جستجوی مقالات مرتبط با کلیدواژه « Femur » در نشریات گروه « پزشکی »

The hip joint is characterized by high anatomical stability. Therefore, hip dislocation usually attributed to a high-energy traumatic incident and may be associated with acetabular fractures or fractures of the femoral head, neck or shaft. Additionally, traumatic anterior dislocation of hip joint is rare; moreover, cases combined with ipsilateral intertrochanteric femur fractures are even rarer and information concerning them is limited to case reports. Recurrent anterior dislocations are extremely rare and have been reported only in individual case reports. This paper reports a case of recurrent anterior hip dislocation following satisfactory reduction and fixation for managing traumatic anterior hip dislocation combined with an ipsilateral intertrochanteric fracture of the femur, and reviews the relevant literature.

Infected segmental bone defects (ISBD) of the femur and tibia pose a significant challenge. Traditionally, bone fixation in the first stage of the Masquelet technique involves external fixation, but intramedullary nail fixation has recently gained popularity. Despite this, little attention has been focused on the elaboration, implantation, and removal of the spacer around the nail. In this technical note, we present gentamicin cement-coated rigid nails as definitive fixation in the first stage. We also detail the technique for placing and removing the one-piece dyed antibiotic spacer around the nail. We highlight its potential benefits in one of the critical steps of this versatile technique. Level of evidence: IV

Perioperative pain management can improve surgery results and patient outcomes. Moreover, multimodal methods for pain control have been advised so this study was conducted to assess the beneficial impact of preoperative ultrasound-guided femoral nerve blocks in hip replacement surgery.

This study is a double-blinded clinical trial including 60 individuals who were candidates for joint replacement surgery. The intervention group (n = 30) received a femoral nerve block prior to general anesthesia.

 After surgery, patients received morphine, Apotel, and morphine + Apotel, all of which were administered at lower doses in the intervention group (femoral nerve block) than in the control group. Pain intensity in first hour (P= 0.01), 4 hours (P= 0.003), 8 hours (P= 0.01), 12 hours (P= 0.001), and 24 hours (P= 0.01) after surgery and average pain 4 hours (P= 0.01), 8 hours (P = 0.01), 12 hours (P = 0.02), and 24 hours (P= 0.01) after surgery was significantly less in the intervention group (femoral nerve block) than in the control group.

The findings of our investigation demonstrated the efficacy of ultrasound-guided femoral nerve blocks in the improvement of pain control following hip replacement surgery.

Proximal femoral fractures are a global epidemiological concern due to their association with mortality and morbidity in the geriatric population.  

We conducted an epidemiological study using hospital registry data to assess the incidence and associated factors of proximal femur fractures among individuals aged 60 years or older living in Almaty City. Student’s t-test was used to assess for between-group differences.   

The data showed that the overall frequency of fractures among the population of Almaty City aged 60 years and older between 2014 and 2019 averaged 169.6 per 100,000, with a higher rate among women (190.3) compared to men (135.8). However, in age groups up to 70 years and over 85 years, the frequency of proximal femur fractures was higher among men. From 2014 to 2019, the incidence of proximal femur fractures increased by 1.6 times. An analysis of the distribution of fracture frequency by season revealed that winter was the most dangerous period.  

Our research suggests a need for further epidemiological studies on the incidence of proximal femur fractures in various regions, identifying risk factors, and developing targeted regional prevention programs.

To investigate the incidence and severity of knee pain following retrograde intramedullary nailing offemur fractures and to better understand functional outcomes using validated patient-reported outcome measures.  Fifty-three patients with OTA 32 or 33 fractures treated by retrograde nail at a single academic Level 1 trauma center between 2009 and 2020 were retrospectively reviewed. Patients verbally completed the Oxford Knee Score (OKS) and Patient-Reported Outcome Measurement Information System (PROMIS) Short Form 6b, minimum one year postoperatively. Thirty-four (64%) patients reported the presence of pain. Of those reporting pain, 16 (47.1%) reported their pain as mild. Compared to those without pain, patients with knee pain had lower OKS (30.38 +/- 10.65, versus 41.95 +/- 6.87; P <0.001) and higher PROMIS scores (14.65 +/- 6.76 versus 10.95 +/- 7.09; P=0.066).  The increasing severity of pain was inversely correlated with functional status as measured by patientreported measures. At present, the reliability, high union rates, and otherwise low complication rates associated with retrograde femoral nailing justify its continued use. However, knee pain and functional outcomes should remain an integral part of the preoperative discussion with the patient. Level of evidence: III

Anthropometric investigations provide valuable data in a variety of groups. The present study aimed to compare the typical hip joint anatomical variations in the south-western population of Iran with those in other populations. This study was carried out on 1000 normal hip joints of participants from both genders in the age group 18–80 years, who had referred to Abadan Medical College Hospitals, Abadan, Iran,  during 2020-2021 to perform the anthropometric analysis. The CT scan gadget was used to obtain a scan and an axial image of the patients’ hip joints. Moreover, neck shaft angle (NSA), head circumference (HC), and neck width (NW) were measured and calculated in all patients. The participants’ mean age was 47 years, and the values obtained for the parameters NSA (142.4°), HC (47.7 mm), and NW (28.9 mm) in this study differed from those reported in other studies. Significant changes were also observed between the right and left sides and the gender of the proximal end of the femur in the study population. When comparing the present findings with those of other studies, there are some differences between the right and left side in NSAs, which were remarkably significant in women populations. Moreover, NW on the right side of the male participants was also remarkably significant. Moreover, HC was comparable to the findings of previous investigations.

Osteosarcoma (OS) is an uncommon bone cancer presented by tissue swelling and nonspecific bone pain. In case of distant metastasis, this malignancy commonly invades the lungs. Skip metastasis is an uncommon type of invasion originating from the malignant bone to adjoining bone tissues detected by magnetic resonance imaging (MRI) with high accuracy. Skip metastasis is an uncommon finding in plain radiography of osteosarcoma cases.

In the current study, we have reported a case of juvenile osteosarcoma with multi-focal skip metastasis, detected by simple plain radiography at first assessments. Further imaging and pathology assessment confirmed skip lesions in the background of high-grade chondroblastic osteosarcoma. Despite the recommendations, the patient and his legal guardian did not consent for further follow up and treatment.

Skip metastases are rarely diagnosed by plain radiography in OS cases. This condition is usually diagnosed by magnetic resonance imaging. Here, we reported a neglected and late-diagnosed case of osteosarcoma with skip lesions in a young boy, simply detected by X-ray. The following article concentrates on the importance of detecting these metastases for their correlation with patient’s survival, and describes different imaging modalities for finding them.

Femoroacetabular impingement (FAI) could cause early osteoarthritis in patients. It is important to diagnosis this condition in the early stages to avoid osteoarthritis. The radiological x-ray is one of the main methods to diagnose FAI. There are many radiological signs which help orthopedic surgeons to diagnose FAI in the pelvic x-ray. Recent studies revealed many new signs for diagnosis and in the present concept article, we try to review all the radiological signs of the FAI in the pelvic and hip x-ray.

The surgical site infections (SSIs) associated with orthopedic surgeries are prevalent since the commonly used implantation techniques increase the risk of infection. This study aimed to evaluate the prevalence of SSI in patients with femoral shaft fracture (FSF).

This retrospective cross-sectional study was performed on patients with FSF referred to Shahid Mohammadi hospital of Bandar Abbas, Iran from 2012 to 2016 for open intramedullary nailing (IMN) of the femoral shaft. Data were entered into the SPSS software version 25.0 for statistical analysis.

Sixty-two individuals with the mean age of 26.95±1.19 years participated in the study, of whom 85.5% were male and 14.5% were female. Twelve patients (19.4%) had open fractures and 50 (80.6%) had closed FSFs. SSI was observed in eight cases, one of whom had deep SSI (osteomyelitis). Our results showed that SSI was not correlated with age or sex (P<0.05), but it was significantly correlated with the frequency of hospitalizations, fractures in other areas, and the type of fracture (open and closed) (P<0.05).

The overall prevalence of SSI was 12.9%, which was higher compared to previous studies. Humidity and warm weather can be major contributing factors to the high prevalence of post-operative infection in this treatment center; however, the conditions of the orthopedic operating room and facilities should also be considered.

Due to the existence of different races and ethnicities and their different life styles, anatomical structure of people vary from one region of the world to another. The goal of this study is to determine the anterior femoral bowing to length ratio, which can be useful for planning major medical and therapeutic projects as well as designing medical equipment (including nails, orthoses and prosthetics). Lateral X-rays of femur bones of 250 patients who referred to Taleghani hospital in recent years (2011-2016) were retrieved from hospital archives and studied. 150 patients were females and 100 were males, ages ranging from 16 to 57 years old. All patients were Iranians with different ethnical backgrounds that referred to radiology centers of Tehran and Taleghani hospital and their records were saved in these centers archive. Based on femoral length, X-rays were categorized into eight groups; 300mm, 320mm, 340mm, 360mm, 380mm, 400mm, 420mm and 440mm, which are standards for manufacturing femoral nails in Iran as well as imported nails to Iran. Results showed significant difference compared to available femoral nails on the Iranian market, which indicates that these nails are not standard for Iranian population. Data analysis was based on anterior femoral bowing to length ratio alone. Gender and age were not considered for data analysis in this study and results were conclusive for all ages and genders.

We present a rare case of pathological shaft of femur fracture in an 18‑year‑old male, with an underlying arteriovenous malformation (AVM). Magnetic resonance imaging showed extensive intraosseous femoral involvement of the vascular malformation, and the canal was deemed to be wide enough for a nail based on the radiograph templates and computed tomography (CT) scan. The patient was given four sessions of stereotactic external beam radiotherapy preoperatively, and closed reduction and internal fixation was performed using a proximal femoral nail without any complications. Radiographic evidence of fracture union was observed at 4 months. Fracture fixation by closed reduction can be either intramedullary fixation or external fixation based on the adequacy of the canal as determined by radiograph and CT scan. Preoperative measures to decrease vascularity such as stereotactic radiotherapy and angiographic embolization can be undertaken to reduce bleeding. A multidisciplinary approach is essential to improve the management of fractures in a patient with AVM

Proper exercise and nutrition can help prevent bone disorders in old age, therefore present study aimed to investigate the effects of high intensity interval training (HIIT) with genistein (Ge) on biomechanical properties of femur bone in elderly female rats.

In this experimental study, 40 elderly female rats with mean age of 18- 24 months and mean weight of 220.15±15.28 g were divided into five groups of eight rats including: 1) control (C), 2) sham (Sh), 3) HIIT, 4) HIIT + Ge, and 5) Ge. During eight weeks groups 3 and 4 performed HIIT for three sessions per week with an intensity of 90 to 95% of maximum oxygen consumption (VO2max) in high intensity intervals and 40 to 45% VO2max in low intensity intervals and groups 4 and 5 received 60 mg/kg/day Ge peritoneally. Maximum bending strength (Fmax) measured with three- point bending test and serum levels of calcium (Ca) and phosphorus were measured by o-Cresolphthalein and molybdate methods, respectively. Shapiro- Wilk, one way ANOVA with Tukey’s post- hoc tests were used for analysis of data (P≤0.05).

HIIT (P=0.02), Ge (P=0.001) and HIIT+Ge (P=0.001) significantly increased Fmax also Ge (P=0.04) and HIIT+Ge (P=0.03) had more favorable effect on increasing Fmax compare to HIIT nevertheless HIIT, Ge and HIIT+Ge had not significant effect on Ca and phosphorus (P≥0.05).

Although HIIT and Ge alone can enhance Fmax in femur of elderly female rats, nevertheless HIIT+Ge has more favorable effect on increase of Fmax compare to HIIT.

Femur is the strongest, longest and heaviest bone in the human body. Due to the great importance of femur in human body, its injury may cause large numbers of disabilities and mortality. Considering various effective parameters such as mechanical properties, geometry, loading configuration, etc. can propel the study to the trustable results..

A 3D finite element model of the femur was subjected to different impact loading and orientations and also material properties. In addition to a reference healthy model of analysis, a total of 14 cases including four different loading conditions, six different bone density conditions and four different load orientations were considered.

Findings showed that the models with higher bone density cannot considerably reduce the stress under the impact loadings but porous models receive high mechanical stress which the bone prone to injury. The stress and displacement of the bone model received more values distributed through the femoral neck.

Porous bone models had greater stress values under an impact load. Higher and faster impacts may create multi-fracture breaks of the femur. The inferior femoral neck regions are the most vulnerable part in response to the impacts.

The hip joint is the largest joint after the knee, which gives stability to the whole human structure. The hip joint consists of a femoral head which articulates with the acetabulum. Due to age and wear between the joints, these joints need to be replaced with implants which can function just as a natural joint. Since the early 19th century, the hip joint arthroplasty has evolved, and many advances have been taken in the field which improved the whole procedure. Currently, there is a wide variety of implants available varying in the length of stem, shapes, and sizes.

In this analytical study of femur, circular, oval, ellipse and trapezoidal-shaped stem designs are considered in the present study. The human femur is modeled using Mimics. CATIA V-6 is used to model the implant models. Static structural analysis is carried out using ANSYS R-19 to evaluate the best implant design.

All the four hip implants exhibited the von Mises stresses, lesser than its yielded strength. However, circular and trapezoidal-shaped stems have less von Mises stress compared to ellipse and oval.

This study shows the behavior of different implant designs when their cross-sections are varied. Further, these implants can be considered for dynamic analysis considering different gait cycles. By optimizing the implant design, life expectancy of the implant can be improved, which will avoid the revision of the hip implant in active adult patients.