A femur fracture is one of the most commonly encountered fractures by orthopaedicians worldwide. Being one of the longest and strongest bones in the body, it is one of the principal load-bearing bones of the lower extremity. Various modalities of fixation have been tried and tested for femur fracture but the most accepted fixation modality for diaphyseal femur fracture worldwide is the interlocking intramedullary nailing. However, intramedullary nailing is not free of any complications. Complications such as infection, non-union, malunion, limb length discrepancy due to wrong size nail, screw or nail breakage, and injury to neurovascular structures while passing guidewire or drilling for the interlocking bolt are commonly reported. We report a case of a patient who presented with a neglected broken femoral nail which resulted in an urethrocutaneous fistula. As per our literature review, this complication has never been reported before.
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http://dx.doi.org/10.1007/s43465-021-00442-1 | DOI Listing |
N Engl J Med
January 2025
From the Department of Medicine, University of Auckland, Auckland, New Zealand (M.J.B., Z.N., A.M., C.G., V.P., B.M., A.G., I.R.R., G.G., A.H.); the Department of Psychology, Stanford University, Stanford, CA (C.G.); and the Department of Radiology, Starship Hospital, Auckland, New Zealand (S.B.).
Background: Zoledronate prevents fractures in older women when administered every 12 to 18 months, but its effects on bone density and bone turnover persist beyond 5 years. Whether infrequent zoledronate administration would prevent vertebral fractures in early postmenopausal women is unknown.
Methods: We conducted a 10-year, prospective, double-blind, randomized, placebo-controlled trial involving early postmenopausal women (50 to 60 years of age) with bone mineral density T scores lower than 0 and higher than -2.
Purpose: To create tridimensional (3D) anatomical models of diaphyseal fractures in dogs (3D AMDFD) and to evaluate the models from their radiographs.
Methods: The study consisted of six stages: preparation of femur from a healthy dog cadaver; digitalization of the bone through a 3D scanner and creation of the base model; creation of a 3D AMDFD based on the image of the base model, 3D modeling carried out to reproduce five different types of diaphyseal fractures; printing the models produced on a 3D printer with a thermoplastic material; insertion of neodymium magnets in the fracture line to allow the assembly and disassembly of the parts; and radiography of 3D AMDFD in lateromedial and craniocaudal positions.
Results: The base model and 3D AMDFD had high precision in the replication of bone structures, like the bone in natura.
J Bone Joint Surg Am
January 2025
Surgical Outcomes and Analysis Department, Kaiser Permanente, San Diego, California.
Background: Although the majority of intertrochanteric femoral fractures in the United States are now treated with cephalomedullary nailing, it remains uncertain whether differences in clinical performance by nail type exist. The purpose of this study was to compare the aseptic revision rates associated with the 3 most commonly utilized cephalomedullary nails in the United States today: the Gamma nail (Stryker), the INTERTAN (Smith+Nephew), and the Trochanteric Fixation Nail/Trochanteric Fixation Nail Advanced (TFN/TFNA; DePuy Synthes).
Methods: Using an integrated health-care system's hip fracture registry, patients ≥60 years of age who were treated with 1 of these 3 commonly used cephalomedullary nail devices were identified.
Osteoporos Int
January 2025
Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Unlabelled: We investigated the efficacy of romosozumab in premenopausal women with low bone mass. Romosozumab substantially increased bone mineral density and trabecular bone score in these women, aligning with its proven therapeutic benefits for postmenopausal osteoporosis.
Purpose: Romosozumab, an anti-sclerostin antibody, is a promising anabolic agent that increases bone formation and decreases bone resorption.
Rev Med Suisse
January 2025
Centre interdisciplinaire des maladies osseuses, Département de l'appareil locomoteur, Centre hospitalier universitaire vaudois, 1011 Lausanne.
The epidemiology of femoral fractures is changing, with more femoral shaft fractures linked to high-risk physical exercise by an older population. Vitamin D given during pregnancy for the mother's health could benefit the child. Zoledronic acid is the most effective bisphosphonate.
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