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Orthop Surg 2020 May 28. Epub 2020 May 28.

Orthopedics Department, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.

Objectives: To evaluate the long-term efficacy of cannulated internal fixation in patients who sustain femoral neck fracture (FNF) and risk factors influencing the outcomes.

Methods: This retrospective study analyzed data from 73 elderly patients aged ≥60 years old, hospitalized for FNF and treated with cannulated internal fixation between August 2008 and July 2016. The inclusion criteria were: (i) patients aged ≥60 years; (ii) patients with recent femoral neck fracture, with times of injury ranging from 12-72 h; and (iii) patients who underwent Garden II-IV closed reduction and internal fixation. Read More

Cureus 2020 Apr 22;12(4):e7773. Epub 2020 Apr 22.

Orthopaedics and Traumatology, Bursa Acıbadem Hospital, Bursa, TUR.

Introduction Periarticular fractures of the knee in adults are generally treated with internal fixation. The Less Invasive Stabilization System (LISS) plate, developed by Arbeitsgemeinschaft Osteosynthesefragen (AO)/Association for the Study of Internal Fixation (ASIF) in the late 1990s, allows reduction and biological fixation through smaller incisions without violating periosteal blood supply. It offers several advantages for the treatment of complex periarticular fractures of the knee. Read More

J Orthop Surg Res 2020 May 27;15(1):192. Epub 2020 May 27.

Medical School of Chinese PLA, No. 28, Fuxing Road, Beijing, 100853, China.

Background: The femoral neck torsion angle (FNTA) is an important but often neglected parameter in assessments of the anatomical morphology of the femoral neck, which is often confused with the femoral neck anteversion angle (FNAA) in the current literature. Currently, the measurement methods reported in the literature all adopt the naked eye or two-dimensional (2D) visualization method, and the measurement parameters and details are not clearly defined. The objection of this research was to provide a reliable 3D method for determining the femoral neck axis, to improve the measurement method of the FNTA, and to analyze the anatomical and clinical significance of the results. Read More

BMC Musculoskelet Disord 2020 May 27;21(1):329. Epub 2020 May 27.

Unfallklinik Ludwigshafen, Klinik für Unfallchirurgie und Orthopädie, Ludwig-Guttmann-Strasse 13, 67071, Ludwigshafen, Germany.

Background: The treatment of fracture-related infections (FRI) is still a challenge for orthopedic surgeons. The prevalence of FRI is particularly high in open fractures with extensive soft-tissue damage. This study aimed to develop a new two-step animal model for non-unions with segmental bone defects, which could be used to evaluate new innovative bone substitutes to improve the therapeutic options in humans with FRI and bone defects. Read More

Hip Int 2020 May 27:1120700020925739. Epub 2020 May 27.

Orthopaedic Department, University Hospital Leuven, Leuven, Belgium.

Objectives: Cemented polished tapered stems have demonstrated excellent long-term outcomes. Based on this concept, many generic tapered stems have been released into the market. The aim of this study was to evaluate implant-related complications of 1 specific stem design. Read More

Chronobiol Int 2020 May 26:1-11. Epub 2020 May 26.

Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine , Lodz, Poland.

Osteoporosis is an important public health problem worldwide. Although a number of factors that affect bone structure have been described; thus far, the current knowledge of occupational factors that may have an influence on bone tissue metabolism is strongly limited. Published studies indicate night shift work and the related circadian rhythm disruption may be considered as plausible underlying factors. Read More

Curr Opin Rheumatol 2020 Jul;32(4):387-393

Nuffield Department of Orthopaedics, Centre for Statistics in Medicine , Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Purpose Of Review: The field of osteoporosis research has been active for the past 20 years and has allowed significant advancement in the management of osteoporosis. This review will give an overview of the latest data from international cohorts that relate to current and recent osteoporosis research.

Recent Findings: The clinical diagnosis of osteoporosis relies heavily on bone mineral density (BMD) measured at femoral neck or spine and although BMD has excellent predictive value for future fractures, fracture risk assessment has evolved over the years, resulting in the birth of fracture prediction tools. Read More

J Orthop Traumatol 2020 May 25;21(1). Epub 2020 May 25.

Department of Traumatology and Orthopaedics, University of Tartu, Puusepa 8, Tartu, 51014, Estonia.

Background: Considering the excellent results already achieved in total hip arthroplasty (THA), new implants must be at least as safe as currently used implants and lead to longer survival. A new cementless femoral stem, SP-CL, has been introduced. The aim of this study is to evaluate intraoperative complications and assess the risk factors of THA with the SP-CL implant. Read More

Eur J Trauma Emerg Surg 2020 May 25. Epub 2020 May 25.

Department of Orthopaedics, Denver Health Medical Center and University of Colorado School of Medicine, Denver, CO, 80204, USA.

Purpose: Terminal complement pathway activation after traumatic brain injury (TBI) leads to formation of the membrane attack complex (MAC/C5b-9) which induces neuronal cell death and host-mediated secondary brain injury. Serum levels of soluble MAC (sC5b-9) have not been previously determined in patients with isolated TBI.

Methods: A prospective observational cohort study was performed during a 5-year time-period on adult patients with isolated TBI admitted to an academic level I trauma center in the United States. Read More

Bone 2020 May 22:115446. Epub 2020 May 22.

Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. Electronic address:

Introduction: Cortical bone thinning and a rarefaction of the trabecular architecture represent possible causes of increased femoral neck (FN) fracture risk. Due to X-ray exposure limits, the bone microstructure is rarely measurable in the FN of subjects but can be assessed at the tibia. Here, we studied whether changes of the tibial cortical microstructure, which were previously reported to be associated with femur strength, are also associated with structural deteriorations of the femoral neck. Read More

J Orthop Surg Res 2020 May 24;15(1):186. Epub 2020 May 24.

Department of Anaesthesia, Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China.

Background: Although it is known that diabetes interferes with fracture healing, the mechanisms remain poorly understood. The aim of this study was to investigate the correlation of BMP-6 and BMP-9 with the impairment in fracture healing in diabetes, by analyses of the difference in size and calcification of the callus, mechanical endurance, and expressing BMP-6 and BMP-9 in the callus, using a clinical related diabetic rodent model.

Methods: We evaluated femur fracture healing by quantification of size and calcification of the callus by X-ray, histological and histochemical images, loading capacity of the fractured bone, and amount of BMP-6 in the callus and the bones using Western blot assay. Read More

Clin Rheumatol 2020 May 24. Epub 2020 May 24.

School of Sciences and Engineering, Pharmacy School, Pharmacoepidemiology-Pharmacovigilance, University of Nicosia, Makedonitissis 46, 2417, Nicosia, Cyprus.

To assess and update the effect of the combination of vitamin D and calcium in the reduction of osteoporotic fractures, a systematic review across Cochrane Database, NIHR HTA database, PubMed and Google Scholar was performed using mesh terms : Cohort studies OR Prospective Studies OR Longitudinal Studies OR Follow-Up Studies OR Incidence OR Risk OR Rate and Osteoporotic Fractures OR Fractures, Bone OR Fractures, Spontaneous OR Spinal Fractures OR Humeral Fractures OR Hip Fractures OR Femoral Neck Fractures AND Vitamin D AND Calcium and key words: vitamin D, fractures, osteoporosis, calcium, dietary supplements. Statistical analysis was performed with Review Manager (RevMan 5.3) using relative risk and confidence interval 95%. Read More

Arch Osteoporos 2020 May 24;15(1):78. Epub 2020 May 24.

Menopausal Research Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

We aim to investigate the nationwide prevalence of asymptomatic radiographic vertebral fracture in Thailand. We found 29% of postmenopausal women had at least one radiographic vertebral fracture. The prevalence was significantly higher among women with osteoporosis at the total hip (TH) region which implies that TH bone mineral density is a determinant of vertebral fracture risk. Read More

Int Orthop 2020 May 24. Epub 2020 May 24.

Department of Surgery, College of Medicine, University of Kerbala, Kerbala, Iraq.

Introduction: Fracture neck of femur (hip fracture) is a very common problem among old age group. Such elderly patients usually have some comorbidities for which they may use anti-platelet therapy (such as clopidogrel, aspirin, or others) for long duration (chronic use). These anti-platelet medications might make the blood thin and increase bleeding tendency. Read More

Int J Surg Case Rep 2020 May 8;71:85-90. Epub 2020 May 8.

Department of Orthopaedic & Traumatology, Cipto Mangunkusumo National Central Hospital and Faculty of Medicine, Universitas Indonesia, Jalan Diponegoro No. 71, Central Jakarta, Jakarta 10430, Indonesia.

Introduction: Traumatic dislocation of the hip is a very severe injury. Posterior hip dislocation can be associated with acetabular fracture, which can ultimately result in a higher incidence of complications.

Case Presentation: We present a case report of 26-year-old men with a motor vehicle accident and suffered a posterior hip dislocation on left hip joint and acetabular fracture with Judet-Letournel type posterior wall and femoral head fracture. Read More

Biochem Biophys Res Commun 2020 Jun 4;527(1):270-275. Epub 2020 May 4.

Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.

Aldehyde dehydrogenase 2 (ALDH2) plays major roles in aldehyde detoxification and in the catalysis of amino acids. ALDH2∗2, a dominant-negative transgenic expressing aldehyde dehydrogenase 2 (ALDH2) protein, is produced by a single nucleotide polymorphism (rs671) and is involved in the development of osteoporosis and hip fracture with aging. In a previous study, transgenic mice expressing Aldh2∗2(Aldh2∗2 Tg) osteoblastic cells or acetaldehyde -treated MC3T3-E1 showed impaired osteoblastogenesis and caused osteoporosis [1]. Read More

Adv Med Sci 2020 May 20;65(2):291-297. Epub 2020 May 20.

Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland.

Purpose: We aimed to examine the polymorphism of the promoter and exon 5 of the TNFSF11 gene and their impact on bone mineral density (BMD) and the frequency of bone fractures. TNFSF11 encodes the receptor activator of the NF-kB ligand (RANKL), a key regulator of bone metabolism and osteoporosis drug targets. BMD is an essential measure in diagnosing osteoporosis and assessing the risk of fractures. Read More

J Bone Miner Res 2020 May 22. Epub 2020 May 22.

Service and Laboratory of Bone Diseases, Geneva University Hospital, Geneva, Switzerland.

In the Active-Controlled Fracture Study in Postmenopausal Women With Osteoporosis at High Risk (ARCH) clinical trial (NCT01631214), 1 year of romosozumab followed by alendronate reduced the risk of vertebral and nonvertebral fractures compared to alendronate alone in women with prevalent fracture. We performed post hoc analyses of data from patients in ARCH (romosozumab, n = 1739; alendronate, n = 1726) who had a baseline BMD measurement and received at least one open-label alendronate dose. We evaluated 1-year mean BMD and corresponding T-score changes; proportions of patients achieving T-scores > -2. Read More

Injury 2020 May 7. Epub 2020 May 7.

Limb Reconstruction Unit, Leeds General Infirmary, Leeds, UK.

Aim: We examined the management and outcome of patients suffering complex paediatric lower limb injuries with bone and soft tissue loss.

Method: Patients were identified from our prospective trauma database (2013-2018). Inclusion criteria were age (<18 years) and open lower-limb trauma. Read More

Medicine (Baltimore) 2020 May;99(20):e20001

Department of Anesthesiology and Pain Medicine, Inje University Haeundae Paik Hospital, Haeundaegu, Busan, Republic of Korea.

Elderly patients with femoral fractures are anticipated to endure the most pain caused by positional changes required for spinal anesthesia. To improve pain relief, we compared the analgesic effects of intravenous dexmedetomidine-ketamine and dexmedetomidine-fentanyl combinations to facilitate patient positioning for spinal anesthesia in elderly patients with proximal femoral fractures. Forty-six patients were randomly assigned to two groups and received either 1 mg/kg of intravenous ketamine (group K) or 1 μg/kg of intravenous fentanyl (group F) concomitant with a loading dose of dexmedetomidine 1 μg/kg over 10 minutes, then dexmedetomidine infusion only was continued at 0. Read More

Medicine (Baltimore) 2020 May;99(20):e19935

Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul.

Introduction: The removal of bent intramedullary (IM) nail can become a challenge. Therefore, various methods have been reported for the extraction of nails after femoral refracture. We want to share our successful treatment. Read More

Medicine (Baltimore) 2020 May;99(20):e19617

Service de Maladies Infectieuses et Tropicales, Hospices Civils de Lyon - Hôpital de la Croix-Rousse Lyon, Cedex 04.

To describe the epidemiological, clinical, laboratory, and radiological features and the management of adult patients who experienced a relapse between 2003 and 2015 of an acute hematogenous osteomyelitis acquired in childhood.A retrospective multicentric cohort study was conducted in 5 centers in France.Thirty-seven patients were included. Read More

Orthop Nurs 2020 May/Jun;39(3):171-179

Kristin O'Mara-Gardner, MSN, RN-BC, ONC, Geriatric Fracture Coordinator, ProMedica Toledo Hospital, Toledo, OH. Roberta E. Redfern, PhD, Research Scientist, ProMedica Toledo Hospital, Toledo, OH. Jeffrey M. Bair, MD, Orthopaedic Trauma Surgeon, ProMedica Toledo Hospital, Toledo, OH.

Background: Traditional care of patients with geriatric hip fracture has been fragmented with patients admitted under various specialty services and to different units within a hospital. This produces inconsistent care and leads to varying outcomes that can be associated with increased length of stay, delays in time from admission to surgery, and higher readmission rates.

Purpose: The purpose of this article is to describe the process taken to establish a successful geriatric hip fracture program (GFP) and the initial results observed in a single institution after its implementation. Read More

J Am Geriatr Soc 2020 May 22. Epub 2020 May 22.

Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Background: Geriatric hip fracture patients are susceptible to the adverse effects of opioid-induced analgesia. Fascia iliaca blocks (FIBs) have emerged as an analgesic technique for this population. There are limited data on a preoperative FIB's effect on perioperative opioid intake. Read More

Acta Orthop Traumatol Turc 2020 May 22. Epub 2020 May 22.

Department of Orthopaedics, Hanil General Hospital, Seoul, Korea.

Objective: Internal fixation with cannulated screws for nondisplaced femoral neck fractures in the elderly has substantial reoperation and mortality rates. The selection of either internal fixation or arthroplasty for nondisplaced femoral neck fracture is debatable.

Methods: We performed a systematic review of the literature regarding complications in the internal fixation of nondisplaced femoral neck fractures in elderly (>60 years old) patients. Read More

AANA J 2020 Jun;88(3):222-228

is in the Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, and the Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, Ohio.

Current criteria used to make the clinical diagnosis of fat embolism syndrome were never intended to be applied to an anesthetized, mechanically ventilated patient in the operating room and, as such, may not be applicable during intraoperative care. Because of this, confusion still exists among anesthesia providers in recognizing this potentially fatal clinical condition. Our goal was to develop and then present a more exacting and rigorous grading scale, tailored specifically for the anesthetized patient, with the hope that it will aid clinicians in recognizing and successfully managing the manifestations of the syndrome. Read More

Vet Surg 2020 May 22. Epub 2020 May 22.

Sirius Veterinary Orthopedic Center, Omaha, Nebraska.

Objective: To develop and evaluate a novel fracture fragment stabilization system, the Sirius minimally invasive bone reduction handle system (SMH), in an artificial fracture model (FxM) simulating a canine femoral fracture repair with a minimally invasive orthopedic approach.

Study Design: In vitro experimental study.

Sample Population: Synthetic fractured femurs with soft-tissue coverage analog (n = 8). Read More

Osteoporos Int 2020 May 21. Epub 2020 May 21.

Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada.

Patients with chronic kidney disease have high risk of osteoporotic fractures. Lower trabecular bone score (TBS) was associated with poorer kidney function and higher fracture risk when kidney function was normal. Addition of TBS to The Fracture Risk Assessment Tool with bone mineral density did not improve fracture risk prediction. Read More

Int Orthop 2020 May 22. Epub 2020 May 22.

Department of Anesthesia of West Hospital, Cangzhou Central Hospital, Xinhua West Road, Cangzhou, 061000, Hebei, China.

Background: Elderly patients with proximal femoral fractures face elevated risk of post-operative deep vein thrombosis and pulmonary embolism, due to the lack of suitable treatment plans after surgery and hospital discharge. This study aimed to investigate the effect of omega-3 fatty acid supplementation in the above-described clinical setting.

Methods: Five hundred and seven elderly patients (> 60 years of age) suffering from proximal femoral fractures were recruited. Read More

J Am Acad Orthop Surg Glob Res Rev 2020 Feb 10;4(2). Epub 2020 Feb 10.

Mallinckrodt Institute of Radiology (Herrmann, Stanborough, Jennings), and the Department of Pathology and Immunology (Chrisinger), Washington University, St. Louis, MO.

The association between hyperparathyroidism and sarcoma is extremely rare with other reported cases describing the development of osteosarcoma and chondrosarcomas in middle-aged adults. This case describes an adolescent male with hyperparathyroidism and a pathologic fracture of a biopsy-proven brown tumor in the distal right femur. The fracture healed but later developed an undifferentiated pleomorphic sarcoma of the bone at the site of the known brown tumor. Read More

BMC Musculoskelet Disord 2020 May 21;21(1):317. Epub 2020 May 21.

Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.

Background: The incidence of periprosthetic fractures after total joint arthroplasty (TJA) is rising due to an increasing number of TJAs performed annually and the growing elderly population. In many elderly patients with periprosthetic fractures, the bone strength is lowered due to the deterioration of bone quality and a decrease in bone quantity; rigid fixation of the fracture is difficult. It is a challenging operation for orthopedic surgeons. Read More

N Z Med J 2020 May 22;133(1515):16-24. Epub 2020 May 22.

Consultant Orthogeriatrician, ARHOP, Counties Manukau Health, Auckland.

Background: Little is known about the prevalence of renal impairment in patients presenting with osteoporotic fractures contraindicating bisphosphonate use in New Zealand, and their eligibility to denosumab.

Aim: To assess the prevalence of renal impairment contraindicating bisphosphonate use in older adults presenting with osteoporotic fractures, differences in demographic variables between those with renal impairment and those who do not, and finally to assess eligibility for denosumab based on the current PHARMAC special authority criteria.

Method: All patients 65 years and older with osteoporotic fractures treated by inpatient orthogeriatric service (IOS) and the outpatient fracture liaison service (FLS) at Middlemore Hospital between 1 February to 31 April 2019 were assessed. Read More

Bone 2020 May 10:115411. Epub 2020 May 10.

Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK; Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK.

Alendronate was synthesized in 1970s in a search for inhibitors of calcification. Istituto Gentili investigators identified it as a potent inhibitor of bone resorption and obtained a patent covering its use in the treatment of osteoporosis and other disorders of excessive bone resorption in the 1980s. Merck licensed alendronate in 1988 and its pharmaceutical chemists reformulated it as a sodium salt with good solubility in a tablet that reduced its potential for esophageal irritation. Read More

Ulus Travma Acil Cerrahi Derg 2020 May;26(3):439-444

Department of Orthopaedics and Traumatology, Cumhuriyet University Faculty of Medicine, Sivas-Turkey.

Background: This study aimed to evaluate the effects on mortality of implant selection used and time to surgery in patients aged over 65 years operated for hip fractures.

Methods: A total of 301 patients aged over 65 years were investigated in this study. Patients were divided into three groups as follows: Group 1 cemented hemiarthroplasty (CH), Group 2 cementless hemiarthroplasty (CLH), and Group 3 proximal femoral nail (PFN). Read More

Indian J Med Microbiol 2019 Oct-Dec;37(4):531-535

Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India.

Background: A single-stage implant revision for failed fixation of proximal femoral fractures is performed only when there is no evidence of infection. Else, a two-staged revision is preferred - where the definitive revision surgery is done a few months after the implant exit. This study aims to audit the safety and incidence of culture positivity in single-stage revisions. Read More

SAGE Open Med 2020 28;8:2050312120918268. Epub 2020 Apr 28.

Department of Anaesthesia, Princess Alexandra Hospital, The University of Queensland, Brisbane, QLD, Australia.

Background: This study evaluated the use of several risk prediction models in estimating short- and long-term mortality following hip fracture in an Australian population.

Methods: Data from 195 patients were retrospectively analysed and applied to three models of interest: the Nottingham Hip Fracture Score, the Age-Adjusted Charlson Comorbidity Index and the Physiological and Operative Severity Score for enUmeration of Mortality and Morbidity. The performance of these models was assessed with receiver operating characteristic curve as well as logistic regression modelling. Read More

Bone Joint Res 2020 Mar 16;9(3):99-107. Epub 2020 May 16.

Department of Orthopaedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Skeleton Materials and Bio-compatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Aims: Cigarette smoking has a negative impact on the skeletal system, causes a decrease in bone mass in both young and old patients, and is considered a risk factor for the development of osteoporosis. In addition, it disturbs the bone healing process and prolongs the healing time after fractures. The mechanisms by which cigarette smoking impairs fracture healing are not fully understood. Read More

Bone Joint Res 2020 Feb 16;9(2):71-76. Epub 2020 May 16.

Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

Aims: The purpose of this study was to determine whether intracellular is associated with recurrent infection in a rat model of open fracture.

Methods: After stabilizing with Kirschner wire, we created a midshaft femur fracture in Sprague-Dawley rats and infected the wound with green fluorescent protein (GFP)-tagged . After repeated debridement and negative swab culture was achieved, the isolation of GFP-containing cells from skin, bone marrow, and muscle was then performed. Read More

Injury 2020 May 12. Epub 2020 May 12.

Department of Orthopedics and Traumatology Service, Şişli Hamidiye Etfal Research And Training Hospital, Halaskargazi Caddesi, Etfal Sokak., 34371, Şişli, İstanbul, Turkey.

Objective: The purpose of this study was to evaluate an association between fall-related intertrochanteric or femoral neck fractures and gluteus medius and minimus atrophy, furthermore, to find a correlation of whether any difference between femoral neck or intertrochanteric fracture and degree of muscle atrophy MATERIALS AND METHODS: A retrospective review of 230 patients with intertrochanteric or femoral neck fracture, aged > 65 years, and 60 age- matched controls was performed. We assessed gluteus medius and minimus atrophy and calculated the cross-sectional area (CSA) and ratio of lean muscle to adipose infiltration (M/A ratio) for each muscle.

Results: The atrophy scores for the g. Read More

Med Eng Phys 2020 May 11:3478. Epub 2020 May 11.

Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, ON, Canada, M5B2K3. Electronic address:

Metallic intramedullary nails are the "gold standard" implant for repairing femur shaft fractures. However, their rigidity may eliminate axial micromotion at the fracture (causing delayed healing) and they may carry too much load relative to the femur (causing "stress shielding"). Consequently, some researchers have proposed fiber-reinforced composite nails, but only one evaluated cyclic fatigue performance. Read More

Asian Spine J 2020 May 21. Epub 2020 May 21.

Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Study Design: Single-center retrospective study in pediatric patients.

Purpose: The purpose of the study was to investigate the effects of the presence and severity of leg-length discrepancy (LLD) on scoliosis in children.

Overview Of Literature: LLD is a common orthopedic problem that can result in standing imbalance, low back pain, and stress fractures. Read More

J Orthop Trauma 2020 May 8. Epub 2020 May 8.

Naval Medical Center San Diego.

Objectives: To review the clinical course, complication rates, and mid-term functional outcomes associated with the treatment of displaced femoral neck stress fractures (FNSFs) DESIGN:: Retrospective Case Series SETTING:: Military Tertiary Referral Center PATIENTS:: Twenty-one operatively treated displaced FNSFs between 2002 and 2015.

Intervention: Urgent reduction and fixation was performed. If nonunion developed, an intertrochanteric osteotomy was performed. Read More

Geriatr Orthop Surg Rehabil 2020 28;11:2151459320922473. Epub 2020 Apr 28.

Department of Orthopedic Surgery, Prince Mohammed bin Abdulaziz Hospital, Riyadh, Saudi Arabia.

Introduction: Femoral neck fracture is a common problem in elderly patients, and it is managed with either total hip arthroplasty or hemiarthroplasty with very good outcomes. However, the reported 1-year mortality rate is as high as 33%.

Material And Methods: This study was a retrospective cohort study. Read More

J Orthop 2020 Nov-Dec;22:220-224. Epub 2020 May 6.

Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Hondo 1-1-1, Akita, 010-8543, Japan.

Purpose: Periprosthetic femoral fractures are difficult to treat, but few reports have included many periprosthetic femoral fractures. The purpose of this study was to investigate the trends and characteristics of a large number of periprosthetic femoral fractures and to determine the best treatment strategy for such fractures.

Methods: The fracture type according to the Vancouver classification, the stem fixation style of previous surgery, the elapsed time from previous surgery, and the treatment method for periprosthetic fractures of 51 patients with periprosthetic femoral fractures who were seen between 2006 and 2018 were investigated. Read More

J Orthop 2020 Nov-Dec;22:207-212. Epub 2020 May 6.

Department of Orthopaedics, Kasturba Hospital, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.

Objectives: Pediatric femoral neck fractures were reviewed to compare complications with the time of presentation.

Methods: 34 pediatric femoral neck fractures were studied to detect union time, avascular necrosis, premature physis fusion, and the neck-shaft angle. All complications were comparable between both groups. Read More

J Orthop 2020 Nov-Dec;22:198-202. Epub 2020 May 4.

Department of Orthopaedic Surgery, North Shore-Long Island Jewish Medical Center, Northwell Health, 270-05 76th Avenue, New Hyde Park, NY, 11040, USA.

Background And Objectives: Cemented hip arthroplasty is considered the standard of care for treating both osteoporotic femoral neck fractures and pathologic disease of the proximal femur due to the ability to achieve strong fixation in poor quality bone. There is minimal literature evaluating uncemented arthroplasty for pathologic disease of the proximal femur. This objective of this study is to compare outcomes of patients undergoing cemented and uncemented arthroplasty of the proximal femur for an oncologic indication. Read More

Orthop Surg 2020 May 18. Epub 2020 May 18.

Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands.

Objectives: To assess the learning curve of the direct superior approach (DSA) for total hip arthroplasty (THA) and to compare surgical, clinical, and radiological results with a matched control group using the mini posterior approach (MPA).

Methods: A prospective cohort study was performed from October 2016 to May 2017 including our first 52 patients undergoing THA using the DSA. Patients with primary osteoarthritis or osteonecrosis and a body mass index (BMI) < 35 who were eligible for surgery were included. Read More

Arch Osteoporos 2020 May 18;15(1):74. Epub 2020 May 18.

Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.

In this 3-year follow-up study of 66 community-dwelling adults with severely deformed vertebral fractures, the annual incidence of adjacent vertebral fracture (AVF) was 6.1%/year. Lower bone mineral density at the femoral neck and spinopelvic malalignment were risk factors for AVF. Read More

Injury 2020 May 11. Epub 2020 May 11.

Landesklinikum Horn, Spitalgasse 10, 3580 Horn, Austria.

Introduction: Typically, a healthcare intervention is evaluated by comparing data before and after its implementation using statistical tests. Comparing group means can miss underlying trends and lead to erroneous conclusions. Segmented linear regression can be used to reveal secular trends but is susceptible to outliers. Read More

J Biomech 2020 May 25;105:109810. Epub 2020 Apr 25.

Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8677, Japan.

Proximal femoral fractures are common in elderly osteoporosis patients; however, its prevalence is clinically rare in hip fracture patients with hip osteoarthritis (OA). This study aimed to evaluate bone strength of the proximal femur with or without hip OA and proximal femoral fracture risk using computed tomography (CT)-based finite element analysis (FEA). A retrospective analysis was done on CT data of 20 patients who underwent total hip arthroplasty for unilateral hip OA. Read More