Paru dans le numero n164 mai 2007 article consulte 4022 fois. Background the femur is the most common site for metastatic bone dis ease requiring surgery. Mr findings of femoral diaphyseal stress injuries ajr. Open reduction and internal fixation was a poor prognostic factor of nonunion in these fractures. This is an enhanced pdf from the journal of bone and joint surgery j bone joint surg am. Further rehabilitation information appropriate to your hospital can be found by. Paru dans le numero n227 octobre 20 article consulte 9481 fois. Les fractures diaphysaires du femur sont frequentes. The concept of neurapraxic nerve injury makes most surgeons choose to watch and see the nerve recovery before deciding second surgery if the nerve does not recover. If you continue browsing the site, you agree to the use of cookies on this website. James e keany, md, facep associate medical director, emergency services, mission hospital regional medical center, childrens hospital of orange county at mission james e keany, md, facep is a member of the following medical societies. Intramedullary nailing for femur fracture management. Koh and tet sen howe introduction epidemiology of femoral fractures in the elderly classification and mechanism of injury associated injuries diagnosis assessment and preparation for surgery treatment intramedullary nailing in elderly femoral shaft fractures plating in elderly femoral shaft. Between january 2004 and december 2009, 9 patients with femoral diaphyseal fractures were treated.
Babst department of trauma surgery, cantonal hospital lucerne, lucerne, switzerland summary this paper describes current treatment strategies of distal femoral fractures as well as their evidence based rationale. The window is in the middle third of the anterior half of the distal femur and 2. Pdf reduction techniques for diaphyseal femur fractures. Pdf musculoskeletal disorders and treatment diaphyseal. Proximal femoral dimensions were measured from radiographs of 80 living subjects whose current body weight and body weight at initial skeletal maturity 18 years could be ascertained. Injuries associated with femoral shaft fractures were very frequent 46. Roberts department of orthopaedic surgery, university of louisville school of medicine, 210 east gray street, suite 1003, louisville, ky 40202, usa keywords nonunion. Normally, the knee joint axis is parallel to the ground, and the anatomic femoral axis subtends an 81 lateral distal femoral angle. Innovative method of traction in a bilateral diaphyseal. The distal part of the femur is considered the most distal 9 to 15 cm of the femur and can involve the articular surface. To compare the functional and radiological results of diaphyseal femur fractures in children between the use of esin elastic stable intramedullary nail versus lcp locking compression plates. Xray examinations at the first visit of these two female patients showed a complete fracture of the femoral diaphysis diagnosed as an atypical femoral fracture aff. Functional outcome in our series at the latest follow up rom 110 is noted in 10. Repair of diaphyseal femoral fractures in cats using.
Femoral shaft fractures are commonly associated with multisystem trauma. The pff modular hook for treating proximal fractures of the femur provides the usual excellent stability of onil locking plates, but with the additional option of securing the greater trochanter using a modular greater trochanter hook. Anatomic reduction of the articular surface and restoration of limb axial. Treatment of pediatric diaphyseal femur fractures case study. Org volume 89a number 1 january 2007 exchange nailing of ununited fractures turns to normal or supranormal levels within days after medullary reaming16,2022. Femoral shaft fractures orthopaedic trauma association ota. Submuscular plating compared with intramedullary nailing. Always remember to complete a thorough trauma evaluation. Col femoral trochanteriennes soustrochanteriennes diaphyse femorale femur. Background atypical femoral fractures aff are an infrequent sideeffect of the antiosteoporotic treatment with bisphosphonates around 510,000 patientsyear. Localized cortical thickening of the femoral diaphysis. Chapitre 12 fractures du femur et traumatismes du genou traduction. Research article longterm results of osteoarticular.
Femoral diaphyseal fractures fixation technique using an. Identification and management of 2 femoral shaft stress injuries marc d. Femoral shaft fractures in emergency medicine differential. The objective of this multicentre study was to assess the reduction and. Hippocrates, the father of medicine, also described the treatment of mandible fractures with circumferential dental. Les fractures longitudinales par insuffisance osseuse sont plus rares. New nailing system used in open diaphyseal fractures mohamed abdelaal1, abdelaleemaziz atallah2 and abdelaleem m2 1department of orthopedics, elbarky general hospital, cairo, egypt 2department of orthopedics surger y, cairo, egypt. Nail dynamization for delayed union and nonunion in femur and. Open reduction and internal fixation of the distal femur.
Articular and diaphyseal remodeling of the proximal femur. Atypical femoral fracture radiology reference article. Femoral nerve blocks are effective for pain management and have less side effects than systemic analgesics. Sat0288 atypical femoral fractures after treatment with. Indications for nonoperative and operative treatment humeral shaft 1. Sexage, y bone diameter, mm callus diameter, mm ratio, callus to bone healed pathologic fracture low energy.
Of these, 57 patients sustained fractures caused by gunshots and had a postoperative computed tomographic scanogram. Unicondylar fractures of the distal femur are rare, complex, intraarticular fractures. New nailing system used in open diaphyseal fractures. The management of paediatric diaphyseal femoral fractures. Open reduction and internal fixation of the distal femur animesh agarwal definition distal femur fractures are difficult, complex injuries that can result in devastating outcomes. Coronal and axial t1weighted spinecho sequences trte, 80015 and t2weighted fast spinspinecho 4,00054 with fat suppression are performed in all studies. Systemic factors summary nonunion of a fracture can be caused by various. Reduction techniques for diaphyseal femur fractures. The incidence of pediatric femur fractures is 19 in.
Anatomy long tubular bone, anterior bowed forward and has oblique course from the neck to distal end. Maitrise orthopedique articles fracture femorale sur. Surgical technique depuy synthes 11 preparation 5 case report. The pediatric orthopedic surgeon will assess your child in order to determine the optimal treatment method. Frequentes, su tout chez ladulte, leu p onostic peut ete aggave pa.
The role of nerve exploration in supracondylar humerus. The atypical fracture pattern occurs in the femur shaft and may be unilateral or bilateral. Identification and management of 2 femoral shaft stress. Both patients had been taking alendronate for more than 3. Femoral and tibial diaphyseal crosssectional geometry in pleistocene homo abstract reassessment of pleistocene homo femoral and tibial diaphyseal crosssectional properties indicates that there was a variably significant decrease in relative cortical area through the pleistocene, especially in the middle portions of. Pseudopathologic fracture of the neck of the femur. Fracture haute energie diaphyse femorale osteosynthese enclouage centromedullaire. Functional outcome of diaphyseal fractures of femur. Femoral or tibial diaphyseal replacement sarcoma uk. Case report innovative method of traction in a bilateral diaphyseal femur fracture in a polytrauma belowknee amputee stefan mitrasinovic,1 georgios kiziridis,1 shauni wellekens,2 charline roslee,1 and syed neshat anjum1 1department of orthopaedics, southampton general hospital, tremona road, southampton, uk 2university college london medical school, gower. Aff usually occur at sites suffering of tensional stress, such as the subtrochanteric or diaphyseal femur. Copr sac i ncorpora ed fl u table 2 patient characteristics patient no. Associated injuries, diaphysis, femur, fracture, treatment dintroduction. Wittig and nirmal tejwani pseudopathologic fracture of the neck of the femur.
Case report open access management of a femoral diaphyseal fracture in a patient with klippeltrenaunayweber syndrome. Pedia articul ograft volu 2017299during walking almost 15 months after surgery in the second case. The aims of treatment must be restoration of length, rotation, and axial alignment and anatomic reconstitution of articular surface to avoid longterm morbidity. Femoral condyle microfracture rehabilitation protocol. Stabilization of fracture fragments using open surgical procedures to place devices, such as plateandscrew, intramedullary rods, wires, and pins and nails to reduce displacement and promote healing. The treatment of these fractures is dictated by various factors. Diagnosis of proximal femoral insufficiency fractures in. Mri findings of femoral diaphyseal stress injuries in athletes.
Case report management of a femoral diaphyseal fracture in. Research article injuries associated with femoral shaft. Fractures diaphyse diaphysaires fermees et ouvertes blog du. Femur fracture femur fracture were hip and femur fracture specialists providing the broadest portfolio of bestinclass products and services, unparalleled expertise, and the most expansive resources in the industry. The supracondylar humerus fracture schf in children is common and can be complicated with nerve injury either primarily immediate posttrauma or secondarily posttreatment. Distal femur fracture fixation by lcp 2 year experience. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Over a 10year period, 417 patients underwent imn of a diaphyseal femur fracture otaao 32ac. Download as pptx, pdf, txt or read online from scribd. Fractures du femur et traumatismes du genou medicine key. Atypical femoral fractures have been defined by the american society for bone and. Intramedullary nailing of diaphyseal femur fractures. Aotrauma principles course diaphyseal fractures dr ahmad fadzli sulong iium kuantan tibia and femur.
Fractures of the distal humeral metaphysealdiaphyseal junction in children. Jul 19, 2009 chaque diaphyse recoit une artere nourriciere qui sanastomose en intramedullaire avec les arteres musculoperiostees transversales. Fortythree patients for whom insufficient data were available in the medical files, insufficient followup had taken place over the first two years after the fracture event and inadequate radiographic documentation was available were excluded. Xrays of these two cases also showed localized cortical thickening of the femoral diaphysis. Femoral and tibial diaphyseal crosssectional geometry in. Nov 11, 2015 open fractures are often the result of highenergy trauma and can lead to significant longterm morbidity and disability. American college of emergency physicians, american college of sports medicine, california medical association. The patient was managed by removal of the fractured allograft and insertion of a. Diaphyseal femoral intramedullary nailing 17 international journal of scienti. A clinical and radiological comparative assessment of. Although femoral shaft stress fractures in the general population are rare, they are more common among endurance athletes and military recruits. Download fulltext pdf femoral diaphysis fractures in cattle.
Locking compression plate in distal femoral intraarticular. The pdf of the article you requested follows this cover page. Atypical femoral fractures, also known as bisphosphonaterelated proximal femoral fractures, are an example of insufficiency fractures, although the direct causative link remains somewhat controversial 2. Intraarticular fractures of distal femur present a huge surgical challenge. Objectiveto determine the outcome of femoral fractures repaired with 4. Soit le trait est franc et il sagit dune fracture simple. The periosteum reacts to the increased blood flow by forming new bone16, which in turn aids in heal ing of the nonunion figs. Femoral shaft fractures orthopaedic trauma association.
For intramedullary fixation of proximal femoral fractures. All potential risks will be explained and discussed with you when the consultant asks you to. The aim of this study is to evaluate functional outcome, fracture healing, and the complications of distal femoral intraarticular fractures using locking compression plates. Bone and joint decade canada 3 acknowledgements the authors of this report would like to thank the members of the steering committee, the coordinators, members of the various working groups and the key experts who.
Treatment of pediatric diaphyseal femur fractures case study introduction isolated pediatric femoral shaft fractures occur at an annual rate of 19 per 100,000 and represent the most frequent pediatric orthopaedic injury requiring hospitalization 12. Femor y ractur ixa t t d canis luus failiaris a felis catus doesticus cta cientiae veterinariae 46 26 introduction fractures are defined as total or partial bone or cartilage loss, which could be followed by several. Diaphyseal tibia and femur fractures linkedin slideshare. Femoral fractures constitute approximately 20% to 25% of all fractures encountered in the dog and cat, and represent 45% of all longbone fractures. Suffered since 3 hours before admitted to the hospital due to a traffic accident. Diaphyseal fractures humerus, femur and tibia orthopaedic trauma for pas and nps ota annual meeting, october 17, 2018 objectives 1. Because it is a major weightbearing bone with minimal space for surgical errors, the operative procedure must be carefully planned and meticulously executed. We herein report two cases of atypical femoral fracture aff.
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