The diagnostics and treatment of pathological fractures of the extremities differ from the approach for conventional fractures. Metastases from breast, bronchial, renal cell and prostate cancer are the predominant cause. Typically, patients present at over 50 years old present after an inadequate trauma. They often report symptoms or swelling in the affected region that already existed before the fracture. An underlying malignant disease is sometimes already known; however, occasionally this is manifested in the form of a fracture. The femur is affected in 74% of cases, followed by the humerus and the tibia. Important indications for the presence of a pathological fracture can even be obtained from conventional radiographs. The diagnostics are supplemented with further modalities depending on the treatment goal. Surgical treatment is the first choice as the fractures do not heal using conservative measures. In this context, a prognosis-stratified approach is recommended.
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http://dx.doi.org/10.1007/s00113-024-01492-4 | DOI Listing |
Medicina (Kaunas)
December 2024
Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon 16499, Republic of Korea.
Valgus-impacted femoral neck fractures (OTA 31B1.1 and 31B1.2) are considered stable fractures with favorable outcomes compared to displaced fractures.
View Article and Find Full Text PDFDiagnostics (Basel)
January 2025
Orthopedic Department, Meir Medical Center, Kfar Saba, Faculty of Medical and Health Sciences, Tel-Aviv University, Tel Aviv 6997801, Israel.
Osteoporotic fractures, particularly subcapital hip fractures (SCF), pose a significant healthcare and economic burden. The routine pathological examination of resected femoral heads in such cases is common practice, aimed at identifying malignancies that may have contributed to bone fragility. This study evaluated the cost-effectiveness and clinical utility of routine femoral head pathology in patients undergoing surgical treatment for SCF.
View Article and Find Full Text PDFHereditas
January 2025
Health Management Research Center, School of Public Health, Southeast University, 87 Dingjiaqiao Road, Gulou District, Nanjing, 210009, P.R. China.
Objectives: Two-sample MR methods were employed to analyze the impact of smoking and bitter beverage consumption on the risk of osteoporosis and osteoporosis with pathological fractures, in order to assess the causal association.
Methods: Publicly available genome-wide association study summary data were analyzed using MR methods. The exposures investigated were smoking (smoking per day, smoking initiation, and lifetime smoking index) and bitter beverages (coffee, tea, bitter alcoholic beverages, bitter non-alcoholic beverages, and total bitter beverages).
Fibrous dysplasia (FD) is a benign tumor condition in which normal bone is replaced by structurally deficient fibrous lamellar bone. It represents approximately 5-7% of benign bone tumors and occurs in two presentations: monostotic, which is the most common, and polyostotic. The proximal femur is one of the most common locations for benign tumors, including FD.
View Article and Find Full Text PDFPLoS One
January 2025
Department of Orthopedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland.
Background: Low-profile double plating seems a viable alternative to conventional single plating for fixation of midshaft clavicle fractures. This study aims to compare the two techniques regarding healing, complications, and removal rate.
Methods: This retrospective cohort study included all patients >16 years that underwent plate fixation for midshaft clavicle fractures between 2020 and 2022 at one trauma-center.
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