Sensitivity of the stress field of the proximal femur predicted by CT-based FE analysis to modeling uncertainties.

Proximal femur anatomy and bone mineral density vary widely among individuals, precluding the use of one predefined finite element (FE) model to determine the stress field for all proximal femurs. This variability poses a challenge in current prosthetic hip design approach. Given the numerous options for generating computed tomography (CT)-based FE models, selecting the best methods for defining the mechanical behavior of the proximal femur is difficult.

Temporal Trends in Hip Fractures: How Has Time-to-Surgery Changed?

Background: Surgical fixation of hip fractures within 24-48 hours of hospital presentation is associated with decreased rates of postoperative morbidity and death, and recently, hospitals nationwide have implemented strategies to expedite surgery. Our aim was to describe how time-to-surgery and short-term complication rates have changed using the National Surgical Quality Improvement Program database from 2011 to 2017.

Methods: We identified more than 73,000 patients aged ≥65 years who underwent surgical fixation.

Can a Novel Scoring System Improve on the Mirels Score in Predicting the Fracture Risk in Patients with Multiple Myeloma?

Background: Stratification of the fracture risk is an important treatment component for patients with multiple myeloma, which is associated with up to an 80% risk of pathologic fracture. The Mirels score, which is commonly used to estimate the fracture risk for patients with osseous lesions, was evaluated in a cohort in which fewer than 15% of lesions were caused by multiple myeloma. The behavior of multiple myeloma lesions often differs from that of lesions caused by metastatic disease, and accurate risk stratification is critical for effective care.

Primary rhabdomyosarcoma of the distal femoral diaphysis: a case report and review of the literature.

Primary rhabdomyosarcoma of the bone is an extremely rare condition with few examples reported in the literature. We present the case of a 34-year-old male who presented with a lesion in the distal femur with initial imaging features consistent with Ewing sarcoma. Histologically, the lesion consisted of atypical pleomorphic polygonal rhabdomyoblasts demonstrating focal desmin and myogenin expression.

Management of Scoliosis in Patients With Loeys-Dietz Syndrome.

Background: Loeys-Dietz syndrome (LDS) is a genetic connective tissue disorder. We sought to determine the incidence of scoliosis in patients with LDS, characterize the spectrum of spinal deformity, determine the results of bracing and surgery, and define surgical complications.

Methods: Patients were selected from our institution's database of 183 patients with LDS.