4,592 results match your criteria Stress Fracture Imaging


Mechanical behavior of metastatic femurs through patient-specific computational models accounting for bone-metastasis interaction.

J Mech Behav Biomed Mater 2019 Jan 30;93:9-22. Epub 2019 Jan 30.

Department of Orthopaedics and Trauma Surgery, Campus Bio-Medico University of Rome, Italy.

This paper proposes a computational model based on a finite-element formulation for describing the mechanical behavior of femurs affected by metastatic lesions. A novel geometric/constitutive description is introduced by modelling healthy bone and metastases via a linearly poroelastic constitutive approach. A Gaussian-shaped graded transition of material properties between healthy and metastatic tissues is prescribed, in order to account for the bone-metastasis interaction. Read More

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http://dx.doi.org/10.1016/j.jmbbm.2019.01.014DOI Listing
January 2019
1 Read

Sacral Pedicle Stress Fracture in an African-American Male, Adolescent, Competitive Basketball and Track and Field Athlete with a Prior Femoral Physeal Injury: A Case Report.

PM R 2019 Feb 6. Epub 2019 Feb 6.

Division, Physical Medicine & Rehabilitation, Departments of Neurology and Orthopedic Surgery, Washington University School of Medicine, St. Louis, Missouri.

A sacral pedicle stress fracture is an uncommon source of low back pain in adolescent athletes. Given the extensive differential diagnosis of low back pain coupled with the fact that non- directed specific imaging can be normal, diagnosis can be delayed. We report the case of a 15- year-old African American male, dual-sport athlete who experienced low back pain from a sacral pedicle stress fracture. Read More

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http://dx.doi.org/10.1002/pmrj.12119DOI Listing
February 2019
1 Read

Medial malleolar stress fracture resulting from repetitive stress caused by lateral ankle instability: A case report.

Medicine (Baltimore) 2019 Feb;98(5):e14311

Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan, Korea.

Rationale: Stress fractures are most commonly sustained in the lower extremities owing to the repetitive weight-bearing forces. They are overuse injuries that are seen often in athletes, but rare in the general population, so early diagnosis and proper treatment are important to enable athletes to return to activity. This is a rare example of successful treatment of a medial malleolar stress fracture with lateral ankle instability. Read More

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http://dx.doi.org/10.1097/MD.0000000000014311DOI Listing
February 2019
1 Read

[Stress fracture of athletes as a cause of groin pain].

Authors:
K Bath I Steinhagen

Radiologe 2019 Jan 30. Epub 2019 Jan 30.

Institut für Diagnostische und Interventionelle Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Ernst Heydemann-Str. 6, 18057, Rostock, Deutschland.

Clinical/methodical Issue: In this article, suitable imaging of stress reactions and stress fractures in athletes will be examined.

Standard Radiological Methods: Diagnostic procedures include X‑ray, computed tomography (CT), magnetic resonance imaging (MRI), and bone scintigraphy.

Methodical Innovations: MRI represents the gold standard for these types of injuries. Read More

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http://dx.doi.org/10.1007/s00117-019-0493-xDOI Listing
January 2019

Biomechanical effects of osteoplasty with or without Kirschner wire augmentation on long bone diaphyses undergoing bending stress: implications for percutaneous imaging-guided consolidation in cancer patients.

Eur Radiol Exp 2019 Jan 28;3(1). Epub 2019 Jan 28.

Department of Interventional Radiology, Nouvel Hôpital Civil (Hôpitaux Universitaires de Strasbourg, HUS), 1, place de l'Hôpital, 67000, Strasbourg, France.

Background: Osteoplasty has been discouraged in long bones. However, despite a substantial lack of pre-clinical biomechanical tests, multiple clinical studies have implemented a wide range of techniques to optimise long bone osteoplasty. The aim of the present study is to evaluate the biomechanical properties of osteoplasty alone and in combination with Kirschner wires (K-wires) in a cadaveric human diaphyseal model undergoing 3-point bending stress. Read More

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http://dx.doi.org/10.1186/s41747-018-0082-1DOI Listing
January 2019

A Case Report: Bilateral Patella Stress Fractures in a Collegiate Gymnast.

J Orthop Case Rep 2018 Jul-Aug;8(4):45-48

Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga, Erlanger Health System, United States.

Introduction: The overuse and repetitive loading of a bone cause a stress fracture, commonly occurring in the weight-bearing structures of the lower extremities of athletes, but rarely the patella. Patella stress fractures are an extremely rare occurrence. Müller first described a patella stress fracture in 1943; however, we could find <15 reported cases in literature since that time. Read More

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http://dx.doi.org/10.13107/jocr.2250-0685.1154DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343559PMC
January 2019
1 Read

A cross-sectional study on the age-related cortical and trabecular bone changes at the femoral head in elderly female hip fracture patients.

Sci Rep 2019 Jan 22;9(1):305. Epub 2019 Jan 22.

Imaging-based Computational Biomedicine Laboratory, Nara Institute of Science and Technology, Ikoma, Japan.

Bone is in a continuous state of remodeling whereby old bone is absorbed and new bone is formed in its place. During this process, new formations reinforce the bone in the direction of the dominant stress trajectories through a functional adaptation. In normal aging, the balance between bone resorption and formation can be shifted. Read More

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http://dx.doi.org/10.1038/s41598-018-36299-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343024PMC
January 2019
1 Read

The effect of plate design, bridging span, and fracture healing on the performance of high tibial osteotomy plates: An experimental and finite element study.

Bone Joint Res 2018 Dec 4;7(12):639-649. Epub 2019 Jan 4.

Department of Mechanical Engineering, University of Bath, Bath, UK.

Objectives: Opening wedge high tibial osteotomy (HTO) is an established surgical procedure for the treatment of early-stage knee arthritis. Other than infection, the majority of complications are related to mechanical factors - in particular, stimulation of healing at the osteotomy site. This study used finite element (FE) analysis to investigate the effect of plate design and bridging span on interfragmentary movement (IFM) and the influence of fracture healing on plate stress and potential failure. Read More

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http://dx.doi.org/10.1302/2046-3758.712.BJR-2018-0035.R1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318751PMC
December 2018

Tibial stress injuries - location, severity, and classification in magnetic resonance imaging examination.

Pol J Radiol 2018 5;83:e471-e481. Epub 2018 Nov 5.

Department of Radiology, Gruca Orthopaedic and Trauma Teaching Hospital, Centre of Postgraduate Education, Otwock, Poland.

Purpose: To describe and illustrate the spectrum of magnetic resonance imaging (MRI) findings of tibial stress injuries (TSI) and propose a simplified classification system.

Material And Methods: Retrospective analysis of MRI exams of 44 patients with clinical suspicion of unilateral or bilateral TSI, using a modified classification system to evaluate the intensity and location of soft-tissue changes and bone changes.

Results: Most of the patients were young athletic men diagnosed in late stage of TSI. Read More

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http://dx.doi.org/10.5114/pjr.2018.80218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334187PMC
November 2018
3 Reads

Bone marrow adipose amount influences vertebral bone strength.

Exp Ther Med 2019 Jan 22;17(1):689-694. Epub 2018 Nov 22.

Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China.

Association of bone marrow adipose and microstructure with bone strength in osteoporotic rats using MR Dixon analysis and micro-CT was evaluated. A total of 40 female Sprague-Dawley rats (6-month-old) were divided randomly into sham-operated (SHAM, n=20) group and ovariectomized (OVX, n=20) group. Fat fraction (FF) was measured by two-point Dixon method with MR imaging at the baseline, 4th, 8th and 12th week, respectively. Read More

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http://www.spandidos-publications.com/10.3892/etm.2018.7003
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http://dx.doi.org/10.3892/etm.2018.7003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307407PMC
January 2019
5 Reads

Incidental Asymptomatic Fibular Stress Fractures Presenting as Varus Knee Osteoarthritis: A Case Report.

Am J Orthop (Belle Mead NJ) 2018 Dec;47(12)

Orthopaedic Surgery, Hackensack University Medical Center, 360 Essex Street, Suite 303, Hackensack, NJ 07601, USA. Email:

Stress fractures are often missed, especially in unusual clinical settings. We report on 2 patients who presented to our orthopedic surgery clinic with incidental findings of asymptomatic proximal fibular tension side stress fractures in severe longstanding varus osteoarthritic knees. Initial plain films demonstrated an expansile deformity of the proximal fibular shaft, and differential diagnosis included a healed or healing fracture versus possible neoplasm. Read More

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http://dx.doi.org/10.12788/ajo.2018.0102DOI Listing
December 2018
2 Reads

Magnetic Resonance Imaging Evaluation of Musculoskeletal Diseases of Ankle and Foot.

Kathmandu Univ Med J (KUMJ) 2018 Jan.-Mar;16(61):28-34

Department of Orthopedics, B and C Teaching Hospital, Birtamod, Jhapa.

Background Ankle and foot pain is a common clinical problem, that may be due to a variety of soft tissue and osseus abnormalities. Magnetic resonance imaging plays vital role for diagnosing internal derangement of the ankle joint, assessing soft tissue structures around the ankle such as tendons, ligaments, nerves and osseus structures. Method Retrospective magnetic resonance imaging evaluation of the ankle and foot was done in 100 patients using 0. Read More

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January 2019
1 Read

3D patient-specific finite element models of the proximal femur based on DXA towards the classification of fracture and non-fracture cases.

Bone 2019 Jan 3;121:89-99. Epub 2019 Jan 3.

BCN MedTech, Universitat Pompeu Fabra (UPF), Barcelona, Spain.

Osteoporotic bone fractures reduce quality of life and drastically increase mortality. Minimally irradiating imaging techniques such as dual-energy X-ray absorptiometry (DXA) allow assessment of bone loss through the use of bone mineral density (BMD) as descriptor. Yet, the accuracy of fracture risk predictions remains limited. Read More

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http://dx.doi.org/10.1016/j.bone.2019.01.001DOI Listing
January 2019
2 Reads

[Bony knee injuries in childhood and adolescence].

Unfallchirurg 2019 Jan;122(1):6-16

Unfallchirurgische Abteilung, Landeskrankenhaus Horn, Spitalgasse 10, 3580, Horn, Österreich.

While fractures around the knee are known to be rare, physicians have encountered a rise in the frequency due to the increased participation of children and adolescents in high-impact sports at a younger age. Even if the treatment of fractures in some cases resembles that in adults, the diagnostics and treatment in childhood and adolescence require a hígh level of experience in order avoid possible sequelae and to enable early recognition. Thorough diagnostics using clinical and imaging investigations as well as a precise weighing up of the treatment are essential to minimize differences in leg length and axial malpositioning of the leg. Read More

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http://dx.doi.org/10.1007/s00113-018-0590-8DOI Listing
January 2019
1 Read

Plexiform Neurofibromatosis in a Woman With a Pubic Ramus Stress Fracture.

J Orthop Sports Phys Ther 2019 Jan;49(1):37

A 22-year-old woman in Army Basic Combat Training was evaluated in a physical therapy clinic for insidious-onset groin pain. The referring primary care physician assistant ordered initial radiographs, which were noncontributory, followed by a bone scan that indicated a left inferior pubic ramus stress fracture. She was prescribed a 30-day convalescent leave. Read More

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http://dx.doi.org/10.2519/jospt.2019.7495DOI Listing
January 2019
3 Reads

Dynamic Stress Fluoroscopy for Evaluation of the Femoral Neck After Intramedullary Nails: Improved Sensitivity for Identifying Occult Fractures.

J Orthop Trauma 2019 Feb;33(2):88-91

University of South Florida, Tampa, FL.

Objectives: To report on the use of dynamic stress fluoroscopy (DSF) for detection of occult fractures of the femoral neck associated with femoral shaft fractures. To compare DSF with a fully static imaging protocol in detecting occult femoral neck fractures.

Design: Multicenter retrospective cohort study. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001343DOI Listing
February 2019
1 Read

Medial iliac stress fractures in athletes: report of two rare cases: review of literature and clinical recommendations.

Skeletal Radiol 2018 Nov 28. Epub 2018 Nov 28.

Department of Radiology, University of California San Diego, San Diego, CA, USA.

Stress fractures are a common diagnosis in sports medicine and can result in significant loss of function, athlete playing time, and potentially lead to chronic symptoms. However, unusual locations of stress fractures may present with vague symptoms and a relatively benign physical exam, leading to difficulty in arriving at the correct diagnosis. Pelvic stress fractures are less common than lower-extremity stress fractures in athletes, occurring in only 1-5% of all stress fractures and typically occur in pubic rami. Read More

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http://dx.doi.org/10.1007/s00256-018-3117-zDOI Listing
November 2018
2 Reads

New Imaging, Diagnostic, and Assessment Techniques in Orthopedic Trauma.

Orthop Clin North Am 2019 Jan;50(1):47-56

University of Tennessee-Campbell Clinic, Department of Orthopaedic Surgery and Biomedical Engineering, 1211 Union Avenue, Suite 500, Memphis, TN 38117, USA; Regional One Health, 877 Jefferson Avenue, Memphis, TN 38103, USA. Electronic address:

This article examines new imaging, diagnostic, and assessment techniques that may affect the care of patients with orthopedic trauma and/or infection. Three-dimensional imaging has assisted in fracture assessment preoperatively, whereas improvement in C-arm technology has allowed real-time evaluation of implant placement and periarticular reduction before leaving the operating room. Advances in imaging techniques have allowed earlier and more accurate diagnosis of nonunion and infection. Read More

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http://dx.doi.org/10.1016/j.ocl.2018.08.010DOI Listing
January 2019

Technologies in the Treatment of Bone Marrow Edema Syndrome.

Orthop Clin North Am 2019 Jan;50(1):131-138

Tehran University of Medical Science, Number 21, Dameshgh Street, Vali-e Asr Avenue, Tehran 1416753955, Iran.

Bone marrow edema syndrome is a rare and self-limited syndrome with an unknown cause. The natural time course for improvement of clinical symptoms and normalization in MRI lasts from 3 to 18 months. This entity must be distinguished from other causes of marrow abnormality, such as stress fractures and osteonecrosis, for the best treatment options. Read More

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http://dx.doi.org/10.1016/j.ocl.2018.08.008DOI Listing
January 2019
1 Read

MRI bone marrow oedema precedes lumbar bone stress injury diagnosis in junior elite cricket fast bowlers.

Br J Sports Med 2018 Nov 13. Epub 2018 Nov 13.

La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.

Objectives: Lumbar bone stress injury ('bone stress injury') is common in junior fast bowlers. The repetitive loading of cricket fast bowling may cause bone marrow oedema (BMO), detectable on MRI, before the bowler suffers from symptomatic bone stress injury. We investigated the temporal relationship between BMO, bone stress injury, along with bowling workload correlates, in elite junior fast bowlers throughout a cricket season. Read More

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http://bjsm.bmj.com/lookup/doi/10.1136/bjsports-2017-097930
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http://dx.doi.org/10.1136/bjsports-2017-097930DOI Listing
November 2018
15 Reads

Imaging Features and Management of Stress, Atypical, and Pathologic Fractures.

Radiographics 2018 Nov-Dec;38(7):2173-2192

From the Departments of Radiology (R.A.M., J.C.M., A.S., B.K.) and Orthopedic Surgery (M.J.W., M.F.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.

Traumatic and atraumatic fractures are entities with distinct but often overlapping clinical manifestations, imaging findings, and management protocols. This article is a review of terminology, etiology, and key imaging features that affect management of atraumatic fractures including stress fractures, atypical femoral fractures, and pathologic fractures. The terminology of atraumatic fractures is reviewed, with an emphasis on the distinctions and similarities of stress, atypical, and pathologic fractures. Read More

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http://dx.doi.org/10.1148/rg.2018180073DOI Listing
November 2018
12 Reads

Risk analysis of patients with an osteolytic acetabular defect after total hip arthroplasty using subject-specific finite-element modelling.

Bone Joint J 2018 Nov;100-B(11):1455-1462

Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.

Aims: Osteolysis, secondary to local and systemic physiological effects, is a major challenge in total hip arthroplasty (THA). While osteolytic defects are commonly observed in long-term follow-up, how such lesions alter the distribution of stress is unclear. The aim of this study was to quantitatively describe the biomechanical implication of such lesions by performing subject-specific finite-element (FE) analysis on patients with osteolysis after THA. Read More

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http://dx.doi.org/10.1302/0301-620X.100B11.BJJ-2018-0092.R2DOI Listing
November 2018
1 Read

An improved geomechanical model for the prediction of fracture generation and distribution in brittle reservoirs.

PLoS One 2018 7;13(11):e0205958. Epub 2018 Nov 7.

Energy Division, Saskatchewan Research Council, Regina, Saskatchewan, Canada.

It is generally difficult to predict fractures of low-permeability reservoirs under high confining pressures by data statistical method and simplified strain energy density method. In order to establish a series of geomechanical models for the prediction of multi-scale fractures in brittle tight sandstones, firstly, through a series of rock mechanics experiments and CT scanning, we determined 0.85 σc as the key thresholds for mass release of elastic strain energy and bursting of micro-fractures. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0205958PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221284PMC
November 2018
9 Reads
3.234 Impact Factor

Trabecular microstructure is influenced by race and sex in Black and White young adults.

Osteoporos Int 2019 Jan 5;30(1):201-209. Epub 2018 Nov 5.

Endocrine Unit, Massachusetts General Hospital, 50 Blossom Street, THR-1051, Boston, MA, 02114, USA.

Lower fracture rates in Black men and women compared to their White counterparts are incompletely understood. High-resolution imaging specific to trabecular bone may provide insight. Black participants have enhanced trabecular morphology. Read More

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http://link.springer.com/10.1007/s00198-018-4729-9
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http://dx.doi.org/10.1007/s00198-018-4729-9DOI Listing
January 2019
9 Reads

Pars interarticularis injury in elite athletes - The role of imaging in diagnosis and management.

Eur J Radiol 2018 Nov 1;108:28-42. Epub 2018 Sep 1.

Fortius Clinic, 17 Fitzhardinghe Street, London W1H 6EQ, United Kingdom. Electronic address:

Injuries of the lumbar neural arch, in particular the pars interarticularis, are widely considered to be due to abnormal bone stress secondary to repetitive loading/shearing, and are a common pathology and a main cause of lower back pain in elite athletes across a range of sports. Medical imaging plays a pivotal role in the diagnosis, monitoring and prognostication of neural arch injury. Early detection is highly desirable in the young elite athlete, as early injuries have been shown to require shorter recovery time and have a higher potential of full healing, whilst accurate grading of injury allows appropriate rehabilitation planning. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S0720048X183030
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http://dx.doi.org/10.1016/j.ejrad.2018.08.029DOI Listing
November 2018
19 Reads

Osteoid osteoma: multimodality imaging with focus on hybrid imaging.

Eur J Nucl Med Mol Imaging 2018 Oct 19. Epub 2018 Oct 19.

Department of Radiology and Nuclear Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland.

Osteoid osteoma is a painful, benign, osteoblastic lesion that occurs in younger patients and affects the extremities or the axial skeleton. While plain film findings may suggest the diagnosis, in complex anatomical regions such as the spine, pelvis, wrist and foot advanced imaging modalities are often required. A typical nidus surrounded by sclerosis or cortical thickening characterizes osteoid osteoma on plain radiography and CT. Read More

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http://link.springer.com/10.1007/s00259-018-4181-2
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http://dx.doi.org/10.1007/s00259-018-4181-2DOI Listing
October 2018
9 Reads

Reverse shoulder arthroplasty vs BIO-RSA: clinical and radiographic outcomes at short term follow-up.

J Orthop Surg Res 2018 Oct 16;13(1):256. Epub 2018 Oct 16.

Orthopaedic Consultant, Alfred Hospital, 55 Commercial Rd, Prahran, Melbourne, Victoria, 3004, Australia.

Background: Bony increased-offset reverse shoulder arthroplasty (BIO-RSA) may address issues such as inferior scapular notching, prosthetic instability and limited postoperative shoulder rotation; all of which have been reported with the standard RSA and attributed to the medialized design. We hypothesised that this lateralization may increase the rate of scapular stress fractures.

Methods: A retrospective review of prospectively collected data was performed on patients who had undergone a RSA between January 2013 and October 2016. Read More

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https://josr-online.biomedcentral.com/articles/10.1186/s1301
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http://dx.doi.org/10.1186/s13018-018-0955-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6192311PMC
October 2018
15 Reads

Metatarsalgia.

Radiol Clin North Am 2018 Nov;56(6):877-892

Department of Radiology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA. Electronic address:

Although causes of metatarsalgia are multifactorial, in practice these most commonly include osseous stress reaction or fracture (including subchondral injury) and interdigital neuroma or plantar plate tear with adjacent pseudoneuroma. The various roles of radiography, ultrasonography, and MR imaging are discussed, and relevant technical issues and imaging findings are reviewed in order to facilitate accurate diagnosis and guide proper treatment of metatarsalgia. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00338389183007
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http://dx.doi.org/10.1016/j.rcl.2018.06.004DOI Listing
November 2018
3 Reads

Osteoporosis development and vertebral fractures after abdominal irradiation in patients with gastric cancer.

BMC Cancer 2018 Oct 11;18(1):972. Epub 2018 Oct 11.

Department of Radiation Oncology, Biruni University Medicana International Hospital, Istanbul, Turkey.

Background: Decrease in bone mineral density, osteoporosis development, bone toxicity and resulting insufficiency fractures as late effect of radiotherapy are not well known. Osteoporosis development related to radiotherapy has not been investigated properly and insufficiency fractures are rarely reported for vertebral bones.

Methods: Ninety-seven patients with gastric adenocarcinoma were evaluated for adjuvant treatment after surgery. Read More

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https://bmccancer.biomedcentral.com/articles/10.1186/s12885-
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http://dx.doi.org/10.1186/s12885-018-4899-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6182865PMC
October 2018
14 Reads
3.362 Impact Factor

Avulsion fracture of the medial collateral ligament association with Segond fracture.

Clin Imaging 2019 Jan - Feb;53:32-34. Epub 2018 Sep 11.

Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, 601 N. Caroline Street, JHOC 3142, Baltimore, MD 21287, USA. Electronic address:

The Segond fracture is a tibial avulsion injury of the insertion of the middle third of the lateral capsular ligament that is typically associated with anterior cruciate ligament and meniscal tears. The classically assigned mechanism of injury is a combination of internal rotation and varus stress. We report two cases of Segond fractures that presented with a variant pattern including osseous avulsion injuries of the medial collateral ligament at the femoral origin, anterior cruciate ligament tear, and pivot shift-type osseous contusion pattern, suggesting an alternative mechanism of injury that includes dominant valgus stress and external rotation components. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08997071183024
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http://dx.doi.org/10.1016/j.clinimag.2018.09.006DOI Listing
September 2018
5 Reads

The enigma of atypical femoral fractures: A summary of current knowledge.

EFORT Open Rev 2018 Sep 12;3(9):494-500. Epub 2018 Sep 12.

Department of Orthopaedics and Traumatology, Odense University Hospital, Denmark.

Atypical femoral fractures (AFF) are stress or 'insufficiency' fractures, often complicated by the use of bisphosphonates or other bone turnover inhibitors. While these drugs are beneficial for the intact osteoporotic bone, they probably prevent a stress fracture from healing which thus progresses to a complete fracture.Key features of atypical femoral fractures, essential for the diagnosis, are: location in the subtrochanteric region and diaphysis; lack of trauma history and comminution; and a transverse or short oblique configuration. Read More

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http://dx.doi.org/10.1302/2058-5241.3.170070DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174857PMC
September 2018
1 Read

Balloon Guided Cement Augmentation of Iliosacral Screws in the Treatment of Insufficiency Fractures of the Sacrum - Description of a New Method and Preliminary Results.

Acta Chir Orthop Traumatol Cech 2018 ;85(2):85-88

BG Unfallklinik Tuebingen, Eberhard-Karls-Universitaet Tuebingen, Germany.

PURPOSE OF THE STUDY Fragility fractures of the pelvic ring in the elderly population are a serious problem in orthopaedics. The treatment options range from conservative treatment to diverse operative options. We present a balloon guided new technique of implanting cement augmented screws aiming at improved implant anchorage and reduced cement leakage. Read More

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January 2019
1 Read

The application of finite element modelling based on clinical pQCT for classification of fracture status.

Biomech Model Mechanobiol 2019 Feb 6;18(1):245-260. Epub 2018 Oct 6.

Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia.

Fracture risk assessment using dual-energy X-ray absorptiometry (DXA) frequently fails to diagnose osteoporosis amongst individuals who later experience fragility fractures. Hence, more reliable techniques that improve the prediction of fracture risk are needed. In this study, we evaluated a finite element (FE) modelling framework based on clinical peripheral quantitative computed tomography (pQCT) imaging of the tibial epiphysis and diaphysis to predict the stiffness at these locations in compression, shear, torsion and bending. Read More

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http://link.springer.com/10.1007/s10237-018-1079-7
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http://dx.doi.org/10.1007/s10237-018-1079-7DOI Listing
February 2019
7 Reads

Management of Isolated Lateral Malleolus Fractures.

J Am Acad Orthop Surg 2019 Jan;27(2):50-59

From the Department of Orthopaedic Surgery, University of Miami Hospital, Miami, FL (Dr. Aiyer and Dr. Zachwieja), the Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO (Dr. Lawrie), and the Orthopaedic Specialty Institute, Orange, CA (Dr. Kaplan).

Isolated lateral malleolus fractures represent one of the most common injuries encountered by orthopaedic surgeons. Nevertheless, appropriate diagnosis and management of these injuries are not clearly understood. Ankle stability is maintained by ligamentous and bony anatomy. Read More

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http://dx.doi.org/10.5435/JAAOS-D-17-00417DOI Listing
January 2019
5 Reads

Vertebral fracture after removing pedicle screws used for posterior lumbar interbody fusion: A case report.

J Clin Neurosci 2018 Nov 19;57:182-184. Epub 2018 Sep 19.

Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan. Electronic address:

It is uncommon to remove pedicle screws after posterolateral lumbar interbody fusion (PLIF), and there are a few case reports of vertebral fracture involving holes remaining after screw removal. We report a case of the vertebral fracture after removing pedicle screws instrumented for PLIF. A 66-year-old woman with osteopenia, who underwent PLIF at L4-S1 10 years earlier, underwent PLIF at L3-L4 to correct adjacent-segment degeneration. Read More

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http://dx.doi.org/10.1016/j.jocn.2018.04.019DOI Listing
November 2018
1 Read

Not One of the Usual Suspects: MRI Features of Insertional Lateral Cord Plantar Fasciopathy.

AJR Am J Roentgenol 2018 Nov 21;211(5):W252-W256. Epub 2018 Sep 21.

3 Department of Radiology, Albert Einstein College of Medicine, Bronx, NY.

Objective: The purpose of this article is to report MRI findings of insertional lateral cord plantar fasciopathy and review the presenting symptoms of the condition and suspected diagnoses.

Conclusion: Lateral cord plantar fasciopathy presents with pain and swelling at the lateral midfoot, which are typically clinically suspected to be caused by fifth metatarsal (MT) base stress fracture of peroneal tendon abnormalities. The MRI findings are identical to those seen in association with the more commonly occurring central cord plantar fasciopathy, which has a calcaneal origin, but the findings affect the insertion of the lateral cord onto the plantar lateral base of the fifth MT. Read More

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http://dx.doi.org/10.2214/AJR.17.19218DOI Listing
November 2018
2 Reads

Assessment of Ankle Mortise Instability After Isolated Supination-External Rotation Lateral Malleolar Fractures.

J Bone Joint Surg Am 2018 Sep;100(18):1557-1562

Departments of Orthopaedic Surgery (B.O.J., T.Y.K., J.H.B., and S.H.S.) and Radiology (J.S.P.), College of Medicine, Kyung Hee University, Seoul, South Korea.

Background: The diagnosis of clinically important instability following isolated supination-external rotation (SER) distal fibular fractures is a challenge. The purpose of this study was to investigate the accuracy of clinical findings including medial tenderness, swelling, and ecchymosis, combined with the gravity stress test and magnetic resonance imaging (MRI), in the assessment of ankle mortise stability in association with isolated SER-type lateral malleolar fractures. The external rotation (ER) stress test was used as the reference with which the methods of assessment were compared. Read More

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http://Insights.ovid.com/crossref?an=00004623-201809190-0000
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http://dx.doi.org/10.2106/JBJS.17.00993DOI Listing
September 2018
16 Reads

Uncommon cause of chest pain in a postoperative spinal patient.

Authors:
Rajesh Dwivedi

BMJ Case Rep 2018 Sep 14;2018. Epub 2018 Sep 14.

Health Care for Older People, Nottingham University Hospitals NHS Trust, Nottingham, UK.

An 84-year-old woman with previous spinal operations including vertebroplasty and lumbar decompressions was admitted electively under the spinal team for right-sided L4/5 decompression for worsening back pain which she undergoes using a posterior approach. Postoperatively, she develops stabbing upper central chest pain and given unremarkable chest X-ray, ECG and cardiac troponin, she undergoes a CT pulmonary angiogram which shows a fracture of the upper part of sternum but no pulmonary embolism. There is no history of recent trauma and this is deemed to be secondary to prolonged spinal surgery in the prone position in a patient with osteopenic bones. Read More

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http://dx.doi.org/10.1136/bcr-2018-225293DOI Listing
September 2018
3 Reads

[An active medical intern with a painful lower leg].

Ned Tijdschr Geneeskd 2018 08 16;162. Epub 2018 Aug 16.

Amsterdam UMC, locatie AMC-UvA, afd. Radiologie.

A 23-year-old female athlete presented with progressive pain in her right lower leg since 3 months. Conventional radiography did not reveal a fracture. However, a CT-scan showed a proximal posteromedial tibial stress fracture, matching with the localisation of the pain. Read More

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Prognostic value of focal scintigraphic findings in clinically suspected cases of tibial stress fracture.

Radiol Bras 2018 Jul-Aug;51(4):225-230

PhD, Full Professor in the Department of Radiology and Oncology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.

Objective: To investigate the correlation between tracer uptake on bone scintigraphy and recovery time in patients with tibial stress fracture.

Materials And Methods: We evaluated two groups of athletes: those with clinical suspicion and a radiological diagnosis of tibial stress fracture (TSF group, n = 21); and those with no symptoms or evidence of fracture (control group, n = 10). All subjects underwent bone scintigraphy and magnetic resonance imaging with a maximum interval of 7 days between the assessments. Read More

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http://dx.doi.org/10.1590/0100-3984.2017.0028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6124586PMC
September 2018
1 Read

Femoral Neck Stress Fractures: MRI Risk Factors for Progression.

J Bone Joint Surg Am 2018 Sep;100(17):1496-1502

Department of Orthopedics, Naval Medical Center San Diego, San Diego, California.

Background: Femoral neck stress fractures are overuse injuries with devastating consequences if not diagnosed and treated appropriately. The aim of this study was to retrospectively review femoral neck stress fractures using a magnetic resonance imaging (MRI)-based protocol and to identify imaging risk factors that could predict fracture progression requiring surgical intervention.

Methods: We identified all femoral neck stress fractures treated at our institution from 2002 to 2015. Read More

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http://dx.doi.org/10.2106/JBJS.17.01593DOI Listing
September 2018
21 Reads

Arthroscopic Microfracture for Traumatic Arthritis of Lateral Tarsometatarsal Joints .

J Am Podiatr Med Assoc 2018 Jul;108(4):344-348

Conservative treatment is generally successful in treating early tarsometatarsal joint arthritis. However, if such treatment fails, invasive arthrodesis or arthroplasty may be needed. Arthroscopy is a less invasive alternative and can provide a precise diagnosis of early osteoarthritis or cartilage injury. Read More

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http://dx.doi.org/10.7547/17-003DOI Listing
July 2018
9 Reads

Physeal fracture in the wrist and hand due to stress injury in a child climber: A case report.

Medicine (Baltimore) 2018 Aug;97(34):e11571

Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Cheonan.

Rationale: In competitive athletes, the upper extremity is subject to tremendous torsional forces with axial loading due to repetitive weight bearing. Approximately 25% of injuries in sports are related to the hand or wrist. Skeletal deformity on the wrist physis is common in athletes due to repetitive loading and presents at early ages between 6 and 13 years. Read More

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http://dx.doi.org/10.1097/MD.0000000000011571DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6112917PMC
August 2018
1 Read

[Bone marrow edema-differential diagnosis of the femoral head necrosis].

Authors:
P Stumpp A Roth

Orthopade 2018 Sep;47(9):717-721

Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie Bereich Endoprothetik/Orthopädie, Universitätsklinik Leipzig AöR, Leipzig, Deutschland.

In patients with hip pain, clinical examination is of only restricted value in the differential diagnosis. Besides a patient's age, their medical history is often helpful in finding the correct diagnosis. Additionally, imaging can give valuable hints for excluding or validating a differential diagnosis. Read More

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http://dx.doi.org/10.1007/s00132-018-3621-9DOI Listing
September 2018
2 Reads

Assessment of the degradation rates and effectiveness of different coated Mg-Zn-Ca alloy scaffolds for in vivo repair of critical-size bone defects.

J Mater Sci Mater Med 2018 Aug 17;29(9):138. Epub 2018 Aug 17.

The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China.

Surgical repair of bone defects remains challenging, and the search for alternative procedures is ongoing. Devices made of Mg for bone repair have received much attention owing to their good biocompatibility and mechanical properties. We developed a new type of scaffold made of a Mg-Zn-Ca alloy with a shape that mimics cortical bone and can be filled with morselized bone. Read More

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http://dx.doi.org/10.1007/s10856-018-6145-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6105203PMC
August 2018
10 Reads

Intraoperative tap test for coronal syndesmotic instability: A cadaveric study.

Injury 2018 Oct 7;49(10):1758-1762. Epub 2018 Aug 7.

University of Alabama at Birmingham (UAB), Department of Orthopedics, Birmingham, AL, United States.

Introduction: Precise diagnosis of distal tibiofibular syndesmotic injury is challenging, and a gold standard diagnostic test has still not been established. Tibiofibular clear space identified on radiographic imaging is considered the most reliable indicator of the injury. The Cotton test is the most widely used intraoperative technique to evaluate the syndesmotic integrity although it has its limitations. Read More

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http://dx.doi.org/10.1016/j.injury.2018.08.005DOI Listing
October 2018
13 Reads

Effect of the screw type (S2-alar-iliac and iliac), screw length, and screw head angle on the risk of screw and adjacent bone failures after a spinopelvic fixation technique: A finite element analysis.

PLoS One 2018 16;13(8):e0201801. Epub 2018 Aug 16.

Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.

Purpose: Spinopelvic fixations involving the S2-alar-iliac (S2AI) and iliac screws are commonly used in various spinal fusion surgeries. This study aimed to compare the biomechanical characteristics, specifically the risk of screw and adjacent bone failures of S2AI screw fixation with those of iliac screw fixation using a finite element analysis (FEA).

Methods: A three-dimensional finite element (FE) model of a healthy spinopelvis was generated. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0201801PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6095501PMC
February 2019
8 Reads

On the internal reaction forces, energy absorption, and fracture in the hip during simulated sideways fall impact.

PLoS One 2018 16;13(8):e0200952. Epub 2018 Aug 16.

Institute for Biomechanics, ETH Zürich, Zürich, Switzerland.

The majority of hip fractures have been reported to occur as a result of a fall with impact to the greater trochanter of the femur. Recently, we developed a novel cadaveric pendulum-based hip impact model and tested two cadaveric femur-pelvis constructs, embedded in a soft tissue surrogate. The outcome was a femoral neck fracture in a male specimen while a female specimen had no fracture. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0200952PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6095517PMC
January 2019
2 Reads

Effects of sclerotic changes on stress concentration in early-stage osteonecrosis: A patient-specific, 3D finite element analysis.

J Orthop Res 2018 Dec 24;36(12):3169-3177. Epub 2018 Aug 24.

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Stress distribution remains unclear in early-stage osteonecrosis of the femoral head (ONFH). To clarify this issue, we generated patient-specific finite element models (FEMs) from 51 patients with ONFH. Patients' hips were classified into three groups: ONFH without a sclerotic boundary (Stage 1, n = 6), ONFH with a sclerotic boundary (Stage 2, n = 10), and ONFH with both a sclerotic boundary and <2 mm collapse (Stage 3, n = 35). Read More

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http://dx.doi.org/10.1002/jor.24124DOI Listing
December 2018
8 Reads