A prospective study on socioeconomic aspects of fracture of the proximal femur.

A prospective survey of hip fracture incidence and outcome was conducted to evaluate their socioeconomic impact. Over the course of 1 year, 404 hip fractures were recorded in 339 women and 65 men following minor or moderate trauma. The subjects' ages were 82.

Novel animal model for studying the molecular mechanisms of bacterial adhesion to bone-implanted metallic devices: role of fibronectin in Staphylococcus aureus adhesion.

Infection around metallic implants is a rare but severe complication of orthopaedic surgery. A novel animal model mimicking conditions of internal fixation devices was developed to evaluate the role of host proteins adsorbed on metallic devices in promoting adhesion and colonization of the material surfaces by Staphylococcus aureus. Small plates made of pure titanium were either fixed (three screws per plate) onto the iliac bones of guinea pigs or implanted into their subcutaneous space as controls.

[Progressive fragmentation of a bipartite patella: apropos of a case].

Purpose Of The Study: Progressive dissolution of the supero-lateral fragment of a bipartite patella is reported.

Material And Methods: The patient, a 44 year old professor of gymnastics, was examined for long standing anterior knee pain. For many years, his daily activities included forceful knee flexion exercises.

Effects of calcium supplements on femoral bone mineral density and vertebral fracture rate in vitamin-D-replete elderly patients.

The efficacy of calcium (Ca) in reducing bone loss is debated. In a randomized placebo-controlled double-masked study, we investigated the effects of oral Ca supplements on femoral shaft (FS), femoral neck (FN) and lumbar spine (LS) bone mineral density (BMD), and on the incidence of vertebral fracture in vitamin-D-replete elderly. Ninety-three healthy subjects (72.

Role of fibronectin in staphylococcal adhesion to metallic surfaces used as models of orthopaedic devices.

Staphylococcal infection of various prosthetic and internal fixation devices is a major complication associated with orthopaedic surgery. This study investigated the role of the host protein fibronectin in promoting adhesion of Staphylococcus aureus and Staphylococcus epidermidis to metallic surfaces representing materials used for orthopaedic devices. Pure human fibronectin was adsorbed in vitro onto coverslips (0.

Fat embolism syndrome.

Twenty cases of clinically patent fat embolism syndrome (FES) were observed at the authors' institution between 1964 and 1989. There were 4 deaths (20%). The injury severity score (ISS) was computed for each patient upon admission and ranged from 9 to 50 (median, 17).

Benefits of oral protein supplementation in elderly patients with fracture of the proximal femur.

Malnutrition has been often suggested as contributing to both the high incidence of hip fracture in elderly people and its complications. In a recent prospective controlled randomized study, the clinical outcome of elderly patients with osteoporotic fracture of the proximal femur (hip fracture) improved by giving a simple oral dietary supplement. This study, however, did not prove that protein was responsible for the clinical improvement since the supplement also contained vitamins and minerals.

Epidemiology of fractures of the proximal femur in Geneva: incidence, clinical and social aspects.

Fracture of the proximal femur (hip fracture) as a consequence of osteoporosis is an important public health problem. Its incidence, which rises with age, varies according to geographical location and race. There is no information concerning hip fracture in Switzerland, which is a Western country with a particularly aged population.

Preferential low bone mineral density of the femoral neck in patients with a recent fracture of the proximal femur.

Bone mass is an important determinant of resistance to fractures. Whether bone mineral density (BMD) in subjects with a fracture of the proximal femur (hip fracture) is different from that of age-matched controls is still debated. We measured BMD of the femoral neck (FN) on the opposite side to the fracture, as well as femoral shaft (FS) and lumbar spine (LS) BMD by dual-photon absorptiometry in 68 patients (57 women and 11 men, mean age 78.

Dietary supplementation in elderly patients with fractured neck of the femur.

59 elderly patients (mean age 82) with femoral neck fractures were randomised into two groups. 27 patients received daily an oral nutrition supplement (250 ml, 20 g protein, 254 kcal) for a mean of 32 days; 32 patients acted as controls. On admission most patients had nutritional deficiencies.

[A combination of dihydroergotamine and acetylsalicylic acid--prevention of postoperative thromboembolic complications. Clinical study in orthopedics].

202 patients undergoing surgery involving the lower limbs were given antithrombotic treatment for at least 21 days, or until they had regained full mobility. Following subcutaneous prophylaxis with a combination of heparin and dihydroergotamine, two oral regimens were compared in a controlled and randomized prospective study. The first treatment consisted of a combination of acetylsalicylic acid (ASA) and dihydroergotamine (DHE), and the second of acenocoumarol.

Delayed internal fixation of femoral shaft fractures--is there an advantage? A review of 320 fractures.

We have reviewed 402 traumatic fractures of the femoral shaft, 320 of which had been treated by operation and had a long follow-up. Of these, 228 closed fractures and 37 open fractures had been stabilised by plating. There was no significant difference in healing between those stabilised early and those having delayed internal fixation.

[Postoperative infection of fractures of the femoral diaphysis treated by osteosynthesis. Long-term outcome].

The authors have operated on 284 simple fractures, complicated by 12 post-operative infections (4.2 per cent) and 43 compound fractures, complicated by four infections (9.3 per cent).

The value of computerized tomography in fractures of the pelvic ring.

Thirty four fractures of the pelvic ring were examined by computerized tomography and the findings compared with those obtained with conventional radiography. CT scanning enabled precise delineation of the fracture sites in the posterior ring. A new classification is proposed which defines five patterns of fracture of the posterior ring.

[Aseptic necrosis of the femoral head in young adults].

Aseptic necrosis of the femoral head is a well-defined entity. The underlying diseases originate from very different types of pathological conditions. Alcoholism, cortisone therapy, gout or hyperuricemia, sickle cell anaemia and others all lead, through various pathways, to the impairment of the medullary blood flow.

Humeral retrotorsion and glenohumeral relationship in the normal shoulder and in recurrent anterior dislocation (scapulometry).

The authors' roentgenographic technique provides precise assessment of the glenohumeral relationship on the basis of two-plane examination. A group of 50 normal male subjects serve as the basis for determining normal values for the following angles or lines: projected and corrected cephalodiaphyseal angle, projected and corrected humeral retrotorsion, glenoid inclination, angle of attack, glenoid retroversion, dimension of glenoid, width of humeral head, and contact index. Two groups of patients suffering from recurrent anterior dislocation (RAD) are compared with the normal group.

[is there an osteomalacia component in femur neck fractures?].

In 29 patients with fractures of the femoral neck (group A) and 22 patients operated on for osteoarthritis of the hip (group) B), plasma levels of 25-hydroxycholecalciferol (25-OH-D3) were compared with the results of histological bone tests. A third group of 19 patients at the Geriatric hospital served as a control in this age group for 25-OH-D3 values (group C). The average level of 25-OH-D3 was 9.

[Preventive antibiotic therapy in orthopedic surgery].

Prophylactic antibiotics are useful if the right substance hits the right place at the right moment. Wound contamination and infection rates are generally low in clean orthopaedic wounds. Systematic treatment is therefore not justified for all patients.