femur diaphysis
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Author(s):  
Ashok Meena ◽  
D S Meena ◽  
Narendra Saini ◽  
Poonam Meena

Background: Rigid interlocking nailing for femoral shaft fracture is ideal for use in adolescents in terms of stability of the fracture and convenience for the patient. Closed reduction and intramedullary interlocking nailing is the surgical treatment of choice for the closed shaft fractures of femur. Present study conducted to study the principles of intramedullary interlocking nailing and to assess the outcome of the patient. Methods: The present study comprises of 30 cases of fracture shaft of the femur in adults about >20 years old. All the fractures, which were included in the study were traumatic in origin, most of them are due to road traffic accidents. Results: The delayed union rate in our series was 6.67%. There were no non-unions. Conclusions: It is concluded that closed intramedullary interlocking nailing method given good result in treatment of shaft fractures of femur. Keywords: Intramedullary nailing, Femur, Diaphysis fractures, Interlocking


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Berit Paul ◽  
Andre Frank ◽  
Michael J. Raschke ◽  
Dirk Wähnert

Abstract Background The implantation of screws is a standard procedure in musculoskeletal surgery. Heat can induce thermal osteonecrosis, damage the bone and lead to secondary problems like implant loosening and secondary fractures. The aim of this study was to investigate whether screw insertion generates temperatures that can cause osteonecrosis. Methods We measured the temperature of twenty human femur diaphysis in a total of 120 measurements, while screws of different material (stainless steel and titanium alloy) and different design (locking and cortex screw) were inserted in three different screwing modes (manual vs. machine screwing at full and reduced rotational speed) with 6 thermocouples (3 cis and 3 trans cortex). Each was placed at a depth of 2 mm with a distance of 1.5 mm from the outer surface of the screw. Results The screw design (cortical > locking), the site of measurement (trans-cortex > cis-cortex) and the type of screw insertion (hand insertion > machine insertion) have an influence on the increase in bone temperature. The screw material (steel > titanium), the site of measurement (trans-cortex > cis-cortex) and the type of screw insertion (machine insertion > hand insertion) have an influence on the time needed to cool below critical temperature values. The combination of the two parameters (maximum temperature and cooling time), which is particularly critical for osteonecrosis, is found only at the trans-cortex. Conclusion Inserting a screw hast the potential to increase the temperature of the surrounding bone tissue above critical values and therefore can induce osteonecrosis. The trans-cortex is the critical area for the development of temperatures above the osteonecrosis threshold, making effective cooling by irrigation difficult. It would be conceivable to cool the borehole with cold saline solution before inserting the screw or to cool the screw in cold saline solution. If possible, insertion by hand should be considered.


Author(s):  
Michael Müller ◽  
Uwe Kahl ◽  
Philipp von Roth ◽  
Robert Hube

AbstractIntra-operative fractures in knee revision surgery are relatively rare and have not been well studied. They may occur during joint exposition, removal of the prosthesis or cement, or implantation of trial or original components. The fractures affect both the metaphyseal area and diaphysis of the tibia and femur. Tibial fractures are slightly more common than femur fractures. On the femur, the medial condyle is most frequently affected, followed by the femur diaphysis. The use of non-cemented stems is associated with a greater risk of intra-operative diaphyseal fractures than that of cemented stems. Overall, women and patients with an osteopenic bone structure have a higher risk of fractures. It is common that fractures are diagnosed post-operatively. In these cases, conservative therapy may be successful, depending on the stability of the prosthesis and bones. The most common surgical fixation options are cerclages and screws, followed by stem extensions for bridging the fracture. Plate fixation or use of strut grafts are also sensible therapy options. Overall, intraoperative fractures have a high healing potential with stable and good joint function. The revision rate is still 15%, which is most often caused by peri-prosthetic infection.


Author(s):  
Milan Krtička ◽  
Lenka Michlovská ◽  
Vladimír Nekuda ◽  
Petr Poláček ◽  
Kristýna Valová ◽  
...  

2020 ◽  
Vol 81 (7) ◽  
pp. 1-7
Author(s):  
Biju Benjamin ◽  
Fares S Haddad

The anatomy of the acetabulum and femur is usually significantly altered in people with developmental dysplasia of the hip and this leads to secondary osteoarthritis of the hip joint. Ideal positioning of implants and reduction of the joint is technically demanding during arthroplasty. Lengthening may result in nerve palsies and therefore procedures may have to be undertaken to shorten the femur. Other complications include dislocation and non-union at the shortening osteotomy site. Thorough preoperative planning and templating is required before surgery to assess the need for shortening. Shortening osteotomies can be performed at the proximal femur, diaphysis or distal femoral levels, with subtrochanteric being the most common level. The procedure should be customised for each patient after extensive planning and detailed counselling.


2020 ◽  
Vol 10 (4) ◽  
pp. 1226 ◽  
Author(s):  
Matija Turk ◽  
Ivan Turk ◽  
Marcel Otte

The paper is a critical review of different evidence for the interpretation of an extremely important archaeological find, which is marked by some doubt. The unique find, a multiple perforated cave bear femur diaphysis, from the Divje babe I cave (Slovenia), divided the opinions of experts, between those who advocate the explanation that the find is a musical instrument made by a Neanderthal, and those who deny it. Ever since the discovery, a debate has been running on the basis of this division, which could only be closed by similar new finds with comparable context, and defined relative and absolute chronology.


2019 ◽  
Vol 71 (6) ◽  
pp. 1873-1879
Author(s):  
L.C. Muñoz ◽  
S. Cardona.-Ramirez ◽  
R.F. Silva

ABSTRACT Hydroxyapatite (HA) is widely used as a biomaterial for bone repair and metallic prostheses coating. The main limitations of the current commercial synthetic hydroxyapatite compounds include high cost and decreased availability, especially for veterinary medicine purposes. Additionally, it is thought that HA biocompatibility and bioactivity could be enhanced by the addition of metal compounds. The objective of this work was to compare the subcutaneous tissue response of commercial and engineered hydroxyapatite obtained from the bovine femur diaphysis mixed with different concentrations of hexa-hydrated Zinc Nitrate in rabbits. Twenty-Five New Zealand female rabbits were used. Five treatments were done according to HA composition (commercial HA, no Zn-HA, 0.1M Zn, 0.2M Zn, and 0.3M Zn). Each treatment was evaluated at five time-points (8, 15, 30, 60 and 90 days post-implantation). Histopathologic analysis was performed to assess inflammation by polymorphonuclear cells infiltration, neovascularization, and fibrosis. Results obtained in this work suggest that general inflammation decreased after 60 days of implantation regardless of Zn concentration. Fibrosis score was increased in the commercial HP compared to control and Zn-hydrated HA. This paper shows that bovine hydroxyapatite is a biocompatible material regardless of nitrate Zinc concentration and has the same properties of commercial hydroxyapatite.


2019 ◽  
Vol 7 (1) ◽  
pp. 87-96
Author(s):  
Mikhail E. Burtsev ◽  
Aleksandr V. Frolov ◽  
Aleksei N. Logvinov ◽  
Dmitry O. Ilyin ◽  
Andrey V. Korolev

Aim. Osteogenesis imperfecta (OI) is characterized by bone fragility and long bones deformities. Most studies are dedicated to surgical treatment of diaphyseal fractures. To our knowledge, there are no reports giving recommendations about surgical treatment of distal femur intraarticular fractures. Clinical case. We describe the surgical treatment of a 14-year-old girl with OI who had intraarticular fracture of the left distal femur and fracture of a right femur diaphysis. Surgical treatment was complicated by migration of a titanium elastic nail and impaired consolidation, which had to be fixed with a plate and led to peri-implant fracture. Results were assessed before trauma and at 1 and 2 years after trauma with Gillette Functional Assessment Questionnaire (GFAQ) and Bleck score. Discussion. During surgical treatment of comminuted intraarticular distal femur fractures in patients with OI, we had to use big cancellous screw that made implantation in an intramedullary fixator more difficult. Internal fixation with a plate in patients with OI is associated with high risks of peri-implant fracture. Conclusion. For treatment of comminuted intraarticular fracture of the distal femur, it is necessary to have large variety of internal fixators, follow the principles of absolute and relative stability, and be familiar with minimally-invasive techniques.


10.3823/2549 ◽  
2018 ◽  
Vol 11 ◽  
Author(s):  
Humberto Ferreira Arquez

Background: Osteochondroma is the most common tumor of bone, accounting for approximately one third of benign lesions in the skeleton is a broad (sessile) or narrow (pedunculated) skeletal protrusion comprised of marrow and cortical bone. Although it is benign, its biological behavior still has a malignant potential. Chondrosarcoma arising in osteochondroma has been recognized for many years. Osteochondromas might occur on any bone preformed in cartilage, they were especially seen on the long bones of the extremities, predominantly around the knee. In fact, the lower limb seemed to be at a higher risk of the tumor than the upper limb on the top two locations: distal part of the femur and proximal part of the tibia, however, the proximal humerus ranked the third place for solitary osteochondroma while the proximal fibula for multiples osteochondromas. Methods and Findings: A total of 20 skeletons and 18 cadavers of both sex, 16 males and 2 females, with different age groups were used, this study was carried out by routine dissection classes for undergraduate medical student´s in the Morphology Laboratory of the University of Pamplona during the years 2013-2016. In only one sample was found the presence of osteochondroma. The measurement of the osseous mass was of 7 x 3.5 x 1.5 cm, attached to the posterolateral aspect of the middle third of the femur. Conclusions: Osteochondroma is generally asymptomatic or discovered accidentally, but it can cause different symptoms depending on site of occurrence local swelling, bony deformities, fracture, bursa formation, arthritis and impingement on adjacent tendons, vascular or neurologic compromise, and dislocation The importance of correct treatment and follow-up of large osteochondromas to avoid complications such as further damage to neighboring neurovascular structures, and potential malignant degeneration. The present study describe a rare location from an osteochondroma in the femur diaphysis.


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