and finally to failure in torsional/sagittal bending. Group 1 had significantly greater load to failure and was significantly stiffer in torsional/sagittal bending than Groups 2 and 3. After cyclic loading, Group 2 had significantly greater axial stiffness than Groups 1 and 3. There was no difference between the three groups in lateral bending stiffness. The average energy absorbed during cyclic loading was significantly lower in Group 2 than in Groups 1 and 3. Bicortical screw placement achieved the highest load to failure and the highest torsional/sagittal bending stiffness. Additional unicortical screws improved axial stiffness when using cable fixation. Lateral bending was not influenced by differences in proximal fixation. To treat periprosthetic fractures, bicortical screw placement should be

  1. Topographic data bases in the product generation of IRS_P6 Liss-4 imagery

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    Jyothi, M. V.; Radhadevi, P. V.; Solanki, S. S.

    A continuous and autonomous co-registration and geo-location of image data from multiple sensors with widely varying view angles and resolution is one of the unique challenges of IRS-P6 data processing. The Liss-4 camera is capable of imaging in either multi-spectral or panchromatic modes with steerability up to +/- 27°. As the satellite sweeps longer strips with oblique viewing configuration, data product generation requires an elevation database to accommodate the errors due to terrain topography. SRTM, GTOPO30, DCW etc. are becoming hidden information to product generation schemes. In this paper, we analyze and justify the requirement of inclusion of a global DEM in the product generation system for Liss-4 data. In the first part of the study, after a brief introduction of sensor model, comparison of elevation from SRTM and GTOPO30 is made which leads towards a conclusion that GTOPO30 is adequate for improving the accuracy. The second part deals with the impact of GTOPO30 on geometric accuracy. Thirdly we analyze the terrain effects on band-to-band registration of Liss-4 multispectral data. A perfect band-to-band registration cannot be achieved without inclusion of digital elevation model. Many Liss_4 data sets with different tilts that cover terrain patches with flat, rolling and highly undulating nature are studied and the results reported.

  2. Rain-induced subsurface airflow and Lisse effect

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    Guo, H.; Jiao, J.J.; Weeks, E.P.

    2008-01-01

    Water-level increase after rainfall is usually indicative of rainfall recharge to groundwater. This, however, may not be true if the Lisse effect occurs. This effect represents the water-level increase in a well driven by airflow induced by an advancing wetting front during highly intensive rains. The rainwater, which may behave like a low-permeability lid, seals the ground surface so that the air pressure beneath the wetting front is increased because of air compression due to downward movement of the wetting front. A rapid and substantial rise of the water level in the well screened below water table, which bears no relationship to groundwater recharge, can be induced when various factors such as soil properties and the rain-runoff condition combine favorably. A transient, three-dimensional and variably saturated flow model was employed to study the air and groundwater flows in the soil under rain conditions. The objectives of this paper are two-fold: to evaluate the reliability of the theory of the Lisse effect presented by Weeks to predict its magnitude in modeled situations that mimic the physical complexity of real aquifers, and to conduct parametric studies on the sensitivity of the water-level rise in the well to soil properties and the rain event. The simulation results reveal that the magnitude of the Lisse effect increases with the ponding depth. Soil permeability plays a key role in generating the Lisse effect. The water-level rise in the well is delayed relative to the air-pressure rise in the unsaturated zone when the soil permeability is low, and the maximum water-level rise is less than the maximum air pressure induced by rain infiltration. The simulation also explores the sensitivity of the Lisse effect to the van Genuchten parameters and the water table depth. Copyright 2008 by the American Geophysical Union.

  3. The effect of C1-esterase inhibitor on systemic inflammation in trauma patients with a femur fracture - The CAESAR study: study protocol for a randomized controlled trial

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    Strengers Paul FW

    2011-10-01

    Full Text Available Abstract Background Systemic inflammation in response to a femur fracture and the additional fixation is associated with inflammatory complications, such as acute respiratory distress syndrome and multiple organ dysfunction syndrome. The injury itself, but also the additional procedure of femoral fixation induces a release of pro-inflammatory cytokines such as interleukin-6. This results in an aggravation of the initial systemic inflammatory response, and can cause an increased risk for the development of inflammatory complications. Recent studies have shown that administration of the serum protein C1-esterase inhibitor can significantly reduce the release of circulating pro-inflammatory cytokines in response to acute systemic inflammation. Objective Attenuation of the surgery-induced additional systemic inflammatory response by perioperative treatment with C1-esterase inhibitor of trauma patients with a femur fracture. Methods The study is designed as a double-blind randomized placebo-controlled trial. Trauma patients with a femur fracture, Injury Severity Score ≥ 18 and age 18-80 years are included after obtaining informed consent. They are randomized for administration of 200 U/kg C1-esterase inhibitor intravenously or placebo (saline 0.9% just before the start of the procedure of femoral fixation. The primary endpoint of the study is Δ interleukin-6, measured at t = 0, just before start of the femur fixation surgery and administration of C1-esterase inhibitor, and t = 6, 6 hours after administration of C1-esterase inhibitor and the femur fixation. Conclusion This study intents to identify C1-esterase inhibitor as a safe and potent anti-inflammatory agent, that is capable of suppressing systemic inflammation in trauma patients. This might facilitate early total care procedures by lowering the risk of inflammation in response to the surgical intervention. This could result in increased functional outcomes and reduced health care related

  4. Outcome analysis of retrograde nailing and less invasive stabilization system in distal femoral fractures: A retrospective analysis

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    Christian Hierholzer

    2011-01-01

    Full Text Available Background: Two major therapeutic principles can be employed for the treatment of distal femoral fractures: retrograde intramedullary (IM nailing (RN or less invasive stabilization on system (LISS. Both operative stabilizing systems follow the principle of biological osteosynthesis. IM nailing protects the soft-tissue envelope due to its minimally invasive approach and closed reduction techniques better than distal femoral locked plating. The purpose of this study was to evaluate and compare outcome of distal femur fracture stabilization using RN or LISS techniques. Materials and Methods: In a retrospective study from 2003 to 2008, we analyzed 115 patients with distal femur fracture who had been treated by retrograde IM nailing (59 patients or LISS plating (56 patients. In the two cohort groups, mean age was 54 years (17-89 years. Mechanism of injury was high energy impact in 57% (53% RN, 67% LISS and low-energy injury in 43% (47% RN, 33% LISS, respectively. Fractures were classified according to AO classification: there were 52 type A fractures (RN 31, LISS 21 and 63 type C fractures (RN 28, LISS 35; 32% (RN and 56% (LISS were open and 68% (RN and 44% (LISS were closed fractures, respectively. Functional and radiological outcome was assessed. Results: Clinical and radiographic evaluation demonstrated osseous healing within 6 months following RN and following LISS plating in over 90% of patients. However, no statistically significant differences were found for the parameters time to osseous healing, rate of nonunion, and postoperative complications. The following complications were treated: hematoma formation (one patient RN and three patients LISS, superficial infection (one patient RN and three patients LISS, deep infection (2 patients LISS. Additional secondary bone grafting for successful healing 3 months after the primary operation was required in four patients in the RN (7% of patients and six in the LISS group (10% of patients

  5. Comparative biomechanical study of reversed less invasive stabilization system and proximal femoral nail antirotation for unstable intertrochanteric fractures

    Institute of Scientific and Technical Information of China (English)

    Chen Ying; Liu Shouyao; Lin Peng; Wang Yunting; Wang Jinhui; Tao Jianfeng; Cai Rongrong

    2014-01-01

    Objective Unstable intertrochanteric fractures (ITFs) are mostly treated by proximal femoral nail antirotation (PFNA),Inter-Tan,Asian Hip,and other new internal fixation devices.But for complex unstable fractures,such as crushed lateral wall of the greater trochanter,the loss of fixation point on lateral wall slightly reduces the fixing effect.This study aimed to compare the biomechanical strengths between reversed less invasive stabilization system (LISS) and PFNA for treatment of unstable ITFs.Methods Forty synthetic femurs were used to simulate unstable ITFs in vitro and were fixed using the reversed LISS or PFNA.These fractures were divided into two groups depending on whether the lateral wall of the greater trochanter is intact or not (AO classification:31-A2.3 and 31-A3.3,respectively).The load-displacement of femur,stiffness,ultimate load,and cyclic fatigue resistance were detected using an incremental load test and a dynamic fatigue test through an MTS 858 test system.Results For both 31-A2.3 and 31-A3.3,the vertical sinking displacement (VSD) of the femoral head under 500 N load was insignificantly smaller after treatment with reversed LISS than with PFNA,and when the displacement was 5 mm,the femoral head bore insignificantly greater load.The fixation with reversed LISS resulted in greater axial stiffness of the femur but smaller ultimate load.During the same cycle in the dynamic fatigue test,the VSD was insignificantly smaller with the fixation of reversed LISS.Conclusion Reversed LISS and PFNA have similar biomechanical strength for unstable ITFs.This conclusion should be supported by additional large-size research on basic biomechanics and clinical application.This is the first comparative biomechanical study comparing reversed LISS and PFNA for unstable ITFs.

  6. Development and design of a line imaging spectrometer sampler (LISS) - A user manual

    DEFF Research Database (Denmark)

    Jørgensen, R.N.; Rasmussen, P.

    2002-01-01

    The objective of this report is to develop and describe the software for a Line Imaging Spectrometer Sampler (LISS) to perform measurements of spectra combined with a digital RGB photo of a measurant. Secondly this report should enable users to performmeasurements with the system. The measuring...... are developed as a Graphical User Interfaced (GUI) hosted by Matlab Release 12 from Mathworks. This GUI enables the operator to perform measurements from alldevices simultaneously together with notes specific for the measurant and store all the data in one Matlab data structure. The software includes dynamic...... devices consist of 2 16-bit cooled SBIG ST-6 CCD cameras each equipped with an Imspector imaging spectrograph for measuring reflectance in the visual and the near infrared range, respectively, a digital cameraand a differential global positioning device (dGPS). The controlling and data collecting tasks...

  7. Inter sensor comparison between RESOURCESAT LISS III, LISS IV and AWiFS with reference to coastal landuse/landcover studies

    Science.gov (United States)

    Chauhan, H. B.; Dwivedi, R. M.

    2008-06-01

    Coastal zone assumes importance due to high productivity of ecosystems, man-made developmental activities, natural hazards and dynamic nature of the coast. As costal ecosystems are unique and fragile, understanding the impact of developmental activities on the sustainability of the coastal zone is very important. Remote sensing, because of repetitive and synoptic nature is an ideal tool for studying this. Time series data analyses for monitoring coastal zone require different type of sensors. Present study deals with atmospheric correction of satellite data, reflectance, selection of coastal features like, mudflat, mangroves, vegetated dune, coastal water, etc. and their inter-comparison using different sensor data of RESOURCESAT sensors. Reflectance values give better separateability for various coastal features in comparison to DN values. LISS IV can be used in place of LISS III or merged (LISS III + PAN) for long-term coastal zone studies.

  8. Ex vivo torsional properties of a 2.5 mm veterinary interlocking nail system in canine femurs. Comparison with a 2.4 mm limited contact bone plate.

    Science.gov (United States)

    Macedo, Aline S; Moens, Noel M M; Runciman, John; Gibson, Tom W G; Minto, Bruno W

    2017-03-20

    To evaluate the torsional properties of the Targon(®) Vet Nail System (TVS) in small canine femurs and to compare these properties to those of the 2.4 mm LC-DCP(®) plates. Thirty-six cadaveric femurs were allocated to three groups (n = 12). In all bones, points just distal to the lesser trochanter and just proximal to the fabellae were marked and a midshaft transverse osteotomy was performed. Group 1: bones were fixed with the 2.5 mm TVS with the bolts applied at the pre-identified marks. Group 2: A TVS system with 25% shorter inter-bolt distance was used. Group 3: A 7-hole 2.4 mm LC-DCP(®) plates were applied. All constructs were tested non-destructively for 10 cycles, followed by an acute torsion to failure. Torque at yield was 0.806 ± 0.183 and 0.805 ± 0.093 Nm for groups 1 and 2 and 1.737 ± 0.461 Nm for group 3. Stiffness was 0.05 ± 0.01, 0.05 ± 0.007, and 0.14 ± 0.015 Nm/° for groups 1 to 3 respectively. Maximal angular displacement under cyclic loading was 16.6° ± 2.5°, 15.6° ± 2.1°, and 7.8° ± 1.06° respectively. There was no significant difference for any of the parameters between groups 1 and 2. Both torque at yield and stiffness were significantly greater between group 3 and groups 1 and 2. The TVS had approximately half the torsional strength and approximately 1/3 of the stiffness of the 2.4 mm bone plate. Slippage of the locking mechanism was probably the cause of the early failure. The system should be considered as a low-strength and low-stiffness system when compared to bone plates.

  9. Automated Registration of Images from Multiple Bands of Resourcesat-2 Liss-4 camera

    OpenAIRE

    2014-01-01

    Continuous and automated co-registration and geo-tagging of images from multiple bands of Liss-4 camera is one of the interesting challenges of Resourcesat-2 data processing. Three arrays of the Liss-4 camera are physically separated in the focal plane in alongtrack direction. Thus, same line on the ground will be imaged by extreme bands with a time interval of as much as 2.1 seconds. During this time, the satellite would have covered a distance of about 14 km on the ground and the e...

  10. Comparison of FLAASH and QUAC atmospheric correction methods for Resourcesat-2 LISS-IV data

    Science.gov (United States)

    Saini, V.; Tiwari, R. K.; Gupta, R. P.

    2016-05-01

    The LISS-IV sensor aboard Resourcesat-2 is a modern relatively high resolution multispectral sensor having immense potential for generation of good quality land use land cover maps. It generates data in high (10-bit) radiometric resolution and 5.8 m spatial resolution and has three bands in the visible-near infrared region. This is of particular importance to global community as the data are provided at highly competitive prices. However, no literature describing the atmospheric correction of Resourcesat-2-LISS-IV data could be found. Further, without atmospheric correction full radiometric potential of any remote sensing data remains underutilized. The FLAASH and QUAC module of ENVI software are highly used by researchers for atmospheric correction of popular remote sensing data such as Landsat, SPOT, IKONOS, LISS-I, III etc. This article outlines a methodology for atmospheric correction of Resourcesat-2-LISS-IV data. Also, a comparison of reflectance from different atmospheric correction modules (FLAASH and QUAC) with TOA and standard data has been made to determine the best suitable method for reflectance estimation for this sensor.

  11. Field testing the Unified Classification System for periprosthetic fractures of the femur, tibia and patella in association with knee replacement: an international collaboration.

    Science.gov (United States)

    Van der Merwe, J M; Haddad, F S; Duncan, C P

    2014-12-01

    The Unified Classification System (UCS) was introduced because of a growing need to have a standardised universal classification system of periprosthetic fractures. It combines and simplifies many existing classification systems, and can be applied to any fracture around any partial or total joint replacement occurring during or after operation. Our goal was to assess the inter- and intra-observer reliability of the UCS in association with knee replacement when classifying fractures affecting one or more of the femur, tibia or patella. We used an international panel of ten orthopaedic surgeons with subspecialty fellowship training and expertise in adult hip and knee reconstruction ('experts') and ten residents of orthopaedic surgery in the last two years of training ('pre-experts'). They each received 15 radiographs for evaluation. After six weeks they evaluated the same radiographs again but in a different order. The reliability was assessed using the Kappa and weighted Kappa values. The Kappa values for inter-observer reliability for the experts and the pre-experts were 0.741 (95% confidence interval (CI) 0.707 to 0.774) and 0.765 (95% CI 0.733 to 0.797), respectively. The weighted Kappa values for intra-observer reliability for the experts and pre-experts were 0.898 (95% CI 0.846 to 0.950) and 0.878 (95% CI 0.815 to 0.942) respectively. The UCS has substantial inter-observer reliability and 'near perfect' intra-observer reliability when used for periprosthetic fractures in association with knee replacement in the hands of experienced and inexperienced users.

  12. [Proximal and total femur replacement].

    Science.gov (United States)

    Pennekamp, P H; Wirtz, D C; Dürr, H R

    2012-07-01

    Reconstruction of segmental bone defects of the proximal femur following wide tumor resection or revision arthroplasty. Aggressive benign or primary malignant bone tumors of the proximal femur; destructive metastases; massive segmental bone defects of the proximal femur; periprosthetic fractures. Local infection; very short life expectancy (acetabular bone stock. Anterolateral approach. Exposure and detachment of the iliopsoas and gluteus medius muscle from the proximal femur with a sufficient safety margin to the bone; distal transsection of the vastus lateralis/intermedius and rectus femoris muscle according to the extraosseous tumor extension; distal femur osteotomy al least 3 cm beyond the farthest point of tumor extension; in case of total femur replacement, additional lateral arthrotomy of the knee with resection of the ligaments and menisci; reaming of the medullary canal after securing the shaft with a Verbrugge clamp; trial assembly and reduction followed by the definitive implantation of the prosthesis with adjustment of the femoral neck anteversion in 5° increments; soft tissue reconstruction and fixation to an attachment tube covering the prosthesis; in case of total femur replacement, the preparation of the tibia is followed by the coupling of the tibial and femoral components. Infection prophylaxis, 20 kg partial weight bearing, continuous passive motion. A total of 20  patients with proximal femur replacement and 2 patients with total femur replacement implanted between June 2007 and December 2011 were retrospectively reviewed. Three patients had primary malignant bone tumors, while 19 patients underwent resection for metastatic disease. The mean age at surgery was 62.0 ± 18.1 years (18-82 years). Fifteen patients with a mean follow-up of 20.3 ± 17.2 months (4-51 months) were studied. Among the 22 cases, periprosthetic infection occurred in 3 patients (13.6%), dislocation in 2 patients (9.1%). Evaluation of the functional

  13. X-Ray Exam: Femur (Upper Leg)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Femur (Upper Leg) KidsHealth > For Parents > X-Ray Exam: Femur (Upper Leg) A A A ... español Radiografía: fémur What It Is A femur X-ray is a safe and painless test that ...

  14. Compression or tension? The stress distribution in the proximal femur

    Directory of Open Access Journals (Sweden)

    Meakin JR

    2006-02-01

    Full Text Available Abstract Background Questions regarding the distribution of stress in the proximal human femur have never been adequately resolved. Traditionally, by considering the femur in isolation, it has been believed that the effect of body weight on the projecting neck and head places the superior aspect of the neck in tension. A minority view has proposed that this region is in compression because of muscular forces pulling the femur into the pelvis. Little has been done to study stress distributions in the proximal femur. We hypothesise that under physiological loading the majority of the proximal femur is in compression and that the internal trabecular structure functions as an arch, transferring compressive stresses to the femoral shaft. Methods To demonstrate the principle, we have developed a 2D finite element model of the femur in which body weight, a representation of the pelvis, and ligamentous forces were included. The regions of higher trabecular bone density in the proximal femur (the principal trabecular systems were assigned a higher modulus than the surrounding trabecular bone. Two-legged and one-legged stances, the latter including an abductor force, were investigated. Results The inclusion of ligamentous forces in two-legged stance generated compressive stresses in the proximal femur. The increased modulus in areas of greater structural density focuses the stresses through the arch-like internal structure. Including an abductor muscle force in simulated one-legged stance also produced compression, but with a different distribution. Conclusion This 2D model shows, in principle, that including ligamentous and muscular forces has the effect of generating compressive stresses across most of the proximal femur. The arch-like trabecular structure transmits the compressive loads to the shaft. The greater strength of bone in compression than in tension is then used to advantage. These results support the hypothesis presented. If correct, a

  15. Subtrochanteric femur fracture treated by intramedullary fixation

    Institute of Scientific and Technical Information of China (English)

    Zu-Bin Zhou; Song Chen; You-Shui Gao; Yu-Qiang Sun; Chang-Qing Zhang; Yao Jiang

    2015-01-01

    Purpose: To discuss surgical technique, operative efficacy and clinical outcome of intramedullary fixation in the treatment of subtrochanteric femur fractures.Methods: From February 2011 to February 2013, 76 cases of subtrochanteric femur fractures were treated by intramedullary fixation in our hospital, including 53 males and 23 females, with the age range of 37 -72 years (mean 53.5 years).According to Seinsheimer classification, there were 2 cases of type Ⅰ, 7 type Ⅱ,15 type Ⅲ, 23 type Ⅳ and 29 type Ⅴ.Firstly, all patients underwent closed reduction with the guidance of C-arm fluoroscopy in a traction table.Two cases of type Ⅰ and 3 cases of type Ⅲ fractures had ideal closed reduction followed by internal fixation.The others needed additional limited open reduction.Radiographic examination was used to evaluate callus formation and fracture healing in postoperative 1, 3, 6 and 12 months follow-up.Functional recovery was evaluated by Harris Hip Scoring (HHS) system.Results: Patients were followed up for 6-12 months.All fractures were healed except one patient with delayed union.The average bone union time was 4.5 months.According to HHS system, 65 cases were considered as excellent in functional recovery, 8 good, 2 fair and 1 poor.The proportion of the patients with excellent and good recovery was 96.05%.Conclusion: Intramedullary fixation is feasible for the treatment of subtrochanteric femur fracture.The accuracy of intraoperative reduction and surgical skill are important for the clinical outcome and the patients' prognosis.

  16. Stressfraktur efter epifysiodese i femur

    DEFF Research Database (Denmark)

    Al-Aubaidi, Zaid; Engell, Vilhelm; Lundgaard, Bjarne

    2010-01-01

    Growth guiding is currently widely practiced for deformity correction in the growing child. Different methods have been developed. In 2007 Stevens described a tension band device (8-plates) as a simple growth control method. Since then it has been widely used, e.g. in hemiepiphysiodesis to correc...... described. We present a case with a fracture in the distal femur through 8-plates screw holes....

  17. Subperiosteal hemangioendothelioma of the femur

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Ajay [Royal National Orthopaedic Hospital NHS Trust, Departments of Orthopaedic Oncology, Stanmore, Middlesex (United Kingdom); Saifuddin, Asif [Royal National Orthopaedic Hospital NHS Trust, Departments of Radiology, Stanmore, Middlesex (United Kingdom); London Bone and Soft Tissue Tumour Service, London (United Kingdom); University College London, Institute of Orthopaedics and Musculoskeletal Sciences, London (United Kingdom); Briggs, Tim W.R. [Royal National Orthopaedic Hospital NHS Trust, Departments of Orthopaedic Oncology, Stanmore, Middlesex (United Kingdom); London Bone and Soft Tissue Tumour Service, London (United Kingdom); University College London, Institute of Orthopaedics and Musculoskeletal Sciences, London (United Kingdom); Flanagan, Adrienne M. [Royal National Orthopaedic Hospital NHS Trust, Departments of Histopathology, Stanmore, Middlesex (United Kingdom); London Bone and Soft Tissue Tumour Service, London (United Kingdom); University College London, Institute of Orthopaedics and Musculoskeletal Sciences, London (United Kingdom)

    2006-10-15

    Primary neoplastic vascular lesions of bone are rare, and include haemangiomas, haemangioendothelioma, epithelioid haemangioendothelioma and angiosarcoma. These lesions may be multicentric, and when they involve bone are typically intraosseous and lytic. Radiological findings are not always specific. We report a case of haemangioendothelioma localised to the subperiosteum of the femur, a site not previously described for this lesion. The nomenclature for vascular neoplasms in bone is discussed. (orig.)

  18. [Giant chondroblastoma of the femur].

    Science.gov (United States)

    Zaspa, O A

    2014-01-01

    Chondroblastoma is a benign cartilaginous bone tumor. The large dimension and aggressive local spread of the tumor may create a diagnostic problem. A 24 x 17 x 15-cm chondroblastoma is described in a 50 year-old woman. The tumor of typical structure was located in the upper femur, growing into soft tissues and pelvic bones. Thirteen months following interilioabdominal exarticulation, the patient was found to have neither local recurrence nor distant metastases.

  19. Far cortical locking screws in distal femur fractures.

    Science.gov (United States)

    Adams, John D; Tanner, Stephanie L; Jeray, Kyle J

    2015-03-01

    Distal femur fractures routinely heal by secondary bone healing, which relies on interfragmentary motion. Periarticular locking plates are commonly used for fixation in distal femur fractures but are associated with a high nonunion rate, likely due to the stiffness of the constructs. Far cortical locking (FCL) screws are designed to allow micromotion at the near cortex while maintaining purchase in only the far cortex. Although clinical data are limited, these screws have been shown in biomechanical studies to provide excellent interfragmentary motion, and animal models have shown increased callus formation compared with traditional locking screws. The purpose of this study was to examine the clinical effects that FCL screws have on healing in distal femur fractures treated with locked constructs. In this retrospective case series, 15 patients with a distal femur fracture treated with MotionLoc screws (Zimmer, Warsaw, Indiana) were analyzed. Serial radiographs were evaluated for callus presence and time to union. All fractures were either 33-A3 or 33-C2 according to the AO classification system, and 5 (33%) were open. Bone loss was recorded in 2 patients. There were no nonunions, and average time to union was 24 weeks. There were no implant failures, and all 5 open fractures, including the 2 with bone loss, healed without intervention. There was 1 reoperation due to painful hardware. Although this is a small case series, these results are promising. Far cortical locking screws may provide the answer to the high nonunion rate associated with distal femur fractures treated with traditional locked constructs.

  20. Trabecular architecture analysis in femur radiographic images using fractals.

    Science.gov (United States)

    Udhayakumar, G; Sujatha, C M; Ramakrishnan, S

    2013-04-01

    Trabecular bone is a highly complex anisotropic material that exhibits varying magnitudes of strength in compression and tension. Analysis of the trabecular architectural alteration that manifest as loss of trabecular plates and connection has been shown to yield better estimation of bone strength. In this work, an attempt has been made toward the development of an automated system for investigation of trabecular femur bone architecture using fractal analysis. Conventional radiographic femur bone images recorded using standard protocols are used in this study. The compressive and tensile regions in the images are delineated using preprocessing procedures. The delineated images are analyzed using Higuchi's fractal method to quantify pattern heterogeneity and anisotropy of trabecular bone structure. The results show that the extracted fractal features are distinct for compressive and tensile regions of normal and abnormal human femur bone. As the strength of the bone depends on architectural variation in addition to bone mass, this study seems to be clinically useful.

  1. Modular endoprosthetic replacement for metastatic tumours of the proximal femur

    Directory of Open Access Journals (Sweden)

    Carter Simon R

    2008-11-01

    Full Text Available Abstract Background and aims Endoprosthetic replacements of the proximal femur are commonly required to treat destructive metastases with either impending or actual pathological fractures at this site. Modular prostheses provide an off the shelf availability and can be adapted to most reconstructive situations for proximal femoral replacements. The aim of this study was to assess the clinical and functional outcomes following modular tumour prosthesis reconstruction of the proximal femur in 100 consecutive patients with metastatic tumours and to compare them with the published results of patients with modular and custom made endoprosthetic replacements. Methods 100 consecutive patients who underwent modular tumour prosthetic reconstruction of the proximal femur for metastases using the METS system from 2001 to 2007 were studied. The patient, tumour and treatment factors in relation to overall survival, local control, implant survival and complications were analysed. Functional scores were obtained from surviving patients. Results and conclusion There were 45 male and 55 female patients. The mean age was 60.2 years. The indications were metastases. Seventy five patients presented with pathological fracture or with failed fixation and 25 patients were at a high risk of developing a fracture. The mean follow up was 15.9 months [range 0–77]. Three patients died within 2 weeks following surgery. 69 patients have died and 31 are alive. Of the 69 patients who were dead 68 did not need revision surgery indicating that the implant provided single definitive treatment which outlived the patient. There were three dislocations (2/5 with THR and 1/95 with unipolar femoral heads. 6 patients had deep infections. The estimated five year implant survival (Kaplan-Meier analysis was 83.1% with revision as end point. The mean TESS score was 64% (54%–82%. We conclude that METS modular tumour prosthesis for proximal femur provides versatility; low implant related

  2. Bisphosphonate-associated atypical subtrochanteric femur fracture.

    Science.gov (United States)

    Wolin, Ely A; Banks, Kevin P; Vroman, Penny J

    2015-03-01

    Bisphosphonates help prevent progressive bone mineralization loss and subsequent osteoporotic fractures. However, long-term bisphosphonate therapy paradoxically increases the risk of a unique injury called an atypical subtrochanteric femur fracture. Despite this, the benefits of bisphosphonates outweigh the risks, because far more pathologic fractures are prevented than induced. The early identification of atypical subtrochanteric femur fractures is important as there is high associated morbidity and mortality. We describe a case of a 76-y-old woman with a completed bisphosphonate-associated atypical subtrochanteric femur fracture.

  3. Intraoperative Periprosthetic Femur Fracture: A Biomechanical Analysis of Cerclage Fixation.

    Science.gov (United States)

    Frisch, Nicholas B; Charters, Michael A; Sikora-Klak, Jakub; Banglmaier, Richard F; Oravec, Daniel J; Silverton, Craig D

    2015-08-01

    Intraoperative periprosthetic femur fracture is a known complication of total hip arthroplasty (THA) and a variety of cerclage systems are available to manage these fractures. The purpose of this study was to examine the in situ biomechanical response of cerclage systems for fixation of periprosthetic femur fractures that occur during cementless THA. We compared cobalt chrome (CoCr) cables, synthetic cables, monofilament wires and hose clamps under axial compressive and torsional loading. Metallic constructs with a positive locking system performed the best, supporting the highest loads with minimal implant subsidence (both axial and angular) after loading. Overall, the CoCr cable and hose clamp had the highest construct stiffness and least reduction in stiffness with increased loading. They were not demonstrably different from each other. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Three-Dimensional Analysis of the Curvature of the Femoral Canal in 426 Chinese Femurs

    Directory of Open Access Journals (Sweden)

    Xiu-Yun Su

    2015-01-01

    Full Text Available Purpose. The human femur has long been considered to have an anatomical anterior curvature in the sagittal plane. We established a new method to evaluate the femoral curvature in three-dimensional (3D space and reveal its influencing factors in Chinese population. Methods. 3D models of 426 femurs and the medullary canal were constructed using Mimics software. We standardized the positions of all femurs using 3ds Max software. After measuring the anatomical parameters, including the radius of femoral curvature (RFC and banking angle, of the femurs using the established femur-specific coordinate system, we analyzed and determined the relationships between the anatomical parameters of the femur and the general characteristics of the population. Results. Pearson’s correlation analyses showed that there were positive correlations between the RFC and height (r=0.339, p<0.001 and the femoral length and RFC (r=0.369, p<0.001 and a negative correlation between the femoral length and banking angle (r=-0.223, p<0.001. Stepwise linear regression analyses showed that the most relevant factors for the RFC and banking angle were the femoral length and gender, respectively. Conclusions. This study concluded that the banking angle of the femur was significantly larger in female than in male.

  5. Early results of reverse less invasive stabilization system plating in treating elderly intertrochanteric fractures: a prospective study compared to proximal femoral nail

    Institute of Scientific and Technical Information of China (English)

    YAO Chen; ZHANG Chang-qing; JIN Dong-xu; CHEN Yun-feng

    2011-01-01

    Background Intertrochanteric femur fracture is common in elderly population. Though multiple treatment options are available, the choice of implant remains controversial. The reverse less invasive stabilization system (LISS) plating was introduced for treatment of a patient with ipsilateral intertrochanteric and midshaft femoral fractures. The aim of this research was to compare such technique to intramedullary nailing (proximal femoral nail, PFN) for intertrochanteric fractures.Methods Fifty-six patients with an age of at least sixty-five years and an AO/OTA type-A1 or A2 fractures were included and divided into LISS and PFN treatment group. Background parameters, fracture and surgery details were documented. Follow-up time was at least 12 months. Radiology, complication, Harris Hip Score and Rapid Disability Rating Score (RDRS) were recorded to evaluate fixation status and hip function for each patient during follow-up.Results There was no significant difference between the two groups in surgical time ((48.0±8.6) minutes, vs.(51.8±10.8) minutes, P=0.3836) and intraoperative blood loss ((149.1±45.1) ml vs. (176.4±25.4) ml, P=0.0712). The LISS group had less postoperative haemoglobin (Hb) reduction ((10.2±4.5) g/L Hb, vs. (15.1~5.9) g/L Hb, P=0.0475). There was no complication observed in PFN group. All 31A1 type fracture in LISS group showed 100% maintenance of reduction. One nonunion with locking screw breakage and 2 varus union were found in the LISS group. Postoperative hip function was similar between the two groups.Conclusions Though reverse LISS plating may not be recommended as a routine fixation method for elderly unstable intertrochanteric fractures compared to PFN, it may possibly be reserved for rapid fixation and damage control in polytrauma patients and ORIF of subtrochanteric and reverse oblique intertrochanteric fractures.

  6. Targeted regeneration of bone in the osteoporotic human femur.

    Directory of Open Access Journals (Sweden)

    Kenneth E S Poole

    Full Text Available We have recently developed image processing techniques for measuring the cortical thicknesses of skeletal structures in vivo, with resolution surpassing that of the underlying computed tomography system. The resulting thickness maps can be analysed across cohorts by statistical parametric mapping. Applying these methods to the proximal femurs of osteoporotic women, we discover targeted and apparently synergistic effects of pharmaceutical osteoporosis therapy and habitual mechanical load in enhancing bone thickness.

  7. Osteometric study of human femur

    Directory of Open Access Journals (Sweden)

    Khaleel N.

    2014-02-01

    Full Text Available Skeleton is playing important role in various like Medicine, Forensic sciences, Anthropology etc. Estimation of sex, age, race, stature by skeleton and the presence of disease is discovered by Krogman and Iscan (1986. Sex is determined after death by skeletal remains of that individual by some forensic anthropologists with the help of pelvis, skull and long bones. The study was undertaken in 50 femurs for measuring epicondylar breadth, Neck shaft angle, transverse and vertical diameter of head. The results were the average meanepicondylar breadth was 75.6 ± 6.06mm, mean right epicondylar breadth was 73.96 ± 4.99mm and left it was 76.35 ± 7.0mm. The average mean neck shaft angle was 125.3 ± 6.50mm, mean right neck shaft angle was 124.44 ± 5.7mm and left it was 126.3 ± 7.33mm. The average mean transverse diameter of head was 37.86 ± 3.06mm, mean right transverse diameter of head was 37.74 ± 3.05mm and left it was 38.00 ± 3.13mm. The average mean vertical diameter of head was 42.24 ± 3.53mm, mean right vertical diameter of head was 41.63 ± 3.09mm and left it was 42.96 ± 3.92mm, Neck shaft angle ranges from a minimum of 106° to maximum 135° with a mean value of 125.3°. The knowledge of osteometric values is helpful to anthropological and forensic practice. [Int J Res Med Sci 2014; 2(1.000: 104-107

  8. LISS钢板治疗膝关节周围严重粉碎性骨折疗效观察%LISS plate for treatment of severe comminuted fractures around the knee Efficacy

    Institute of Scientific and Technical Information of China (English)

    张越民; 苏文

    2015-01-01

    Objective To investigate the AO Less Invasive Stabilization System (less invasive stabilization system, LISS) treatment of severe comminuted fractures around the knee and the efficacy of surgical indications. Method In March 2009-2012 years, in October applied around the LISS plate for treatment of severe comminuted fracture of the knee in 23 cases, including 13 cases of femoral fractures, tibial fractures in 10 cases. Combined patella fracture in 2 cases, with other parts of the fracture in 4 cases. According to AO/OTA classification, femur fractures , 33-A3 type 3 cases ,33-C2-type 6 cases ,33-C3 type 4 cases;tibial fractures ,41-A3 type 3 cases ,41-B2 type 4 cases, 41-C2-type 3 case. Use of indirect reduction surgery,Chong-dimensional incision, the periosteum and the muscles inserted between the outer steel plate,a small incision through the skin will take locking head screws with locking screw plate. Results All patients were followed up,with an average time of 15 months (12 to 24 months). Wound healed, and 1 case of delayed union of bone. HSS score:excellent in 17 cases, good in 3 cases, 2 case and poor in 1 case, good rate of 86.9%.Conclusion LISS plate for the treatment of severe comminuted around the knee with a minimally invasive,reliable fixation,postoperative recovery was quick and fast fracture healing advantages of the treatment of severe comminuted fractures around the knee the ideal fixation materials. Clear hand Surgery indications , strict control procedures and attention to the treatment of bone defects is the key to satisfactory effect.%目的:探讨AO微创内固定系统(less invasive stabilization system,LISS)治疗膝关节周围严重粉碎性骨折的手术适应证及其疗效。方法2009年3月—2012年10月应用LISS钢板治疗膝关节周围严重粉碎性骨折23例,其中股骨骨折13例,胫骨骨折10例。合并髌骨骨折2例,伴其他部位骨折4例。按AO/OTA分型,股骨骨折中,33-A3型3例,33-C2型6

  9. Initial stability comparison of modular hip implants in synthetic femurs.

    Science.gov (United States)

    Lee, T Q; Danto, M I; Kim, W C

    1998-08-01

    Synthetic femurs were used to assess the initial bone-implant interface stability of three total hip systems: Wright Medical Technology's Infinity smooth trochanteric module (S-TM), Infinity porous-coated trochanteric module (PC-TM), and Johnson and Johnson S-ROM with a porous surface. The hips were implanted into synthetic femurs, rigidly fixed, and subjected to internal rotation and cyclic, axial compressive loads. The results showed that all three implants achieved good initial implant stability and would be expected to permit bone ingrowth. The porous-coated implants showed greater initial implant stability with less axial micromotion compared with the smooth implants. This finding suggests that surface texture plays a role in initial stability of uncemented prostheses if the bone behaves similar to the material used in this study.

  10. Elastic Comparison Between Human and Bovine Femural Bone

    Directory of Open Access Journals (Sweden)

    Mohamed S. Gaith

    2012-12-01

    Full Text Available In this study, the elastic stiffness and the degree of anisotropy will be compared for the femur human and bovine bones are presented. A scale for measuring the overall elastic stiffness of the bone at different locations is introduced and its correlation with the calculated bulk modulus is analyzed. Based on constructing orthonormal tensor basis elements using the form-invariant expressions, the elastic stiffness for orthotropic system materials is decomposed into two parts; isotropic (two terms and anisotropic parts. The overall elastic stiffness is calculated and found to be directly proportional to bulk modulus. A scale quantitative comparison of the contribution of the anisotropy to the elastic stiffness and to measure the degree of anisotropy in an anisotropic material is proposed using the Norm Ratio Criteria (NRC. It is found that bovine femure plexiform has the largest overall elastic stiffness and bovine has the most isotropic (least anisotropic symmetry.

  11. Pediatric femur fractures, epidemiology and treatment

    Directory of Open Access Journals (Sweden)

    Petković Lazar

    2011-01-01

    Full Text Available Background/Aim. Femur fractures in children most often occur as a consequence of traffic accidents, during play and sport activities, and due to different pathological states. Diagnosis is rather simple and it includes physical and radiographycal examination. Femur fractures treatment in children can be operative and unoperative, depending on several facts: age, localisation and type of fracture, joint injuries of soft tissues, the presence of other injuries (in polytrauma, economical and social aspects, ect. The aim of this study was to present epidemiological characteristics of pediatric femur fractures, that is in the stage of development, including a special analysis of the used treatment techniques, as well as the comparison of the obtained data with those from the literature. Methods. The evaluation included following parameters: age, gender, cause, localisation and type of femur fracture, applied treatment and hospitalisation duration. Results. Among the presented 143 patients with femur fracture, 109 were boys and 34 were girls (3.2 : 1 ratio; p = 0.0001. Average age for both genders was 8.6 years, and no difference between boys and girls were found for the age (p = 0.758. In total, the most common fracture was diaphyseal fracture of femur in 93 (65.03% patients. The second was proximal fracture in 30 (20.98% patients, and the last distal fracture of the femur in 20 (13.99% patients (p = 0.0001. Three main causes of femur fracture can be distinguished: during play and sport activities in 67 (46.8% children, in traffic accidents in 64 (44.8% children, and pathological fractures in 12 (8.4% children. Inoperative treatment was applied in 82 (57.3% patients, and operative one in 61 (42.7% patients. The most common tretament was traction, in 71 (49.6% patients, followed by immobilization by hip spica cast mostly in young children. Intramedullar elastic nailing was applied in 16 (11.2% cases, and intramedullar rigid nailing (Küntscher in 19

  12. The Effect of Weight-Bearing Exercise on the Strength of Femur Bone in Ovariectomized Rats

    Directory of Open Access Journals (Sweden)

    GH Sharifi

    2011-08-01

    Full Text Available Introduction & Objective: Fractures due to osteoporosis after menopause in women is widespread. Osteoporosis may occur in case of inadequate lack of physical activity .The aim of this study was to determine the effect of running training on femur bone strength in ovariectomized rats. Materials & Methods Forty matured Sprague Dawley rats were chosen for this study. A group of 10 were killed randomly to measure their initial femur strength. The remaining rats had ovarian surgery. After three months, in order to reach menopause period, they were randomly divided into 3 groups, including pre test, running training and control groups. The running training program was carried out for one hour a day, five days a week, for eight weeks. Femur bone strength was measured by HOUNSFIELD system. Data was analyzed by using one-way analysis of variance and dependent T- tests by the SPSS software. Results: Results of this study showed that ovariectomy leads to significant decrease of femur bone strength. On the other hand the eight weeks running training lead to significant increase of femur bone strength. Conclusion: The results of this study suggest that life style is important factors in preventing of osteoporosis and running training program had an inhibitory or reversal effect on decrease of menopause-induced femur bone strength.

  13. [Surgical treatment of pathologic fractures of the humerus and femur].

    Science.gov (United States)

    Gruber, G; Zacherl, M; Leithner, A; Giessauf, C; Glehr, M; Clar, H; Windhager, R

    2009-04-01

    The life expectancy of patients with malignant tumours and the incidence of osseous metastases have increased over the last decades. Operations for skeletal metastases of the extremities represent the most frequent surgery in orthopaedic oncology. The purpose of this study was to evaluate and compare the different operative treatment options for patients with pathologic fractures of the humerus and femur in terms of complications, postoperative recovery, and survival.From 2000 to 2005, 109 patients were surgically treated for pathologic fractures of the humerus (n=19) or femur (n=90). The study group consisted of 60 women and 43 men, with a mean age of 67 years (13-88). Breast carcinoma (36%) was the most common primary tumour, followed by kidney (17%) and bronchial (16%) carcinoma. Of all patients, 75 (73%) had numerous skeletal metastases, and 38 (37%) had visceral metastases.Wide or marginal resection was performed in seven fractures of the humerus and 14 fractures of the femur; intralesional resection was done in seven humeral and 73 femoral fractures; and stabilisation alone was done in five fractures of the humerus and three fractures of the femur. The median survival time for all patients was 6 months (0-102). The survival rate at 1 year was 25% (25% for both humeral and femoral fractures), 15% at 2 years (17% for humeral and 15% for femoral fractures), and 8% at 3 years (16% for humeral and 7% for femoral fractures). The overall complication rate was 11%, and revision surgeries were performed in seven patients (6.4%). The majority of patients (n=65; 60%), especially those with fractures close to the articular joint, were successfully treated with endoprosthetic replacement. Patients with fractures stabilised by intramedullary nails had shorter operating times, a shorter hospital stay, and fewer complications than patients treated with plating systems. Therefore, we recommend intralesional resection of the metastasis and stabilisation with intramedullary

  14. Challenges in Subtrochanteric Femur Fracture Management.

    Science.gov (United States)

    Hak, David J; Wu, Haotian; Dou, Chenhao; Mauffrey, Cyril; Stahel, Philip F

    2015-08-01

    Subtrochanteric femur fractures present significant treatment challenges. The deforming muscle forces make fracture reduction difficult. Treatment options include cephalomedullary nailing and various types of plate fixation. There is a high rate of treatment complications, including malunion, delayed union, nonunion, and implant failure.

  15. ESTUDO COMPARATIVO ENTRE OS ÍNDICES NDVI OBTIDOS A PARTIR DOS SENSORES LANDSAT 5 - TM E RESOURCESAT - LISS III

    Directory of Open Access Journals (Sweden)

    Cesar Vinícius Mendes Nery

    2013-07-01

    Full Text Available A importância das imagens de sensoriamento remoto para o monitoramento da cobertura vegetal é algo inegável. Por mais de três décadas a série Landsat tem fornecido imagens da terra, porém a partir de novembro de 2011 o satélite interrompeu a disponibilização de suas imagens para o monitoramento ambiental. Uma das alternativas de imagens ao Landsat têm sido as imagens do sensor LISS III a bordo do satélite indiano Resourcesat 1. O presente trabalho tem como área de estudo o município de Janaúba, por estar em uma área de transição de dois biomas, e o mesmo tem por objetivo comparar os dois sensores, o sensor TM que se encontra a bordo do satélite Landsat 5 e o sensor LISS III a bordo do satélite Resourcesat 1. Para esse estudo comparativo as imagens foram adquiridas do site do Instituto Nacional de Pesquisas Espaciais (INPE e seus valores de níveis digitais (ND foram convertidos em reflectância com correção atmosférica utilizando o método de correção DOS. Amostras de pixels das imagens índice foram coletadas para o estudo de correlação e ajuste de uma equação linear por meio da técnica de regressão. Utilizando a equação ajustada foram gerados dois mapas temáticos de ambos os sensores, sendo os mesmos comparados pelo teste estatístico Kappa. Os resultados mostraram uma forte correlação entre os valores de NDVI (0,81, sendo possível o ajuste de uma equação linear que expresse a forma dessa relação. O sensor TM, superestimou os valores de NDVI em relação ao sensor LISS III (Inclinação de 1,1035. O valor de Kappa para os mapas temáticos obtidos foi de 0,5894 e o índice de acerto foi de 98,81%, o que mostra uma boa similaridade entre eles. O sensor LISS III pode ser perfeitamente utilizado como alternativa ao Landsat 5.

  16. Treatment of comminuted fractures at distal femur with AO less invasive stabilization systems%AO微创内固定系统在股骨远端粉碎性骨折的应用

    Institute of Scientific and Technical Information of China (English)

    张景福; 马殿忠; 颜晓东

    2007-01-01

    [目的]探讨应用AO微创内固定系统(Less invasive stabilization systems,LISS)治疗股骨远端粉碎性骨折的方法和临床疗效.[方法]回顾分析2003年5月~2006年3月对18例股骨远端粉碎性骨折患者进行修复重建,其中男13例,女5例;年龄:19~57岁.左侧10例,右侧8例;交通伤14例,高处坠落伤2例,摔倒跌伤2例;闭合性骨折15例,开放性骨折3例;新鲜性骨折17例,陈旧性骨折1例.骨折按照AO/OTA分类:A型关节外骨折5例,C型关节内骨折13例.术前X线片示股骨髁上、髁间粉碎性骨折.患者均应用AO微创内固定系统进行内固定,手术对骨缺损较大者进行一期植骨,术后对其伤口愈合、术前及术后X线检查及关节功能恢复情况进行了观察.[结果]患者均获随访6~25个月,平均12.8个月.术后14个月X线片显示骨折对位对线佳,骨折均愈合,愈合时间5~8个月.按照Kolmert和Wulff的评价标准:A型5例,优4例、良1例;C型13例:优11例、良1例、可1例.[结论]采用AO微创内固定系统治疗股骨远端粉碎性骨折,是一种有效的内固定方法,具有操作简便,创伤小,疗效肯定等优点.

  17. Three-dimensional quantitative analysis of the proximal femur and the pelvis in children and adolescents using an upright biplanar slot-scanning X-ray system

    Energy Technology Data Exchange (ETDEWEB)

    Szuper, Kinga; Schlegl, Adam Tibor; Vermes, Csaba; Somoskeoey, Szabolcs; Than, Peter [University of Pecs, Department of Orthopaedics, Institute of Musculoskeletal Surgery, Clinical Centre, Pecs (Hungary); Leidecker, Eleonora [University of Pecs, Institute of Physiotherapy and Nutritional Sciences, Faculty of Health Sciences, Pecs (Hungary)

    2015-03-01

    The anatomy and biomechanics of the pelvis and lower limbs play a key role in the development of orthopaedic disorders. This study aimed to establish normal reference standards for the measurement of gender-specific pelvic and femoral parameters in children and adolescents with the EOS 2-D/3-D system. EOS 2-D images of 508 individuals (ages 4-16 years) were obtained as part of routine diagnostics. Patients with lower limb abnormalities were excluded. Pelvic and femoral surface 3-D models were generated and clinical parameters calculated by sterEOS 3-D reconstruction software. Data were evaluated using Spearman correlation, paired-samples and independent-samples t-test and linear regression analysis. Changes in anatomical parameters were found to correlate with age and gender in (1) femoral mechanical axis length: 27.3-43.7 cm (males), 25.5-41.2 cm (females), (2) femoral head diameter: 29.4-46.1 mm (males), 27.7-41.3 mm (females), (3) femoral offset: 26.8-42.4 mm (males), 25.5-37.9 mm (females) and (4) femoral neck length: 35.1-52.9 mm (males), 32.8-48.1 mm (females). There was no gender-specific correlation for the neck shaft angle with values from 130.4 to 129.3 , for femoral torsion (22.5 -19.4 ), for sacral slope (39.0 -44.4 ) and for lateral pelvic tilt (5.1 mm-6.2 mm). Sagittal pelvic tilt exhibited no significant correlation with age showing average values of 6.5 . The EOS 2-D/3-D system proved to be a valuable method in the evaluation of female and male developmental changes in pelvic and lower limb anatomical parameters, in normal individuals younger than 16 years of age. (orig.)

  18. Femur Shaft Fractures (Broken Thighbone)

    Science.gov (United States)

    ... going, whether you were the driver or a passenger, whether you were wearing your seat belt, and ... are sometimes treated with a cast. For more information on that, ... is a pulley system of weights and counterweights that holds the broken ...

  19. Test Bench Development for Femur Stability Assessment

    Directory of Open Access Journals (Sweden)

    Samuel SANCHEZ-CABALLERO

    2015-01-01

    Full Text Available This paper shows the design and development of a test bench for humanfemurs. The main uses of this test bench will run from artificial femurs comparisonwith real femurs, to join stability assessment after bone a fracture repair. Amongthis uses is specially designed for condylar fractures testing. The test bench isdeveloped from a self-made existing tensile/compression testing machine. Thedesign procedure is supported by a literature review about the bone mechanicalbehavior and composition generally and the knee joint performance and repairparticularly. On the basis of this review, the machine was designed to simulate theadduction and abduction movements of the joint. The magnitudes to be measuredare: the compression force, the bone displacement (vertical and the knee jointrotation

  20. Periosteal osteoid osteoma of the distal femur

    Directory of Open Access Journals (Sweden)

    Mohammed Fahd Amar

    2010-07-01

    Full Text Available Periosteal osteoid osteoma is extremely rare. The diagnosis is not always clear. We report a case of periosteal osteoid osteoma arising from the posterior surface of the right distal femur in a 21-year-old woman. After careful evaluation and excisional biopsy, histological examination confirmed the diagnosis of osteoid osteoma, showing the nidus, surrounding osteosclerosis, and catarrhal synovitis. The lesion was treated successfully with excision of the nidus.

  1. Load along the femur shaft during activities of daily living.

    Science.gov (United States)

    D'Angeli, V; Belvedere, C; Ortolani, M; Giannini, S; Leardini, A

    2013-08-09

    A comprehensive knowledge of the loads applied during activities of daily living to the femur shaft is necessary to the design of direct attachments of relevant prostheses. A motion analysis system was used together with an established protocol with skin markers to estimate the three components of the forces and moments acting on ten equidistant points along the full femur shaft. Twenty healthy young volunteers were analyzed while performing three repetitions of the following tasks: level walking at three different speeds, straight-line and with sudden changes of direction to the right and to the left, stairs ascending and descending, squat, rising from a chair and sitting down. Average load patterns, after normalisation for body weight and height, were calculated over subjects for each point, about the three anatomical axes, and for each motor task. These patterns were found consistent over subjects, but different among the anatomical axes and tasks. In general, the moments were observed limitedly influenced by the progression speed, and higher for more proximal points. The moments were also higher in abd/adduction (8.1% body weight*height on average), nearly three times larger than those in flex/extension (2.6) during stair descending. The largest value over all moments was 164.8 N m, abd/adduction in level walking at high speed. The present results should be of value also for a most suitable level for amputation in transfemoral amputation, for in-vitro mechanical tests and for finite element models of the femur. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Three-dimensional microarchitecture of the proximal femur in osteoarthritis and rheumatoid arthritis

    DEFF Research Database (Denmark)

    Wang, B. L.; Ding, Ming; Overgaard, Søren

    2015-01-01

    microstructure has an important impact on bone quality. Recently, the quantification of bone architecture based on micro-CT has been widely used in the research of various bone diseases. OBJECTIVE: To observe the osteoarthritis- and rheumatoid arthritis-related changes in the properties of the proximal femur...... from each individual femur, perpendicular to the main trabecular direction on X-ray films. The specimens were analyzed by using micro-CT system. After scanning, the data were transferred to three-dimensional images, and then detailed structural parameters of the cortical bone, cancellous bone...

  3. Proximal femur reconstruction by an allograft prosthesis composite.

    Science.gov (United States)

    Donati, Davide; Giacomini, Stefano; Gozzi, Enrico; Mercuri, Mario

    2002-01-01

    Twenty-seven patients who had resection of the proximal femur for bone tumors and reconstruction with an allograft prosthesis composite are reported. In most of the patients, the prosthesis was a long-stem revision type, cemented in the allograft and uncemented in the femoral shaft. The abductor muscles and iliopsoas were sutured to the corresponding tendons on the allograft. Implant-related complications and functional results were evaluated and are reported. Twenty-two patients achieved a minimum followup of 36 months (range, 36-126 months; average, 58 months). The implant was removed in two patients (one for infection, one for intraoperative fracture of the allograft). One patient experienced nonunion, whereas in the remaining 24 patients, the allograft eventually united to the host bone. A frequent late complication (17 patients) was fracture of the greater trochanter of the allograft. In the whole series, only four new operations were done for implant-related complications. In 22 patients who could be evaluated, the functional evaluation according to the Musculoskeletal Tumor Society System was excellent in 16 (73%) patients, good in four (18%), and fair in two (9%). These results compare favorably with those of megaprostheses for tumor resection of the proximal femur, where a Trendelenburg gait almost always is present.

  4. Surgical treatment of metastatic disease of the femur.

    Science.gov (United States)

    Swanson, K C; Pritchard, D J; Sim, F H

    2000-01-01

    Nearly every malignant neoplasm has been described as having the capability to metastasize to bone. Of the estimated 1.2 million new cases of cancer diagnosed annually, more than 50% will eventually demonstrate skeletal metastasis. Advances in systemic and radiation therapy have led to a considerable improvement in the prognosis of patients with metastatic disease. As a result, orthopaedic surgeons are being asked with increasing frequency to evaluate and treat the manifestations of skeletal metastases. The femur is commonly the site of large impending lesions and complete pathologic fractures. Although the health status of some patients may preclude operative intervention, established pathologic fractures of the femur and metastatic lesions deemed likely to progress to imminent fracture generally should be treated surgically. A rational approach to selection of the proper treatment for these problems includes consideration of the patient's overall medical condition and the type, location, size, and extent of the tumor. Treatment principles are the same regardless of location. A construct should ideally provide enough stability to allow immediate full weight bearing with enough durability to last the patient's expected lifetime. All areas of weakened bone should be addressed at the time of surgery in anticipation of disease progression. To minimize disease progression and possible implant or internal fixation failure, postoperative external-beam irradiation should be considered.

  5. Periprosthetic proximal femur fractures: current concepts.

    Science.gov (United States)

    Parvizi, Javad; Vegari, David N

    2011-06-01

    With the increase in demand for total hip and knee arthroplasty, the orthopaedic community has seen a dramatic increase in periprosthetic fractures. Given the high morbidity and mortality associated with these fractures, the orthopaedic surgeon needs to be prepared to deal with this difficult problem. The purpose of this article is to provide the surgeon with an algorithmic approach that allows for easy classification and treatment options for periprosthetic fractures of the proximal femur. Such an approach should prevent the mismanagement of these complications.

  6. Salter Harris Fractures of the Distal Femur

    Science.gov (United States)

    Hamilton, Steven W.; Barker, Simon L.

    2013-01-01

    Salter Harris–type injuries of the distal femur should be treated as a dislocation of the knee and therefore as a medical emergency. Senior medical staff should be involved early, ankle–brachial index ratio should be measured in all patients and the clinician should have a high index of suspicion for a vascular injury. Ideally reduction, stabilization, and vascular repair, if necessary, should be carried out within 6 hours of the initial event. There should be a low threshold for fasciotomies. These 2 cases demonstrate the importance of having a high index of suspicion for vascular injury and the need for continued reassessment. PMID:26425580

  7. Salter Harris Fractures of the Distal Femur

    Directory of Open Access Journals (Sweden)

    Sean M. McKenna

    2013-07-01

    Full Text Available Salter Harris–type injuries of the distal femur should be treated as a dislocation of the knee and therefore as a medical emergency. Senior medical staff should be involved early, ankle–brachial index ratio should be measured in all patients and the clinician should have a high index of suspicion for a vascular injury. Ideally reduction, stabilization, and vascular repair, if necessary, should be carried out within 6 hours of the initial event. There should be a low threshold for fasciotomies. These 2 cases demonstrate the importance of having a high index of suspicion for vascular injury and the need for continued reassessment.

  8. Periosteal osteoblastoma of the distal femur

    Energy Technology Data Exchange (ETDEWEB)

    Nakatani, Tetsuya; Yamamoto, Tetsuji; Akisue, Toshihiro; Marui, Takashi; Hitora, Toshiaki; Kawamoto, Teruya; Nagira, Keiko; Yoshiya, Shinichi; Kurosaka, Masahiro [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe (Japan); Fujita, Ikuo; Matsumoto, Keiji [Department of Orthopaedic Surgery, Hyogo Medical Center for Adults, Akashi, Hyogo (Japan)

    2004-02-01

    Osteoblastomas located on the surface of the cortical bone, so-called periosteal osteoblastomas, are extremely rare. We report on a case of periosteal osteoblastoma arising from the posterior surface of the right distal femur in a 17-year-old man. Roentgenographic, computed tomographic, magnetic resonance imaging, and histologic features of the case are presented. Periosteal osteoblastoma should be radiologically and histologically differentiated from myositis ossificans, avulsive cortical irregularity syndrome, osteoid osteoma, parosteal osteosarcoma, periosteal osteosarcoma, and high-grade surface osteosarcoma. Although periosteal osteoblastoma is rare, this tumor should be included in the differential diagnosis of surface-type bone tumors. (orig.)

  9. Bisphosphonates and Atypical Fractures of Femur

    Directory of Open Access Journals (Sweden)

    Tero Yli-Kyyny

    2011-01-01

    Full Text Available Bisphosphonates are the most widely prescribed medicines for the treatment of osteoporosis and have generally been regarded as well-tolerated and safe drugs. Since 2005, there have been numerous case reports about atypical fractures of the femur linked to long-term treatment of osteoporosis with bisphosphonates. Some attempts to characterize pathophysiology and epidemiology of these fractures have been published as well. However, as the American Society for Bone and Mineral Research (ASBMR concluded in their task force report, the subject warrants further studies.

  10. Association of isolated short fetal femur with intrauterine growth restriction

    NARCIS (Netherlands)

    Vermeer, N.; Bekker, M.N.

    2013-01-01

    OBJECTIVES: To analyze the outcomes of fetuses referred because of short femur length. METHODS: This was a retrospective study of all singleton pregnancies referred to a tertiary care referral hospital with a femur length below the 5(th) percentile. All ultrasound scan reports, including Doppler,

  11. EVALUATION OF NECK SHAFT ANGLE OF FEMUR ON DRY BONES

    OpenAIRE

    Radha; Ravi Shankar; Naveen; Roopa

    2015-01-01

    BACKGROUND: Evaluation of the neck shaft angle of femur helps to understand clinical relevance in bio mechanics of the hip joint. It helps for the better treatment of different pathological conditions of hip and femur and also to design prosthesis. Femoral neck shaft angle is important to convey the information regarding the race to ...

  12. Stochastic gradient boosting classification trees for forest fuel types mapping through airborne laser scanning and IRS LISS-III imagery

    Science.gov (United States)

    Chirici, G.; Scotti, R.; Montaghi, A.; Barbati, A.; Cartisano, R.; Lopez, G.; Marchetti, M.; McRoberts, R. E.; Olsson, H.; Corona, P.

    2013-12-01

    This paper presents an application of Airborne Laser Scanning (ALS) data in conjunction with an IRS LISS-III image for mapping forest fuel types. For two study areas of 165 km2 and 487 km2 in Sicily (Italy), 16,761 plots of size 30-m × 30-m were distributed using a tessellation-based stratified sampling scheme. ALS metrics and spectral signatures from IRS extracted for each plot were used as predictors to classify forest fuel types observed and identified by photointerpretation and fieldwork. Following use of traditional parametric methods that produced unsatisfactory results, three non-parametric classification approaches were tested: (i) classification and regression tree (CART), (ii) the CART bagging method called Random Forests, and (iii) the CART bagging/boosting stochastic gradient boosting (SGB) approach. This contribution summarizes previous experiences using ALS data for estimating forest variables useful for fire management in general and for fuel type mapping, in particular. It summarizes characteristics of classification and regression trees, presents the pre-processing operation, the classification algorithms, and the achieved results. The results demonstrated superiority of the SGB method with overall accuracy of 84%. The most relevant ALS metric was canopy cover, defined as the percent of non-ground returns. Other relevant metrics included the spectral information from IRS and several other ALS metrics such as percentiles of the height distribution, the mean height of all returns, and the number of returns.

  13. Femur Model Reconstruction Based on Reverse Engineering and Rapid Prototyping

    Science.gov (United States)

    Tang, Tongming; Zhang, Zheng; Ni, Hongjun; Deng, Jiawen; Huang, Mingyu

    Precise reconstruction of 3D models is fundamental and crucial to the researches of human femur. In this paper we present our approach towards tackling this problem. The surface of a human femur was scanned using a hand-held 3D laser scanner. The data obtained, in the form of point cloud, was then processed using the reverse engineering software Geomagic and the CAD/CAM software CimatronE to reconstruct a digital 3D model. The digital model was then used by the rapid prototyping machine to build a physical model of human femur using 3D printing. The geometric characteristics of the obtained physical model matched that of the original femur. The process of "physical object - 3D data - digital 3D model - physical model" presented in this paper provides a foundation of precise modeling for the digital manufacturing, virtual assembly, stress analysis, and simulated surgery of artificial bionic femurs.

  14. Monitoring Environment with GIS for Part of Thiruvallur Town Using Cartosat 1 Stereo, Pan & Resourcesat Liss 4 MSS Merged Data

    Science.gov (United States)

    Mohamed, G. S.; Venkatchalam, R. V.; Ramamurthhy, M.; Gummidipoondi, R. J.; Ramillah, M.

    2012-07-01

    Thiruvallur town is about 44 km from Chennai in Tamil nadu state of India with a population of 130000 , covering 10.75 sq km area. It is about 2km from Sri Venkateswara College of Engineering and Technology. It was Taluk (Sub Division'.s) head quarters and from 1991 it was upgraded as District head quarters after the formation of Thiruvallur District. With rapid growth of town the Population density of Thiruvallur has increased in the past three decades from 300 persons/sq.km in 1951, to 6000 persons/sq.km in 1981 and now it is 12925 persons/sq.km in 2011. The creation of District administrative collector office, headquarters offices for police, judicial courts and Tamil Nadu and Federal Government development department's offices, establishment of multinationals major industries like Caterpillar, Kingfishers,Hindustan Motors, Mahendra Automobiles, Coco cola, Japanese Glass industry, Korean LOTO etc apart from mushrooming growth of about 41 Engineering, Nursing, Education, Medical, Naval, Arts and Science colleges, International Public schools,Governmentt, Private schools and Polytechnics added to the population of this Town. It is well connected by National Highways and Railways and upgraded as District Municipality. This resulted in urban drainage problem and conversion of Agriculture land and lakes for housing, establishment of major Govt and Private Hospitals including special units for Eye care, Cardiology, and Health Clinics, pharmacies etc. The effect of urbanization on environment of this once silent rural temple town which was supporting intensive agriculture activities , green with paddy fields is studied with high resolution satellite data is know the impact on health and environment changes from 2008 to 2011, using 2.5m resolution PAN stereo data of Cartosat 1 merged with 5.8 m resolution Multi Spectral data of LISS 4 of Resourcesat 1 of Indian Remote sensing satellites and Geo Eye satellite image of 2011 from Google Earth web site for the western part

  15. FE and experimental study on how the cortex material properties of synthetic femurs affect strain levels.

    Science.gov (United States)

    Lopes, Vitor M M; Neto, Maria A; Amaro, Ana M; Roseiro, Luis M; Paulino, M F

    2017-08-01

    The primary aim of this work was to validate the "numerical" cortex material properties (transversely isotropic) of synthetic femurs and to evaluate how the strain level of the cancellous bone can be affected by the FE modeling of the material's behavior. Sensitivity analysis was performed to find out if the parameters of the cortex material affect global strain results more than the Polyurethane (PU) foam used to simulate cancellous bone. Standard 4th generation composite femurs were made with 0.32g/cm(3) solid PU foam to model healthy cancellous bone, while 0.2g/cm(3) cellular PU was used to model unhealthy cancellous bone. Longitudinal and transversal Young's moduli of cortical bone were defined according the manufacturer data, while shear modulus and Poisson's ratios were defined from the literature. All femurs were instrumented with rosette strain gauges and loaded according to ISO7206 standards, simulating a one-legged stance. The experimental results were then compared with those from finite element analysis. When cortical bone was modelled as transversely isotropic, an overall FE/experimental error of 11% was obtained. However, with isotropic material the error rose to 20%. Strain field distributions predicted inside the two bone models were similar, but the strain state of a healthy cancellous bone was much more a compression state than that of unhealthy bone, the compression state decreased about 90%. Strain magnitudes show that average strain-levels of cancellous bone can be significantly affected by the properties of the cortical bone material and, therefore, simulations of femur-implanted systems must account for the composite behavior of the cortex, since small shear strains would develop near isotropic cancellous bone-implant interfaces. Moreover, the authors suggest that changing the volume fraction of glass fibers used to manufacture the cortical bone would allow a more realistic osteoporotic synthetic femurs to be produced. Copyright © 2017 IPEM

  16. 股骨-胫骨通配型全膝关节假体治疗重度内翻膝%Femur Tibial All-matched Prosthesis Total Knee System in the Treatment of the Severe Varus Knee

    Institute of Scientific and Technical Information of China (English)

    郭建立; 唐志良; 张海滨

    2014-01-01

    [ABSTRACT]Objective: To study the femur tibial prosthesis all-match total knee prosthesis treatment with varus knee deformity combined with tibial plateau bone defect. Methods: From January 2012 and May 2012, 43 knees of 40 severe osteoarthritis patients underwent TKA with domestic AK femur tibial prosthesis all-match total knee prosthesis in our hospital that include 6 cases severe varus deformity combined with tibial plateau bone defect.For preoperative examination include measure the knee joint mobility and tibial femoral angle by using X ray (femorotibial angle, FTA), measuring KSS score.Took the medial parapatellar approach in surgery, conventional bone cutting, treatment for the tibial plateau bone defect cases with increasing cutting in tibia plateau, bone cement filling and autologous bone graft and tibia lateral extension rod in order to increase the stability of the knee joint prosthesis, the femur tibial prosthesis all-match total knee prosthesis took from Beijing AKEC Co., Ltd. For postoperative follow-up over 6 months to 1 year, regular measure the KSS score, knee joint mobility and the FTA, to evaluate the treatment effect. Results:The patients were successfully completed.36 cases received follow-up, included 6 cases of combined with the tibial plateau bone defect.No complications such as postoperative incision infection and joint dislocation.According to the KSS score method to evaluate after 6 months: 30 cases excellent, 5 cases good, and 1 case medium, good rate was 97℅, 5 cases severe varus deformity combined with tibial plateau bone defect was good. Conclusion: Use the femur tibial prosthesis all-match total knee prosthesis to treatment for severe varus deformity, especially for the combined with tibial plateau bone defect cases, it could solve the problems of the femurs tibial prosthesis size does not match in TKA, and reduce prosthesis wear rate.%目的:探讨应用股骨-胫骨通配型全膝关节假体治疗合并胫骨平台骨缺损

  17. EVALUATION OF NECK SHAFT ANGLE OF FEMUR ON DRY BONES

    Directory of Open Access Journals (Sweden)

    Radha

    2015-04-01

    Full Text Available BACKGROUND: Evaluation of the neck shaft angle of femur helps to understand clinical relevance in bio mechanics of the hip joint. It helps for the better treatment of different pathological conditions of hip and femur and also to design prosthesis. Femoral neck shaft angle is important to convey the information regarding the race to which they belong. Hence the present study was under taken to determine the neck shaft angle of femur in humans. OBJECTIVE: 1. To correct the different types of deformity and to have a normal good walking Mechanism. 2. To know the recent methodology and attempt to evaluate the range of normal Angles of femora and their sex differences. METHODS: ANTHROPOMETRIC: 100 Adult dry bones were studied and analyzed . The neck shaft angle of femur was measured by tracing outlines of contours of all femora. RESULTS: The neck shaft angle of the femur have revealed that there is no much difference in between males and females. There was slightly higher 0.2° in females. INTERPRETATION & CONCLUSION: There was no significant gender difference in neck shaft angle. The Knowledge of knowing the neck shaft angle helps to understand the Biomechanics of the hip joint and also for better treatment of pathological condition of hip and femur.

  18. A study of diaphyseal nutrient foramina in human femur

    Directory of Open Access Journals (Sweden)

    Roopam Kumar Gupta

    2016-03-01

    Results: The mean number of nutrient foramina per femur bone was 1.64 and mean distance of NF from upper end of femur was 19.48 cms. The foraminal index obtained was 45.01%. The most common location of NF was on the medial lip of linea aspera (40.9%. 44.6% femur had only one NF, while 49.4% had two NF, 3.8% femur had three NFs and 2.24% femur had four NFs. 50.48% of NFs were of big size caliber, 26.6% were of medium size and 22.8% were of small caliber. So 77.1% NFs in femur were dominant foramina. In all the bones studied the direction of the nutrient foramina was always directed upwards. Conclusions: The findings of this study on nutrient foramina adds to the information from studies in the past by other authors but the importance of this study lies in the large sample size and the detailed study of caliber of the nutrient foramen for the first time. [Int J Res Med Sci 2016; 4(3.000: 706-712

  19. Development of a locking femur nail for mice.

    Science.gov (United States)

    Holstein, J H; Menger, M D; Culemann, U; Meier, C; Pohlemann, T

    2007-01-01

    We herein report on a novel locking intramedullary nail system in a murine closed femur fracture model. The nail system consists of a modified 24-gauge injection needle and a 0.1-mm-diameter tungsten guide wire. Rotation stability was accomplished by flattening the proximal and distal end of the needle. Torsional mechanical testing of the implants in osteotomized cadaveric femora revealed a superiority of the locking nail (3.9+/-1.0 degrees rotation at a torque of 0.9 Nmm, n=10) compared to the unmodified injection needle (conventional nail; 52.4+/-3.2 degrees, n=10, pfracture in C57BL/6 mice. Of interest, none of the 10 animals showed a dislocation of the locking nail over a 5-week period, while 3 of 4 animals with conventional nail fracture stabilization showed a significant pin dislocation within the first 3 days (pfractures can be fixed with rotation stability, the herein introduced model may represent an ideal tool to study bone healing in transgenic and knockout mice.

  20. Grade 3C open femur fractures with vascular repair in adults.

    Science.gov (United States)

    Balci, Halil I; Saglam, Yavuz; Tunali, Onur; Akgul, Turgut; Aksoy, Murat; Dikici, Fatih

    2015-06-01

    Grade 3C open femur fractures are challenging injuries with higher rates of complications. This is a retrospective review of grade 3C open femur fractures with vascular repair between 2002 and 2012. Outcomes included initial MESS score, additional injuries, duration of operation, complications, secondary operations or amputations, and social life implications. Thirty-one of 39 total patients were selected for revascularization and fracture fixation based on soft tissue injury and MESS score. The intra-operative approach included temporary arterial shunt replacement, orthopedic fixation, arterial reconstruction venous and/or nerve repair and routine fasciotomies. An external fixation and reverse saphenous vein graft was used in a majority of the patients (respectively; 93.5%, 90.3%). The mean follow up was 5.4 years (range 2.2-10). The decision to amputate versus salvage should be left up to patients and their care teams after discussing options and future possibilities rather than using a scoring system.

  1. 不同内固定方法治疗股骨远端骨折的疗效分析%The comparative analysis of the clinical effect of different fixation methods in the treatment of distal femur fracture

    Institute of Scientific and Technical Information of China (English)

    杜峰; 侯辉宝; 程树银

    2016-01-01

    Objective:To explore the clinical effects of Liss and GSH in the treatment of distal femur fracture. Methods:According to the AO typing,patient′s physical condition and local soft tissue situation,the type A1,A2,A3,C1 and C2 in 19 patients( GSH group) and type A1,A2,A3,C1,C2 and C3 in 18 patients(Liss group) were treated with GSH and Liss,respectively. The fracture healing time and HSS scores between two groups were compared. Results:All cases were followed up. The fractures were anatomically reset,and the incision was smooth healed. The heal time of fractures in GSH and Liss group were(5. 0 ± 1. 2) and(4. 8 ± 1. 17) months,respectively, the difference of which was not statistically significant(P>0. 05). The HSS knee scores in GSH and Liss group were(89. 4 ± 10. 6) and(89.9±11.11),respectively,the difference of which was not statistically significant(P>0.05).Conclusions:The treatment of distal femur fracture with Liss and GSH can achieve good effects,the difference of which is no obvious.%目的::探讨Liss钢板( Liss)与逆行铰锁髓内钉( GSH)内固定治疗股骨远端骨折的临床疗效。方法:根据AO分型,结合患者身体条件及局部软组织情况,A1、A2、A3及C1、C2型19例选用GSH( GSH组),A1、A2、A3及C1、C2、C3型18例选用Liss ( Liss组),比较2组骨折愈合时间及HSS评分情况。结果:37例均获随访,骨折解剖复位,切口顺利愈合。 GSH组骨折愈合时间为(5.0±1.2)个月,Liss组愈合时间为(4.8±1.17)个月,2组差异无统计学意义(P>0.05)。 GSH组膝关节HSS评分(89.4±10.6)分,Liss组(89.9±11.11)分,2组差异亦无统计学意义(P>0.05)。结论:Liss内固定治疗股骨远端骨折疗效与GSH内固定疗效相当,均能取得良好的效果。

  2. THE THIRD TROCHANTER IN HUMAN FEMUR : A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Rajkumari

    2015-05-01

    Full Text Available During routine osteology demonstration class of 100 numbers of Under Graduate M . B . B . S . S tudents at the Department of Anatomy , Regional Institute of Medical Sciences , Imphal , Manipur , we have come across one unique and unusual finding that one right human femur was found to be p resent with an elongated bony projection along the superior border of the gluteal tuberosity . It was found to be present about 7cm below the tip of the greater trochanter and the bony projection was about 1 . 70cm in length . It was localised laterally to the line connecting the tip of greater trochanter with superior bifurcation to the linear aspera . No any other anatomical abnormality was found in the above mentioned femur . The other remaining portion of the said femur was fo und with their normal anatomical features . The photograph of the right human femur mentioned above was taken for proper documentation and for ready reference . This case report has provided some additional evidence to the researchers and anatomists to enhan ce the understanding of the human femur more particularly the third trochanter and its significance . The present case study revealed an unusual finding as referred to above .

  3. Geometric morphometric analysis reveals sexual dimorphism in the distal femur.

    Science.gov (United States)

    Cavaignac, Etienne; Savall, Frederic; Faruch, Marie; Reina, Nicolas; Chiron, Philippe; Telmon, Norbert

    2016-02-01

    An individual's sex can be determined by the shape of their distal femur. The goal of this study was to show that differences in distal femur shape related to sexual dimorphism could be identified, visualized, and quantified using 3D geometric morphometric analysis. Geometric morphometric analysis was carried out on CT scans of the distal femur of 256 subjects living in the south of France. Ten landmarks were defined on 3D reconstructions of the distal femur. Both traditional metric and geometric morphometric analyses were carried out on these bone reconstructions; these analyses identified trends in bone shape in sex-based subgroups. Sex-related differences in shape were statistically significant. The subject's sex was correctly assigned in 77.3% of cases using geometric morphometric analysis. This study has shown that geometric morphometric analysis of the distal femur is feasible and has revealed sexual dimorphism differences in this bone segment. This reliable, accurate method could be used for virtual autopsy and be used to perform diachronic and interethnic comparisons. Moreover, this study provides updated morphometric data for a modern population in the south of France. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. SIFT algorithm-based 3D pose estimation of femur.

    Science.gov (United States)

    Zhang, Xuehe; Zhu, Yanhe; Li, Changle; Zhao, Jie; Li, Ge

    2014-01-01

    To address the lack of 3D space information in the digital radiography of a patient femur, a pose estimation method based on 2D-3D rigid registration is proposed in this study. The method uses two digital radiography images to realize the preoperative 3D visualization of a fractured femur. Compared with the pure Digital Radiography or Computed Tomography imaging diagnostic methods, the proposed method has the advantages of low cost, high precision, and minimal harmful radiation. First, stable matching point pairs in the frontal and lateral images of the patient femur and the universal femur are obtained by using the Scale Invariant Feature Transform method. Then, the 3D pose estimation registration parameters of the femur are calculated by using the Iterative Closest Point (ICP) algorithm. Finally, based on the deviation between the six degrees freedom parameter calculated by the proposed method, preset posture parameters are calculated to evaluate registration accuracy. After registration, the rotation error is less than l.5°, and the translation error is less than 1.2 mm, which indicate that the proposed method has high precision and robustness. The proposed method provides 3D image information for effective preoperative orthopedic diagnosis and surgery planning.

  5. Pilot study on proximal femur strains during locomotion and fall-down scenario

    Energy Technology Data Exchange (ETDEWEB)

    Klodowski, Adam, E-mail: adam.klodowski@lut.fi; Valkeapaeae, Antti, E-mail: antti.valkeapaa@lut.fi; Mikkola, Aki, E-mail: aki.mikkola@lut.fi [Lappeenranta University of Technology (Finland)

    2012-09-15

    The most common and severe type of fracture among the elderly is known as a proximal femur fracture. Aging-related bone loss is one of the major contributing factors to increased likelihood of bone fracture. Specific exercises can be used to strain bones and increase bone strength to counter the effects of bone loss. The flexible multibody simulation approach can be used as a non-invasive method for estimating bone strains caused by physical activity. This method was recently used to analyze the strain of locomotion in regard to human femur and tibia leg bones. The current study focuses on strain analysis of the femoral neck. The research test person was a clinically healthy 65-year old Caucasian male. The computed tomography was used to build a geometrically accurate finite element model of the femur with inhomogeneous material properties derived from the voxel data. The anthropometric data was used to model the musculoskeletal system of the test person. The multibody skeletal model was utilized to estimate loading on the femoral neck during walking, which represents a routine daily activity. The flexible multibody simulation results were compared to strains that occurred during a simulated fall onto the greater trochanter of the femur. The fall simulation was made entirely using finite element software. Results from the finite element analysis were compared with the previous study showing that the test person does not belong to the high-risk hip fracture group. Finally, the estimated strains gathered from the walking simulation were compared to the strain values from the simulated fall-down scenario.

  6. Fracture of Human Femur Tissue Monitored by Acoustic Emission Sensors

    Directory of Open Access Journals (Sweden)

    Dimitrios. G. Aggelis

    2015-03-01

    Full Text Available The study describes the acoustic emission (AE activity during human femur tissue fracture. The specimens were fractured in a bending-torsion loading pattern with concurrent monitoring by two AE sensors. The number of recorded signals correlates well with the applied load providing the onset of micro-fracture at approximately one sixth of the maximum load. Furthermore, waveform frequency content and rise time are related to the different modes of fracture (bending of femur neck or torsion of diaphysis. The importance of the study lies mainly in two disciplines. One is that, although femurs are typically subjects of surgical repair in humans, detailed monitoring of the fracture with AE will enrich the understanding of the process in ways that cannot be achieved using only the mechanical data. Additionally, from the point of view of monitoring techniques, applying sensors used for engineering materials and interpreting the obtained data pose additional difficulties due to the uniqueness of the bone structure.

  7. Finite Element Analysis of a New Semi-Arthroplasty Prosthesis System Applied for the Elderly Patient with Unstable Transtrochanteric Fractures of the Femur%新研制的老年不稳定型股骨粗隆间骨折半髋假体有限元分析

    Institute of Scientific and Technical Information of China (English)

    储小兵; 杨予; 郝改平; 童培建

    2012-01-01

    对计算机辅助设计的新型股骨粗隆间骨折半髋假体进行模拟人体植入后的三维有限元分析,检验其设计的合理性.对1名60岁正常男性志愿者进行双下肢的股骨中上段CT扫描,以DICOM格式导人Mimics11.1软件,建立股骨近端模型,模拟AO分型中A2.2型骨折(大、小粗隆均有骨折的不稳定型股骨粗隆间骨折)形态建立老年不稳定型股骨粗隆间骨折的模型,将计算机辅助设计生成的新型半髋假体的Pro/E文件导入骨折模型中按手术要求进行装配,然后利用Mimics11.1软件进行网格划分、单元保形优化以及按灰度进行单元弹性模量赋值,最后导入Ansys11.0软件生成三维有限元模型,加载负荷,进行假体植入后股骨应力分布的量化分析研究.所研制的半髋假体植入人体后,力学加载后的应力云图显示假体柄与股骨接触应力主要由股骨粗隆部以下的骨干部所承担,最大平均Von Mises应力值在17.69 ~26.41 MPa,而大、小粗隆处的应力水平较低,最大平均Von Mises应力值分别为2.76和4.95 MPa.对于老年骨质疏松患者,所研制的股骨粗隆间骨折半髋假体属远段生物固定型假体,符合股骨粗隆间骨折治疗的要求,不易导致骨折分离和假体失稳.%This work is aimed to determine femoral stress distribution after implantation of a new semi-arthroplasty prosthesis in aged patients suffered unstable transtrochanteric fractures of the femur by means of finite element analysis program to check the rationality of its design. A 60 years old volunteer received a CT scanning at middle and upper regions of his both intact femur. The serial digitized image data of spiral CT in DICOM format were imported to Mimicsll. 1 program to establish a three dimensional solid model of the proximal femur. Simulating A2. 2 Type of transtrochanteric fractures of the femur in AO classification system, a solid model of unstable transtrochanteric fracture of the femur

  8. Three-Dimensional Bone Adaptation of the Proximal Femur

    DEFF Research Database (Denmark)

    Bagge, Mette

    1998-01-01

    The bone remodeling of a three-dimensional model of the proximal femur is considered. The bone adaptation is numerically described as an evolution in time formulated such that the structural change goes in an optimal direction within each time step for the optimal boundary conditions. In the bone...

  9. Fracturen van het distale deel van het femur

    NARCIS (Netherlands)

    Duyn, Cornelius Diederikus van

    1977-01-01

    ln dit proefschrift wordt een analyse gegeven van de behandeling en de daarmee bereikte resultaten van 123 patiënten die in de periode 1 januari 1958 tot en met 31 december 1972 wegens een fractuur van het distale deel van het femur werden behandeld in de Kliniek voor Heelkunde van het Academisch

  10. Statistical shape model-based femur kinematics from biplane fluoroscopy

    DEFF Research Database (Denmark)

    Baka, N.; de Bruijne, Marleen; Walsum, T. van

    2012-01-01

    on the distal femur using eight biplane fluoroscopic drop-landing sequences. The proposed dynamic prior and features increased the convergence rate of the reconstruction from 71% to 91%, using a convergence limit of 3 mm. The achieved root mean square point-to-surface accuracy at the converged frames was 1...

  11. Automatic detection and measurement of femur length from fetal ultrasonography

    Science.gov (United States)

    Mukherjee, Prateep; Swamy, Gokul; Gupta, Madhumita; Patil, Uday; Krishnan, Kajoli Banerjee

    2010-03-01

    Femur bone length is used in the assessment of fetal development and in the prediction of gestational age (GA). In this paper, we present a completely automated two-step method for identifying fetal femur and measuring its length from 2D ultrasound images. The detection algorithm uses a normalized score premised on the distribution of anatomical shape, size and presentation of the femur bone in clinically acceptable scans. The measurement process utilizes a polynomial curve fitting technique to determine the end-points of the bone from a 1D profile that is most distal from the transducer surface. The method has been tested with manual measurements made on 90 third trimester femur images by two radiologists. The measurements made by the experts are strongly correlated (Pearson's coefficient = 0.95). Likewise, the algorithm estimate is strongly correlated with expert measurements (Pearson's coefficient = 0.92 and 0.94). Based on GA estimates and their bounds specified in Standard Obstetric Tables, the GA predictions from automated measurements are found to be within +/-2SD of GA estimates from both manual measurements in 89/90 cases and within +/-3SD in all 90 cases. The method presented in this paper can be adapted to perform automatic measurement of other fetal limbs.

  12. Etude du point critique des paliers lisses alimentés à la graisse Study of Critical Point on Plain Bearings Lubricated by Grease

    Directory of Open Access Journals (Sweden)

    Delneuville P.

    2006-11-01

    Full Text Available Cet article est essentiellement consacré à l'étude du fonctionnement limite des paliers lisses lubrifiés à la graisse ; son but est de permettre la détermination des conditions nécessaires à l'obtention d'un film lubrifiant d'épaisseur suffisante. L'auteur cherche à cette occasion une loi théorique qui permet de départager les régimes de lubrification, non plus empiriquement, mais sur la base de lois statistiques. La formulation finale doit permettre aux utilisateurs de situer correctement les conditions de fonctionnement d'un palier lisse et d'en estimer la sécurité du régime. This article deals essentially with the boundary behaviour of plain bearings lubricated by grease. Its aim is to determine the conditions required to obtain a sufficiently thick lubricating film. The author proposes a theoretical law for separating lubrication types. This law is not empirical but is based on statistical laws. The final formulation should enable users to correctly situate the operating conditions of a plain bearing and to evaluate the safety factor during running.

  13. Extracting seasonal cropping patterns using multi-temporal vegetation indices from IRS LISS-III data in Muzaffarpur District of Bihar, India

    Directory of Open Access Journals (Sweden)

    Saptarshi Mondal

    2014-12-01

    Full Text Available The advancement in satellite technology in terms of spatial, temporal, spectral and radiometric resolutions leads, successfully, to more specific and intensified research on agriculture. Automatic assessment of spatio-temporal cropping pattern and extent at multi-scale (community level, regional level and global level has been a challenge to researchers. This study aims to develop a semi-automated approach using Indian Remote Sensing (IRS satellite data and associated vegetation indices to extract annual cropping pattern in Muzaffarpur district of Bihar, India at a fine scale (1:50,000. Three vegetation indices (VIs – NDVI, EVI2 and NDSBVI, were calculated using three seasonal (Kharif, Rabi and Zaid IRS Resourcesat 2 LISS-III images. Threshold reference values for vegetation and non-vegetation thematic classes were extracted based on 40 training samples over each of the seasonal VI. Using these estimated value range a decision tree was established to classify three seasonal VI stack images which reveals seven different cropping patterns and plantation. In addition, a digitised reference map was also generated from multi-seasonal LISS-III images to check the accuracy of the semi-automatically extracted VI based classified image. The overall accuracies of 86.08%, 83.1% and 83.3% were achieved between reference map and NDVI, EVI2 and NDSBVI, respectively. Plantation was successfully identified in all cases with 96% (NDVI, 95% (EVI2 and 91% (NDSBVI accuracy.

  14. FORCE COUPLE MECHANICS ON FEMUR DURING CLOSED KINETIC CHAIN ACTIVITIES OF LOWER LIMBS

    Directory of Open Access Journals (Sweden)

    R.Vinodh Rajkumar

    2014-11-01

    Full Text Available Exploration of the biomechanical interaction of musculoskeletal system keeps endorsing the fact that the human body can ensure efficient biomechanics without any kinematic aberrations in the joints. Excluding the injuries caused by unexpected collisions, the major potential factors that ruin the protective configuration of musculoskeletal system can be lack of exercise and incorrect exercise. A fresh perspective; ‘force couple mechanics (FCM on femur’ (torque on femur by two muscular forces in opposite directions at two different locations, has been discussed in this article using fundamental information on anatomical linkages of muscles & correlation of various scientific reports, finally expected to stimulate electromyographic studies to dig out further scientific data.

  15. A new morphological measurement technique of the femur and its application for Japanese patients with osteoarthrosis of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Miura, Toshinori [Kanazawa Univ. (Japan). School of Medicine

    1998-12-01

    In this study, a new morphological measurement technique of the femur was proposed and applied to a number of Japanese osteoarthrosis of the hip (OAH) patients, in order to measure the femoral torsion. The anteversion angle of the femoral neck (angle A) between the perpendicular line to the Ax through the center of the femoral head and a torsion basal plane (BP) defined by the femur coordinate system, and the torsion angle (T) of the proximal segment of the femur between the principal axis of inertia of the outer borders of the corrected sections and BP are selected as giving a good measurement of the torsion value to characterize the femur morphology. The angle A and the angles of principal axis were measured in 110 OAH and 36 normal hips. Regarding the angle A, the mean of this parameter was significantly greater, and the range was wider in the OAH group. Sixty-seven percent of patients with OAH showed the values within the normal range and twenty-nine percent showed greater values. Furthermore, it was observed that the T of the femoral body especially in the proximal region above the section 6 mm below the level of the lesser trochanter was significantly greater in the OAH group than the control group. Besides the T of the femoral body in the proximal region was also significantly greater in high T group of the femoral neck in the OAH group than the control group. (K.H.)

  16. Transplantation of human neonatal foreskin stromal cells in ex vivo organotypic cultures of embryonic chick femurs

    DEFF Research Database (Denmark)

    Aldahmash, Abdullah; Vishnubalaji, Radhakrishnan

    2017-01-01

    NSSCs in ex vivo organotypic cultures of embryonic chick femurs. Isolated embryonic chick femurs (E10 and E11) were cultured for 10 days together with micro-mass cell pellets of hNSSCs, human umbilical vein endothelial cells (HUVEC) or a combination of the two cell types. Changes in femurs gross morphology...

  17. An alternative model of vascularized bone marrow transplant: partial femur transplantation.

    Science.gov (United States)

    Chen, Jian-Wu; Chen, Chen; Su, Ying-Jun; Yan, Lun; Wang, Shi-Ping; Guo, Shu-Zhong

    2014-12-01

    The vascularized whole femur transplantation model is one of the commonly used vascularized bone marrow transplant models. It involves technical complexity and morbidities. To optimize this model, we took 2/3 femur as the carrier of bone marrow cells, and developed a vascularized partial femur model. Four experimental groups were carried out, namely, the syngeneic partial femur transplantation, allogeneic partial femur transplantation with or without cyclosporine A, and allogeneic whole femur transplantation with cyclosporine A. The results showed that the partial femur model was technically simpler and shortened the operative and ischemia time compared to the whole femur model. Gross and histologic appearance confirmed the viability of femur, and its bone marrow inside the bone could also maintain normal morphologically at 60-day posttransplant. Besides, donor multilineage chimerism could be continuously detected in immunosuppressed allogeneic partial femur recipients at 1-, 2-, 3-, 4-, and 8-week posttransplant, and it showed no significant differences when compared with whole femur transplantation. Meanwhile, long-term engraftment of donor-origin cells was also confirmed in recipients' bone marrow, lymph nodes, and spleen, but not in thymus. Therefore, the vascularized partial femur can serve as a continuous resource of bone morrow cells and may provide a useful tool for the study of immune tolerance in vascularized composite allotransplantation.

  18. Principles of management and results of treating the fractured femur during and after total hip arthroplasty.

    Science.gov (United States)

    Greidanus, Nelson V; Mitchell, Philip A; Masri, Bassam A; Garbuz, Donald S; Duncan, Clive P

    2003-01-01

    The management of fractures of the femur during and after total hip arthroplasty can be difficult, and treatment can be fraught with complications. The ideal scenario would be one in which these fractures are prevented. It is important that the surgeon has a through understanding of the principles of managing these fractures and has access to a variety of fixation and prosthetic devices and allograft bone when necessary in order to provide the best treatment. Because periprosthetic fractures range from the very simple (requiring no surgical intervention) to the complex (requiring major revision), a classification system of these fractures aids in understanding both the principles of management and results of treatment.

  19. The prevention of periprosthetic fractures of the femur during and after total hip arthroplasty.

    Science.gov (United States)

    Mitchell, Philip A; Greidanus, Nelson V; Masri, Bassam A; Garbuz, Donald S; Duncan, Clive P

    2003-01-01

    The increasing prevalence of periprosthetic fractures of the femur associated with total hip arthroplasty (THA) is caused by several factors, including the increasing use of cementless prostheses in both primary and revision procedure, the rise in THAs in younger patients, who are more at risk of high-energy trauma, and the increasing longevity of elderly patients after THA. With approximately 200,000 THAs performed annually in North America, fracture prevention is extremely important for the individual patient and has a significant impact on the health care system.

  20. Effect of nonphytate phosphorus and phytase levels on broiler femur.

    Directory of Open Access Journals (Sweden)

    Luana Martins Schaly

    2009-03-01

    Full Text Available This experiment was carried out to evaluate the effect of nonphytate phosphorus (NPP and phytase levels on the weight, morphometry and weight/length index (WLI of broiler femurs at 21 and 42 days of age. One thousand, two hundred chicks were allocated in a completely randomized design and 4 x 3 factorial arrangement (NPP x phytase levels, with four replicates. The NPP levels, at each phase were of 0.45, 0.37, 0.29 and 0.21% in the initial phase, 0.41, 0.33, 0.25 and 0.17% in the growth phase, and of 0.37, 0.29, 0.21 and 0.13% in the final phase. The phytase levels used were 0, 500 and 1000U/kg of diet. At 21 and 42 days of age, 48 birds were sacrificed for femur collection. At 21 days, there was no effect (P > 0.05 of NPP x phytase interaction on bone parameters, but the NPP reduction decreased (P < 0.05 the weight, length and WLI of the femurs, and the inclusion of 500U/kg of phytase improved (P < 0.05 the weight and WLI of the bones. At 42 days of age, NPP x phytase interaction was significant (P < 0.05 for the weight and length, and birds fed diets with no phytase had femurs that were lighter and shorter when the lowest NPP levels were evaluated. However, the inclusion of 500 or 1000U/kg of phytase produced weights and lengths similar to those produced by treatment with recommended NPP levels, and the lower NPP levels evaluated caused a reduction (P < 0.05 in the diameter and WLI of femurs. It was concluded that diets with 0.29, 0.25 or 0.21% of NPP, with 500 U/kg of phytase, could be used with no negative effect on the femur quality in broilers from one to 42 days of age.

  1. A parametric approach to construct femur models and their fixation plates

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    Xiaozhong Chen

    2016-05-01

    Full Text Available Although anatomic plates reflect an important breakthrough in the treatment of distal femur fractures, there are still some patients experiencing healing complications. For individual differences in bone morphology and fractures, the development of patient specific plates is very complex and needs a long cycle. In this study, a parametric approach was proposed to conveniently construct femur models and design their fixation plates. First, the typical femur anatomy was described with the average femur model. Second, five surface features were defined to represent the femur surface model by setting up parameterization and parameter constraints. Third, according to the fracture information of a specific patient, customized plate surface with a suitable contour was created from the reconstructed femur model. Finally, the femur plate was represented by feature parameterization, and the hierarchical constraints between femur parameters and plate parameters were built to construct a plate model. The experimental results showed that the proposed method could effectively represent femur surface shape features and intuitively construct and edit individualized plates with high-level parameters. The method is competitive in time saving and design convenience and may provide a basic tool for digital restoration of incomplete femurs and the design of patient specific femur plates.

  2. Estimation and Mapping Forest Attributes Using “k Nearest Neighbor” Method on IRS-P6 LISS III Satellite Image Data

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    Amir Eslam Bonyad

    2015-06-01

    Full Text Available In this study, we explored the utility of k Nearest Neighbor (kNN algorithm to integrate IRS-P6 LISS III satellite imagery data and ground inventory data for application in forest attributes (DBH, trees height, volume, basal area, density and forest cover type estimation and mapping. The ground inventory data was based on a systematic-random sampling grid and the numbers of sampling plots were 408 circular plots in a plantation in Guilan province, north of Iran. We concluded that kNN method was useful tool for mapping at a fine accuracy between 80% and 93.94%. Values of k between 5 and 8 seemed appropriate. The best distance metrics were found Euclidean, Fuzzy and Mahalanobis. Results showed that kNN was accurate enough for practical applicability for mapping forest areas.

  3. Sex determination using discriminant analysis of the medial and lateral condyles of the femur in Koreans.

    Science.gov (United States)

    Kim, Deog-Im; Kwak, Dai-Soon; Han, Seung-Ho

    2013-12-10

    The proximal and distal parts of the femur show the differences between the sexes. Head diameter and the breadth of the epicondyle of the femur are known to distinguish males from females. The proximal end of the femur is studied to determine sex using discriminant analysis but; its distal end is not done. This study aims to develop an equation specific to Koreans by using the medial and lateral condyles of the femur, and to demonstrate the usefulness of equations for specific population groups. We used three-dimensional images from 202 Korean femurs. Twelve variables were measured with a computer program after the femurs were in alignment. Eleven variables showed a statistically significant difference between the sexes (Psex determination in situations where the skull and pelvis are missing and part of the femur is available. The study also demonstrates the need for different equations for different population groups.

  4. [Pathological proximal femur fracture: consider also primary bone tumour].

    Science.gov (United States)

    van de Sande, Michiel A J; van Rijswijk, Carla S P; Dijkstra, P D Sander; Taminiau, Antonie M H

    2010-01-01

    Two male and one female patient, aged 64, 70 and 51 respectively, were surgically treated for pathological fracture of the proximal femur without preoperative biopsy. In contrast to their benign radiological diagnosis, all three patients were finally diagnosed as having a malignant primary bone tumour. The proximal femur is the primary location of pathological fractures in the appendicular skeleton. Metastases to bone are the most common cause of a destructive lesion of the skeleton in an adult. Although rare, a primary bone tumour must be included in differential diagnosis of a pathological fracture. A systematic diagnostic strategy is critical to avoid complications that make curative treatment impossible. A solitary bone lesion seen on radiography should never be assumed to be a bone metastasis. Without further diagnostic research, surgical treatment for a pathological fracture should never be commenced before a definitive diagnosis is made.

  5. Treatment outcomes of intertrochanteric femur fractures treated with DLT™ nail

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    Mehmet Arıcan

    2015-12-01

    Full Text Available Objective: Intramedullary nails frequently use in proximal femur fractures. In this study, 49 patients with intertrochanteric fractures were evaluated clinical and radiological results treated with dyna locking trochanteric (DLT™ nail retrospectively. Methods: Twenty-two (44.9% patients were male and 27 (55.1% patients were female. Mean age was 74.29±1.98 (28-99 years and Followed up for a mean of 14.35±3.43 (9-24 months. Thirty-seven (75.6% of the fractures resulted from simple falls while 6 (12.2% caused from traffic accidents and 6 (12.2% fall down from height. There were 24 (49.0% left and 25 (51.0% right lower extremities fractured. According to Orthopaedic Trauma Association classification system; 21 (42.9%, 21 (42.9% and 7 (14.2% fractures were classified as 31A1, 31A2, and 31A3 respectively. One (2.0% patient had claviculae fracture, 3 (6.1% patients had radius distal fracture and 1 (2.0% patient had total knee arthroplasty. After surgery, X-ray was used for radiological results and functional outcomes were evaluated according to the Harris hip scoring system. Results: The average waiting time for the surgery was 2.02±0.18 (1-7 days and hospitalization time was 6.23±0.29 (4-15 days. Mean fracture healing time was 11.74±1.82 (8-15 weeks. Three patients had screw cut-out in the follow-up time and performed hemiarthroplasty. The average Harris hip score was 88.02±1.21 (42-97 points and included 29 (59.2% excellent cases, 17 (34.7% good and 3 (6.1% poor. Conclusion: DLT ™ nail is a safe and successful method because of low complication rates, and capability of detection.

  6. Immune Cell Isolation from Mouse Femur Bone Marrow

    OpenAIRE

    Liu, Xiaoyu; Quan, Ning

    2015-01-01

    The bone marrow is the site of hematopoesis and contains mixed population of blood cells including erythrocytes, granulocytes, monocytes, dendritic cells, lymphocytes and hematopoietic stem cells. The following protocol provides a simple and fast method for isolation of bone marrow immune cells (no erythrocytes) from mouse femurs with a yield of approximate 8 × 107 cells in 5 ml culture media (1.6 × 104 cells/μl). Further isolation or flow cytometric analysis might be required for study of sp...

  7. Epithelioid Hemangioendothelioma of the Femur with Benign Cystic Appearance

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jung Ah; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Kim, Yeo Goon [Dept. of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul (Korea, Republic of); Chung, Jin Haeng [Dept. of Patholgy, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Oh, Joo Han [Dept. of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2011-12-15

    An epithelioid hemangioendothelioma is an intermediate grade tumor between hemangioma and angiosarcoma that frequently shows marked enhancement because it is a vascular tumor. Herein, we describe a rare case of a malignant epithelioid hemangioendothelioma of the femur that was mistaken as a benign lesion such as a simple bone cyst or fibrous dysplasia because the tumor had a benign cystic appearance on MRI and its imaging findings showed a histopathologic correlation.

  8. Morphological characteristics of the developing proximal femur: A biomechanical perspective

    Directory of Open Access Journals (Sweden)

    Đurić Marija

    2012-01-01

    Full Text Available Introduction. In contrast to a plethora of studies on the proximal femur in adults, its external and internal morphology in growing children has not been sufficiently analyzed. Objective. We analyzed changes in external and internal morphology of the proximal femur during growth and development to interpret the links between them and concepts of the human femoral biomechanics. Methods. We assessed external geometry, internal trabecular and cortical arrangement, and bone mineral density (BMD of the proximal femur in 29 children (age at death from 1 month to 14 years from archaeological context by using microscopic and radiographic methods. Results. The results showed that both the femoral neck width and length increased with age, with the femoral neck becoming more elongated, while the collo-diaphyseal angle decreased. A strong relationship between age and adjusted areal BMD was found, showing continuous increase during childhood. Parallel trabecular pattern at birth changed to mature three distinct trabecular groups (longitudinal – principal compressive, transversal – tensile and randomly scattered starting from the age of 8 months. In older children the superior and inferior aspects of the femoral neck differently changed with growth, with medial neck having thicker cortex and trabeculae. Conclusion. In the light of bone adaptation principle, the observed changes in external and internal morphology are governed by mechanical forces acting on the developing femur. Our findings on the development of trabecular pattern and cortical distribution are compatible with recent views on the femoral biomechanics which point out the predominance of compressive stresses in the femoral neck, adaptation to shear stresses, multiaxial loading perspective, prevalence of muscle effects over body weight, and existence of adaptational eccentricity. [Projekat Ministarstva nauke Republike Srbije, br. 45005

  9. Anatomical evaluation and stress distribution of intact canine femur.

    Science.gov (United States)

    Verim, Ozgur; Tasgetiren, Suleyman; Er, Mehmet S; Ozdemir, Vural; Yuran, Ahmet F

    2013-03-01

    In the biomedical field, three-dimensional (3D) modeling and analysis of bones and tissues has steadily gained in importance. The aim of this study was to produce more accurate 3D models of the canine femur derived from computed tomography (CT) data by using several modeling software programs and two different methods. The accuracy of the analysis depends on the modeling process and the right boundary conditions. Solidworks, Rapidform, Inventor, and 3DsMax software programs were used to create 3D models. Data derived from CT were converted into 3D models using two different methods: in the first, 3D models were generated using boundary lines, while in the second, 3D models were generated using point clouds. Stress analyses in the models were made by ANSYS v12, also considering any muscle forces acting on the canine femur. When stress values and statistical values were taken into consideration, more accurate models were obtained with the point cloud method. It was found that the maximum von Mises stress on the canine femur shaft was 34.8 MPa. Stress and accuracy values were obtained from the model formed using the Rapidform software. The values obtained were similar to those in other studies in the literature. Copyright © 2012 John Wiley & Sons, Ltd.

  10. A method for sex estimation using the proximal femur.

    Science.gov (United States)

    Curate, Francisco; Coelho, João; Gonçalves, David; Coelho, Catarina; Ferreira, Maria Teresa; Navega, David; Cunha, Eugénia

    2016-09-01

    The assessment of sex is crucial to the establishment of a biological profile of an unidentified skeletal individual. The best methods currently available for the sexual diagnosis of human skeletal remains generally rely on the presence of well-preserved pelvic bones, which is not always the case. Postcranial elements, including the femur, have been used to accurately estimate sex in skeletal remains from forensic and bioarcheological settings. In this study, we present an approach to estimate sex using two measurements (femoral neck width [FNW] and femoral neck axis length [FNAL]) of the proximal femur. FNW and FNAL were obtained in a training sample (114 females and 138 males) from the Luís Lopes Collection (National History Museum of Lisbon). Logistic regression and the C4.5 algorithm were used to develop models to predict sex in unknown individuals. Proposed cross-validated models correctly predicted sex in 82.5-85.7% of the cases. The models were also evaluated in a test sample (96 females and 96 males) from the Coimbra Identified Skeletal Collection (University of Coimbra), resulting in a sex allocation accuracy of 80.1-86.2%. This study supports the relative value of the proximal femur to estimate sex in skeletal remains, especially when other exceedingly dimorphic skeletal elements are not accessible for analysis.

  11. A biomechanical testing system to determine micromotion between hip implant and femur accounting for deformation of the hip implant: Assessment of the influence of rigid body assumptions on micromotions measurements.

    Science.gov (United States)

    Leuridan, Steven; Goossens, Quentin; Roosen, Jorg; Pastrav, Leonard; Denis, Kathleen; Mulier, Michiel; Desmet, Wim; Vander Sloten, Jos

    2017-02-01

    Accurate pre-clinical evaluation of the initial stability of new cementless hip stems using in vitro micromotion measurements is an important step in the design process to assess the new stem's potential. Several measuring systems, linear variable displacement transducer-based and other, require assuming bone or implant to be rigid to obtain micromotion values or to calculate derived quantities such as relative implant tilting. An alternative linear variable displacement transducer-based measuring system not requiring a rigid body assumption was developed in this study. The system combined advantages of local unidirectional and frame-and-bracket micromotion measuring concepts. The influence and possible errors that would be made by adopting a rigid body assumption were quantified. Furthermore, as the system allowed emulating local unidirectional and frame-and-bracket systems, the influence of adopting rigid body assumptions were also analyzed for both concepts. Synthetic and embalmed bone models were tested in combination with primary and revision implants. Single-legged stance phase loading was applied to the implant - bone constructs. Adopting a rigid body assumption resulted in an overestimation of mediolateral micromotion of up to 49.7μm at more distal measuring locations. Maximal average relative rotational motion was overestimated by 0.12° around the anteroposterior axis. Frontal and sagittal tilting calculations based on a unidirectional measuring concept underestimated the true tilting by an order of magnitude. Non-rigid behavior is a factor that should not be dismissed in micromotion stability evaluations of primary and revision femoral implants. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Endomedullary radiofrequency ablation of metastatic lesion of the right femur 5 years after primary breast carcinoma: a case report.

    Science.gov (United States)

    Majerović, Mate; Augustin, Goran; Jelincić, Zeljko; Buković, Damir; Burcar, Ivan; Smud, Dubravko; Kekez, Tihomir; Kinda, Emil; Matosević, Petar; Turcić, Josip

    2008-12-01

    Metastatic tumors of the long bones usually present with severe pain refractory to analgesic therapy. Pathologic fractures of the bone may lead to the significant decrease of patient's quality of life and necessitate further surgical therapy. We present 66 year old female with metastatic left breast carcinoma (T2N0M0) diagnosed 5 years before presentation of the metastatic lesion of the right femur causing severe pain in the middle of the right upper leg. Pain persisted after palliative irradiation therapy. We performed radiofrequency ablation of the metastatic lesion of the right femur using R.I.TA. Medical System Generator. This resulted in total necrosis of the tumor mass that caused osteolysis of the internal part of the femoral cortex. First three months after RFA procedure, the pain and tenderness were absent and normal daily activities were performed without restrictions.

  13. Fractures of the proximal femur: correlates of radiological evidence of osteoporosis

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Salil H.; Murphy, Kieran P. [Johns Hopkins School of Medicine, Radiology, Baltimore, Maryland (United States)

    2006-04-15

    Fractures of the proximal femur are common sequelae of osteoporosis, and are responsible for significant morbidity and mortality in elderly patients worldwide. Plain film radiographic assessment methods to assess for fracture risk may be of particular value. The authors present the results of biomechanical testing, radiographic imaging, and histologic exam of 20 embalmed human bone specimens, with implications for clinical correlation of radiologic findings. Authors assessed bone architecture using the Singh Index, using a blinded 3-rater system to reduce bias and measure intra-observer reliability. After loading to failure with ultimate tensile strength (UTS), bone specimens were assessed by fracture location type and by trabecular bone volume (TBV). Singh scoring was performed with Inter-Class Correlation of 0.80 (F=0.24, by ICC Portney Model 2). A statistically-significant difference among the UTS distributions was noted for UTS by Fracture Site (F=4.49, p=0.026, by ANOVA). No significant association of Singh Index with TBV, or TBV with UTS, was observed, although a trend toward greater UTS with higher Singh grade was observed. The authors propose that the Singh Index is a valuable and reliable indicator which may reflect structural integrity in trabecular bone. Fracture site along the femur is associated with tensile strength. The authors, in the light of these findings, address the promise and potential impact of prophylactic hip augmentation in populations at risk for femoral neck pathology. (orig.)

  14. 3D reconstruction of patient-specific femurs using Coherent Point Drift

    Directory of Open Access Journals (Sweden)

    Shaobin Sun

    2013-02-01

    Full Text Available This paper dealt with the problem that the overlapping digital radiographs couldn`t reflect the 3D space information of the patient-specific femur in the orthopaedic surgery diagnosis. A 2D-3D non-rigid registration method based on Coherent Point Drift was proposed to realize the 3D reconstruction of the patient-specific femur before the surgery, which used biplanar digital radiographs of the patient-specific femur and the CT volume data of a generic femur. With the advantages of low cost, fast imaging speed and little radiation to the patients and doctors, this method provided more effective 3D imaging information for the femur diagnosis and preoperative plans. The registration experiments showed that the proposed method recovered the 3D model and the pose of the patient-specific femur effectively with a fast, accurate and robust registration result, which had satisfied the needs of clinical application.

  15. Percutaneous Stabilization of Impending Pathological Fracture of the Proximal Femur

    Energy Technology Data Exchange (ETDEWEB)

    Deschamps, Frederic, E-mail: frederic.deschamps@igr.fr; Farouil, Geoffroy, E-mail: g.farouil@gmail.com; Hakime, Antoine, E-mail: thakime@yahoo.com; Teriitehau, Christophe, E-mail: cteriitehau@me.com; Barah, Ali, E-mail: ali.barah@gmail.com; Baere, Thierry de, E-mail: debaere@igr.fr [Institut Gustave Roussy, Interventional Radiology Department (France)

    2012-12-15

    Objective: Percutaneous osteosynthesis plus cementoplasty (POPC) is a minimally invasive technique that has never been reported before and that we have prospectively evaluated for patients with impending pathological fracture of the proximal femur. Methods: We performed POPC in 12 patients (3 males, 9 females) with metastasis of the proximal femur with a high risk of fracture (Mirels' score {>=}8) between February 2010 and July 2011. Patients were not candidates for standard surgical stabilization. We analyzed the feasibility, duration, and complication of the procedure, the risk of fracture, the decrease in pain (Visual Analog Scale, VAS), and length of stay in hospital. Data were prospectively collected in all patients. Results: The mean Mirels' score was 9.8 {+-} 1.2 (range, 8-11). The technical success was 100%. POPC was performed under general anesthesia (n = 6) or conscious sedation (n = 6). The mean duration was 110 {+-} 43 (range, 60-180) minutes. All patients stood up and walked the second day after the procedure. The average length of stay in the hospital was 4 {+-} 1.6 (range, 2-7) days. We experienced two hematomas in two patients and no thromboembolic complication. For symptomatic patients (n = 8), VAS decreased from 6.5/10 (range, 2-9) before treatment to 1/10 (range, 0-3) 1 month after. No fracture occurred after a median follow-up of 145 (range, 12-608) days. Conclusions: POPC for impending pathological fracture of the proximal femur seems to be a promising alternative for cancer patients who are not candidates for surgical stabilization. Further studies are required to confirm this preliminary experience.

  16. Static or dynamic intramedullary nailing of femur and tibia.

    Science.gov (United States)

    Omerovic, Djemil; Lazovic, Faruk; Hadzimehmedagic, Amel

    2015-04-01

    The basic principle of non-surgical fracture treatment is to restore the original anatomical position of fractured fragments by different techniques, without direct access to the bone and without further traumatizing of tissues. Intramedullary nailing is synthesis and consolidation of fracture fragments with the main goal to gain strength and permanent placement of the implants. Two techniques of intramedullary osteosynthesis are used: with dynamic or with static intramedullary nail. Dynamization include conversion of static nail by removing screws from the longest fragment. The aim of this study is to determine whether there is a difference in the speed and quality of healing of the type A and B fractures of the femur and tibia treated by static or dynamic intramedullary nails and to compare the results. The study was conducted at the Clinic for Orthopaedics and Traumatology, Clinical Center University Sarajevo from January 2004 to June 2009. The study was retrospective-prospective, manipulative, controlled and it was conducted on a total of 129 patients with closed fractures of the diaphysis of the femur and tibia type A and type B, with different segments of bone, regardless of sex and age structure, with the exception of children under 14 years of age. Precisely there were 47 patients with femoral fractures and 82 patients with tibial fractures. The average number of weeks of healing femoral and tibial fractures was slightly in advantage of static intramedullary osteosynthesis, it was 17.08 weeks (SD=3.382). The average number of weeks of healing in 23 patients with fractures of the femur, treated by dynamic intramedullary osteosynthesis was 17.83 (SD=2.978). We can conclude that static intramedullary nailing osteosynthesis unable movements between fragments which directly stimulates bone formation and formation of minimal callus. Static intramedullary osteosynthesis resolve the problem of stabilizing the fracture, limb shortening and rotation of fragments.

  17. The BHU bicentric bipolar prosthesis in fracture neck femur in active elderly

    Directory of Open Access Journals (Sweden)

    Singh Saurabh

    2008-09-01

    Full Text Available Abstract Background 55 BHU bicentric bipolar hemiarthroplasties were reviewed after a mean follow up of 4 years (range 1–5 years. Patients with displaced subcapital fractures were selected for operation on the basis of good mobility before the fracture. Object of the study was to see the efficacy of BHU bipolar prostheses and functional outcome. Results There were no incidences of dislocation. Modified Harris hip scoring system scoring system was used which included sitting crosslegged and squatting in view of the sociocultural needs of the patients of Indian subcontinent. Modified Harris hip scoring system 89% had a good or excellent result and 94% had no or only occasional pain. Majority of the patients returned to their prefracture activity. Conclusion Thus at follow up of 4 year the BHU bicentric bipolar prosthesis has been shown to be a good option for intracapsular fractures of neck femur with encouraging results.

  18. Investigating the Capability of IRS-P6-LISS IV Satellite Image for Pistachio Forests Density Mapping (case Study: Northeast of Iran)

    Science.gov (United States)

    Hoseini, F.; Darvishsefat, A. A.; Zargham, N.

    2012-07-01

    In order to investigate the capability of satellite images for Pistachio forests density mapping, IRS-P6-LISS IV data were analyzed in an area of 500 ha in Iran. After geometric correction, suitable training areas were determined based on fieldwork. Suitable spectral transformations like NDVI, PVI and PCA were performed. A ground truth map included of 34 plots (each plot 1 ha) were prepared. Hard and soft supervised classifications were performed with 5 density classes (0-5%, 5-10%, 10-15%, 15-20% and > 20%). Because of low separability of classes, some classes were merged and classifications were repeated with 3 classes. Finally, the highest overall accuracy and kappa coefficient of 70% and 0.44, respectively, were obtained with three classes (0-5%, 5-20%, and > 20%) by fuzzy classifier. Considering the low kappa value obtained, it could be concluded that the result of the classification was not desirable. Therefore, this approach is not appropriate for operational mapping of these valuable Pistachio forests.

  19. Primary osteosarcoma of the distal femur in two consecutive brothers.

    Science.gov (United States)

    Chin, K R; Mankin, H J; Gebhardt, M C

    2001-01-01

    The following report describes two consecutive brothers from a nonimmigrant family, with no identifiable predisposing factors, who presented with osteosarcomas of their distal femurs, one at the age of 18 years and the other at the age of 21 years. Until a cost-effective program is developed to screen for osteosarcoma, a detailed family history should be obtained from every new patient with osteosarcoma and parents should be urged to schedule early evaluations of siblings with complaints of painful extremities. Increased frequency of cytogenetic studies to screen for genetic abnormalities in patients with osteosarcoma is recommended to help elucidate the cause of osteosarcoma.

  20. A case of acute bilateral femur fracture with vascular injury

    Institute of Scientific and Technical Information of China (English)

    Slavisa Zagorac; Aleksandar Lesic; Marko Bumbasirevic

    2016-01-01

    The femoral fractures remain the great challenge for orthopedic surgeons regarding time of fixation and appropriate fixation techniques. There is a bimodal distribution of fractures occurring most frequently in young males after high-energy trauma (motor vehicle accidents) and in elderly females after falls from standing. Young patients with femoral fracture are under the great risk of multiple injuries. Hence, the great significance is optimal time of fixation. We present a case of unusual pattern of injury and fixation technique of bilateral proximal femur fracture associated with vascular injury, with very satisfied outcome.

  1. A case of acute bilateral femur fracture with vascular injury

    Directory of Open Access Journals (Sweden)

    Slavisa Zagorac

    2016-01-01

    Full Text Available The femoral fractures remain the great challenge for orthopedic surgeons regarding time of fixation and appropriate fixation techniques. There is a bimodal distribution of fractures occurring most frequently in young males after high-energy trauma (motor vehicle accidents and in elderly females after falls from standing. Young patients with femoral fracture are under the great risk of multiple injuries. Hence, the great significance is optimal time of fixation. We present a case of unusual pattern of injury and fixation technique of bilateral proximal femur fracture associated with vascular injury, with very satisfied outcome.

  2. Three-Dimensional Bone Adaptation of the Proximal Femur

    DEFF Research Database (Denmark)

    Bagge, Mette

    1998-01-01

    The bone remodeling of a three-dimensional model of the proximal femur is considered. The bone adaptation is numerically described as an evolution in time formulated such that the structural change goes in an optimal direction within each time step for the optimal boundary conditions. In the bone...... remodeling scheme is included the memory of past loadings to account for the delay in the bone response to the load changes. In order to get a realistic bone adaptation process, the bone structure at the onset of the remodeling needs to be realistic too. A start design is obtained by structural optimization...

  3. Correlation of measurable serum markers of inflammation with lung levels following bilateral femur fracture in a rat model

    Directory of Open Access Journals (Sweden)

    Benjamin W Sears

    2010-08-01

    Full Text Available Benjamin W Sears1, Dustin Volkmer1, Sherri Yong2, Ryan D Himes1, Kristen Lauing1, Michele Morgan1, Michael D Stover1, John J Callaci11Department of Orthopaedics, 2Department of Pathology, Loyola University Medical Center, Maywood, IL, USAIntroduction: Evaluation of the systemic inflammatory status following major orthopedic trauma has become an important adjunct in basing post-injury clinical decisions. In the present study, we examined the correlation of serum and lung inflammatory marker levels following bilateral femur fracture.Materials and methods: 45 Sprague Dawley rats underwent sham operation or bilateral femoral intramedullary pinning and mid-diaphyseal closed fracture via blunt guillotine. Animals were euthanized at specific time points after injury. Serum and lung tissue were collected, and 24 inflammatory markers were analyzed by immunoassay. Lung histology was evaluated by a blinded pathologist.Results: Bilateral femur fracture significantly increased serum markers of inflammation including interleukin (IL-2, IL-6, IL-10, GM-CSF, KC/GRO, MCP-1, and WBC. Femur fracture ­significantly increased serum and lung levels of IL-1a and KC/GRO at 6 hours. Lung levels of IL-6 ­demonstrated a trend towards significance. Histologic changes in pulmonary tissue after fracture included pulmonary edema and bone elements including cellular hematopoietic cells, bone fragments and marrow emboli.Discussion and conclusion: Our results indicate that bilateral femur fracture with fixation in rats results in increases in serum markers of inflammation. Among the inflammatory markers measured, rise in the serum KC/GRO (CINC-1, a homolog to human IL-8, correlated with elevated levels of lung KC/GRO. Ultimately, analysis of serum levels of KC/GRO (CINC-1, or human IL-8, may be a useful adjunct to guide clinical decisions regarding surgical timing.Keywords: blunt trauma, injury, cytokine, IL-8, bone marrow emboli

  4. Bone mineral density of lumbar spine and femur in acromegaly. Knochendichte an Lendenwirbelsaeule und Femur bei Akromegalie

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    Huebsch, P. (Ludwig-Boltzmann-Institut fuer Radiologisch-Physikalische Tumordiagnostik, Vienna (Austria)); Kotzmann, H. (Universitaetsklinik fuer Innere Medizin 3, Vienna (Austria)); Svoboda, T. (Universitaetsklinik fuer Innere Medizin 3, Vienna (Austria)); Kainberger, F.M. (Ludwig-Boltzmann-Institut fuer Radiologisch-Physikalische Tumordiagnostik, Vienna (Austria)); Bankier, A. (Ludwig-Boltzmann-Institut fuer Radiologisch-Physikalische Tumordiagnostik, Vienna (Austria)); Seidl, G. (Ludwig-Boltzmann-Institut fuer Radiologisch-Physikalische Tumordiagnostik, Vienna (Austria))

    1993-08-01

    Acromegaly is regarded as a cause for secondary osteoporosis, whereas recent papers suggest that growth hormone increases bone mineral density (BMD). In 16 patients with active acromegaly we found an increased BMD compared to normal controls in the lumbar spine and the proximal femur by means of dual energy X-ray absoptiometry. This increase in BMD was statistically significant in the femoral neck and in Ward's triangle (P=0.05). Moreover, no signs of osteoporosis were found radiologically. (orig.)

  5. Effects of Hip Geometry on Fracture Patterns of Proximal Femur

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    Seyyed Morteza Kazemi

    2016-07-01

    Full Text Available Background: Some studies have previously shown that geometry of proximal femur can affect the probability of fracture and type of fracture. It happens since the geometry of the proximal femur determines how a force is applied to its different parts. In this study, we have compared proximal femur’s geometric characteristics in femoral neck (FNF, intertrochanteric (ITF and Subtrochanteric (STF fractures. Methods: In this study, 60 patients who had hip fractures were studied as case studies. They were divided into FNF, ITF and STF groups based on their fracture types (20 patients in each group. Patients were studied with x-ray radiography and CT scans. Radiological parameters including femoral neck length from lateral cortex to center of femoral head (FNL, diameter of femoral head (FHD, diameter of femoral neck (FND, femoral head neck offset (FHNO, neck-shaft angle (alpha, femoral neck anteversion (beta were measured and compared in all three groups. Results: Amount of FNL was significantly higher in STF group compared to FNF (0.011 while ITF and STF as well as FNT and ITF did not show a significant different. Also, FND in FNF group was significantly lower than the other two groups, i.e. ITF and STF. In other cases there were no instances of significant statistical difference. Conclusion: Hip geometry can be used to identify individuals who are at the risk of fracture with special pattern. Also, it is important to have more studies in different populations and more in men.

  6. Effects of Hip Geometry on Fracture Patterns of Proximal Femur

    Science.gov (United States)

    Kazemi, Seyyed Morteza; Qoreishy, Mohamad; Keipourfard, Ali; Sajjadi, Mohammadreza Minator; Shokraneh, Shahram

    2016-01-01

    Background: Some studies have previously shown that geometry of proximal femur can affect the probability of fracture and type of fracture. It happens since the geometry of the proximal femur determines how a force is applied to its different parts. In this study, we have compared proximal femur’s geometric characteristics in femoral neck (FNF), intertrochanteric (ITF) and Subtrochanteric (STF) fractures. Methods: In this study, 60 patients who had hip fractures were studied as case studies. They were divided into FNF, ITF and STF groups based on their fracture types (20 patients in each group). Patients were studied with x-ray radiography and CT scans. Radiological parameters including femoral neck length from lateral cortex to center of femoral head (FNL), diameter of femoral head (FHD), diameter of femoral neck (FND), femoral head neck offset (FHNO), neck-shaft angle (alpha), femoral neck anteversion (beta) were measured and compared in all three groups. Results: Amount of FNL was significantly higher in STF group compared to FNF (0.011) while ITF and STF as well as FNT and ITF did not show a significant different. Also, FND in FNF group was significantly lower than the other two groups, i.e. ITF and STF. In other cases there were no instances of significant statistical difference. Conclusion: Hip geometry can be used to identify individuals who are at the risk of fracture with special pattern. Also, it is important to have more studies in different populations and more in men. PMID:27517071

  7. Valgus osteotomy for nonunion and neglected neck of femur fractures.

    Science.gov (United States)

    Varghese, Viju Daniel; Livingston, Abel; Boopalan, P R; Jepegnanam, Thilak S

    2016-05-18

    Nonunion neck of femur can be a difficult problem to treat, particularly in the young, and is associated with high complication rates of avascular necrosis due to the precarious blood supply and poor biomechanics. The various treatment options that have been described can be broadly divided according to the aim of improving either biology or biomechanics. Surgeries aimed at improving the biology, such as vascularized fibula grafting, have good success rates but require high levels of expertise and substantial resources. A popular surgical treatment aimed at improving the biomechanics-valgus intertrochanteric osteotomy-optimizes conditions for fracture healing by converting shear forces across the fracture site into compressive forces. Numerous variations of this surgical procedure have been developed and successfully applied in clinical practice. As a result, the proximal femoral orientation for obtaining a good functional outcome has evolved over the years, and the present concept of altering the proximal femoral anatomy as little as possible has arisen. This technical objective supports attaining union as well as a good functional outcome, since excessive valgus can lead to increased joint reaction forces. This review summarizes the historical and current literature on valgus intertrochanteric osteotomy treatment of nonunion neck of femur, with a focus on factors predictive of good functional outcome and potential pitfalls to be avoided as well as controversies surrounding this procedure.

  8. Evaluation of Catrosat 1PAN Stereo and Resourcesat Liss 4 MSS Merged Data for Morphometric Analysis, Delineation of Drainage Basins and Codification in Tamil Nadu, India and Australia

    Science.gov (United States)

    Mohamed, G. S.; Srinivasan, S.; Pandian, R.; Gummidipoondi, R. J.; Venkatchalam, R. V.; Swaminathan. S, S.

    2012-07-01

    The Topographic maps and Aerial Photographs are used for morphometric analysis of drainage basins and mapping contours with drainage. The stereo pairs of 2.5 m resolution Cartosat 1, Indian satellite 2 and merged data with 5.5 m resolution P6 Resourcesat 1 LISS 4 Indian satellite of 2001 is used to map, rills, gullies, and streams of first order to evaluate part of drainage basin of Cooum and Poondi Reservoir in Thiruvallur taluk of Tamil Nadu state. The Geo Eye latest 2011data is also used with Catrosat 1Stereo data to study present morphology of tiny micro watersheds to study the use of High resolution data for delineation and codification of watersheds. This study area is in an inter fluvial drainage basin of Cooum and Kusasthalai rivers. Kusasthalai river drains in Poondi reservoir which is about 50 km from Chennai. The excess water from Kosasthalai is also diverted through Kesawaram weir to Cooum river which passes through Thiruvallur and Chennai city before it's confluence with Bay of Benegal in the east. As Cooum basin is at higher elevation, water for irrigation is again diverted through chain of tanks to Kusasthalai river basin to drain in Poondi reservoir. Delineation of water sheds in this fluvial basin is difficult by manual survey as man made irrigation channels, natural drainage streams etc., have to be clearly identified. The streams of various orders are identified based on Strahler stream order hierarchy of tributaries, slops and contours using large scale satellite data. The micro water sheds are delinated identifying the ridges from Catrosat data for this interfluves basin which has mild slop. To illustrate this research, parts of two micro watersheds which were delineated using 1:50000 data for Tamil Nadu watershed Atlas up to 7th order streams are taken up for a detailed study using high resolution data. 19 Micro watersheds with streams up to 10th order are mapped. The capability of high resolution satellite data for digital as well as visual

  9. EVALUATION OF CATROSAT 1PAN STEREO AND RESOURCESAT LISS 4 MSS MERGED DATA FOR MORPHOMETRIC ANALYSIS, DELINEATION OF DRAINAGE BASINS AND CODIFICATION IN TAMIL NADU, INDIA AND AUSTRALIA

    Directory of Open Access Journals (Sweden)

    G. S. Mohamed

    2012-07-01

    Full Text Available The Topographic maps and Aerial Photographs are used for morphometric analysis of drainage basins and mapping contours with drainage. The stereo pairs of 2.5 m resolution Cartosat 1, Indian satellite 2 and merged data with 5.5 m resolution P6 Resourcesat 1 LISS 4 Indian satellite of 2001 is used to map, rills, gullies, and streams of first order to evaluate part of drainage basin of Cooum and Poondi Reservoir in Thiruvallur taluk of Tamil Nadu state. The Geo Eye latest 2011data is also used with Catrosat 1Stereo data to study present morphology of tiny micro watersheds to study the use of High resolution data for delineation and codification of watersheds. This study area is in an inter fluvial drainage basin of Cooum and Kusasthalai rivers. Kusasthalai river drains in Poondi reservoir which is about 50 km from Chennai. The excess water from Kosasthalai is also diverted through Kesawaram weir to Cooum river which passes through Thiruvallur and Chennai city before it's confluence with Bay of Benegal in the east. As Cooum basin is at higher elevation, water for irrigation is again diverted through chain of tanks to Kusasthalai river basin to drain in Poondi reservoir. Delineation of water sheds in this fluvial basin is difficult by manual survey as man made irrigation channels, natural drainage streams etc., have to be clearly identified. The streams of various orders are identified based on Strahler stream order hierarchy of tributaries, slops and contours using large scale satellite data. The micro water sheds are delinated identifying the ridges from Catrosat data for this interfluves basin which has mild slop. To illustrate this research, parts of two micro watersheds which were delineated using 1:50000 data for Tamil Nadu watershed Atlas up to 7th order streams are taken up for a detailed study using high resolution data. 19 Micro watersheds with streams up to 10th order are mapped. The capability of high resolution satellite data for digital

  10. Rule-based semi-automated approach for the detection of landslides induced by 18 September 2011 Sikkim, Himalaya, earthquake using IRS LISS3 satellite images

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    Sajad Siyahghalati

    2016-01-01

    Full Text Available Landslide is considered as one of the most devastating and most costly natural hazards in highlands, which is triggered mainly by rainfalls or earthquakes. In comparison with other methods, landslide mapping and monitoring via remote sensing data products are considered as the least expensive method of data collection. The current research attempts to detect landslides which occurred due to a 6.9 magnitude earthquake in Sikkim Himalaya, India, on 18 September 2011 and also to establish the spatial relationship between landslides and the slope of the terrain. To detect the landslides, decision tree method was applied on two Indian remote sensing satellites linear imaging self-scanning sensor (LISS III images acquired from 2007 and 2011 which were taken before and after the earthquake. As the study area was relatively huge for identifying the landslides, the region was separated into two parts: “tested study area” and “real study area”. The overall accuracy of landslide detection was 76%, and 75% for tested and real study area, respectively. Then, the spatial relationship between the landslides and the slope of the terrain was conducted using the digital elevation model. The results revealed that most of the landslides occurred between the slope of 25° and 45° covering 2.3 km2 and no landslide recorded in the slope of 65°–90° in the real study area. The results obtained in this study may be useful for decision-making and policy support towards reconstruction effort after the landslide occurrence. In addition, the information can be useful for reducing the risk of potential damages to substructures and properties by developing new and efficient strategies.

  11. 微创LISS钢板治疗胫腓骨骨折疗效观察%The observation of the effect of using minimally invasive LISS in the treatment of tibia and fibula fractures

    Institute of Scientific and Technical Information of China (English)

    黄朝靖; 孟山明

    2014-01-01

    目的:分析AO微创内固定系统( LISS)治疗胫腓骨骨折疗效。方法手术治疗92例胫腓骨骨折患者, LISS钢板组47例,解剖钢板组45例,观察两组骨折复位、膝关节功能恢复情况。结果患者均获随访,时间6~24个月。两组骨折愈合时间、内翻角比较差异无统计学意义( P>0.05);LISS钢板组后倾角、膝关节自由活动度分别为10.7°±2.9°、128.3°±18.5°,均大于解剖钢板组的8.3°±1.7°、102.4°±17.6°(P0. 05). The dip, knee free activity of the LISS plate group was 10. 7° ± 2. 9°,128. 3° ± 18. 5°, which were greater than those in the anatomic plate group of 8. 3° ± 1. 7°, 102. 4° ± 17. 6°(P<0. 01). Knee function score of the LISS plate group was (98. 4 ± 20. 3) points, higher than that in the anatomic plate group of (80. 3 ± 18. 9) points (P<0. 01). Complication rate of the LISS plate group was 4. 26%, lower than that in anatomic plate group of 20. 00% (P<0. 05). Conclusions LISS is safe and reliable in the treatment of tibia and fibula fractures. The knee function recovers well.

  12. SUPRACONDYLAR FRACTURE FEMUR T REATED WITH INTRAMEDULLARY NAIL : A PROSPECTIVE STUDY

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    Venkateswara Rao

    2015-08-01

    Full Text Available BACKGROUND: Supracondylar fractures are one of the commonest fractures encountered in high velocity trauma which are associated with high morbidity and mortality . 1 Isolated fracture can itself lead to complications such as ARDS and pulmonary embo lism 1 . This necessitates early stabilization of fractures. Internal fixation is the choice of treatment in supracondylar fractures (AO type – A . 2 Retrograde supracondylar nail has shown to give one of the best results in terms of recovery, fracture union, r eturn to work and the functional outcome. METHODS: 20 patients with supracondylar fracture femur were studied (AO type - A. Supracondylar fractures femur were treated by closed or open reduction and internal fixation by Retrograde supracondylar nail inserte d through inter - condylar notch between July 2012 to September 2014 at our institution. The patients were evaluated clinically and radiologically for outcomes. All patients were followed up for an average of 12 months. Outcome was assessed using NEER’S SCOR E . 3 RESULTS: Supracondylar femoral extra - articular fractures in 20 patients were treated in this study with retrograde intramedullary supracondylar nail after closed or open reduction. The AO - ASIF fracture classification was used. All extra - articular fractures were selected for study. Six were compound fractures according to the Gustilo - Anderson classification , 4 the fracture was stabilized with the chosen system at an average of 6.9 days post - trauma, with an average operative time of 65. 9 minutes. In 15 cases closed reduction was possible while 5 required open reduction. Post - operatively all patients were shifted to continuous passive mobilization with early toe touch walking and gradually progressive weight bearing with appearance of clinical and radi ological signs of union. Evaluation was done according to Neer’s rating system . 3 65% excellent results were found. In the present study, road traffic accidents

  13. Interval hypoxic training in complex treatment of fractures of trochanteric area of the femur

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    Василь Михайлович Шимон

    2015-05-01

    Full Text Available The method of interval hypoxic training (IHT is used to increase physical endurance of athletes and for treatment of certain systemic diseases, due to the ability of IHT affect metabolism, homeostasis and the immune system. The aims of the article are improving the results of treatment and rehabilitation of patients with fractures of the trochanteric area of the femur by the method of interval hypoxic training and study its influence on bone metabolism.Materials and methods. 17 patients who were hospitalized in the clinic of general surgery UzhNU with fractures of the trochanteric area of the femur are examined in the period from 2012 to 2015.The first group consisted of 6 patients who from day-patient treatment is conducted IHT by gas mixture of 12 % oxygen. The second group consisted of 4 patients with thyrotoxicosis who are also receiving IHT by gas mixture of 12% oxygen.The control group consisted of 7 patients with fractures of the trochanteric area of the femur who refused from IHT.Results and its discussion. The best physical activity is observed in the first group. Starting physical activity is the lowest in the second group, but its development is faster. Slowly increase the duration of physical activity compared with the first two groups is observed in the control group.In the control study after 1 month it is noted that calcium level increased in all three groups. Increase in the second group is biggest. The level of phosphorus decreased in the first and the control group and increased in the second group.The levels of osteocalcin and alkaline phosphatase increased. Rates were higher and increase was substantial in the first two groups in comparison with the control group.Conclusions.• Intensive growth of length of one-time physical activity most notably in patients with thyrotoxicosis is observed in patients who are receiving IHT.• Improvement of the activity of bone metabolism is observed in patients after IHT

  14. [Atypical subtrochanteric femur fracture under alendronate therapy in spite of an intramedullar implant].

    Science.gov (United States)

    Sobotta, H-P; Gösling, T

    2017-02-01

    There are a number of case reports about women undergoing long-term bisphosphonate therapy who have suffered an atypical subtrochanteric or femoral shaft fracture due to an inadequate trauma.The present case reports on a patient who underwent a subtrochanteric femur fracture with the inserted AO femur interlocking nail.

  15. Preparation for femur prosthesis of ceramic-metal combination artificial hip joint

    Institute of Scientific and Technical Information of China (English)

    王欣宇; 李世普; 陈晓明; 贺建华

    2002-01-01

    Al2O3 material was synthesized by using high purity alumina micro-powder and Mg-Zr-Y composite additives at temperature of 1600℃, which had good mechanics property of 416MPa bending strength and 5.46MPa*m1/2 fracture toughness. Femur head prosthesis of hip joint was prepared by using this material; Ti alloy femur handle was sprayed bioactive hydroxyapatite (HA) by plasma on surface, which improves the chemistry stability and biocompatibility of Ti alloy; ceramic-metal combination artificial hip joint femur prosthesis was made by combining Al2O3 femur head with Ti alloy femur handle, so the manufacturing process is improved and the property and application flexibility are advanced.

  16. Osteoporosis or Low Bone Mass at the Femur Neck or Lumbar Spine in Older Adults: United States, 2005-2008

    Science.gov (United States)

    ... Order from the National Technical Information Service NCHS Osteoporosis or Low Bone Mass at the Femur Neck ... Survey, 2005–2008. What is the prevalence of osteoporosis or low bone mass at the femur neck ...

  17. Segmentation of radiographic images under topological constraints: application to the femur

    Energy Technology Data Exchange (ETDEWEB)

    Gamage, Pavan; Xie, Sheng Quan [University of Auckland, Department of Mechanical Engineering (Mechatronics), Auckland (New Zealand); Delmas, Patrice [University of Auckland, Department of Computer Science, Auckland (New Zealand); Xu, Wei Liang [Massey University, School of Engineering and Advanced Technology, Auckland (New Zealand)

    2010-09-15

    A framework for radiographic image segmentation under topological control based on two-dimensional (2D) image analysis was developed. The system is intended for use in common radiological tasks including fracture treatment analysis, osteoarthritis diagnostics and osteotomy management planning. The segmentation framework utilizes a generic three-dimensional (3D) model of the bone of interest to define the anatomical topology. Non-rigid registration is performed between the projected contours of the generic 3D model and extracted edges of the X-ray image to achieve the segmentation. For fractured bones, the segmentation requires an additional step where a region-based active contours curve evolution is performed with a level set Mumford-Shah method to obtain the fracture surface edge. The application of the segmentation framework to analysis of human femur radiographs was evaluated. The proposed system has two major innovations. First, definition of the topological constraints does not require a statistical learning process, so the method is generally applicable to a variety of bony anatomy segmentation problems. Second, the methodology is able to handle both intact and fractured bone segmentation. Testing on clinical X-ray images yielded an average root mean squared distance (between the automatically segmented femur contour and the manual segmented ground truth) of 1.10 mm with a standard deviation of 0.13 mm. The proposed point correspondence estimation algorithm was benchmarked against three state-of-the-art point matching algorithms, demonstrating successful non-rigid registration for the cases of interest. A topologically constrained automatic bone contour segmentation framework was developed and tested, providing robustness to noise, outliers, deformations and occlusions. (orig.)

  18. Primary desmoplastic small round cell tumor of the femur

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Akihiko; Garcia, Joaquin [Memorial Sloan-Kettering Cancer Center, Department of Pathology, New York, NY (United States); Edgar, Mark A. [Memorial Sloan-Kettering Cancer Center, Department of Pathology, New York, NY (United States); Weill Medical College of Cornell University, New York, NY (United States); Meyers, Paul A. [Weill Medical College of Cornell University, New York, NY (United States); Memorial Sloan-Kettering Cancer Center, Department of Pediatrics, New York, NY (United States); Morris, Carol D. [Weill Medical College of Cornell University, New York, NY (United States); Memorial Sloan-Kettering Cancer Center, Department of Surgery, Orthopaedic Service, New York, NY (United States); Panicek, David M. [Weill Medical College of Cornell University, New York, NY (United States); Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States)

    2008-09-15

    Desmoplastic small round cell tumor (DSRCT) is a rare malignant neoplasm typically involving the abdominal cavity of a young male. Extra-abdominal occurrence of this tumor is very rare. We report a 10-year-old girl with primary DSRCT arising within the left femur. The patient presented with knee pain, and radiological findings were strongly suggestive of osteogenic sarcoma. In addition to the typical microscopic appearance and immunophenotype, RT-PCR demonstrated the chimeric transcript of EWS-WT1, which is diagnostic of DSRCT. Pulmonary metastases were present at initial staging studies, but no abdominal or pelvic lesion was present. Despite chemotherapy and complete tumor excision, the patient developed progressive lung and bone metastases and died 3 years after initial presentation. This is the second reported case of primary DSRCT of bone with genetic confirmation. (orig.)

  19. Atypical femur fractures associated with bisphosphonates: from prodrome to resolution

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    Braulio Sastre-Jala

    2015-10-01

    Full Text Available Atypical fractures related to the prolonged use of bisphosphonates are caused by low energy mechanisms and are characterized by oblique and transverse lines and frequent bilateralism. We present a clinical case of a patient who we believe illustrates, both in clinical and radiological aspects, the new definition of atypical femur fracture related to treatment using bisphosphonates treated conservatively and successfully with discharge and teriparatide 20 mcg/80 mcl s.c./24h. The appearance of painful symptoms in the upper thigh, especially if bilateral, in patients treated with bisphosphonates for long periods of time, makes it necessary to dismiss bone lesions that might otherwise suggest atypical fracture. In those cases where the fracture is incomplete, restoring bone metabolism through the administration of teriparatide 20 mcg/80 mcl s.c./24h could prevent displaced fractures.

  20. Determination of muscle effort at the proximal femur rotation osteotomy

    Science.gov (United States)

    Sachenkov, O.; Hasanov, R.; Andreev, P.; Konoplev, Yu

    2016-11-01

    The paper formulates the problem of biomechanics of a new method for treatment of Legg-Calve-Perthes disease. Numerical calculations of the rotational flexion osteotomy have been carried out for a constructed mathematical model of the hip joint, taking into account the main set of muscles. The work presents the results of the calculations and their analysis. The results have been compared with the clinical data. The calculations of the reactive forces arising in the acetabulum and the proximal part of the femur allowed us to reveal that this reactive force changes both in value and direction. These data may be useful for assessing the stiffness of an external fixation device used in orthopedic intervention and for evaluating the compression in the joint.

  1. Retrograde nailing for distal femur fractures in the elderly

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    Giddie Jasdeep

    2015-01-01

    Full Text Available Introduction: We report the results of treating a series of 56 fractures in 54 elderly patients with a distal femur fracture with a retrograde femoral nail. Methods: Fifty-four of the nails were inserted percutaneously with a closed reduction. After surgery all patients were allowed to weight bear as tolerated. Four fractures were supported in a temporary external splint. Results: The mean age of patients was 80.6 years (range 51–103 years, 52/54 (96% were females. There were no cases of nail related complications and no re-operations were required. One patient was lost to follow up. The 30-day mortality was 5/54 (9.3% and the one year mortality was 17/54 (31.5%. Conclusions: Distal femoral nail fixation provides a good method of fixation allowing immediate mobilisation for this group of patients.

  2. Blocking screws for the treatment of distal femur fractures.

    Science.gov (United States)

    Seyhan, Mustafa; Cakmak, Selami; Donmez, Ferdi; Gereli, Arel

    2013-07-01

    Intramedullary nailing is one of the most convenient biological options for treating distal femoral fractures. Because the distal medulla of the femur is wider than the middle diaphysis and intramedullary nails cannot completely fill the intramedullary canal, intramedullary nailing of distal femoral fractures can be difficult when trying to obtain adequate reduction. Some different methods exist for achieving reduction. The purpose of this study was determine whether the use of blocking screws resolves varus or valgus and translation and recurvatum deformities, which can be encountered in antegrade and retrograde intramedullary nailing. Thirty-four patients with distal femoral fractures underwent intramedullary nailing between January 2005 and June 2011. Fifteen patients treated by intramedullary nailing and blocking screws were included in the study. Six patients had distal diaphyseal fractures and 9 had distal diaphyseo-metaphyseal fractures. Antegrade nailing was performed in 7 patients and retrograde nailing was performed in 8. Reduction during surgery and union during follow-up were achieved in all patients with no significant complications. Mean follow-up was 26.6 months. Mean time to union was 12.6 weeks. The main purpose of using blocking screws is to achieve reduction, but they are also useful for maintaining permanent reduction. When inserting blocking screws, the screws must be placed 1 to 3 cm away from the fracture line to avoid from propagation of the fracture. When applied properly and in an adequate way, blocking screws provide an efficient solution for deformities encountered during intramedullary nailing of distal femur fractures. Copyright 2013, SLACK Incorporated.

  3. Commande vectorielle de la machine a reluctance variable à stator lisse. Prise en compte de la saturation et de l'amortissement

    Science.gov (United States)

    Tounzi, A.; Meibody-Tabar, F.; Sargos, F. M.

    1997-04-01

    This paper deals with the field-oriented control of a smooth stator, non excited salient rotor synchronous machine. First, a nonlinear modelling of the machine, taking into account both damping and saturation effects, is developed in PARK's rotor-bound frame. Then, a vector control strategy, which maintains a constant saturation level in the machine, is set-up. This strategy, wich consists in keeping the stator direct current at a high constant value, allows to linearize the model of the machine and to control it in the same way as a DC machine. A numerical simulation of a VRM, fed by a PWM-VSI and controlled thanks to this control strategy, is built up and the computed results are given and commented. Cet article est consacré à la commande vectorielle d'une machine à réluctance variable à stator lisse et rotor massif. D'abord, une modélisation non linéaire de la machine a été effectuée dans le repère de Park. Cette dernière permet de prendre en compte l'effet d'amortissement dû au rotor massif, ainsi que celui de la saturation inhérent à ce genre de machine. Ensuite, une stratégie de contrôle vectoriel, qui maintient un niveau de saturation constant dans la machine, a été élaborée. Cette stratégie, qui consiste à maintenir le courant direct statorique à une valeur élevée, permet de linéariser le modèle de la machine et ainsi de pouvoir la contrôler comme une machine à courant continu. Une simulation numérique de la machine à réluctance variable, alimentée par un onduleur de tension à MLI et commandée par la stratégie mise au point, a été effectuée. Les résultats de cette simulation sont donnés et commentés à la fin de l'article.

  4. PROSPECTIVE STUDY OF MANAGEMENT OF FRACTURE NECK OF FEMUR BY HEMIARTHROPLASTY WITH CEMENTED BIPOLAR

    Directory of Open Access Journals (Sweden)

    Hanu Tej

    2015-12-01

    Full Text Available BACKGROUND AND OBJECTIVES Fracture neck of femur is a leading cause of hospital admissions in elderly age group. The number of such admissions is on a rise because of increased longevity, osteoporosis and sedentary habits. Conservative methods of treatment is not acceptable because it results in nonunion with unstable hip and limitation of hip movement as well as complications of prolonged immobilization like bed sores, deep vein thrombosis and respiratory infections. Hemiarthroplasty remains the most common modality of treatment in our country. The time-tested unipolar prosthesis is being slowly replaced by bipolar prosthesis, which is claimed to have a lower incidence of complications. This study was conducted to analyze the results of surgical management of fracture neck of femur using modular bipolar hemiarthroplasty. MATERIALS AND METHODS The present study was a prospective study of 50 cases of fracture neck of femur admitted to Basaweshwar Hospital attached to MR Medical College, Kalburagi, between the study periods of July 2014 to July 2015. Cases were selected according to inclusion and exclusion criteria, i.e., patients with intra-capsular fracture neck of femur above the age of 55yrs. Medically unfit and patients not willing for surgery were excluded from the study. RESULTS In our series of 50 cases, there were 19 males and 31 females with a maximum age of 92 yrs, minimum age of 58 yrs, and an average age of 65 years. There was a slight predominance of left-sided fractures when compared to the right. The mean duration of hospital stay was 5 days. At the final one year follow-up assessment with Harris Hip Score, 18 patients (35% achieved 'Excellent' result, 22 patients (45% achieved 'Good' result, 5 patients (10% achieved 'Fair' result and 5 patients (10% achieved 'Poor' result. Overall, 80% of the patients achieved an excellent or good result. On enquiry regarding the overall satisfaction with the procedure and return to pre

  5. Stress Transfer Modeling at the Interface of Cemented Prosthesis and Femur

    Institute of Scientific and Technical Information of China (English)

    YU Xue-zhong; GUO Yi-mu; ZHANG Yun-qiu; LI Jun; HE Rong-xing

    2008-01-01

    .Objective:To model the stress transfer at the interface of the cemented prosthesis and femur, an axisymmetric model of the interfacial stress transfer was established.Methods: Assuming that the prosthesis, the cement and the femur were concentric cylinders with linear elastic and isotropic properties, distributions of the axial stresses in the prosthesis, the cement and the femur as well as the interfacial shear stresses at the prosthesis/cement interface and the cement/femur interface in the axial direction were obtained from the established axisymmetric stress transfer model.Results: Interfacial failure was the main form for the prosthesis/cement/femur structure under external loads. Considering the residual thermal stresses, it was more likely to produce the mixed failure form than the pure shear failure form. Since the cement had a relatively high thermal expansion coefficient, the thermal effect accelerated the interface failure and thus aggravated the stress shielding effect. Due to a relatively high thermal residual temperature difference, the interfacial debonding and femur failure was more likely to occur for the cobalt-chromium alloy prosthesis material than the Ti-6Al-4V alloy prosthesis material.Conclusion: Assuming that the prosthesis, the cement and the femur are concentric cylinders with linear elastic and isotropic properties, distributions of the axial stresses in the prosthesis, the cement and the femur as well as the interfacial shear stresses at the prosthesis/cement interface and the cement/femur interface in the axial direction was obtained using the basic equations of axisymmetric elastic mechanics when the prosthesis bears the compressive stresses. Interface failure is the main failure form for the prosthesis/cement/femur structure under external loads. The thermal effects accelerate the failure of the prosthesis/cement interface and the cement/femur interface and the relaxation of the prosthesis, and then aggravates the stress shielding

  6. Treatment of intertrochanteric fractures of the femur withL.trapezoid compression plate and its mechanicalprinciples

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To improve the results of the treatment of unstable types of intertrochanteric fractures of the femur (ITFF) by internal fixation. Methods: A L-trapezoid compression plate system (L-TCP) was designed and compared to the AO/ASIF angle plates of 95° and 130° (L-AP) with mechanical tests. An Evans Type Ⅲ model was made, the simulation electrical test with loading on single and both legs were done. The results demonstrated that the stability of the L-TCP fixation was significantly greater, and the stress concentration at the upper screw hole was relevantly smaller than that of L-AP. From June 1986 to June 1998, 82 patients of ITFF were treated with L-TCP fixation. The average age was 67.4 years old (26-91). Seventy-four of those fractures were unstable. Fifty-eight patients were treated with open reduction, and 24 cases were treated by closed reduction and limited open (only lateral aspect of upper femur was exposed) fixation with L-TCP under X-ray monitoring. Results: Sixty-six patients were followed up for 6-69months. Complications, including 3 wound infection, 1 non-union, 3 coxa varus and 2 implant breakage (9complications of 7 cases ), all occurred in the open reduction group. No complication was found in the dosed reduction group. Conclusions: In the treatment of ITFF, the results of closed reduction and limited open fixation with L-TCP is significantly better than that of open reduction and fully exposed fixation.

  7. Simultaneous Periprosthetic Fractures of the Femur and the Acetabulum After Bipolar Hip Arthroplasty

    Science.gov (United States)

    Verettas, Dionysios-Alexandros; Chloropoulou, Pelagia-Paraskevi; Drosos, Georgios; Vogiatzaki, Theodosia; Tilkeridis, Konstantinos; Kazakos, Konstantinos

    2016-01-01

    Patient: Female, 68 Final Diagnosis: Periprosthetic fractures of the acetabulum and femur after bipolar hip arthroplasty Symptoms: Inability to walk Medication: — Clinical Procedure: Revision cup and internal fixation femur Specialty: Orhopedics and Traumatology Objective: Rare co-existance of disease or pathology Background: Although periprosthetic fractures of the femur are a recognized complication of total hip arthroplasty, periprosthetic fractures of the acetabulum are rare. Simultaneous periprosthetic fractures of both the acetabulum and the femur have not been reported, to our knowledge. Case Report: We report a simultaneous fracture of the acetabulum and the femur in a 68-year-old female patient who had previously sustained a subcapital fracture of the femur, treated with a bipolar uncemented prosthesis. We discuss the possible mechanism of this combination of fractures. Conclusions: Simultaneous periprosthetic fractures of the femur and the acetabulum can occur if, in the presence of osteoporotic bone, the metallic femoral head has migrated medially in the acetabulum while the femoral stem is not loose. PMID:28003639

  8. Ossification of the femur and tibia of the post-hatching Japanese quail.

    Science.gov (United States)

    Ahmed, Yasser A; Soliman, Soha A; Abdel-Hafez, Enas A

    2013-09-01

    The current study aimed to describe the histological changes of the femur and tibia of the post-hatching quail. Femur and tibia from 1-day- to 6-weeks post-hatching quail were processed for light microscopy. Histological examination revealed that endochondral ossification was a delayed process in the development of femur and tibia preceded by periosteal ossification. Femur and tibia of 1-day-post-hatching quail consisted of growth cartilage enclosed in a tube of periosteal bone collar. The collar extended toward the epiphysis dividing it into articular cartilage proper and lateral articular cartilage. Down to the articular cartilage, there was a physeal growth cartilage, in which the chondrocytes were organized into resting, proliferative and hypertrophic zones. Focal areas of hypertrophic chondrocytes were observed in the epiphysis of the tibia but not of the femur, which acted as a nidus for formation of the secondary ossification centre after in 2-week-posthathcing quail. Primary ossification centre was seen in both femur and tibia after 2 weeks and ossification continued replacing the cartilage until the 6th week when only permanent articular cartilage remained. Cartilage canals were present in both femur and tibia starting from the day 1, but chondrified and completely disappeared after the 6th week. The current study suggests that the periosteal ossification preceded the endochondral ossification and plays an important role in quail long bones development.

  9. RECONSTRUCTION OF TOTAL LENGTH OF FEMUR FROM ITS PROXIMAL AND DISTAL FRAGMENTS

    Directory of Open Access Journals (Sweden)

    Ajay M. Parmar

    2015-12-01

    Full Text Available Aims and Objectives: To find out the correlation between maximum length of femur and its proximal & distal fragments. and to formulate regression equation for estimation of stature from maximum femoral length. Materials and methods: This study consists 50 femur (27 of right side & 23 of left side. The maximum length of femur, proximal (P1,P2,P3,P4 and distal (D1,D2,D3,D4 measurements was taken with help of osteometric board and by vernier calliper. Results: The correlation found in P1,P2,P3,P4, D1,D4 on right side femur and P2, P3, P4, D1, D4 on left side femur. The strongest correlation observed in the D4 on right femur and P2 of left femur. The result obtained were analysed and derived regression equation between maximum femoral length and its proximal and distal fragments. Conclusion: The positive correlation between maximum femoral length and its proximal and distal fragments and regression equations derived in this study helpful to estimate stature in Medico-legal investigations and in Anthropometry.

  10. A rare case of metaphyseodiaphyseal chondroblastoma of proximal femur presenting with constitutional symptoms in a six-year-old child.

    Science.gov (United States)

    Bali, Kamal; Kumar, Vishal; Rawall, Saurabh; Sudesh, Pebam

    2012-03-01

    Primary metaphyseodiaphyseal chondroblastoma is rare. To our knowledge, very few such cases have been reported in the English literature. Insidious onset of pain is the most common complaint in patients with chondroblastoma. A clinical presentation of constitutional symptoms along with a metaphyseodiaphyseal lesion on radiographs in a young child usually points toward a diagnosis of Ewing's sarcoma or infection. Here, we document a case of metaphyseodiaphyseal chondroblastoma of femur in a 6-year-old child presenting with chief local complaints of an intermediate onset pain and swelling along with systemic complaints of fever and malaise. The patient was operated by excision of the tumor and reconstruction using autogenous-free fibular graft.

  11. Pathological Fracture of the Femur by Metastatic Carcinoma Penis-a Rare Presentation.

    Science.gov (United States)

    Hussain, Shabbir; Solanki, Fanindra Singh; Sharma, Deepti B; Sharma, Dhananjay

    2016-04-01

    We report herein a clinical case of a patient with femur fracture due to metastasis from penile squamous cell carcinoma. A young man, who was treated for carcinoma penis, presented with pathological fracture of femur and lung metastasis from metastatic carcinoma penis after 18 months. Long bone metastasis from penile cancer is extremely rare, to the best of our knowledge; this is the first report of a patient with penile cancer spread to the femur from primary squamous cell carcinoma of the penis.

  12. Three-dimensional Effect of the Single Plane Proximal Femur Osteotomy

    OpenAIRE

    Kim, Sung Soo

    2015-01-01

    Purpose Three-dimensional (3D) effects of the single plane osteotomies of the proximal femur are compared and analyzed by the trigonometric method. Materials and Methods The shape of proximal femur was simplified as a bent line. The bent line is the continuation of the three points-the center of the femoral head, the center of femoral neck at the base, and the center of the femoral shaft. Then rotated the proximal femur at the junction of the neck and shaft with the each rotation axis of X, Y...

  13. Compartment syndrome of the thigh complicating surgical treatment of ipsilateral femur and ankle fractures

    Science.gov (United States)

    Moore, M. R.; Garfin, S. R.; Hargens, A. R.

    1987-01-01

    A 26-year-old man presented with ipsilateral femur and ankle fractures. The patient was treated with interlocking nail of his femur fracture, followed by open reduction and internal fixation of his ankle fracture under tourniquet control. Postoperatively, the patient developed compartment syndrome of his thigh with elevated pressures, requiring decompressive fasciotomies. This case illustrates the possible complication of treating a femur fracture with intramedullary nailing and then immediately applying a tourniquet to treat an ipsilateral extremity fracture. Because of the complication with this patient, we feel the procedure should be staged, or a tourniquet should be avoided if possible.

  14. Image-Based Macro-Micro Finite Element Models of a Canine Femur with Implant Design Implications

    Science.gov (United States)

    Ghosh, Somnath; Krishnan, Ganapathi; Dyce, Jonathan

    2006-06-01

    In this paper, a comprehensive model of a bone-cement-implant assembly is developed for a canine cemented femoral prosthesis system. Various steps in this development entail profiling the canine femur contours by computed tomography (CT) scanning, computer aided design (CAD) reconstruction of the canine femur from CT images, CAD modeling of the implant from implant blue prints and CAD modeling of the interface cement. Finite element analysis of the macroscopic assembly is conducted for stress analysis in individual components of the system, accounting for variation in density and material properties in the porous bone material. A sensitivity analysis is conducted with the macroscopic model to investigate the effect of implant design variables on the stress distribution in the assembly. Subsequently, rigorous microstructural analysis of the bone incorporating the morphological intricacies is conducted. Various steps in this development include acquisition of the bone microstructural data from histological serial sectioning, stacking of sections to obtain 3D renderings of void distributions, microstructural characterization and determination of properties and, finally, microstructural stress analysis using a 3D Voronoi cell finite element method. Generation of the simulated microstructure and analysis by the 3D Voronoi cell finite element model provides a new way of modeling complex microstructures and correlating to morphological characteristics. An inverse calculation of the material parameters of bone by combining macroscopic experiments with microstructural characterization and analysis provides a new approach to evaluating properties without having to do experiments at this scale. Finally, the microstructural stresses in the femur are computed using the 3D VCFEM to study the stress distribution at the scale of the bone porosity. Significant difference is observed between the macroscopic stresses and the peak microscopic stresses at different locations.

  15. Morphological analysis of the proximal femur using quantitative computed tomography

    Science.gov (United States)

    Jacobson, Donald; Carrera, Guilermo

    2006-01-01

    The anatomy of the proximal femur was studied in 35 specimens using quantitative computed tomography (QCT) and compared with anatomical sections studied by plane radiography and gross dissection. We found the primary supporting structure of the femoral head to be the primary compressive strut, which is a dense column of trabecular bone projecting from the pressure buttress of the medial femoral neck to the epiphyseal scar. Trabecular bone mushroomed from the epiphyseal scar and terminated at right angles to the cortex of the femoral head. We believe the primary compressive strut is the predominant load-bearing structure connecting the femoral head to the femoral neck, as many specimens lacked continuity of the head cortex to the femoral neck. Based on the CT number, the primary compressive strut had similar bone density to cortical structures such as the lesser trochanter, calcar femorale and posterior lateral femoral cortex. Ward’s triangle lacked structural integrity in many cases, and we doubt the significance of tensile trabculae for sharing load. Surgical techniques such as femoral fracture fixation, resurfacing hip arthroplasty and allograft transplantation may benefit from this knowledge. PMID:16896872

  16. Design and Optimization of Sinusoidal Formed Femur Prosthesis

    Directory of Open Access Journals (Sweden)

    Ahmet Zafer ŞENALP

    2015-01-01

    Full Text Available One of the major problems in hip replacement surgery is the hip replacement loosening. Hip replacement loosening occurs over time after the surgery and it is related to the discretization between the bone cement and prosthesis. The underlying factors of this situation are the stress occurring in the bone cement and the shape of the prosthesis. In this study, cortical and trabecular layers of the femur, bone cement and prosthesis were modeled. The models of bone cement and prosthesis were constructed parametrically and two different sinusoidal formed prostheses were developed unlike the former prostheses shapes. Analyses were conducted for these two different sinusoidal forms by using finite element method and optimization was conducted to obtain the appropriate prosthesis stem shape and bone cement thickness by using parametric modeling in finite element analyses. For finite element analyses and optimization, Ansys Workbench software was used and analyses were conducted for 316LS stainless steel material. Finally, the optimum prosthesis stem shape and bone cement thickness was determined by using the results of the analyses in the first stage

  17. Concomitant physeal fractures of the distal femur and proximal tibia

    Energy Technology Data Exchange (ETDEWEB)

    Sferopoulos, N.K. [Aristotle University of Thessaloniki, Department of Pediatric Orthopaedics, Thessaloniki (Greece)

    2005-07-01

    Concomitant physeal fractures of the distal femur and proximal tibia are very rare in children and adolescents. They are included in the classification of the ''floating knee'' injuries. Two cases with this combined injury are reported. They were closed injuries and in both patients the fracture of the proximal tibial epiphyseal plate was nondisplaced. In the first, a six-year-old girl, an early diagnosis was made radiographically. The intra-articular femoral fracture was operatively reduced and fixed. No growth abnormality was encountered 12 years later. The second patient, a 16-year-old boy, was conservatively treated for a displaced fracture-separation of the distal femoral epiphysis. Four weeks later there was physeal widening on both sides of the knee which indicated an associated fracture of the proximal tibial epiphyseal plate. One year after injury there was a varus deformity of the knee that was treated with a corrective osteotomy. Ten years later there is normal alignment of the leg. (orig.)

  18. Assessment of femur and tibia subchondral parts mineral bone density in gonarthrosis

    Directory of Open Access Journals (Sweden)

    E M Zaitseva

    2005-01-01

    Full Text Available Objective. To assess association between bone mineral density (BMD of parts of femur and tibia gonarthrosis stage. Material and methods. 53 female with bilateral gonarthrosis aged 42 to 84 years with body mass index from 21,2 to 43 kg/m2 were included. Knee joints X-ray examination, densitometry of lumbar spine, femoral neck and condyles of femur and tibia were performed. Subchondral BMD assessment was done in 5 regions of knee. Results. Increase of gonarthrosis stage was accompanied by rise of subchondral tibia BMD values. Increase of medial femur condyles BMD was associated with knee joint space decrease, presence of subchondral osteosclerosis and marginal osteophytes so as knee varus deformity. Subchondral femur BMD values correlated only with the presence of marginal osteophytes.

  19. Predicting the stiffness and strength of human femurs with real metastatic tumors.

    Science.gov (United States)

    Yosibash, Zohar; Plitman Mayo, Romina; Dahan, Gal; Trabelsi, Nir; Amir, Gail; Milgrom, Charles

    2014-12-01

    Predicting patient specific risk of fracture in femurs with metastatic tumors and the need for surgical intervention are of major clinical importance. Recent patient-specific high-order finite element methods (p-FEMs) based on CT-scans demonstrated accurate results for healthy femurs, so that their application to metastatic affected femurs is considered herein. Radiographs of fresh frozen proximal femur specimens from donors that died of cancer were examined, and seven pairs with metastatic tumor were identified. These were CT-scanned, instrumented by strain-gauges and loaded in stance position at three inclination angles. Finally the femurs were loaded until fracture that usually occurred at the neck. Histopathology was performed to determine whether metastatic tumors are present at fractured surfaces. Following each experiment p-FE models were created based on the CT-scans mimicking the mechanical experiments. The predicted displacements, strains and yield loads were compared to experimental observations. The predicted strains and displacements showed an excellent agreement with the experimental observations with a linear regression slope of 0.95 and a coefficient of regression R(2)=0.967. A good correlation was obtained between the predicted yield load and the experimental observed yield, with a linear regression slope of 0.80 and a coefficient of regression R(2)=0.78. CT-based patient-specific p-FE models of femurs with real metastatic tumors were demonstrated to predict the mechanical response very well. A simplified yield criterion based on the computation of principal strains was also demonstrated to predict the yield force in most of the cases, especially for femurs that failed at small loads. In view of the limited capabilities to predict risk of fracture in femurs with metastatic tumors used nowadays, the p-FE methodology validated herein may be very valuable in making clinical decisions. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. The effects of glucocorticoid on microarchitecture, collagen, mineral and mechanical properties of sheep femur cortical bone

    DEFF Research Database (Denmark)

    Ding, Ming; Danielsen, Carl C; Overgaard, Søren

    mechanical properties in the glucocorticoid-2. In conclusion, 7 months glucocorticoid treatment with malnutrition had significant impact on cortical microarchitecture of sheep femur midshaft. These changes occurred particularly 3 months after the glucocorticoid cessation suggesting a delayed effect......The effects of glucocorticoid on microarchitecture, collagen, mineral and mechanical properties of sheep femur cortical bone – Validation of large animal model for tissue engineering and biomaterial research Ming Ding,1* Carl Christian Danielsen,2 Søren Overgaard1 1Orthopaedic Research Laboratory...

  1. FEMUR SHAPE RECOVERY FROM VOLUMETRIC IMAGES USING 3-D DEFORMABLE MODELS

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    A new scheme for femur shape recovery from volumetric images using deformable models was proposed. First, prior 3-D deformable femur models are created as templates using point distribution models technology. Second, active contour models are employed to segment the magnetic resonance imaging (MRI) volumetric images of the tibial and femoral joints and the deformable models are initialized based on the segmentation results. Finally, the objective function is minimized to give the optimal results constraining the surface of shapes.

  2. Oral bisphosphonates and risk of subtrochanteric or diaphyseal femur fractures in a population-based cohort.

    Science.gov (United States)

    Kim, Seo Young; Schneeweiss, Sebastian; Katz, Jeffrey N; Levin, Raisa; Solomon, Daniel H

    2011-05-01

    Bisphosphonates are the primary therapy for postmenopausal and glucocorticoid-induced osteoporosis. Case series suggest a potential link between prolonged use of bisphosphonates and low-energy fracture of subtrochanteric or diaphyseal femur as a consequence of oversuppression of bone resorption. Using health care utilization data, we conducted a propensity score-matched cohort study to examine the incidence rates (IRs) and risk of subtrochanteric or diaphyseal femur fractures among oral bisphosphonate users compared with raloxifene or calcitonin users. A Cox proportional hazards model evaluated the risk of these fractures associated with duration of osteoporosis treatment. A total of 104 subtrochanteric or diaphyseal femur fractures were observed among 33,815 patients. The estimated IR of subtrochanteric or diaphyseal femur fractures per 1000 person-years was 1.46 [95% confidence interval (CI) 1.11-1.88] among the bisphosphonate users and 1.43 (95% CI 1.06-1.89) among raloxifene/calcitonin users. No significant association between bisphosphonate use and subtrochanteric or diaphyseal femur fractures was found [hazard ratio (HR) = 1.03, 95% CI 0.70-1.52] compared with raloxifene/calcitonin. Even with this large study size, we had little precision in estimating the risk of subtrochanteric or diaphyseal femur fractures in patients treated with bisphosphonates for longer than 5 years (HR = 2.02, 95% CI 0.41-10.00). The occurrence of subtrochanteric or diaphyseal femur fracture was rare. There was no evidence of an increased risk of subtrochanteric or diaphyseal femur fractures in bisphosphonate users compared with raloxifene/calcitonin users. However, this study cannot exclude the possibility that long-term bisphosphonate use may increase the risk of these fractures.

  3. The Analysis of Biomechanical Properties of Proximal Femur after Implant Removal

    Science.gov (United States)

    Yang, Jae Hyuk; Jung, Tae Gon; Honnurappa, Arjun Rupanagudi; Cha, Jae Min; Ham, Chang Hwa; Kim, Tae Yoon

    2016-01-01

    Introduction. To compare the biomechanical stability of the femur following the removal of proximal femoral nail antirotation (PFNA-II) and dynamic hip screw (DHS). Material and Methods. 56 paired cadaveric femurs were used as experimental and control groups. In the experimental group, PFNA-II and DHS were randomly inserted into femurs on both sides and then removed. Thereafter, compression load was applied until fracture occurred; biomechanical stability of the femurs and associated fracture patterns were studied. Results. The ultimate load and stiffness of the control group were 6227.8 ± 1694.1 N and 990.5 ± 99.8 N/mm, respectively. These were significantly higher than experimental group (p = 0.014, fracture patterns were different between two devices, intertrochanteric and subtrochanteric fractures. Conclusions. Mechanical stability of the proximal femurs does not differ after the removal of 2 different of fixation devices regardless of the age. However, it was significantly lower compared to an intact femur. Different fracture patterns have been shown following the removal of different fixation devices as there are variations in the site of stress risers for individual implants. PMID:27597807

  4. Long-term radiographic follow-up of bisphosphonate-associated atypical femur fractures

    Energy Technology Data Exchange (ETDEWEB)

    Favinger, Jennifer L. [University of Washington, Department of Radiology, 1959 N.E. Pacific Street, Box 357115, Seattle, WA (United States); Hippe, Daniel [University of Washington, Department of Radiology, Seattle, WA (United States); Ha, Alice S. [University of Washington, Department of Radiology, 4245 Roosevelt Way NE, Box 354755, Seattle, WA (United States)

    2016-05-15

    To evaluate the appearance of bisphosphonate-related femur insufficiency fractures on long-term follow-up radiographic studies and to describe the rate of fracture line obscuration and cortical beak healing over time. In this retrospective study, bisphosphonate-related femur fracture radiographs were reviewed by two radiologists for the presence of a fracture line, callus, and the characteristic cortical beak. Kaplan-Meier curves were used to analyze the time to first indication of healing. Femurs were also subdivided into those who underwent early versus late surgical fixation and those who underwent early versus late discontinuation of bisphosphonate. Clinical data including pain level and medication history were collected. Forty-seven femurs with a bisphosphonate-related femur fracture were identified in 28 women. Eighty-five percent took a bisphosphonate for greater than 5 years and 59 % for greater than 10 years. The median time to beak healing was 265 weeks and the median time to fracture line healing was 56 weeks in the 31 femurs with a baseline fracture. No statistically significant difference was identified between surgical fixation and conservative management. Bisphosphonate-related fractures demonstrate notably prolonged healing time on long-term follow-up. (orig.)

  5. Exploring the Use of Non-Image-Based Ultrasound to Detect the Position of the Residual Femur within a Stump

    Science.gov (United States)

    Chong, Sook-Yee; Röhrle, Oliver

    2016-01-01

    A satisfactorily fitted socket interacts dynamically with the stump in order to support body weight, transmit load effectively, enhance dynamic stability, and enable the control and stabilization of the residual limb. The internal dynamics occurring within a socket is important in determining optimal fit. Many measurement and imaging techniques, such as X-rays, have been utilized to investigate the movement of the residual femur within the stump during gait. However, due to associated health risks and costs, none of the current techniques have been extended to clinical prosthetics. The use of B-mode ultrasound has been suggested as a safe and cheap alternative, and has been utilized in previous studies to monitor the motion of the femur. However, the need to create a duplicate socket and time-consuming analysis of the images were obstacles to the system being applied clinically. This study aims to gauge the effectiveness of a non-image based ultrasound system. Here, we determined errors expected from the measurements. Accuracy errors of 2.9 mm to 8.4 mm and reproducibility measurements within a standard deviation of 3.9 mm are reported. We also estimated errors up to 14.4 mm in in-vivo measurements. We think there is potential in developing this technique, and we hope to reduce some technical difficulties such that it can, one day, be easily incorporated into prosthetic fitting. PMID:27764120

  6. Micro-computed tomography assisted distal femur metaphyseal blunt punch compression for determining trabecular bone strength in mice.

    Science.gov (United States)

    Sankar, Uma; Pritchard, Zachary J; Voor, Michael J

    2016-05-03

    Shorter generation time and the power of genetic manipulation make mice an ideal model system to study bone biology as well as bone diseases. However their small size presents a challenge to perform strength measurements, particularly of the weight-bearing cancellous bone in the murine long bones. We recently developed an improved method to measure the axial compressive strength of the cancellous bone in the distal femur metaphysis in mice. Transverse micro-computed tomography image slices that are 7µm thick were used to locate the position where the epiphysis-metaphysis transition occurs. This enabled the removal of the distal femur epiphysis at the exact transition point exposing the full extent of metaphyseal trabecular bone, allowing more accurate and consistent measurement of its strength. When applied to a murine model system consisting of five month old male wild-type (WT) and Ca(2+)/calmodulin dependent protein kinase kinase 2 (CaMKK2) knockout (KO) Camkk2(-/-) mice that possess recorded differences in trabecular bone volume, data collected using this method showed good correlation between bone volume fraction and strength of trabecular bone. In combination with micro-computed tomography and histology, this method will provide a comprehensive and consistent assessment of the microarchitecture and tissue strength of the cancellous bone in murine mouse models.

  7. The effect of the dimensions of the distal femur and proximal tibia joint surfaces on the development of knee osteoarthritis.

    Science.gov (United States)

    Işik, Derya; Işik, Çetin; Apaydin, Nihal; Üstü, Yusuf; Uğurlu, Mahmut; Bozkurt, Murat

    2015-07-01

    The aim of this study was to determine whether the dimensions of the distal femur and proximal tibia joint surfaces affect the etiology of knee osteoarthritis (OA). The study comprised the records of 1,324 patients who had been admitted to hospital with knee pain. Anterioposterior (AP) and lateral radiographs of the knee were taken. Using the Kellgren-Lawrence Scale, the patient group comprised Stages 2, 3, and 4 radiographs and the controls comprised Stages 0 and 1 radiographs. Four lengths were measured for each patient in both groups: femur mediolateral (femur ML), tibia mediolateral (tibia ML), femur anteroposterior (femur AP), and tibia anteroposterior (tibia AP). Osteophytes were not included in the measurements in the patient group. All the measurements were repeated by two researchers at two different times. The groups were compared in terms of these measurements and the correlations between them. The mean femur ML length was significantly greater in the patient group than the control group (P = 0.032) and the mean femur AP length was significantly less (P = 0.037). In addition, the difference between the femur ML and AP lengths was significantly high in the patient group (P tibia and femur ML lengths was significantly high in the patient group (P tibia and femur AP lengths was higher in the control group (P = 0.001). A longer femur ML and a shorter femur AP, together with a greater difference between these two lengths and a greater difference between the tibia ML and femur ML lengths, could be a risk factor for developing knee OA. More extensive anatomical and biomechanical studies in the future will enable these results to be corroborated.

  8. Uncemented allograft-prosthetic composite reconstruction of the proximal femur

    Directory of Open Access Journals (Sweden)

    Li Min

    2014-01-01

    Full Text Available Background: Allograft-prosthetic composite can be divided into three groups names cemented, uncemented, and partially cemented. Previous studies have mainly reported outcomes in cemented and partially cemented allograft-prosthetic composites, but have rarely focused on the uncemented allograft-prosthetic composites. The objectives of our study were to describe a surgical technique for using proximal femoral uncemented allograft-prosthetic composite and to present the radiographic and clinical results. Materials and Methods: Twelve patients who underwent uncemented allograft-prosthetic composite reconstruction of the proximal femur after bone tumor resection were retrospectively evaluated at an average followup of 24.0 months. Clinical records and radiographs were evaluated. Results: In our series, union occurred in all the patients (100%; range 5-9 months. Until the most recent followup, there were no cases with infection, nonunion of the greater trochanter, junctional bone resorption, dislocation, allergic reaction, wear of acetabulum socket, recurrence, and metastasis. But there were three periprosthetic fractures which were fixed using cerclage wire during surgery. Five cases had bone resorption in and around the greater trochanter. The average Musculoskeletal Tumor Society (MSTS score and Harris hip score (HHS were 26.2 points (range 24-29 points and 80.6 points (range 66.2-92.7 points, respectively. Conclusions: These results showed that uncemented allograft-prosthetic composite could promote bone union through compression at the host-allograft junction and is a good choice for proximal femoral resection. Although this technology has its own merits, long term outcomes are yet not validated.

  9. The shape of the early hominin proximal femur.

    Science.gov (United States)

    Harmon, Elizabeth H

    2009-06-01

    Postcranial skeletal variation among Plio-Pleistocene hominins has implications for taxonomy and locomotor adaptation. Although sample size constraints make interspecific comparisons difficult, postcranial differences between Australopithecus afarensis and Australopithecus africanus have been reported (McHenry and Berger: J Hum Evol 35 1998 1-22; Richmond et al.: J Hum Evol 43 [2002] 529-548; Green et al.: J Hum Evol 52 2007 187-200). Additional evidence indicates that the early members of the genus Homo show morphology like recent humans (e.g., Walker and Leakey: The Nariokotome Homo erectus skeleton. Cambridge: Harvard, 1993). Using a larger fossil sample than previous studies and novel methods, the early hominin proximal femur is newly examined to determine whether new data alter the current view of femoral evolution and inform the issue of interspecific morphological variation among australopiths. Two- and three-dimensional data are collected from large samples of recent humans, Pan, Gorilla, and Pongo and original fossil femora of Australopithecus, Paranthropus, and femora of African fossil Homo. The size-adjusted shape data are analyzed using principal components, thin plate spline analysis, and canonical variate analysis to assess shape variation. The results indicate that femora of fossil Homo are most similar to modern humans but share a low neck-shaft angle (NSA) with australopiths. Australopiths as a group have ape-like greater trochanter morphology. A. afarensis differs from P. robustus and A. africanus in attributes of the neck and NSA. However, interspecific femoral variation is low and australopiths are generally morphologically similar. Although the differences are not dramatic, when considered in combination with other postcranial evidence, the adaptive differences among australopiths in craniodental morphology may have parallels in the postcranium.

  10. Reducing returns to theatre for neck of femur fracture patients.

    Science.gov (United States)

    Graham, Selina; Dahill, Mark; Robinson, Derek

    2017-01-01

    The Royal United Hospital, Bath, admits approximately 550 patients with neck of femur fractures per year. The risks from returning to theatre for this patient group are often life-threatening. Post-operative wound ooze was noted to cause a significant rate of return to theatre, with increased lengths of stay and patient morbidity. A wound closure protocol was agreed by the consultant body. This information was disseminated by email and teaching sessions to all members of the multidisciplinary team, including surgeons, theatre staff and ortho-geriatricians. The plan-do-study-act model for improvement was used to reduce rates of returns to theatre for wound ooze. Interventions included cyclical teaching during each trainee rotation, updated inductions, posters, email reminders and scrub team involvement to open the protocol sutures unprompted. The primary outcome measure was returns to theatre for wound complications. Baseline data showed 4 returns to theatre over a two month period (4.40% of patients). Length of stay for each patient affected by wound ooze was also compared to the departmental mean. In the 6 month intervention period there was one return to theatre (0.36% of patients). The observed reduction saved the department an estimated £13,831 in length of stay alone. The standardisation of wound closure protocol, with continued reinforcement to all members of the multidisciplinary team, improves patient outcome in this group. Mobilising a group of clinicians across a variety of specialities, with one common goal, is highly effective for patients, improves multidisciplinary working and reduces cost.

  11. Interpretation of hip fracture patterns using areal bone mineral density in the proximal femur.

    Science.gov (United States)

    Hey, Hwee Weng Dennis; Sng, Weizhong Jonathan; Lim, Joel Louis Zongwei; Tan, Chuen Seng; Gan, Alfred Tau Liang; Ng, Jun Han Charles; Kagda, Fareed H Y

    2015-12-01

    Bone mineral density scans are currently interpreted based on an average score of the entire proximal femur. Improvements in technology now allow us to measure bone density in specific regions of the proximal femur. The study attempts to explain the pathophysiology of neck of femur (NOF) and intertrochanteric/basi-cervical (IT) fractures by correlating areal BMD (aBMD) scores with fracture patterns, and explore possible predictors for these fracture patterns. This is a single institution retrospective study on all patients who underwent hip surgeries from June 2010 to August 2012. A total of 106 patients (44 IT/basi-cervical, 62 NOF fractures) were studied. The data retrieved include patient characteristics and aBMD scores measured at different regions of the contralateral hip within 1 month of the injury. Demographic and clinical characteristic differences between IT and NOF fractures were analyzed using Fisher's Exact test and two-sample t test. Relationship between aBMD scores and fracture patterns was assessed using multivariable regression modeling. After adjusted multivariable analysis, T-Troc and T-inter scores were significantly lower in intertrochanteric/basi-cervical fractures compared to neck of femur fractures (P = 0.022 and P = 0.026, respectively). Both intertrochanteric/basi-cervical fractures (mean T.Tot -1.99) and neck of femur fractures (mean T.Tot -1.64) were not found to be associated with a mean T.tot less than -2.5. However, the mean aBMD scores were consistently less than -2.5 for both intertrochanteric/basi-cervical fractures and neck of femur fractures. Gender and calcium intake at the time of injury were associated with specific hip fracture patterns (P = 0.002 and P = 0.011, respectively). Hip fracture patterns following low energy trauma may be influenced by the pattern of reduced bone density in different areas of the hip. Intertrochanteric/basi-cervical fractures were associated with significantly lower T-Troc and T-Inter scores

  12. A biomechanical comparison of various methods of stabilization of subtrochanteric fractures of the femur.

    Science.gov (United States)

    Tencer, A F; Johnson, K D; Johnston, D W; Gill, K

    1984-01-01

    Subtrochanteric femoral fractures with and without bony contact were simulated in cadaver specimens, fixed with one of seven different types of intramedullary or plate implants, and tested biomechanically. The implants used were Enders pins, Zickel nail, compression hip screw, AO angled blade plate, and intramedullary locked nail systems of the Klemm-Schellman, Brooker-Wills, and Grosse-Kempf types. Femur-implant constructs using intramedullary devices were a maximum of 5% as stiff in torsion as intact cadaveric femora tested in the same manner, while plate-fixed fractures were nearly 50% as stiff. In bending, all devices except the Enders pins were approximately 80% as stiff as intact femora. Loss of bony contact at the fracture site had little effect on stiffness except in the case of the keyless compression hip screw, where the screw rotated freely in the barrel. In combined bending and compression to failure, a test to simulate forces due to body weight, the intramedullary locked rods were found to support between 300 and 400% of body weight while the plate systems failed at loads between 100 and 200% of body weight.

  13. Influence of effective number of pulses on the morphological structure of teeth and bovine femur after femtosecond laser ablation.

    Science.gov (United States)

    Nicolodelli, Gustavo; Lizarelli, Rosane de Fátima Zanirato; Bagnato, Vanderlei Salvador

    2012-04-01

    Femtosecond lasers have been widely used in laser surgery as an instrument for contact-free tissue removal of hard dental, restorative materials, and osseous tissues, complementing conventional drilling or cutting tools. In order to obtain a laser system that provides an ablation efficiency comparable to mechanical instruments, the laser pulse rate must be maximal without causing thermal damage. The aim of this study was to compare the different morphological characteristics of the hard tissue after exposure to lasers operating in the femtosecond pulse regime. Two different kinds of samples were irradiated: dentin from human extracted teeth and bovine femur samples. Different procedures were applied, while paying special care to preserving the structures. The incubation factor S was calculated to be 0.788±0.004 for the bovine femur bone. These results indicate that the incubation effect is still substantial during the femtosecond laser ablation of hard tissues. The plasma-induced ablation has reduced side effects, i.e., we observe less thermal and mechanical damage when using a superficial femtosecond laser irradiation close to the threshold conditions. In the femtosecond regime, the morphology characteristics of the cavity were strongly influenced by the change of the effective number of pulses.

  14. 股骨转子间骨折与股骨远端骨折的可视化仿真手术研究%Visualized simulative surgery for intertrochanteric and distal fractures of the femur

    Institute of Scientific and Technical Information of China (English)

    王丹; 金丹; 裴国献; 王义生; 夏磊; 鲍苏苏; 谢叻

    2014-01-01

    Objective To study the application of three-dimensional (3D) models of femoral intertrochanteric and distal fractures in visualized simulative surgery.Methods Enrolled in this study were a male patient (45 years old) with right femoral intertrochanteric fracture and a female patient (34 years old) with left femoral distal fracture.Their original image data of 64-slice spiral CT were obtained.Using adaptive region growing algorithm,the serial CT images were segmented and automatically extracted for 3D reconstruction of the femur and its anatomically related structures with a self-designed program.The model was then processed with Freeform Modeling System for image modification and smoothing.Next Computer Aided Design (CAD) software Unigraphics NX4.0 and Freeform Modeling System V9.0 were used to develop dynamic hip screw system,femoral retrograde intramedullary nailing system and less invasive stable system.With the assistance of GHST SDK and PHANTOM software,preoperative simulative surgery for femoral fractures was performed on the basis of the established femoral model.Results The reconstructed 3D model clearly and freely demonstrated the 3D images of the femoral structures,the intertrochanteric fracture with dynamic hip plate fixation,the femoral distal fracture with AO LISS plating and retrograde intramedullary nailing.During the simulative surgery for femoral fractures,the GHOST SDK system allowed effective application of the virtual surgical instruments.The use of PHANTOM software produced a surgical experience highly resembling that from an actual operation.The whole process from the start of model establishment till the finish of internal fixation lasted 1.2 hours for the femoral intertrochanteric fracture and 1.5 hours for the femoral distal fracture.Conclusion Since the visualized simulative surgery for femoral intertrochanteric and distal fractures on the 3D model can familiarize surgeons with the 3D structures of the fracture,it has a great value in

  15. Analyze of Ortho-SUV™, software base hybrid fixation on three planar femur deformity

    Directory of Open Access Journals (Sweden)

    Mohammadreza Effatparvar

    2017-05-01

    Full Text Available Background: Application of Hybrid 6 degrees of freedom fixation could lead to space motion in each 3 anatomic plates together and decrease the time of complex deformities correction. This study is an investigation on the function of hybrid external fixation and the influence of it on decreasing the treatment time. About this case utilize of Ortho-SUV Frame (OSF system is explained for the first time in Iran and report of its novel. These robotic systems are divided into two groups: active and passive, about active system all movements are done by actuators in joints and links. And in passive, the system needs an operator or patient to actuates Sturats by hand. Methods: The femur bone has been investigated was non:union: with deformity in sagittal, frontal and transversal planes. Ilizarov external fixation was applicate firstly, with this condition that the OSF systems jacks were replaced instead of simple rods in side of fracture. Software work was done on February of 2016 in Ayatollah Taleghani Hospital, Tehran, Iran. Fractures were happened in a car accident and some other operating were perforemed for this patient without any result. Results: The correction of studied deformity needs 3 planar moving. Acting this movement by Ilizarov requirements 33 mm displacement in frontal plane, 12 mm horizontal distraction and 48 mm displacement in sagittal plane. Due to the rate of correction in Ilizarov which is 1 mm per day, this bone needs 93 days for general correction and three times changing in shape of rings connections. While, by using the hybrid external fixation, all displacements were corrected in 46 days and first connection had supported all planes.    Conclusion: According to that the decreasing of treatment time is one of the main goal, the hybrid external fixation systems could be an appointment choice in complex deformities and replaced with some common fixation. In addition to, using of updated software increases the accuracy of

  16. Consideration of multiple load cases is critical in modelling orthotropic bone adaptation in the femur.

    Science.gov (United States)

    Geraldes, Diogo M; Modenese, Luca; Phillips, Andrew T M

    2016-10-01

    Functional adaptation of the femur has been investigated in several studies by embedding bone remodelling algorithms in finite element (FE) models, with simplifications often made to the representation of bone's material symmetry and mechanical environment. An orthotropic strain-driven adaptation algorithm is proposed in order to predict the femur's volumetric material property distribution and directionality of its internal structures within a continuum. The algorithm was applied to a FE model of the femur, with muscles, ligaments and joints included explicitly. Multiple load cases representing distinct frames of two activities of daily living (walking and stair climbing) were considered. It is hypothesised that low shear moduli occur in areas of bone that are simply loaded and high shear moduli in areas subjected to complex loading conditions. In addition, it is investigated whether material properties of different femoral regions are stimulated by different activities. The loading and boundary conditions were considered to provide a physiological mechanical environment. The resulting volumetric material property distribution and directionalities agreed with ex vivo imaging data for the whole femur. Regions where non-orthogonal trabecular crossing has been documented coincided with higher values of predicted shear moduli. The topological influence of the different activities modelled was analysed. The influence of stair climbing on the properties of the femoral neck region is highlighted. It is recommended that multiple load cases should be considered when modelling bone adaptation. The orthotropic model of the complete femur is released with this study.

  17. Geometric morphometric analysis reveals age-related differences in the distal femur of Europeans.

    Science.gov (United States)

    Cavaignac, Etienne; Savall, Frederic; Chantalat, Elodie; Faruch, Marie; Reina, Nicolas; Chiron, Philippe; Telmon, Norbert

    2017-12-01

    Few studies have looked into age-related variations in femur shape. We hypothesized that three-dimensional (3D) geometric morphometric analysis of the distal femur would reveal age-related differences. The purpose of this study was to show that differences in distal femur shape related to age could be identified, visualized, and quantified using three-dimensional (3D) geometric morphometric analysis. Geometric morphometric analysis was carried out on CT scans of the distal femur of 256 subjects living in the south of France. Ten landmarks were defined on 3D reconstructions of the distal femur. Both traditional metric and geometric morphometric analyses were carried out on these bone reconstructions. These analyses were used to identify trends in bone shape in various age-based subgroups (60). Only the average bone shape of the < 40-year subgroup was statistically different from that of the other two groups. When the population was divided into two subgroups using 40 years of age as a threshold, the subject's age was correctly assigned 80% of the time. Age-related differences are present in this bone segment. This reliable, accurate method could be used for virtual autopsy and to perform diachronic and interethnic comparisons. Moreover, this study provides updated morphometric data for a modern population in the south of France. Manufacturers of knee replacement implants will have to adapt their prosthesis models as the population evolves over time.

  18. A method for accounting for test fixture compliance when estimating proximal femur stiffness.

    Science.gov (United States)

    Rossman, Timothy; Dragomir-Daescu, Dan

    2016-09-06

    Fracture testing of cadaveric femora to obtain strength and stiffness information is an active area of research in developing tools for diagnostic prediction of bone strength. These measurements are often used in the estimation and validation of companion finite element models constructed from the femora CT scan data, therefore, the accuracy of the data is of paramount importance. However, experimental stiffness calculated from force-displacement data has largely been ignored by most researchers due to inherent error in the differential displacement measurement obtained when not accounting for testing apparatus compliance. However, having such information is necessary for validation of computational models. Even in the few cases when fixture compliance was considered the measurements showed large lab-to-lab variation due to lack of standardization in fixture design. We examined the compliance of our in-house designed cadaveric femur test fixture to determine the errors we could expect when calculating stiffness from the collected experimental force-displacement data and determined the stiffness of the test fixture to be more than 10 times the stiffness of the stiffest femur in a sample of 44 femora. When correcting the apparent femur stiffness derived from the original data, we found that the largest stiffness was underestimated by about 10%. The study confirmed that considering test fixture compliance is a necessary step in improving the accuracy of fracture test data for characterizing femur stiffness, and highlighted the need for test fixture design standardization for proximal femur fracture testing.

  19. Open reduction and intramedullary stabilisation of subtrochanteric femur fractures: A retrospective study of 56 cases.

    Science.gov (United States)

    Beingessner, Daphne M; Scolaro, John A; Orec, Robert J; Nork, Sean E; Barei, David P

    2013-12-01

    Subtrochanteric femur fractures commonly present with predictable displacement because of the deforming muscle forces acting upon the proximal femur. For this reason, successful closed reduction and femoral nailing can be a technically demanding procedure. Open reduction prior to nail placement has been advocated to improve and maintain anatomic fracture alignment. The purpose of this study was to evaluate the results of patients with closed subtrochanteric femur fractures treated with open reduction and a reamed antegrade statically locked intramedullary nail. An initial query of our database identified 154 patients who had sustained a subtrochanteric femur fracture over the defined study period. Ninety-six patients had adequate radiographic and clinical follow-up. Fifty-six (58%) patients were treated with open reduction and nail placement. There were no wound complications or infections and all patients went on to successful osseous union. There was no loss of reduction and a final coronal and sagittal plane deformity of subtrochanteric femur fractures followed by intramedullary nailing leads to high union rates with rare complications.

  20. The femur as a musculo-skeletal construct: a free boundary condition modelling approach.

    Science.gov (United States)

    Phillips, A T M

    2009-07-01

    Previous finite element studies of the femur have made simplifications to varying extents with regard to the boundary conditions used during analysis. Fixed boundary conditions are generally applied to the distal femur when examining the proximal behaviour at the hip joint, while the same can be said for the proximal femur when examining the distal behaviour at the knee joint. While fixed boundary condition analyses have been validated against in vitro experiments it remains a matter of debate as to whether the numerical and experimental models are indicative of the in vivo situation. This study presents a finite element model in which the femur is treated as a complete musculo-skeletal construct, spanning between the hip and knee joints. Linear and non-linear implementations of a free boundary condition modelling approach are applied to the bone through the explicit inclusion of muscles and ligaments spanning both the hip joint and the knee joint. A non-linear force regulated, muscle strain based activation strategy was found to result in lower observed principal strains in the cortex of the femur, compared to a linear activation strategy. The non-linear implementation of the model in particular, was found to produce hip and knee joint reaction forces consistent with in vivo data from instrumented implants.

  1. Comparative morphometric analysis of the proximal femur of African hominids and felids

    Directory of Open Access Journals (Sweden)

    Andrew Gallagher

    2015-09-01

    Full Text Available Size and shape of the mammalian proximal femur and taxon-specific distinctions in the relative proportions of the proximal articulation, the femoral neck and the proximal femoral diaphysis, are critical determinants in its adaptation to differential biomechanical stresses and observed locomotor habitus in different taxa. The morphometrics of the proximal femur are considered equally critical in the assessment of locomotor habitus of extinct fossil mammals, particularly extinct Miocene anthropoids and Plio-Pleistocene hominins. Analyses of size and shape of k=10 dimensions of the proximal femur were undertaken for a large sample series of two extant mammal families the Felidae and Hominidae using conventional multivariate statistical procedures, commonly used size-correction methods, and post-hoc tests of significance. While significant differences in form do exist, there are equally striking convergences in the functional morphology of extant hominid and felid taxa. Multivariate and bivariate allometric analyses confirm that the proximal femur of these two mammalian families share a common underlying structure manifest in a shared first common principal component. Nevertheless, while considerable convergences in general form of the proximal femur of African hominids and large-bodied felids are apparent, there exist equally discreet distinctions which are consistent with the differential structural demands imposed by their distinct locomotor and behavioural habitus.

  2. Bone remodelling in the proximal femur after Charnley total hip arthroplasty.

    Science.gov (United States)

    Cohen, B; Rushton, N

    1995-09-01

    We measured bone mineral density (BMD) in the proximal femur by dual-energy X-ray absorptiometry (DEXA) in 20 patients after cemented total hip arthroplasty over a period of one year. We found a statistically significant reduction in periprosthetic BMD after six months on the medial side and on the lateral side adjacent to the mid and distal thirds of the prosthesis. At one year after operation there was a mean 6.7% reduction in BMD in the region of the calcar and a mean 5.3% increase in BMD in the femoral shaft distal to the tip of the implant. These changes reflect a pattern of reduced stress in the proximal femur and increased stress around the tip of the prosthesis. They support current concepts of bone remodelling in the proximal femur in response to prosthetic implantation.

  3. A STUDY OF CLOSED INTERLOCKING NAILING FOR FRACTURES OF SHAFT OF FEMUR IN ADULTS

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    Ashwin

    2013-06-01

    Full Text Available ABSTRACT: BACKGROUND:-This study is to determine the clinical course and results after interlocking nailing for femoral shaft fractures , merits and demerits of interlocking nailing, achieving the final goals of femoral shaft fracture management with special references to time for radiological union, knee stiffness, limb length discrepancy, ambulation and return to work. Femur is the strongest and heaviest bone in the human skeleton. It is also the longest bone contributing 26% to height of an individual. Fractures of the shaft of the femur are among the most common fractures encountered in orthopaedic practice, can cause prolong morbidity and extensive disability unless treatment is appropriate. Many treatment modalities were described; with many surgeons advocating different methods of treatment .At present Interlocking nailing of the femur seems to be the ideal method of treatment for complex femoral fractures.

  4. Incidence rates and trends of hip/femur fractures in five European countries

    DEFF Research Database (Denmark)

    Requena, G; Abbing-Karahagopian, V; Huerta, C

    2014-01-01

    Hip fractures represent a major public health challenge worldwide. Multinational studies using a common methodology are scarce. We aimed to estimate the incidence rates (IRs) and trends of hip/femur fractures over the period 2003-2009 in five European countries. The study was performed using seven...... electronic health-care records databases (DBs) from Denmark, The Netherlands, Germany, Spain, and the United Kingdom, based on the same protocol. Yearly IRs of hip/femur fractures were calculated for the general population and for those aged ≥50 years. Trends over time were evaluated using linear regression......, P femur fractures varied greatly across European countries. With the exception of Denmark, no decreasing trend was observed over the study period....

  5. The effects of glucocorticoid on microarchitecture, collagen, mineral and mechanical properties of sheep femur cortical bone

    DEFF Research Database (Denmark)

    Ding, Ming; Danielsen, Carl C; Overgaard, Søren

    2010-01-01

    The effects of glucocorticoid on microarchitecture, collagen, mineral and mechanical properties of sheep femur cortical bone – Validation of large animal model for tissue engineering and biomaterial research Ming Ding,1* Carl Christian Danielsen,2 Søren Overgaard1 1Orthopaedic Research Laboratory...... treatment. Group 3 was left untreated and served as the controls. All sheep received restricted diet with low calcium and phosphorus. At sacrifice, cortical bone samples from the femur midshaft of sheep were harvested, micro-CT scanned and tested in 3 point bending and in tensile. Bone collagen and mineral...... mechanical properties in the glucocorticoid-2. In conclusion, 7 months glucocorticoid treatment with malnutrition had significant impact on cortical microarchitecture of sheep femur midshaft. These changes occurred particularly 3 months after the glucocorticoid cessation suggesting a delayed effect...

  6. Bone morphology in 46 BXD recombinant inbred strains and femur-tibia correlation.

    Science.gov (United States)

    Zhang, Yueying; Huang, Jinsong; Jiao, Yan; David, Valentin; Kocak, Mehmet; Roan, Esra; Di'Angelo, Denis; Lu, Lu; Hasty, Karen A; Gu, Weikuan

    2015-01-01

    We examined the bone properties of BXD recombinant inbred (RI) mice by analyzing femur and tibia and compared their phenotypes of different compartments. 46 BXD RI mouse strains were analyzed including progenitor C57BL/6J (n = 16) and DBA/2J (n = 15) and two first filial generations (D2B6F1 and B6D2F1). Strain differences were observed in bone quality and structural properties (P tibia. More importantly, positive and negative femur-tibia associations indicated that genetic makeup had an influence on skeletal integrity. We conclude that (a) femur-tibia association in bone morphological properties significantly varies from strain to strain, which may be caused by genetic differences among strains, and (b) strainwise variations were seen in bone mass, bone morphology, and bone microarchitecture along with bone structural property.

  7. Percutaneous cementoplasty for painful osteolytic distal femur metastases: a case report.

    Science.gov (United States)

    Lei, Mingxing; Liu, Yaosheng; Yang, Shaoxing; Jiang, Weigang; Cao, Yuncen; Liu, Shubin

    2016-01-01

    Percutaneous cementoplasty has been shown to immediately restore the mechanical stability of affected bones, prevent further risk of bone fractures, and allow immediate weight bearing. It is emerging as one of the most promising procedures for patients with painful bone metastasis who are unsuitable for surgery or who show resistance to radiotherapy and/or analgesic therapies. This study aimed at describing the procedure, indications, and benefits of percutaneous cementoplasty for painful osteolytic distal femur metastases. We report the case of a painful metastatic lesion in the left distal femur secondary to non-small-cell lung cancer in a 58-year-old woman. The patient underwent percutaneous cementoplasty and experienced effective pain relief and recovery of knee function postoperatively. In addition, no perioperative complication was observed. Percutaneous cementoplasty for osteolytic distal femur metastases offers effective pain relief and restores impaired knee function. Although this method may be a safe option, larger samples of retrospective or prospective confirmation are warranted.

  8. Genu valgum secondary to focal fibrocartilaginous dysplasia of the distal femur.

    Science.gov (United States)

    Ruchelsman, David E; Madan, Sanjeev S; Feldman, David S

    2004-01-01

    We report a case of unilateral genu valgum secondary to focal fibrocartilaginous dysplasia (FFCD) isolated in the posterolateral cortex of the distal femur. This case is the first incidence of a discrete fibrous band occurring in conjunction with a FFCD lesion in the distal posterolateral femur treated with excision of the tether and the overlying periosteum with curettage of the cortical focal fibrocartilaginous defect. Treatment was considered successful with gradual resolution of the 30 degrees valgus deformity over 24 months, and we avoided the necessity of corrective osteotomy and its associated risks. To our knowledge, resolution of genu valgum secondary to FFCD in the distal posterolateral femur after curettage has not been previously described in the literature. Copyright 2004 Lippincott Williams and Wilkins

  9. Segmental fracture of the femur with concomitant genu valgum: a one-stage solution.

    Science.gov (United States)

    Ballal, Moez S; Verma, Rajat; Nayagam, Selvadurai

    2010-09-01

    Segmental fractures of the femur are high energy injuries usually treated with internal fixation. We present the case of such a fracture in which the femur had a preexisting genu valgum deformity from an earlier distal femur physeal arrest. This prevented standard intramedullary nailing or minimally invasive plate fixation. A technique of simultaneous correction of the distal femoral deformity coupled with stabilization of the segmental fracture is reported. Surgery involved an external fixator-assisted corrective osteotomy of the deformity and simultaneous minimally invasive plating of the segmental fracture. The advent of modern concepts of deformity correction has allowed a combination with present day internal fixation techniques to achieve correction, stabilization and union in a problem that would otherwise require two stages of surgery.

  10. [Biomechanical test study of rat femurs growing under different stress environment].

    Science.gov (United States)

    Liu, Yingxi; Zhao, Wenzhi; Zhang, Jun; Li, Shouju; Li, Jingnian; Sun, Xiaojiang

    2005-06-01

    By creating two kinds of stress environment in the same animal model, we performed a three-point bending test and a compressing test on the rat femurs growing under different stress conditions to characterize the effect of stress on bone mechanical properties. The right hindlimbs were subjected to sciatic nerve resection to become cripple and were used as unloading group; the left hindlimbs bore excess load and made up the overloading group; the normal rats were used as control group. The animals were encouraged to exercise for half an hour everyday in the morning, noon and evening. The experiment observation finished in four weeks. The biomechanical parameters of femur diaphyses were measured. The experiment results showed that stress environment may change several mechanical parameters of rat femurs. This study indicated that bone tissues can adapt to its stress environment by changing its mechanical properties. The experimental model in this article is practical and reliable.

  11. Magnetic resonance imaging findings of osteoid osteoma of the proximal femur

    Energy Technology Data Exchange (ETDEWEB)

    Gaeta, Michele; Minutoli, Fabio; Pandolfo, Ignazio; Vinci, Sergio; Blandino, Alfredo [Department of Radiological Sciences, University of Messina, Policlinico ' ' G. Martino' ' , Via Consolare Valeria, 98100, Messina (Italy); D' Andrea, Letterio [Department of Orthopedics, University of Messina, Policlinico ' ' G. Martino' ' , Via Consolare Valeria, 98100, Messina (Italy)

    2004-09-01

    Osteoid osteoma (OO) is a benign bone tumor whose main radiological finding is nidus. OO of the proximal femur can also result in non-specific findings such as hip joint effusion, perinidal bone marrow edema and soft tissue mass. Since the nidus may be difficult to identify with MR, these non-specific findings can lead to erroneous diagnosis. Therefore, MR imaging technique should be optimized in order to identify nidus. Since MR imaging has assumed increasing importance in the evaluation of disorders of the hip, radiologists must be aware of the spectrum of findings of OO of the proximal femur. The aim of this pictorial review is to show the MR imaging findings of intra-articular and extra-articular OO of the proximal femur. (orig.)

  12. Mechanical, biochemical and morphometric alterations in the femur of mdx mice.

    Science.gov (United States)

    Nakagaki, Wilson Romero; Bertran, Celso Aparecido; Matsumura, Cintia Yuri; Santo-Neto, Humberto; Camilli, José Angelo

    2011-02-01

    The bone tissue abnormalities observed in patients with Duchenne muscular dystrophy are frequently attributed to muscle weakness. In this condition, bones receive fewer mechanical stimuli, compromising the process of bone modeling. In the present study we hypothesize that other factors inherent to the disease might be associated with bone tissue impairment, irrespective of the presence of muscle impairment. Mdx mice lack dystrophin and present cycles of muscle degeneration/regeneration that become more intense in the third week of life. As observed in humans with muscular dystrophy, bone tissue abnormalities were found in mdx mice during more intense muscle degeneration due to age. Under these circumstances, muscle deficit is probably one of the factors promoting these changes. To test our hypothesis, we investigated the changes that occur in the femur of mdx mice at 21 days of age when muscle damage is still not significant. The mechanical (structural and material) and biochemical properties and morphometric characteristics of the femur of mdx and control animals were evaluated. The results demonstrated a lower strength, stiffness and energy absorption capacity in mdx femurs. Higher values for structural (load and stiffness) and material (stress, elastic modulus and toughness) properties were observed in the control group. Mdx femurs were shorter and were characterized by a smaller cortical area and thickness and a smaller area of epiphyseal trabecular bone. The hydroxyproline content was similar in the two groups, but there was a significant difference in the Ca/P ratios. Thermogravimetry showed a higher mineral matrix content in cortical bone of control animals. In conclusion, femurs of mdx mice presented impaired mechanical and biochemical properties as well as changes in collagen organization in the extracellular matrix. Thus, mdx mice developed femoral osteopenia even in the absence of significant muscle fiber degeneration. This weakness of the mdx femur is

  13. The Analysis of Biomechanical Properties of Proximal Femur after Implant Removal

    Directory of Open Access Journals (Sweden)

    Jae Hyuk Yang

    2016-01-01

    Full Text Available Introduction. To compare the biomechanical stability of the femur following the removal of proximal femoral nail antirotation (PFNA-II and dynamic hip screw (DHS. Material and Methods. 56 paired cadaveric femurs were used as experimental and control groups. In the experimental group, PFNA-II and DHS were randomly inserted into femurs on both sides and then removed. Thereafter, compression load was applied until fracture occurred; biomechanical stability of the femurs and associated fracture patterns were studied. Results. The ultimate load and stiffness of the control group were 6227.8±1694.1 N and 990.5±99.8 N/mm, respectively. These were significantly higher than experimental group (p=0.014, <0.001 following the removal of PFNA-II (4085.6±1628.03 N and 656.3±155.3 N/mm and DHS (4001.9±1588.3 N and 656.3±155.3 N/mm. No statistical differences in these values were found between the 2 device groups (p=0.84, 0.71, regardless of age groups. However, fracture patterns were different between two devices, intertrochanteric and subtrochanteric fractures. Conclusions. Mechanical stability of the proximal femurs does not differ after the removal of 2 different of fixation devices regardless of the age. However, it was significantly lower compared to an intact femur. Different fracture patterns have been shown following the removal of different fixation devices as there are variations in the site of stress risers for individual implants.

  14. Normobaric interval hypoxic training in the treatment of fractures of the trochanteric region of the femur

    OpenAIRE

    2015-01-01

    Trochanteric fractures of the femur amount from 2 to 13.5 % of all fractures of bones and 28–37,5 % of femoral fractures, and unsatisfactory outcomes of their treatment — from 16 to 40 %. Negative impact on the outcome of the treatment have osteopo­rosis, immunosuppressive conditions associated with long-term therapy, hormonal therapy, diabetes and thyrotoxicosis.Objec­tive: To improve outcomes of treatment and rehabilitation in patients with fractures of the trochanteric region of the femur ...

  15. Persistent wound drainage after tumor resection and endoprosthetic reconstruction of the proximal femur

    DEFF Research Database (Denmark)

    Hettwer, Werner H; Horstmann, Peter F; Grum-Schwensen, Tomas A

    2014-01-01

    resection and subsequent endoprosthetic reconstruction of the proximal femur, between 2010 and 2012, in a single center. RESULTS: PWD for 7 days or more was observed in 41 cases (48%). The wounds only ceased oozing after a mean of 8.4 days, leading to prolonged administration of prophylactic antibiotics...... (mean 8.7 days) and length of hospital stay (mean 10.2 days). Total femur replacement, bone sarcoma and additional pelvic reconstruction were identified as significant independent risk factors for an even longer duration of PWD. CONCLUSION: Compared to conventional hip arthroplasty, PWD appears...

  16. The effects of glucocorticoid on microarchitecture, collagen, mineral and mechanical properties of sheep femur cortical bone

    DEFF Research Database (Denmark)

    Ding, Ming; Danielsen, Carl Christian; Overgaard, Søren

    2011-01-01

    of 3 months without treatment. Group 3 was left untreated and served as controls. All sheep received a restricted diet with low calcium and phosphorus. At sacrifice, cortical bone samples from the femur midshaft of each sheep were harvested, micro-CT scanned and subjected to three-point bending...... the groups, while there was a trend towards decreasing bending mechanical properties in the glucocorticoid-2 group. In conclusion, 7 months of glucocorticoid treatment with malnutrition had a significant impact on the cortical microarchitecture of the sheep femur midshaft. These observed changes occurred 3...

  17. NEGLECTED FRACTURE NECK OF FEMUR OPERATED WITH NON VASCULARISED FIBULAR GRAFT

    Directory of Open Access Journals (Sweden)

    Kamareddy

    2014-11-01

    Full Text Available Neglected fracture neck of femur is a common presentation in developing countries like India. We report a case of 58years old male patient which was successfully managed at our institute. Treatment options vary from arthroplasty and osteotomy (with or without graft to osteosynthesis using various implants and grafting techniques (muscle pedicle, vascularized, and non-vascularised fibular graft. We performed a non vascularised fibular graft with cancellous screw fixation. Patient had a satisfactory bony union without any avascular changes. We emphasize that Non vascularised fibular graft is a treatment option for surgical management of fracture neck of femur.

  18. ASSESSMENT OF RELATIONSHIP BETWEEN NECK SHAFT ANGLE AND NECK LENGTH WITH INTEREPICONDYLAR DISTANCE IN FEMUR

    Directory of Open Access Journals (Sweden)

    Ishita Ghosh

    2015-12-01

    Full Text Available Background: Femur is the longest and strongest bone of the body. It transmits body weight from hip bone to tibia in standing position. Femoral neck is a constricted part connecting head with shaft at an angle of about 125°-known as angle of inclination or neck shaft angle (NSA; this facilitates the movement of hip joint enabling the limb to swing clear of pelvis. Abnormal femoral neck angle (FNA may be associated with various clinical problems ranging from harmless in toeing gait in childhood to disabling osteoarthritis in adults. The current study attempted to find out if a co-relation exists between those parameters and other clinically measurable variables like inter-epicondylar distance or distance between greater trochanter to lateral epicondyle. This may help to predict the risk of fracture neck femur without any risk of radiation exposure and proper prophylactic measures can be undertaken (Vit-D, calcium to decrease risk of fracture. Results: Measurements were taken in dry femora mostly in East Indian population. Variables that were measured in 158 dry femora (85 femora from left side and 73 from the right side are: - a Neck shaft angle of femur, b Neck length of femur, c Neck circumference of femur, d Inter-epicondylar distance of femur, e Distance between lateral epicondyle and greater trochanter of femur. No significant difference was found between the right and left sided femoral groups regarding any of the study variables. From the analysis it was revealed that no positive or negative correlation exists between the study variables. Therefore, it is not possible to predict the value of one or more of them from the magnitude of the other variable(s. Conclusions: Our study attempted to find out if it was possible to predict the risk of fracture neck femur by simple clinical procedure without exposing the subjects to radiation hazards associated with a radiological imaging. A screening test and subsequent prophylactic measures could

  19. 3D CAD model reconstruction of a human femur from MRI images

    Directory of Open Access Journals (Sweden)

    Benaissa EL FAHIME

    2013-05-01

    Full Text Available Medical practice and life sciences take full advantage of progress in engineering disciplines, in particular the computer assisted placement technique in hip surgery. This paper describes the three dimensional model reconstruction of human femur from MRI images. The developed program enables to obtain digital shape of 3D femur recognized by all CAD software and allows an accurate placement of the femoral component. This technic provides precise measurement of implant alignment during hip resurfacing or total hip arthroplasty, thereby reducing the risk of component mal-positioning and femoral neck notching.

  20. Reducing subtrochanteric femur fractures: tips and tricks, do's and don'ts.

    Science.gov (United States)

    Yoon, Richard S; Donegan, Derek J; Liporace, Frank A

    2015-04-01

    Treatment of subtrochanteric fracture remains a challenge, but evolution of strategy has allowed for reliable results with low complications. Although several fixation options exist, reamed, antegrade intramedullary nailing (IMN) has evolved as the standard of care. Cognizant effort to achieve anatomic reduction before IMN passage allows for desired outcomes. Several reduction techniques can be used to overcome the deforming forces present in the proximal femur to allow for proper IMN placement. The purpose of this article is to review the tips, tricks, and pitfalls to avoid in the treatment of subtrochanteric femur fractures with IMN.

  1. Chronic Osteomyelitis of the Femur with Segmental Bone Defect: Concepts and Treatment

    Directory of Open Access Journals (Sweden)

    Mohd. Y. Bajuri

    2017-04-01

    Full Text Available Chronic osteomyelitis of the femur has always been a challenging scenario for the treating surgeon. It leads to morbidity to the patient as it interferes with the patient's rehabilitation and mobilisation. This is further complicated with the presence of a segmental bone loss following debridement due to the infection. We present a case of a young man who had a femur fracture which was initially treated with intramedullary nailing and subsequently was complicated with deep surgical site infection leading to chronic osteomyelitis.

  2. ASYMMETRICAL BILATERAL HIP DISLOCATION WITH SEGMENTAL FRACTURE FEMUR: AN UNUSUAL CASE REPORT AND LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Ramesh

    2015-01-01

    Full Text Available Bilateral traumatic hip dislocation is rarely seen. A unique case is presented, consisting of asymmetric bilateral hip dislocation with associated segmental fracture femur, resulting from fall from bus. This case represents an unusual, severe combination of injuries resulting from the fall from bus under influence of alcohol. Traumatic hip dislocation represents a true orthopaedic emergency . Given the severity of associated complications, every effort should be made to ensure pr ompt diagnosis and immediate therapy. We report our experience in the management of this complex injury pattern and review the pertinent literature on this subject. Keywords: Bilateral hip dislocation , Asymmetric hip dislocation , Segmental femur fracture , Closed reduction , Fall from bus .

  3. Fratura supra e intracondiliana exposta de femur em atleta de motocross: relato de caso Supra and intracondylar open fracture of the femur in a motocross athlete: case report

    Directory of Open Access Journals (Sweden)

    Jorge Sayum Filho

    2011-10-01

    Full Text Available Os autores apresentam o relato de um caso de uma paciente (atleta amador de motocross que sofreu uma queda durante uma competição e teve fratura supra e intracondiliana exposta de fêmur direito.The authors report the case of a patient (amateur motocross competitor who suffered a fall during a motocross competition resulting in a supra and intracondylar open fracture in the right femur.

  4. Fratura supra e intracondiliana exposta de femur em atleta de motocross: relato de caso Supra and intracondylar open fracture of the femur in a motocross athlete: case report

    OpenAIRE

    Jorge Sayum Filho; Jorge Sayum; Rogério Teixeira de Carvalho; Alexandre Nicolini; Marcelo Mitsuro Matsuda; Wu Tu Cheng; Moisés Cohen

    2011-01-01

    Os autores apresentam o relato de um caso de uma paciente (atleta amador de motocross) que sofreu uma queda durante uma competição e teve fratura supra e intracondiliana exposta de fêmur direito.The authors report the case of a patient (amateur motocross competitor) who suffered a fall during a motocross competition resulting in a supra and intracondylar open fracture in the right femur.

  5. Vertebral metastasis of femur primary osteosarcoma: a case report and literature review; Metastase vertebral de osteossarcoma primario de femur: relato de caso e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Cioni, Claudia Helena [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Radiologia Pediatrica; Francisco, Marina Celli; Lederman, Henrique Manoel [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: nana_celli@hotmail.com; Francisco, Fabiano Celli [Hospital de Caridade Sao Braz, Porto Uniao, SC (Brazil); Oliveira, Andrea Alencar de [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Oncologia Pediatrica; Neves, Felipe Trentin [Hospital Ipiranga, Sao Paulo, SP (Brazil). Cirurgia Geral

    2006-10-15

    We present a case of a 21-year-old patient, bearer of femur primary osteosarcoma, who began with pain in the thoracic column. The metastasis of primary osteosarcoma has greater incidence on lungs, rarely affecting vertebras. We reviewed the literature about this disease and emphasized the image's characteristics on the several methods used (traditional radiographic exams, bone scintigraphy, computed tomography, magnetic resonance) and the main differential diagnostics. (author)

  6. Dynamic examination of the femur in a rat model of osteoporosis after injection of CPC containing ABK and PLLA

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, A.; Kusaka, T.; Sasaki, S.; Takano, I.; Tahara, Y.; Ishii, Y. [Kyorin Univ. School of Medicine, Tokyo (Japan). Dept. of Orthopaedic Surgery

    2001-07-01

    We developed calcium phosphate cement containing antibiotics and poly lactic acid, and examined the effects on bone strength by injecting the cement into the medullary space of the femur in model rats with osteoporosis. A good strength of bone was obtained over 6 months by injecting bone paste into the medullary space of the femur in model rats with bone formation. (orig.)

  7. Osteoporosis and low bone mass at the femur neck or lumbar spine in older adults: United States, 2005-2008

    Science.gov (United States)

    Many current clinical guidelines recommend that assessment of osteoporosis or low bone mass, as defined by the World Health Organization (WHO) (1), be based on bone mineral density at either the femur neck region of the proximal femur (hip) or the lumbar spine (2,3). This data brief presents the mos...

  8. Femur ultrasound (FemUS)-first clinical results on hip fracture discrimination and estimation of femoral BMD

    DEFF Research Database (Denmark)

    Barkmann, R; Dencks, S; Laugier, P

    2010-01-01

    A quantitative ultrasound (QUS) device for measurements at the proximal femur was developed and tested in vivo (Femur Ultrasound Scanner, FemUS). Hip fracture discrimination was as good as for DXA, and a high correlation with hip BMD was achieved. Our results show promise for enhanced QUS......-based assessment of osteoporosis. INTRODUCTION: Dual X-ray absorptiometry (DXA) at the femur is the best predictor of hip fractures, better than DXA measurements at other sites. Calcaneal quantitative ultrasound (QUS) can be used to estimate the general osteoporotic fracture risk, but no femoral QUS measurement...... has been introduced yet. We developed a QUS scanner for measurements at the femur (Femur Ultrasound Scanner, FemUS) and tested its in vivo performance. METHODS: Using the FemUS device, we obtained femoral QUS and DXA on 32 women with recent hip fractures and 30 controls. Fracture discrimination...

  9. Using of computer simulation in surgical treatment of patients with fractures of proximal femur

    Directory of Open Access Journals (Sweden)

    I.A. Norkin

    2010-06-01

    Full Text Available In this article questions of femur computer models base making for future it using in free patients medicine are discussed. Last allows possibility for educate doctors using computer models, increase their professional level and makes complications decrease. Comparing of fixation properties of DHS and PFN-A was performed

  10. Outcome of fetuses with short femur length detected at second-trimester anomaly scan

    DEFF Research Database (Denmark)

    Mathiesen, J. M.; Aksglaede, L.; Skibsted, L.

    2014-01-01

    Objective To assess the relationship between the finding of fetal femur diaphysis length (FL) below the 5th percentile at the second-trimester scan and pregnancy outcome, in a population in which more than 90% of women attend first-trimester screening. Methods This was a retrospective study of all...

  11. Implant failure caused by non-union of bisphosphonate-associated subtrochanteric femur fracture.

    LENUS (Irish Health Repository)

    O'Neill, Barry James

    2014-04-03

    Bisphosphonate use has been identified as a contributory factor in atypical subtrochanteric fracture of the femur. These fractures are commonly treated with an intramedullary device. We present a case of implant failure of an intrameduallary device caused by non-union of an atypical subtrochanteric fracture.

  12. Three-dimensional geometric morphometric analysis reveals ethnic dimorphism in the shape of the femur.

    Science.gov (United States)

    Cavaignac, Etienne; Li, Ke; Faruch, Marie; Savall, Frederic; Chiron, Philippe; Huang, W; Telmon, Norbert

    2017-12-01

    Ethnic dimorphism in the distal femur has never been studied in a three-dimensional analysis focused on shape instead of size. Yet, this dimorphism has direct implications in orthopedic surgery and in anthropology. The goal of this study was to show that differences in distal femur shape related to ethnic dimorphism could be identified, visualized, and quantified using 3D geometric morphometric analysis. CT scans of the distal femur were taken from 482 patients who were free of any bone-related pathology: 240 patients were European (E) and 242 were Asian (A). Ten osteometric landmarks based on standard bone landmarks used in anthropometry were placed on these scans. Geometric morphometric analysis, principal component analysis (PCA), canonical variates analysis (CVA), and other discriminant analyses (Goodall's F-test and Mahalanobis distance) were performed. A cross-validation analysis was carried out to determine the percentage of cases in which the ethnicity was correctly estimated. The shape of the E and A distal femur differed significantly (Goodall's F = 94.43, P geometric morphometric analysis made it possible to demonstrate these differences. The large number of subjects studied has helped modernize the references for certain bone measurements, with direct implication for orthopedic surgery and anthropology.

  13. Endoprosthetic reconstruction for metastatic phaeochromocytoma in the distal femur: A case report.

    Science.gov (United States)

    Srikanth, Kanchana Pala; Srinivas, Chirukuri; Gowrishankarswamy, Lakshmipura Gangadharaiah; Chandrasekar, Chikkamuniyappa

    2016-01-01

    Metastatic spread of malignant phaeochromocytoma is known to involve multiple organs including the axial skeleton. Its presentation as a solitary lesion in the long bones of the extremities is extremely rare. We report a unique case of solitary metastatic phaeochromocytoma presenting in the distal femur, 16 years after excision of primary abdominal tumor. A 60 year old female, operated for adrenal phaeochromocytoma 16 years back was detected to have a bone tumor in her left distal femur. Chest and abdominal CT evaluation including bone scintigraphy confirmed the lesion to be solitary. Magnetic resonance imaging of the left femur revealed the tumor to be of aggressive nature. It involved whole of the distal femoral metaphysis with bone destruction, soft tissue extension and an impending pathological fracture. The tumor was histopathologically confirmed to be phaeochromocytoma. Patient underwent wide surgical resection of the tumor along with simultaneous endoprosthetic reconstruction. Following surgery, rehabilitation was rapid and effortless with patient ambulating independently. She had pain free full range of knee movements and resumed her daily activity uneventfully. On 18 months follow up the patient had no recurrence or complications. Late and solitary skeletal metastasis of malignant phaeochromocytoma although rare, can occur in the distal femur mimicking a primary bone tumor. Wide surgical excision and simultaneous endoprosthetic reconstruction should be considered as a treatment option. This not only permits limb salvage and early rehabilitation, but also restores form and function of the limb.

  14. Spontaneous Hemarthrosis of the Knee - Late Complication of Flexible Femur Nailing: A Case Report

    Directory of Open Access Journals (Sweden)

    Kushare

    2016-03-01

    Full Text Available We present a case report of acute spontaneous knee hemarthosis due to erosion of the nail through the knee joint capsule in a boy, seven months following retrograde flexible nailing for fractured femur. Careful positioning of the location of the insertion site of flexible nails and proper nail tip management are important to avoid this rare late complication.

  15. Spontaneous Hemarthrosis of the Knee - Late Complication of Flexible Femur Nailing: A Case Report

    Science.gov (United States)

    Kushare, Indranil V; Oetgen, Matthew E; Walters, Suzanne J

    2016-01-01

    We present a case report of acute spontaneous knee hemarthosis due to erosion of the nail through the knee joint capsule in a boy, seven months following retrograde flexible nailing for fractured femur. Careful positioning of the location of the insertion site of flexible nails and proper nail tip management are important to avoid this rare late complication. PMID:28180118

  16. Spontaneous Hemarthrosis of the Knee - Late Complication of Flexible Femur Nailing: A Case Report

    OpenAIRE

    Kushare; Oetgen; Walters

    2016-01-01

    We present a case report of acute spontaneous knee hemarthosis due to erosion of the nail through the knee joint capsule in a boy, seven months following retrograde flexible nailing for fractured femur. Careful positioning of the location of the insertion site of flexible nails and proper nail tip management are important to avoid this rare late complication.

  17. Spontaneous Hemarthrosis of the Knee - Late Complication of Flexible Femur Nailing: A Case Report.

    Science.gov (United States)

    Kushare, Indranil V; Oetgen, Matthew E; Walters, Suzanne J

    2016-09-01

    We present a case report of acute spontaneous knee hemarthosis due to erosion of the nail through the knee joint capsule in a boy, seven months following retrograde flexible nailing for fractured femur. Careful positioning of the location of the insertion site of flexible nails and proper nail tip management are important to avoid this rare late complication.

  18. Prediction of the mechanical response of the femur with uncertain elastic properties.

    Science.gov (United States)

    Wille, Hagen; Rank, Ernst; Yosibash, Zohar

    2012-04-30

    A mandatory requirement for any reliable prediction of the mechanical response of bones, based on quantitative computer tomography, is an accurate relationship between material properties (usually Young's modulus E) and bone density ρ. Many such E-ρ relationships are available based on different experiments on femur specimens with a large spread due to uncertainties. The first goal of this study is to pool and analyze the relevant available experimental data and develop a stochasticE-ρ relationship. This analysis highlights that there is no experimental data available to cover the entire density range of the human femur and that some "popular" E-ρ relationships are based on data that contains extreme scatter, while others are based on a very limited amount of information. The second goal is to use the newly developed stochastic E-ρ relationship in high-order finite element analyses (FEAs) for the computation of strains and displacements in two human proximal femurs, mimicking in vitro experiments. When compared with the experimental observations, the FEA predictions using the median of the stochastic E-ρ relationship follow the underlying distribution of the stochastic E-ρ relationship. Thus, most deviations of the FEA predictions from experimental observations can possibly be explained by uncertain elastic properties of the femur.

  19. Detecting Early Biomechanical Effects of Zoledronic Acid on Femurs of Osteoporotic Female Rats

    Directory of Open Access Journals (Sweden)

    Evandro Pereira Palacio

    2012-01-01

    Full Text Available Aim. To investigate the biomechanical effects of zoledronic acid (ZA on femurs of female osteoporotic rats after follow-up periods of 9 and 12 months. Methods. Eighty female Wistar rats were prospectively assessed. At 60 days of age, the animals were randomly divided into two groups: bilateral oophorectomy (O (n=40 and sham surgery (S (n=40. At 90 days of age, groups O and S were randomly subdivided into four groups, according to whether 0.1 mg/kg of ZA or distilled water (DW was intraperitoneally administered: OZA (n=20, ODW (n=20, SZA (n=20, and SDW (n=20. The animals were sacrificed at 9 and 12 months after the administration of the substances, and then their right femurs were removed and analyzed biomechanically. Axial compression tests that focused on determining the maximum load (N, yield point (N, and stiffness coefficient (N/mm of the proximal femur were performed in the biomechanical study. Results. ZA significantly increased the maximum load and yield point, reducing the stiffness coefficient concerning the oophorectomy status and follow-up period. Conclusion. Zoledronic acid, at a dose of 0.1 mg/kg, significantly increased the maximum loads and yield points and reduced the stiffness coefficients in the femurs of female rats with osteoporosis caused by bilateral oophorectomy.

  20. Bone Morphology in 46 BXD Recombinant Inbred Strains and Femur-Tibia Correlation

    Directory of Open Access Journals (Sweden)

    Yueying Zhang

    2015-01-01

    Full Text Available We examined the bone properties of BXD recombinant inbred (RI mice by analyzing femur and tibia and compared their phenotypes of different compartments. 46 BXD RI mouse strains were analyzed including progenitor C57BL/6J (n=16 and DBA/2J (n=15 and two first filial generations (D2B6F1 and B6D2F1. Strain differences were observed in bone quality and structural properties (P<0.05 in each bone profile (whole bone, cortical bone, or trabecular bone. It is well known that skeletal phenotypes are largely affected by genetic determinants and genders, such as bone mineral density (BMD. While genetics and gender appear expectedly as the major determinants of bone mass and structure, significant correlations were also observed between femur and tibia. More importantly, positive and negative femur-tibia associations indicated that genetic makeup had an influence on skeletal integrity. We conclude that (a femur-tibia association in bone morphological properties significantly varies from strain to strain, which may be caused by genetic differences among strains, and (b strainwise variations were seen in bone mass, bone morphology, and bone microarchitecture along with bone structural property.

  1. Osteoarthritis of the hip in fibrous dysplasia of the proximal femur.

    Science.gov (United States)

    Kim, H-S; Im, S B; Han, I

    2015-07-01

    Deformity of the proximal femur in fibrous dysplasia leads to deviation of the mechanical axis of the hip, which may lead to the development of secondary osteoarthritis (OA). This study investigated the prevalence and predisposing factors for the development of OA in patients with fibrous dysplasia of the proximal femur. We reviewed the records of 209 patients from our institutional database with fibrous dysplasia of the proximal femur, investigating possible predisposing factors including patient demographics, the extent of the coxa vara deformity, the presence of peri-articular disease, and the overall burden of skeletal disease. Of the 209 patients, 24 (12%) had radiological evidence of OA in the ipsilateral hip. The prevalence was significantly higher in patients with polyostotic fibrous dysplasia compared with those with monostotic disease (p dysplasia have a high risk of developing secondary OA of the hips. This risk is higher in patients with peri-articular disease, and those with a more severe deformity of proximal femur. ©2015 The British Editorial Society of Bone & Joint Surgery.

  2. ESTIMATION OF STATURE FROM FRAGMENT OF FEMUR (POPLITEAL LENGTH IN BENGALEE POPULATION

    Directory of Open Access Journals (Sweden)

    Tapas Ghosh

    2015-09-01

    Full Text Available Introduction: Of the mathematical methods, regression equations have been successfully used for estimation of stature. Population specific formulae produce more accurate results. The present investigation was designed to estimate stature from fragment of femur obtained from a collection of Bengalee population of the state of West Bengal of India. Materials & Methods: The fragment of the femur (Popliteal length of femur was measured by a vertical length from the point where the distance between external borders of both linea aspera lips becomes 10 mm (it was considered as the lower end of linea aspera, where the two lips diverges below, to the ground where lower surfaces of both the condyles were in contact. Results: The following regression equation was obtained: Stature in feet = 0.127[20.1184 + 1.6890x]. (‘x’ stands for popliteal length of femur in centimeter. Discussion: This would help in identification of unknown skeletal remains, as estimation of stature is an important part in establishing the biological profile of skeletal remains.

  3. Implant failure caused by non-union of bisphosphonate-associated subtrochanteric femur fracture

    OpenAIRE

    2014-01-01

    Bisphosphonate use has been identified as a contributory factor in atypical subtrochanteric fracture of the femur. These fractures are commonly treated with an intramedullary device. We present a case of implant failure of an intrameduallary device caused by non-union of an atypical subtrochanteric fracture.

  4. 3D Finite Element Analysis of a Man Hip Joint Femur under Impact Loads

    Institute of Scientific and Technical Information of China (English)

    YU Xue-zhong; GUO Yi-mu; LI Jun; ZHANG Yun-qiu; HE Rong-xin

    2007-01-01

    The biomechanical characters of the bone fracture of the man femoral hip joint under impact loads are explored. Methods: A biosystem model of the man femoral hip joint by using the GE ( General Electric) lightspeed multi-lay spiral CT is conducted. A 3D finite element model is established by employing the finite element software ANSYS. The FE analysis mainly concentrates on the effects of the impact directions arising from intense movements and the parenchyma on the femoral hip joint on the stress distributions of the proximal femur. Results:The parenchyma on the hip joint has relatively large relaxation effect on the impact loads. Conclusion:Effects of the angle δ of the impact load to the anterior direction and the angle γ of the impact load to the femur shaft on the bone fracture are given;δ has larger effect on the stress and strain distributions than the angle γ, which mainly represents the fracture of the upper femur including the femoral neck fracture when the posterolateral femur is impacted, consistent with the clinical results.

  5. Dynamic Finite Element Analysis of Impulsive Stress Waves Propagating from Distal End of Femur

    Directory of Open Access Journals (Sweden)

    Sarai,Takaaki

    2012-10-01

    Full Text Available The human femur is subjected to an impulsive load at its distal end during daily life. Femoral bone fracture caused by impact loading is common in elderly women. It is important to clarify the dynamic response of the femur and to evaluate the change in its stress state during impact loading. A 3-dimensional model of the femur was prepared in the present study, and the impulsive stress waves propagating from the distal end of the femur were analyzed by the dynamic finite element method. This model showed that the von Mises equivalent stress is large on the anterior and posterior sides of the mid-diaphysis when the impact direction is different from that of the bone axis. As for the femoral neck, the absolute value of minimum principal stress initially increases on the medial side;slightly later the maximum principal stress increases on the lateral side. In this case, the absolute value of the maximum principal stress was found to be larger than that of the minimum principal stress, and the absolute value of the principal stress decreased as the impact angle increased. Further, the femoral neck and the trochanter were shown to have a higher risk of bone fracture when the impact direction is coincident with the bone axis.

  6. Percutaneous cementoplasty for painful osteolytic distal femur metastases: a case report

    Directory of Open Access Journals (Sweden)

    Lei M

    2016-10-01

    Full Text Available Mingxing Lei,1 Yaosheng Liu,1 Shaoxing Yang,2 Weigang Jiang,1 Yuncen Cao,1 Shubin Liu1 1Department of Orthopedic Surgery, 2Department of Pulmonary Neoplasms Internal Medicine, The Affiliated Hospital of Academy of Military Medical Sciences, Beijing, People’s Republic of China Abstract: Percutaneous cementoplasty has been shown to immediately restore the mechanical stability of affected bones, prevent further risk of bone fractures, and allow immediate weight bearing. It is emerging as one of the most promising procedures for patients with painful bone metastasis who are unsuitable for surgery or who show resistance to radiotherapy and/or analgesic therapies. This study aimed at describing the procedure, indications, and benefits of percutaneous cementoplasty for painful osteolytic distal femur metastases. We report the case of a painful metastatic lesion in the left distal femur secondary to non-small-cell lung cancer in a 58-year-old woman. The patient underwent percutaneous cementoplasty and experienced effective pain relief and recovery of knee function postoperatively. In addition, no perioperative complication was observed. Percutaneous cementoplasty for osteolytic distal femur metastases offers effective pain relief and restores impaired knee function. Although this method may be a safe option, larger samples of retrospective or prospective confirmation are warranted. Keywords: minimally invasive procedure, percutaneous cementoplasty, bone metastasis, distal femur

  7. Simultaneously detected parosteal osteoma and osteochondroma in the distal femur of a single patient.

    Science.gov (United States)

    Yun, Seong Jong; Jin, Wook; Park, Yong Koo; Han, Chung Soo; Ryu, Kyung Nam; Park, Ji Seon; Park, So Young

    2013-01-01

    Parosteal osteoma arising from long tubular bone is an extremely rare bone tumor and should be distinguished from parosteal osteosarcoma, whereas osteochondroma is a common benign bone tumor showing an outgrowth of medullary and cortical bone with a cartilaginous cap. This report describes simultaneously detected parosteal osteoma and osteochondroma arising from the distal femur in a single patient.

  8. A fracture risk assessment model of the femur in children with osteogenesis imperfecta (OI) during gait.

    Science.gov (United States)

    Fritz, Jessica M; Guan, Yabo; Wang, Mei; Smith, Peter A; Harris, Gerald F

    2009-11-01

    Osteogenesis imperfecta (OI) is a heritable bone fragility disorder characterized by skeletal deformities and increased bone fragility. There is currently no established clinical method for quantifying fracture risk in OI patients. This study begins the development of a patient-specific model for femur fracture risk assessment and prediction based on individuals' gait analysis data, bone geometry from imaging and material properties from nanoindentation (Young's modulus=19 GPa, Poisson's ratio=0.3). Finite element models of the femur were developed to assess fracture risk of the femur in a pediatric patient with OI type I. Kinetic data from clinical gait analysis was used to prescribe loading conditions on the femoral head and condyles along with muscle forces on the bone's surface. von Mises stresses were analyzed against a fracture strength of 115 MPa. The patient with OI whose femur was modeled showed no risk of femoral fracture during normal gait. The highest stress levels occurred during the mid-stance and loading responses phases of gait. The location of high stress migrated throughout the femoral diaphysis across the gait cycle. Maximum femoral stress levels occurred during the gait cycle phases associated with the highest loading. The fracture risk (fracture strength/von Mises stress), however, was low. This study provides a relevant method for combining functional activity, material property and analytical methods to improve patient monitoring.

  9. The best location for proximal locking screw for femur interlocking nailing: A biomechanical study

    Directory of Open Access Journals (Sweden)

    Ahmet A Karaarslan

    2016-01-01

    Conclusion: According to our findings, there is twice as much difference in locking screw bending resistance between these two application levels. To avoid proximal locking screw deformation, locking screws should be placed in the level of the lesser trochanter in nailing of 1/3 middle and distal femur fractures.

  10. Study of Ender’s Nailing in Shaft Femur Fractures of Older Children

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    Ladani HG

    2014-12-01

    Full Text Available Background: Fractures in shaft femur in children are relatively common. Various methods of treating these fractures starting from non operative to methods like closed intramedullary nailing are at our disposal. Traditionally non operative methods are acceptable and find wide acceptance even today in very young children. However in older children certain problems are encountered like failure to control angulation and shortening, prolonged immobilization which causes very much discomfort & the overgrowth phenomenon. In view of above difficulties, closed intramedullary nailing was attempted in older children and adolescents. I have tried to study 23 cases of shaft femur fractures in older children treated by Ender’s nails. Methodology: 22 pts., out of which one having bilateral # shaft femur (total 23 #s with age ranging from 7 to 16 yrs. were studied. 3 pts. having polio limbs studied separately. Fracture was in upper third shaft femur in 5 pts., middle third in 13 pts., lower third in 3pts. & involving more than one region in 2 pts. Fracture was transverse in 6 pts., spiral in 3 pts., oblique in 12 pts.& comminuted in 2 pts.. Results: Average union time was 10 weeks except in polio pts. where it was delayed. No nonunion, no infection. Excellent hip & knee movements in almost all pts. Out of 20 pts. ( except polio pts. limb length was equal in 17 pts., one pt. was having 1 cm. lengthening & 2 pts. were having shortening ( 1cm. & 2 cm.. Conclusion: Results of this study strongly favor the use of Ender’s nailing in shaft femur fractures in older children. Second surgery of implant removal is mandatory. Closed reduction can usually be achieved if surgery is performed earlier.

  11. Femur specific polyaffine model to regularize the log-domain demons registration

    Science.gov (United States)

    Seiler, Christof; Pennec, Xavier; Ritacco, Lucas; Reyes, Mauricio

    2011-03-01

    Osteoarticular allograft transplantation is a popular treatment method in wide surgical resections with large defects. For this reason hospitals are building bone data banks. Performing the optimal allograft selection on bone banks is crucial to the surgical outcome and patient recovery. However, current approaches are very time consuming hindering an efficient selection. We present an automatic method based on registration of femur bones to overcome this limitation. We introduce a new regularization term for the log-domain demons algorithm. This term replaces the standard Gaussian smoothing with a femur specific polyaffine model. The polyaffine femur model is constructed with two affine (femoral head and condyles) and one rigid (shaft) transformation. Our main contribution in this paper is to show that the demons algorithm can be improved in specific cases with an appropriate model. We are not trying to find the most optimal polyaffine model of the femur, but the simplest model with a minimal number of parameters. There is no need to optimize for different number of regions, boundaries and choice of weights, since this fine tuning will be done automatically by a final demons relaxation step with Gaussian smoothing. The newly developed synthesis approach provides a clear anatomically motivated modeling contribution through the specific three component transformation model, and clearly shows a performance improvement (in terms of anatomical meaningful correspondences) on 146 CT images of femurs compared to a standard multiresolution demons. In addition, this simple model improves the robustness of the demons while preserving its accuracy. The ground truth are manual measurements performed by medical experts.

  12. Two-Stage Surgical Treatment for Non-Union of a Shortened Osteoporotic Femur

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    Galal Zaki Said

    2013-01-01

    Full Text Available Introduction: We report a case of non-union with severe shortening of the femur following diaphysectomy for chronic osteomyelitis.Case Presentation: A boy, aged 16 years presented with a dangling and excessively short left lower limb. He was using an elbow crutch in his right hand to help him walk. He had a history of diaphysectomy for chronic osteomyelitis at the age of 9. Examination revealed a freely mobile non-union of the left femur. The femur was the seat of an 18 cm shortening and a 4 cm defect at the non-union site; the knee joint was ankylosed in extension. The tibia and fibula were 10 cm short. Considering the extensive shortening in the femur and tibia in addition to osteoporosis, he was treated in two stages. In stage I, the femoral non-union was treated by open reduction, internal fixation and iliac bone grafting. The patient was then allowed to walk with full weight bearing in an extension brace for 7 months. In Stage II, equalization of leg length discrepancy (LLD was achieved by simultaneous distraction of the femur and tibia by unilateral frames. At the 6 month follow- up, he was fully weight bearing without any walking aid, with a heel lift to compensate the 1.5 cm shortening. Three years later he reported that he was satisfied with the result of treatment and was leading a normal life as a university student.Conclusions: Two-stage treatment succeeded to restore about 20 cm of the femoral shortening in a severely osteoporotic bone. It has also succeeded in reducing the treatment time of the external fixator.

  13. Treatment of open femur fractures in children: comparison between external fixator and intramedullary nailing.

    Science.gov (United States)

    Ramseier, Leonhard Erich; Bhaskar, Atul R; Cole, William G; Howard, Andrew W

    2007-01-01

    Open femur fractures in children are uncommon and usually associated with other injuries. In adults, there is a current trend to treat open fractures with intramedullary (IM) devices. The goal of this study was to compare external fixator (EF) to IM devices in the treatment of open femur fractures in children. Diaphyseal femur fractures without growth plate involvement were included. Thirty-five patients (12 IM; 23 EF) were identified. Age, hospital stay, polytrauma, mechanism of injury, and Gustilo-Anderson grade were recorded. Follow-up was at least until the fracture was clinically and radiographically healed. Patients with EFs were 5.2 times more likely (95% confidence interval, 1.05-25.5) to have any complication. Excluding pin track infections, patients with EFs were 2.7 times as likely (95% confidence interval, 0.567-13.2) to have a complication. Refractures occurred only in the EF group (6/23, 26%) and not in the IM nailing group (P = 0.062, Fischer exact test). These were associated with varus malunions-all 3 of the EF group with more than 15 degrees of varus at fracture union suffered a refracture. Treatment of open femur fractures in children is a challenging problem. Treatment with IM devices had fewer complications than the EF. We think that whenever possible, the use of IM devices for the treatment of open femur fracture in children should be considered, especially grade 1 open injuries. If EFs are used, avoiding varus malunion may decrease the refracture rate, and secondary change to an IM device should be considered. Comparative cohort study. Grade 3 level of evidence.

  14. [Experience of using anterior windowing of the femur in revision total hip arthroplasty].

    Science.gov (United States)

    Li, Hu; Lin, Jian-hao

    2012-05-01

    To discuss the clinical results of anterior windowing of the femur to remove the femoral component and cement in revision total hip arthroplasty. From September 1999 to May 2011, 31 revision cases received anterior windowing of the femur in operation. There were 12 male and 19 female, with the average age in operation was 61.8 years (from 40 to 83 years). The reason for revision included aseptic loosening in 12 cases, infection in 4 cases, breakage of femoral stem in 11 cases and acetabular liner wear in 4 hemi-arthroplasties. Nine cases were cemented and 22 were non-cemented for the primary stem. The position of the window located in the anterior femur with 6 cases of complete windowing from the proximal to the end of the stem. Another 25 cases received regional windowing just around the tip of the stem. In revisions, non-cemented rectangular revision stem were used for 27 cases and two-stage surgery were used for 4 infection cases. In all revisions, femoral stems and cement fragments were removed successfully and safely without any complications of fracture and perforation of new stems. All femur windows showed successfully union for average 14 weeks (12-18 weeks). There were some postoperative complications. One recurrent dislocation was treated using plaster external fixation for 8 weeks. One case with dislocation and fracture along with the window was revised by cerclage fixation. One periprosthetic fracture due to trauma was treated by cerclage fixation. The average Harris score of the hip improved to 83 points (75 to 90 points) at an average 5.5 years follow-up (0.5 to 12.0 years). Twenty six cases were completely followed up. Revision femoral stems were well-fixed without any subsidence or loosening. Anterior windowing of the femur is a proven technique which can be used to remove femoral stem and cement conveniently and safely without any fractures in revision total hip arthroplasty.

  15. Evaporation of refrigerant HFC 407C on plain tubes or at an improved surface; Evaporation du refrigerant HFC 407C sur des tubes lisses ou a surface amelioree

    Energy Technology Data Exchange (ETDEWEB)

    Zuercher, O.; Favrat, D.; Thome, J.R.; Kattan, N.; Nidegger, E. [Ecole polytechnique federale, Lab. d`energetique industrielle, Lausanne (Switzerland)

    1996-11-15

    The substitution of CFC refrigerants in refrigeration systems, heat pumps and organic Rankine cycles for heat recovery, requires good methods for predicting heat transfer of substitute fluids. The measurements in the LENI test facility (concentric tubes with water flowing in a counter-current flow) with HFC 407C, HFC 134a, HCFC 123, HFC 404a and HFC/HCFC 402A provide a new data bank for new refrigerants, and allow a coherent comparison with old refrigerants CFC 11, CFC 12, CFC/HCFC 502 and with existing correlations. The existing correlations were found to be inadequate. Because of this work, an improved flow pattern map and flow boiling model were developed, which resulted in a substantial progress in the accurate predict of heat transfer in plain, horizontal tubes for refrigerants without oil. The Kattan et al. correlation was programmed to calculate and compare predicted heat transfer coefficients to the new HFC 407C test data. The flow pattern map proposed by Kattan et al. was also programmed and compared to flow regimes observed for HFC 407C. It predicted the HFC 407C flow pattern data quite accurately. The original objective of the HFC 407C measurements was the validation of the Kattan et al. correlation applied to a zeotropic refrigerant blend. Local flow boiling heat transfer coefficients were measured for HFC 407C evaporating inside a microfin and a plain tube. In addition, microfin heat transfer augmentation relative to a plain tube was investigated. The presence of oil in the evaporator had a complex effect on heat transfer coefficients. Local flow boiling heat transfer coefficients were measured for refrigerant HFC 407C ester oil mixtures (Mobil EAL Arctic 68). A new thermodynamic approach for modeling mixtures of zeotropic refrigerant blends and lubricating oils was also developed. (author) figs., tabs., 14 refs.

  16. STUDY OF FUNCTIONAL OUTCOME OF DISTAL FEMUR FRACTURES TREATED BY OPEN REDUCTION AND INTERNAL FIXATION WITH LOCKING COMPRESSION PLATE

    Directory of Open Access Journals (Sweden)

    Sahaya R

    2016-04-01

    Full Text Available BACKGROUND Distal femur fractures account for about 7% of all femur fractures. These fractures can lead to knee stiffness and have the tendency to collapse into varus. The management of distal femur fractures has seen a paradigm shift from nonoperative measures to biological fixation and evolution of modern implants like Locking Compression Plate has been used in current times. With the use of Locking Compression Plate double plating can be avoided. In our study, we have evaluated the short-term Functional Outcome of patients who underwent open reduction internal fixation with Locking Compression Plate using Sander’s criteria. Ours is both prospective and retrospective study of 20 patients with distal femur fractures treated operatively from April 2013 to October 2015. Our surgical modality of treatment is open reduction and internal fixation with locking compression plate using standard lateral approach. We have used AO classification to classify the distal femur fractures. With the results of our study, we have come to a conclusion that locking compression plate is a best option for both intra-articular and extra-articular distal femur fractures. It avoids the use of dual plating of distal femur which requires extensive soft tissue stripping in both sides, resulting in reduced blood supply, potential non-union and implant failure. Locking Compression Plate also helps in anatomical reduction of comminuted intra-articular fractures and it could also be used effectively in osteoporotic bone.

  17. A CLINICAL STUDY OF PROXIMAL FEMUR LOCKING COMPRESSION PLATE (LCP - PF IN THE MANAGEMENT OF COMMUNITED INTERTROCHANTERIC AND SUBTROCHANTERIC FRACTURES OF THE FEMUR

    Directory of Open Access Journals (Sweden)

    Hari Babu

    2015-10-01

    Full Text Available Fractures of proximal femur and hip are relatively common injuries in elderly individuals . The incidence of peritrochanteric and intertrochanteric fracture is also increasing among young population, who sustain high energy trauma Rigid Internal fixation and early mobilization has been the standard method of treatment. A combination of orthopaedic surgery and early postoperative physiotherapy and ambulation is the best approach. The overall goal in the treatment of hip fractures is to return the patient to pre - morbid level of function. AIMS & OBJECTIVE : To analyse the anatomical and f unctional outcome of the treatment with LCP - Proximal femur. METHODOLOGY : The present study consists of 12 adult patients of peritrochanteric factures of femur satisfying the inclusion criteria , treated with Proximal Femoral Locking Compression Plate at S. V. R. R . Govt . General Hospital, Tirupati during the period of nov 2013 to Oct 2015. INCLUSION CRITERIA : Age >18years , comminuted trochanteric and sub trochanteric fractures , Signed written informed consent . EXCLUSION CRITERIA: Inter trochanteric fractures involving piriformis fossa , Compound fractures . Pathological fractures . Any displacement of a femoral neck fracture . A ssociated malignancy. RESULTS : Average age incidence in the present study was 62.7 years. , Predominantly males (75% were affected. , Most cases occurred after a fall 10 (50% cases which was statistically significant , Right side involvement was more common. , Average post - operative stay was 13.5 days. , Out of the 12 cases, evaluated using Salvati - Wilson scoring : 3 cases (25% had good, 8 cases (66.67% fair, 1 case (8.33% had poor score , Average weight bearing time was14.5 weeks , Average union rate was 19.45 weeks.

  18. Intramedullary versus extramedullary fixation in the management of subtrochanteric femur fractures: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Liu PC

    2015-04-01

    Full Text Available Pengcheng Liu,1,2,* Xing Wu,1,* Hui Shi,1,2 Run Liu,1 Hexi Shu,1 JinPeng Gong,1 Yong Yang,1 Qi Sun,1 Jiezhou Wu,1,2 Xiaoyang Nie,1 Ming Cai1 1Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University, School of Medicine, Shanghai, 2First Clinical Medical College, Nanjing Medical University, Nanjing, People’s Republic of China *These authors contributed equally to this work Background: Intramedullary and extramedullary fixation methods are used in the management of subtrochanteric femur fractures. However, whether intramedullary or extramedullary fixation is the primary treatment for subtrochanteric femur fractures in adults remains debatable.Level of evidence: Meta-analyses of prospective studies, level I.Materials and methods: The Cochrane library, Embase, Google Scholar, and PubMed databases were searched separately for all relevant studies published before January 1, 2015. No language restriction was applied. Prospective randomized controlled trials that compared intramedullary or extramedullary internal fixation to repair subtrochanteric femur fractures in adults were included. We determined intraoperative data, postoperative complications, fracture fixation complications, wound infection, hospital stay days, and final outcome measures to assess the relative effects of different internal fixation methods for the treatment of subtrochanteric femur fractures in adults.Results: Six studies were included in our meta-analysis. The relative risks (RRs of revision rate was 83% lower (RR, 0.17, 95% confidence interval [CI], 0.05 to 0.60; P=0.006, fixation failure rate was 64% lower (RR, 0.36, 95% CI, 0.12 to 1.08; P=0.07, non-union rate was 77% lower (RR, 0.23, 95% CI, 0.07 to 0.81; P=0.02 in the intramedullary group compared with the extramedullary group. No significant differences were found between the intramedullary group and extramedullary group for intraoperative data, postoperative complications, wound infection

  19. Ipsilateral Fracture Shaft Femur with Neglected Dislocation of Prosthesis: A Case Report

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    Mantu Jain

    2013-10-01

    Full Text Available Introduction: Neglected hip dislocation is rare in today’s world and after prosthesis replacement even rarer finding. However such patients may not report to surgeons until they develop secondary complications. Management of such patient’s is a challenge to the treating surgeon and need to be tailored suiting to patient’s demands, expectations and constraints of financial resources. We did not find a similar case in the electronic and print media and therefore report this case which was innovatively managed. Case Report: A 60 year farmer presented with fracture shaft femur and ipsilateral dislocation prosthesis of right hip. He had a hemiarthroplasty done for fracture neck of femur in the past but used to walk with a lurch since he started to ambulate after discharge. However he was satisfied despite “some problems” which had caused shortening of his limb. The patient was informed of the various treatment options and their possible complications. He expressed his inability to afford a Total Hip Arthroplasty (THA at any stage and consented for other options discussed with him. The patient was positioned supine and adductor tenotomy done. Next he was positioned laterally and the fracture was fixed with heavy duty broad dynamic compression plate and screws. The wound was temporarily closed. Now through the previous scar via posterior approach the hip was exposed. The prosthesis was found to be firmly fixed to the proximal femur. The acetabulum was cleared with fibrous tissue. All attempts the prosthesis to relocate the prosthesis failed after several attempts and it was best decided to leave alone. Post operatively period was uneventful. At follow up he refused for any further manoeuvre in future inform of heavy traction and attempts to reduce the same. At one year when he was walking unaided and his X-rays showed that fracture had well united his SF-36 score was PCS – 49.6 and MCS – 51.9. Conclusion: Ipsilateral shaft femur fracture

  20. Functional and oncologic outcomes after excision of the total femur in primary bone tumors: Results with a low cost total femur prosthesis

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    Ajay Puri

    2012-01-01

    Full Text Available Background: The extent of tumor may necessitate resection of the complete femur rarely to achieve adequate oncologic clearance in bone sarcomas. We present our experience with reconstruction in such cases using an indigenously manufactured, low-cost, total femoral prosthesis (TFP. We assessed the complications of the procedure, the oncologic and functional outcomes, and implant survival. Materials and Methods: Eight patients (four males and four females with a mean age of 32 years, operated between December 2003 and June 2009, had a TFP implanted. The diagnosis included osteogenic sarcoma (5, Ewing′s sarcoma (1, and chondrosarcoma (2. Mean followup was 33 months (9-72 months for all and 40 months (24-72 months in survivors. They were evaluated by Musculoskeletal Tumor Society score, implant survival as well as patient survival. Results: There was one local recurrence and five of seven patients are currently alive at the time of last followup. The Musculoskeletal Tumor Society score for patients ranged from 21 to 25 with a mean of 24 (80%. The implant survival was 88% at 5 years with only one TFP needing removal because of infection. Conclusions: A TFP in appropriately indicated patients with malignant bone tumors is oncologically safe. A locally manufactured, cost-effective implant provided consistent and predictable results after excision of the total femur with good functional outcomes.

  1. The Effect of Bone Loss Pattern on the Structural Capacity of the Proximal Femur

    Institute of Scientific and Technical Information of China (English)

    FAN Li-xia; Eric Wang

    2006-01-01

    The effect of age-related bone loss on the structural capacity of the proximal femur were investigated by Finite Element Analysis(FEA). Four bone loss patterns were considered. These were "uniform cortical bone loss", "neck cortical bone loss", "intertrochanteric cortical bone loss" and "uniform trabecular bone loss". The results show that the two "non-uniform cortical bone loss" patterns are more dangerous than the "uniform cortical bone loss" pattern, and that the cortical bone loss in intertrochanteric region is associated with a greater reduction in cortical failure load than the cortical bone loss in the femoral neck. The trabecular bone loss causes a limited decrease in both cortical failure and trabecular failure loads. This research should be helpful to the clinical assessment of femur fracture risk due to age-related bone loss.

  2. The combination of structural parameters and areal bone mineral density improves relation to proximal femur strength

    DEFF Research Database (Denmark)

    Hansen, Stinus; Jensen, Jens-Erik Beck; Ahrberg, Fabian

    2011-01-01

    The aim of this study was to assess structural indices from high-resolution peripheral quantitative computed tomography (HR-pQCT) images of the human proximal femur along with areal bone mineral density (aBMD) and compare the relationship of these parameters to bone strength in vitro. Thirty......-one human proximal femur specimens (8 men and 23 women, median age 74 years, range 50-89) were examined with HR-pQCT at four regions of interest (femoral head, neck, major and minor trochanter) with 82 μm and in a subgroup (n = 17) with 41 μm resolution. Separate analyses of cortical and trabecular geometry...

  3. Osteosynthesis of fractures of the femur with flexible metallic intramedullary nails.

    Science.gov (United States)

    Firica, A; Troianescu, O; Petre, M

    1978-04-01

    The authors discuss their use of Ender's method in the treatment of fractures of the femur. The diameter and length of the nails depends on the type of fracture. 1) Three nails of 4 mm diameter are introduced in parallel from the medial condyle in fractures of the femoral neck; 2) 5 mm nails are used, in similar fashion, for the fixation of intertrochanteric and subtrochanteric fractures; 3) 5 mm nails are used for diaphyseal, supracondylar and intercondylar fractures, introduced in crossed fashion ("Eiffel Tower" technique) from both medial and lateral condyles. This method of fixation has proved to be extremely stable. The operation itself is quick, with no blood loss or shock. The patient can resume partial weight bearing after a week in stabilised intertrochanteric and shaft fractures, after a month in less stable types, and after three to four months in fractures of the neck of the femur. This report is based on the first 250 cases treated by this method.

  4. A comparative approach to computer aided design model of a dog femur.

    Science.gov (United States)

    Turamanlar, O; Verim, O; Karabulut, A

    2016-01-01

    Computer assisted technologies offer new opportunities in medical imaging and rapid prototyping in biomechanical engineering. Three dimensional (3D) modelling of soft tissues and bones are becoming more important. The accuracy of the analysis in modelling processes depends on the outline of the tissues derived from medical images. The aim of this study is the evaluation of the accuracy of 3D models of a dog femur derived from computed tomography data by using point cloud method and boundary line method on several modelling software. Solidworks, Rapidform and 3DSMax software were used to create 3D models and outcomes were evaluated statistically. The most accurate 3D prototype of the dog femur was created with stereolithography method using rapid prototype device. Furthermore, the linearity of the volumes of models was investigated between software and the constructed models. The difference between the software and real models manifests the sensitivity of the software and the devices used in this manner.

  5. Changes in internal architectonics of proximal femur in children with hip dysplasia development

    Directory of Open Access Journals (Sweden)

    Dokhov M.M.

    2014-12-01

    Full Text Available The aim of the research is to identify common patterns of compensatory changes in internal architectonics of the proximal femur with valgus and varus deformity. Material and Methods. The parameters of the proximal femur were determined on the basis of 78 roentgenograms of children with hip dysplasia (1-4 years, 4-7 years, 7-16 years before and after surgical treatment (after 6 months. Results. The degree of change in internal architectonics of the bone substance has been determined after changing of the femoral neck-shaft angle achieved with the help of correcting osteotomy in different age groups. Conclusion. Maximum recovery of internal architectonics of the bone substance is observed in the groups aged 4-7 years.

  6. A STUDY OF CLINICAL AND SURGICAL OUTCOME OF FRACTURE NECK OF FEMUR

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    Anish G. Cherian

    2016-09-01

    Full Text Available BACKGROUND Fracture neck of femur has high incidence of complications even with treatment, hence it is also termed as unsolved fracture. Factors making treatment difficult are the blood supply to head, which gets cut off and difficulty in achieving reduction. Impacted fractures can be treated conservatively. If the fracture is undisplaced, a conservative approach may be done or multiple cancellous screws can be used. If the patient’s age is less than 60 years, a closed reduction under C-arm control can be tried. If the reduction is possible, then multiple screw fixations can be done. If reduction is not achieved, then open screw reduction and screw fixation can be done. If the patient is above 60 years of age, then it is preferable to excise the head off and replace it with prosthesis. If the hip is normal, then hemiarthroplasty with a unipolar or bipolar prosthesis can be done. If the hip has pre-existing arthritis, then total hip replacement surgery is advisable. A sincere effort has been put to understand the clinical and surgical outcome of fracture neck of femur in elderly. This paper is intended to help the practicing orthopaedicians to understand the various treatment modalities which is commonly used in practice and also the complications which are associated with the pathology. METHODS  The study was done in the Department of Orthopaedics, Travancore Medical College at Kollam.  The study was done from August 2014 to June 2016.  Eighty cases who attended in the Department of Orthopaedics were taken for the study.  Detailed History and Clinical Examination was conducted. INCLUSION CRITERIA  Both traumatic and pathological fractures were taken up for the study.  Individuals who were aged more than 55 years were taken up for the study. EXCLUSION CRITERIA  Aged less than 55 years were not considered.  All the statistical analysis was done using the latest SPSS software 2015 (California. RESULT Fracture neck of femur

  7. Physical therapy in the postoperative of proximal femur fracture in elderly. Literature review

    OpenAIRE

    Carneiro, Mariana Barquet; Alves, Débora Pinheiro Lédio; Mercadante,Marcelo Tomanik

    2013-01-01

    The proximal femoral fracture in the elderly is a serious public health problem. Surgical treatment of this fracture is used to reduce morbidity, together with postoperative physical therapy. The objective was to conduct a systematic review of physical therapy protocols in postoperative for fractures of the proximal femur in elderly. We selected randomized controlled trials in elderly in the past 10 years, in Portuguese and English. There were 14 articles in the literature. Physical therapy h...

  8. Association of sarcopenia and physical activity with femur bone mineral density in elderly women

    Science.gov (United States)

    Lee, Inhwan; Ha, Changduk; Kang, Hyunsik

    2016-01-01

    [Purpose] This study examined the association of femur bone mineral density (BMD) with body composition and physical activity in elderly women. [Methods] This was a cross sectional study involving 119 women with mean age of 73.1±5.5 years. Body composition parameters including body mass index (BMI), percent of body fat (%BF), appendicular skeletal muscle mass (ASM) index and femur BMD was measured by dual-energy X-ray absorptiometry (DXA). Physical activity was assessed by the uniaxial accelerometer for 7 consecutive days including weekends. Based on femur BMD T-scores, subjects were classified as optimal group, osteopenia group, and osteoporosis group. Based on ASM index, subjects were classified as normal group and sarcopenia group. According to WHO recommendations of physical activity for elderly, the subjects were classified as active group or inactive group. Logistic regression analyses were used to determine the odds ratio (OR) for osteopenia and osteoporosis. [Results] There were linear decreases for body composition parameters including weight (P=.023), BMI (P=.039), lean mass (P=.032), ASM index (P=.007) and physical activity parameters including daily of step (P<.001), low intensity physical activity (P<.001), moderate intensity physical activity (P=.001) across femur BMD levels. Compared to the normal group (OR=1), the sarcopenia group had a significantly higher OR (OR=4.823; P=.042), and the inactive group had a significantly higher OR (OR=5.478; P=.005) having osteopenia and osteoporosis when compared to the active group (OR=1). [Conclusion] The findings of this study suggested that physical activity along with a healthy nutrition should be promoted as a preventive strategy against osteopenia and osteoporosis in elderly women. PMID:27298809

  9. Weakness in the mechanical properties of the femurs of growing female rats exposed to cadmium

    Energy Technology Data Exchange (ETDEWEB)

    Brzoska, Malgorzata M.; Moniuszko-Jakoniuk, Janina [Medical University of Bialystok, Department of Toxicology, Bialystok (Poland); Majewska, Katarzyna [University of Warmia and Mazury (Poland). Faculty of Food Science

    2005-09-01

    The study assessed the effect of cadmium (Cd) intoxication on the risk of deformities and fractures of the growing bones of female rats, in order to model human exposure to this metal. For this purpose, bone mineral density and mechanical properties of the proximal and distal ends and diaphysis of the femur were investigated in female Wistar rats exposed to 1, 5 and 50 mg Cd/l in drinking water for 3, 6, 9 and 12 months after the onset of weaning. Daily Cd doses received from drinking water during the treatment period were in the following ranges: 0.059-0.219, 0.236-1.005 and 2.247-9.649 mg/kg body weight at 1, 5 and 50 mg Cd/l, respectively. Biomechanical properties of the femoral proximal and distal ends were evaluated in a compression test, and those of the femoral diaphysis in a cutting test, with loading perpendicular to the longitudinal axis of the bone in all tests. The mineralization and mechanical properties of the bone tissue at various locations on the femur were affected by exposure to Cd in a dose- and duration-dependent manner. Exposure to 1 mg Cd/l (corresponding to low human exposure) during skeletal development weakened the fracture strength of the femoral neck and the trabecular bone at the level of the distal end of the femur and affected the elastic properties of the cortical bone at the femoral diaphysis. At higher levels of Cd exposure, adverse effects were generally observed after a shorter exposure period than for 1 mg Cd/l, and were more advanced. The cadmium-induced weakening of the biomechanical properties of bone at particular sites on the femur correlated with the decreased bone mineralization. The results indicate that even a low exposure to Cd may affect the mineralization and biomechanical properties of growing bone, thus enhancing the risk of fracture. (orig.)

  10. Weakness in the mechanical properties of the femur of growing female rats exposed to cadmium

    Energy Technology Data Exchange (ETDEWEB)

    Brzoska, Malgorzata M.; Moniuszko-Jakoniuk, Janina [Medical University of Bialystok, Department of Toxicology, Bialystok (Poland); Majewska, Katarzyna [University of Warmia and Mazury, Olsztyn (Poland). Faculty of Food Science

    2005-05-01

    This study was aimed at assessing the effect of cadmium (Cd) intoxication on the risk of deformities and fractures of the growing bone on a female rat model of human exposure to this metal. For this purpose, bone mineral density (BMD) and mechanical properties of the proximal and distal ends and diaphysis of the femur were investigated in female Wistar rats exposed to 1, 5, and 50 mg Cd L{sup -1} in drinking water for 3, 6, 9, and 12 months since weaning. Daily Cd doses received from the drinking water during the treatment period were in the ranges 0.059-0.219, 0.236-1.005, and 2.247-9.649 mg kg{sup -1} body weight at 1, 5, and 50 mg Cd L{sup -1}, respectively. Biomechanical properties of the femoral proximal and distal ends were evaluated in a compression test and those of the femoral diaphysis in a cutting test with loading perpendicular to the bone longitudinal axis in all tests. Cd dose- and exposure duration-dependently affected the mineralization and mechanical properties of the bone tissue at various locations of the femur. Exposure to 1 mg Cd L{sup -1} (corresponding to low human exposure) during skeletal development weakened the fracture strength of the femoral neck and of the trabecular bone at the level of the distal end of the femur and affected the elastic properties of the cortical bone at the femoral diaphysis. At the higher levels of Cd treatment, the adverse action generally occurred after shorter exposure than at 1 mg Cd L{sup -1} and was more seriously advanced. The Cd-induced weakening in the bone biomechanical properties at particular sites of the femur correlated with the decreased bone mineralization. The results indicate that even low exposure to Cd may affect the mineralization and biomechanical properties of growing bone, thus increasing the risk of fractures. (orig.)

  11. Metastatic adenocarcinoma of Proximal Femur treated by Custom made Hip Prosthesis

    OpenAIRE

    Pal, Chandra Prakash; Gupta, Surabhi; Kumar, Deepak; Singh, Pulkesh

    2012-01-01

    Introduction: Bone is the third most common site of metastatic disease. Treatment of metastatic tumours of proximal femur usually used to be either palliative in the form of radiotherapy and chemotherapy or a very radical in form of hemipelvectomy and hip disarticulation. Both forms of treatment were associated with dismal outcomes. Now with the technological advancement and refinement in surgeries a custom made hip prosthesis offers a much better treatment option to the surgeon and a good qu...

  12. SEX DETERMINATION OF FEMUR: A MORPHOMETRIC ANALYSIS IN THE NORTH INDIAN POPULATION

    OpenAIRE

    Aprajita Sikka; Anjali Jain

    2016-01-01

    Bones are an important tool for establishing the biological profile of an individual. In the absence of skull and pelvis, long bones can play a major role in determining the sex. Femur is the longest and strongest bone of the body and resists environmental effects and hence becomes important in medico-legal investigations. AIMS To determine the sex of 180 femora and to set up baseline parameters for the North Indian population with the help of demarcating and limiting value...

  13. Custom 95 degree condylar blade plate for pediatric subtrochanteric femur fractures.

    Science.gov (United States)

    Segal, L S

    2000-02-01

    Subtrochanteric fractures in the older child and adolescent often are not amenable to conservative methods of treatment. The anatomic constraints of the proximal femur including the small diameter of the femoral neck and the presence of the capital femoral physis may limit the type of internal fixation used in these patients. This article presents our preliminary experience with a custom 95 degree condylar blade plate for subtrochanteric fractures in older children and adolescents.

  14. Atypical Subtrochanteric Femur Fracture in Patient with Metastatic Breast Cancer Treated with Zoledronic Acid

    OpenAIRE

    2012-01-01

    Several case series have suggested an association exists between atypical femoral subtrochanteric fractures and long-term use of bisphosphonates. It is thought that prolonged use of bisphosphonates may lead to adynamic, fragile bone. The radiologic features of atypical fractures include diffuse cortical thickening, transverse fracture, and beaking at the lateral subtrochanteric area. Atypical subtrochanteric femur fractures have been reported after use of alendronate, but there have been rare...

  15. The outcome of patients sustaining a proximal femur fracture who suffer from alcohol dependency.

    Science.gov (United States)

    Faroug, R; Amanat, S; Ockendon, M; Shah, S V; Gregory, J J

    2014-07-01

    There are many negative health consequences associated with alcohol dependency. Fractures of the proximal femur carry significant morbidity and mortality. This study examines the outcomes in patients with alcohol dependency, who sustain a fracture of the proximal femur. Twenty-eight consecutive alcohol dependent patients who suffered a fracture of the proximal femur were identified over a three year period. Data were collected on demographics, co-morbidity, surgical factors, mobility and mortality. The median age of patients was 61 years. The median weekly alcohol intake was 158 units. Thirteen patients sustained an extra-capsular fracture and 15 an intra-capsular proximal femoral fracture. Twenty-two fractures were treated with internal fixation and six with arthroplasty. The overall mortality rate was 29% at a median of 15 months post fracture. The failure rate of intra-capsular fractures fixed with cannulated screws was 56% at a median time of 43 days. All patients had a reduction in mobility compared to their pre-operative function. The reduction in mobility was greatest in patients with intra-capsular fractures treated with cannulated screw fixation. Alcohol dependent patients sustaining a fracture of the proximal femur are significantly younger than non-alcohol dependent patients sustaining the same injury. Despite the younger age at presentation the one year mortality rate of this group was high (29%). The high rate of complications with fracture fixation and high one year mortality suggest that hemiarthroplasty may be the best treatment option for intra-capsular fractures in this patient group.

  16. Case report 373: Diametaphyseal chrondroblastoma of the upper portion of the left femur

    Energy Technology Data Exchange (ETDEWEB)

    Sotelo-Avila, C.; Sundaram, M.; Graviss, E.R.; Kyriakos, M.; Tayob, A.A.

    1986-06-01

    In summary, a case has been presented of a chondroblastoma of the diametaphysis of the upper end of the left femur in an 11-year-old girl. Despite its atypical location, the tumor proved to be a characteristic chondroblastoma on microscopic examination. The literature was reviewed comprehensively and it was noted that 12 examples of chondroblastoma arising outside an epiphysis (or apophysis) were noted. (orig./SHA).

  17. Early result of hemiarthroplasty in elderly patients with fracture neck of femur

    Directory of Open Access Journals (Sweden)

    Mue Daniel

    2015-01-01

    Full Text Available Background: Fractured neck of femur is a frequent and severe injury in elderly patients with consequent high morbidity and mortality. Hemiarthroplasty is an established treatment modality for displaced intracapsular femoral neck fractures in elderly patients above 60 years. This study analysed the early functional outcome and complications of Austin Moore endoprosthesis in elderly patients above 60 years with fractured neck of femur. Materials and Methods: Retrospective data were obtained over a 5 year period from January 2007 to December 2012. Thirty-five elderly patients of 60 years and above with displaced intracapsular fracture neck of femur treated with hemiarthroplasty using Austin Moore endoprosthesis were included. Data were analysed using SPSS version 21. Results: A total of 35 patients were involved. The age-range was 60-90 years with mean age of 69.7 ΁ 7 years. The predominant mechanism of injury was trivial falls in 18 (66.7% patients. The commonest complication was pressure sore in 2 (5.7% patients, followed by surgical site infection in 1 (2.9% patient and periprosthetic fracture in 1 (2.9% patients. Early post-operative mortality was 2.9%. Post-operative hip functional status according to Postel and Merle d Aubigne revealed that majority (66.6% of patients had satisfactory hip function. Conclusion: Functional outcome of Austin Moore in elderly patients above 60 years with fracture neck of femur was satisfactory in most of the cases with minimal morbidity. Careful patient selection for hemiarthroplasty is vital and may decrease the incidence of complications and ameliorate the outcomes in the treatment of intracapsular femoral neck fractures.

  18. Respons Tulang Femur Tikus Ovariohisterektomi yang Mengkonsumsi Kasein dan Disuplementasi Calcitriol Selama 30 Minggu (THE RESPONSE OF BONE FEMUR OVARIOHISTERECTOMIZED RATS CONSUMING CASEIN AND CALCITRIOL SUPPLEMENTATION FOR 30 WEEKS

    Directory of Open Access Journals (Sweden)

    Hartiningsih .

    2015-05-01

    Full Text Available Calcitriol supplementation in ovariohisterectomized rat was known to decreased calcium retention.The objective of the research was to study the response of femur bone to calcitriol supplementation for 30weeks in ovariohisterectomized rats consuming casein. Twenty female Wistar rats at 8 weeks of age wererandomly divided into four groups (unovariohisterectomy without calcitriol supplementation (N,unovariohisterectomy with calcitriol supplementation (ND, ovariohisterectomy without calcitriolsupplementation (O and ovariohisterectomy with calcitriol supplementation (OD of five each. Thirtyweeks after surgery, femur was taken for histopathological and immunohistochemistry examination.Immunohistochemistry of distal femur metaphysis in group O and OD were revealed decreasing tartrateresistant alkaline phosphatase 5b (TRAP5b in trabecular bone, which was located in bone marrow space,and also in trabecular speculum surface. Histopathological analysis of distal femur metaphysis in groupN and ND were showed normal structure, meanwhile, distal femur metaphysis in group O and OD wereshown some abonormalities, such as increased of bone marrow space, domination of adipocytes in the bonemarrow, and decreased of trabecular bone speculum in metaphysis. Based on the results, it was concludedthat femur bone of ovariohisterectomized rats fed casein with and without calcitriol 8ng/daysupplementation for 30 weeks were showed unbalanced between resorption and formation of bone whichwas domination by bone resorption.

  19. Sex determination in femurs of modern Egyptians: A comparative study between metric measurements and SRY gene detection

    Directory of Open Access Journals (Sweden)

    Iman F. Gaballah

    2014-12-01

    Conclusion: The SRY gene detection method for sex determination is quick and simple, requiring only one PCR reaction. It corroborates the results obtained from anatomical measurements and further confirms the sex of the femur bone in question.

  20. Subtrochanteric and diaphyseal femur fractures in patients treated with alendronate: a register-based national cohort study

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Eiken, Pia; Eastell, Richard

    2009-01-01

    of bone turnover. Two national observational register-based studies were performed: (1) cross-sectional study (N = 11,944) comparing age distribution, exposure, and trauma mechanisms between different types of proximal femur fractures and (2) matched cohort study in patients with prior nonhip fractures (N......Alendronate (aln) is a potent bisphosphonate with a prolonged duration of action. Recent reports have found long-term aln use to be common in patients with subtrochanteric or proximal diaphyseal femur fracture, raising concerns that these fractures could be a consequence of excessive suppression...... = 5187 + 10,374), testing the hypothesis that the increase in the risk of subsequent atypical femur fractures exceeded the increase in typical hip fractures. We also sought evidence of a dose-response relationship, where high adherence to or long-term use of aln led to more atypical femur fractures. We...

  1. The Effect of GSM Mobile Phone Electromagnetic Field on Femur Fracture Healing in a Rat Model

    Directory of Open Access Journals (Sweden)

    Ali Kalender

    2012-10-01

    Full Text Available Aim: Biological effects of electromagnetic field (EMF and their consequences on human health have been the subject of much interest and research in recent years. The aim of this study was to investigate the effects of 900 MHz EMF on femur fracture healing in a rat model. Material and Method: After sixty male Sprague-Dawley rats were exposed to a closed right femur fracture under anesthesia, the reduction and fixation were done with a 21 g needle. Then, 900 MHz radiation (2 W peak output power and 1.04 mW/cm2 power density was applied to EM group for one hour/day for seven days. The healing was assessed using radiological (Lane and Sandhu classification, histological (Huo scale for callus evaluation, and biomechanical (3-point bending measures at 2nd, 4th and 6th weeks after fracture. Results: Fracture healing, as assessed radiologically and histopathologically, in Group EM and control animals was similar at 2nd, 4th and 6th weeks. Fracture healing, as assessed biomechanically, was significantly better in Group EM compared to controls in those sacrificed at 2nd week post-procedure (p<0.05. Biomechanical strength was not different between the groups at 4th and 6th weeks. Discussion: 900 MHz EMF from a mobile phone in this rat femur fracture model resulted in no significant difference in healing from controls not exposed to EM radiation.

  2. ANATOMIC STUDY OF THE PROXIMAL THIRD OF THE FEMUR: FEMOROACETABULAR IMPACT AND THE CAM EFFECT

    Science.gov (United States)

    Labronici, Pedro José; Alves, Sergio Delmonte; da Silva, Anselmo Fernandes; Giuberti, Gilberto Ribeiro; de Azevedo Neto, Justino Nóbrega; Mezzalira Penedo, Jorge Luiz

    2015-01-01

    To analyze anatomical variations of the proximal end of femur that could cause a femoroacetabular impact. Methods: 199 skeletically mature anatomical specimens of femurs were used. The femurs were measured in order to determine the anteversion angle of the femoral neck, neckshaft angle, sphericity of the femoral head at anteroposterior and superoinferior, angle between epiphysis and the anterior femoral neck, angle between epiphysis and the neck at lateral plane, anteroposterior distance at 5mm of the head and neck junction and anteroposterior distance of the neck base. Results: we found that the impact subgroup presented a significantly larger junction diameter of 5mm (p = 0.0001) and cam-head (%) (p= 0.0001), while base-cam (%) (p = 0.0001) showed a significantly smaller diameter than the subgroup without impact. It was identified that cam-head (%) ≤ 80 e base-cam (%) ≤ 73 were identified as the optimal impact points. Conclusion: our study showed that the effect cam, caused by anatomical variations of the proximal femoral end focused the head-neck junction and base of the neck-junction head-neck. These rates can be predictive factors of the impact. PMID:26998462

  3. Shape Ontogeny of the Distal Femur in the Hominidae with Implications for the Evolution of Bipedality.

    Directory of Open Access Journals (Sweden)

    Melissa Tallman

    Full Text Available Heterochrony has been invoked to explain differences in the morphology of modern humans as compared to other great apes. The distal femur is one area where heterochrony has been hypothesized to explain morphological differentiation among Plio-Pleistocene hominins. This hypothesis is evaluated here using geometric morphometric data to describe the ontogenetic shape trajectories of extant hominine distal femora and place Plio-Pleistocene hominins within that context. Results of multivariate statistical analyses showed that in both Homo and Gorilla, the shape of the distal femur changes significantly over the course of development, whereas that of Pan changes very little. Development of the distal femur of Homo is characterized by an elongation of the condyles, and a greater degree of enlargement of the medial condyle relative to the lateral condyle, whereas Gorilla are characterized by a greater degree of enlargement of the lateral condyle, relative to the medial. Early Homo and Australopithecus africanus fossils fell on the modern human ontogenetic shape trajectory and were most similar to either adult or adolescent modern humans while specimens of Australopithecus afarensis were more similar to Gorilla/Pan. These results indicate that shape differences among the distal femora of Plio-Pleistocene hominins and humans cannot be accounted for by heterochrony alone; heterochrony could explain a transition from the distal femoral shape of early Homo/A. africanus to modern Homo, but not a transition from A. afarensis to Homo. That change could be the result of genetic or epigenetic factors.

  4. A study of management of fracture shaft femur in children in a rural population

    Directory of Open Access Journals (Sweden)

    Soumya Ghosh

    2013-01-01

    Full Text Available Background: Femoral shaft fractures account for 1.6% of all bony injuries in children, and the mode of treatment for children between 6 and 16 years of age is still debatable. Objectives: To compare the merits and demerits of operative and conservative managements of fracture shaft femur in children in a rural population in a developing country. Materials and Methods: Forty patients in the age group of 6-14 years with transverse fractures of shaft of the femur and two different treatment protocols were selected. The patients treated in skeletal traction or fixed traction in Thomas′ splint were included in one group and patients who were treated operatively with titanium elastic nails comprised the other group. Data was analyzed using Chi-square test. Results: The commonest cause of injury was motor vehicle accident, accounting for 70% of the cases, with left femur (60% more commonly injured. All fractures in the operative group united clinically by 8 weeks and radiologically by 10 weeks, and, in the conservative group, by 9 weeks clinically and 12 weeks radiologically. The difference was statistically significant. Shortening and angular mal alignments were found more commonly in the conservative group, and the difference was significant. The follow-up for 1 year of all cases were uneventful. Conclusion: Internal fixation with titanium elastic nails provides better results than conservative treatment in traction.

  5. Investigation of hyperelastic models for nonlinear elastic behavior of demineralized and deproteinized bovine cortical femur bone.

    Science.gov (United States)

    Hosseinzadeh, M; Ghoreishi, M; Narooei, K

    2016-06-01

    In this study, the hyperelastic models of demineralized and deproteinized bovine cortical femur bone were investigated and appropriate models were developed. Using uniaxial compression test data, the strain energy versus stretch was calculated and the appropriate hyperelastic strain energy functions were fitted on data in order to calculate the material parameters. To obtain the mechanical behavior in other loading conditions, the hyperelastic strain energy equations were investigated for pure shear and equi-biaxial tension loadings. The results showed the Mooney-Rivlin and Ogden models cannot predict the mechanical response of demineralized and deproteinized bovine cortical femur bone accurately, while the general exponential-exponential and general exponential-power law models have a good agreement with the experimental results. To investigate the sensitivity of the hyperelastic models, a variation of 10% in material parameters was performed and the results indicated an acceptable stability for the general exponential-exponential and general exponential-power law models. Finally, the uniaxial tension and compression of cortical femur bone were studied using the finite element method in VUMAT user subroutine of ABAQUS software and the computed stress-stretch curves were shown a good agreement with the experimental data.

  6. Comparing discriminant analysis and neural network for the determination of sex using femur head measurements.

    Science.gov (United States)

    Alunni, Véronique; Jardin, Philippe du; Nogueira, Luisa; Buchet, Luc; Quatrehomme, Gérald

    2015-08-01

    The measurement of the femoral head is usually considered an interesting variable for the sex determination of skeletal remains. To date, there are few published reference measurements of the femoral head in a modern European population for the purpose of sex determination. In this study, 116 femurs from 58 individuals of the South of France (Nice Bone Collection, Nice, France) were studied. Three measurements of the femoral head were taken: the vertical head diameter (VHD), the transversal head diameter (THD) and the head circumference (HC). The results show that: (i) there is no statistical difference between the right and left femurs for each of the three measurements (VHD, THD and HC). Therefore we arbitrarily chose to use the measures from the right femurs (N=58) to pursue our experiments; (ii) the measurements of the femoral head are similar to those of contemporary American populations; (iii) the dimensions of the femoral head place the measurements of the French population somewhere between Germany or Croatia, and Spain; (iv) there is no significant secular trend (in contrast with the femoral neck diameter); (v) the femoral head measurement as a single variable is useful for sex determination: a 96.5% rate of accuracy was obtained using THD and HC measurements with the artificial neural network; and a 94.8% rate of accuracy using VHD, both with the discriminant analysis and the neural network.

  7. A STUDY ON SURGICAL MANAGEMENT OF INTERTROCHANTERIC AND SUBTROCHANTERIC FRACTURES OF FEMUR BY PROXIMAL FEMORAL NAIL

    Directory of Open Access Journals (Sweden)

    Kuppa Srinivas

    2015-01-01

    Full Text Available AIMS AND OBJECTIVES: To study the various fracture patte rns, mechanism of injury, operative difficulties encountered, result in terms of radiological union and ultimate functional outcome of intertrochanteric and subtrochanteric fractures of femur treated by proximal femoral nail. RESULTS: In the present study , 22 cases of subtrochanteric and intertrochanteric fractures of proximal femur treated by proximal femoral nail at Govt. General Hospital, Kurnool from August 2010 to July 2012 were included. Out of 22 cases, 18 were subtrochanteric and 4 were intertrochanteric fractures. In subtrochanteric fractures, seinsheimer type III were 44.4%,in intertrochanteric fractures evan’s unstable fractures were 75%. The mean age group was 45years with males 82%, right side femur were involved in 55%, road traffic accidents accounted for 55%, associated injuries found in 36%. Mean duration of hospital stay was 16.83 days, union was achieved in 86.6% with mean time for union was 12.75 weeks. Hip joint stiffness was found 23% and non - union in 4%. CONCLUSI ON: By the analysis of data collected in the present study, proximal femoral nail is an effective device in the management of complex proximal femoral fractures. It offers superior stabilization and good fracture union

  8. Shape Ontogeny of the Distal Femur in the Hominidae with Implications for the Evolution of Bipedality.

    Science.gov (United States)

    Tallman, Melissa

    2016-01-01

    Heterochrony has been invoked to explain differences in the morphology of modern humans as compared to other great apes. The distal femur is one area where heterochrony has been hypothesized to explain morphological differentiation among Plio-Pleistocene hominins. This hypothesis is evaluated here using geometric morphometric data to describe the ontogenetic shape trajectories of extant hominine distal femora and place Plio-Pleistocene hominins within that context. Results of multivariate statistical analyses showed that in both Homo and Gorilla, the shape of the distal femur changes significantly over the course of development, whereas that of Pan changes very little. Development of the distal femur of Homo is characterized by an elongation of the condyles, and a greater degree of enlargement of the medial condyle relative to the lateral condyle, whereas Gorilla are characterized by a greater degree of enlargement of the lateral condyle, relative to the medial. Early Homo and Australopithecus africanus fossils fell on the modern human ontogenetic shape trajectory and were most similar to either adult or adolescent modern humans while specimens of Australopithecus afarensis were more similar to Gorilla/Pan. These results indicate that shape differences among the distal femora of Plio-Pleistocene hominins and humans cannot be accounted for by heterochrony alone; heterochrony could explain a transition from the distal femoral shape of early Homo/A. africanus to modern Homo, but not a transition from A. afarensis to Homo. That change could be the result of genetic or epigenetic factors.

  9. Morphometric Evaluation of Korean Femurs by Geometric Computation: Comparisons of the Sex and the Population

    Directory of Open Access Journals (Sweden)

    Ho-Jung Cho

    2015-01-01

    Full Text Available We measured 28 parameters of 202 femurs from Koreans by an automated geometric computation program using 3D models generated from computed tomography images. The measurement parameters were selected with reference to physical and forensic anthropology studies as well as orthopedic implant design studies. All measurements were calculated using 3D reconstructions on a computer using scientific computation language. We also analyzed sex and population differences by comparison with data from previous studies. Most parameters were larger in males than in females. The height, head diameter, head center offset, and chord length of the diaphysis, most parameters in the distal femur, and the isthmic width of the medullary canal were smaller in Koreans than in other populations. However, the neck-shaft angle, subtense, and width of the intercondylar notch in the distal femur were larger than those in other populations. The results of this study will be useful as a reference for physical and forensic anthropology as well as the design of medical devices suitable for Koreans.

  10. Evaluation of skeletal tissue repair, part 2: enhancement of skeletal tissue repair through dual-growth-factor-releasing hydrogels within an ex vivo chick femur defect model.

    Science.gov (United States)

    Smith, E L; Kanczler, J M; Gothard, D; Roberts, C A; Wells, J A; White, L J; Qutachi, O; Sawkins, M J; Peto, H; Rashidi, H; Rojo, L; Stevens, M M; El Haj, A J; Rose, F R A J; Shakesheff, K M; Oreffo, R O C

    2014-10-01

    There is an unmet need for improved, effective tissue engineering strategies to replace or repair bone damaged through disease or injury. Recent research has focused on developing biomaterial scaffolds capable of spatially and temporally releasing combinations of bioactive growth factors, rather than individual molecules, to recapitulate repair pathways present in vivo. We have developed an ex vivo embryonic chick femur critical size defect model and applied the model in the study of novel extracellular matrix (ECM) hydrogel scaffolds containing spatio-temporal combinatorial growth factor-releasing microparticles and skeletal stem cells for bone regeneration. Alginate/bovine bone ECM (bECM) hydrogels combined with poly(d,l-lactic-co-glycolic acid) (PDLLGA)/triblock copolymer (10-30% PDLLGA-PEG-PLDLGA) microparticles releasing dual combinations of vascular endothelial growth factor (VEGF), chondrogenic transforming growth factor beta 3 (TGF-β3) and the bone morphogenetic protein BMP2, with human adult Stro-1+bone marrow stromal cells (HBMSCs), were placed into 2mm central segmental defects in embryonic day 11 chick femurs and organotypically cultured. Hydrogels loaded with VEGF combinations induced host cell migration and type I collagen deposition. Combinations of TGF-β3/BMP2, particularly with Stro-1+HBMSCs, induced significant formation of structured bone matrix, evidenced by increased Sirius red-stained matrix together with collagen expression demonstrating birefringent alignment within hydrogels. This study demonstrates the successful use of the chick femur organotypic culture system as a high-throughput test model for scaffold/cell/growth factor therapies in regenerative medicine. Temporal release of dual growth factors, combined with enriched Stro-1+HBMSCs, improved the formation of a highly structured bone matrix compared to single release modalities. These studies highlight the potential of a unique alginate/bECM hydrogel dual growth factor release

  11. Intact and Implanted Femur Behavior During Walking and Jogging

    Science.gov (United States)

    2007-11-02

    particular for investigations including temporal effects such as studies on fracture healing, fatigue, micromotion and remodeling to examine the...directed superiorly. The resultant hip joint reaction force was applied on the near-hemispherical surface of the acetabulum -femoral head contact area of the...given system of coordinates during the cycle period. Second, the actual contact area of the acetabulum and the femoral head and the way the joint

  12. Three-dimensional conformal intensity-modulated radiation therapy of left femur foci does not damage the sciatic nerve

    Institute of Scientific and Technical Information of China (English)

    Wanlong Xu; Xibin Zhao; Qing Wang; Jungang Sun; Jiangbo Xu; Wenzheng Zhou; Hao Wang; Shigui Yan; Hong Yuan

    2014-01-01

    During radiotherapy to kill femoral hydatid tapeworms, the sciatic nerve surrounding the focus can be easily damaged by the treatment. Thus, it is very important to evaluate the effects of ra-diotherapy on the surrounding nervous tissue. In the present study, we used three-dimensional, conformal, intensity-modulated radiation therapy to treat bilateral femoral hydatid disease in Meriones meridiani. The focus of the hydatid disease on the left femur was subjected to radio-therapy (40 Gy) for 14 days, and the right femur received sham irradiation. Hematoxylin-eosin staining, electron microscopy, and terminal deoxynucleotidyl transferase-dUTP nick end labeling assays on the left femurs showed that the left sciatic nerve cell structure was normal, with no ob-vious apoptosis after radiation. Trypan blue staining demonstrated that the overall protoscolex structure in bone parasitized withEchinococcus granulosus disappeared in the left femur of the animals after treatment. The mortality of the protoscolex was higher in the left side than in the right side. The succinate dehydrogenase activity in the protoscolex in bone parasitized withEchi-nococcus granulosus was lower in the left femur than in the right femur. These results suggest that three-dimensional conformal intensity-modulated radiation therapy achieves good therapeutic effects on the secondary bone in hydatid disease inMeriones meridiani without damaging the morphology or function of the sciatic nerve.

  13. Effect of amputation level on the stress transferred to the femur by an artificial limb directly attached to the bone.

    Science.gov (United States)

    Newcombe, L; Dewar, M; Blunn, G W; Fromme, P

    2013-12-01

    Attachment of an artificial limb directly to the skeleton has a number of potential benefits and the technique has been implemented for several amputation sites. In this paper the transfer of stress from an external, transfemoral prosthesis to the femur during normal walking activity is investigated. The stress distribution in the femur and at the implant-bone interface is calculated using finite element analysis for the 3D geometry and inhomogeneous, anisotropic material properties obtained from a CT scan of a healthy femur. Attachment of the prosthetic leg at three different levels of amputation is considered. Stress concentrations are found at the distal end of the bone and adjacent to the implant tip and stress shielding is observed adjacent to the implant. It is found that the stress distribution in the femur distal to the epiphysis, where the femur geometry is close to cylindrical, can be predicted from a cylindrical finite element model, using the correct choice of bone diameter as measured from a radiograph. Proximal to the lesser trochanter the stress decreases as the femur geometry diverges significantly from a cylinder. The stress concentration at the distal, resected end of the bone is removed when a collared implant is employed. These findings form the basis for appropriate settings of an external fail-safe device to protect the bone from excessive stress in the event of an undue load.

  14. Extensively coated revision stems in proximally deficient femur: Early results in 15 patients

    Directory of Open Access Journals (Sweden)

    Marya SKS

    2008-01-01

    Full Text Available Background: Hip replacement following failed internal fixation (dynamic hip screw for intertrochanteric fractures or previous hip arthroplasty presents a major surgical challenge. Proximal fitting revision stems do not achieve adequate fixation. Distal fixation with long-stemmed extensively coated cementless implants (like the Solution™ system affords a suitable solution. We present our early results of 15 patients treated with extensively coated cementless revision stems. Materials and Methods: Fifteen patients with severely compromised proximal femora following either failed hip arthroplasty or failed internal fixation (dynamic hip screw fixation for intertrochanteric fractures were operated by the senior author over a two-year period. Eight patients had aseptic loosening of their femoral stems following cemented hip replacements, with severe thinning of their proximal cortices and impending stress fractures. Seven had secondary hip arthritis following failure of long implants for comminuted intertrochanteric or subtrochanteric femoral fractures. All patients were treated by removal of implant (cemented stems/DHS implants and insertion of long-stemmed extensively coated cementless revision (′ Solution™; DePuy, Warsaw (IN, US′ stems along with press-fit acetabular component (Duraloc Cup, DePuy, Warsaw (IN, US. All eight hip revisions needed extended trochanteric osteotomies. Results: All patients were primarily kept in bed on physiotherapy for six weeks and then gradually progressed to weight-bearing walking over the next six to eight weeks. The Harris Hip Scores and patient satisfaction were used for final evaluation. We achieved good results in the short term studied. In our first three patients (all following failed cemented total hip replacements, we resorted to cerclage wiring to hold osteotomised segments (done to facilitate stem removal. The subsequent 12 proceeded without the need for cerclage wiring. One patient had a

  15. Salter-Harris type III fractures of the distal femur: plain radiographs can be deceptive.

    Science.gov (United States)

    Lippert, William C; Owens, Richard F; Wall, Eric J

    2010-09-01

    Salter-Harris (SH) III fractures of the distal femur, although rare, can have devastating effects. The purposes of this study were to: (1) compare the intra-articular fracture displacement measured on plain x-ray and magnetic resonance imaging (MRI) or computed tomography (CT) scan and (2) report the outcomes of patients with a SH III fracture of the distal femur. All SH III distal femur fractures treated at a large Children's Hospital with a Level I Pediatric Trauma Center between 1995 and 2006 were retrospectively reviewed. A total of 14 patients (average age: 13 y, 11 mo; range: 7 y, 8 mo to 17 y, 11 mo) with an average follow-up time of 21.50 months (range: 2 to 47 mo) were included in this study. Fracture displacement on plain x-ray was compared with the fracture displacement measured on MRI or CT scan. The average time between the initial plain x-ray and MRI or CT scan was 37.48 days (range: 3 h to 6 mo). Plain x-rays significantly underestimated the displacement of SH III fractures versus MRI or CT scan. Six patients who had both plain x-ray and MRI or CT scan had a measured displacement of 0.42 mm and 2.70 mm, respectively (paired Student t test, P=0.005). Ten of the 14 patients (71%) had no physical limitations and full knee motion at their most recent follow-up visit. The treatment of 4 patients (29%) was changed based on the findings of the additional MRI or CT scan. This study and earlier studies have shown a high rate of poor results with SH III fractures of the distal femur. This type of fracture pattern is extremely unstable and the true displacement is often underestimated by x-rays. Thus, it is strongly recommended that an MRI or CT scan be obtained on every SH III fracture of the distal femur. Moreover, any SH III fracture visible on plain radiographs should be treated with open reduction, internal fixation. Level IV.

  16. The use of {sup 18}F-fluoride and {sup 18}F-FDG PET scans to assess fracture healing in a rat femur model

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, W.K.; Feeley, B.T.; Krenek, L.; Stout, D.B.; Chatziioannou, A.F. [David Geffen School of Medicine at UCLA, Center for Health Sciences, Department of Orthopaedic Surgery, Los Angeles, CA (United States); Lieberman, J.R. [University of Connecticut Health Center, The Musculoskeletal Institute, Department of Orthopaedic Surgery, Farmington, CT (United States)

    2007-08-15

    Currently available diagnostic techniques can be unreliable in the diagnosis of delayed fracture healing in certain clinical situations, which can lead to increased complication rates and costs to the health care system. This study sought to determine the utility of positron emission tomography (PET) scanning with {sup 18}F-fluoride ion, which localizes in regions of high osteoblastic activity, and {sup 18}F-fluorodeoxyglucose (FDG), an indicator of cellular glucose metabolism, in assessing bone healing in a rat femur fracture model. Fractures were created in the femurs of immunocompetent rats. Animals in group I had a fracture produced via a manual three-point bending technique. Group II animals underwent a femoral osteotomy with placement of a 2-mm silastic spacer at the fracture site. Fracture healing was assessed with plain radiographs, {sup 18}F-fluoride, and {sup 18}F-FDG PET scans at 1, 2, 3, and 4-week time points after surgery. Femoral specimens were harvested for histologic analysis and manual testing of torsional and bending strength 4 weeks after surgery. All fractures in group I revealed abundant callus formation and bone healing, while none of the nonunion femurs were healed via assessment with manual palpation, radiographic, and histologic evaluation at the 4-week time point. {sup 18}F-fluoride PET images of group I femurs at successive 1-week intervals revealed progressively increased signal uptake at the union site during fracture repair. In contrast, minimal tracer uptake was seen at the fracture sites in group II at all time points after surgery. Data analysis revealed statistically significant differences in mean signal intensity between groups I and II at each weekly interval. No significant differences between the two groups were seen using {sup 18}F-FDG PET imaging at any time point. This study suggests that {sup 18}F-fluoride PET imaging, which is an indicator of osteoblastic activity in vivo, can identify fracture nonunions at an early time

  17. Analysis of femur head microstructure in ovariectomized rats

    Science.gov (United States)

    Andrade, C. B. V.; Nogueira, L. P.; Salata, C.; da Silva, C. M.; Ferreira-Machado, S. C.; de Almeida, C. E.; Almeida, A. P.; Colaço, M. V.; Alessio, R. C. P. V.; Braz, D.; Tromba, G.; Barroso, R. C.

    2013-07-01

    It is well accepted that rat ovariectomy (OVX) is a model of estrogen deficiency. OVX played a very important role in the initiating and developing of osteoporosis and it has been shown to be a major risk factor for the development of postmenopausal osteoporosis in women. In this work we used synchrotron radiation computed microtomography to investigate the skeletal effects in femoral head of female Wistar rats after bilateral ovariectomy surgery. The CT system was set up at the SYRMEP beamline in the synchrotron radiation facility ELETTRA (Trieste, Italy). Micro-CT images provided 3D information on precise trabecular microstructure by the reconstruction of multiple 2D images with almost 2 μm resolution. Our aim was to use histomorphometric analysis to reveal the effect of OVX on the three-dimensional (3D) trabecular bone microarchitecture. Evaluated morphometric parameters were trabecular bone volume-tissue volume ratio (BV/TV), trabecular number (Tb.N), trabecular separation (Tb.Sp) and trabecular thickness (Tb.Th). OVX group presented noticeable reduction in the Tb.N and Tb.Th when compared with control group (P 0.05). Our data may help to gain more insight into the potential mechanism of osteoporotic femoral head fractures.

  18. [Osteoporotic fractures of the proximal femur. What's new?].

    Science.gov (United States)

    Bonnaire, F; Straßberger, C; Kieb, M; Bula, P

    2012-10-01

    -neck fragment with angular stable blade systems and the option of polymethyl-methacrylate (PMMA) cement augmentation are promising advantages that still remain to be clinically tested. Endoprosthetic treatment of pertrochanteric femoral fractures still has 3 times higher complication rate and is implemented only in exceptional situations.

  19. Osteoporotic fractures of proximal femur: clinical and epidemiological features in a population of the city of São Paulo

    Directory of Open Access Journals (Sweden)

    Ana Claudia Ramalho

    Full Text Available CONTEXT: It is believed that about 25% of menopausal women in the USA will exhibit some kind of fracture as a consequence of osteoporosis. Fractures of the proximal femur are associated with a greater number of deaths and disabilities and higher medical expenses than all the other osteoporotic fractures together. OBJECTIVE: To study the clinical and epidemiological features of patients with proximal femur fracture in hospitals in São Paulo. DESIGN: Transversal and retrospective study. LOCAL: Hospital São Paulo and Hospital Servidor Público Estadual "Francisco Morato Oliveira". PARTICIPANTS: Patients aged sixty-five years or more hospitalized because of proximal femur fracture, from March to November 1996 (N = 73. This group was compared to patients of the same age without fracture of the proximal femur. INTERVENTION: Evaluation of weight, height, body mass index; lifestyle habits (physical activity at home, ingestion of dairy calcium, drinking of coffee, smoking habit, gynecological history (ages at menarche and menopause, number of pregnancies and lactations, previous morbidity, use of medications, history of previous fractures, family history of osteoporosis. MEASUREMENT: The comparison of the different data regarding lifestyle habits between the two groups was made using the chi-squared test. Other data were analyzed using the Mann -- Whitney test. P £ 0.05 was considered significant. RESULTS: We noted a predominance of proximal femur fracture among females in relation to males (a female/male ratio of 3.3:1 with a progressive increase in the frequency of proximal femur fracture with age in both sexes. The group with proximal femur fracture, in comparison with the control group, showed a lower body mass index, less physical activity, and a greater number of pregnancies and lactations. Other data were not different. CONCLUSION: In accordance with the literature, we found a predomination of proximal femur fracture in women in relation to men

  20. Use of a condylar screw plate for repair of a Salter-Harris type-III fracture of the femur in a 2-year-old horse.

    Science.gov (United States)

    Byron, Christopher R; Stick, John A; Brown, Jennifer A; Lugo, Joel

    2002-11-01

    A 2-year-old sexually intact male Paint horse weighing 427 kg (940 lb) was admitted for examination and treatment of intermittent non-weight-bearing lameness of the right hind limb of 1 week's duration. Radiography revealed a displaced Salter-Harris type-III fracture of the right femoral condyle with the sagittal component of the fracture line located in the intercondylar space and the transverse component exiting on the medial aspect of the femur. The fracture was repaired with a condylar screw plate designed for repair of femoral condylar fractures in humans. The owner reported by telephone 9 months after surgery that the horse was sound. To our knowledge, use of this particular implant system for fixation of a Salter-Harris type-III fracture on the medial side of the femur in a horse has not been described. Results in this horse suggest that this implant can be successfully used for repair of femoral condylar fractures in selected adult horses.

  1. Research progress of finite element analysis of femur biomechanics%股骨生物力学有限元分析研究进展

    Institute of Scientific and Technical Information of China (English)

    张思能; 黄潮桐; 陈隆福; 张美超

    2013-01-01

    Finite element (FE) analysis of femur biomechanics is a hotspot in the research field of digital orthopedics. In this paper, FE model establishment of femur and the following stress analysis based on the models were introduced, FE results for femoral injury systems were discussed, and finally the clinical application value of FE techniques for preoperative planning guidance, risk prediction and prognosis evaluation, as well as the design, optimization and modification of medical devices were reviewed.%股骨生物力学有限元分析是目前数字骨科领域的一个研究热点。该文介绍股骨有限元模型的建立及应力分析,阐述股骨损伤机制的有限元研究结果,综述股骨生物力学有限元分析技术在手术方案指导、风险预测和预后评估以及医疗器械设计、优化和改良等方面的临床应用价值。

  2. Effect of Pentoxifylline Administration on an Experimental Rat Model of Femur Fracture Healing With Intramedullary Fixation.

    Science.gov (United States)

    Vashghani Farahani, Mohammad Mahdi; Masteri Farahani, Reza; Mostafavinia, Ataroalsadat; Abbasian, Mohammad Reza; Pouriran, Ramin; Noruzian, Mohammad; Ghoreishi, Seyed Kamran; Aryan, Arefe; Bayat, Mohammad

    2015-12-01

    Globally, musculoskeletal injuries comprise a major public health problem that contributes to a large burden of disability and suffering. Pentoxifylline (PTX) has been originally used as a hemorheologic drug to treat intermittent claudication. Previous test tube and in vivo studies reported the beneficial effects of PTX on bony tissue. This study aims to evaluate the effects of different dosages of PTX on biomechanical properties that occur during the late phase of the fracture healing process following a complete femoral osteotomy in a rat model. We applied intramedullary pin fixation as the treatment of choice. This experimental study was conducted at the Shahid Beheshti University of Medical Sciences, Tehran, Iran. We used the simple random technique to divide 35 female rats into five groups. Group 1 received intraperitoneal (i.p.) PTX (50 mg/kg, once daily) injections, starting 15 days before surgery, and group 2, group 3, and group 4 received 50 mg/kg, 100 mg/kg, and 200 mg/kg i.p. PTX injections, respectively, once daily after surgery. All animals across groups received treatment for six weeks (until sacrificed). Complete surgical transverse osteotomy was performed in the right femur of all rats. At six weeks after surgery, the femurs were subjected to a three-point bending test. Daily administration of 50 mg/kg PTX (groups 1 and 2) decreased the high stress load in repairing osteotomized femurs when compared with the control group. The highest dose of PTX (200 mg/kg) significantly increased the high stress load when compared with the control group (P = 0.030), group 1 (P = 0.023), group 2 (P = 0.008), and group 3 (P = 0.010), per the LSD findings. Treatment with 200 mg/kg PTX accelerated fracture healing when compared with the control group.

  3. A Femur-Implant Model for the Prediction of Bone Remodeling Behavior Induced by Cementless Stem

    Institute of Scientific and Technical Information of China (English)

    He Gong; Lingyan Kong; Rui Zhang; Juan Fang; Meisheng Zhao

    2013-01-01

    Bone remodeling simulation is an effective tool for the prediction of long-term effect of implant on the bone tissue,as well as the selection of an appropriate implant in terms of architecture and material.In this paper,a finite element model of proximal femur was develop.ed to simulate the structures of internal trabecular and cortical bones by incorporating quantitative bone functional adaptation theory with finite element analysis.Cementless stems made of titanium,two types of Functionally Graded Material (FGM) and flexible 'iso-elastic' material as comparison were implanted in the structure of proximal femur respectively to simulate the bone remodeling behaviors of host bone.The distributions of bone density,von Mises stress,and interface shear stress were obtained.All the prosthetic stems had effects on the bone remodeling behaviors of proximal femur,but the degrees of stress shielding were different.The amount of bone loss caused by titanium implant was in agreement with the clinical observation.The FGM stems caused less bone loss than that of the titanium stem,in which FGM I stem (titanium richer at the top to more HAP/Col towards the bottom) could relieve stress shielding effectively,and the interface shear stresses were more evenly distributed in the model with FGM I stem in comparison with those in the models with FGM II (titanium and bioglass) and titanium stems.The numerical simulations in the present study provided theoretical basis for FGM as an appropriate material of femoral implant from a biomechanical point of view.The next steps are to fabricate FGM stem and to conduct animal experiments to investigate the effects of FGM stem on the remodeling behaviors using animal model.

  4. Mechanical Properties of a Single Cancellous Bone Trabeculae Taken from Bovine Femur

    Science.gov (United States)

    Enoki, Shinichi; Sato, Mitsuhiro; Tanaka, Kazuto; Katayama, Tsutao

    The increase of patients with osteoporosis is becoming a social problem, thus it is an urgent issue to find its prevention and treatment methods. Since cancellous bone is metabolically more active than cortical bone, cancellous bone is often used for diagnosis of osteoporosis and has received much attention within the study of bone. Bone is a hierarchically structured material and its mechanical properties vary at different structural levels, therefore it is important to break down the mechanical testing of bone according to the various levels within bone material. Mechanical properties of cancellous bone is said to be depended on quantities and orientation of trabecular bone. It is supposed that mechanical properties of trabecular bone are constant without depending on any structural arrangement and parts. However, such assumption has not been established in studies of trabecular bone. Furthermore test results have a large margin of error caused by insufficient shape assessment. In this study, three point bending tests of single cancellous bone trabeculae extracted from bovine femur were conducted to evaluate the effects of directions to the femur major axis direction on the mechanical properties. X-ray μCT was used to obtain shape of trabecular bone specimens. Furthermore compression tests of cancellous bone specimens, which were extracted in 10mm cubic geometry, were conducted for evaluation of directional properties.There were small difference in the elastic modulus of the trabecular bones which were extracted in parallel and in perpendicular to the major axis of femur. Considering from the results that the cancellous bone specimens, which were extracted in 10mm cubic geometry, have different elastic properties depending on the tested directions; the bone structure has larger influence than bone material property on the mechanical properties of cancellous bone.

  5. Fatigue stress injuries of the pelvic bones and proximal femur: evaluation with MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kiuru, Martti J. [Department of Radiology, Helsinki University Central Hospital, P.O. Box 340, Haartmaninkatu 4, 00029 Helsinki (Finland); Research Institute of Military Medicine, Mannerheimintie 164, 00300 Helsinki (Finland); Pihlajamaki, Harri K. [Department of Surgery, Central Military Hospital, Mannerheimintie 164, 00300 Helsinki (Finland); Ahovuo, Juhani A. [Department of Radiology, Helsinki University Central Hospital, P.O. Box 340, Haartmaninkatu 4, 00029 Helsinki (Finland)

    2003-03-01

    The purpose of this study was to determine the prevalence and the distribution as well as male/female differences in patients with hip or pelvic pain based on MRI results. Three hundred forty consecutive conscripts (45 women, 295 men; age range 18-29 years; mean age 20.7 years) suffering from stress-related hip, buttock or groin pain took part in the study. All 340 patients underwent MR imaging. Radiographic data were available for 215 patients. Two radiologists interpreted the images by consensus. In MRI 174 stress injuries were diagnosed in 137 patients (32 women, 105 men). The incidence of bone stress injuries in women was significantly higher than that in men (p<0.0001). One hundred five of the injuries (60%) were related to the proximal femur, 70 (67%) to the neck, 34 (32%) to the proximal shaft, and one (1%) to the head. Sixty-nine of the 174 stress injuries (40%) concerned the pelvic bones: sacrum 28 (41%); inferior pubic ramus 34 (49%); superior pubic ramus 3 (4%); iliac bone 3 (4%); and acetabulum 1 (1%). In 31 of the 174 cases (18%) symptoms were contralateral to MR findings. Thirty-three of the 137 patients (24%) had multiple bone stress injuries, 29 had two bone stress injuries and 4 patients had three. The sensitivity of radiography was 37%, specificity 79%, accuracy 60%, positive predictive value 59% and negative predictive value 61%. The kappa value for agreement between radiography and MRI was poor (0.17, p=0.0008). Patients suffering from stress-related hip pain MRI revealed bone stress injuries in 40%; of these, 60% were located in the proximal femur and 40% in the pelvic bones. For accurate diagnosis of bone stress injuries, and to ensure appropriate treatment, the entire pelvis and both proximal femurs should be studied simultaneously by means of MRI. (orig.)

  6. In vivo strains in the femur of the nine-banded armadillo (Dasypus novemcinctus).

    Science.gov (United States)

    Copploe, Joseph V; Blob, Richard W; Parrish, John H A; Butcher, Michael T

    2015-08-01

    The capacity of limb bones to resist the locomotor loads they encounter depends on both the pattern of those loads and the material properties of the skeletal elements. Among mammals, understanding of the interplay between these two factors has been based primarily on evidence from locomotor behaviors in upright placentals, which show limb bones that are loaded predominantly in anteroposterior bending with minimal amounts of torsion. However, loading patterns from the femora of opossums, marsupials using crouched limb posture, show appreciable torsion while the bone experiences mediolateral (ML) bending. These data indicated greater loading diversity in mammals than was previously recognized, and suggested the possibility that ancestral loading patterns found in sprawling lineages (e.g., reptilian sauropsids) might have been retained among basal mammals. To further test this hypothesis, we recorded in vivo locomotor strains from the femur of the nine-banded armadillo (Dasypus novemcinctus), a member of the basal xenarthran clade of placental mammals that also uses crouched limb posture. Orientations of principal strains and magnitudes of shear strains indicate that armadillo femora are exposed to only limited torsion; however, bending is essentially ML, placing the medial aspect of the femur in compression and the lateral aspect in tension. This orientation of bending is similar to that found in opossums, but planar strain analyses indicate much more of the armadillo femur experiences tension during bending, potentially due to muscles pulling on the large, laterally positioned third trochanter. Limb bone safety factors were estimated between 3.3 and 4.3 in bending, similar to other placental mammals, but lower than opossums and most sprawling taxa. Thus, femoral loading patterns in armadillos show a mixture of similarities to both opossums (ML bending) and other placentals (limited torsion and low safety factors), along with unique features (high axial tension

  7. Effect of calcium citrate on bone integration in a rabbit femur defect model

    Institute of Scientific and Technical Information of China (English)

    Wei Zhang; Peng-Fei Nie; Xiu-Cui Li; Ferdinand An Rompis; Hang Huang; Hua Zhang; Zhong-Lin Mu; Lei Peng; Wei Wang; Qing-Yu Chen; Zhong-Qin Lin; Shao-Wen Cheng; Dong-Quan Kou; Xiao-Zhou Ying; Yue Shen; Xiao-Jie Cheng

    2012-01-01

    ABSTRACT Objective:To explore effect of calcium citrate on bone integration in a rabbit femur defect model, and to compare the bone formation with different sizes by radiological and histological study. Methods:Twenty-four male Japanese white rabbits were randomly divided into three groups (GroupA, B, C) in this study. Under anesthesia, defects of four sizes (1.2, 1.5, 2.0 and2.5 mm) were created in each of the rabbits. Commercially pure calcium citrate powder was placed inside the medullary compartment of the femur (Experimental), while in the contralateral femur (Control) nothing was implanted. The defects were analyzed using radiography and histological analysis by using Imagepro-Plus6.0 software after animal was sacrificed at 4th(GroupA), 6th(GroupB) and8th(GroupC) weeks postoperatively. Four samples were analyzed for each size of defect and each healing period.Results:The histological and the radiologic evaluation were performed after sacrification of all rabbits on postoperative4th and6th weeks, It showed significant difference between the experimental group and the control group when these defects were less than or equal to2.0 mm. No statistical difference was observed when these defects were larger than2.0 mm at all healing periods except at the4th week.Conclusions: Calcium citrate affects the early periods of bone defects healing mechanism in Japanese white rabbits positively, especially when the defect is not too large. We suggest further studies on calcium citrate to determine the effects of various dosages, administration ways and the experimental time on the bone defects.

  8. Moulting of insect tracheae captured by light and electron-microscopy in the metathoracic femur of a third instar locust Locusta migratoria.

    Science.gov (United States)

    Snelling, Edward P; Seymour, Roger S; Runciman, Sue

    2011-09-01

    The insect tracheal system is an air-filled branching network of internal tubing that functions to exchange respiratory gases between the tissues and the environment. The light and electron-micrographs presented in this study show tracheae in the process of moulting, captured from the metathoracic hopping femur of a juvenile third instar locust (Locusta migratoria). The images provide evidence for the detachment of the cuticular intima from the tracheal epithelial cells, the presence of moulting fluid between the new and old cuticle layers, and the withdrawal of the shed cuticular lining through larger upstream regions of the tracheal system during moulting. The micrographs also reveal that the cuticular intima of the fine terminal branches of the tracheal system is cast at ecdysis. Therefore, the hypothesis that tracheoles retain their cuticle lining at each moult may not apply to all insect species or developmental stages.

  9. A proximal femur aneurysmal bone cyst resulting in amputation: a rare case report.

    Directory of Open Access Journals (Sweden)

    Khodamorad Jamshidi

    2015-02-01

    Full Text Available Aneurysmal bone cyst (ABC is blood filled expansile cystic lesion that most commonly occurs in patients during the second decade of their lives. Traditionally it has been described as a benign lesion but can be locally aggressive and result in the destruction of the involved bone. Treatment methods include surgical excision and curettage with or without bone grafting. We report a proximal femur aneurysmal bone cyst, which resulted in the amputation of the lower extremity, even though all available classic methods of treatment were applied for it.

  10. Salter Harris Fractures of the Distal Femur: Learning Points From Two Cases Compared.

    Science.gov (United States)

    McKenna, Sean M; Hamilton, Steven W; Barker, Simon L

    2013-01-01

    Salter Harris-type injuries of the distal femur should be treated as a dislocation of the knee and therefore as a medical emergency. Senior medical staff should be involved early, ankle-brachial index ratio should be measured in all patients and the clinician should have a high index of suspicion for a vascular injury. Ideally reduction, stabilization, and vascular repair, if necessary, should be carried out within 6 hours of the initial event. There should be a low threshold for fasciotomies. These 2 cases demonstrate the importance of having a high index of suspicion for vascular injury and the need for continued reassessment.

  11. Long bone florid reactive periostitis ossificans: a case in the distal femur mimicking osteosarcoma.

    Science.gov (United States)

    Azorín, Daniel; López-Pino, Miguel A; González-Mediero, Imelda; Epeldegui, Tomás; López-Barea, Fernando

    2008-11-01

    Florid reactive periostitis ossificans is a well-known benign lesion classically described in hands and feet which histopathological features can lead to a misdiagnosis of osteosarcoma. To the best of our knowledge, there is only one previous report of this lesion in a long bone. In this study we report a case of florid reactive periostitis ossificans located in the distal metaphysis of the left femur that histologically mimicked an osteosarcoma and discuss the differential diagnosis between these two entities to warn about a diagnostic pitfall.

  12. Comparison of the effectiveness of phalanges vs. humeri and femurs to estimate lizard age with skeletochronology

    Energy Technology Data Exchange (ETDEWEB)

    Comas, M.; Reguera, S.; Zamora-Camacho, F.J.; Salvado, H.; Moreno-Rueda, G.

    2016-07-01

    Skeletochronology allows estimation of lizard age with a single capture (from a bone), making long–term monitoring unnecessary. Nevertheless, this method often involves the death of the animal to obtain the bone. We tested the reliability of skeletochronology of phalanges (which may be obtained without killing) by comparing the estimated age from femurs and humeri with the age estimated from phalanges. Our results show skeletochronology of phalanges is a reliable method to estimate age in lizards as cross–section readings from all bones studied presented a high correlation and repeatability regardless of the bone chosen. This approach provides an alternative to the killing of lizards for skeletochronology studies. (Author)

  13. Subtrochanteric Femur Fracture after Slipped Capital Femoral Epiphysis Pinning: A Novel Treatment

    Directory of Open Access Journals (Sweden)

    Michael Paloski

    2011-01-01

    Full Text Available Slipped capital femoral epiphysis is a common injury suffered by adolescents worldwide. Treatment of most slips can be accomplished by percutaneous screw fixation, as this is an accepted and proven method associated with minimal morbidity. Complications, although limited, can be problematic for both the patient and treating physician. These include avascular necrosis, chondrolysis, infection, and fracture. We report a case of an individual who sustained a subtrochanteric femure fracture three weeks after in situ pinning of his left hip treated with a reconstruction intramedullary nail. This option allowed both the subtrochanteric fracture and SCFE to be treated concomitantly with minimized morbidity.

  14. Arthroscopic Excision of an Intraarticular Osteoid Osteoma in the Distal Femur

    Science.gov (United States)

    Kang, Suk; Kim, Young Sung; Lee, Ho Min; Lee, Min Young

    2016-01-01

    An intraarticular osteoid osteoma of the knee is uncommon, and its treatment is challenging. The authors present a case of arthroscopic excision of an intraarticular osteoid osteoma in the distal femur, which was accessible through the knee joint. After confirming the nidus of the osteoid osteoma by computed tomography, the lesion was completely removed arthroscopically. The patient reported complete pain relief immediately after surgery. This case demonstrates that intraarticular osteoid osteomas in the knee joint can be treated by arthroscopic excision and that good results can be obtained. PMID:27904732

  15. Evaluation of the isometry of different points of the patella and femur for medial patellofemoral ligament reconstruction.

    Science.gov (United States)

    Gobbi, Riccardo Gomes; Pereira, César Augusto Martins; Sadigursky, David; Demange, Marco Kawamura; Tírico, Luis Eduardo Passarelli; Pécora, José Ricardo; Camanho, Gilberto Luis

    2016-10-01

    The location of patellar and femoral fixation of the graft in medial patellofemoral ligament reconstructions has been widely discussed. This study aimed to assess the distances between different patellar and femoral fixation points to identify the least anisometric pairs of points. Ten cadaver knees were attached to an apparatus that simulated an active range of motion of 120°, with three metallic markers fixed onto the medial side of the patella, and seven markings onto the medial epicondyle. The examined points included the proximal patella pole (1), the patellar center (3), the midpoint between points 1 and 3 (2), a point directly on the epicondyle (6), points 5mm anterior (5) and posterior (7) to the epicondyle, points 5mm anterior to point 5 (4) and 5mm posterior to point 7 (8), and points 5mm proximal (9) and distal (10) to the epicondyle. The distances between patella and femur points were measured by a photogrammetry system at 15° intervals. The pair of points that exhibited the lowest average variability in distance, and hence was the most isometric, was the patella center combined with the anterior to the medial femoral epicondyle. The pairs of points that exhibited the highest average variability in distance, and hence were the least isometric, were the ones located distal or posterior to the medial femoral epicondyle, with less influence by the patellar location. Surgeons should avoid positioning the graft distally or posterior to the epicondyle due to the increase in anisometry. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Comparison of Percutaneous Cementoplasty with and Without Interventional Internal Fixation for Impending Malignant Pathological Fracture of the Proximal Femur

    Energy Technology Data Exchange (ETDEWEB)

    Tian, Qing-Hua, E-mail: ddqinghua-tian@163.com; He, Cheng-Jian, E-mail: tianhechengjian@163.com; Wu, Chun-Gen, E-mail: 649514608@qq.com; Li, Yong-Dong, E-mail: tianliyongdong@163.com; Gu, Yi-Feng, E-mail: tianyifenggu@163.com; Wang, Tao, E-mail: tianandwangtao@163.com; Xiao, Quan-Ping, E-mail: tianxiaoquanping@163.com; Li, Ming-Hua, E-mail: tianminghuali@163.com [Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Department of Diagnostic and Interventional Radiology (China)

    2016-01-15

    PurposeTo compare the efficacy of percutaneous cementoplasty (PCP) with and without interventional internal fixation (IIF) on malignant impending pathological fracture of proximal femur.MethodsA total of 40 patients with malignant impending pathological fracture of proximal femur were selected for PCP and IIF (n = 19, group A) or PCP alone (n = 21, group B) in this non-randomized prospective study. Bone puncture needles were inserted into the proximal femur, followed by sequential installation of the modified trocar inner needles through the puncture needle sheath. Then, 15–45 ml cement was injected into the femur lesion.ResultsThe overall excellent and good pain relief rate during follow-ups were significantly higher in group A than that in group B (89 vs. 57 %, P = 0.034). The average change of VAS, ODI, KPS, and EFES in group A were significantly higher than those in group B at 1-, 3-, 6-month, 1-year (P < 0.05). Meanwhile, The stability of the treated femur was significantly higher in group A than that in group B (P < 0.05).ConclusionPCP and IIF were not only a safe and effective procedure, but resulted in greater pain relief, bone consolidation, and also reduced the risk of fracture than the currently recommended approach of PCP done on malignant proximal femoral tumor.

  17. Peripheral fractures of prosthesis of femur after total hip arthroplasty%人工髋关节置换后股骨假体周围骨折

    Institute of Scientific and Technical Information of China (English)

    郑东

    2012-01-01

    BACKGROUND: Total hip arthroplasty is the most effective method for treatment of severe hip disease, and peripheral fractures of femur prosthesis is a serious complication after total hip arthroplasty. OBJECTIVE: To explore the trend of the literatures related to peripheral fractures of femur prosthesis after total hip arthroplasty. METHODS: A computer-based research was performed in CNKI database from January 2002 to December 2011 for the literatures related to the fracture around the femur prosthesis after total hip arthroplasty. The key words were "total hip arthroplasty, prosthesis, peripheral fractures". The database analysis capabilities and Excel charts functions was used to analyze the data characteristics. RESULTS AND CONCLUSION: The peripheral fractures of femur prosthesis after total hip arthroplasty was mainly caused by the trauma, and the renovation treatment, aging of the patients, the type of prosthesis, the fixation of the prosthesis and the increasing of the amount of joint activities also related to the occurrence of the fracture. Vancouver typing methods were often used to evaluate the peripheral fractures of femur prosthesis after total hip arthroplasty. Vancouver typing included the site of fracture, the type of fracture, fixation of prosthesis, loosening of the prosthesis and bone loss of proximal femur and other factors, which has a good guiding value on the treatment of peripheral fractures of femur prosthesis. The shape memory embracing fixator, less invasive stabilization system, locking compression plate, allogenic cortical bone plates, carbon fiber plates, impaction bone grafting and revision and other fixation methods are often used for the treatment of peripheral fractures of femur prosthesis after total hip arthroplasty.%背景:人工髋关节置换是治疗严重髋关节疾病最有效的方法,股骨假体周围骨折是人工髋关节置换后严重的并发症之一.目的:对人工髋关节置换后股骨假体周围骨折

  18. Pathological fracture of the femur in a patient with Paget's disease of bone: a case report.

    Science.gov (United States)

    Petrescu, Pompiliu HoraŢiu; Izvernariu, Dragoş Andrei; Iancu, Cătălina; Dinu, Gabriel Ovidiu; Berceanu-Văduva, Marcel Mihai; Crişan, Dan; Iacob, Mihaela; Bucur, Venera Margareta; RăuŢia, Ion Călin; Prejbeanu, Ion Radu; Dema, Sorin; DuŢă, Ciprian Constantin

    2016-01-01

    Paget's disease of bone is a benign disease characterized by exaggerated remodeling of the bone matrix after osteoclast-mediated bone destruction. Its etiology is still unknown, despite the fact that it was discovered and described in 1877, but genetic factors and environmental triggers were shown to play their part in the pathogenesis of the disease. The main clinical presentations of the disease are related to bone pain and deformities. Radiological diagnosis is the main detection tool, though many monostotic Paget's disease cases may remain undiagnosed. We present the case of an 81-year-old male patient admitted to the Clinic of Orthopedics, Emergency County Hospital, Timisoara, Romania, with intense pain and deformity of the upper left thigh. Radiological examination performed shows a complete fracture of the upper third diaphysis of the left femur with suggestive signs for Paget's disease of the bone therefore a biopsy was taken and the patient was treated by surgical realignment with favorable evolution. He was discharged 13 days after surgery. The biopsy of the bone revealed extensive bone remodeling with numerous osteoclasts and extensive bone matrix deposition, unevenly stained and unevenly mineralized and reverse cement lines, which are consistent with the diagnosis of Paget's disease of the bone. Histomorphometric analysis show intense matrix deposition with a highly active remodeling process. Computed tomography (CT) scans were performed three years later and show the extension of the disease into the lower half of the left femur.

  19. The Effect of Gabapentin and Tramadol in Cancer Pain Induced by Glioma Cell in Rat Femur.

    Science.gov (United States)

    Corona-Ramos, Janette Nallely; Déciga-Campos, Myrna; Romero-Piña, Mario; Medina, Luis A; Martínez-Racine, Issac; Jaramillo-Morales, Osmar A; García-López, Patricia; López-Muñoz, Francisco Javier

    2017-08-01

    Preclinical Research The presence of pain as part of the cancer process is variable. Glioblastoma multiform (GBM) can produce bone metastasis, a condition that involves other pathological phenotypes including neuropathic and inflammatory pain. Tramadol and gabapentin are drugs used in the treatment of neuropathic pain. However, there are no studies evaluating their analgesic effects in bone metastasis. We produced a pain model induced by the inoculation of glioma cells (10(5) ) into the rat femur, by perforating the intercodiloid fossa. Painful behavior was evaluated by measuring mechanical allodynia using the Von Frey test while thermal hyperalgesia was assessed in the plantar test. Histopathological features were evaluated and antinociceptive responses were compared using tramadol and gabapentin. The inoculation of cells inside the right femur produced nociceptive behaviors. Tramadol and gabapentin produced an anti-allodynic effect in this condition, but tramadol did not produce an anti-hyperalgesic response. The development of this model will allow us to perform tests to elucidate the pathology of bone metastasis, cancer pain, and in particular the pain produced by glioma. Drug Dev Res 78 : 173-183, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  20. Histomorphometry of the organic matrix of the femur in ovariectomized rats treated with sodium alendronate

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    Patricia Tanios Haddad

    2015-02-01

    Full Text Available OBJECTIVE: To evaluate the effect of two different concentrations of sodium alendronate on the quantity of organic matrix in the femur of rats with estrogen suppression caused by ovariectomy.METHODS: Sixty-days-old Wistar rats (Rattus norvegicus were subjected to bilateral laparotomy to remove the ovaries. The animals were divided into a control group, in which they only underwent laparotomy; an ovariectomized group (OVX; an ovariectomized group treated with 1 mg/kg of alendronate (OVX 1 mg; and an ovariectomized group treated with 2 mg/kg of alendronate (OVX 2 mg. The rats received alendronate twice a week for 90 days. The left femur was then removed, fixed and processed for embedding in paraffin. Semi-serial sections stained with hematoxylin and eosin were used to determine the area occupied by organic bone matrix, by means of image analysis software. The animals' weights were obtained at the beginning and end of the experiment.RESULTS: The ovariectomized animals and those treated with 1 mg/kg of alendronate presented significant increases in body weight (p 0.05 to that of the non-ovariectomized control animals (2,04,800 ± 9590, which indicates that this medication had a preventive effect with regard to bone mass loss.CONCLUSION: The higher concentration of the medication, administered twice a week for 90 days, was more effective than the dose of 1 mg/kg over the same period.

  1. Effects of chronic lead exposure on bone mineral properties in femurs of growing rats.

    Science.gov (United States)

    Álvarez-Lloret, Pedro; Lee, Ching Ming; Conti, María Inés; Terrizzi, Antonela Romina; González-López, Santiago; Martínez, María Pilar

    2017-02-15

    Lead exposure has been associated with several defective skeletal growth processes and bone mineral alterations. The aim of the present study is to make a more detailed description of the toxic effects of lead intoxication on bone intrinsic material properties as mineral composition, morphology and microstructural characteristics. For this purpose, Wistar rats were exposed (n=12) to 1000ppm lead acetate in drinking water for 90days while control group (n=8) were treated with sodium acetate. Femurs were examined using inductively coupled plasma optical emission spectrometry (ICP-OES), Attenuated Total Reflection Fourier transform infrared spectroscopy (ATR-FTIR), X-ray diffraction (XRD), and micro-Computed Tomography (μCT). Results showed that femur from the lead-exposed rats had higher carbonate content in bone mineral and (Ca(2+)+Mg(2+)+ Na(+))/P ratio values, although no variations were observed in crystal maturity and crystallite size. From morphological analyses, lead exposure rats showed a decreased in trabecular bone surface and distribution while trabecular thickness and cortical area increased. These overall effects indicate a similar mechanism of bone maturation normally associated to age-related processes. These responses are correlated with the adverse actions induced by lead on the processes regulating bone turnover mechanism. This information may explain the osteoporosis diseases associated to lead intoxication as well as the risk of fracture observed in populations exposed to this toxicant. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. SEX DETERMINATION OF FEMUR: A MORPHOMETRIC ANALYSIS IN THE NORTH INDIAN POPULATION

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    Aprajita Sikka

    2016-07-01

    Full Text Available Bones are an important tool for establishing the biological profile of an individual. In the absence of skull and pelvis, long bones can play a major role in determining the sex. Femur is the longest and strongest bone of the body and resists environmental effects and hence becomes important in medico-legal investigations. AIMS To determine the sex of 180 femora and to set up baseline parameters for the North Indian population with the help of demarcating and limiting values. MATERIALS AND METHODS Seven parameters were studied in 180 femora to determine their sex. Mean and standard deviation were calculated. They were analysed using student ‘t’ test, Hotelling T2 square test for multivariate analysis and discriminant function analysis. Also, demarcating and limiting values were calculated for each parameter. RESULTS The difference between males and females for all parameters was highly significant. Males showed higher values as compared to females. By multivariate analysis also, p value was less than 0.001. We could correctly classify 90% bones using discriminant function analysis. CONCLUSION Femur exhibits significant sexual dimorphism. Different populations require their own standards of sex determination. The accuracy of classification increases with increase in number of parameters

  3. Computational study of Wolff's law with trabecular architecture in the human proximal femur using topology optimization.

    Science.gov (United States)

    Jang, In Gwun; Kim, Il Yong

    2008-08-07

    In the field of bone adaptation, it is believed that the morphology of bone is affected by its mechanical loads, and bone has self-optimizing capability; this phenomenon is well known as Wolff's law of the transformation of bone. In this paper, we simulated trabecular bone adaptation in the human proximal femur using topology optimization and quantitatively investigated the validity of Wolff's law. Topology optimization iteratively distributes material in a design domain producing optimal layout or configuration, and it has been widely and successfully used in many engineering fields. We used a two-dimensional micro-FE model with 50 microm pixel resolution to represent the full trabecular architecture in the proximal femur, and performed topology optimization to study the trabecular morphological changes under three loading cases in daily activities. The simulation results were compared to the actual trabecular architecture in previous experimental studies. We discovered that there are strong similarities in trabecular patterns between the computational results and observed data in the literature. The results showed that the strain energy distribution of the trabecular architecture became more uniform during the optimization; from the viewpoint of structural topology optimization, this bone morphology may be considered as an optimal structure. We also showed that the non-orthogonal intersections were constructed to support daily activity loadings in the sense of optimization, as opposed to Wolff's drawing.

  4. Optimal Design Strategies of Femur Tumor Hyperthermia Based on Finite Element Analysis of Temperature Field

    Institute of Scientific and Technical Information of China (English)

    Monan Wang∗; Lei Sun

    2015-01-01

    A 3D femoral model was built to obtain the three⁃dimensional temperature distribution of femur and its surrounding tissues and provide references for clinical applications. According to the relationship between gray⁃value and material properties, the model was assigned with various materials to make sure that it is more similar to the real femur in geometry and physical properties. 3D temperature distribution is obtained by using finite element analysis software ANSYS 11�0 on the basis of heat conduction theory, Laplace equation, Pennes bio⁃heat transfer equation, thermo physical parameters of bone tissues, the boundary condition, and initial conditions. Taken the asymmetry of the 3D distribution of temperature into account, it is necessary to adopt the heating method with multiple heat sources. This method can ensure that the temperature fields match well with the tumor tissues and kill the tumor cells efficiently under the condition of protecting the normal tissues from damage. The analysis results supply important guidance for determining the needle position and the needle number and controlling the intensity of heating.

  5. Prostaglandin release from rat femurs after implantation of hydroxylapatite and aluminium oxide ceramics.

    Science.gov (United States)

    Wittenberg, J M; Wittenberg, R H; Osborn, J F

    1995-12-01

    The bony reaction after implantation of uncemented ceramics is of special interest. Therefore porous and dense hydroxylapatite and aluminium oxide ceramics were implanted in rat femurs. One group received no surgical manipulation and another with a sham procedure where no ceramics were implanted served as controls. After 6 and 10 days the rat femurs were harvested and the release of PGE2 and 6-keto-PGF1 alpha was measured with specific radioimmunoassays. Decrease in the release of PGE2 from day 6 to day 10 was present in all three implants. In contrast, 6-keto-PGF1 alpha increased from day 6 to day 10. Comparing the ceramic types an increase in 6-keto-PGF1 alpha release was seen in the porous hydroxylapatite group. These prostaglandin (PG) release patterns after ceramic implantation are similar to those of fracture healing, but aluminium oxide seems to be inert, while hydroxylapatite, especially the porous type, stimulates 6-keto-PGF1 alpha release.

  6. Nonunion with Breakage of Gamma Nail and Subsequent Fracture in the Ipsilateral Femur

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    Takahiro Niikura

    2013-01-01

    Full Text Available We describe a rare case with breakage of gamma nail accompanied by nonunion of the original fracture and a subsequent new fracture in the ipsilateral femur. A 73-year-old woman suffered a subtrochanteric fracture of the femur, and the fracture was fixed with gamma nail at a previous hospital. However, fracture reduction was not adequately achieved and a large gap remained between the fracture fragments. The fracture demonstrated atrophic nonunion 10 months after surgery, and autologous bone grafting was performed at the same hospital. Two months after the second surgery, a breakage of the nail at the distal screw hole was observed. Twenty-six months after the second surgery, the patient fell and a fracture occurred at the level of the nail breakage. The atrophic nonunion site and fresh fracture site were very close thus demonstrating a segmental fracture. We exchanged the original gamma nail with a long gamma nail and performed autologous bone grafting at the nonunion site. Both the fresh fracture site and the nonunion site obtained bony union. This tragic chain of events was caused by inappropriate initial treatment and replacing the nail to a longer nail and autologous bone grafting were effective as salvage surgery.

  7. Study on animals‘ femur blood flow alteration under inadequate decompression with 133Xe isotope washout method

    Institute of Scientific and Technical Information of China (English)

    YuShao-Ning; TiaoWu-Xun; 等

    1998-01-01

    Animals' regional femur blood(F) alteration was studied under an inadequate decompression by using the inhaled isotope 133Xe washout method.Results showed that the average F on left and right side of minipigs' femur decreased from 15.4±1.8 and 16.9±2.0mg/(100g.min)(before exposure)to 10±1.8and 11.1±1.6mg(100mg.min)(after expposure for 1.5h under the pressure of 0.5 MPa and then decompression to normal with the rate of 0.03-0.04MPa/min)respectively;the blood flow of hematopoietic marrow tissues(f1) on both sides also decreased from 19.3±2.0 and 22.1±1.9ml(100mg.min)to 13.9±1.4 and 13.8±1.0ml(100mg.min).The exact same alteration also happened in the experiment on New Zealand rabbits.It indicates that inadequate decompression in hyperbaric exposure can give rise to decrease animals' one blood flow and insufficient bone blood supply serves as one of the reasons for causing decompressive osteonecrosis.

  8. Outcomes of Four Different Surgical Techniques in the Treatment of Geriatric Intertrochanteric Femur Fractures

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    Altuğ Duramaz

    2014-12-01

    Full Text Available Aim: The aim of this study was to evaluate the suicide and intoxication cases between April 2011 and April 2013. Methods: One hundred eighty-two patients operated due to intertrochanteric femur fracture in our clinic were divided into four groups: hemiarthroplasty (HA, proximal femoral nail (PFN, sliding hip screw (SHC, and external fixator (EF groups. Time to surgery, comorbidities, anesthesia techniques, postoperative ambulation time, mortality rates and daily activity levels were compared. The patients were evaluated via outpatient follow-up and telephone interview. The Barthel index of activities of daily living was used for evaluation. Results: Patient distribution was: HA: 17 patients, PFN: 26 patients, SHC: 71 patients, and EF: 68 patients. The gender distribution (F/M and the mean age were: HA: 11/6, 83.4 years, PFN: 18/8, 81.2 years, SHC: 48/23, 82.1 years, and EF: 44/24, 84.5 years. There was no statistically significant difference between the groups in gender, comorbidities, anesthesia techniques, mean follow-up period, and Barthel index scores. In HA group, walking with double support duration was shorter (p=0.028. Conclusion: Elderly intertrochanteric femur fractures should be operated as soon as possible in order to prevent eventual complications preferably by regional anesthesia and internal fixation.

  9. Changes in bone mineral density of the acetabulum and proximal femur after total hip resurfacing arthroplasty.

    Science.gov (United States)

    Huang, Qiang; Shen, Bin; Yang, Jing; Zhou, Zong-ke; Kang, Peng-de; Pei, Fu-xing

    2013-12-01

    Our aim was to investigate the changes in bone mineral density (BMD) of acetabulum and proximal femur after total hip resurfacing arthroplasty. A comparative study was carried out on 51 hips in 48 patients. Group A consisted of 25 patients (26 hips) who had undergone total hip resurfacing and group B consisted of 23 patients (25 hips) who had had large-diameter metal-on-metal total hip arthroplasty (THA). BMDs around the acetabulum and proximal femur were measured using dual-energy x-ray absorptiometry (DEXA) at 2 weeks, 6 months, 1 year and annually thereafter during the 3 years after surgery. At final follow-up, the acetabular net mean BMD decreased by 11% in group A and 10% in group B with no differences between two groups (P = .35). For the femoral side, in Gruen zone 1, the mean BMD increased by 4% in group A, whereas it decreased by 11% in group B (P = .029). In Gruen zone 7, the mean BMD increased by 8% at the final follow-up in group A, whereas it decreased by 13% in group B (P = .02). In both groups the mean BMD increased by 3% in Gruen zones 3, 4, 5, and 6. Stress-related bone loss of the acetabulum was comparable for MOM THA and resurfacing devices, but proximal femoral bone density increased in the resurfacing group and decreased in the THA group.

  10. The Tribology of Explanted Hip Resurfacings Following Early Fracture of the Femur

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    James K. Lord

    2015-10-01

    Full Text Available A recognized issue related to metal-on-metal hip resurfacings is early fracture of the femur. Most theories regarding the cause of fracture relate to clinical factors but an engineering analysis of failed hip resurfacings has not previously been reported. The objective of this work was to determine the wear volumes and surface roughness values of a cohort of retrieved hip resurfacings which were removed due to early femoral fracture, infection and avascular necrosis (AVN. Nine resurfacing femoral heads were obtained following early fracture of the femur, a further five were retrieved due to infection and AVN. All fourteen were measured for volumetric wear using a co-ordinate measuring machine. Wear rates were then calculated and regions of the articulating surface were divided into “worn” and “unworn”. Roughness values in these regions were measured using a non-contacting profilometer. The mean time to fracture was 3.7 months compared with 44.4 months for retrieval due to infection and AVN. Average wear rates in the early fracture heads were 64 times greater than those in the infection and AVN retrievals. Given the high wear rates of the early fracture components, such wear may be linked to an increased risk of femoral neck fracture.

  11. The Tribology of Explanted Hip Resurfacings Following Early Fracture of the Femur.

    Science.gov (United States)

    Lord, James K; Langton, David J; Nargol, Antoni V F; Meek, R M Dominic; Joyce, Thomas J

    2015-10-15

    A recognized issue related to metal-on-metal hip resurfacings is early fracture of the femur. Most theories regarding the cause of fracture relate to clinical factors but an engineering analysis of failed hip resurfacings has not previously been reported. The objective of this work was to determine the wear volumes and surface roughness values of a cohort of retrieved hip resurfacings which were removed due to early femoral fracture, infection and avascular necrosis (AVN). Nine resurfacing femoral heads were obtained following early fracture of the femur, a further five were retrieved due to infection and AVN. All fourteen were measured for volumetric wear using a co-ordinate measuring machine. Wear rates were then calculated and regions of the articulating surface were divided into "worn" and "unworn". Roughness values in these regions were measured using a non-contacting profilometer. The mean time to fracture was 3.7 months compared with 44.4 months for retrieval due to infection and AVN. Average wear rates in the early fracture heads were 64 times greater than those in the infection and AVN retrievals. Given the high wear rates of the early fracture components, such wear may be linked to an increased risk of femoral neck fracture.

  12. GROWTH CHANGES OF THE FEMUR AND TIBIA AFTER FRACTURES IN CHILDREN

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    Valery V. Timofeev

    2017-03-01

    Full Text Available Introduction. In contrast to adults, the reparative process in children with fractures has one essential feature: the consolidation of bones tissue runs parallel to further growth and bone formation. The aim of the study. To determine the frequency of growth changes of different segments of the lower extremities in children, to determine the association of these types of fractures with age and/or method of treatment; to clarify the indications for orthopedic correction or surgical treatment of these deformities in long-term perspective. Material and methods. Between 2001 and 2014, 306 children with multiple fractures of the lower limbs were treated in the Regional Clinical Emergency Hospital, Barnaul. Fifty six with femoral and tibial fractures of 306 children were re-evaluated in 3-10 years for the long-term results of treatment. Results and discussion. In the long-term follow-up period, the measuring of the contralateral lower limb segments (tibia and femur showed that 27 (44.3% children had marked differences in their length. Three of them had shortening of limb segment and 24 children had lengthening shortening of limb segment. Changes in the growth rate were observed in fractures of the femur in 22 cases and in fractures of the tibia in 5 cases. Conclusion. The frequency of limb segment elongation after surgical and conservative treatment was approximately the same.

  13. Evaluation of Decalcification Techniques for Rat Femurs Using HE and Immunohistochemical Staining

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    Haixia Liu

    2017-01-01

    Full Text Available Aim. In routine histopathology, decalcification is an essential step for mineralized tissues. The purpose of this study is to evaluate the effects of different decalcification solutions on the morphological and antigenicity preservation in Sprague Dawley (SD rat femurs. Materials and Methods. Four different decalcification solutions were employed to remove the mineral substances from rat femurs, including 10% neutral buffered EDTA, 3% nitric acid, 5% nitric acid, and 8% hydrochloric acid/formic acid. Shaking and low temperature were used to process the samples. The stainings of hematoxylin-eosin (HE and immunohistochemical (IHC were employed to evaluate the bone morphology and antigenicity. Key Findings. Different decalcification solutions may affect the quality of morphology and the staining of paraffin-embedded sections in pathological examinations. Among four decalcifying solutions, 3% nitric acid is the best decalcifying agent for HE staining. 10% neutral buffered EDTA and 5% nitric acid are the preferred decalcifying agents for IHC staining. Significance. The current study investigated the effects of different decalcifying agents on the preservation of the bone structure and antigenicity, which will help to develop suitable protocols for the analyses of the bony tissue.

  14. Radiographic study on the anatomical characteristics of the proximal femur in Brazilian adults

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    Tércio Henrique Soares de Farias

    2015-02-01

    Full Text Available OBJECTIVE: To ascertain the geometry of the femur in the Brazilian population by means of a radiographic study and to correlate the values with regard to sex and right/left side.METHODS: Five hundred anteroposterior radiographs of the pelvis of skeletally mature patients (250 of each sex who did not present any osteoarthrosis, fractures or tumoral or infectious lesions were analyzed. The length and width of the femoral neck, length of the femoral axis, neck-shaft angle and femoral offset were measured.RESULTS: The following means were observed: 36.54 mm for the length of the femoral neck; 37.48 mm for the width of the femoral neck; 108.42 mm for the length of the femoral axis; 130.47° for the neck-shaft angle; and 44.4 mm for the femoral offset.CONCLUSION: The mean values for the main measurements on the proximal femur in Brazilians differed from those of previous studies. It could also be shown that there was a statistically significant mean difference between men and women for all the variables, both on the left and on the right side, and that the men had greater means than the women.

  15. Neck of femur fracture fixation in a bilateral amputee: an uncommon condition requiring an improvised fracture table positioning technique.

    Science.gov (United States)

    Berg, Andrew James; Bhatia, Chandra

    2014-02-21

    While neck of femur fractures are common it is rare to see this injury in a bilateral leg amputee. Special consideration needs to be given to the management of these patients. We report the case of a 58-year-old man with bilateral leg amputation who presented to the emergency department with left hip pain following a fall. A fracture of the left neck of femur with extension into the femoral shaft was diagnosed. Internal fixation was planned with a dynamic hip screw. Standard fracture table setup, which allows for traction of the fractured limb and positioning of the contralateral limb such that anteroposterior and lateral X-rays can be obtained, was not possible in this case due to the amputations. We highlight considerations that need to be made in positioning a bilateral amputee for neck of femur fracture fixation and also highlight an improvised technique that can be utilised by other surgeons.

  16. Uso de imagens do LISS-3/Resourcesat-1 e do OLI/Landsat-8 no estudo espacial da queda do nível de água no lago de Furnas no ano de 2012

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    Gabriel Thomé Brochado

    2014-10-01

    Full Text Available O presente trabalho teve como objetivo analisar, por meio de imagens de diferentes sensores e técnicas de geoprocessamento, o efeito da queda do nível de água que ocorreu no Lago de Furnas no ano de 2012. Esta análise foi feita com base nas imagens satélites em três distintos anos: antes do evento (imagens de 2010, durante o evento (imagens de 2012 e depois do evento (imagens do ano de 2013. Para realizar o mapeamento do nível de água nos anos de 2010 e 2012 foram utilizadas imagens do LISS3/Resourcesat-1 e para o ano de 2013 imagens do OLI/Landsat-8, todas processadas e interpretadas em ambiente SIG. O produto final apresenta quatro classes: i superfície de água permanente nos três anos, ii superfície seca permanente nos três anos, iii superfícies de água recuperada e iv não recuperada até ao último ano (2013. A metodologia consistiu de cinco etapas: preparo, fatiamento, álgebra de mapas, edição matricial e cálculo de áreas. O mapa da redução do nível de água do Lago foi gerado a partir de uma operação matricial algébrica entre as máscaras de superfície de água extraídas das bandas do infravermelho próximo, cujo resultado foi editado manualmente para corrigir erros de classificação. Para validar o mapa foram usadas fotografias veiculadas pela imprensa local, durante o evento de redução de nível de água. Os resultados desta pesquisa permitiram concluir que esta metodologia é fácil de ser reproduzida e pode ser utilizada em outras regiões.

  17. [Treatment of fractures of the distal femur on total knee arthroplasty].

    Science.gov (United States)

    Hernigou, P; Poignard, A; Manicom, O; Chabane-Sari, M A

    2006-04-01

    Fractures of the distal femur near a total knee arthroplasty are usually observed in patients aged over 70 years victims of low-energy trauma. The rate of complications is high: in the literature 25-75 %, even when treated by experienced surgeons. The purpose of this study was to detail therapeutic modalities used for the treatment of these fractures with their advantages and disadvantages and to determine the morbidity of complications which do occur. Twenty distal fracture of the femur were treated between 1990 and 2000 in twenty patients who had a total knee arthroplasty. Mean patient age at surgery was 72 years (range 69-77). The fracture was a short oblique fracture in four, transversal in five, long and spiral in four and comminuted in the others. In four fractures, the preoperative radiographic analysis suggested concomitant loosening. Therapeutic modalities included suspension traction for two, femorotibial external fixation for two. Retrograde nailing was possible in two patients. Fixation with a screw plate or a blade plate was used for nine fractures. The prosthesis was revised systematically if loosening was observed. This was done in three cases with preservation of the tibial piece and in two cases, changing the complete prosthesis, using a long femoral stem in all. Mean follow-up was two to ten years. Immediate weight bearing was possible for four of the five patients for whom only the femoral piece was changed with a long stem. For the others, weight bearing was deferred until fracture healing was obtained after a mean five months (range 4-42). Bone healing required one, or two, revisions in three patients. Three patients died within one year of their fracture of the distal femur. There were no cases of infection or late healing. At last follow-up, the knee and function score regressed after treatment of the fracture. The two scores dropped 20 points compared with the pre-operative score (78 +/- 15 to 56 +/- 19 for the knee score and 72 +/- 16 to 54

  18. QCT of the proximal femur--which parameters should be measured to discriminate hip fracture?

    Science.gov (United States)

    Museyko, O; Bousson, V; Adams, J; Laredo, J -D; Engelke, K

    2016-03-01

    For quantitative computed tomography (QCT), most relevant variables to discriminate hip fractures were determined. A multivariate analysis showed that trabecular bone mineral density (BMD) of the trochanter with "cortical" thickness of the neck provided better fracture discrimination than total hip integral BMD. A slice-by-slice analysis of the neck or the inclusion of strength-based parameters did not improve fracture discrimination. For QCT of the proximal femur, a large variety of analysis parameters describing bone mineral density, geometry, or strength has been considered. However, in each given study, generally just a small subset was used. The aim of this study was to start with a comprehensive set and then select a best subset of QCT parameters for discrimination of subjects with and without acute osteoporotic hip fractures. The analysis was performed using the population of the European Femur Fracture (EFFECT) study (Bousson et al. J Bone Min Res: Off J Am Soc Bone Min Res 26:881-893, 2011). Fifty-six female control subjects (age 73.2 ± 9.3 years) were compared with 46 female patients (age 80.9 ± 11.1 years) with acute hip fractures. The QCT analysis software MIAF-Femur was used to virtually dissect the proximal femur and analyze more than 1000 parameters, predominantly in the femoral neck. A multivariate best-subset analysis was used to extract the parameters best discriminating hip fractures. All results were adjusted for age, height, and weight differences between the two groups. For the discrimination of all proximal hip fractures as well as for cervical fractures alone, the measurement of neck parameters suffices (area under the curve (AUC) = 0.84). Parameters characterizing bone strength are discriminators of hip fractures; however, in multivariate models, only "cortical" cross-sectional area in the neck center remained as a significant contributor. The combination of one BMD parameter, trabecular BMD of the trochanter, and one geometry

  19. Sensitivity and specificity of CT- and MRI-scanning in evaluation of occult fracture of the proximal femur

    DEFF Research Database (Denmark)

    Haubro, M; Stougaard, C; Torfing, T

    2015-01-01

    OBJECTIVE: To estimate sensitivity and specificity of CT and MRI examinations in patients with fractures of the proximal femur. To determine the interobserver agreement of the modalities among a senior consulting radiologist, a resident in radiology and a resident in orthopaedics surgery. MATERIALS...... and a resident in orthopaedic surgery. Sensitivity and specificity were estimated with MRI as the golden standard. Kappa value was used to assess level of agreement in both MRI and CT finding. RESULTS: 15 fractures of the proximal femur were found (7 intertrochanteric-, 3 femoral neck and 5 fractures...

  20. Influence of Physical Exercise and Food Restriction on the Biomechanical Properties of the Femur of Ageing Male Rats

    DEFF Research Database (Denmark)

    Thomsen, Jesper Skovhus; Skalicky, Monika; Viidik, Andrus

    2008-01-01

    the body weights and fat-free mass increased from BL to SE group, the occiput-sacrum length did not increase and the length of the femur increased marginally. These lengths were slightly retarded in RW and PW groups compared to the SE group. The strength of the distal femoral metaphysis decreased from BL...... to SE group. This decrease was counteracted by physical exercise (RW and TM groups) as well as by food restriction (PW group). In contrast, the strength of the femoral mid-diaphysis did not differ between BL and SE groups. CONCLUSIONS: The distal metaphysis in the male rat femur is more prone...

  1. Suprakondiler femur kırığı ile birlikte olan morbid obez hastada anestezi yönetimi

    OpenAIRE

    2009-01-01

    To our literature search, supracondylar femur fracture is not a rare circumstance with morbid obesity. We report a case of closed reduction and internal fixation for a supracondylar femur fracture of a 46-year-old, 168 kg, 172 cm tall [body mass index-(BMI) > 55 kg/m ] morbid obese man. The patient was premedicated with diazepam 10 mg orally and was brought to the operating room on a transport stretcher and taken onto conventional operating tables hardly that had been placed side by side. Sin...

  2. SHORT TERM RESULTS OF MUSCLE PEDICLE BONE GRAFT (MPBG IN FRACTURE NECK FEMUR: A CASE SERIES OF 7 CASES

    Directory of Open Access Journals (Sweden)

    Sarabjeet

    2016-03-01

    Full Text Available INTRODUCTION Neglected, untreated and delayed neck femur fractures are commonly encountered fractures and the treatment dilemma arises specially when the patient is physiologically young and osteosynthesis is the preferred option. Past literature creates confusion as the various head salvage surgeries like valgus subtrochanteric osteotomy, non-vascularised fibular bone grafting, muscle pedicle bone grafting (Tensor fascia lata (TFL and Quadratus femoris graft and vascularised bone grafting do not have clear lines of indications. We present a series of fracture neck femur cases, each with delayed presentation beyond the vascular emergency period, which were treated with osteosynthesis with MPBG using tensor fascia lata muscle pedicle graft.

  3. Determination of the Whiteside line on femur surface models by fitting high-order polynomial functions to cross-section profiles of the intercondylar fossa.

    Science.gov (United States)

    Cerveri, Pietro; Marchente, Mario; Manzotti, Alfonso; Confalonieri, Norberto

    2011-01-01

    Innovative methods for morphological and functional analysis of bones have become a primary objective in the development of planning systems for total knee replacement (TKR). These methods involve the interactive identification of clinical landmarks (reference points, distances, angles, and functional axes of movement) and the determination of the optimal implant size and positioning. Among the functional axes used to estimate the correct alignment of the femoral component, the Whiteside line, namely, the anterior-posterior (AP) direction, is one of the most common. In this paper, we present a computational framework that allows automatic identification of the Whiteside line. The approach is based on geometric analysis of the saddle shape of the intercondylar fossa to extract the principal line in the AP direction. A plane parallel to the frontal plane is moved in the AP direction to obtain the 2D profiles of the intercondylar fossa. Each profile is fitted to a fifth-order polynomial curve and its maximum curvature point computed. The point set collected across all the profiles is then processed to compute the principal direction. The 2D profile-fitting and 3D line-fitting residual errors were analyzed to study the relationship between the intercondylar fossa aspect and the nominal saddle surface. The method was validated using femur specimens from elderly subjects reconstructed from CT scans. The repeatability of the method was evaluated across five different femur surface resolutions. For comparison, three expert orthopaedic surgeons identified, by virtual palpation, the Whiteside line on the same 3D femur models. The repeatability (median angular error) of the Whiteside lines computed by the automated method and by manual virtual palpation, was approximately 1.0° and 3.5°, respectively. The angular skew error between the two axes, measured on the axial plane, averaged approximately 4.00° (SD: 2.64°) with no statistical difference. The automated method

  4. Time domain optical coherence tomography investigation of bone matrix interface in rat femurs

    Science.gov (United States)

    Rusu, Laura-Cristina; Negruá¹±iu, Meda-Lavinia; Sinescu, Cosmin; Hoinoiu, Bogdan; Topala, Florin-Ionel; Duma, Virgil-Florin; Rominu, Mihai; Podoleanu, Adrian G.

    2013-08-01

    The materials used to fabricate scaffolds for tissue engineering are derived from synthetic polymers, mainly from the polyester family, or from natural materials (e.g., collagen and chitosan). The mechanical properties and the structural properties of these materials can be tailored by adjusting the molecular weight, the crystalline state, and the ratio of monomers in the copolymers. Quality control and adjustment of the scaffold manufacturing process are essential to achieve high standard scaffolds. Most scaffolds are made from highly crystalline polymers, which inevitably result in their opaque appearance. Their 3-D opaque structure prevents the observation of internal uneven surface structures of the scaffolds under normal optical instruments, such as the traditional light microscope. The inability to easily monitor the inner structure of scaffolds as well as the interface with the old bone poses a major challenge for tissue engineering: it impedes the precise control and adjustment of the parameters that affect the cell growth in response to various mimicked culture conditions. The aim of this paper is to investigate the interface between the femur rat bone and the new bone that is obtained using a method of tissue engineering that is based on different artificial matrixes inserted in previously artificially induced defects. For this study, 15 rats were used in conformity with ethical procedures. In all the femurs a round defect was induced by drilling with a 1 mm spherical Co-Cr surgical drill. The matrixes used were Bioss and 4bone. These materials were inserted into the induced defects. The femurs were investigated at 1 week, 1 month, 2 month and three month after the surgical procedures. The interfaces were examined using Time Domain (TD) Optical Coherence Tomography (OCT) combined with Confocal Microscopy (CM). The optical configuration uses two single mode directional couplers with a superluminiscent diode as the source centered at 1300 nm. The scanning

  5. Development and testing of texture discriminators for the analysis of trabecular bone in proximal femur radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Huber, M. B.; Carballido-Gamio, J.; Fritscher, K.; Schubert, R.; Haenni, M.; Hengg, C.; Majumdar, S.; Link, T. M. [Department of Radiology and Biomedical Imaging, University of California, 400 Parnassus Avenue, San Francisco, California 94143 (United States); University of Health Sciences, Medical Informatics and Technology, 6060 Hall (Austria); AO Development Institute, 7270 Davos Platz (Switzerland); Medical University Innsbruck, 6020 Innsbruck (Austria); Department of Radiology and Biomedical Imaging, University of California, 400 Parnassus Avenue, San Francisco, California 94143 (United States)

    2009-11-15

    Purpose: Texture analysis of femur radiographs may serve as a potential low cost technique to predict osteoporotic fracture risk and has received considerable attention in the past years. A further application of this technique may be the measurement of the quality of specific bone compartments to provide useful information for treatment of bone fractures. Two challenges of texture analysis are the selection of the best suitable texture measure and reproducible placement of regions of interest (ROIs). The goal of this in vitro study was to automatically place ROIs in radiographs of proximal femur specimens and to calculate correlations between various different texture analysis methods and the femurs' anchorage strength. Methods: Radiographs were obtained from 14 femoral specimens and bone mineral density (BMD) was measured in the femoral neck. Biomechanical testing was performed to assess the anchorage strength in terms of failure load, breakaway torque, and number of cycles. Images were segmented using a framework that is based on the usage of level sets and statistical in-shape models. Five ROIs were automatically placed in the head, upper and lower neck, trochanteric, and shaft compartment in an atlas subject. All other subjects were registered rigidly, affinely, and nonlinearly, and the resulting transformation was used to map the five ROIs onto the individual femora. Results: In each ROI, texture features were extracted using gray level co-occurence matrices (GLCM), third-order GLCM, morphological gradients (MGs), Minkowski dimensions (MDs), Minkowski functionals (MFs), Gaussian Markov random fields, and scaling index method (SIM). Coefficients of determination for each texture feature with parameters of anchorage strength were computed. In a stepwise multiregression analysis, the most predictive parameters were identified in different models. Texture features were highly correlated with anchorage strength estimated by the failure load of up to R{sup 2

  6. Neck of Femur Fracture in a Patient with a Chronic Osteomyelitis of the Ipsilateral Foot

    Directory of Open Access Journals (Sweden)

    Anne-Carolin Döring

    2016-01-01

    Full Text Available This case report describes a successful two-stage treatment in a 75-year-old male with a displaced neck of femur fracture, also suffering from an active chronic osteomyelitis of the ipsilateral calcaneus. In our case, a below-knee amputation was performed first, followed by total hip arthroplasty two weeks later. At 15-month follow-up, full recovery of the prefracture level of activities of daily living without significant impairment was obtained. Only a few cases of total hip arthroplasty in amputees have been published, but the indication for surgery was mainly traumatic or advanced osteoarthritis. Treating patients with this type of comorbidities is challenging; therapeutic dilemmas can be major. The management in cases like these requires a thorough evaluation and a clear surgical and medical treatment plan, preferably conducted by a multidisciplinary orthogeriatric team.

  7. Neck of Femur Fracture in a Patient with a Chronic Osteomyelitis of the Ipsilateral Foot

    Science.gov (United States)

    Döring, Anne-Carolin; Vochteloo, Anne J. H.; van Doorn, Kees; Huis in 't Veld, Rianne M. H. A.

    2016-01-01

    This case report describes a successful two-stage treatment in a 75-year-old male with a displaced neck of femur fracture, also suffering from an active chronic osteomyelitis of the ipsilateral calcaneus. In our case, a below-knee amputation was performed first, followed by total hip arthroplasty two weeks later. At 15-month follow-up, full recovery of the prefracture level of activities of daily living without significant impairment was obtained. Only a few cases of total hip arthroplasty in amputees have been published, but the indication for surgery was mainly traumatic or advanced osteoarthritis. Treating patients with this type of comorbidities is challenging; therapeutic dilemmas can be major. The management in cases like these requires a thorough evaluation and a clear surgical and medical treatment plan, preferably conducted by a multidisciplinary orthogeriatric team. PMID:27843662

  8. Effects of a sliding plate on morphology of the epiphyseal plate in goat distal femur.

    Science.gov (United States)

    Lin, Da-sheng; Lian, Ke-jian; Hong, Jia-yuan; Ding, Zhen-qi; Zhai, Wen-liang

    2012-01-01

    The aim of this study was to observe the effects of a sliding plate on the morphology of the epiphyseal plate in goat distal femur. Eighteen premature female goats were divided randomly into sliding plate, regular plate and control groups. Radiographic analysis and histological staining were performed to evaluate the development of epiphyseal plate at 4 and 8 weeks after surgery. In the sliding plate group, the plate extended accordingly as the epiphyseal plate grows, and the epiphyseal morphology was kept essential normal. However, the phenomenon of the epiphyseal growth retardation and premature closure were very common in the regular plate group. In addition, the sliding plate group exhibited more normal histologic features and Safranin O staining compared to the regular plate group. Our results suggest that the sliding plate can provide reliable internal fixation of epiphyseal fracture without inhibiting epiphyseal growth.

  9. Effects of a Sliding Plate on Morphology of the Epiphyseal Plate in Goat Distal Femur

    Directory of Open Access Journals (Sweden)

    Da-sheng LIN, Ke-jian LIAN, Jia-yuan HONG, Zhen-qi DING, Wen-liang ZHAI

    2012-01-01

    Full Text Available The aim of this study was to observe the effects of a sliding plate on the morphology of the epiphyseal plate in goat distal femur. Eighteen premature female goats were divided randomly into sliding plate, regular plate and control groups. Radiographic analysis and histological staining were performed to evaluate the development of epiphyseal plate at 4 and 8 weeks after surgery. In the sliding plate group, the plate extended accordingly as the epiphyseal plate grows, and the epiphyseal morphology was kept essential normal. However, the phenomenon of the epiphyseal growth retardation and premature closure were very common in the regular plate group. In addition, the sliding plate group exhibited more normal histologic features and Safranin O staining compared to the regular plate group. Our results suggest that the sliding plate can provide reliable internal fixation of epiphyseal fracture without inhibiting epiphyseal growth.

  10. The impact of nicotine on osseointegration. An experimental study in the femur and tibia of rabbits

    DEFF Research Database (Denmark)

    Balatsouka, Dimitra; Gotfredsen, Klaus; Lindh, Christian H

    2005-01-01

    OBJECTIVES: The aim of the present study was to analyze the effect of an enhanced systematic dose of nicotine on osseointegration of titanium implants. MATERIAL AND METHODS: Sixteen female rabbits received either nicotine (n=8) or saline (n=8) administered subcutaneously via mini-osmotic pumps...... for 2 months. The pump delivered 6 mug/kg/min of nicotine for the animals in the test group. Blood was withdrawn and plasma cotinine levels were measured weekly. Thirty-two titanium implants were inserted into the femur and tibia of all rabbits after 4 weeks and after 6 weeks of nicotine...... and the peri-implant BD-i showed no significant differences between the test and the control group after 2 or after 4 weeks. CONCLUSION: Nicotine exposure for a short period of time even in a high dose did not have a significant impact on implant osseointegration in rabbits....

  11. INCIDENCE AND CHARACTERIZATION OF ELDERLY IN THE ORTHOPEDIC CLINIC FOR FEMUR FRACTURE, CACERES MT

    Directory of Open Access Journals (Sweden)

    Andréia Costa Ferreira

    2013-05-01

    Full Text Available Introduction:The elderly population is growing gradually in recent years, it increases theincidence of elderly people at risk of falls and hip fractures develop.Objective:To identifythe incidence and characterize elderly patients hospitalized with hip fractures in theOrthopedic Clinic of the Hospital Regional Dr º Antonio Cáceres sources.Methodology:Thisis an epidemiological, descriptive, quantitative and retrospective data collection documentbasis. The study population comprised 105.Results:It was found that the fracture of thefemur showed predominance in females, comprising 40.90% of the cases and the right lowerlimb most affected. As for location, the trochanteric fractures showed 39.04%, followed byfractures of the femoral shaftwith 27.61% of the cases. The treatment applied in 62.85% ofpatients went to surgery.Conclusion:It is concluded that the femur fracture may preclude theelderly in their daily activities.

  12. Expandable self-locking nail in the management of closed diaphyseal fractures of femur and tibia

    Directory of Open Access Journals (Sweden)

    Kapoor Sudhir

    2009-01-01

    Full Text Available Background : Intramedullary fixation is the treatment of choice for closed diaphyseal fractures of femur and tibia. The axial and rotational stability of conventional interlocking nails depends primarily on locking screws. This method uses increased operating time and increased radiation exposure. An intramedullary implant that can minimize these disadvantages is obviously better. Expandable intramedullary nail does not rely on interlocking screws and achieves axial and rotational stability on hydraulic expansion of the nail. We analyzed 32 simple fractures of shaft of femur and tibia treated by self-locking expandable nail. Materials and Methods: Intramedullary fixation was done by using self-locking, expandable nail in 32 patients of closed diaphyseal fractures of tibia (n = 10 and femur (n = 22. The various modes of injury were road traffic accidents (n = 21, fall from height (n = 8, simple fall (n = 2, and pathological fracture (n = 1. Among femoral diaphyseal fractures 16 were males and six females, average age being 33 yrs (range, 18- 62 yrs. Seventeen patients had AO type A (A1 (n = 3, A2 (n = 4, A3 (n = 10 and 5 patients had AO type B (B1 (n = 2, B2 (n = 2, B3 (n = 1 fractures. Eight patients having tibial diaphyseal fractures were males and two were females; average age was 29.2 (range, 18- 55 yrs. Seven were AO type A (A1 (n = 2, A2 (n = 3, A3 (n = 2 and three were AO type B (B1 (n = 1, B2 (n = 1, and B3 (n = 1. We performed closed (n = 27 or open reduction (n = 5 and internal fixation with expandable nail to stabilize these fractures. The total radiation exposure during surgery was less as no locking screws were required. Early mobilisation and weight-bearing was started depending on fracture personality and evidences of healing. Absence of localised tenderness and pain on walking was considered clinical criteria for union, radiographic criteria of union being continuity in at least in three cortices in both AP and lateral views

  13. Atraumatic intracapsular neck of femur fractures after prolonged bisphosphonate treatment: a new atypical variant?

    Science.gov (United States)

    Khan, Sameer Khalid; Savaridas, Terence; Hemers, Jennifer S.; Maarouf, Zouheir; Orgee, Jane M.; Orr, Michael M.

    2016-01-01

    Summary We present 2 cases of elderly females presenting with atraumatic, near-vertical (Pauwells grade 3), intracapsular neck of femur fractures. Following diagnosis of osteoporosis on DEXA scans, they had received alendronic acid for 7 and 10 years respectively. Routine blood tests and serum estimations of calcium, vitamin-D and thyroid-stimulating hormone, done at admission, were within the normal ranges. These patients were managed with a hemiarthroplasty and a dynamic hip screw (DHS) respectively, following discontinuation of bisphosphonates. We present these 2 cases in light of emerging evidence that associates long-term bisphosphonate use with atypical low energy femoral fractures. Only subtrochanteric/diaphyseal fractures have been reported to date. We present a new variant of atypical femoral neck fractures in metaphyseal bone related to prolonged bisphosphonate therapy. PMID:27252743

  14. PATHOLOGICAL SUB TROCHANTERIC FRACTURE OF FEMUR FOLLOWING PELVIC IRRADIATION FOR CA CERVIX: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Shiva Naik

    2014-12-01

    Full Text Available : INTRODUCTION: Subtrochanteric fractures account for approximately 10-30% of all hip fractures, and they affect persons of all ages. Most frequently, these fractures are seen in 2 patient populations, namely older osteopenic patients after a low-energy fall and younger patients involved in high-energy trauma. A newer population of patients experience subtrochanteric fractures after bisphosphonate use. CASE PRESENTATION: A 45year old Indian woman presented at our orthopaedic outpatients department with 4 months history of pain in left hip and a 1 month history of inability to walk. She had pelvic irradiation for carcinoma of cervix 1 year earlier. Pelvic radiograph confirmed sub trochanteric fracture of left femur. CONCLUSION: Patients with hip pain who have been treated with pelvic irradiation should be thoroughly investigated for hip fractures.

  15. A new compression design that increases proximal locking screw bending resistance in femur compression nails.

    Science.gov (United States)

    Karaarslan, Ahmet Adnan; Karakaşli, Ahmet; Karci, Tolga; Aycan, Hakan; Yildirim, Serhat; Sesli, Erhan

    2015-06-01

    The aim is to present our new method of compression, a compression tube instead of conventional compression screw and to investigate the difference of proximal locking screw bending resistance between compression screw application (6 mm wide contact) and compression tube (two contact points with 13 mm gap) application. We formed six groups each consisting of 10 proximal locking screws. On metal cylinder representing lesser trochanter level, we performed 3-point bending tests with compression screw and with compression tube. We determined the yield points of the screws in 3-point bending tests using an axial compression testing machine. We determined the yield point of 5 mm screws as 1963±53 N (mean±SD) with compression screw, and as 2929±140 N with compression tubes. We found 51% more locking screw bending resistance with compression tube than with compression screw (p=0,000). Therefore compression tubes instead of compression screw must be preferred at femur compression nails.

  16. Total femur arthroplasty for revision hip failure in osteogenesis imperfecta: limits of biology

    Directory of Open Access Journals (Sweden)

    Pablo Sanz-Ruiz, PhD, MD

    2017-09-01

    Full Text Available Osteogenesis imperfecta (OI is a rare congenital disease characterized by alterations in bone quality, with susceptibility to fractures, instability, deformities, and osteoarthrosis. Prosthetic surgery in these patients is associated with an abnormally high rate of implant failures. On the other hand, abnormal bone fragility adds to the complexity of revision surgery in such individuals—thus representing a genuine challenge for the orthopaedic surgeon. We present a case of femoral reconstruction in a patient with OI and prosthetic loosening after reconstruction secondary to femoral septic pseudoarthrosis. Intramedullary total femoral reconstruction was carried out after exceeding the biological reconstruction limits. This is the first reported instance of the use of an intramedullary total femur arthroplasty as salvage technique in an OI patient. This technique should be considered when we have exceeded biological limits for femoral fixation.

  17. Ender nailing for supracondylar fracture of the femur after total knee arthroplasty: five case reports.

    Science.gov (United States)

    Hayakawa, Kazue; Nakagawa, Kenji; Ando, Kenichi; Ohashi, Hiroshi

    2003-10-01

    We studied 5 women with supracondylar fractures after total knee arthroplasty (TKA). The mean age at fracture was 67.4 years. Four patients had chronic rheumatoid arthritis, and 1 had osteoarthritis. The range of motion, knee score, femorotibial angle, and component alignment were investigated. Flexion was slightly decreased after Ender nailing, but extension only changed in 1 patient. The knee score decreased, but all patients were ambulatory. The femorotibial angle changed in all patients. Measurement of femoral component alignment showed a postoperative change of angle alpha (1 degrees to 11 degrees ) and angle gamma (0 degrees to 9 degrees ). Union was achieved in all patients. Ender nailing is an acceptable method of treatment for supracondylar fractures of the femur after TKA if the nails can be inserted deeply into the femoral condyles.

  18. DEFORMATIONS OF THE PROXIMAL FEMUR CONSEQUENTLY BENIGN TUMORS IN CHILDREN AND ADOLESCENTS

    Directory of Open Access Journals (Sweden)

    I. E. Shpilevsky

    2010-01-01

    Full Text Available Benign tumors are affecting the proximal part of the femur in 19% of all cases. Their distinctive feature is the relatively late diagnosis, which requiring the necessity, in addition to removing the tumor and bone grafting, to solve the problem of deformations correction. We have discovered the reasons of deformity appearance of the 31 patients aged 3-16 years. The following types of deformation were defined: ductile (12, after pathological fracture (12 and as a result of growth plate dysfunction (7. The correction of deformation, along with the tumour removing was performed at 15 patients: 3 - Oilier disease, 6 - fibrous dysplasia, 4 - bone cysts, 2 - exostotic chondrodysplasia. In 2 cases the correction of deformity was supposed unreasonable by its severity and accompanying pathology, and in 14 - the deformities were considered as permissible, that not required operative adjustment.

  19. Pathologic Fracture of the Femur in Brown Tumor Induced in Parathyroid Carcinoma: A Case Report

    Science.gov (United States)

    Park, Sang-Hyun; Kwon, Yong-Uk; Park, Jun-Ho

    2016-01-01

    Brown tumor refers to a change of skeletones that develops as a complication of hyperparathyroidism. As osteoclast is activated to stimulate reabsorption and fibrosis of bone, it causes a cystic change of the bone. Parathyroid carcinoma is being reported as a tumor that induces primary hyperparathyroidism. It causes excessive secretion of the parathyroid hormone and increases the blood parathyroid hormone and calcium. Bone deformation due to brown tumor is known to be naturally recovered through the treatment for hyperparathyroidism. However, there is no clearly defined treatment for lesions that can induce pathological fractures developing in lower extremities. We experienced a case where brown tumor developed in the proximal femur of a 57-year-old female patient due to parathyroid carcinoma. In this case, spontaneous fracture occurred without any trauma, and it was cured by performing intramedullary nailing fixation and parathyroidectomy. We report the treatment results along with a literature review. PMID:27777921

  20. SAPHO syndrome with a tumour-like bony proliferative lesion in distal femur. A case report.

    Science.gov (United States)

    Watanuki, Munenori; Hatori, Masahito; Kokubun, Shoichi

    2006-01-01

    SAPHO syndrome is a group of bone and joint abnormalities associated with skin lesions. A 29-year-old male presented with severe acne on his trunk and anterior chest wall, right knee and foot pain. Radiographs and magnetic resonance images showed hyperostosis in the sternocostoclavicular region, sclerosis of one-third of the right distal 5th metatarsal bone and bony outgrowth from the medial condyle of the right femur. The histological findings of the biopsy specimen were consistent with-those of old osteomyelitis. All fungal and microbacterial cultures were negative. Pain and swelling of the right knee and foot repeated remission and aggravation. There were no radiological changes of the above-mentioned lesions noted within 4-years follow-up.

  1. One-Piece Zirconia Ceramic versus Titanium Implants in the Jaw and Femur of a Sheep Model: A Pilot Study

    Directory of Open Access Journals (Sweden)

    A. Siddiqi

    2016-01-01

    Full Text Available Reports have documented titanium (Ti hypersensitivity after dental implant treatment. Alternative materials have been suggested including zirconia (Zr ceramics, which have shown predictable osseointegration in animal studies and appear free of immune responses. The aim of the research was to investigate the bone-to-implant contact (BIC of one-piece Zr, compared with one-piece Ti implants, placed in the jaws and femurs of domestic sheep. Ten New Zealand mixed breed sheep were used. A One-piece prototype Ti (control and one Zr (test implant were placed in the mandible, and one of each implant (Ti and Zr was placed into the femoral epicondyle of each animal. The femur implants were submerged and unloaded; the mandibular implants were placed using a one-stage transgingival protocol and were nonsubmerged. After a healing period of 12 weeks, %BIC was measured. The overall survival rate for mandibular and femur implants combined was 87.5%. %BIC was higher for Zr implants versus Ti implants in the femur (85.5%, versus 78.9% (p=0.002. Zirconia implants in the mandible showed comparable %BIC to titanium implants (72.2%, versus 60.3% (p=0.087. High failure rate of both Zr and Ti one-piece implants in the jaw could be attributed to the one-piece design and surface characteristics of the implant that could have influenced osseointegration. Further clinical trials are recommended to evaluate the performance of zirconia implants under loading conditions.

  2. One-Piece Zirconia Ceramic versus Titanium Implants in the Jaw and Femur of a Sheep Model: A Pilot Study

    Science.gov (United States)

    De Silva, R. K.; Zafar, S.

    2016-01-01

    Reports have documented titanium (Ti) hypersensitivity after dental implant treatment. Alternative materials have been suggested including zirconia (Zr) ceramics, which have shown predictable osseointegration in animal studies and appear free of immune responses. The aim of the research was to investigate the bone-to-implant contact (BIC) of one-piece Zr, compared with one-piece Ti implants, placed in the jaws and femurs of domestic sheep. Ten New Zealand mixed breed sheep were used. A One-piece prototype Ti (control) and one Zr (test) implant were placed in the mandible, and one of each implant (Ti and Zr) was placed into the femoral epicondyle of each animal. The femur implants were submerged and unloaded; the mandibular implants were placed using a one-stage transgingival protocol and were nonsubmerged. After a healing period of 12 weeks, %BIC was measured. The overall survival rate for mandibular and femur implants combined was 87.5%. %BIC was higher for Zr implants versus Ti implants in the femur (85.5%, versus 78.9%) (p = 0.002). Zirconia implants in the mandible showed comparable %BIC to titanium implants (72.2%, versus 60.3%) (p = 0.087). High failure rate of both Zr and Ti one-piece implants in the jaw could be attributed to the one-piece design and surface characteristics of the implant that could have influenced osseointegration. Further clinical trials are recommended to evaluate the performance of zirconia implants under loading conditions. PMID:28058261

  3. 2D-3D shape reconstruction of the distal femur from stereo X-Ray imaging using statistical shape models

    DEFF Research Database (Denmark)

    Baka, N.; Kaptein, B. L.; de Bruijne, Marleen

    2011-01-01

    pose estimation of ground truth shapes as well as 3D shape estimation using a SSM of the whole femur, from stereo cadaver X-rays, in vivo biplane fluoroscopy image-pairs, and an in vivo biplane fluoroscopic sequence. Ground truth shapes for all experiments were available in the form of CT segmentations...

  4. Incidence of fractures of the femur, including subtrochanteric, up to 8 years since initiation of oral bisphosphonate therapy

    DEFF Research Database (Denmark)

    Pazianas, M; Abrahamsen, B; Wang, Y;

    2012-01-01

    In a cohort study of users of bisphosphonates, we evaluated the incidence of fragility fractures at all sites on the femur following for up to 8 years of therapy with alendronate or risedronate. We did not find evidence for a reversal of fracture protection with long-term use of bisphosphonates. ...

  5. Bone splint technique and plating application in adolescent high-energy comminuted fracture of distal femur with bone defects

    Institute of Scientific and Technical Information of China (English)

    LIU Hui; DING Zhen-qi; ZHAI Wen-liang; KANG Liang-qi; YAO Xiao-tao

    2008-01-01

    @@ Comminuted fracture of distal femur is a common lower limb injury from traffic accidents, especially from motor accidents. Routine dynamic condylar screw ( DCS ) or 95-degree condylar plate ( CP ) sometimes cannot solve the bone defect in the center of alignment and contralateral diaphysis for the reason of absent screw anchor point, especially for AO C2. 2-2. 3 types.

  6. The 5-year survival following the marginal resection of a primary leiomyosarcoma of the distal femur and a stump fracture.

    Science.gov (United States)

    Plath, J; Gurk, S; Strophal, G; Johnson, M; Jansson, V

    2001-09-01

    In this case, we present a 5-year follow-up of a 3-fault-affected primary leiomyosarcoma of the distal femur (spontaneous fracture treated by osteosynthesis; marginal resection; stump fracture after adequate trauma) with an extended local recurrence but without metastasis.

  7. [Adjusted cupula in the treatment of massive osteonecrosis of the upper part of the femur in adolescent children].

    Science.gov (United States)

    Lefort, G; Bouche-Pillon, M A; Lefebvre, F; Daoud, S

    1989-01-01

    Six important necrosis of the apophysis of the femur were treated by arthroplasty with adjusted cup. This operation always made these hips painless, 5 times, the mobility was greatly improved. This a normal social life was quickly recovered. However, the distant future remains uncertain. With the exception of one immediate failure, one hip had to be reoperated, 8 years after the total arthroplasty.

  8. Bone mineral density of rat femurs after hindlimb unloading and different physical rehabilitation programs

    Directory of Open Access Journals (Sweden)

    Adelton Andrade Barbosa

    2011-08-01

    Full Text Available Bone weakening can occur due to the absence of load on the skeleton or even short periods of decreased physical activity. Therefore, musculoskeletal diseases that involve temporary immobilization by casts, inactivity or tension increases the risk of fractures. Physical activity is the most studied procedure both to prevent damage and to restore bone structure. The present study aimed at evaluating, by bone densitometry on rat femurs, the influence of hindlimb unloading and later running activity on treadmill or free movement. Sixty-four Wistar rats were used, aged 65 days with a mean corporal mass of 316.11g, randomly divided into eight experimental groups: group 1, the suspended control with seven animals under hindlimb unloading regimen for 28 days, then euthanized; groups 2 and 3, the trained suspended comprising of 7 and five animals, respectively, subjected to hindlimb unloading for 28 days, followed by treadmill exercise for 28 days (group 2 or 56 days (group 3, then euthanized; groups 4 and 5, designated free suspended, comprised of 7 animals each under hindlimb unloading regimen for 28 days followed by free activity in cages for 28 days (group 4 or 56 days (group 5, then euthanized; groups 6, 7 and 8, negative controls, each with 8 animals allowed to free activity in cages and euthanized at the ages of 93, 121 and 149 days, respectively. Bone mineral density (BMD of the left femur was analyzed by bone densitometry. Unloading by tail-suspension decreased BMD while treadmill training and free activity in cages promoted its recovery in a similar way and over time.

  9. Stature estimation from the femur and tibia in Black South African sub-adults.

    Science.gov (United States)

    Brits, Desiré M; Bidmos, Mubarak A; Manger, Paul R

    2017-01-01

    Stature estimation can play a role in the positive identification of unknown individuals and as such it is routinely assessed during the examination of adult remains. Unfortunately, this is not a standard procedure when dealing with sub-adult remains due to the general lack of standard procedures for the estimation of sub-adult stature. The aim of this study was therefore to derive regression equations for the estimation of stature in black South African sub-adults. Fifty nine black South African sub-adult males and females, aged 10-17 years, voluntarily participated in the study by undergoing a full body Magnetic Resonance Imaging (MRI) scan. Living stature was measured with a stadiometer and the maximum and diaphyseal lengths of the femur and tibia were measured from the MRI scans using the image processing software OsiriX. Pearson's correlation coefficients and linear least square regression analyses were used to assess the correlations between living stature and the measurements and to generate sub-adult stature estimation equations for males, females and a combined sex sample. Measurements of the femur, tibia and the combined measures thereof showed strong statistically significant positive correlations with living stature, while the obtained regression equations were characterized by low standard error of estimates. The strong correlations and low standard error of estimates are comparable to stature estimation models reported for Black South African adults and therefore these variables can be considered good estimators of sub-adult stature which will contribute valuable information to the biological profile of unidentified sub-adult skeletal remains.

  10. The effects of glucocorticoid on microarchitecture, collagen, mineral and mechanical properties of sheep femur cortical bone.

    Science.gov (United States)

    Ding, Ming; Danielsen, Carl Christian; Overgaard, Søren

    2012-06-01

    In this study, 18 female skeletally mature sheep were randomly allocated into three groups of six each. Group 1 (glucocorticoid-1) received prednisolone treatment (0.60 mg/kg/day, five times weekly) for 7 months. Group 2 (glucocorticoid-2) received the same treatment regime followed by observation of 3 months without treatment. Group 3 was left untreated and served as controls. All sheep received a restricted diet with low calcium and phosphorus. At sacrifice, cortical bone samples from the femur midshaft of each sheep were harvested, micro-CT scanned and subjected to three-point bending and tensile strength testing. Bone collagen and mineral were determined. Cortical porosity was significantly increased in the glucocorticoid-2 compared with the glucocorticoid-1 and control groups. Apparent density was significantly decreased in the glucocorticoid-2 compared with the glucocorticoid-1 group. Collagen content was significantly increased in the glucocorticoid-2 compared with the glucocorticoid-1 and control groups. Bone mineral content did not differ between the groups. Neither the three-point bending mechanical properties nor the tensile mechanical properties differed significantly between the groups, while there was a trend towards decreasing bending mechanical properties in the glucocorticoid-2 group. In conclusion, 7 months of glucocorticoid treatment with malnutrition had a significant impact on the cortical microarchitecture of the sheep femur midshaft. These observed changes occurred 3 months after glucocorticoid cessation, suggesting a delayed effect of glucocorticoid on cortical bone. Thus, changes in cortical bone beyond cancellous bone might further increase fracture risk in patients treated with glucocorticoids. This model might be used as a glucocorticoid-induced osteoporotic model for orthopaedic biomaterial, joint prosthesis and medical device researches.

  11. Biomechanics and structural adaptations of the rat femur after hindlimb suspension and treadmill running

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    M.M. Shimano

    2009-04-01

    Full Text Available We microscopically and mechanically evaluated the femurs of rats subjected to hindlimb unloading (tail suspension followed by treadmill training. Female Wistar rats were randomly divided into five groups containing 12-14 rats: control I (118 days old, control II (139 days old, suspended (tail suspension for 28 days, suspended-released (released for 21 days after 28 days of suspension, and suspended-trained (trained for 21 days after 28 days of suspension. We measured bone resistance by bending-compression mechanical tests of the entire proximal half of the femur and three-point bending tests of diaphyseal cortical bone. We determined bone microstructure by tetracycline labeling of trabecular and cortical bone. We found that tail suspension weakened bone (ultimate load = 86.3 ± 13.5 N, tenacity modulus = 0.027 ± 0.011 MPa·m vs ultimate load = 101.5 ± 10.5 N, tenacity modulus = 0.019 ± 0.006 MPa·m in control I animals. The tenacity modulus for suspended and released animals was 0.023 ± 0.010 MPa·m vs 0.046 ± 0.018 MPa·m for trained animals and 0.035 ± 0.010 MPa·m for control animals. These data indicate that normal activity and training resulted in recovered bone resistance, but suspended-released rats presented femoral head flattening and earlier closure of the growth plate. Microscopically, we found that suspension inhibited new bone subperiosteal and endosteal formation. The bone disuse atrophy secondary to hypoactivity in rats can be reversed by an early regime of exercising, which is more advantageous than ordinary cage activities alone.

  12. The effect of alendronate treatment on cortical thickness of the proximal femur in postmenopausal women.

    Science.gov (United States)

    Mobini, Maryam; Dehghan, Leyla; Yosefi, Gholamali; Mohammadpour, Alireza; Abdi, Rohollah

    2016-01-01

    Bisphosphonates (BPs) are used extensively for managing the osteoporosis. There are some controversies on atypical fractures of femur that associated with increase in cortical thickness (CT) and BPs' use. In this study, the effects of alendronate consumption were studied on femoral CT as a predictor for atypical fracture. Forty nine post-menopausal women aged 50-70 years with osteopenia-osteoporosis who were treated with alendronate 70 mg/week for at least one year were compared to 49 controls for CT in subtrochanteric region of femur by hip dual-energy X-ray absorptiometry (DXA) scans and hip Xray. CT and its ratio were measured at 3.5 and 4.0 cm below the tip of the greater trochanter (GT) and 0.5 cm below lesser trochanter (LT) in DXA and at 9.5 and 10.5 cm of GT and 1 cm of LT in Xray. In this study, 98 women participated whose mean age and age at menopause were 60 (17±5.6) and 49 (40±2.7) years, respectively. Duration of BP consumption in alendronate group was 1.76±1.38 (1-10) years. No difference was seen in the mean of CT and its ratio between the alendronate and control groups in BMD scan or X-ray. The best correlation between two imaging modalities was in cortical ratio in 3.5 cm of GT in BMD scan and 9.5 cm of GT in X-ray. Alendronate treatment did not appear to increase femoral CT throughout the detection limits of BMD scan or X-ray.

  13. Finite element analysis of the femur during stance phase of gait based on musculoskeletal model simulation.

    Science.gov (United States)

    Seo, Jeong-Woo; Kang, Dong-Won; Kim, Ju-Young; Yang, Seung-Tae; Kim, Dae-Hyeok; Choi, Jin-Seung; Tack, Gye-Rae

    2014-01-01

    In this study, the accuracy of the inputs required for finite element analysis, which is mainly used for the biomechanical analysis of bones, was improved. To ensure a muscle force and joint contact force similar to the actual values, a musculoskeletal model that was based on the actual gait experiment was used. Gait data were obtained from a healthy male adult aged 29 who had no history of musculoskeletal disease and walked normally (171 cm height and 72 kg weight), and were used as inputs for the musculoskeletal model simulation to determine the muscle force and joint contact force. Among the phases of gait, which is the most common activity in daily life, the stance phase is the most affected by the load. The results data were extracted from five events in the stance phase: heel contact (ST1), loading response (ST2), early mid-stance (ST2), late mid-stance (ST4), and terminal stance (ST5). The results were used as the inputs for the finite element model that was formed using 1.5mm intervals computed tomography (CT) images and the maximum Von-Mises stress and the maximum Von-Mises strain of the right femur were examined. The maximum stress and strain were lowest at the ST4. The maximum values for the femur occurred in the medial part and then in the lateral part after the mid-stance. In this study, the results of the musculoskeletal model simulation using the inverse-dynamic analysis were utilized to improve the accuracy of the inputs, which affected the finite element analysis results, and the possibility of the bone-specific analysis according to the lapse of time was examined.

  14. Individual-specific multi-scale finite element simulation of cortical bone of human proximal femur

    Energy Technology Data Exchange (ETDEWEB)

    Ascenzi, Maria-Grazia, E-mail: mgascenzi@mednet.ucla.edu [UCLA/Orthopaedic Hospital, Department of Orthopaedic Surgery, Rehabilitation Bldg, Room 22-69, 1000 Veteran Avenue, University of California, Los Angeles, CA 90095 (United States); Kawas, Neal P., E-mail: nealkawas@ucla.edu [UCLA/Orthopaedic Hospital, Department of Orthopaedic Surgery, Rehabilitation Bldg, Room 22-69, 1000 Veteran Avenue, University of California, Los Angeles, CA 90095 (United States); Lutz, Andre, E-mail: andre.lutz@hotmail.de [Institute of Biomechanics and Numerical Mechanics, Leibniz University Hannover, 30167 Hannover (Germany); Kardas, Dieter, E-mail: kardas@ibnm.uni-hannover.de [ContiTech Vibration Control, Jaedekamp 30 None, 30419 Hannover (Germany); Nackenhorst, Udo, E-mail: nackenhorst@ibnm.uni-hannover.de [Institute of Biomechanics and Numerical Mechanics, Leibniz University Hannover, 30167 Hannover (Germany); Keyak, Joyce H., E-mail: jhkeyak@uci.edu [Department of Radiological Sciences, Medical Sciences I, Bldg 811, Room B140, University of California, Irvine, CA 92697-5000 (United States)

    2013-07-01

    We present an innovative method to perform multi-scale finite element analyses of the cortical component of the femur using the individual’s (1) computed tomography scan; and (2) a bone specimen obtained in conjunction with orthopedic surgery. The method enables study of micro-structural characteristics regulating strains and stresses under physiological loading conditions. The analysis of the micro-structural scenarios that cause variation of strain and stress is the first step in understanding the elevated strains and stresses in bone tissue, which are indicative of higher likelihood of micro-crack formation in bone, implicated in consequent remodeling or macroscopic bone fracture. Evidence that micro-structure varies with clinical history and contributes in significant, but poorly understood, ways to bone function, motivates the method’s development, as does need for software tools to investigate relationships between macroscopic loading and micro-structure. Three applications – varying region of interest, bone mineral density, and orientation of collagen type I, illustrate the method. We show, in comparison between physiological loading and simple compression of a patient’s femur, that strains computed at the multi-scale model’s micro-level: (i) differ; and (ii) depend on local collagen-apatite orientation and degree of calcification. Our findings confirm the strain concentration role of osteocyte lacunae, important for mechano-transduction. We hypothesize occurrence of micro-crack formation, leading either to remodeling or macroscopic fracture, when the computed strains exceed the elastic range observed in micro-structural testing.

  15. Biomechanical properties of the mid-shaft femur in middle-aged hypophysectomized rats as assessed by bending test.

    Science.gov (United States)

    Bozzini, Clarisa; Picasso, Emilio O; Champin, Graciela M; Alippi, Rosa María; Bozzini, Carlos E

    2012-10-01

    Both stiffness and strength of bones are thought to be controlled by the "bone mechanostat". Its natural stimuli would be the strains of bone tissue (sensed by osteocytes) that are induced by both gravitational forces (body weight) and contraction of regional muscles. Body weight and muscle mass increase with age. Biomechanical performance of load-bearing bones must adapt to these growth-induced changes. Hypophysectomy in the rat slows the rate of body growth. With time, a great difference in body size is established between a hypophysectomized rat and its age-matched control, which makes it difficult to establish the real effect of pituitary ablation on bone biomechanics. The purpose of the present investigation was to compare mid-shaft femoral mechanical properties between hypophysectomized and weight-matched normal rats, which will show similar sizes and thus will be exposed to similar habitual loads. Two groups of 10 female rats each (H and C) were established. H rats were 12-month-old that had been hypophysectomized 11 months before. C rats were 2.5-month-old normals. Right femur mechanical properties were tested in 3-point bending. Structural (load-bearing capacity and stiffness), geometric (cross-sectional area, cortical sectional area, and moment of inertia), and material (modulus of elasticity and maximum elastic stress) properties were evaluated. The left femur was ashed for calcium content. Comparisons between parameters were performed by the Student's t test. Average body weight, body length, femur weight, femur length, and gastrocnemius weight were not significantly different between H and C rats. Calcium content in ashes was significantly higher in H than in C rats. Cross-sectional area, medullary area, and cross-sectional moment of inertia were higher in C rats, whereas cortical area did not differ between groups. Structural properties (diaphyseal stiffness, elastic limit, and load at fracture) were about four times higher in hypophysectomized rats

  16. PTH(1-34) and zoledronic acid have differing longitudinal effects on juvenile mouse femur strength and morphology.

    Science.gov (United States)

    Bartlow, Christopher M; Oest, Megan E; Mann, Kenneth A; Zimmerman, Nicholas D; Butt, Bilal B; Damron, Timothy A

    2016-09-21

    Treatment of secondary pediatric osteoporosis-particularly that due to chronic diseases, immobilization, and necessary medical treatments-is currently limited by a poor understanding of the long-term efficacy and safety of skeletal metabolism modifying drugs. This study aimed to characterize longitudinal effects of representative anabolic (parathyroid hormone, PTH) and anti-catabolic (zoledronic acid, ZA) drugs on skeletal morphology, mechanical strength, and growth in juvenile mice. BALB/cJ mice aged 4 weeks were given PTH(1-34) or vehicle (control) daily for 8 weeks, or 4 weekly doses of ZA, and evaluated at time points 0-26 weeks after treatment initiation. There were no enduring differences in body length or mass between treatment groups. ZA increased femur size as early as week 0, including increased distal femur bone volume and diaphyseal cross-sectional area, persisting through week 26. PTH treatment only transiently increased bone size, including distal femur volume at weeks 4-12. ZA decreased diaphyseal cortical tissue mineral density (TMD) at 12-26 weeks versus controls; PTH decreased TMD only at 2 weeks (vs. controls). ZA increased bending strength at 0-12 weeks and flexural strength at week 4 (vs. controls), but decreased flexural strength and modulus at week 26. PTH treatment increased bending strength only at 4 weeks, and did not affect flexural strength. Overall, ZA rapidly and persistently increased femur strength and size, but compromised bone material quality long-term. In healthy juvenile mice, limited-duration PTH treatment did not exert a strong anabolic effect, and had no adverse effects on femur strength, morphology, or growth. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

  17. A novel framework for the temporal analysis of bone mineral density in metastatic lesions using CT images of the femur

    Science.gov (United States)

    Knoop, Tom H.; Derikx, Loes C.; Verdonschot, Nico; Slump, Cornelis H.

    2015-03-01

    In the progressive stages of cancer, metastatic lesions in often develop in the femur. The accompanying pain and risk of fracture dramatically affect the quality of life of the patient. Radiotherapy is often administered as palliative treatment to relieve pain and restore the bone around the lesion. It is thought to affect the bone mineralization of the treated region, but the quantitative relation between radiation dose and femur remineralization remains unclear. A new framework for the longitudinal analysis of CT-scans of patients receiving radiotherapy is presented to investigate this relationship. The implemented framework is capable of automatic calibration of Hounsfield Units to calcium equivalent values and the estimation of a prediction interval per scan. Other features of the framework are temporal registration of femurs using elastix, transformation of arbitrary Regions Of Interests (ROI), and extraction of metrics for analysis. Build in Matlab, the modular approach aids easy adaptation to the pertinent questions in the explorative phase of the research. For validation purposes, an in-vitro model consisting of a human cadaver femur with a milled hole in the intertrochanteric region was used, representing a femur with a metastatic lesion. The hole was incrementally stacked with plates of PMMA bone cement with variable radiopaqueness. Using a Kolmogorov-Smirnov (KS) test, changes in density distribution due to an increase of the calcium concentration could be discriminated. In a 21 cm3 ROI, changes in 8% of the volume from 888 ± 57mg • ml-1 to 1000 ± 80mg • ml-1 could be statistically proven using the proposed framework. In conclusion, the newly developed framework proved to be a useful and flexible tool for the analysis of longitudinal CT data.

  18. Prospects of implant with locking plate in fixation of subtrochanteric fracture: experimental demonstration of its potential benefits on synthetic femur model with supportive hierarchical nonlinear hyperelastic finite element analysis

    Directory of Open Access Journals (Sweden)

    Latifi Mohammed

    2012-04-01

    Full Text Available Abstract Background Effective fixation of fracture requires careful selection of a suitable implant to provide stability and durability. Implant with a feature of locking plate (LP has been used widely for treating distal fractures in femur because of its favourable clinical outcome, but its potential in fixing proximal fractures in the subtrochancteric region has yet to be explored. Therefore, this comparative study was undertaken to demonstrate the merits of the LP implant in treating the subtrochancteric fracture by comparing its performance limits against those obtained with the more traditional implants; angle blade plate (ABP and dynamic condylar screw plate (DCSP. Materials and Methods Nine standard composite femurs were acquired, divided into three groups and fixed with LP (n = 3, ABP (n = 3 and DCSP (n = 3. The fracture was modeled by a 20 mm gap created at the subtrochanteric region to experimentally study the biomechanical response of each implant under both static and dynamic axial loading paradigms. To confirm the experimental findings and to understand the critical interactions at the boundaries, the synthetic femur/implant systems were numerically analyzed by constructing hierarchical finite element models with nonlinear hyperelastic properties. The predictions from the analyses were then compared against the experimental measurements to demonstrate the validity of each numeric model, and to characterize the internal load distribution in the femur and load bearing properties of each implant. Results The average measurements indicated that the constructs with ABP, DCPS and LP respectively had overall stiffness values of 70.9, 110.2 and 131.4 N/mm, and exhibited reversible deformations of 12.4, 4.9 and 4.1 mm when the applied dynamic load was 400 N and plastic deformations of 11.3, 2.4 and 1.4 mm when the load was 1000 N. The corresponding peak cyclic loads to failure were 1100, 1167 and 1600 N. The errors

  19. Large Segment Bone Allograft Reconstruction Following Femur Tumors Resection%大段异体骨移植重建股骨肿瘤性缺损

    Institute of Scientific and Technical Information of China (English)

    贾金鹏; 毕文志; 韩纲; 王威; 许猛; 李静东

    2012-01-01

    目的 探讨大段异体骨移植在股骨肿瘤扩大切除后缺损重建中的作用及临床效果.方法 回顾性分析从2005年1月至2010年1月共30例患者.均行股骨肿瘤保肢手术并采用大段异体骨重建肿瘤切除后缺损的患者.结果 22例患者获得随访,8例患者失访.10例患者死于多发转移.12例存活的患者随访时间为20个月至7年,平均随访时间4.2年.所有患者术后X线片显示异体骨位置良好.6例发生延迟愈合或不愈合.其中有5例发生应力性骨折,1例患者发生深部感染.2例患者发生内固定失败.1例患者局部复发.所有患者中未发现明显的排斥反应.结论 大段异体骨移植能够获重建股骨肿瘤后较大的骨缺损,满足了部分股骨肿瘤保肢治疗的需要,是股骨肿瘤保肢治疗中一种可以选择的方法.%Objective Probe into the feasibility of the clinical outcome of large segment bone allograft for reconstruction of the defect after femur tumor resection. Methods During January 2005 to January 2010, 30 patients were carried out limb-spanng surgery due to femur tumors, and large segment bone allograft was used to reconstruction the bone defects after tumor resection. Results 22 patients were followed up; 8 patients were lost of follow-up. 10 patients died of generalized metastases. Patients were followed up from 20 months to 7 years. The mean follow-up was 4. 2 years. There were 6 patients had delayed union or nonunion, 5 patients had stress fractures, 1 patient occurred primary deep infection. Failure of the internal fixation system occurred in 2 patients, lpatient had local recurrences. No evident immune rejection was observed. Conclusions Large segment bone allograft can meet to the present demand in reconstruction of the massive defect following femur tumor resection, and still to be a very useful alternative to prosthesis in limb-sparing surgery of femur tumors.

  20. Ultrasound study of the motion of the residual femur within a trans-femoral socket during daily living activities other than gait.

    Science.gov (United States)

    Convery, P; Murray, K D

    2001-12-01

    This study analyses the residual femur motion of a single amputee within a transfemoral socket during a series of daily living activities. Two simultaneously transmitting, socket mounted transducers were connected to two ultrasound scanners. Displacement measurements of the ultrasound image of the femur were video recorded and measured on "paused" playback. Abduction/adduction and flexion/extension of the residual femur within the socket at any instant during these activities were estimated, knowing the relative positions of the two transducers and the position of the residual femur on the ultrasound image. Consistent motion patterns of the residual femur within the trans-femoral socket were noted throughout each monitored daily living activity of the single amputee studied. Convery and Murray (2000) reported that during level walking, relative to the socket, the residual femur extends 6 degrees and abducts 9 degrees by mid-stance while flexing 6 degrees and adducting 2 degrees by toe-off. Uphill/downhill, turning to the right and stepping up/down altered this reported pattern of femoral motion by approximately 1 degree. During the standing activity from a seated position the femur initially flexed 4 degrees before moving to 7 degrees extension, while simultaneously adducting 6 degrees. During the sitting activity from a standing position the femur moved from 7 degrees extension and 6 degrees adduction to 3 degrees flexion and 1 degree abduction. The activity of single prosthetic support to double support introduced only minor femoral motion whereas during the activity of prosthetic suspension the femur flexed 8 degrees while simultaneously adducting 9 degrees. Additional studies of more amputees are required to validate the motion patterns presented in this investigation.

  1. Evaluation of a short glass fibre-reinforced tube as a model for cat femur for biomechanical testing of orthopaedic implants.

    Science.gov (United States)

    Gibson, T W G; Moens, N M M; Runciman, R J; Holmberg, D L

    2008-01-01

    The biomechanical testing of tubes made of third generation short glass fibre-reinforced (SGFR) material approximating cat femurs was performed in order to determine their suitability as cat femur surrogates for the biomechanical testing of orthopaedic implants. The tubes were tested in compression, three-point bending, notch testing, and screw pullout. Thin walled (B1-tubes) had a 13% lower maximum load to failure, a 19% higher maximum strength and a 13% lower elastic modulus compared to cat femurs tested in compression. B1-tubes maximum load to failure in three-point bending and screw pullout strength were considerably lower compared to cat femurs (29% and 63%, respectively). Notch testing was not performed on B1-tubes due to low bending strength. Thicker walled (B2-tubes) had a 23% higher maximum load to failure, a 10% higher maximum strength and a 21% lower elastic modulus compared to cat femurs tested in compression. The comparison of B2-tubes and cat femurs in three-point bending revealed a 7% increase in maximum load to failure for the B2-tubes. Drilled B2-tubes (notch testing) were weaker with a 30% lower load to failure compared to cat femurs. A screw pullout comparison of B2-tubes and cat femurs revealed a 2% increase in maximum load to failure for the B2-tubes. These tubes were intended to provide a model as a suitable surrogate for cat femurs for testing the bending strength of various orthopaedic constructs involving plates and screws. Testing revealed that third generation SGFR tubes were not suitable for these purposes and emphasizes the need to carefully evaluate the suitability of any model.

  2. Revising Australian Pristomerus (Hymenoptera, Ichneumonidae, Cremastinae): species with a tooth on the hind femur.

    Science.gov (United States)

    Klopfstein, Seraina

    2016-09-15

    The Australian insect fauna is among the least-well studied in the world, and conservative estimates state that 75% of the species still await description. In the more species-rich groups, this percentage might be even larger, which is certainly the case in parasitoid wasps which have received very little attention by taxonomists. The genus Pristomerus of the family Ichneumonidae is distributed worldwide, with most species found in the tropics. Its members attack concealed larvae of small Lepidoptera, and several species are used in biocontrol. Five species have been reported from Australia, all of them endemic, but many more undescribed species are present in various collections.        I here revise Australian Pristomerus, focussing on the species that bear a tooth on the ventral side of the hind femur. Twenty-two species are recorded, 19 of which are described as new: Pristomerus australiensis n. sp., P. bertschmanni n. sp., P. callitrinus n. sp., P. dundeei n. sp., P. flavicephalus n. sp., P. fourecksensis n. sp., P. gracilis n. sp., P. kakaduensis n. sp., P. laetus n. sp., P. luculentus n. sp., P. lunatus n. sp., P. mangiferus n. sp., P. merus n. sp., P. nedkellyi n. sp., P. pellicius n. sp., P. periculosus n. sp., P. stellatus n. sp., P. tenebrosus n. sp., and P. venustus n. sp. A dichotomous key and an online interactive key to the known Australian species with a tooth on the hind femur are provided, including photographs of all the species.        The origin of the considerable number of Australian Pristomerus species remains unclear. They might represent Southern relict elements with affinities to South American taxa, or their ancestors might have immigrated from the Paleotropics in more recent times; this question can only be solved with a dated phylogeny of the genus. However, support for a Palaeotropic origin of at least a good portion of the taxa comes from their current distribution, as the Australian Pristomerus are found to be most

  3. Computed tomographic evaluation of the proximal femur: A predictive classification in displaced femoral neck fracture management

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    Narender Kumar Magu

    2014-01-01

    Full Text Available Background: Femoral neck fracture is truly an enigma due to the high incidence of avascular necrosis and nonunion. Different methods have been described to determine the size of the femoral head fragment, as a small head has been said to be associated with poor outcome and nonunion due to inadequate implant purchase in the proximal fragment. These methods were two dimensional and were affected by radiography techniques, therefore did not determine true head size. Computed tomography (CT is an important option to measure true head size as images can be obtained in three dimensions. Henceforth, we subjected patients to CT scan of hip in cases with displaced fracture neck of femur. The study aims to define the term "small head or inadequate size femoral head" objectively for its prognostic significance. Materials and Methods: 70 cases of displaced femoral neck fractures underwent CT scan preoperatively for proximal femoral geometric measurements of both hips. Dual energy X-ray absorptiometry scan was done in all cases. Patients were treated with either intertrochanteric osteotomy or lag screw osteosynthesis based on the size of the head fragment on plain radiographs. Results: The average femoral head fragment volume was 57 cu cm (range 28.3-84.91 cu cm; standard deviation 14 cu cm. Proximal fragment volume of >43 cu cm was termed adequate size (type I and of ≤43 cu cm as small femoral head (type II. Fractures which united (n = 54 had a relatively large average head size (59 cu cm when compared to fractures that did not (n = 16, which had a small average head size (49 cu cm and this difference was statistically significant. In type I fractures union rate was comparable in both osteotomy and lag screw groups (P > 0.05. Lag screw fixation failed invariably, while osteotomy showed good results in type II fractures (P < 0.05. Conclusion: Computed tomography scan of the proximal femur is advisable for measuring true size of head fragment. An objective

  4. Ekspresi Tartrate-Resistant Acid Phosphatase-5b pada Epifisis Tulang Femur Tikus Ovariektomi yang Mengkonsumsi Calcitriol dan Raloxifene (TARTRATE-RESISTANT ACID PHOSPHATASE-5b EXPRESSION OF EPIPHYSYS DISTALIS FEMUR OVARIECTOMIZED RATS CONSUMING CALCITRIO

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    Hartiningsih .

    2016-03-01

    Full Text Available Tartrate resistant alkaline phosphatase 5b (TRACP5b is secreted by osteoclasts during bonedifferentiation and resorption. The objective of the research was to study TRAP5b expression inovariectomized Wistar rat consuming the combinations of calcitriol and raloxifene supplementation foreight weeks. Twenty five female Wistar rats aged eight weeks were randomly divided into five groups:normal control (NK, ovariectomy control (OVK, ovariectomy+calcitriol supplementation (OVD,ovariectomy+ raloxifene supplementation (OVR, and ovariectomy+calcitriol+ raloxifene supplementation(OVDR. At the end of the treatment, blood samples were taken from plexus orbitalis medialis forestrogen analysis. All rats were euthanized, the uteri were taken and weighed. Left femur was taken forhistopatological examination and immunohistochemistry TRAP5b using monoclonal antibody anti TRAP5bwhich was detected with streptavidin-biotin. The results showed that estrogen levels of the rats in OVKgroup were significantly decreased compared to the rats in NK group, meanwhile estrogen levels in the OVDR rat group were significantly decreased compared to the NK and OVK rat group. Histopathologicalobservation of distal femur epiphysis in group NK showed normal structure, meanwhile, distal femurepiphysis in OVK group was found osteoporosis, with some abnormalities, such as: increased of bonemarrow space, domination of adipocytes in the bone marrow, and decrease of trabecular bone speculum inepiphysis. Histopathological findings of distal femur epiphysis in OVDR group were increased of trabecularbone speculum in epiphysis and the domination of adipocytes in the bone marrow of epiphysis.Immunohistochemistry of distal femur epiphysis in OVDR group revealed increasing tartrate resistantalkaline phosphatase 5b (TRAP5b expression in trabecular bone, which was located in bone marrow spaceand trabecular speculum surface as well. It can be concluded that the combination of calcitriol and

  5. Morphometrical measurements of resected surface of femurs in Chinese knees: correlation to the sizing of current femoral implants.

    Science.gov (United States)

    Ho, Wei-Pin; Cheng, Cheng-Kung; Liau, Jiann-Jong

    2006-01-01

    Morphometrical data were measured in the resected femurs of seventy Chinese patients who underwent total knee arthroplasties. Two measured parameters, the anterior-posterior length of the lateral condyle and the total width of the distal condyle, were compared to the anterior-posterior length and the medial-lateral width of five femoral implants currently used in Taiwan. Three implants (Duracon, NexGen and UKnee) have a larger medial-lateral width than the total width of the resected distal condyle for a given femoral implant anterior-posterior length. These implants tend to overhang the medial-lateral width of resected femurs from Chinese patients. In addition, one femoral implant (Duracon), which has previously been shown to be suitable for use in Caucasian patients, is not suitable in Chinese patients. Our results will allow manufacturers to design femoral implants better suited to Chinese patients.

  6. Posterior periosteal disruption in Salter-Harris Type II fractures of the distal femur: evidence for a hyperextension mechanism.

    Science.gov (United States)

    Kritsaneepaiboon, Supika; Shah, Rajvee; Murray, Martha M; Kleinman, Paul K

    2009-12-01

    Patterns of periosteal disruption are important factors in assessing the mechanism of injury of radiologically evident Salter-Harris (SH) fractures. The purpose of this study is to assess the frequency of posterior periosteal disruption on MRI in radiographically occult or subtle SH type II fractures of the distal femur and to evaluate associated soft-tissue findings that support a hyperextension mechanism of injury. We found that all children in our experience with occult or subtle SH type II fractures of the distal femur have posterior periosteal disruption and other MRI findings to indicate a hyperextension mechanism of injury. Direct indicators of fracture may be inconspicuous, and the presence of posterior periosteal disruption is a clue that should prompt a search for other features of this serious pediatric injury, which may be followed by limb shortening or angular deformity.

  7. Pathologic fracture of the femur due to endometrial adenocarcinoma metastasis in a female pet rabbit (Oryctolagus cuniculi).

    Science.gov (United States)

    Haist, Verena; Hirschfeld, Simon Gonzales; Mallig, Carolin; Fehr, Michael; Baumgärtner, Wolfgang

    2010-01-01

    This case report describes the clinical, pathomorphological and histopathological findings in a 12-year-old female pet rabbit with a pathologic fracture of the femur due to a metastasising endometrial adenocarcinoma. The animal was presented due to a history of right hindlimb lameness and inappetence. A fracture of the right femur with adjacent lyric bone lesions was detected by clinical and X-ray examination. Necropsy and histopathology revealed an endometrial adenocarcinoma with metastasis to the right femoral bone, resulting in the pathologic fracture. In both locations, tumour cells were immunohistochemically positive for pan-cytokeratin. Additionally, the animal suffered from an Encephalitozoon cuniculi infection which manifested itself in a multifocal granulomatous encephalitis and bilateral chronic inflammatory lesions in the kidneys.The report shows that in case of bone fractures in female pet rabbits the possibility of a pathologic fracture due to metastasising endometrial adenocarcinoma has to be considered.

  8. Computer assisted reconstruction of three-dimensional canal model of femur and design for custom-made stem

    Institute of Scientific and Technical Information of China (English)

    刘建国; 李冬松; 马卫华; 周振平; 徐莘香

    2004-01-01

    @@ The maximum stem-cortical bone contact plays a dominant role in the long-term fixation of the prosthesis; narrowing stem-cortical bone space and the bony ingrowths reduces the reaction to debris due to wear, the particle flows caused by the wear debris, the bone resorption, and the growth of pseudomembrane.1-4 We realized that the endosteal contour varies significantly from person to person.5,6 Thus, only one common designed prosthesis is not sufficient to achieve a high degree of accuracy in terms of modelling the proximal femur, therefore computer-assisted reconstruction of a three-dimensional canal model of the femur is a very promising way to produce custom hip stem prostheses.7-9

  9. Biomechanical research of joint III. An experimental biomechanical research on the Femur's articular surface of knee of pongidae

    Science.gov (United States)

    Renxiang, Zhang; Zuyun, Lan; Wenji, Qu

    1986-06-01

    In this paper, moiré contour fringes is applied to study the femur's articular surface of the knee of Pongidae. The preliminary division of the femur's articular surface of knee into three types is proposed. The moiré contour fringes ofthe medial condyle is taken as a mark according to the references. Owing to the fact that the moiré contour fringes obtained from experiments after the 2nd order of fringe basically follow a certain rule, an investigation is made on the distribution of the angle α which is defined as the angle of the major axis of the 2nd order's near-oval shaped moiré contour fringe on the medial condyle with the horizontal axis. Preliminary distribution graphs are given in the paper.

  10. Ununited fracture neck of femur treated with closed reduction and internal fixation with cancellous screw and fibular strut graft

    Directory of Open Access Journals (Sweden)

    Singh Daria

    2006-01-01

    Full Text Available Background: Ununited fracture neck of femur in young adults has been tackled in various ways. Methods: Twenty five patients of ununited fracture neck of femur in age group 21-55 years were treated by closed reduction, cancellous screw fixation and fibular strut graft and followed up for 2-6 years. Time gap between injury and operation was 6 weeks to 58 weeks. Five cases were previously fixed with various fixation devices. Results: Osseous union was achieved in 24 cases with average time of 18.16 weeks. Main complication encountered in follow-up was avascular necrosis of femoral head, others were joint stiffness and shortening. Functional end results were good to excellent in 24 cases. Conclusion: Closed reduction with internal fixation by cancellous screw and fibular strut grafting is easy and useful procedure.

  11. Acute postoperative osteomyelitis in femur fracture: contribution of bone scintilography (case report)

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Natalie Ferreira; Rezende, Cleuza Maria de Faria; Sanchez-Ucros, Natalia; Laguardia, Priscilla [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Escola de Veterinaria; Diniz, Simone Odilia Fernandes; Cardoso, Valbert Nascimento [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Faculdade de Farmacia; Rodrigues, Carlos Jorge Simal [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Faculdade de Medicina; Santos, Raquel Gouvea dos [Centro de Desenvolcimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil). Lab. de Radiobiologia

    2009-07-01

    The treatment of bone fractures is aimed at consolidating and returns of function as soon as possible and can be performed by different methods. Treatment with the plate in fractures of the femur in bridge aims not to address the location of fracture and stabilize it, maintaining the anatomical axis by the fixation of proximal and distal segments. Postoperative follow-up of the fracture is necessary to evaluate the irrigation of the bone structure and the effect of the method. The scintigraphy is a method capable of assessing the degree of bone remodeling and the presence or absence of local bone homeostasis. The objective of this report is to present the case of a rabbit, male, which was subjected to osteotomy and fixation of the femoral diaphysis by means of the plate in the bridge. After 10 days the animal was subjected to scintigraphic and radiographic evaluations. The animal came to death and an autopsy was performed on the same when it was observed macroscopy consistent with acute osteomyelitis due to contamination postoperative time. Radiographic evaluation in acute osteomyelitis is unclear. The methods assist in the scintigraphic diagnosis of osteomyelitis by allowing the detection of functional changes in this infectious process. The bone scintigraphy with diphosphonates labeled with technetium-99m shows increased bone turnover in the infected area and its high sensitivity, even in an early stage makes it the method of choice in the diagnosis of acute osteomyelitis in patients without prior bone disease and bone radiologically normal. (author)

  12. Does Computer-Assisted Femur First THR Improve Musculoskeletal Loading Conditions?

    Directory of Open Access Journals (Sweden)

    Tim A. Weber

    2015-01-01

    Full Text Available We have developed a novel, computer-assisted operation method for minimal-invasive total hip replacement (THR following the concept of “femur first/combined anteversion,” which incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position (CAS FF. The purpose of this study is to assess whether the hip joint reaction forces and patient’s gait parameters are being improved by CAS FF in relation to conventional THR (CON. We enrolled 60 patients (28 CAS FF/32 CON and invited them for gait analysis at three time points (preoperatively, postop six months, and postop 12 months. Data retrieved from gait analysis was processed using patient-specific musculoskeletal models. The target parameters were hip reaction force magnitude (hrf, symmetries, and orientation with respect to the cup. Hrf in the CAS FF group were closer to a young healthy normal. Phase-shift symmetry showed an increase in the CAS FF group. Hrf orientation in the CAS FF group was closer to optimum, though no edge or rim-loading occurred in the CON group as well. The CAS FF group showed an improved hrf orientation in an early stage and a trend to an improved long-term outcome.

  13. The Outcome in Early Cases of Treatment of Subtrochanteric Fractures with Proximal Femur Locking Compression Plate

    Directory of Open Access Journals (Sweden)

    U Gunadham

    2014-07-01

    Full Text Available The objective of this study was to evaluate the outcome in early treatment of subtrochanteric fractures with proximal femur locking compression plate (PF-LCP.The patients included in this study were those with subtrochanteric fractures (AO type 32A-C treated with PF-LCP (Synthes between Jan 2009 and Jun 2011. The patient characteristics and details of clinical conditions were obtained from records. Clinical and radiographic follow-ups were done at one, two, four and 6 months intervals, and at one year. The primary outcome studied included fracture union and functional ambulatory status. Twenty-six patients were included in the study, 19 of whom were male with a mean age of 42.4 years. Fourteen patients (53.9% had sustained AO type 32B fractures, the majority in motor vehicle accidents. Twenty-two fractures (84.6% achieved union, while sixpatients (23.1% had complications such as broken plate, varus collapse, and broken screw. Four patients (15.4% underwent a second operation. At the end of the follow-ups, 25 patients (96.2% were community ambulators. We conclude that PF-LCP is an effective alternative treatment for subtrochanteric fractures when properly performed.

  14. Synthesis and characterization of bovine femur bone hydroxyapatite containing silver nanoparticles for the biomedical applications

    Energy Technology Data Exchange (ETDEWEB)

    Nirmala, R.; Sheikh, Faheem A. [Chonbuk National University, Bio-Nano System Engineering, College of Engineering (Korea, Republic of); Kanjwal, Muzafar A. [Chonbuk National University, Department of Polymer Nano Science and Technology (Korea, Republic of); Lee, John Hwa [Chonbuk National University, College of Veterinary Medicine (Korea, Republic of); Park, Soo-Jin [Chonbuk National University, Department of Organic Materials and Fiber Engineering, Center for Healthcare Technology and Development (Korea, Republic of); Navamathavan, R. [College of Engineering, Chonbuk National University, Semiconductor Materials Processing Laboratory, School of Advanced Materials Engineering (Korea, Republic of); Kim, Hak Yong, E-mail: khy@jbnu.ac.kr [Chonbuk National University, Department of Organic Materials and Fiber Engineering, Center for Healthcare Technology and Development (Korea, Republic of)

    2011-05-15

    Bovine femur bone hydroxyapatite (HA) containing silver (Ag) nanoparticles was synthesized by thermal decomposition method and subsequent reduction of silver nitrate with N,N-dimethylformamide (DMF) in the presence of poly(vinylacetate) (PVAc). The structural, morphological, and chemical properties of the HA-Ag nanoparticles were characterized using X-ray diffraction (XRD), scanning electron microscopy (SEM), field-emission scanning electron microscopy (FE-SEM), transmission electron microscopy (TEM), and X-ray photoelectron spectroscopy (XPS). TEM images showed that the Ag nanoparticles with size ranging from 8 to 20 nm and were arranged at the periphery of HA crystals. Bactericidal activity of HA-Ag with different concentration of Ag nanoparticles immobilized on the surface of HA was investigated against gram-positive Staphylococcus aureus (S. aureus, non-MRSA), Methicillin resistant S. aureus (MRSA) and gram-negative Escherichia coli (E.coli) by the disc diffusion susceptibility test. The HA-Ag nanoparticles showed that broad spectrum activity against non-MRSA, MRSA, and E. coli bacterial strains.

  15. Relationship between the shape and density distribution of the femur and its natural frequencies of vibration.

    Science.gov (United States)

    Campoli, G; Baka, N; Kaptein, B L; Valstar, E R; Zachow, S; Weinans, H; Zadpoor, A A

    2014-10-17

    It has been recently suggested that mechanical loads applied at frequencies close to the natural frequencies of bone could enhance bone apposition due to the resonance phenomenon. Other applications of bone modal analysis are also suggested. For the above-mentioned applications, it is important to understand how patient-specific bone shape and density distribution influence the natural frequencies of bones. We used finite element models to study the effects of bone shape and density distribution on the natural frequencies of the femur in free boundary conditions. A statistical shape and appearance model that describes shape and density distribution independently was created, based on a training set of 27 femora. The natural frequencies were then calculated for different shape modes varied around the mean shape while keeping the mean density distribution, for different appearance modes around the mean density distribution while keeping the mean bone shape, and for the 27 training femora. Single shape or appearance modes could cause up to 15% variations in the natural frequencies with certain modes having the greatest impact. For the actual femora, shape and density distribution changed the natural frequencies by up to 38%. First appearance mode that describes the general cortical bone thickness and trabecular bone density had one of the strongest impacts. The first appearance mode could therefore provide a sensitive measure of general bone health and disease progression. Since shape and density could cause large variations in the calculated natural frequencies, patient-specific FE models are needed for accurate estimation of bone natural frequencies.

  16. Assessment of femur length for fetal biometry in Malaysian pregnant women

    Science.gov (United States)

    Ramli, Ramzun Maizan; Adam, Noraina; Jaafar, Mohamad Suhaimi; Rahman, Azhar Abdul; Mustafa, Iskandar Shahrim; Radzi, Yasmin; Nordin, Suriani; Kamarudin, Izyani

    2013-05-01

    The fetal biometry assessment of femur length (FL) was developed in most countries to evaluate the foetus growth. In this study, the FL values for Malaysia population were determined. A prospective study was conducted and a number of 6501 pregnant women were involved with 12372 FL data were collected, performed at antenatal care clinic of Hospital Pulau Pinang, Malaysia. The SPSS software version 17 (regression analysis and paired sample t-test) were used for analysis. The FL values of this study were constructed and rapid FL growth rate in second trimester (2.59 mm/week) than third trimester (1.43 mm/week) was observed. By ethnicity, no significant difference (p ≥ 0.05) was found between the FL values for fetuses of Malay and Indian ethnic's mother (t = -2.042), however these two groups shows significantly (p populations (India, China, Korea and Japan). As conclusion, it is strong suggested that medical practitioner in Malaysia should avoid in using biometry references based on other population to avoid under- or over-estimation and for accurate assessment of the fetus growth. As this study involved local Malaysian fetuses, therefore the medical practitioner can use the FL values of this study as reference value for fetus biometry assessment in Malaysia.

  17. Morphological analysis of the proximal femur by computed tomography in Japanese subjects

    Energy Technology Data Exchange (ETDEWEB)

    Hagiwara, Masashi [Chiba Univ. (Japan). School of Medicine

    1995-11-01

    In order to evaluate the morphological features of the proximal femur in the Japanese, 100 femora of normal Japanese subjects (normal group) and 60 femora of 43 Japanese patients with secondary osteoarthrosis of the hip (OA group) were analyzed using CT images. The scans for the dried bones (normal group) were done at a setting of 80 kV and 20 mA, for 2 sec duration. The scans were reconstructed using the soft tissue algorithm built into the GE-9800 scanner. The patient scans (OA group) were done at 120 kV and 170 mA also for 2 sec duration, and reconstructed using the same bone algorithm. The results were as follows: Thinning of the femoral cortex occurred in normal females over 60 years of age. The canal flare index at the proximal part of the femoral diaphysis was negatively correlated with the canal diameter at the isthmus. The index at the upper part was greater than that at the lower part. The two groups showed no statistical difference in this index. In the metaphysis, the canal flare index at the anterior portion was twice that at the posterior portion. In absolute terms, the OA group had a reduced flare or curve along the medial portion. In cross-section, the canal shape of the diaphysis was more elliptical in the OA group than in the normal group. The longitudinal axis of the canal was directed more sagittally in the OA group than in the normal group. (author).

  18. Salubrinal improves mechanical properties of the femur in osteogenesis imperfecta mice.

    Science.gov (United States)

    Takigawa, Shinya; Frondorf, Brian; Liu, Shengzhi; Liu, Yang; Li, Baiyan; Sudo, Akihiro; Wallace, Joseph M; Yokota, Hiroki; Hamamura, Kazunori

    2016-10-01

    Salubrinal is an agent that reduces the stress to the endoplasmic reticulum by inhibiting de-phosphorylation of eukaryotic translation initiation factor 2 alpha (eIF2α). We and others have previously shown that the elevated phosphorylation of eIF2α stimulates bone formation and attenuates bone resorption. In this study, we applied salubrinal to a mouse model of osteogenesis imperfecta (Oim), and examined whether it would improve Oim's mechanical property. We conducted in vitro experiments using RAW264.7 pre-osteoclasts and bone marrow derived cells (BMDCs), and performed in vivo administration of salubrinal to Oim (+/-) mice. The animal study included two control groups (wildtype and Oim placebo). The result revealed that salubrinal decreased expression of nuclear factor of activated T cells cytoplasmic 1 (NFATc1) and suppressed osteoclast maturation, and it stimulated mineralization of mesenchymal stem cells from BMDCs. Furthermore, daily injection of salubrinal at 2 mg/kg for 2 months made stiffness (N/mm) and elastic module (GPa) of the femur undistinguishable to those of the wildtype control. Collectively, this study supported salubrinal's beneficial role to Oim's femora. Unlike bisphosphonates, salubrinal stimulates bone formation. For juvenile OI patients who may favor strengthening bone without inactivating bone remodeling, salubrinal may present a novel therapeutic option. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  19. Analysis of microstructure in mouse femur and decalcification effect on microstructure by electron microscopy

    Directory of Open Access Journals (Sweden)

    Taehoon Jeon

    2010-10-01

    Full Text Available Microstructure and decalcification effect by ethylenediaminetetraacetic acid (EDTA on microstructure were studied for the compact bone of mouse femur by optical and electron microscopy. Especially the (002 reflection plane on the selected area electron diffraction (SAED of hydroxyapatite (HA was analyzed in detail. Two types of HA crystals were observed by transmission electron microscopy (TEM. One was needle-like crystals known as general HA crystals, and the other was flake-like crystals. Major constituents of two types of crystals were calcium, phosphorus, and oxygen. The Ca/P ratios of two types of crystals were close to the ideal value of HA within experimental error. Intensity data obtained from each crystals were also very similar. These results indicated that two types of crystals were actually same HA crystals. It was noticed that the (002 reflection plane on SAED displayed ring, spot, or arc patterns in accordance with orientations of HA crystals. Decalcification by EDTA process obsecured outline of osteons and havarsian canals, and changed morphology of the bone section. As the results of decalcification it was observed by TEM-EDS (Energy Dispersive Spectroscopy that all peaks of calcium and phosphorus disappeared, and intensity of oxygen peak was substantially reduced. Moreover, collagen appeared to be disaggreated.

  20. Granulocytic sarcoma of the femur in a patient with acute megakaryoblastic leukaemia

    Directory of Open Access Journals (Sweden)

    Čolović Milica

    2011-01-01

    Full Text Available Introduction. Granulocytic sarcoma, chloroma or myeloblastoma are observed in 3% to7% of acute myeloid leukaemia and represents localized tumour composed of collection of immature leukaemic cells. It appears most frequently in patients with M2, M4 and M5 subtypes of acute myeloid leukaemia Case Outline. A 58-year-old female presented with pain and oedema of the right upper limb in November 2009. After two months the patinet had fracture dislocation and numerous osteolytic lesions of the right femur. Immunohistochemistry of tumour biopsy showed megakaryoblastic granulocytic sarcoma which was CD31++, F-XIII++, CD34-, FVIII+++, S100-, aktin-, EMA++, Bcl2++, CD43++, with positive proliferative marker measured with Ki-67 positivity in more of 50% of cells. Aspirate of bone marrow and immunophenotyping with flowcytometry revealed diagnosis of acute megakaryoblastic leukaemia. The course of the disease was rapid and the patient died before commencing chemotherapy, five months after first complaints. Conclusion. Granulocytic sarcoma is extramedullary localization of collection of leukaemia cells which can proceed, to arise concomitantly with leukaemia, or may be the only manifestation of the disease. The diagnosis can be established only with immunohystochemistry.

  1. Fat emboli syndrome in isolated fractures of the tibia and femur.

    Science.gov (United States)

    Ganong, R B

    1993-06-01

    The fat emboli syndrome (FES) was studied in otherwise healthy young skiers with isolated fractures of the tibia and femur treated from 1980 until 1991. During the first year, 13 of 56 tibial and femoral fractures developed FES. The overall incidence of FES was 23%: 19% among fractured tibiae and 75% among fractured femora. Thirty-three percent of displaced transverse tibial fractures developed FES. During the next ten year, only those tibial or femoral fractures that developed FES were studied. There were 44 such cases. Symptoms included a mean PO2 of 45 mm Hg and a fever of 39 degrees. In addition, 40% of the patients had petechiae. The mean patient age was 26 years. None of the patients had other significant injuries or illnesses, 75% received oxygen, and 9% received steroids. None of the patients received mechanical ventilation. All cases had developed by the third day of hospitalization, and the duration of the syndrome was less than four days in 86% of the patients. The mortality rate was 0%. In 50% of the patients, hospitalization was prolonged because of FES; otherwise, there were no complications. This study of isolated femoral and tibial fractures in healthy young skiers demonstrates that FES occurs more commonly than previously thought, is not associated with mortality, and causes little morbidity. Treatment should consist of supportive care only, with specific care directed toward the underlying injury.

  2. Sex Specific Association of Physical Activity on Proximal Femur BMD in 9 to 10 Year-Old Children

    Science.gov (United States)

    Cardadeiro, Graça; Baptista, Fátima; Ornelas, Rui; Janz, Kathleen F.; Sardinha, Luís B.

    2012-01-01

    The results of physical activity (PA) intervention studies suggest that adaptation to mechanical loading at the femoral neck (FN) is weaker in girls than in boys. Less is known about gender differences associated with non-targeted PA levels at the FN or other clinically relevant regions of the proximal femur. Understanding sex-specific relationships between proximal femur sensitivity and mechanical loading during non-targeted PA is critical to planning appropriate public health interventions. We examined sex-specific associations between non-target PA and bone mineral density (BMD) of three sub-regions of the proximal femur in pre- and early-pubertal boys and girls. BMD at the FN, trochanter (TR) and intertrochanter (IT) regions, and lean mass of the whole body were assessed using dual-energy x-ray absorptiometry in 161 girls (age: 9.7±0.3 yrs) and 164 boys (age: 9.7±0.3 yrs). PA was measured using accelerometry. Multiple linear regression analyses (adjusted for body height, total lean mass and pubertal status) revealed that vigorous PA explained 3–5% of the variability in BMD at all three sub-regions in boys. In girls, vigorous PA explained 4% of the variability in IT BMD and 6% in TR BMD. PA did not contribute to the variance in FN BMD in girls. An additional 10 minutes per day of vigorous PA would be expected to result in a ∼1% higher FN, TR, and IT BMD in boys (p<0.05) and a ∼2% higher IT and TR BMD in girls. In conclusion, vigorous PA can be expected to contribute positively to bone health outcomes for boys and girls. However, the association of vigorous PA to sub-regions of the proximal femur varies by sex, such that girlś associations are heterogeneous and the lowest at the FN, but stronger at the TR and the IT, when compared to boys. PMID:23209801

  3. One-Piece Zirconia Ceramic versus Titanium Implants in the Jaw and Femur of a Sheep Model: A Pilot Study

    OpenAIRE

    Siddiqi, A; W. J. Duncan; R. K. De Silva; Zafar, S.

    2016-01-01

    Reports have documented titanium (Ti) hypersensitivity after dental implant treatment. Alternative materials have been suggested including zirconia (Zr) ceramics, which have shown predictable osseointegration in animal studies and appear free of immune responses. The aim of the research was to investigate the bone-to-implant contact (BIC) of one-piece Zr, compared with one-piece Ti implants, placed in the jaws and femurs of domestic sheep. Ten New Zealand mixed breed sheep were used. A One-pi...

  4. Reimplantation of an Extruded Femoral Segment After Gamma Sterilization in A Type IIIA Supracondylar Femur Fracture: A Case Report

    Directory of Open Access Journals (Sweden)

    Aizah N

    2014-07-01

    Full Text Available Extruded bone is a rare complication of high energy open fractures, and there is only a handful of literature on reimplantation of the extruded segment. No clear guidelines exist regarding timing of reimplantation, stabilization of extruded bone segments, and also bone disinfection and sterilization techniques. Previous reports describe sterilization using thermal or chemical methods. We present a case of successful reimplantation of an extruded metaphyseal segment of femur after gamma sterilization in a fourteen- year old boy.

  5. Cherubism associated with neurofibromatosis type 1, and multiple osteolytic lesions of both femurs: A previously undescribed association of findings

    Energy Technology Data Exchange (ETDEWEB)

    Martinez-Tello, Francisco J. [Hospital Universitario ' ' 12 de Octubre' ' , Departamento de Anatomia Patologica, Madrid (Spain); Manjon-Luengo, Palmira [Hospital Universitario ' ' 12 de Octubre' ' , Department of Radiology, Madrid (Spain); Martin-Perez, Manuel [Hospital Universitario ' ' 12 de Octubre' ' , Department of Pathology, Madrid (Spain); Montes-Moreno, Santiago

    2005-12-01

    We present a patient with neurofibromatosis type 1, with the clinical, radiological and histological features of cherubism mandibular lesions, and multiple osteolytic, geographic lesions in both femurs, consistent with multiple non-ossifying fibromas. We have been unable to find a similar case in the world literature. We discuss our findings in relationship with a number of syndromes that present clinical, radiological or pathological similarities. (orig.)

  6. Safety aspects in surgical treatment of pathological fractures of the proximal femur – modular endoprosthetic replacement vs. intramedullary nailing

    OpenAIRE

    Fakler, Johannes KM; Hase, Franziska; Böhme, Jörg; Josten, Christoph

    2013-01-01

    Background Pathologic fractures of the femoral intertrochanteric and subtrochanteric region require special consideration in terms of biomechanically stable fixation and durability of the implant. In addition, the type of surgery might also influence patient survival. We conducted this retrospective study to evaluate the safety of modular proximal femur replacement compared to intramedullary nailing with patient survival being the primary and complications the secondary endpoint. Methods We r...

  7. Partial long-stem resection Austin-Moore hip endoprosthesis in the treatment of metastases to the proximal femur.

    Science.gov (United States)

    Chrobok, Adam; Spindel, Jerzy; Mrozek, Tomasz; Miszczyk, Leszek; Koczy, Bogdan; Tomasik, Patryk; Matysiakiewicz, Jacek

    2005-12-30

    Background. The proximal femur is a frequent location of bone metastases, and pathological fractures in this area are common. A pathological fracture and/or pain associated with bone destruction are indications for surgery. Among many methods of surgical treatment, partial resection and subsequent arthroplasty appears to be the most efficient. The low cost of the implant and the relatively simple surgical technique incline us to apply long-stem (305mm) partial Austin-Moore hip prosthesis in these cases. Material and methods. Between June 2003 and February 2005 we operated 31 patients (10 men and 21 women) for pathological fracture or proximal femur metastasis. The average age of these patients was 63.8 years. The most common primary neoplasmatic focus among the women was breast cancer (17 cases, 80%), and among the men, clarocellular renal cancer (3 cases, 34%). Results. In most cases - 21 patients (67%) - we achieved excellent or good outcome according to the Merle d'Aubigne Functional Test, as well as reasonable pain relief. Endoprosthesis dislocation occurred in 2 cases and early postoperative death in 2 other cases. Conclusions. Surgical treatment is needed in cases of actual or impending pathological fracture of the proximal femur. Resection arthroplasty is the method of choice in bone metastases to proximal femur. This procedure is well tolerated by patients. The use of long-stem partial Austin-Moore hip prosthesis appears to be a good alternative to costly modular implants, while its long stem protects the femoral shaft against fractures in cases where additional metastatic lesions are found there.

  8. Unifocal Granuloma of Femur due to Langerhans' Cell Histiocytosis: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Harpreet Singh

    2010-01-01

    Full Text Available The radiological diagnosis of osteolytic lesions of the long bones in pediatric population constitutes a challenge when the case history and clinical data are uncharacteristic. We believe that the description of few clinically and histologically proven cases to verify the existence of radiological signs useful for diagnosis may be of interest. Here, we describe a case of Langerhans' cell histiocytosis (LCH presenting as unifocal eosinophilic granuloma of femur along with a brief review of the literature.

  9. EVALUATION OF FUNCTIONAL OUTCOME AFTER OPEN REDUCTION AND INTERNAL FIXATION OF DISTAL FEMUR FRACTURES BY LOCKING COMPRESSION PLATE

    Directory of Open Access Journals (Sweden)

    L. Lokanadha Rao

    2016-09-01

    Full Text Available BACKGROUND In the supra and intercondylar fractures of femur particularly with intra articular extension, patient may develop stiffness of knee, shortening, rotational deformities, internal derangement of knee with instability, varus and valgus deformities which affect patient’s routine lifestyle. If these cases were treated with locking compression plate, the results obtained were successful, superior, timesaving providing early ambulation and least disability improving the functional outcome. MATERIALS AND METHODS This is a prospective interventional study. This study includes 25 supracondylar and intercondylar fractures of femur (both Muller’s Type ‘A’, Type B and Type ‘C’ fractures treated with open reduction and internal fixation by Locking Compression Plate in the Department of Orthopaedics, King George Hospital, Visakhapatnam from September 2013 to September 2015. There are 16 males and 9 females with age ranging from 20 to 80 years with an average of 44.6 years. Average age for males is 28.9 years and average age for females is 25 years. 18 fractures were due to road traffic accidents and 6 cases are due to fall from significant heights, 1 case due to simple fall from standing (osteoporosis. 15 cases were in right femur (60% and 10 cases were in left femur (40%. RESULTS 25 cases were included in the study. There is an increase in the rate of union, decreased time taken for union, increased knee range of motion, decreased time for weight-bearing, postoperative complications and duration for hospital stay. CONCLUSION LCP proved to be a good implant which could take the challenges like poor bone stock, severe comminution both metaphyseal and articular and prove successful. The locking head screws distally have prevented varus collapse, even in cases of osteoporosis. The Condylar LCP can be used in either an open or a minimally invasive manner.

  10. Comparison of Primary Hip Spica with Crossed Retrograde Intramedullary Rush Pins for the Management of Diaphyseal Femur Fractures in Children: A Prospective, Randomized Study

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    Mohammad Ruhullah

    2013-12-01

    Conclusions: Intra-medullary crossed Rush pinning is an effective method of paediatric diaphyseal femur fracture fixation as compared to primary hip spica in terms of early weight bearing and restoration of normal anatomy.

  11. Postoperative Ambulatory Performance Status Significantly Affects Implant Failure Rate Among Surgical Treatment Strategies in Patients With Proximal Femur Metastasis.

    Science.gov (United States)

    Tsai, Shang-Wen; Wu, Po-Kuei; Chen, Cheng-Fong; Chang, Ming-Chau; Chen, Wei-Ming

    2016-11-08

    Surgical treatment strategies for proximal femur metastasis have been reported with mixed results. Little is known about risk factor for implant failure except for longer patient survival. Therefore, we determined whether implant survivorship differed among treatment strategies, as well as risk factors for implant failure. We retrospectively reviewed a consecutive 106 patients with proximal femur metastasis treated with prosthesis replacement (n = 38), intramedullary nail (n = 32), and dynamic hip screw (DHS) (n = 36). Eastern Cooperative Oncology Group (ECOG) scale and Karnofsky index were used to evaluate functional outcome. Patient characteristics and postoperative ambulatory performance status were assessed for their values in determining implant failure. Overall implant failure rate was 11.3% (12 of 106). Prosthesis replacement was related to better implant survivorship (P = 0.041), without mechanical failures. On the contrary, 7 of the 10 implant failures in the fixation group were considered mechanical failures. Better postoperative ambulatory status (ECOG ≤ 2) was a risk factor for implant failure (P = 0.03). Notably, for patients with poor ambulatory status (ECOG ≥ 3), implant survivorship was not different among choice of implants. In conclusion, prosthesis replacement would be a more durable option in the treatment of proximal femur metastasis. Postoperative ambulatory status could be an additional consideration. For patients with poor expected ambulatory performance status, fixation with intramedullary nail or DHS might be considered for a less technical demanding procedure.

  12. Fully automatic segmentation of femurs with medullary canal definition in high and in low resolution CT scans.

    Science.gov (United States)

    Almeida, Diogo F; Ruben, Rui B; Folgado, João; Fernandes, Paulo R; Audenaert, Emmanuel; Verhegghe, Benedict; De Beule, Matthieu

    2016-12-01

    Femur segmentation can be an important tool in orthopedic surgical planning. However, in order to overcome the need of an experienced user with extensive knowledge on the techniques, segmentation should be fully automatic. In this paper a new fully automatic femur segmentation method for CT images is presented. This method is also able to define automatically the medullary canal and performs well even in low resolution CT scans. Fully automatic femoral segmentation was performed adapting a template mesh of the femoral volume to medical images. In order to achieve this, an adaptation of the active shape model (ASM) technique based on the statistical shape model (SSM) and local appearance model (LAM) of the femur with a novel initialization method was used, to drive the template mesh deformation in order to fit the in-image femoral shape in a time effective approach. With the proposed method a 98% convergence rate was achieved. For high resolution CT images group the average error is less than 1mm. For the low resolution image group the results are also accurate and the average error is less than 1.5mm. The proposed segmentation pipeline is accurate, robust and completely user free. The method is robust to patient orientation, image artifacts and poorly defined edges. The results excelled even in CT images with a significant slice thickness, i.e., above 5mm. Medullary canal segmentation increases the geometric information that can be used in orthopedic surgical planning or in finite element analysis.

  13. Effects of ethanol consumption and alcohol detoxification on the biomechanics and morphology the bone in rat femurs

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    J. A. D. Garcia

    Full Text Available Abstract The objective of this study was to verify the effects of ethanol consumption and alcohol detoxification on the biomechanics, area and thickness of cortical and trabecular bone in rat femur. This was an experimental study in which 18 male Wistar rats were used, with 40 days of age, weighing 179±2.5 g. The rats were divided into three groups (n=06: CT (control, AC (chronic alcoholic, DT (detoxification. After experimental procedures, the animals were euthanized by an overdose of the anesthetic and their femurs were collected for mechanical testing and histological processing. All animals did not present malnutrition or dehydration during experimentation period. Morphometric analysis of cortical and trabecular bones in rat femurs demonstrated that AC animals showed inferior dimensions and alcohol detoxification (DT allowed an enhancement in area and thickness of cortical and trabecular bone. Material and structural properties data of AC group highlighted the harmful effects of ethanol on bone mechanical properties. The results of this study demonstrated that chronic alcoholic rats (AC presented major bone damage in all analyzed variables. Those findings suggested that alcohol detoxification is highly suggested in pre-operative planning and this corroborates to the success of bone surgery and bone tissue repair. Thanks to the financial support offered by PROBIC – UNIFENAS.

  14. Extraction of 3D Femur Neck Trabecular Bone Architecture from Clinical CT Images in Osteoporotic Evaluation: a Novel Framework.

    Science.gov (United States)

    Sapthagirivasan, V; Anburajan, M; Janarthanam, S

    2015-08-01

    The early detection of osteoporosis risk enhances the lifespan and quality of life of an individual. A reasonable in-vivo assessment of trabecular bone strength at the proximal femur helps to evaluate the fracture risk and henceforth, to understand the associated structural dynamics on occurrence of osteoporosis. The main aim of our study was to develop a framework to automatically determine the trabecular bone strength from clinical femur CT images and thereby to estimate its correlation with BMD. All the 50 studied south Indian female subjects aged 30 to 80 years underwent CT and DXA measurements at right femur region. Initially, the original CT slices were intensified and active contour model was utilised for the extraction of the neck region. After processing through a novel process called trabecular enrichment approach (TEA), the three dimensional (3D) trabecular features were extracted. The extracted 3D trabecular features, such as volume fraction (VF), solidity of delta points (SDP) and boundness, demonstrated a significant correlation with femoral neck bone mineral density (r = 0.551, r = 0.432, r = 0.552 respectively) at p TEA method would be useful for spotting women vulnerable to osteoporotic risk.

  15. Bone mineral density of the proximal femur after hip resurfacing arthroplasty: 1-year follow-up study

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    Anttila Esa

    2011-05-01

    Full Text Available Abstract Background Hip resurfacing arthroplasty (HRA is considered a bone-preserving procedure and may eliminate proximal femoral stress shielding and osteolysis. However, in addition to implant-related stress-shielding factors, various patient-related factors may also have an effect on bone mineral density (BMD of the proximal femur in patients with HRA. Thus, we studied the effects of stem-neck angle, demographic variables, and physical functioning on the BMD of the proximal femur in a one-year follow-up. Methods Thirty three patients (9 females and 24 males with a mean (SD age of 55 (9 years were included in the study. BMD was measured two days and 3, 6, and 12 months postoperatively and 10 regions of interest (ROI were used. Stem-neck angle was analyzed from anteroposterior radiographs. Results Three months postoperatively, BMD decreased in six out of 10 regions of interest (ROI on the side operated on and in one ROI on the control side (p Conclusions After an early drop, the BMD of the upper femur was restored and even exceeded the preoperative level at one year follow-up. From a clinical standpoint, the changes in BMD in these HRA patients could not be explained by stem-neck angle or patient related factors.

  16. Effects of ethanol consumption and alcohol detoxification on the biomechanics and morphology the bone in rat femurs.

    Science.gov (United States)

    Garcia, J A D; Souza, A L T; Cruz, L H C; Marques, P P; Camilli, J A; Nakagaki, W R; Esteves, A; Rossi-Junior, W C; Fernandes, G J M; Guerra, F D; Soares, E A

    2015-11-01

    The objective of this study was to verify the effects of ethanol consumption and alcohol detoxification on the biomechanics, area and thickness of cortical and trabecular bone in rat femur. This was an experimental study in which 18 male Wistar rats were used, with 40 days of age, weighing 179 ± 2.5 g. The rats were divided into three groups (n=06): CT (control), AC (chronic alcoholic), DT (detoxification). After experimental procedures, the animals were euthanized by an overdose of the anesthetic and their femurs were collected for mechanical testing and histological processing. All animals did not present malnutrition or dehydration during experimentation period. Morphometric analysis of cortical and trabecular bones in rat femurs demonstrated that AC animals showed inferior dimensions and alcohol detoxification (DT) allowed an enhancement in area and thickness of cortical and trabecular bone. Material and structural properties data of AC group highlighted the harmful effects of ethanol on bone mechanical properties. The results of this study demonstrated that chronic alcoholic rats (AC) presented major bone damage in all analyzed variables. Those findings suggested that alcohol detoxification is highly suggested in pre-operative planning and this corroborates to the success of bone surgery and bone tissue repair. Thanks to the financial support offered by PROBIC - UNIFENAS.

  17. Analysis of the Geometry of the Distal Femur and Proximal Tibia in the Osteoarthritic Knee: A 3D Reconstruction CT Scan Based Study of 449 Cases

    OpenAIRE

    Dimitrios Lyras; Craig Loucks; Robert Greenhow

    2016-01-01

    Background: The aim of this study is to evaluate the geometry of the distal femur and the proximal tibia in the osteoarthritic knee using 3D reconstructive CT scan imaging. Methods: 449 patients with knee osteoarthritis were treated surgically in our center with patient-specific technology total knee arthroplasty. Preoperatively, all the patients underwent a CT scan according to a standard protocol. Using this database, the Hip-Knee-Angle (HKA), the Femur Valgus Angle (FVA), the Tibia Varus A...

  18. Primary hydatid disease of the femur: unsuspected and incidental MRI findings with long-term curative results on medical treatment alone

    Energy Technology Data Exchange (ETDEWEB)

    Poyanli, A.; Sencer, S. [Dept. of Radiology, Istanbul Faculty of Medicine (Turkey); Akan, K.; Poyanli, O. [Dept. of Orthopaedics and Traumatology, Goeztepe SSK Educational Hospital, Istanbul (Turkey); Sayrak, H. [Dept. of Pathology, Goeztepe SSK Educational Hospital, Istanbul (Turkey)

    2001-11-01

    This report describes the early magnetic resonance imaging (MRI) findings and long-term follow-up results of albendazole treatment in a 16-year-old girl with primary hydatid disease of the femur diagnosed incidentally during the course of a post-traumatic knee infection. As far as we know, this is the first report of the early MRI findings and long-term outcome of medical treatment in primary hydatid disease of the femur in this age group. (orig.)

  19. Meyer’s Muscle Pedicle Bone Graft a Novel Procedure in Treatment of Neglected Fracture Neck of Femur in Pediatric Age Group-A Case Report

    OpenAIRE

    2016-01-01

    Meyers muscle pedicle graft has been used in delayed presentation and non-union of neck femur fracture in adults with good results. Delayed presentation or non-union neck femur in children is not uncommon in children. Subtrochanteric valgus osteotomy with or without fixation has been suggested with varying results. We present meyers muscle graft being used in paediatric age group with excellent result at 3 years follow-up. There are limited report literature of meyers muscle pedicle graft bei...

  20. A Systematic Review and Meta-Analysis of Ilizarov Methods in the Treatment of Infected Nonunion of Tibia and Femur.

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    Peng Yin

    Full Text Available Infected nonunion of tibia and femur are common in clinical practice, however, the treatment of these diseases has still been a challenge for orthopaedic surgeons. Ilizarov methods can eradicate infection, compensate bone defects and promote the bone union through progressive bone histogenesis. The objective of this systematic review was to review current available studies reporting on Ilizarov methods in the treatment of infected nonunion of tibia and femur, and to perform meta-analysis of bone and functional results and complications to evaluate the efficacy of Ilizarov methods.A comprehensive literature search was performed from the SCI, PubMed, Cochrane Library; and Embase between January 1995 and August 2015. Some major data were statistically analyzed using weighted means based on the sample size in each study by SPSS 13.0, including number of patients, mean age, mean previous surgical procedures, mean bone defects, mean length of follow-up, bone union, complications per patient, external fixation time, and external fixation index(EFI. Bone results (excellent, good, fair and poor rate, functional results (excellent, good, fair and poor rate and complications were analyzed by Stata 9.0.A total of 590 patients from 24 studies were included in this systematic review. The average of bone union rate was 97.26% in all included studies. The poor rate in bone results and functional results was 8% (95%CI, 0.04-0.12; I2 = 44.1%, P = 0.065 and 10% (95%CI, 0.05-0.14; I2 = 34.7%, P = 0.121 in patients with infected nonunion of tibia and femur treated by Ilizarov methods. The rate of refracture, malunion, infectious recurrence, knee stiffness, amputation, limb edema and peroneal nerve palsy was respectively 4%, 7%, 5%, 12%, 4%, 13% and 13%.Our systematic review showed that the patients with infected nonunion of tibia and femur treated by Ilizarov methods had a low rate of poor bone and functional results. Therefore, Ilizarov methods may be a good choice

  1. Computer-supported indirect-form lifestyle-modification support program using Lifestyle Intervention Support Software for Diabetes Prevention (LISS-DP) for people with a family history of type 2 diabetes in a medical checkup setting: a randomized controlled trial.

    Science.gov (United States)

    Tokunaga-Nakawatase, Yuri; Nishigaki, Masakazu; Taru, Chiemi; Miyawaki, Ikuko; Nishida, Junko; Kosaka, Shiho; Sanada, Hiromi; Kazuma, Keiko

    2014-10-01

    To investigate the effect of a computer-supported indirect-form lifestyle-modification program using Lifestyle Intervention Support Software for Diabetes Prevention (LISS-DP), as a clinically feasible strategy for primary prevention, on diet and physical activity habits in adults with a family history of type 2 diabetes. This was a two-arm, randomized controlled trial: (1) lifestyle intervention (LI) group (n=70); (2) control (n=71). Healthy adults aged 30-60 years with a history of type 2 diabetes among their first-degree relatives were recruited. LI group received three times of lifestyle intervention using LISS-DP during six-month intervention period via mail. Lifestyle intervention group showed significantly greater decrease in energy intake six months after baseline, compared to control (-118.31 and -24.79 kcal/day, respectively, p=0.0099, Cohen's d=0.22), though the difference disappeared 1 year after from baseline. No difference was found in physical activity energy expenditure. A computer-based, non-face-to-face lifestyle intervention was effective on dietary habits, only during the intervention period. Further examination of the long-term effects of such intervention and physical activity is required. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  2. EFEK PEMBERIAN SPILANTHES ACMELLA DAN LATIHAN FISIK TERHADAP JUMLAH SEL OSTEOBLAS FEMUR MENCIT YANG DIINDUKSI DEKSAMETASON

    Directory of Open Access Journals (Sweden)

    Hening Laswati

    2015-05-01

    Full Text Available AbstrakTelah dilakukan penelitian untuk mengetahui uji aktivitas anti-osteoporosis secara in vivo dari tanaman Spilanthes acmella terhadap sel osteoblas tulang trabekula proksimal femur mencit jantan model osteoporosis induksi deksametason. Penelitian ini dilakukan dengan rancangan penelitian posttest only control group, 60 ekor mencit jantan sehat (usia >5 bulan dikelompokkan secara random menjadi 10 kelompok yaitu kelompok sehat tanpa induksi deksametason dan kelompok osteoporosis induksi deksametason. Kontrol positif mendapat suspensi alendronat dan kelompok latihan fiik menggunakantreadmill mencit berjalan 10m/menit bertahap selama 5 -12 menit, 3 kali dalam satu minggu, kelompok kombinasi ekstrak etanol 70% dan latihan fiik serta kelompok uji fraksi butanol, heksan, etil asetat dan air. Penelitian ini dilakukan selama 4 minggu. Osteoporosis akibat pemakaian glukokortikoid menjadi penyebab osteoporosis sekunder yang meningkatkan risiko fraktur. Telah banyak bukti klinik tentang peran fioestrogen dalam pengobatan osteoporosis pada pascamenopause. Spilanthes acmella, atau yang dikenal masyarakat dengan sebutan Legetan, termasuk famili Asteracea merupakan satu tanaman obat di Indonesia yang mempunyai kandungan senyawa polifenol dan flvonoid. Dari hasil penelitian sebelumnya diketahui bahwa baik fraksi butanol dan air dari tanaman tersebut mampu meningkatkan aktivitas enzim alkalin fosfatase yang merupakan marker pembentukan tulang. Hasil menunjukkan bahwa ekstrak etanol 70% Spilanthes acmella dikombinasikan dengan latihan fiik meningkatkan jumlah sel osteoblas secara bermakna bila dibandingkan dengan hanya ekstrak etanol atau latihan fiik. Ini membuktikan bahwa ekstrak etanol 70% Spilanthes acmella mempunyai efek additive terhadap efek latihan pembebanan aksial pada kondisi osteoporosis. Fraksi heksana, etil asetat dan air juga meningkatkan secara bermakna jumlah sel osteoblas. Fraksi non polar merupakan fraksi yang lebih potensial untuk

  3. Biomechanical properties of osteoporotic rat femurs after different hormonal treatments: genistein, estradiol, and estradiol/progesterone

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    Azboy İbrahim

    2016-01-01

    Full Text Available Introduction: The purpose of the study is to compare the effects of genistein, estradiol, estradiol/progesterone combination on the bone mineral density and biomechanical properties of ovariectomized rats’ bone. Methods: 50 female adult Sprague-Dawley rats were divided into five groups. Bilaterally ovaeriectomy were performed in all groups except the sham-operated group. Groups were a sham-operated group and a control group (water was given, estradiol treated group (17-β estradiol 0.015 mg/kg per day, genistein treated group (genistein 10 mg/kg per day, and an estradiol/progesterone combination group (17-β estradiol 0.015 mg/kg plus drosperinone 0.028 mg/kg per day. The water or hormones were implemented in relevant groups for eight weeks by orogasthric catheter. The bone mineral density and biomechanical properties of the femur were analyzed. Results: Genistein, estradiol, and estradiol/progesterone groups increased bone mineral density significantly compared to the control group. In diaphysis and metaphysis bending test, all groups had higher peak load values than the control group. There were statistically significant differences between the estrogen/progesterone group and control group in diaphysis bending with regard to peak load. There were statistically significant differences between the estradiol and control groups in metaphysis bending with regard to peak load. In axial rotation test, all groups had higher peak torque values than the control groups. Conclusions: Genistein, estradiol and estrogen/progesterone combination improved the biomechanical properties of the ovariectomized rat bone. Genistein which has less side effects may be considered as an alternative in the treatment of postmenopausal osteoporosis.

  4. Intraoperative fracture of the femur in revision total hip arthroplasty with a diaphyseal fitting stem.

    Science.gov (United States)

    Meek, R M Dominic; Garbuz, Donald S; Masri, Bassam A; Greidanus, Nelson V; Duncan, Clive P

    2004-03-01

    In revision total hip arthroplasty, intraoperative split fractures and cortical perforation fractures are becoming a more common concern with the increasing use of diaphyseal fitting cementless stems. The purpose of this study was to evaluate the risk factors and frequency of intraoperative fractures with the use of these stems and their effect on radiographic and functional outcomes. We performed a retrospective case-control study of 211 consecutive patients who had undergone revision hip arthroplasty with a diaphyseal fitting cementless stem between December 1998 and March 2002. Sixty-four patients sustained an intraoperative fracture of the femur. One hundred and fifteen patients were followed for a minimum of two years; function was analyzed with self-administered outcome questionnaires, and radiographs were evaluated for evidence of bone ingrowth into the femoral stem. Risk factors associated with an intraoperative fracture were a substantial degree of preoperative bone loss, a low femoral cortex-to-canal ratio, underreaming of the cortex, and the use of a large-diameter stem. The majority of the diaphyseal undisplaced linear fractures occurred at the distal end of an extended trochanteric osteotomy during stem insertion. Fracture due to cortical perforation occurred most often during cement removal. These intraoperative fractures had no significant effect on the functional outcome or radiographic evidence of bone ingrowth. There was a surprisingly high rate of intraoperative femoral fractures associated with the use of a diaphyseal fitting stem in revision total hip arthroplasty. Identification of risk factors such as preoperative bone loss and a low cortex-to-canal ratio may permit planning to avoid such fractures. However, the final functional and radiographic outcomes appear to have been unaffected by the fracture when it had been managed appropriately. Prognostic study, Level II-1 (retrospective cohort study). See Instructions to Authors for a complete

  5. Use of DXA-Based Structural Engineering Models of the Proximal Femur to Discriminate Hip Fracture

    Science.gov (United States)

    Yang, Lang; Peel, Nicola; Clowes, Jackie A; McCloskey, Eugene V; Eastell, Richard

    2011-01-01

    Several DXA-based structural engineering models (SEMs) of the proximal femur have been developed to estimate stress caused by sideway falls. Their usefulness in discriminating hip fracture has not yet been established and we therefore evaluated these models. The hip DXA scans of 51 postmenopausal women with hip fracture (30 femoral neck, 17 trochanteric, and 4 unspecified) and 153 age-, height-, and weight-matched controls were reanalyzed using a special version of Hologic’s software that produced a pixel-by-pixel BMD map. For each map, a curved-beam, a curved composite-beam, and a finite element model were generated to calculate stress within the bone when falling sideways. An index of fracture risk (IFR) was defined over the femoral neck, trochanter, and total hip as the stress divided by the yield stress at each pixel and averaged over the regions of interest. Hip structure analysis (HSA) was also performed using Hologic APEX analysis software. Hip BMD and almost all parameters derived from HSA and SEM were discriminators of hip fracture on their own because their ORs were significantly >1. Because of the high correlation of total hip BMD to HSA and SEM-derived parameters, only the bone width discriminated hip fracture independently from total hip BMD. Judged by the area under the receiver operating characteristics curve, the trochanteric IFR derived from the finite element model was significant better than total hip BMD alone and similar to the total hip BMD plus bone width in discriminating all hip fracture and femoral neck fracture. No index was better than total hip BMD for discriminating trochanteric fractures. In conclusion, the finite element model has the potential to replace hip BMD in discriminating hip fractures. PMID:18767924

  6. Study of proximal femoral locking compression plate in extra capsular fracture neck of femur

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    Ravi G.O.

    2015-12-01

    Results: In our study of 21 cases, cases 13 cases were intertrochanteric fracture and remaining 8 were subtrochanteric fracture with the mean age was 51.47 years. Minimum age was 19 years and maximum age was 85 years. 14 patients (67% were males and 7 patients (33% were females, 13 IX patients (62% had right-sided fracture and 8 patients (38% had left-sided fracture. with right side being more common side affected. The average duration of stay in the hospital was 25.31 days. The average follow up was 18 months [11 to 23 months]. Out of 21 patients in our study 16 patients (76% are able to sit cross-legged and can squat on ground without any problem. The functional results were graded according to Harris Hip Scoring, In our study, 10 patients (48%had excellent results, 8 patients (38%had good results, 2 patients (10%had poor result, and 1 failed case (5% as she is an elderly female of 85 years with limited activity both preoperatively due to physiological age and general weakness. Conclusions: In conclusion the potentiality of the Proximal Femoral Locking Compression Plate (PF-LCP in varied indications, shows its versatility. Although not free of complications our study has demonstrated excellent results. The procedure offers, faster mobilization, rapid return to activities of daily living, improves the quality of life and gave a long term solution in patients with extracapsular fracture neck of femur. Larger studies with longer follow up will further validate the procedure. [Int J Res Med Sci 2015; 3(12.000: 3726-3733

  7. A histological investigation on tissue responses to titanium implants in cortical bone of the rat femur.

    Science.gov (United States)

    Ohtsu, A; Kusakari, H; Maeda, T; Takano, Y

    1997-03-01

    Implant materials are placed under various sites-including cortical bone, spongy bone, and bone marrow-at the same time according to the depth at implantation. Although cortical bone is an important site for the prognosis of implantation, detailed reports on tissue responses to implantation have been meager. The present study aims to reveal tissue responses to pure titanium implantation in rat femoris cortical bone. The rats received titanium bars surgically in their femurs and were sacrificed 1 day to 40 weeks post-implantation. The prepared tissue specimens were processed for light and transmission electron microscopy (TEM). Further histochemical detections were performed. One day post-implantation, empty osteocytic lacunae indicating degeneration of osteocytes were found in pre-existing cortical bone around the implant. Such pre-existing bone was replaced by new bone, but remained in part even 40 weeks post-implantation. Light microscopy showed that direct contact between the implant and new bone was identified 12 weeks post-implantation. Chronological and ultrastructural observation showed that new bone deposition appeared to proceed toward the implant, and that the intervening layer at the interface was derived from the degenerated debris of multinucleated giant cells and/or osteoblasts. Furthermore, it seemed that the width of intervening layer varied in relation to the distance from the blood vessels. The cells showing tartrate resistant acid phosphatase activity possessed cytological features of osteoclasts under TEM; they were frequently observed in perivascular sites near the implants even after osseointegration, suggesting that bone remodeling took place steadily around the implant.

  8. Epidemiology of fractures of the proximal third of the femur in elderly patients ☆

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    Daniel Daniachi

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVE: This was an epidemiological study on fractures of the proximal third of the femur in elderly patients who were treated at a teaching hospital in the central region of São Paulo. METHODS: The subjects were patients over the age of 60 years who were attended over a 1-year period. A questionnaire seeking basic sociodemographic data and information on comorbidities presented and medications used was drawn up. The circumstances of the fractures and their characteristics, the treatment instituted and the intra-hospital mortality rate were evaluated. RESULTS: The 113 patients included in the study presented a mean age of 79 years. The ratio between the sexes was three women to each man. Only 30.4% of the patients reported having osteoporosis and only 0.9% had had treatment for the disease. Low-energy trauma was the cause of 92.9% of the fractures. Femoral neck fractures accounted for 42.5% of the fractures and trochanteric fractures, 57.5%. Five patients did not undergo operations; 39 underwent joint replacement; and 69 underwent osteosynthesis. The mean length of hospital stay was 13.5 days and the mean length of waiting time until surgery was 7 days. The intra-hospital mortality rate was 7.1%. CONCLUSION: The patients attended at this institution presented an epidemiological profile similar to what is found in the Brazilian literature. Chronic kidney failure is a significant factor with regard to intra-hospital mortality. Preventive measures such as early diagnosis and treatment of osteoporosis and regular physical activity practices were not implemented.

  9. The locomotion of Babakotia radofilai inferred from epiphyseal and diaphyseal morphology of the humerus and femur.

    Science.gov (United States)

    Marchi, Damiano; Ruff, Christopher B; Capobianco, Alessio; Rafferty, Katherine L; Habib, Michael B; Patel, Biren A

    2016-09-01

    Palaeopropithecids, or "sloth lemurs," are a diverse clade of large-bodied Malagasy subfossil primates characterized by their inferred suspensory positional behavior. The most recently discovered genus of the palaeopropithecids is Babakotia, and it has been described as more arboreal than Mesopropithecus, but less than Palaeopropithecus. In this article, the within-bone and between-bones articular and cross-sectional diaphyseal proportions of the humerus and femur of Babakotia were compared to extant lemurs, Mesopropithecus and Palaeopropithecus in order to further understand its arboreal adaptations. Additionally, a sample of apes and sloths (Choloepus and Bradypus) are included as functional outgroups composed of suspensory adapted primates and non-primates. Results show that Babakotia and Mesopropithecus both have high humeral/femoral shaft strength proportions, similar to extant great apes and sloths and indicative of forelimb suspensory behavior, with Babakotia more extreme in this regard. All three subfossil taxa have relatively large femoral heads, also associated with suspension in modern taxa. However, Babakotia and Mesopropithecus (but not Palaeopropithecus) have relatively small femoral head surface area to shaft strength proportions suggesting that hind-limb positioning in these taxa during climbing and other behaviors was different than in extant great apes, involving less mobility. Knee and humeral articular dimensions relative to shaft strengths are small in Babakotia and Mesopropithecus, similar to those found in modern sloths and divergent from those in extant great apes and lemurs, suggesting more sloth-like use of these joints during locomotion. Mesopropithecus and Babakotia are more similar to Choloepus in humerofemoral head and length proportions while Palaeopropithecus is more similar to Bradypus. These results provide further evidence of the suspensory adaptations of Babakotia and further highlight similarities to both extant suspensory

  10. Magnetic resonance perfusion and diffusion imaging characteristics of transient bone marrow edema, avascular necrosis and subchondral insufficiency fractures of the proximal femur

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Dirk, E-mail: d.mueller@uk-koeln.de [Department of Radiology, University of Cologne (Germany); Department of Radiology, Technische Universität München (Germany); Schaeffeler, Christoph, E-mail: schaeffeler@me.com [Department of Radiology, Cantonal Hospital Graubuenden, Chur (Switzerland); Department of Radiology, Cantonal Hospital Graubuenden, Chur (Switzerland); Baum, Thomas, E-mail: thomas-baum@gmx.de [Department of Radiology, Technische Universität München (Germany); Walter, Flavia, E-mail: flavia_walter2000@yahoo.de [Department of Radiology, Technische Universität München (Germany); Rechl, Hans, E-mail: rechl@tum.de [Department of Orthopaedics, Technische Universität München (Germany); Rummeny, Ernst J., E-mail: rummeny@tum.de [Department of Radiology, Technische Universität München (Germany); Woertler, Klaus, E-mail: klaus.woertler@tum.de [Department of Radiology, Technische Universität München (Germany)

    2014-10-15

    Highlights: • DCE-MRI may add information to the pathophysiology of bone marrow edema (BME) of the proximal femur. • Patients with transient bone marrow edema (TBME) or subchondral insufficiency fractures (SIF) and avascular osteonecrosis (AVN) showed different MR perfusion patterns. • Perfusion characteristics suggest different pathophysiology for AVN compared with TBME or SIF. • Diffusion weighted imaging (DWI) was not able to discriminate necrotic from edematous bone marrow. • DWI is of limited value to evaluate BME of the proximal femur. - Abstract: Purpose: To evaluate magnetic resonance (MR) perfusion and diffusion imaging characteristics in patients with transient bone marrow edema (TBME), avascular necrosis (AVN), or subchondral insufficiency fractures (SIF) of the proximal femur. Materials and methods: 29 patients with painful hip and bone marrow edema pattern of the proximal femur on non-contrast MR imaging were examined using diffusion-weighted and dynamic gadolinium-enhanced sequences. Apparent diffusion coefficients (ADCs) and perfusion parameters were calculated for different regions of the proximal femur. Regional distribution and differences in ADC values and perfusion parameters were evaluated. Results: Seven patients presented with TBME, 15 with AVN and seven with SIF of the proximal femur. Perfusion imaging showed significant differences for maximum enhancement values (E{sub max}), slope (E{sub slope}) and time to peak (TTP) between the three patient groups (p < 0.05). In contrast, no significant differences for ADC values were calculated when comparing TBME, AVN, and SIF patients. Conclusion: Diffusion weighted imaging of bone marrow of the proximal femur did not show significant differences between patients with TBME, AVN or SIF. In contrast, MR perfusion imaging demonstrated significant differences for the different patient groups and may as a complementary imaging technique add information to the understanding of the pathophysiology

  11. Associations of vitamin D deficiency with postoperative gait and mortality among patients with fractures of the proximal femur

    Directory of Open Access Journals (Sweden)

    David Nicoletti Gumieiro

    2015-04-01

    Full Text Available OBJECTIVE: To assess whether serum vitamin D concentration is associated with gait status and mortality among patients with fractures of the proximal femur, six months after suffering the fracture.METHODS: Consecutive patients aged ≥65 years with fractures of the proximal femur, who were admitted to the orthopedics and traumatology ward of our service between January and December 2011, were prospectively evaluated. Clinical, radiological, epidemiological and laboratory analyses were performed, including vitamin D. The patients underwent surgery and were followed up as outpatients, with return visits 15, 30, 60 and 180 days after discharge, at which the outcomes of gait and mortality were evaluated.RESULTS: Eighty-eight patients were evaluated. Two of them were excluded because they presented oncological fractures. Thus, 86 patients of mean age 80.2 ± 7.3 years were studied. In relation to serum vitamin D, the mean was 27.8 ± 14.5 ng/mL, and 33.7% of the patients presented deficiency of this vitamin. In relation to gait, univariate and multivariate logistic regression showed that vitamin D deficiency was not associated with gait recovery, even after adjustment for gender, age and type of fracture (OR: 1.463; 95% CI: 0.524-4.088; p = 0.469. Regarding mortality, Cox regression analysis showed that vitamin D deficiency was not related to its occurrence within six months, even in multivariate analysis (HR: 0.627; 95% CI: 0.180-2.191; p = 0.465.CONCLUSION: Serum vitamin D concentration was not related to gait status and/or mortality among patients with fractures of the proximal femur, six months after suffering the fracture.

  12. Outcome Assessment of Hybrid External Fixation in the Treatment of Comminuted Distal Femur and Proximal Tibial Fractures

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    Sarrafan

    2016-02-01

    Full Text Available Background Treatment of comminuted fractures of the distal femur and proximal tibia is difficult, and a challenge in the field of orthopedic trauma. Objectives The aim of this study was to assess the short-term results of hybrid external fixation in the treatment of these fractures. Patients and Methods In a prospective study, 44 patients with comminuted fractures of the distal femur or proximal tibia, with an overlying soft tissue injury treated by closed reduction and hybrid external fixation, were included. Parameters such as pin-track infection, union, limb shortening, knee motion, and alignment were evaluated during a mean follow-up period of 14 months. Results Forty-four patients with distal femoral (n = 23 and proximal tibial (n = 21 fractures were treated using hybrid external fixation. Bone union was seen in 35 (80% of the patients. Pin tract infection was seen in three patients (6.8%, one case (4.6% with a PTF and two cases (8% with DFFs. Malunion was observed in 4 patients (9.1%; of these, three cases (13% had DFF and one case (4.8% of pain was detected in the DFF group. One case had malunion and three cases had union. Findings showed satisfactory results in more than 80% of patients. In general, lower postoperative complications were detected in the proximal tibial fractures than the distal femoral fractures. According to a chi-square test, the difference between the patients with PTFs and those with DFFs was not clinically significant. Conclusions Closed reduction and hybrid external fixation can be used as a definitive treatment for severe comminuted fractures of the distal femur and proximal tibia, when the concomitant contusion of the skin and soft tissue damage prohibits safe open reduction and internal fixation.

  13. Degradation and silicon excretion of the calcium silicate bioactive ceramics during bone regeneration using rabbit femur defect model.

    Science.gov (United States)

    Lin, Kaili; Liu, Yong; Huang, Hai; Chen, Lei; Wang, Zhen; Chang, Jiang

    2015-06-01

    The investigation of the bone regeneration ability, degradation and excretion of the grafts is critical for development and application of the newly developed biomaterials. Herein, the in vivo bone-regeneration, biodegradation and silicon (Si) excretion of the new type calcium silicate (CaSiO3, CS) bioactive ceramics were investigated using rabbit femur defect model, and the results were compared with the traditional β-tricalcium phosphate [β-Ca3(PO4)2, β-TCP] bioceramics. After implantation of the scaffolds in rabbit femur defects for 4, 8 and 12 weeks, the bone regenerative capacity and degradation were evaluated by histomorphometric analysis. While urine and some organs such as kidney, liver, lung and spleen were resected for chemical analysis to determine the excretion of the ionic products from CS implants. The histomorphometric analysis showed that the bioresorption rate of CS was similar to that of β-TCP in femur defect model, while the CS grafts could significantly stimulate bone formation capacity as compared with β-TCP bioceramics (P < 0.05). The chemical analysis results showed that Si concentration in urinary of the CS group was apparently higher than that in control group of β-TCP. However, no significant increase of the Si excretion was found in the organs including kidney, which suggests that the resorbed Si element is harmlessly excreted in soluble form via the urine. The present studies show that the CS ceramics can be used as safe, bioactive and biodegradable materials for hard tissue repair and tissue engineering applications.

  14. SURGICAL OUTCOMES OF SUBTROCHANTERIC FRACTURES OF FEMUR TREATED WITH PROXIMAL FEMORAL NAIL (PFN

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    Jenson

    2016-06-01

    Full Text Available BACKGROUND AND OBJECTIVES Subtrochanteric fractures of the femur remain one of the most challenging fractures facing orthopaedic surgeons. Most of the fractures in the elderly results from trivial fall from standing or walking, while in the younger age group it is mainly due to road traffic accidents. Closed management of these subtrochanteric fractures thus poses difficulties in obtaining and maintaining a reduction, making operative management the preferred treatment. Hence, this study is intended to determine the effectiveness of intramedullary fixation of subtrochanteric fractures with the proximal femoral nail and the complications involved in the management of subtrochanteric fractures. METHODOLOGY This is a prospective study of 90 cases of Subtrochanteric fracture admitted to Tagore Medical College and Hospitals between October 2013 and Jan 2016 treated with the proximal femoral nail. Cases were taken according to inclusion and exclusion criteria, i.e. fresh Subtrochanteric fracture in adults. Pathologic fractures, multiple fractures, fractures in children, old neglected fractures were excluded from the study. RESULTS In our study of 90 cases, there were 75 male and 15 female patients with age ranging from 17 years to 75 years with most patients in between 21-40 years; 67% of the cases admitted were road traffic accidents, 23% due to fall from height and 10% due to trivial fall with right side being more common side affected. Russell and Taylor type IA fracture accounted for 40% of cases. Mean duration of hospital stay was 12 days and mean time of full weight bearing was 14 weeks in our patients. Out of 90 cases, 9 cases were lost in follow-up and 3 cases died. Good-to-excellent results were seen in 80% of cases in our study. CONCLUSION From our study, we conclude that PFN is a reliable implant for subtrochanteric fractures leading to high rate of bone union and minimal soft tissue damage. Intramedullary fixation has biological and

  15. Is the rotation of the femural head a potential initiation for cutting out? A theoretical and experimental approach

    LENUS (Irish Health Repository)

    Lenich, Andreas

    2011-04-22

    Abstract Background Since cut-out still remains one of the major clinical challenges in the field of osteoporotic proximal femur fractures, remarkable developments have been made in improving treatment concepts. However, the mechanics of these complications have not been fully understood. We hypothesize using the experimental data and a theoretical model that a previous rotation of the femoral head due to de-central implant positioning can initiate a cut-out. Methods In this investigation we analysed our experimental data using two common screws (DHS\\/Gamma 3) and helical blades (PFN A\\/TFN) for the fixation of femur fractures in a simple theoretical model applying typical gait pattern on de-central positioned implants. In previous tests during a forced implant rotation by a biomechanical testing machine in a human femoral head the two screws showed failure symptoms (2-6Nm) at the same magnitude as torques acting in the hip during daily activities with de-central implant positioning, while the helical blades showed a better stability (10-20Nm). To calculate the torque of the head around the implant only the force and the leverarm is needed (N [Nm] = F [N] * × [m]). The force F is a product of the mass M [kg] multiplied by the acceleration g [m\\/s2]. The leverarm is the distance between the center of the head of femur and the implant center on a horizontal line. Results Using 50% of 75 kg body weight a torque of 0.37Nm for the 1 mm decentralized position and 1.1Nm for the 3 mm decentralized position of the implant was calculated. At 250% BW, appropriate to a normal step, torques of 1.8Nm (1 mm) and 5.5Nm (3 mm) have been calculated. Comparing of the experimental and theoretical results shows that both screws fail in the same magnitude as torques occur in a more than 3 mm de-central positioned implant. Conclusion We conclude the center-center position in the head of femur of any kind of lag screw or blade is to be achieved to minimize rotation of the femoral head

  16. Sex specific association of physical activity on proximal femur BMD in 9 to 10 year-old children.

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    Graça Cardadeiro

    Full Text Available The results of physical activity (PA intervention studies suggest that adaptation to mechanical loading at the femoral neck (FN is weaker in girls than in boys. Less is known about gender differences associated with non-targeted PA levels at the FN or other clinically relevant regions of the proximal femur. Understanding sex-specific relationships between proximal femur sensitivity and mechanical loading during non-targeted PA is critical to planning appropriate public health interventions. We examined sex-specific associations between non-target PA and bone mineral density (BMD of three sub-regions of the proximal femur in pre- and early-pubertal boys and girls. BMD at the FN, trochanter (TR and intertrochanter (IT regions, and lean mass of the whole body were assessed using dual-energy x-ray absorptiometry in 161 girls (age: 9.7±0.3 yrs and 164 boys (age: 9.7±0.3 yrs. PA was measured using accelerometry. Multiple linear regression analyses (adjusted for body height, total lean mass and pubertal status revealed that vigorous PA explained 3-5% of the variability in BMD at all three sub-regions in boys. In girls, vigorous PA explained 4% of the variability in IT BMD and 6% in TR BMD. PA did not contribute to the variance in FN BMD in girls. An additional 10 minutes per day of vigorous PA would be expected to result in a ∼1% higher FN, TR, and IT BMD in boys (p<0.05 and a ∼2% higher IT and TR BMD in girls. In conclusion, vigorous PA can be expected to contribute positively to bone health outcomes for boys and girls. However, the association of vigorous PA to sub-regions of the proximal femur varies by sex, such that girlś associations are heterogeneous and the lowest at the FN, but stronger at the TR and the IT, when compared to boys.

  17. Comparative evaluation of femoral nerve block and intravenous fentanyl for positioning during spinal anaesthesia in surgery of femur fracture

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    Ashok Jadon

    2014-01-01

    Full Text Available Background: Spinal anaesthesia is the preferred technique to fix fracture of the femur. Extreme pain does not allow ideal positioning for this procedure. Intravenous fentanyl and femoral nerve block are commonly used techniques to reduce the pain during position for spinal anaesthesia however; results are conflicting regarding superiority of femoral nerve block over intravenous fentanyl. Aims: We conducted this study to compare the analgesic effect provided by femoral nerve block (FNB and intra- venous (IV fentanyl prior to positioning for central neuraxial block in patients undergoing surgery for femur fracture. Patients and Methods: In this randomized prospective study 60 patients scheduled for fracture femur operation under spinal were included. Patients were distributed in two groups through computer generated random numbers table; Femoral nerve block group (FNB and Intravenous fentanyl group (FENT. In FNB group patients received FNB guided by a peripheral nerve stimulator (Stimuplex; B Braun, Melsungen, AG 5 minutes prior to positioning. 20mL, 1.5% lidocaine with adrenaline (1:200,000 was injected incrementally after a negative aspiration test. Patients in the fentanyl group received injection fentanyl 1 μg/kg IV 5 mins prior to positioning. Spinal block was performed and pain scores before and during positioning were recorded. Statistical analysis was done with Sigmaplot version-10 computer software. Student t-test was applied to compare the means and P < 0.05 was taken as significant. Results: VAS during positioning in group FNB: 0.57 ± 0.31 versus FENT 2.53 ± 1.61 (P = 0.0020. Time to perform spinal anesthesia in group FNB: 15.33 ± 1.64 min versus FENT 19.56 ± 3.09 min (P = 0.000049. Quality of patient positioning for spinal anesthesia in group FNB 2.67± 0.606 versus FENT 1.967 ± 0.85 (P = 0.000027. Patient acceptance was less in group FENT (P = 0.000031. Conclusion: Femoral nerve block provides better analgesia, patient

  18. Low cost continuous femoral nerve block for relief of acute severe cancer related pain due to pathological fracture femur

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    Rachel Cherian Koshy

    2010-01-01

    Full Text Available Pathological fractures in cancer patient cause severe pain that is difficult to control pharmacologically. Even with good pain relief at rest, breakthrough and incident pain can be unmanageable. Continuous regional nerve blocks have a definite role in controlling such intractable pain. We describe two such cases where severe pain was adequately relieved in the acute phase. Continuous femoral nerve block was used as an efficient, cheap and safe method of pain relief for two of our patients with pathological fracture femur. This method was proved to be quite efficient in decreasing the fracture-related pain and improving the level of well being.

  19. Is the rotation of the femural head a potential initiation for cutting out? A theoretical and experimental approach

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    Nerlich Michael

    2011-04-01

    Full Text Available Abstract Background Since cut-out still remains one of the major clinical challenges in the field of osteoporotic proximal femur fractures, remarkable developments have been made in improving treatment concepts. However, the mechanics of these complications have not been fully understood. We hypothesize using the experimental data and a theoretical model that a previous rotation of the femoral head due to de-central implant positioning can initiate a cut-out. Methods In this investigation we analysed our experimental data using two common screws (DHS/Gamma 3 and helical blades (PFN A/TFN for the fixation of femur fractures in a simple theoretical model applying typical gait pattern on de-central positioned implants. In previous tests during a forced implant rotation by a biomechanical testing machine in a human femoral head the two screws showed failure symptoms (2-6Nm at the same magnitude as torques acting in the hip during daily activities with de-central implant positioning, while the helical blades showed a better stability (10-20Nm. To calculate the torque of the head around the implant only the force and the leverarm is needed (N [Nm] = F [N] * × [m]. The force F is a product of the mass M [kg] multiplied by the acceleration g [m/s2]. The leverarm is the distance between the center of the head of femur and the implant center on a horizontal line. Results Using 50% of 75 kg body weight a torque of 0.37Nm for the 1 mm decentralized position and 1.1Nm for the 3 mm decentralized position of the implant was calculated. At 250% BW, appropriate to a normal step, torques of 1.8Nm (1 mm and 5.5Nm (3 mm have been calculated. Comparing of the experimental and theoretical results shows that both screws fail in the same magnitude as torques occur in a more than 3 mm de-central positioned implant. Conclusion We conclude the center-center position in the head of femur of any kind of lag screw or blade is to be achieved to minimize rotation of the

  20. Episomal plasmid-based generation of induced pluripotent stem cells from fetal femur-derived human mesenchymal stromal cells.

    Science.gov (United States)

    Megges, Matthias; Oreffo, Richard O C; Adjaye, James

    2016-01-01

    Human bone mesenchymal stromal cells derived from fetal femur 55 days post-conception were reprogrammed to induced pluripotent stem cells using episomal plasmid-based expression of OCT4, SOX2, NANOG, LIN28, SV40LT, KLF4 and c-MYC and supplemented with the following pathway inhibitors - TGFβ receptor inhibitor (A-83-01), MEK inhibitor (PD325901), GSK3β inhibitor (CHIR99021) and ROCK inhibitor (HA-100). Successful induction of pluripotency in two iPS-cell lines was demonstrated in vitro and by the Pluritest.

  1. Genetic Differences Control the Response of Femur and Lumbar Spine Trabecular Bone Microstructure to Dietary Calcium Restriction in Mice

    OpenAIRE

    2013-01-01

    Both dietary calcium and genetics influence bone density and structure. However, how genetics affect the adaptation response of bone parameters to dietary calcium (Ca) restriction is unknown. 11 inbred strains of mice were fed adequate (0.5%) or low (0.25%) Ca diets from 4-12 weeks of age and were evaluated for gene-by-diet interactions affecting bone structure at the femur and lumbar spine. We observed that genetics and diet main effects as well as gene-by-diet interactions si...

  2. CT analysis of the upper end of the femur: the asterisk sign and ischaemic bone necrosis of the femoral head.

    Science.gov (United States)

    Dihlmann, W

    1982-01-01

    In computed tomography (CT) of the head of the femur, a star-shaped structure can be seen which we refer to as the asterisk or asterisk sign. The asterisk is formed by thickened weight-bearing bone trabeculae. It can be shown by CT that the asterisk exhibits a characteristic change in ischaemic bone necrosis of the femoral head, even when the disease is in an early stage. CT of the hip joint is therefore an important examination for early diagnosis of ischaemic disease of the femoral head.

  3. Age-related Marrow Conversion and Developing Epiphysis in the Proximal Femur: Evaluation with STIR MR Imaging

    Institute of Scientific and Technical Information of China (English)

    NIU Jinliang; FENG Gansheng; KONG Xiangquan; WANG Jun; HAN Ping

    2007-01-01

    In order to observe the feature of age-related marrow conversion and maturation of epi-physeal cartilage and analyze the distribution of red and yellow marrow in the proximal femur at STIR MR imaging, STIR and T1 weighted MR imaging of the proximal femur in 52 subjects, aged 4 months to 25 years old, were retrospectively analyzed for the distribution and appearance of red and yellow marrow. The subjects with no known bone marrow abnormalities were divided into 6 age groups. The signal intensity of the marrow in the proximal epiphysis, proximal metaphysis, proximal diaphysis, distal diaphysis and greater trochanter was compared with the signal intensity and homo- geneity of surrounding muscle and fat and graded by two observers. The results showed that the con- version of hematopoietic marrow in the proximal femur followed a well-defined sequence, occurring first in the proximal epiphysis, followed by the distal diaphysis, and then greater trochanter and metaphysis. STIR in combination with T1-weighted imaging could display clearly the origin of ossi-fication center and the course of conversion from red to yellow marrow in proximal epiphysis and greater trochanter. STIR imaging showed that the marrow conversion in proximal metaphysic began below epiphyseal plate and intertrochanter. The site of red yellow was distributed in weight-bearing axis by 20 years of age. The marrow conversion of diaphysis was from distal end to proximal end, and the consequence of conversion was that distal diaphysis contained yellow marrow but proximal diaphysis partly red marrow connected with the red marrow of metaphysic. The epiphyseal cartilage had different characters of signal-intensity with age in STIR sequence. The distribution of red marrow in STIR imaging was more close to that of anatomy than T1-weighted imaging. It was concluded that STIR could dynamically display the feature of morrow conversion and the development of epiphyseal cartilage and accurately reveal the age

  4. The precision and influence of rotation for measurements of bone mineral density of the distal femur following total knee arthroplasty: a methodological study using DEXA.

    Science.gov (United States)

    Therbo, Matthias; Petersen, Michael M; Schrøder, Henrik M; Nielsen, Palle K; Zerahn, Bo; Lund, Bjarne

    2003-12-01

    We evaluated the feasibility of DEXA (Norland XR-26 mark II) for quantitative measurements of bone mineral density (BMD) in the lateral plane of the distal femur after total knee arthroplasty (TKA). BMD was measured in 5-6 regions of interest (ROI) in close relation to the femoral component. In an in vitro study using 3 different distal femur phantoms, we found that the precision was affected by rotation of the distal femur. When BMD measurements were repeated within a range of motion of 40 degrees, 20 degrees, and 0 degrees, the coefficient of variation (CV) was approximately 15%, 10%, and 0.6%, respectively. We found that the use of bone cement for implant fixation had no effect on the level of BMD. Double measurements performed in 28 patients gave average CV values of 3.3%, 3.0%, and 2.6% for the uncemented Duracon, and Interax femoral components and the cemented AGC components, respectively. Our in vivo average CV measurements of BMD of the distal femur after TKA were on a level, suitable for repeated BMD measurements in prospective studies, which evaluate adaptive bone remodeling of the distal femur after cemented and uncemented TKA.

  5. {sup 99m}Tc-MDP bone uptake in secondary hyperparathyroidism: comparison among mandible, cranium, radius and femur

    Energy Technology Data Exchange (ETDEWEB)

    Boasquevisque, Edson; Silva, Jorge Wagner Esteves da; Bernardo, Vanessa V. de Albuquerque; Macedo, Sara Mello Santana de; Boasquevisque, Camila S.

    2008-07-01

    Full text: Objective: Evaluating bone involvement in secondary hyperparathyroidism (SHPT) by {sup 99m}Tc-MDP uptake in the mandible, cranium, radius and femur and with data correlation with PTHi serum (Intact Parathyroid Hormone). Materials and Methods: In a prospective study of 54 patients with SHPT due to chronic renal disease and 15 normal individuals (control group), all patients had elevated serum PTHi, concentration and positive {sup 99m}Tc-MDP bone scintigraphy. Bone uptake measurements were carried out drawing regions-of-interest (ROI) on the mandible, posterior cranium, distal radius and proximal femur. Additionally, soft tissue uptake was measured with one region-of-interest on the internal tight soft tissue (BG). The ROI-BG ratio used as the index of normalized bone uptake. Results: The uptake differences from SHPT and control groups mainly for mandible (p = 0,001) and cranium (p = 0,002) were statistically significant, even when the SHPT groups were separated according to serum PTHi levels. There was increased bone uptake with the increased levels of PTHi serum. All of the mandibles of the SHPT patients were abnormal with 33% having focal lesions. Conclusions: The bone uptake in SHPT group was abnormal in all areas evaluated, with high uptake of {sup 99m}Tc-MDP correlated to the increase of PTHi serum concentration. (author)

  6. Decreased bone density of the distal femur after uncemented knee arthroplasty. A 1-year follow-up of 29 knees.

    Science.gov (United States)

    Petersen, M M; Lauritzen, J B; Pedersen, J G; Lund, B

    1996-08-01

    We measured the early adaptive bone remodeling of the distal femur prospectively for 1 year after uncemented total knee arthroplasty (TKA) in 29 knees with primary arthrosis. 18 patients were randomized to receive a PCA Modular femoral component (n 9) or a modified version of the same prosthesis (n 9) with an altered location of the porous coating. The other 11 patients (n 11) formed a consecutive series with the Duracon femoral component. In the trabecular bone above the femoral component, bone mineral density (BMD) was measured in 2 regions of interest (ROI) anteriorly to the fixation pegs (ROI 1) and above the pegs (ROI 2), using dual photon absorptiometry (DPA). There were no differences between the Modular component and the modified version regarding the postoperative decrease in BMD. There was a decrease in BMD in both ROI 1 and ROI 2 with all 3 different femoral components, and in both ROIs the highest bone loss rate was observed during the first 3 months after surgery. On average (n 29), a significant bone loss of 44% and 19% in ROI 1 and ROI 2, respectively, was reached at the 1-year follow-up, compared to the initial values. A decrease of this magnitude in BMD in the anterior distal femur 1 year after TKA may be an important determinant of periprosthetic fracture and later failure of the femoral component. In this experimental set-up, a modified femoral component with an altered location of the porous coating did not influence the development of bone loss.

  7. Bone neoformation in defects treated with platelet-rich fibrin membrane versus collagen membrane: a histomorphometric study in rabbit femurs.

    Directory of Open Access Journals (Sweden)

    Edwin Meza

    2015-02-01

    Full Text Available The aim of the present research was to compare bone neoformation in bone defects treated with platelet-rich fibrin (PRF and collagen membrane (CM at 3 and 5 weeks. For this purpose, two bone defects with a width of 4 mm and depth of 6 mm were created in the left distal femur diaphysis of New Zealand rabbits (n=12. The subjects were randomly allocated into two groups. One of the defects was covered with a platelet-rich fibrin membrane (Centrifuged resorbable autologous blood biopolymer without biochemical modification or a collagen membrane (gold standard - Neo Mem. The second defect was left uncovered (NC. The rabbits were sacrificed after 3 and 5 weeks (3 rabbits per period. The femur was completely removed and processed histomophometrically. The bone neformation analysis was performed using a differential point-counting method. Data was statistically analyzed (ANOVA, Tukey. The histomorphometric results showed that bone neformation in the defects treated with PRF at 3 weeks was equivalent to the CM (p<0.05. After 5 weeks, bone neformation obtained with PRF was higher than the control group and lower compared with the CM (p<0.05. The conclusion of the present study is that bone neformation in defects treated with PRF showed lower histomorphometric results compared with the one obtained with the collagen membrane and higher when compared with the control defects.

  8. sup 99m Tc-MDP abnormal uptake in the shaft of femur with hemi-lateral hip joint disorders

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Hidetoshi; Tanaka, Kouji (Gifu Prefectural Tajimi Hospital (Japan)); Sakuma, Sadayuki

    1990-08-01

    During the past 4 years, three-phase bone scintigraphy using {sup 99m}Tc-MDP has been studied in 68 patients suffering from hemi-lateral hip-joint disorders. We were impressed on abnormal uptake of the shaft of femur on the involved side. {sup 99m}Tc-MDP uptake in the shaft of femur was compared with between involved leg and normal leg of 68 patients with hemi-lateral hip-joint disorders (76 examinations). We excluded cases of osteomyelitis, cases of malignant tumor, and post-operative cases. In early images, the {sup 99m}Tc-MDP uptake was not always increased in involved side. But in delayed images, there were no patients whose normal side's {sup 99m}Tc-MDP uptake was increased. The {sup 99m}Tc-MDP uptake in early image was not related only with blood flow of the tigh but with the amount of soft tissue of the tigh. And the {sup 99m}Tc-MDP uptake in delayed image was related with disuse osteoporosis. (author).

  9. Bilateral undisplaced insufficiency neck of femur fractures associated with short-term steroid use: a case report

    Directory of Open Access Journals (Sweden)

    Gurdezi Sabahat

    2008-03-01

    Full Text Available Abstract Introduction We present an interesting and unusual case of a 61-year-old woman with bilateral, undisplaced, stress neck of femur fractures associated with short-term steroid use. Insufficiency fractures of the neck of femur without preceding trauma have been described in the literature, although bilateral involvement is infrequent. These fractures have been associated with strenuous exercise, seizures, renal osteodystrophy, fluoride treatment, long-term corticosteroid use, amenorrhoea, abnormal anatomy and osteomalacia due to nutritional and/or hormonal factors. Case Presentation The case we present differs from other published reports, in that the patient's symptoms developed acutely after only a short course of steroids and with no associated trauma or strenuous exercise. It is also the only case described where no operative intervention was required. Conclusion Our case reiterates the importance of considering insufficiency or stress fractures in high-risk patients who present with musculoskeletal pain. Institution of bone protection should also be considered in these patients. Morbidity related to delayed treatment has been well documented, so a high level of clinical suspicion is imperative.

  10. Using a Truss-Inspired Model with the Uniform Strength Optimization Theory to Predict Spongy Bone Geometry in Proximal Femur

    Directory of Open Access Journals (Sweden)

    Hamed Pishdast

    2009-01-01

    Full Text Available This paper presents a new naïve approach for simulating bone remodeling process. It is based on the uniform strength theory of optimization and employs a truss-like model for bone. The truss was subjected to external loads including 5 point loads simulating the hip joint contact forces and 3 muscular forces at the attachment sites of the muscles to the bone and the rest are reactions of ligaments. The strain in the links was calculated and the links with high strains were identified. The initial truss is modified by introducing new links wherever the strain exceeds a prescribed or critical value. The critical value was assumed to be equal to an average of the absolute value of strains in the initial model. Each link which undergoes a high strain is replaced by several new links by adding new nodes around it using Delaunay method. Introducing the new links to the truss, which is conducted according to a weighted arithmetic mean formula, will strengthen the structure and reduce the strain within the respective zone. This procedure was repeated for several times. Convergence was achieved when there were no critical links remaining. This method was used to study the 2D shape of proximal femur in the frontal plane and provided results which are in a fairly good agreement with CT image of the human proximal femur.

  11. Personalized x-ray reconstruction of the proximal femur via a non-rigid 2D-3D registration

    Science.gov (United States)

    Yu, Weimin; Zysset, Philippe; Zheng, Guoyan

    2015-03-01

    In this paper we present a new approach for a personalized X-ray reconstruction of the proximal femur via a non-rigid registration of a 3D volumetric template to 2D calibrated C-arm images. The 2D-3D registration is done with a hierarchical two-stage strategy: the global scaled rigid registration stage followed by a regularized deformable b-spline registration stage. In both stages, a set of control points with uniform spacing are placed over the domain of the 3D volumetric template and the registrations are driven by computing updated positions of these control points, which then allows to accurately register the 3D volumetric template to the reference space of the C-arm images. Comprehensive experiments on simulated images, on images of cadaveric femurs and on clinical datasets are designed and conducted to evaluate the performance of the proposed approach. Quantitative and qualitative evaluation results are given, which demonstrate the efficacy of the present approach.

  12. [Intramedullary osteosynthesis in treating intertrochanteric fracture of the femur, based on our own experience using Gamma nails and Ender rods].

    Science.gov (United States)

    Bednarenko, Marcin; Kotela, Ireneusz; Zieńzuk, Witold; Korzec, Artur

    2008-01-01

    Intertrochanteric fractures have always posed an interdisciplinary medical problem. Most frequently it happens between 7th and 8th decades of life. The majority of them are due to osteoporosis. Both for a medical doctor and surgeon they face quite a challenge when it comes to treating a patient with a fracture of the proximal epiphysis of the femur. Recently, the outcome of the fracture treatment has improved greatly due to introduction of modern methods of intramedullary and periosteal fusion. In this study we present a possible utilization of Gamma nails, its advantages and disadvantages compared with the stabilisation achieved using Ender rods. We analyzed the outcome of treatment of 198 patients treated for intertrochanteric fractures of the femur. We present advantages and disadvantages of both methods of stabilization. We stress the importance of the correct reduction of the bone even if requiring opening. We also point to difficulties that accompany both types of stabilization. The final results reveal a considerably better outcome in patients treated using Gamma nails, especially if fractures were instable.

  13. A simple technique to position patients with bilateral above-knee amputations for operative fixation of intertrochanteric fractures of the femur: a case report

    Directory of Open Access Journals (Sweden)

    Dramis Asterios

    2010-11-01

    Full Text Available Abstract Introduction Intertrochanteric fractures of the femur are common fractures in the elderly, and management includes operative fixation after patient positioning on the fracture table. Patients with bilateral above-knee amputations are challenging in terms of positioning on the table. We describe a simple technique to overcome this special problem. Case presentation A 75-year-old wheelchair-bound Caucasian man with bilateral above-knee amputations presented to our hospital after a fall. Plain radiographs showed an intertrochanteric fracture of the femur, and operative fixation with a dynamic hip screw was planned. His positioning on the table posed a particular problem, and therefore we developed a technique to overcome this problem. Conclusion Positioning of patients for fixation of intertrochanteric fractures of the femur poses a particular problem that can be solved by using our simple technique.

  14. FETAL GESTATIONAL AGE ESTIMATION BY FETAL FOOT LENGTH MEASUREMENT AND FETAL FEMUR TO FOOT LENGTH RATIO IN INDIAN POPULATION - A PROSPECTIVE STUDY

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    Mukta

    2014-03-01

    Full Text Available BACKGROUND: Multiple parameters are in use for the accurate assessment of the gestational age by ultrasound, but the literature suggests that fetal foot length can be used to estimate gestational age, when other parameters are not available for measurement. Foetal femur/ foot length ratio can help in differentiating the foeti that have dysplastic limb reduction, from those whose limbs are short because of constitutional factors/IUGR. A prospective study was done to measure the fetal foot length for gestational age and to evaluate fetal femur to foot length ratio in pregnant women of 16-37 weeks gestation. MATERIALS & METHOD: One hundred and three normal singleton pregnant women of 16-37 weeks gestation were examined for routine obstetrics ultrasound. In these patients fetal foot length measurements were taken and the gestational age was assessed. In addition, fetal femur length to foot length ratio was calculated in each patient. RESULTS/OBSERVATION: Linear relationship between foot length and gestational age was present with a R2 value of 0.90 (p < than 0.001 and the fetal femur length/foot length ratio was found to be more than or equal to 0.92.The foot length can be a reliable parameter for use in assessment of gestational age and as most skeletal dysplasias spare the feet, the fetal femur length/foot length ratio can be used to detect most skeletal dysplasia. CONCLUSIONS: Foetal foot length is a reliable parameter for assessment of gestational age and femur length/foot length ratio is approximately 1 and a ratio of < 0.92 shall be useful in the detection of most skeletal dysplasia.

  15. Premenopausal and postmenopausal changes in bone mineral density of the proximal femur measured by dual-energy X-ray absorptiometry

    DEFF Research Database (Denmark)

    Ravn, Pernille; Hetland, M L; Overgaard, K

    1994-01-01

    Total and regional bone mineral density (BMD) of the proximal femur was measured by DXA in 1238 healthy white women. In the 389 premenopausal women, aged 21-54 years, no bone loss was observed before the menopause, except in the femoral neck and Ward's triangle, in which BMD decreased by 0.3%/year...... femur and a postmenopausal bone loss, which is influenced mainly by YSM within the first 10-15 years after menopause. BMD correlated with body mass index (BMI) in the postmenopausal years, confirming...

  16. Estimation of femoral bone density from trabecular direct wave and cortical guided wave ultrasound velocities measured at the proximal femur in vivo

    DEFF Research Database (Denmark)

    Barkmann, Reinhard; Dencks, Stefanie; Bremer, Alexander

    2008-01-01

    Bone mineral density (BMD) of the proximal femur is a predictor of hip fracture risk. We developed a Quantitative Ultrasound (QUS) scanner for measurements at this site with similar performance (FemUS). In this study we tested if ultrasound velocities of direct waves through trabecular bone...... echoes reflected from the skin of the leg to yield speed-of-sound (SOS) of different wave components. Data were cross-calibrated and pooled (62 women). Bivariate correlations and a multivariate model were calculated for the estimation of femur BMD. BMD correlated both with trabecular and cortical SOS...

  17. Peripartum Primary Prophylaxis Inferior Vena Cava Filter Placement in a Patient with Stage IV B-Cell Lymphoma Presenting with a Pathologic Femur Fracture

    Directory of Open Access Journals (Sweden)

    David M. Sherer

    2015-10-01

    Full Text Available Background  -Pulmonary embolus (PE remains a leading etiology of maternal mortality in the developed world. Increasing utilization of retrievable inferior vena cava (IVC filter placement currently includes pregnant patients. Case - A 22-year-old woman at 27 weeks' gestation was diagnosed with Stage IV high-grade malignant B cell lymphoma following pathologic femur fracture. Significant risk factors for PE led to placement of primary prophylaxis IVC filter before cesarean delivery, open reduction and internal fixation of the fractured femur, and chemotherapy. Conclusion - This case supports that primary prophylaxis placement of IVC filters in highly selected pregnant patients may assist in decreasing PE-associated maternal mortality.

  18. Meyer’s Muscle Pedicle Bone Graft a Novel Procedure in Treatment of Neglected Fracture Neck of Femur in Pediatric Age Group-A Case Report

    Science.gov (United States)

    Ponnanna, KM; Mannual, Sunil

    2016-01-01

    Meyers muscle pedicle graft has been used in delayed presentation and non-union of neck femur fracture in adults with good results. Delayed presentation or non-union neck femur in children is not uncommon in children. Subtrochanteric valgus osteotomy with or without fixation has been suggested with varying results. We present meyers muscle graft being used in paediatric age group with excellent result at 3 years follow-up. There are limited report literature of meyers muscle pedicle graft being used in children. PMID:27790536

  19. Application of Minimally Invasive PHILOS Fixation in the Treatment of Pediatric Subtrochanteric Femur Fractures%微创PHILOS钢板内固定在儿童股骨粗隆下骨折中的应用

    Institute of Scientific and Technical Information of China (English)

    陈俞涛; 杜璠; 杨江伟; 王春生; 王坤正

    2014-01-01

    Objective To summarize the outcome and complications of minimally invasive proximal humerus internal loc-king system( PHILOS)and the nonoperative treatment for pediatric subtrochanteric femur fractures. Methods A total of 24 children with subtrochanteric femur fractures treated with proximal humerus internal locking system and nonoperative treatment between Febrary 2005 and Febrary 2011 were identified. We retrospectively compared 15 children treated with minimally inva-sive proximal humerus internal locking system to 9 children treated nonoperatively. Comparative analysis was performed from the length of hospitalization,time to radiographic union,time to full weightbearing,outcome scores and postoperative complica-tions. Results All 24 patients were followed up for a mean time of 31. 5 months after surgery. The difference in the length of hospitalization,time to radiographic union and time to full weightbearing was significant for the 2 groups(P<0. 05). Outcome scores were significantly better in the proximal humerus internal locking system group(P<0. 05)and the overall complication rate was lower compared with nonoperative group(P<0. 05). Conclusion Our results indicate that minimally invasive proxi-mal humerus internal locking system of pediatric subtrochanteric femur fractures is associated with better outcome scores and a lower overall complication rate when compared with nonoperative group. Minimally invasive proximal humerus internal locking system had became one of the ideal treatment of pediatric subtrochanteric femur fractures.%目的:总结应用微创肱骨近端锁定钢板内固定与非手术治疗儿童股骨粗隆下骨折的结果和并发症。方法2005年2月至2011年2月,我院采用肱骨近端锁定钢板和非手术治疗儿童股骨粗隆下骨折共24例患者,回顾性比较15例采用肱骨近端锁定钢板和9例采用非手术治疗的患者,从住院时间、完全负重时间和影像愈合时间以及结果评分和术

  20. 康复护理在股骨骨折患者功能恢复过程中的作用%The effect of rehabilitation nursing on patients with fracture of femur in the period of function recovery

    Institute of Scientific and Technical Information of China (English)

    杨绍霞; 曹乃美; 蔡跃花

    2003-01-01

    @@ BACKGROUND:Dysfunction of knee joint is a common sequela after fracture of femur.The key of avoiding or decreasing dysfunction lies in early prevention,muscular practices of isometric contraction and functional exercises of knee joint as soon as possible.It is an essential component part of rehabilitation care for functional recovery of patients with fracture of femur.

  1. FUNCTIONAL OUTCOME OF SUPRACONDYLAR FRACTURES OF FEMUR MANAGED BY OPEN REDUCTION AND INTERNAL FIXATION WITH LOCKING COMPRESSION PLATE

    Directory of Open Access Journals (Sweden)

    Madhusudhana

    2015-10-01

    Full Text Available INTRODUCTION : Incidence of distal femur fractures is approximately 37 per 1 , 00,000 person - years.¹Distal femoral fractures has two different injury mechanisms, high energy trauma and low energy trauma. In high - energy trauma, the problem of restoring the function in a destroyed knee joint persists. Complex knee ligament injuries frequently occur additionally to extensive cartilage injuries. In elderly patients, extreme osteoporosis represents a particular problem for anchoring the implant. 2 Supracondylar and inter condylar fractures often are unstable and comminuted and tend to occur in the elderly or those with multiple injuries. Treatment options are many with varied results. The final outcome would depend upon the type of fracture, stabilization of fixation and and perhaps patient general condition. 3 The options for operative treatment are traditional plating techniques that require compression of the implant to the femoral shaft (blade plate, Dynamic Condylar Screw, non - locking condylar buttress plate, antegrade nailing fixation, retrograde nailing, sub muscular locked internal fixation and external fixation. 4 However, as the complexity of fractures needing treatment has changed from simple extra - articular supra - condylar types to inter - condylar and metaphyseal comminuted types, these implants may not be ideal. Double plating, and more recently, locked plating techniques have been advocated 5 . However with double plating there is often extensive soft tissue stripping on both sides of the femur, resulting in reduced blood supply and potential non - union and failure of the implants 6 . The LCP is a single beam construct where the strength of its fixation is equal to the sum of all screw - bone interfaces rather than a single screw’s axial stiffness or pullout resistance as seen in unlocked plates 7,8 . Its unique biomechanical function is based on splinting rather than compression resulting in flexible stabilization

  2. CORRECTION OF FEMUR DEFORMITIES BY ILIZAROV METHOD AND BY APPARATUS «ORTHO-SUV» BASED ON COMPUTER NAVIGATION

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    L. N. Solomin

    2011-01-01

    Full Text Available Results of correction of femur deformations by Ilizarov method and with apparatus Orto-SuV working on the basis of computer navigation are analyzed. For elimination of difficult deformations in order to avoid multiple external fixator remounting with stage-by-stage radiological control it is expedient to use apparatus Orto-SUV. In order to elimination of moderate and simple deformations (except torsion as hexapods and traditional techniques can be a choice method. The use «Orto-SUV» apparatus allows to reduce time necessary for deformation correction and osteosynthesis term in 1,4–2,4 times (for average and severe deformations.

  3. Through-knee amputation for a patient with proximal femur focal deficiency and tibial hemimelia: surgical anatomy and clinical implications.

    Science.gov (United States)

    Lloyd, Selvyn; Rashid, Abdul Halim Abd; Das, Srijit; Ibrahim, Sharaf

    2014-03-01

    Tibial hemimelia is a rare anomaly of unknown etiology. This condition can occur sporadically or may have a familial inheritance. It is characterized by deficiency of the tibia with a relatively intact fibula. The anomaly may be unilateral or bilateral. We report a case of a 2-year-old girl who presented with right lower limb deformity since birth. She was diagnosed with proximal femur focal deficiency with absence of the ipsilateral tibia. She presented with a shorter right lower limb and a deformed foot. She was treated with a through-knee amputation. Anatomical dissection of the amputated limb was carried out to verify the anomalies. The dissection showed that the distal phalanx of the great toe was trifid. The anatomical and clinical significance of this interesting case is discussed.

  4. Early Bone Formation at a Femur Defect Using CGF and PRF Grafts in Adult Dogs: A Comparative Study.

    Science.gov (United States)

    Park, Hyun-Chun; Kim, Su-Gwan; Oh, Ji-Su; You, Jae-Seek; Kim, Jae-Sung; Lim, Sung-Chul; Jeong, Mi-Ae; Kim, Jin-Son; Jung, Chan; Kwon, Young-Sun; Ji, Hyeok

    2016-06-01

    The purpose of this study was to compare the predictability of new bone formation using an autologous concentrated growth factor (CGF) graft alone and platelet graft alone. Four bony defects of 8 mm were formed, and 3.7- × 10-mm implants were placed in the right femur. The platelet-rich fibrin (PRF), CGF, and synthetic bone were grafted to the bone defect area. Enzyme linked immunosorbent assay quantitative analysis and microscopic analysis of the fibrinogen structure were performed. At 4 weeks, the comparisons of each experimental group showed a significant difference between the CGF group and the synthetic bone graft group. When comparing the CGF and allograft material groups, the allograft group showed significantly more new bone formation. In the case of vascular endothelial growth factor, CGF had 1.5 times more than PRF. CGF showed a fibrinogen structure with a constant diameter. When applied to a clinical case, CGF is predicted to show better results than PRF.

  5. A comparative study of trochanteric and basicervical fractures of the femur treated with the Ender and McLaughlin techniques.

    Science.gov (United States)

    Indemini, E; Clerico, P; Fenoglio, E; Mariotti, U

    1982-09-01

    Endomedullary nailing as proposed by Ender is an important alternative in the treatment of trochanteric and basicervical fractures of the femur (Amici et al., 1980; Carret et al., 1980; Ender, 1970; Kempf et al., 1979; Zinghi et al., 1979). Rush's concept (Eiffel Tower, for the distal epiphysis) is reproposed with some variations and transposed to the femoral neck. The aim of the operation differs from that of the nail and plate technique in that, instead of trying to achieve anatomical reconstruction, an immediate functional by-pass of the fractured part is attempted. After using this technique for three years, we compared the old method, which we had not abandoned, the McLaughlin nail and plate, with the new Ender nail.

  6. Femur-bending properties as influenced by gravity. IV - Limits after high and low weight-bearing

    Science.gov (United States)

    Wunder, C. C.; Tipton, C. M.; Cook, K. M.

    1980-01-01

    Gravity enhances femur growth as measured in terms of strength, but shows little or even a growth-retarding effect in terms of relative brittleness, defined as the inverse of ultimate or tolerable strain. Chronic weightlessness was simulated by harness suspension or by extrapolation of results from 3-g centrifugation. Experimental results from 45 male, white rats (34-520 d old) were compared to 72 control or baseline rats (28-520 d old) with correction for age and size differences. After suspension, the youngest rats showed subnormal tolerable strains. Combined results, however, although predicting 19 + or 1% below normal strength, after a week of weightlessness, predicted less effect (1 + or - 4%) for the tolerable strain.

  7. Influence of Lateral Muscle Loading in the Proximal Femur after Fracture Stabilization with a Trochanteric Gamma Nail (TGN)

    Science.gov (United States)

    Sitthiseripratip, Kriskrai; Mahaisavariya, Banchong; Suwanprateeb, Jintamai; Bohez, Erik; Vander Sloten, Jos

    The purpose of this study was to investigate the influence of lateral muscle loading on the stress/strain distributions of the trochanteric Gamma nail (TGN) fixation within the healed, trochanteric and subtrochanteric femoral fractures by means of a finite element method. The effect of three muscle groups, the abductors (ABD), the vastus lateralis (VL) and the iliotibial band (ITB), were investigated. The analytical results showed that addition of lateral muscle forces, iliotibial band and vastus lateralis, produced compensation of forces and reduction of bending moments in the bone and in the trochanteric Gamma nail especially in the lateral aspect. The iliotibial band produced a higher impact as compared to the vastus lateralis. Therefore in the finite element analysis of the proximal femur with the trochanteric Gamma nail fracture fixation should include the lateral muscle forces to simulate load condition with maximal physiological relevance to the closed nailing technique.

  8. Comparative study of the Ender method and Dynamic Hip Screw stabilization in the treatment of intertrochanteric fractures of the femur.

    Science.gov (United States)

    Walo, Roman; Semenowicz, Jacek; Grabowski, Marcin; Komarek, Marcin; Czuma, Przemysław

    2003-02-28

    Background. The aim of this retrospective study was to compare the results of two fixation devices (Ender rods in 118 patients and dynamic hip screw in 98 patients) for treatment of intertrochateric fractures of the hip. Material and methods. The two treatment groups were similar with respect to important preoperative variables such as age, coexisting disseases, bone quality and incidence of stable and unstable fractures. The following outcomes were assessed: quality of reduction, length of hospital stay, early mortality, reoperations, persistent pain at a knee or hip, decrease in range of motion of the knee and leg shortening. Results and conclusions. The subgroup analysis showed higher incidence of complications in patients with unstable type of fracture treated with Ender nailing. These complications included mainly valgus angulation and malrotation of the fracture, need for a secondary procedure due to loss of stabilization and knee pain. Intramedullary stabilization with Ender rods is not recommended in treatment of unstable intertrochanteric fractures of the femur.

  9. A MULTIDISCIPLINARY APPROACH IN THE TREATMENT OF FRACTURES OF THE PROXIMAL FEMUR ON THE BACKGROUND OF SENILE OSTEOPOROSIS

    Directory of Open Access Journals (Sweden)

    N. V. Zagorodniy

    2016-01-01

    Full Text Available The article presents a review of published data on the problem of osteoporosis in patients older than 75 years who have had fractures of the proximal femur. We used descriptive and analytical methods. Search publications have done in accessible to free search databases. Based on our analysis, it was found: the majority of researchers in Russia and abroad are united in the opinion that this issue requires a multidisciplinary approach; surgical treatment should be initiated as early as possible after the onset of fracture, before the complications from side of the internal organs; patients with fractures on the background of senile osteoporosis should receive drugs that affect to the quantitative and qualitative components of bone.

  10. Use of lean principals to improve flow of patients with fractured neck of femur--the HOPE study.

    Science.gov (United States)

    McNamara, R; Butler, A; Baker, C; Mullen, J; Lenehan, B; Grimes, S; O'Donoghue, H; Evans, P; Liston, M; Cummins, F; Condon, F

    2014-03-01

    We describe the implementation of a care pathway for patients with fractured neck of femur (NOF) using Lean and Six Sigma principles. After introduction of the Lean pathway, 32 patients out a total of 86 (37%) with fractured NOF were admitted to the Trauma Ward within 4 hours of presentation to the hospital; prior to implementation this was 16 patients out of a total of 59 (27%). Post-Lean an earlier mean theatre start time of 8.40am was achieved, resulting in a 38 minute increase in daily theatre time. An additional 52 patients (12%) received surgery within 24 hours of admission, resulting in 1 night length of stay reduction. Lean methodology proved an effective method to guide change resulting in an improved journey for the patient and significant workflow gains.

  11. Analysis of 50 cases of arthroscopic minimal invasion combined with LISS steel plate in treatment of knee joint injuries%关节镜下微创加LISS钢板治疗膝关节损伤50例分析

    Institute of Scientific and Technical Information of China (English)

    石玉刚; 沙广钊; 朱献忠; 沙磊

    2015-01-01

    目的:探讨关节镜下微创加LISS钢板治疗膝关节损伤的疗效。方法2010年1月~2014年7月我科收治膝关节损伤患者100例。分观察组和对照组各50例,观察组采用关节镜下微创加LISS钢板治疗;对照组采用开放复位钢板螺丝钉固定骨折,直视下修复交叉韧带和侧副韧带,修复或切除半月板。结果膝关节功能按Lysholm评估,观察组优良率为92.00%,对照组为74.00%,两组膝关节功能优良率比较有统计学意义(x2=5.4767,P<0.05)。两组并发症比较:观察组发生各种并发症7例,对照组发生各种并发症10例,两组并发症比较无统计学意义(x2=1.7718,P>0.05)。结论对于膝关节损伤患者,使用关节镜微创加LISS钢板固定,膝关节功能恢复优于开放治疗好,功能恢复满意。%ObjectiveTo explore curative effect of arthroscopic minimal invasion combined with LISS steel plate in treatment of knee joint injuries.Methods 100 patients with knee joint injuries who were admitted to our department in our hospital from April 2010 to July 2014 were selected and allocated to the observation group and the control group. The observation group was treated with arthroscopic minimal invasion combined with LISS steel plate while the control group was treated with open reduction steel plate screw fixed fracture, repairing cruciate ligament and collateral ligament under direct vision and repairing or resecting meniscus.ResultsExcellent and good rate of knee joint function in the observation group was 92.00% while that in the control group was 74.00% which was evaluated by Lysholm. Excellent and good rate of knee joint function of two groups had statistical significance (x2=5.4767,P0.05).Conclusion Arthroscopic minimal invasion combined with LISS steel plate fixation in treatment with patients with knee joint injuries has a better and satisfying knee joint function recovery than open treatment.

  12. [Prevalence of hip, femur and knee fractures at the High Specialty Medical Unit, Hospital de Traumatología y Ortopedia "Lomas Verdes", Instituto Mexicano del Seguro Social].

    Science.gov (United States)

    Lovato-Salas, F; Luna-Pizarro, D; Oliva-Ramírez, S A; Flores-Lujano, J; Núñez-Enríquez, J C

    2015-01-01

    Lower limb fractures are more frequent among older patients with osteopenia after a low energy fall and/or among young patients who sustain a high energy trauma. The prevalence of hip, femur and knee fractures at the High Specialty Medical Unit, Hospital de Traumatología y Ortopedia "Lomas Verdes" is unknown. Cross-sectional study, descriptive and retrospective design. Cases with low extremity fractures treated from January 1st, 2012 to December 31st, 2013 at the Hip, Femur and Knee Service, High Specialty Medical Unit, Hospital de Traumatología y Ortopedia "Lomas Verdes", were reviewed. Most patients (52.2%) were females; 64.1% of patients were over 60 years of age. Fracture distribution according to the segment involved was as follows: 73.4% (n = 1,327) were femur fractures, 13.5% (n = 244) tibial plateau fractures, and 13.2% (n = 238) patellar fractures. 66.8% (n = 1,209) of patients had a long hospital stay (more than 10 days). According to the anatomical location of fractures, transtrochanteric fractures (49.1%) were the most frequent ones, followed by patellar fractures (13.2%), and femur shaft fractures (12.7%). The prevalence of lower limb fractures at our hospital corresponds to what has been reported internationally.

  13. A reliable method for measuring proximal tibia and distal femur bone mineral density using dual-energy X-ray absorptiometry

    NARCIS (Netherlands)

    Bakkum, Arjan J. T.; Janssen, Thomas W. J.; Rolf, Marijn P.; Roos, Jan C.; Burcksen, Jos; Knol, Dirk L.; de Groot, Sonja

    2014-01-01

    Purpose: To assess the intra- and inter-rater reliability of a standardized protocol for measuring proximal tibia and distal femur bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA). Methods: Ten able-bodied individuals (7 males) participated in this study. During one measuremen

  14. Cumulative alendronate dose and the long-term absolute risk of subtrochanteric and diaphyseal femur fractures: a register-based national cohort analysis

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Eiken, Pia Agnete; Eastell, Richard

    2010-01-01

    Bisphosphonates are the mainstay of anti-osteoporotic treatment and are commonly used for a longer duration than in the placebo-controlled trials. A link to development of atypical subtrochanteric or diaphyseal fragility fractures of the femur has been proposed, and these fractures are currently...

  15. Trabecular orientation in the human femur and tibia and the relationship with lower-limb alignment for patients with osteoarthritis of the knee.

    Science.gov (United States)

    Sampath, Shameem A; Lewis, Sandra; Fosco, Matteo; Tigani, Domenico

    2015-04-13

    Wolff׳s Law suggests that the orientation of trabeculae in human bone changes in response to altered loading patterns. The aim of this study was to investigate trabecular orientation in both the femur and tibia and to compare this with the mechanical axis of the leg. The study involved analysis of radiographs from patients with osteoarthritis of the knee (n=91). For each patient, the trabecular orientation in both the distal femur and proximal tibia was measured from a standard anteroposterior radiograph of the knee and the mechanical axis of the leg was calculated from a long leg view taken while weight bearing. There was a significant correlation between the mechanical axis and the trabecular orientation in each of the regions considered in the femur (r=-0.41, -0.30, 0.52, and 0.23) and tibia (r=-0.27 and 0.31). Multiple regression analysis, with mechanical axis as the dependent variable, produced an R(2) of 0.62. Greater trabecular anisotropy (i.e. greater alignment) was observed in the medial femur and tibia compared to the lateral side (ptibia will reflect the angle of mechanical loading through the knee.

  16. Fracture of the Femur of A Newborn after Cesarean Section for Breech Presentation and Fibroid Uterus :A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ibrahima Farikou

    2014-01-01

    Full Text Available Introduction: The practice of cesarean section is known to decrease the occurrence of long bone fractures. We present here an unusual diaphyseal fracture of the femur of a newborn after cesarean section, the only case observed in our 14 years of practice. Case Report: The patient was a 3.4-kg female child born at 38 weeks of gestation. The mother was a primipara and aged 39 years. Ultrasound examination at 20th week revealed intrauterine fibroids with a breech presentation. Therefore, elective cesarean section was indicated. There was no apparent bone disorder that could predispose to sustain femur fracture. The fracture was treated successfully with a bilateral spica cast. The cesarean section was indicated in an aged primipara, bearer of uterine fibroids, and breech presentation. She had a good general health status, but her bone density was unknown since this examination is not routinely performed in our clinical settings in Africa. Conclusion: Elderly age, primipara status, presence of uterine fibroids, and breech presentation are usual indications for cesarean section. However, there are not many reports on femur fracture after cesarean section. Our present case suggests that despite the latest advances in delivery techniques, cesarean section for breech presentation predisposes the neonate to femoral fractures. Keywords: Femur fracture; Cesarean section; Fibroid; Breech presentation; Africa.

  17. Early Definitive Fixation of an Open Periprosthetic Femur Fracture in the Polytraumatized Patient: A Case Report and Review of the Literature.

    Science.gov (United States)

    Aleem, Ilyas S; Bhandari, Mohit; Elizalde, Sebastian Rodriguez

    2016-01-01

    Periprosthetic fractures of the femur after total hip arthroplasty are increasing in frequency. In the polytraumatized patient with long-bone fracture, an ongoing debate exists regarding early definitive stabilization versus initial damage control orthopaedics, followed by delayed fixation. It remains to be seen whether this rationale applies to the polytraumatized patient with periprosthetic fracture. We present the case of a 73-years old Caucasian woman who sustained bilateral Gustillo-Anderson grade III open femur fractures; the fracture on the right was a Vancouver C open periprosthetic fracture after cemented total hip arthroplasty. After massive fluid resuscitation in the trauma bay she was taken to the intensive care unit in a hemodynamically unstable condition. She was subsequently operated and underwent early definitive fixation of both femurs with the rationale of potentially reducing pulmonary complications and promoting early mobilization. Early definitive stabilization versus delayed fixation in the polytraumatized patient with an open periprosthetic femur fracture is reviewed. Although several treatment algorithms based on fracture classification and implant stability exist, further study is required to delineate the preferred method and timeline of fixation for this growing cohort of patients.

  18. Use of inhaled and oral glucocorticoids, severity of inflammatory disease and risk of hip/femur fracture : a population-based case-control study

    NARCIS (Netherlands)

    de Vries, F.; Pouwels, S.; Lammers, J.W.J.; Leufkens, H.G.M.; Bracke, M.; Cooper, C.; van Staa, T.P.

    BACKGROUND: Patients using higher dosages of inhaled or oral glucocorticoids (GCs) have an increased risk of hip/femur fractures. The role of the underlying disease in the aetiology of this increased risk has not been widely studied. OBJECTIVE: To evaluate the contribution of the underlying disease

  19. Heating produced by therapeutic ultrasound in the presence of a metal plate in the femur of canine cadavers

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    A.O. Andrades

    2014-10-01

    Full Text Available The present study aimed to assess the heat generated by a therapeutic ultrasound (TUS in a metal bone plate and adjacent structures after fixation to the femur of canine cadavers. Ten pairs of hind limbs were used, and they were equally distributed between groups that were subjected to 1- and 3-MHz frequencies, with each frequency testing 1- and 2-W/cm² intensities. The right hind limb was defined as the control group (absence of the metal plate, and the left hind limb was the test group (presence of the metal plate. Therefore, the control groups (CG were denominated CGI, using TUS with 1-MHz frequency and 1-W/cm² intensity; CGII, using 1-MHz frequency and 2-W/cm² intensity; CGIII, using 3-MHz frequency and 1-W/cm² intensity; and CGIV, using 3-MHz frequency and 2-W/cm² intensity. For each control group, its respective test group (TG was denominated TGI, TGII, TGIII and TGIV. The TUS was applied to the lateral aspect of the thigh using the continuous mode and a 3.5-cm² transducer in a 6.25-cm² area for 2 minutes. Sensors were coupled to digital thermometers that measured the temperature in different sites before (t0 and after (t1 of the TUS application. The temperatures in t1 were higher in all tested groups. The intramuscular temperature was significantly higher (P<0.05 in the groups used to test the 3-MHz frequency in the presence of the metal plate. The therapeutic ultrasound in the continuous mode using frequencies of 1 and 3 MHz and intensities of 1 and 2 W/cm2 for 2 minutes caused heating of the metal plate and adjacent structures after fixation to the femur of canine cadavers.

  20. Numerical investigations on the strain-adaptive bone remodelling in the periprosthetic femur: Influence of the boundary conditions

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    Stukenborg-Colsman Christina

    2009-04-01

    Full Text Available Abstract Background There are several numerical investigations on bone remodelling after total hip arthroplasty (THA on the basis of the finite element analysis (FEA. For such computations certain boundary conditions have to be defined. The authors chose a maximum of three static load situations, usually taken from the gait cycle because this is the most frequent dynamic activity of a patient after THA. Materials and methods The numerical study presented here investigates whether it is useful to consider only one static load situation of the gait cycle in the FE calculation of the bone remodelling. For this purpose, 5 different loading cases were examined in order to determine their influence on the change in the physiological load distribution within the femur and on the resulting strain-adaptive bone remodelling. First, four different static loading cases at 25%, 45%, 65% and 85% of the gait cycle, respectively, and then the whole gait cycle in a loading regime were examined in order to regard all the different loadings of the cycle in the simulation. Results The computed evolution of the apparent bone density (ABD and the calculated mass losses in the periprosthetic femur show that the simulation results are highly dependent on the chosen boundary conditions. Conclusion These numerical investigations prove that a static load situation is insufficient for representing the whole gait cycle. This causes severe deviations in the FE calculation of the bone remodelling. However, accompanying clinical examinations are necessary to calibrate the bone adaptation law and thus to validate the FE calculations.

  1. Effect of intertrochanteric osteotomy on the proximal femur of rabbits: assessment with power Doppler sonography and scintigraphy

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    Doria, Andrea S. [University of Toronto (Canada). Hospital for Sick Children. Dept. of Diagnostic Imaging; Cunha, Fabiano G.; Modena; Marcelo; Godoy Junior, Rui de; Bolliger Neto, Raul; Guarniero, Roberto [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Dept. of Cirurgia Ortopedica]. E-mail: andrea.doria@sickkids.ca; Rodrigues, Consuelo Junqueira [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Dept. de Patologia; Garcez, Alexandre Teles; Melo, Ivani Bortoleti; Buchpiguel, Carlos; Molnar, Laszlo J. [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Dept. de Medicina Nuclear

    2007-07-01

    Objective: In bone injury, repair results in local increased vascularity and bone marrow remodeling. Characterizing the vascular and metabolic imaging patterns of the proximal femur following an intertrochanteric osteotomy may help clinicians decide proper management of the patient. Our objective was to measure Doppler sonography and scintigraphy interval changes in the proximal femur following intertrochanteric osteotomy and compare imaging and histomorphometric measurements in the late post-operative stage (6 weeks after surgery) in a rabbit model of bone injury. Materials and methods: Both hips of 12 adult rabbits were imaged with power Doppler sonography and scintigraphy prior to and after (7 days and 6 weeks) unilateral osteotomy. Accuracy of the imaging methods was evaluated using hip operative status and histomorphometric results (vascular fractional area and number of vessels per area unit) as reference standard measures. Results: A significant difference in the mean number of pixels was noted between operated and non-operated femura in late post-operative power Doppler examinations (P=0.049). Although without reaching statistical significance, the AUC of Doppler measurements (AUC=0.99) was numerically greater than the AUC of scintigraphy measurements (AUC=0.857{+-}0.099) (P=0.15) in differentiating proximal femura with regard to their fractional vascular areas in the late post-operative stage. In contrast, scintigraphy tended to perform better (AUC=0.984{+-}0.022) than Doppler ultrasound (AUC=0.746{+-}0.131) to demonstrate the vascularity intensity per area unit (P=0.07) in the late stage. Conclusion: Our results warrant further investigation to determine the value of different imaging modalities for assessment of pathologic changes following hip surgery. Power Doppler sonography demonstrated larger AUCs (representing higher accuracy) for the discrimination of vascular fractional areas and scintigraphy, for discrimination of the number of vessels per area

  2. A comparative study of fracture shaft of femur in adults treated with broad dynamic compression plate versus intramedullary interlocking nail

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    Sushil Thapa

    2016-08-01

    Full Text Available Background and Objectives: Diaphyseal femur fracture is one of the commonest fractures to present in an emergency room. The objective of the study was to compare femoral shaft fractures treated using nail with those using plate and screws. Patients and Methods: We studied a total of 62 patients of fracture shaft of femur admitted in the Bharatpur Hospital, Bharatpur, Chitwan and National Academy of Medical Sciences, BirHospital,Kathmandu. Two cases were lost to follow up. Thirty cases were treated with plating and 30 cases with nailing. The age group was from 16-30 years. Fifty-three were male and seven were females. Fifty-eight patients had closed fracture and two had Gustillo Anderson grade I openfracture. Result: Time from injury to surgery was 19 days on an average. Mean time for union was more in patients treated by plating, 19.46 weeks as compared to nailing 14.78 weeks. We found one case of infection with plating and breakage of plate in four patients. One patient with nailing did not show any signs of healing and two had failure in case of nailing. Our series revealed 23(38.3% excellent, five (8.3% good and two (3.3% poor results in patients who had nailing while 15 (25.5% excellent, nine (15% good, one (1.7% fair and five (8.3% poor in patients who had plating out of 30 patients in each group. Conclusion:In our study we found that there was no significant difference in outcomes between plating and intramedullary nailing of femoral diaphysis fracture in terms of union, infection and implant failure.JCMS Nepal. 2016;12(2:66-9.

  3. Assessment of the Resistance of a Polymethylmethacrylate (Pmma Dynamic Compression Plate (DCP Prototype Tested on Osteotomized Canine Femurs

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    Leonel Cardona R.

    2011-06-01

    Full Text Available Femur fractures are the most frequent long bone fractures in small animals. Due to the femur’s anatomical position, it is difficult to immobilize, and therefore internal fixations are very useful. Dynamic compression plates (DCP provide high stability, are durable, minimize fragment movement and promote primary healing of the bone. Advantages of this treatment include anatomical reconstruction, early mobility and carrying capacity of the affected limb. Polymethylmethacrylate (PMMA is an acrylic resin that has proved very useful in bone tumor treatment, cranial deformation prosthesis, percutaneous vertebroplasty and testicular prosthesis in animals. The purpose of this study was to manufacture DCP-PMMA and test its resistance to the different forces present in a fracture. Forty-eight (48 3.5MM x 4-hole DCP were made from an alginate mold. Six (6 femurs were obtained from canine cadavers zeighing from 10 to 20 kg, which underwent osteotomy simulating an oblique fracture. The plates were subsequently positioned in the osteotomized bones to submit them to the various forces involved in a fracture. The DCP-PMMA resisted a torque force of 2.83 newton/metres and a compression and flexion force of 0.21 kilonewton. The obtained resistance of the DCP-PMMA was an average of 20 kg per force. The results of this study show that it is possible to make a DCP-PMMA 3.5 mm x 4-hole, the resistance of which is of 20 kg against the three applied forces, and that it can be used to stabilize long bone fractures subjected to a pressure of less than 20 kg.

  4. COHORT STRUCTURE OF PATIENTS WITH PROXIMAL FEMUR FRACTURES AND ESTIMATION OF AVERAGE ANNUAL DEMAND FOR EMERGENCY SURGICAL TREATMENT

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    T. N. Vorontsova

    2016-01-01

    Full Text Available The aim of this study is to examine cohort structure of patients with proximal femoral fractures (PFF and estimate an average annual demand in emergency surgical treatment for St. Petersburg adult population with mentioned diagnosis. Material and methods. The authors examined case histories and radiographs of 1412 adult patients with proximal femur fractures admitted to three St. Petersburg large general hospitals during one year. Analysis was done using statistical and expert evaluation methods.Results. Cohort structure of patients with PFF demonstrated the following distribution: female – 71,7%, male – 28,3%; Patients of elderly group prevailed: 70 years and older – 70,6%, 60–69 years old – 12%, 50–59 years old – 10,8%; Retirees with various disability status – 80%. Injury structure showed prevalence of femoral neck fractures –52%, pertrochanteric fractures represented 42%, subtrochanteric fractures – 5%. 11,3 days was the average time span from injury till surgery. The authors separately estimated urgent surgical treatment demand for patients with femoral neck fractures and patients with trochanteric fractures. Consequently, both groups results were summed up to generate the total average annual demand for emergency operative treatment for PFF which for adult population of St. Petersburg amounted to 4098 interventions, meaning one surgery per one thousand of adults.Conclusions. Absence of a common consistent approach to treatment of patients with proximal femur fractures as well as significant variance among St. Petersburg hospitals in respect of material, technical and staff resources result in a situation when not every patient with PFF undergoes surgical treatment. There is a strong need to develop and regulate implementation of a standardized treatment algorithm for such injuries, to improve infrastructure and resources of St. Petersburg general hospitals as well as to continuously monitor quality of medical treatment

  5. Effects of diet-induced obesity and voluntary wheel running on the microstructure of the murine distal femur

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    Timonen Jussi

    2011-01-01

    Full Text Available Abstract Background Obesity and osteoporosis, two possibly related conditions, are rapidly expanding health concerns in modern society. Both of them are associated with sedentary life style and nutrition. To investigate the effects of diet-induced obesity and voluntary physical activity we used high resolution micro-computed tomography (μCT together with peripheral quantitative computed tomography (pQCT to examine the microstructure of the distal femoral metaphysis in mice. Methods Forty 7-week-old male C57BL/6J mice were assigned to 4 groups: control (C, control + running (CR, high-fat diet (HF, and high-fat diet + running (HFR. After a 21-week intervention, all the mice were sacrificed and the left femur dissected for pQCT and μCT measurements. Results The mice fed the high-fat diet showed a significant weight gain (over 70% for HF and 60% for HFR, with increased epididymal fat pad mass and impaired insulin sensitivity. These obese mice had significantly higher trabecular connectivity density, volume, number, thickness, area and mass, and smaller trabecular separation. At the whole bone level, they had larger bone circumference and cross-sectional area and higher density-weighted maximal, minimal, and polar moments of inertia. Voluntary wheel running decreased all the cortical bone parameters, but increased the trabecular mineral density, and decreased the pattern factor and structure model index towards a more plate-like structure. Conclusions The results suggest that in mice the femur adapts to obesity by improving bone strength both at the whole bone and micro-structural level. Adaptation to running exercise manifests itself in increased trabecular density and improved 3D structure, but in a limited overall bone growth

  6. Oxidative and nonoxidative benzodiazepines and the risk of femur fracture. The Systematic Assessment of Geriatric Drug Use Via Epidemiology Study Group.

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    Sgadari, A; Lapane, K L; Mor, V; Landi, F; Bernabei, R; Gambassi, G

    2000-04-01

    Benzodiazepine use is a well-identified risk factor for falls and the resulting femur fractures in elderly adults. Benzodiazepines not requiring hepatic biotransformation may be safer than agents undergoing oxidation because oxidative activity has been shown to decline with age. The association between the use of either oxidative or nonoxidative benzodiazepines and the risk of femur fracture among elderly adults living in nursing homes was studied. A nested case-control study was conducted using the Systematic Assessment of Geriatric drug use via Epidemiology (SAGE) database; the records of 9,752 patients hospitalized for incident femur fracture during the period 1992 to 1996 were extracted, matching by age, gender, state, and index date to the records of 38,564 control patients. Conditional logistic regression models were conducted to estimate the odds ratios (ORs) for femur fracture with adjustment for potential confounders. The adjusted OR for the overall use of benzodiazepines was 1.10 (95% confidence interval [CI], 0.98-1.20); the risk seemed of only slightly greater magnitude for exposure to nonoxidative agents (1.18; 95% CI, 1.03-1.36) than to oxidative benzodiazepines (1.08; 95% CI, 0.95-1.23). Among the latter, the effect was mainly accounted for by the use of agents with a long elimination half-life. A dose relationship was observed exclusively among users of long half-life oxidative benzodiazepines. The risk associated with the use of nonoxidative benzodiazepines showed no relationship to the age of the patients. In contrast, patients aged 85 years or older receiving oxidative benzodiazepines at high dosages or as needed had a two- to three-fold increased risk of femur fracture than did patients in the younger age group. Among older individuals, the use of benzodiazepines slightly increased the risk of femur fracture, mainly irrespective of the metabolic fate of the drug. Our results suggest that the use of nonoxidative benzodiazepines does not carry a

  7. Coffee consumption and CYP1A2 genotype in relation to bone mineral density of the proximal femur in elderly men and women: a cohort study

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    Lind Lars

    2010-02-01

    Full Text Available Abstract Background Drinking coffee has been linked to reduced calcium conservation, but it is less clear whether it leads to sustained bone mineral loss and if individual predisposition for caffeine metabolism might be important in this context. Therefore, the relation between consumption of coffee and bone mineral density (BMD at the proximal femur in men and women was studied, taking into account, for the first time, genotypes for cytochrome P450 1A2 (CYP1A2 associated with metabolism of caffeine. Methods Dietary intakes of 359 men and 358 women (aged 72 years, participants of the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS, were assessed by a 7-day food diary. Two years later, BMD for total proximal femur, femoral neck and trochanteric regions of the proximal femur were measured by Dual-energy X-ray absorptiometry (DXA. Genotypes of CYP1A2 were determined. Adjusted means of BMD for each category of coffee consumption were calculated. Results Men consuming 4 cups of coffee or more per day had 4% lower BMD at the proximal femur (p = 0.04 compared with low or non-consumers of coffee. This difference was not observed in women. In high consumers of coffee, those with rapid metabolism of caffeine (C/C genotype had lower BMD at the femoral neck (p = 0.01 and at the trochanter (p = 0.03 than slow metabolizers (T/T and C/T genotypes. Calcium intake did not modify the relation between coffee and BMD. Conclusion High consumption of coffee seems to contribute to a reduction in BMD of the proximal femur in elderly men, but not in women. BMD was lower in high consumers of coffee with rapid metabolism of caffeine, suggesting that rapid metabolizers of caffeine may constitute a risk group for bone loss induced by coffee.

  8. Ultrasonographic measurement of fetal foot length and femur/foot length ratio in second trimester of normal pregnancy tn Korean women

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    Ji, Eun Kyung [Pochon CHA Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-06-01

    The aim of this study was to determine, using prenatal ultrasongraphy, normal fetal foot length and the femur length ratio during the second trimester of a normal pregnancy in Korean women. From May to July 1999, and in September of the same year, 1018 normal Korean singleton pregnancies showing no abnormality on prenatal sonograms were included in this study. The gestational age ranged from 19 to 30 weeks. Femur and foot length were measured by one radiologist. Regression analysis was performed for foot length and gestational age, and the mean value of the femur/foot length ratio and 95th percentile confidence interval of that mean value were calculated. The data obtained was compared with that obtained from caucasians. Foot length correlated with gestational age (r{sup 2}=0.87, {rho} value= 0.0001). The regression formula was as follows; Gestational age (days) = 70.98-2.15 X foot length (mm). Mean foot length at each gestational week was not different from the corresponding figure for Cancasians. The mean ({+-}SD) value of the femur/foot length ratio was 0.96 ({+-}0.05) and the 95{sup th} percentile confidence interval of that mean value was 0.96{+-} 0.000301, figures which are significantly lower than those for Caucasians. Fetal foot length during the second trimester of a normal pregnancy in Korean women is a reliable parameter for use in the assessment of gestational age. In our study the fetal foot length was not different from that of caucasians, while the femur/foot length ratio was lower than the value in that group. The nomogram depicted in of this study will serve as a useful adjunct in the screening of chromosomal abnormality or skeletal dysplasia among Koreans.

  9. Body mass index as a prognostic factor for fracturing of the proximal extremity of the femur: a case-control study,

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    Renato Cavanus Pagani

    2014-10-01

    Full Text Available Objectives:To compare the body mass index (BMI of patients with fractures in the proximal extremity of the femur with the BMI of patients without any previous history of fractures.Methods:We investigated patients of both sexes, aged 65 years or over, who were admitted to Hospital Independência, Hospital Beneficência Portuguesa or ULBRA University Hospital, between December 2007 and December 2010, with histories of low-energy trauma such as falling from a standingposition. These individuals were compared with patients of the same age but without any history of fracturing of the proximal extremity of the femur (n = 89, who were attended at the geriatrics outpatient clinic of the Sociedade Porto-Alegrense de Auxílio aos Necessitados (SPAAN.Results:The age group of the patients with fractures in the proximal extremity of the femur ranged from 65 to 96 years (mean: 77.58. The main type of fracture was trochanteric (47; 62.2%, followed by femoral neck fractures (27; 36%. Among the patients who presented on fracturing the proximal extremity of the femur, 12% had low weight, 62.7% normal weight, 24% overweight, and 1.3% obesity. Among the patients without any history of fractures, 5.6% presented low weight, 43.8% normal weight, 33.7% overweight, and 9.8% obesity. It was observed that the patients with fractures in the proximal extremity of the femur (n = 75 presented a mean BMI of 22.6, while the patients without fractures presented a mean BMI of 25.5.Conclusion:The patients in the group with fractures were significantly taller than those in the group without fractures and presented significantly lower BMI than those in the group without fractures.

  10. Body mass index as a prognostic factor for fracturing of the proximal extremity of the femur: a case–control study☆☆☆

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    Pagani, Renato Cavanus; Kunz, Rodrigo Ernesto; Girardi, Ricardo; Guerra, Marcelo

    2014-01-01

    Objectives To compare the body mass index (BMI) of patients with fractures in the proximal extremity of the femur with the BMI of patients without any previous history of fractures. Methods We investigated patients of both sexes, aged 65 years or over, who were admitted to Hospital Independência, Hospital Beneficência Portuguesa or ULBRA University Hospital, between December 2007 and December 2010, with histories of low-energy trauma such as falling from a standing position. These individuals were compared with patients of the same age but without any history of fracturing of the proximal extremity of the femur (n = 89), who were attended at the geriatrics outpatient clinic of the Sociedade Porto-Alegrense de Auxílio aos Necessitados (SPAAN). Results The age group of the patients with fractures in the proximal extremity of the femur ranged from 65 to 96 years (mean: 77.58). The main type of fracture was trochanteric (47; 62.2%), followed by femoral neck fractures (27; 36%). Among the patients who presented on fracturing the proximal extremity of the femur, 12% had low weight, 62.7% normal weight, 24% overweight, and 1.3% obesity. Among the patients without any history of fractures, 5.6% presented low weight, 43.8% normal weight, 33.7% overweight, and 9.8% obesity. It was observed that the patients with fractures in the proximal extremity of the femur (n = 75) presented a mean BMI of 22.6, while the patients without fractures presented a mean BMI of 25.5. Conclusion The patients in the group with fractures were significantly taller than those in the group without fractures and presented significantly lower BMI than those in the group without fractures. PMID:26229845

  11. Protocol for a randomized controlled trial on risk adapted damage control orthopedic surgery of femur shaft fractures in multiple trauma patients

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    Rixen Dieter

    2009-08-01

    Full Text Available Abstract Background Fractures of the long bones and femur fractures in particular are common in multiple trauma patients, but the optimal management of femur fractures in these patients is not yet resolved. Although there is a trend towards the concept of "Damage Control Orthopedics" (DCO in the management of multiple trauma patients with long bone fractures as reflected by a significant increase in primary external fixation of femur fractures, current literature is insufficient. Thus, in the era of "evidence-based medicine", there is the need for a more specific, clarifying trial. Methods/Design The trial is designed as a randomized controlled open-label multicenter study. Multiple trauma patients with femur shaft fractures and a calculated probability of death between 20 and 60% will be randomized to either temporary fracture fixation with fixateur externe and defined secondary definitive treatment (DCO or primary reamed nailing (early total care. The primary objective is to reduce the extent of organ failure as measured by the maximum sepsis-related organ failure assessment (SOFA score. Discussion The Damage Control Study is the first to evaluate the risk adapted damage control orthopedic surgery concept of femur shaft fractures in multiple trauma patients in a randomized controlled design. The trial investigates the differences in clinical outcome of two currently accepted different ways of treating multiple trauma patients with femoral shaft fractures. This study will help to answer the question whether the "early total care" or the „damage control” concept is associated with better outcome. Trial registration Current Controlled Trials ISRCTN10321620

  12. The rehabilitation treatment of children after operation of aseptic necrosis of head of femur%小儿股骨头无菌性坏死术后康复治疗

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Background: Aseptic necrosis of head of femur of children is a kind of ischemic necrosis of the center of epiphysis of femoral head. Currently we treat it with synovectomy, transplantation of vessel tract, intertrochanteric osteotomy and every kinds of pelvic truncation to improve head-mortar relation, but the effect is not satisfying. After head of femur conversion and self-ilium transplantation operation, the follow-up effect is satisfying. Objective: Discussing the treatment effect of operation on children aseptic necrosis of head of femur. Unit:Second People's Hospital of Ningxia Municipality.

  13. Continence promotion for older hospital patients following surgery for fractured neck of femur: Pilot of a randomized controlled trial

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    Lynne Parkinson

    2008-01-01

    Full Text Available Lynne Parkinson1,2, Pauline Chiarelli3, Jennifer Byrne1, Richard Gibson1, Suzanne McNeill4, Gillian Lloyd5, Wendy Watts6, Julie Byles11Research Centre for Gender, Health and Ageing, Faculty of Health, The University of Newcastle, NSW, Australia; 2Hunter Ageing Research, Faculty of Health, The University of Newcastle, NSW, Australia; 3Faculty of Health, The University of Newcastle, NSW, Australia; 4NC Trauma Orthopedics, John Hunter Hospital, New Lambton Heights, NSW, Australia; 5Hunter New England Health, Wallsend Community Health Centre, Wallsend, NSW, Australia; 6Royal Newcastle Centre, John Hunter Hospital, New Lambton Heights, NSW, AustraliaAbstract: Evidence suggests that bladder control problems develop or worsen as a result of fractured neck of femur (#NOF and its subsequent management. The primary aim of this study was to reduce the prevalence and severity of post surgery continence problems among patients, aged from 60-years, undergoing surgery for #NOF, using a best practice “case-management model” multifactorial intervention. Eligible consenting patients admitted with #NOF were randomized to intervention or control group. Self-report questionnaires compared pre-surgery, post surgery, and follow-up continence status between groups.This pilot randomized controlled trial, which included 45 eligible patients aged 60 to 93-years, found no evidence that the intervention was effective in reducing prevalence of post-surgery incontinence in this acute setting. Staff surveys highlighted the need for open communication between the research team and hospital staff. Unclear results were attributed to the small sample size.A central outcome was evidence that intervention to improve continence management for older people post-surgery is imperative. Focused assessment and treatment for those most at risk of incontinence after #NOF would be more acceptable to staff and a more efficient use of resources. A simple screening tool would ensure that

  14. Mycotic aneurysm of the femoral artery resulting from mismanagement of a pathological femur fracture due to chronic osteomyelitis: a case report

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    Mwaka Erisa Sabakaki

    2013-01-01

    Full Text Available Abstract Introduction Mycotic aneurysms are rarely listed among the possible complications of osteomyelitis of the long bones. To the best of our knowledge this is the first case of chronic osteomyelitis associated with a pathological fracture of the femur and a mycotic aneurysm of the femoral artery. Case presentation We present the case of a 13-year-old Ugandan boy who was referred to our hospital with chronic osteomyelitis associated with a pathological fracture of the right femur and a mycotic aneurysm of the femoral artery. He underwent a successful above-knee amputation and is currently undergoing rehabilitation. Conclusions Aneurysms associated with chronic osteomyelitis of the long bones are very rare. However, in Africa, where people often still believe in crude traditional remedies, they should be considered among the possible diagnoses especially where acute injuries of the limbs are massaged and manipulated.

  15. Effect of extracorporeal shock wave therapy on fracture healing in rat femural fractures with intact and excised periosteum.

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    Oktaş, Birhan; Orhan, Zafer; Erbil, Barış; Değirmenci, Erdem; Ustündağ, Nil

    2014-01-01

    The aim of this study is to compare the effect of extracorporeal shock wave therapy (ESWT) on fractures with intact periosteum and excised periosteum. Thirty-seven Wistar albino rats were randomized into four groups. Osteotomy and intramedullary Kirschner wire fixation were performed on all right femurs under ketamin anesthesia. The first group (n=10) was identified as control group. In the second group (n=10), periosteum located at the osteotomy site was excised circumferentially during surgery. In the third group (n=9), periosteum was left intact and ESWT was applied. In the forth group (n=8), periosteums of all rats were excised and ESWT was applied. All fracture lines were evaluated radiographically each two weeks and histologically at the sixth week. Results were evaluated statistically. In periosteum excised group which represents a model of open fractures with soft tissue defect, ESWT application had a significantly positive histologic effect on bone healing. However, radiological evaluation did not reveal any statistically significant difference between groups with intact and excised periosteums. According to our findings, ESWT can be used to improve fracture healing and prevent pseudoarthrosis in the treatment of open fractures with accompanying soft tissue and periosteum damage. However, further clinical studies are required to include ESWT in routine practice.

  16. Distal greater trochanteric transfer in the treatment of deformity of the proximal femur caused by avascular necrosis.

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    Pucher, Andrzej; Ruszkowski, Krzysztof; Nowicki, Jan; Strzyzewski, Wojciech; Kaczmarek, Wiesław; Kucharski, Jakub

    2006-02-28

    Background. Distal greater trochanteric transfer is one of the surgical methods used to correct proximal femoral deformity arising in the course of treatment for developmental dysplasia of the hip. Material and methods. We reviewed a series of 49 patients (55 hips) who had undergone distal greater trochanteric transfer at the mean age of 13.9 years due to deformity of the proximal femur after treatment for developmental dysplasia of the hip, in order to verify the value of the procedure. The mean follow-up was 15 years. Clinical and radiological assessment was supplemented with strain-gauging evaluation of the muscles involved. Results. Good results were achieved in those patients who had good range of movement or isolated restriction of abduction before the operation. After surgery, a 22% increase of abductor torque was found, the Trendelenburg sign disappeared in 30 individuals, and 15 patients regained normal gait. Conclusions. Distal greater trochanteric transfer improved hip joint biomechanics. Good abduction/adduction range of hip movement was essential for clinical improvement and increased muscle strength after surgery. Arthritic changes occurred primarily in those hip joints without clinical improvement. Distal transfer of the greater trochanter delayed osteoarthritis of the hip.

  17. Behavior study of the doped castor bean polymer rod with bioactive glass and hidroxyapatite in mice femur medullary canal.

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    Santos, Viviani Teixeira Dos; Facco, Gilberto Gonçalves; Ortiz, Hudman Cunha; Silva, Iandara Schettert da

    2017-02-01

    Purpose To evaluate the polymer doped rods behavior with bioactive glass and hydroxyapatite for possible application as a fracture fixing method. Methods Twenty eight Rattus norvegicus Wistar underwent bone defect for access to the femoral medullary canal and distributed into three experimental groups: group A - doped castor bean polymer with bioactive glass; group B - castor bean polymer and; group C - castor bean polymer doped with bioactive glass and hydroxyapatite. After 15 and 60 evaluation days, the femurs were removed and sent for histology and scanning electron microscopy. Results Initially mild and moderate inflammatory infiltrate is observed that decreases as time goes by, and the presence of connective tissue capsule around the graft in all groups. Regarding the biomaterials resorption little was observed. The implanted rods did not favor the osteoconductive process in the femoral medullary canal which was observed only in the C15 group. Conclusions The association of castor bean polymer, bioactive glass and hydroxyapatite was biocompatible and osteointegrable. The osteoconductive only occurred in the presence of hydroxyapatite and bioactive glass (C15 Group) and little biodegradation was observed.

  18. Pathologic femur fracture due to a brown tumor in a patient with secondary hyperparathyroidism and vitamin D-resistant rickets.

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    Wallace, Eric; Day, Matthew; Fadare, Oluwole; Schaefer, Heidi

    2013-02-01

    Vitamin D-resistant rickets is the common clinical outcome of multiple genetic mutations that alter the regulation of phosphorus and vitamin D metabolism, mainly through their effects on fibroblast growth factor 23 (FGF-23). These diseases typically present in childhood with the classic physical examination finding of nutritional rickets, such as genu varum/valgum and rachitic rosary. Treatment, which is aimed at improving severe bone disease with vitamin D and phosphorus supplementation, can cause secondary hyperparathyroidism and/or kidney failure from nephrocalcinosis over the life of the patient. Although FGF-23 has been shown to downregulate parathyroid hormone in vitro, its effect on parathyroid secretion in disease states such as chronic kidney disease and X-linked hypophosphatemic rickets is unclear because elevations in FGF-23 and parathyroid hormone levels characterize both of these disease states. We describe a case of vitamin D-resistant rickets that presented with a femur fracture through a brown tumor. Radiographs show the combination of severe bony abnormalities associated with both long-standing hyperparathyroidism and vitamin D-resistant rickets.

  19. [Identification of the primary lesion in a patient with concomitant breast and kidney cancer following fracture of the femur].

    Science.gov (United States)

    Sato, Yasufumi; Okishiro, Masatsugu; Ishida, Tomo; Morimoto, Yoshihiro; Kusama, Hiroki; Matsusita, Katsunori; Hashimoto, Tadayoshi; Kimura, Kei; Katsura, Yoshiteru; Nitta, Kanae; Kagawa, Yoshinori; Takeno, Atsushi; Sakisaka, Hideki; Nakahira, Shin; Taniguchi, Hirokazu; Egawa, Chiyomi; Takeda, Yutaka; Kato, Takeshi; Tamura, Shigeyuki; Takatsuka, Yuichi; Oku, Kazuko; Goto, Takayoshi; Nagano, Teruaki; Nakatsuka, Shinichi

    2014-11-01

    A 61-year-old woman was diagnosed with breast cancer [T3N3cM0: Stage IIIC, estrogen receptor [ER] (+), progesterone receptor [PgR] (+), human epidermal growth factor receptor 2[HER2] (-)]at the time of initial presentation. Following diagnosis, combined modality therapy including hormone therapy and chemotherapy were initiated, but hemorrhage from the primary lesion and bone metastases were observed. Priority was given to treatment of the breast cancer, and chemotherapy was administered, after which, right mastectomy and axillary lymph node sampling were performed to assess local disease control. In addition, concurrent right kidney enucleation was performed for a renal lesion. The renal neoplasm was diagnosed as T1aN0M0, Stage I. After this intervention, treatment of the breast cancer was continued, but pain of the right femoral region developed, and bone metastasis was diagnosed on close inspection. The bone metastasis was considered to derive from the breast cancer. During hospitalization, the patient fell and broke her right femur. Open reduction and internal fixation was performed immediately, and bone metastasis of kidney cancer was diagnosed via perioperative cytodiagnosis. Pulmonary metastasis, local recurrence, and metastasis to the shoulder blade have been detected. The metastases are considered to derive from the breast cancer, for which treatment has been continued. In the case of concomitant cancers, biopsy for metastatic foci can be considered essential, whenever it can be performed safely.

  20. Bone radiofrequency ablation combined with prophylactic internal fixation for metastatic bone tumor of the femur from hepatocellular carcinoma.

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    Ogura, Koichi; Miyake, Ryoko; Shiina, Shuichiro; Shinoda, Yusuke; Okuma, Tomotake; Kobayashi, Hiroshi; Goto, Takahiro; Nakamura, Kozo; Kawano, Hirotaka

    2012-08-01

    A 64-year-old man with 6-year history of hepatocellular carcinoma (HCC) was referred to us regarding bone metastasis to the right proximal femur. Although he underwent radiotherapy for pain palliation and local tumor control, the pain persisted and the tumor relapsed 3 months after the radiotherapy and he was thought to be at high risk of pathologic fracture. Given hypervascularity and large tumor size, a prophylactic internal fixation combined with adjuvant radiofrequency ablation (RFA) was proposed to reduce blood loss and prevent viable tumor cells being disseminated. His postoperative course was uneventful without requiring blood transfusion and preoperative symptoms immediately disappeared after surgery. He became capable of weight-bearing walk with a single cane and was almost asymptomatic without local progression on the plain radiographs when he died 14 months after surgery. Combination therapy of RFA and internal fixation using intramedullary nailing for metastases of the long bones from HCC seems to be a very promising technique both for sufficient pain relief and for local control of the tumor. Adjuvant RFA may become a potential option for patients with metastases of the long bones for the purpose of prevention of tumor dissemination and reduction of intraoperative blood loss.

  1. Selecting boundary conditions in physiological strain analysis of the femur: Balanced loads, inertia relief method and follower load.

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    Heyland, Mark; Trepczynski, Adam; Duda, Georg N; Zehn, Manfred; Schaser, Klaus-Dieter; Märdian, Sven

    2015-12-01

    Selection of boundary constraints may influence amount and distribution of loads. The purpose of this study is to analyze the potential of inertia relief and follower load to maintain the effects of musculoskeletal loads even under large deflections in patient specific finite element models of intact or fractured bone compared to empiric boundary constraints which have been shown to lead to physiological displacements and surface strains. The goal is to elucidate the use of boundary conditions in strain analyses of bones. Finite element models of the intact femur and a model of clinically relevant fracture stabilization by locking plate fixation were analyzed with normal walking loading conditions for different boundary conditions, specifically re-balanced loading, inertia relief and follower load. Peak principal cortex surface strains for different boundary conditions are consistent (maximum deviation 13.7%) except for inertia relief without force balancing (maximum deviation 108.4%). Influence of follower load on displacements increases with higher deflection in fracture model (from 3% to 7% for force balanced model). For load balanced models, follower load had only minor influence, though the effect increases strongly with higher deflection. Conventional constraints of fixed nodes in space should be carefully reconsidered because their type and position are challenging to justify and for their potential to introduce relevant non-physiological reaction forces. Inertia relief provides an alternative method which yields physiological strain results.

  2. Melatonin can Ameliorate Radiation-Induced Oxidative Stress and Inflammation-Related Deterioration of Bone Quality in Rat Femur.

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    Çakir, Zelal Ünlü; Demirel, Can; Kilciksiz, Sevil Cagiran; Gürgül, Serkan; Zincircioğlu, S Burhanedtin; Erdal, Nurten

    2016-06-01

    The aim of the present study was to evaluate the radioprotective effects of melatonin on the biomechanical properties of bone in comparison to amifostine (WR-2721). Forty Sprague Dawley rats were divided equally into 5 groups namely; control (C), irradiation (R; single dose of 50 Gy), irradiation + WR-2721 (R + WR-2721; irradiation + 200 mg/kg WR-2721) radiation + melatonin 25 mg/kg (R + M25; irradiation + 25 mg/kg melatonin), and radiation + melatonin 50 mg/kg (R + M50; irradiation + 50 mg/kg melatonin). In order to measure extrinsic (organ-level mechanical properties of bone; the ultimate strength, deformation, stiffness, energy absorption capacity) and intrinsic (tissue-level mechanical properties of bone; ultimate stress, ultimate strain, elastic modulus, toughness) features of the bone, a three-point bending (TPB) test was performed for biomechanical evaluation. In addition, a bone mineral density (BMD) test was carried out. The BMD and extrinsic properties of the diaphyseal femur were found to be significantly higher in the R + M25 group than in group R (p melatonin was similar to that of WR-2721. Thus, biomechanical quality of irradiated bone can be ameliorated by free radical scavenger melatonin.

  3. Pneumothorax complicating pulmonary embolism after combined spinal epidural anesthesia in a chronic smoker with open femur fracture

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    Shivendu Bansal

    2011-01-01

    Full Text Available Pulmonary embolism during or after regional anaesthesia is although very rare, it has been reported in cases undergoing lower limb orthopedic procedures. We presenting a 48 years old male, a known smoker since 25 years, with history of road traffic accident and open fracture right femur for external fixation. Combined spinal epidural anaesthesia was given. After 35 minutes patient complained dyspnea and chest pain. SpO2 decreased to 82% from 100%. Continuous positive airway pressure with 100% oxygen was given. SpO2 increased from 82% to 96%. Suddenly he had bouts of cough and SpO2 became 79-80% with unstable haemodynamics. On chest auscultation there was decreased breath sounds on right side with limited expansion. Trachea was intubated after inducing anaesthesia with fentanyl 70 μg and thiopental 300 mg. Chest radiograph showed right sided pneumothorax. Intercostal drain with a water seal was put. After 5 minutes HR was 80/min, BP was 110/69 mmHg and SpO2 was 97%. Pulmonary thromboembolism secondary to deep vein thrombosis was suspected and was confirmed by D-dimer Elisa and color Doppler of lower limbs. Patient was shifted to intensive care unit after completion of surgery. Anticoagulant therapy was started. He was weaned from the ventilator on 3rd day and trachea was extubated. Chest drain was removed after 9 days and he was discharged from hospital on 15th post operative day

  4. EVALUATION OF RESULTS IN INTRAMEDULLARY FIXATION OF SUBTROCHANTERIC FRACTURE OF FEMUR WITH PROXIMAL FEMORAL NAILING (AO TYPE OF DESIGN

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    D. Nitin Reddy

    2016-08-01

    Full Text Available BACKGROUND Among the femoral shaft injuries, upper femoral fractures present a peculiar problem of securing effective neutralization of deforming forces. The mechanical stresses at this level are very high, as they occur at the junction between the trabecular and cortical zone and also because of the deforming forces due to peculiar muscle insertion to the proximal and distal fragments. The present study was conducted to assess the utility and effectiveness of Proximal Femoral Nail evolved by AO-ASIF in 1997, for various types of upper femoral fractures. MATERIAL AND METHOD The present study consists of the patients admitted to Orthopaedic Units of KIMS Hospital, between June 2012 and July 2014; 1267 fracture cases were treated in Department of Orthopaedics, Konaseema Institute of Medical Sciences, Amalapuram, during this period. Of these 264 patients were admitted for femoral fractures. Of the 264 femoral fractures, 18 patients above the age of 20 years with subtrochanteric fractures were included in this study. RESULT Reduction was good in 72.2% (13 of the cases. Acceptable reduction was achieved in 3 (16.6% patients. Poor reduction was noted in 2 (11.1% patients. One of them were of elderly age group and had poor outcome at final follow-up. SUMMARY AND CONCLUSION From this sample study, we conclude that Proximal Femoral Nail is a good implant for the treatment of subtrochanteric fractures of femur provided optimal reduction of the fracture and good positioning of the nail and screws are achieved.

  5. Evaluation of bone deformities of the femur, tibia, and patella in Toy Poodles with medial patellar luxation using computed tomography.

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    Yasukawa, Shinji; Edamura, Kazuya; Tanegashima, Koji; Seki, Mamiko; Teshima, Kenji; Asano, Kazushi; Nakayama, Tomohiro; Hayashi, Kei

    2016-01-01

    To evaluate morphological parameters of the femur, tibia, and patella in Toy Poodles with medial patellar luxation (MPL) using three-dimensional (3D) computed tomography (CT) and to compare these parameters between radiography and CT. Thirty-five hindlimbs of Toy Poodles were divided into normal and grade 2 and 4 MPL groups. The anatomical and mechanical lateral proximal femoral angle, anatomical and mechanical lateral distal femoral angle (aLDFA, mLDFA), femoral varus angle (FVA), inclination of the femoral head angle, procurvation angle, anteversion angle (AA), frontal angle of the femoral neck, mechanical medial proximal or distal tibial angle, mechanical cranial proximal or distal tibial angle, tibial plateau angle, tibial torsion angle (TTA), Z angle, relative tibial tuberosity width, ratio of the medial distance of tibial tuberosity to the proximal tibial width (MDTT/PTW), patella size, and the patellar ligament length: patellar length (L:P) ratio were evaluated on radiography and 3D CT. The aLDFA, mLDFA, FVA, and TTA were significantly larger and the AA, MDTT/PTW, and patella were significantly smaller in the grade 4 MPL group. There were significant differences in many parameters between imaging tools, and CT was considered less susceptible to potential artefacts and rotational deformities. Toy Poodles with grade 4 MPL had significant femoral varus deformity, medial displacement of the tibial tuberosity, internal torsion of the proximal tibia, and hypoplasia of the patella.

  6. The Characterization of Mechanical Properties of a Rabbit Femur-Anterior Cruciate Ligament-Tibia Complex During Cyclic Loading

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    Sekiguchi, Hidetaka; Han, Jungsoo; Ryu, Jaiyoung; Han, Changsoo

    The purpose of this study was to investigate the effect of cyclic loading, which produced the condition of ACLs during sports activities, on tensile properties of femur-ACL-tibia complexes (FATCs). Paired FATCs of 40 New Zealand white rabbits were tested on a materials testing machine. One specimen of each pair was designated as a control and loaded until failure. The contralateral specimen was loaded cyclically (1.4 Hz, 1 hr.) with 20%, 30%, 40%, or 50% of ultimate tensile strength (UTS) of the control and then loaded until failure. The UTS and mode of failure were recorded after each test. Five specimens ruptured during cyclic loading in the 50% group. In the 40% group, the mean value of UTS of cycled specimens was significantly lower than that of controls. There was no statistically significant difference in UTS values between control and cycled specimens in the 20% and 30% groups. Cycled specimens had a significantly higher incidence of substance failure than controls. Our results demonstrated that FATCs have the strength to withstand cyclic loading within normal sports activity levels. However, FACTs can be damaged by cyclic loading under strenuous sports activity levels. We speculate that cyclic loading makes the ACL substance weaker than the insertion site.

  7. A simple technique to position patients with bilateral above-knee amputations for operative fixation of intertrochanteric fractures of the femur: a case report

    OpenAIRE

    Dramis Asterios; Desai Aravind; Aqil Adeel; Hossain Saqif

    2010-01-01

    Abstract Introduction Intertrochanteric fractures of the femur are common fractures in the elderly, and management includes operative fixation after patient positioning on the fracture table. Patients with bilateral above-knee amputations are challenging in terms of positioning on the table. We describe a simple technique to overcome this special problem. Case presentation A 75-year-old wheelchair-bound Caucasian man with bilateral above-knee amputations presented to our hospital after a fall...

  8. Three-dimensional micro-level computational study of Wolff's law via trabecular bone remodeling in the human proximal femur using design space topology optimization.

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    Boyle, Christopher; Kim, Il Yong

    2011-03-15

    The law of bone remodeling, commonly referred to as Wolff's Law, asserts that the internal trabecular bone adapts to external loadings, reorienting with the principal stress trajectories to maximize mechanical efficiency creating a naturally optimum structure. The goal of the current study was to utilize an advanced structural optimization algorithm, called design space optimization (DSO), to perform a micro-level three-dimensional finite element bone remodeling simulation on the human proximal femur and analyse the results to determine the validity of Wolff's hypothesis. DSO optimizes the layout of material by iteratively distributing it into the areas of highest loading, while simultaneously changing the design domain to increase computational efficiency. The result is a "fully stressed" structure with minimized compliance and increased stiffness. The large-scale computational simulation utilized a 175 μm mesh resolution and the routine daily loading activities of walking and stair climbing. The resulting anisotropic trabecular architecture was compared to both Wolff's trajectory hypothesis and natural femur samples from literature using a variety of visualization techniques, including radiography and computed tomography (CT). The results qualitatively revealed several anisotropic trabecular regions, that were comparable to the natural human femurs. Quantitatively, the various regional bone volume fractions from the computational results were consistent with quantitative CT analyses. The global strain energy proceeded to become more uniform during optimization; implying increased mechanical efficiency was achieved. The realistic simulated trabecular geometry suggests that the DSO method can accurately predict bone adaptation due to mechanical loading and that the proximal femur is an optimum structure as the Wolff hypothesized.

  9. Bilateral Humerus and Right Femur Fracture in a Newborn after Cesarean Section for Breech Presentation in a Twin Pregnancy: A Very Rare Case Report.

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    Rahul, P; Grover, Amit Rakesh; Ajoy, S M

    2017-01-01

    The most common fractures during vaginal delivery occur in the clavicle, humerus, and femur. Cesarean section reduces the chances of a child having a birth injury. However, in some difficult extractions, long bone fractures may occur. Cesarean section further reduces the incidence of birth injuries, especially in a breech delivery. Maneuvers employed during cesarean section, energetic traction, improper uterine incisions, and contracted uterus may cause these injuries. In the medical literature, there are few articles highlighting the occurrence of long bone fractures during cesarean section. There has been no case reported with a combined bilateral humerus and femur fracture in the medical literature. A 2-day-old neonate born after cesarean section for breech presentation in a twin pregnancy presented with restricted movements of both his arms and right leg. Infantogram revealed bilateral humerus and right femur fracture. Biochemical tests were normal, and there were no other findings on clinical examination. There was no evidence of child abuse or any positive family history. Child was splinted for 3 weeks. X-rays suggested good callus at the fracture site of the right femur and bilateral humerus fracture were united. To conclude, we would like to emphasize that long bone fractures can happen with cesarean section also. To prevent such untoward complications, during delivery of the baby the surgeon should be very careful, avoid energetic traction and should plan his incisions. Appropriate relaxation of the uterus must be achieved. Clavicles and other long bones should be palpated after a difficult delivery. However, it is important to note that long bone fractures in children heal rapidly without the need for any major intervention.

  10. In-vitro comparison of LC-DCP- and LCP-constructs in the femur of newborn calves – a pilot study

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    Hoerdemann Mona

    2012-08-01

    Full Text Available Abstract Background To compare the biomechanical in-vitro characteristics of limited-contact dynamic compression plate (LC-DCP and locking compression plate (LCP constructs in an osteotomy gap model of femoral fracture in neonatal calves. Pairs of intact femurs from 10 calves that had died for reasons unrelated to the study were tested. A 7-hole LC-DCP with six 4.5 mm cortical screws was used in one femur and a 7-hole LCP with four 5.0 mm locking and two 4.5 mm cortical screws was used in the corresponding femur. The constructs were tested to failure by cyclic compression at a speed of 2 mm/s within six increasing force levels. Results The bone-thread interface was stripped in 21 of 80 cortical screws (26.3% before a pre-set insertion torque of 3 Nm was achieved. Only 3 corresponding intact pairs of constructs could be statistically compared for relative structural stiffness, actuator excursion and width of the osteotomy gap. Relative structural stiffness was significantly greater, actuator excursion and width of the osteotomy gap were significantly smaller in the LCP constructs. While failure occurred by loosening of the screws in the LC-DCP constructs, locking constructs failed by cutting large holes in the soft distal metaphyseal bone. Conclusions An insertion torque sufficient to provide adequate stability in femurs of newborn calves could not be achieved reliably with 4.5 mm cortical screws. Another limiting factor for both constructs was the weak cancellous bone of the distal fracture fragment. LCP constructs were significantly more resistant to compression than LC-DCP constructs.

  11. Intravenous analgesia with opioids versus femoral nerve block with 0.2% ropivacaine as preemptive analgesic for fracture femur: A randomized comparative study

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    Singh, Arvinder Pal; Kohli, Vaneet; Bajwa, Sukhminder Jit Singh

    2016-01-01

    Background and Objective: Femoral fractures are extremely painful and pain invariably worsens on any movement. Anesthesia for fracture femur surgery is usually provided by spinal block. This study was undertaken to compare the analgesic effects of femoral nerve block (FNB) using nerve stimulator with 0.2% ropivacaine (15 ml) and intravenous (I.V.) fentanyl before patient positioning for fracture femur surgery under spinal anesthesia. Materials and Methods: A prospective, randomized, double-blind, comparative study was conducted on 60 American Society of Anesthesiologists I and II patients (18–60 years) scheduled for femur surgery under combined spinal epidural anesthesia. Patients in Group I (n = 30), were administered FNB using nerve stimulator with 0.2% ropivacaine (15 ml) and in Group II patients (n = 30), I.V. fentanyl 0.5 μg/kg was given as preemptive analgesia. Parameters observed included time to spinal anesthesia, intra-operative and postoperative visual analog scale (VAS) for any pain and postoperative epidural top-ups dosages. Results: Demographic profile was comparable in both the groups. VAS at 2 min in Group I was 5.63 and in Group II it was 8.00. Satisfaction score was better in Group I as compared to Group II patients. Time to administer subarachnoid block was 17.80 min in patients of Group I as compared to 25.03 min in Group II patients. Postoperatively, VAS scores were lower in Group I than Group II patients. The frequency of epidural top-ups was higher in Group II than in Group I patients. Conclusions: FNB is comparatively better in comparison to I.V. fentanyl when used as preemptive and postoperative analgesic in patients being operated for fracture femur. PMID:27212771

  12. Alterations in geometry, biomechanics, and mineral composition of juvenile rat femur induced by nonplanar PCB-155 and/or planar PCB-169.

    Science.gov (United States)

    Brankovič, Jana; Jovanovski, Sašo; Jevnikar, Peter; Hofmeister, Alexander; Reininger-Gutmann, Birgit; Jan, Janja; Grošelj, Maja; Osredkar, Joško; Uršič, Matjaž; Fazarinc, Gregor; Pogačnik, Azra; Vrecl, Milka

    2017-04-01

    Exposure to widespread lipophilic and bioaccumulative polychlorinated biphenyls (PCBs) induces diverse biochemical and toxicological responses in various organs, including the bone. The aim of this study was to evaluate the changes in growth rate, geometry, serum, and bone biochemical parameters and biomechanics of juvenile rat femur induced by lactational exposure to nonplanar PCB-155 and planar PCB-169 individually and in combination. Fifteen lactating Wistar rats were divided into four groups (PCB-169, PCB-155, PCB-155+169, and control), and PCBs were administered intraperitoneally at different time points after delivery. Femurs from 22-day-old offspring were analyzed by microCT, three-point bending test and inductively coupled plasma-mass spectrometry (ICP-MS) to obtain data on bone geometry, biomechanics and mineral composition. The serum levels of calcium, phosphate and alkaline phosphatase were also determined. Lactational exposure to planar PCB-169 resulted in shorter and thinner femurs, reduced endosteal and periosteal perimeters, smaller total cross-sectional and medullary areas, and lowered serum bone marker levels and calcium levels in the bone, while femur mechanical properties were not significantly altered. The changes observed in the combination exposure (PCB-155+169) group were similar to those observed in the PCB-169 group but were less pronounced. In summary, our results demonstrate that alterations in lactationally exposed offspring were primarily induced by planar PCB-169. The milder outcome in the combined group suggested that the PCB-169-mediated toxic effects on the bone might be reduced by a nonplanar PCB-155 congener. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 1135-1146, 2017.

  13. High saturated fat diet alters the lipid composition of triacylglycerol and polar lipids in the femur of dam and offspring rats.

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    Miotto, Paula M; Castelli, Laura M; Amoye, Foyinsola; Ward, Wendy E; LeBlanc, Paul J

    2015-06-01

    Previous work has shown that dietary lipids alter femur lipid composition. Specifically, we have shown that exposure to high saturated fatty acid (SFA) diets in utero, during suckling, or post-weaning alters femur total lipid composition, resulting in higher percent bone mass in males and females and bone mineral density (BMD) in female offspring with no effect on bone mineral outcomes in dams. Comparatively, high n-3 polyunsaturated fatty acid (PUFA) diets increase femur polar (PL) lipid n-3 content, which has been associated with increased bone mineral content and strength. However, the extent that PL or triacylglycerol (TAG) lipids change with high SFA diets is unknown. The current investigation examined the influence of a high SFA diet (20 % lard by weight) on femur PL and TAG lipid composition in 5-month old female Wistar rats (fed high SFA diet from age 28 days onwards; dams) and their 19-day old offspring (exposed to high SFA in utero and during suckling; pups). High SFA exposure resulted in increased monounsaturates and decreased n-3 and n-6 PUFA in the TAG fraction in both dams and pups, and higher SFA and n-6:n-3 ratio in dams only. The PL fraction showed decreased n-6 PUFA in both dams and pups. The magnitude of the diet-mediated responses, specifically TAG 18:1 and PL n-6 PUFA, may have contributed to the previously reported altered BMD, which was supported with correlation analysis. Future research should investigate the relationship of diet-induced changes in bone lipids on bone structure, as quantified through micro-computed tomogra