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Sample records for open rat femoral

  1. Femoral development in chronically centrifuged rats

    NASA Technical Reports Server (NTRS)

    Smith, S. D.

    1977-01-01

    Groups of 30-d-old male and female rats were centrifuged at 2.00 G (RE, Rotation Experimental), 1.05 G (RC, Rotation Control) or exposed to the noise and wind of the centrifuge at 1.00 G (EC, Earth Control) for periods of 1, 2, 4, 8, and 16 weeks. Measurements of their femurs indicated that exposure to centrifugation a) decreased femoral length in RE animals, b) increased femoral length in RC animals, c) reduced femoral diameter in RE and RC animals, d) increased L/D ratios in RC animals, e) decreased L/D ratios in RE animals, f) increased femur length/body weight in RE animals, g) decreased cortical thickness (CT) in RE animals, h) increased relative CT in RE animals, and decreased it in RC animals, i) accelerated ossification in RC femoral heads, j) thinned and distorted RE epiphyseal plates, and k) thickened condylar cartilage in RE females. The effects tended to be strongly sexually dimorphic, with females more severely affected by the stress than males.

  2. Unusual Foreign Bone Fragment in Femoral Open Fracture

    PubMed Central

    Sadoni, Hanon; Arti, Hamidreza

    2016-01-01

    Introduction: Femoral shaft fracture is one of the typical bone fractures due to high energy trauma and may occur as an open fracture. Some foreign materials may enter the fracture site such as sand, cloth particles and so on. Case Presentation: A 28-year-old motorcycle riding military member and his collaborator were received in the hospital because of multiple traumas due to a fall in a hollow during a surveillance mission. His collaborator died because of head trauma and multiple severe open fractures. When fixing the patients femoral fracture, a large femoral butterfly fragment was removed from the patient’s thigh as a foreign segment. The patient’s femur was fixed with a plate and screws. No femoral defect was detected during surgery or post-operative X-rays and CT scan. The removed segment was not a part of the patient’s femur. Conclusions: Surgical and post-surgical findings showed that this segment was not related to the patient’s femur. The foreign segment may have belonged to the other victim of this trauma.

  3. Decreased femoral arterial flow during simulated microgravity in the rat

    NASA Technical Reports Server (NTRS)

    Roer, Robert D.; Dillaman, Richard M.

    1994-01-01

    To determine whether the blood supply to the hindlimbs of rats is altered by the tail-suspension model of weightlessness, rats were chronically instrumented for the measurement of femoral artery flow. Ultrasonic transit-time flow probes were implanted into 8-wk-old Wistar-Furth rats under ketamine-xylazine anesthesia, and, after 24 h of recovery, flow was measured in the normal ambulatory posture. Next, rats were suspended and flow was measured immediately and then daily over the next 4-7 days. Rats were subsequently returned to normal posture, and flow was monitored daily for 1-3 days. Mean arterial flow decreased immediately on the rats being suspensed and continued to decrease until a new steady state of approximately 60% of control values was attained at 5 days. On the rats returning to normal posture, flow increased to levels observed before suspension. Quantile-quantile plots of blood flow data revealed a decrease in flow during both systole and diastole. The observed decrease in hindlimb blood flow during suspension suggests a possible role in the etiology of muscular atrophy and bone loss in microgravity.

  4. Femoral Strength after Induced Lesions in Rats (Rattus norvegicus)

    PubMed Central

    Belill, Kathryn A; Settle, Timothy L; Angel, C Roselina; Kim, Seon-Woo; Rothwell, Stephen W

    2014-01-01

    Rats are a common model for the study of bone healing, with the cranium, femur, and tibia being the bones studied most frequently. This study examines noncritical-sized lesions that would allow rats to continue to bear weight without the need for fixation but that are sufficiently large to enable characterization of the healing process. We compared the femoral bone strength associated with 3 lesion sizes selected for use in future studies. Sprague–Dawley rats (age, 10 to 16 wk) were used to assess the ultimate breaking strength, stress, and break force of normal, unmanipulated femurs. We then created lesions of 3 different sizes in the mid- to distal diaphysis of the left and right femurs and characterized the associated decreases in bone strength. Femurs (n= 85) for this study were collected through tissue sharing from rats used in other acute surgical procedures and were tested by using a 3-point bending flexural materials-testing machine. Our hypothesis was that, as a model for bone healing, 3 induced lesions of different sizes would show incremental and proportional decreases in femoral strength, with the intermediate-sized (1.5-mm) lesion demonstrating a decrease of 20% to 40%. A lesion of 1.5 mm yielded a decrease in strength of 17% for both the left and right femurs. The strength of left femurs carrying intermediate lesions was significantly less than that of control, uninjured femur bones. In addition to providing validation for our own future bone-healing project, these data are a useful baseline for other investigators studying bone healing in a rat femur model. PMID:24956210

  5. Heterologous mesenchymal stem cells successfully treat femoral pseudarthrosis in rats

    PubMed Central

    2012-01-01

    Background This study evaluated the effectiveness of treating pseudarthrosis in rats by using bone marrow cell suspensions or cultures of bone marrow mesenchymal stromal cells Methods Thirty-eight specific pathogen-free (SPF) animals were randomly assigned to four groups: Group 1, Control, without surgical intervention; Group 2 (Placebo), experimental model of femoral pseudarthrosis treated only with saline solution; Group 3, experimental model of femoral pseudarthrosis treated with heterologous bone marrow cells suspension; Group 4, experimental model of femoral pseudarthrosis treated with cultures of heterologous mesenchymal stromal cells from bone marrow. When pseudarthrosis was confirmed by simple radiological studies, digital radiography and histopathology after a 120-day postoperative period, Groups 2, 3 and 4 were treated as above. At 30, 60 and 90 days after the treatment, all animals were evaluated by simple radiological studies, and at the end of the experiment, the animals were assessed by computed axial tomography and anatomopathological and histomorphometric examinations. Results Injected cells were detected in the areas affected by pseudarthrosis using scintigraphy within the first 24 hours after their administration. After 60 days, the animals of Group 3 showed callus formation while the animals of Group 4 presented periosteal reaction and had some consolidated areas. In contrast, Group 2 showed a predominance of fibro-osteoid tissue. After 90 days, bone consolidation and remodeling was observed in all animals from Group 3 whereas animals from Group 4 exhibited partial consolidation and those ones from Group 2 persisted with pseudarthrosis. Conclusion The treatment with heterologous bone marrow cells suspension proved to be effective in the treatment of pseudarthrosis whereas cultures of heterologous bone marrow mesenchymal stromal cells did not show the same potential to aid bone healing. PMID:22429995

  6. Opening- and Closing-Wedge Distal Femoral Osteotomy

    PubMed Central

    Chahla, Jorge; Mitchell, Justin J.; Liechti, Daniel J.; Moatshe, Gilbert; Menge, Travis J.; Dean, Chase S.; LaPrade, Robert F.

    2016-01-01

    Background: Lateral compartment osteoarthritis of the knee can be a challenging pathology in the younger, active population due to limited treatment options and high patient expectations. Distal femoral osteotomy (DFO) has been reported to be a potential treatment option. Purpose: To perform a systematic review on the survival, outcomes, and complications of DFO for treatment of genu valgum with concomitant lateral compartment osteoarthritis of the knee. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature was performed using the Cochrane Database of Systematic Reviews, the Cochrane Central Registry of Controlled Trials, PubMed, and MEDLINE from 1980 to present. Inclusion criteria were as follows: outcomes of opening- and closing-wedge DFOs performed for treatment of genu valgum with concomitant lateral compartment osteoarthritis of the knee, English language, minimum 2-year follow-up, and human studies. Data abstracted from the selected studies included type of osteotomy (opening vs closing), survival rate, patient-reported and radiographic outcomes, and complications. Results: Fourteen studies met the inclusion criteria and were considered for the review. A total of 9 closing-wedge and 5 opening-wedge DFO studies were included. All were retrospective studies and reported good to excellent patient-reported outcomes after DFO. Survival decreased with increasing time from surgery, with 1 study reporting a 100% survival rate at 6.5 years, compared with 21.5% at 20 years in another study. A low rate of complications was reported throughout the review. Conclusion: Highly heterogeneous literature exists for both opening- and closing-wedge DFOs for the treatment of isolated lateral compartment osteoarthritis with valgus malalignment. A mean survival rate of 80% at 10-year follow-up was reported, supporting that this procedure can be a viable treatment option to delay or reduce the need for joint arthroplasty. A low

  7. Effects of risedronate on femoral bone mineral density and bone strength in sciatic neurectomized young rats.

    PubMed

    Iwamoto, Jun; Seki, Azusa; Takeda, Tsuyoshi; Sato, Yoshihiro; Yamada, Harumoto

    2005-01-01

    Immobilization induces a rapid loss of bone density and bone strength in rats. The purpose of the present study was to examine the effects of risedronate (Ris) on the femoral bone density and bone strength of sciatic neurectomized young rats. Forty male Sprague-Dawley rats, 6 weeks of age, were randomized by the stratified weight method into the following four treatment groups of 10 rats each: sham-operation, bilateral sciatic neurectomy (NX), NX + low-dose Ris (0.25 mg/kg/day, orally), and NX + high-dose Ris (0.5 mg/kg/day, orally). After 8 weeks of feeding, the volumetric bone mineral density (vBMD) and stress strain index (SSI) of the femoral distal metaphysis and middiaphysis of the rats were measured by peripheral quantitative computed tomography. The mechanical properties of the femoral distal metaphysis and middiaphysis were measured by the compression and three-point bending tests, respectively. The femoral length was also measured. As compared with the findings in the sham-operated controls, NX resulted in a loss of femoral length, cancellous vBMD, SSI, maximum load, stiffness, and breaking energy of the femoral distal metaphysis; there was also loss of cortical thickness, SSI, maximum load, and stiffness of the femoral middiaphysis, with no significant effects on the cortical vBMD or breaking energy of the femoral middiaphysis. High-dose Ris increased the vBMD to values higher than those in the sham-operated controls, and prevented the loss of SSI, maximum load, and stiffness of the femoral distal metaphysis, while low-dose Ris prevented the loss of cancellous vBMD of the femoral distal metaphysis. Neither high- nor low-dose Ris affected any of the cortical bone parameters of the femoral middiaphysis, except for cortical thickness, or the femoral length. These findings suggest that Ris may prevent immobilization-induced loss of cancellous bone density and bone strength in a dose-dependent manner without interfering with bone growth, but has no apparent

  8. Barium responsiveness of the rat aorta and femoral artery during pregnancy.

    PubMed

    Hart, J L

    1982-01-11

    The barium responses of isolated aortic strips and femoral arteries from non-pregnant and pregnant rats were investigated. Barium caused concentration-related increases in tension of vessels from both pregnant and non-pregnant rats. The concentration-response curves of femoral arteries from non-pregnant and 3 week pregnant rats were not different; however contractility and slopes of concentration-response lines for thoracic aortas from 1, 2 and 3 week pregnant rats were significantly less than those of aortas from non-pregnant rats. In addition, barium caused rhythmic contractions to develop in both femoral arteries and aortas of 3 week pregnant rats more frequently than vessels from non-pregnant rats. Rhythmic contractions did not develop in aortas from 3 week pregnant rats in calcium-free Krebs. Since the effects of barium on the electrical and mechanical activity of various muscles have been postulated to be similar to and/or dependent on calcium, these results may indicate that changes in calcium sensitivity of vascular smooth muscle occur during pregnancy. Such changes may contribute to the blood flow redistribution and other cardiovascular adaptations of pregnancy. PMID:7054642

  9. Effects of metabolic syndrome on the ultrastructure of the femoral nerve in aging rats.

    PubMed

    Rodrigues de Souza, Romeu; Gama, Eliane F; El-Razi Neto, Semaan; Maldonado, Diogo

    2015-10-01

    The aim of the present study was to characterize the morphometry of the femoral nerve in aging rats with metabolic syndrome compared to controls. Systolic blood pressure and fasting plasma glucose were measured, and myelinated and unmyelinated fibers in the femoral nerves were quantitatively assessed under electron microscopy. Aging rats exposed to a regimen of metabolic syndrome developed elevation of plasma glucose concentration, mild hypertension and polyneuropathy characterized by a decrease in myelin fiber area, axon diameter, myelin sheath thickness and myelin fiber loss in the femoral nerve. The histogram of size distribution for myelinated fibers and axons from the aging rats of the control group was bimodal. For aging MS animals, the histogram turned out to be unimodal. The ultrastructure of unmyelinated fibers and of Schwann cells in 18-month-old rats was well preserved. Granules of lipofuscin were seen in unmyelinated fiber axons of 18-month-old rats with MS. The damage percentage of the large myelinated fibers has increased significantly in 18-month-old and 18-month-old (MS) rats in relation to the controls. No significant difference was observed among the groups for the g-ratio. Comparing the three groups, the number of neurotubules and neurofilaments in myelinated fibers of 18-month-old rats with MS was significantly smaller than for the groups of 18-month-old and 14-month-old rats. The overall changes seen in the femoral nerve from aging rats seem minor compared to the changes in the aging rats with MS, suggesting that long-term MS accelerates the progressive modifications in peripheral nerves that develop in old age. PMID:25866014

  10. TLR4 stimulation and corticosteroid interactively induce osteonecrosis of the femoral head in rat.

    PubMed

    Okazaki, Shunichiro; Nagoya, Satoshi; Matsumoto, Hiroshi; Mizuo, Keisuke; Shimizu, Junya; Watanabe, Satoshi; Inoue, Hiromasa; Yamashita, Toshihiko

    2016-02-01

    We previously reported that a toll-like receptor 4 signaling contributes to the development of osteonecrosis of the femoral head. Also, oxidative stress is suggested to be one of the possible pathogenesis of osteonecrosis of the femoral head. A recent study showed that toll-like receptor 4 signaling leads to oxidative stress. The aim of the present study was to evaluate whether toll-like receptor 4 stimulation and subsequent corticosteroid treatment lead to the development of osteonecrosis of the femoral head in rat, and oxidative stress is associated with it. Male Wistar rats were randomly divided into four treatment groups: Saline + Saline, Saline + Methylprednisolone, Lipopolysaccharide + Saline, Lipopolysaccharide + Methylprednisolone. Osteonecrosis of the femoral head at 14 days after the treatment was observed in 1 of 10 Lipopolysaccharide + Saline, and 5 of 10 Lipopolysaccharide + Methylprednisolone treated rats. However, it was not observed at all in the Saline + Saline and Saline + Methylprednisolone treated groups. Glutathione peroxidase activity in the liver at 1 day after the treatment was significantly increased when treated with lipopolysaccharide. However, methylprednisolone treatment reduced the activity. On the other hand, glutathione peroxidase activity in the femur did not change in any intergroup. In conclusion, the present study showed that toll-like receptor 4 stimulation by lipopolysaccharide administration strengthen incidence of corticosteroid-induced osteonecrosis of the femoral head, however, concomitant oxidative stress via toll-like receptor 4 signaling may not contribute to the development of osteonecrosis of the femoral head in rats. PMID:26249756

  11. Results of the treatment of the open femoral shaft fractures in children

    PubMed Central

    Tomaszewski, Ryszard; Gap, Artur

    2014-01-01

    Background Intramedullary nailing has become the treatment of choice for closed femoral shaft fractures in children and adolescents. Immediate intramedullary nailing of open fractures of femur in children remains controversial, with most surgeons preferring to treat grade II or III open fractures either by debridement and traction or external fixation. The aims The aim of this study is to evaluate the results of intramedullary nailing of open femoral fractures in children. Methods 172 children were treated for femoral shaft fracture in our department. 19 fractures were opened in 18 patients. Results In children with polytrauma, multiple fractures, head injuries and other conditions which necessitate intensive nursing care, intramedullary nailing of opens femoral shaft fractures (type I, II, IIIA, IIIB) should be preferred. Conclusion Satisfactory results were obtained in all patients in terms of self evaluation of patients, radiological and clinical evaluation. The infection rate was much lower for patients who had been given a cephalosporin than for patient who had been given a penicillin or had been given no antibiotic. PMID:25104890

  12. Hindlimb suspension diminishes femoral cross-sectional growth in the rat

    NASA Technical Reports Server (NTRS)

    van der Meulen, M. C.; Morey-Holton, E. R.; Carter, D. R.

    1995-01-01

    Growth, functional adaptation, and torsional strength were examined in the femora of 39-day-old male Sprague-Dawley rats subjected to hindlimb suspension for 0, 1, 2, 3, or 4 weeks and were compared with measurements for age-matched control animals. Our goal was to understand the effect of reduced loading on the normal age-related changes in femoral properties during growth. The control animals exhibited growth-related increases in all geometric and torsional properties of the femur. The mean body mass and femoral length of the hindlimb-suspended rats were similar to those of the controls throughout the experiment. Over 4 weeks, the femoral cross-sectional and torsional measurements from the hindlimb-suspended rats demonstrated increases in comparison with the basal values (+33% cross-sectional area, +64% polar moment of inertia, +67% ultimate torque, and +181% torsional rigidity), but the age-matched controls showed significantly greater growth-related increases (+71% cross-sectional area, +136% polar moment of inertia, +127% ultimate torque, and +367% torsional rigidity). The differences in femoral structural strength between the hindlimb-suspended animals and the age-matched controls were attributable to differences in altered cross-sectional geometry.

  13. GS/DBM/PLA porous composite biomaterial for the treatment of infective femoral condyle defect in rats

    PubMed Central

    LIU, XIAOMING; YANG, LIN; LI, JING; ZHANG, YUMING; XU, WEIJUN; REN, YAN; LIU, BIWANG; YANG, BIAO; LI, BAOXING

    2016-01-01

    A bone defect resulting from open bone trauma may easily become infected; however, the administration of efficacious systemic antibiotics cannot be performed at safe levels. Previous studies have investigated anti-infective biomaterials that incorporate into bone and facilitate the direct application of high-concentration local antibiotics. In the present study, the effect of a novel porous composite with gentamicin sulfate (GS) in treating infected femoral condyle defects was investigated using a rat model. A novel porous composite biomaterial was prepared based on a supercritical carbon dioxide fluid technique that combined GS, demineralized bone matrix (DBM) and polylactic acid (PLA). A rat femoral condyle fracture model of infection was established. The GS/DBM/PLA composite biomaterial was implanted and its physicochemical characteristics, biocompatibility and ability to facilitate repair of infected bone defect were assessed. The GS/DBM/PLA composite biomaterial maintained the antibiotic activity of GS, with good anti-compression strength, porosity and biocompatibility. The results of the animal experiments indicated that the GS/DBM/PLA composite biomaterial exerted marked anti-infective effects and facilitated bone defect repair, while simultaneously controlling infection. Porous GS/DBM/PLA is therefore a promising composite biomaterial for use in bone tissue engineering. PMID:27284292

  14. Vasculature deprivation – induced osteonecrosis of the rat femoral head as a model for therapeutic trials

    PubMed Central

    Bejar, Jacob; Peled, Eli; Boss, Jochanan H

    2005-01-01

    Experimental Osteonecrosis The authors' experience with experimentally produced femoral capital osteonecrosis in rats is reviewed: incising the periosteum at the base of the neck of the femur and cutting the ligamentum teres leads to coagulation necrosis of the epiphysis. The necrotic debris is substituted by fibrous tissue concomitantly with resorption of the dead soft and hard tissues by macrophages and osteoclasts, respectively. Progressively, the formerly necrotic epiphysis is repopulated by hematopoietic-fatty tissue, and replaced by architecturally abnormal and biomechanically weak bone. The femoral heads lose their smooth-surfaced hemispherical shape in the wake of the load transfer through the hip joint such that, together with regressive changes of the joint cartilage and inflammatory-hyperplastic changes of the articular membrane, an osteoarthritis-like disorder ensues. Therapeutic Choices Diverse therapeutic options are studied to satisfy the different opinions concerning the significance of diverse etiological and pathogenic mechanisms: 1. Exposure to hyperbaric oxygen. 2. Exposure to hyperbaric oxygen and non-weight bearing on the operated hip. 3. Medication with enoxaparin. 4. Reduction of intraosseous hypertension, putting to use a procedure aimed at core decompression, namely drilling a channel through the femoral head. 5. Medication with vascular endothelial growth factor with a view to accelerating revascularization. 6. Medication with zoledronic acid to decrease osteoclastic productivity such that the remodeling of the femoral head is slowed. Glucocorticoid-related osteonecrosis appears to be apoptosis-related, thus differing from the vessel-deprivation-induced tissue coagulation found in idiopathic osteonecrosis. The quantities of TNF-α, RANK-ligand and osteoprotegerin are raised in glucocorticoid-treated osteoblasts so that the differentiation of osteoclasts is blocked. Moreover, the osteoblasts and osteocytes of the femoral cortex mostly

  15. Alterations in Vasoreactivity of Femoral Artery Induced by Hindlimb Unweighting are Related to the Changes of Contractile Protein in Rats

    NASA Technical Reports Server (NTRS)

    Ma, Jin; Ren, Xinling; Meng, Qinjun; Zhang, Lifan; Purdy, Ralph E.

    2005-01-01

    Responses of endothelium removed femoral arterial rings to vasoactive compounds were examined in vitro, and the expression of Myosin and Actin of femoral artery were observed by Western Blotting and Immunohistochemistry in hndlimb unweighting rats and control rats. The results showed that contractile responses of femoral arterial rings evoked by Phenylephrine, Endothelin-1, Vasopressin, KCl, Ca(2+) and Ca(2+) ionophore A23187 were decreased in hindlimb unweighting rats as compared with that of controls. But vasoddatory responses induced by SNPand cGMP were not different between groups. No significant differences have been found in expressions of Calponin, Myosin, Actin, and the ratio of MHC SM1/SM2 between the two groups, but expression of alpha-SM-Actin decreased in hindlimb unweighting rats. The data indicated that the diminished contractile responsiveness probably result from altered contractile apparatus, especially the contractile proteins.

  16. The correlation between dielectric properties and microstructure of femoral bone in rats with different bone qualities.

    PubMed

    Tao, Feng; Fu, Feng; You, Fusheng; Ji, Zhenyu; Wen, Jun; Shi, Xuetao; Dong, Xiuzhen; Yang, Min

    2014-06-01

    Bone dielectric properties (DP) have been extensively studied. However, little literature has reported DP of bone from identical anatomical site under different status and its correlation with microstructure. Therefore, interrelationship between DP and microstructure of rat femurs with varying bone qualities (normal, osteoporotic and partially osteoporotic) was investigated. Diabetic osteoporosis was induced by streptozotocin (STZ) injection. 8 normal rats as control group together with 16 diabetic rats equally assigned to diabetes mellitus (DM) and DM treated by pulsed electromagnetic fields (PEMF) (DM + PEMF) group were used. DM + PEMF group was daily exposed to PEMF of 15 Hz, 1 mT for 8 weeks. After sacrifice, the femurs were harvested for microCT analysis and dielectric measurements (from 10 Hz to 1 MHz). It was found that DP (conductivity and permittivity) altered after PEMF stimulation improved femoral microstructures (p < 0.01). Significant correlations were found between microstructure indices (MI) and conductivity in the full frequency range (|r| ≥ 0.64, n = 24) as well as permittivity in middle and low frequencies (|r| ≥ 0.52, n = 24, from 1 Hz to 1 kHz). The findings demonstrated the good correlation between DP and MI of femoral bone in rats, which makes it possible to distinguish bone under different status and predict MI variation through dielectric measurements. PMID:24710797

  17. Vitamin K2 Prevents Glucocorticoid-induced Osteonecrosis of the Femoral Head in Rats

    PubMed Central

    Zhang, Yue-Lei; Yin, Jun-Hui; Ding, Hao; Zhang, Wei; Zhang, Chang-Qing; Gao, You-Shui

    2016-01-01

    Glucocorticoid medication is one of the most common causes of atraumatic osteonecrosis of the femoral head (ONFH), and vitamin K2 (VK2) has been shown to play an important and beneficial role in bone metabolism. In this study, we hypothesized that VK2 could decrease the incidence of glucocorticoid-induced ONFH in a rat model. Using in vitro studies, we investigated how bone marrow-derived stem cells in the presence of methylprednisolone proliferate and differentiate, specifically examining osteogenic-related proteins, including Runx2, alkaline phosphatase and osteocalcin. Using in vivo studies, we established glucocorticoid-induced ONFH in rats and investigated the preventive effect of VK2. We employed micro-CT scanning, angiography of the femoral head, and histological and immunohistochemical analyses, which demonstrated that VK2 yielded beneficial effects for subchondral bone trabecula. In conclusion, VK2 is an effective antagonist for glucocorticoid on osteogenic progenitors. The underlying mechanisms include acceleration of BMSC propagation and promotion of bone formation-associated protein expression, which combine and contribute to the prevention of glucocorticoid-induced ONFH in rats. PMID:27019620

  18. A rat model for evaluating physiological responses to femoral shaft fracture reduction using a surgical robot.

    PubMed

    Oszwald, Markus; Westphal, Ralf; O'Loughlin, Padhraig F; Kendoff, Daniel; Hufner, Tobias; Wahl, Friedrich; Krettek, Christian; Gosling, Thomas

    2008-12-01

    The first step in treatment of displaced femoral shaft fractures is adequate reduction of the fracture fragments. Manually performed, reduction can be challenging, and is frequently associated with soft tissue damage, especially when repeated reduction attempts are made. The magnitude of local and systemic inflammatory responses caused by prolonged and repeated reduction maneuvers has not been fully established. We devised an operative technique utilizing a robotic reduction device for use in a rat. A femoral fracture was simulated by means of an osteotomy. The robot enabled reproduction of both manual and guided precision reductions, performed in a single path movement. An external fixator was designed specifically to manipulate the rat femur and also for fixation of the osteotomy region. First, reduction accuracy was assessed in eight femurs, then the quality of fixator placement and reduction accuracy was analyzed in 22 femurs. In the first case, 100% of the femurs were accurately reduced. In the second case, 91% had successful stable fixation and an accurate reduction was achieved in 86% of the specimens. We demonstrated the feasibility of a model of robot-assisted fracture reduction that could be used to analyze the effects of reduction on the surrounding soft tissue via biochemical and histopathological means. A future aspect will be to evaluate whether the robot confers an advantage in fracture reduction versus the conventional technique, which would have significant implications for the use of robotic devices in orthopaedic surgery. PMID:18634014

  19. Ultrasound method applied to characterize healthy femoral diaphysis of Wistar rats in vivo.

    PubMed

    Fontes-Pereira, A; Matusin, D P; Rosa, P; Schanaider, A; von Krüger, M A; Pereira, W C A

    2014-05-01

    A simple experimental protocol applying a quantitative ultrasound (QUS) pulse-echo technique was used to measure the acoustic parameters of healthy femoral diaphyses of Wistar rats in vivo. Five quantitative parameters [apparent integrated backscatter (AIB), frequency slope of apparent backscatter (FSAB), time slope of apparent backscatter (TSAB), integrated reflection coefficient (IRC), and frequency slope of integrated reflection (FSIR)] were calculated using the echoes from cortical and trabecular bone in the femurs of 14 Wistar rats. Signal acquisition was performed three times in each rat, with the ultrasound signal acquired along the femur's central region from three positions 1 mm apart from each other. The parameters estimated for the three positions were averaged to represent the femur diaphysis. The results showed that AIB, FSAB, TSAB, and IRC values were statistically similar, but the FSIR values from Experiments 1 and 3 were different. Furthermore, Pearson's correlation coefficient showed, in general, strong correlations among the parameters. The proposed protocol and calculated parameters demonstrated the potential to characterize the femur diaphysis of rats in vivo. The results are relevant because rats have a bone structure very similar to humans, and thus are an important step toward preclinical trials and subsequent application of QUS in humans. PMID:24838643

  20. Leptin ameliorates ischemic necrosis of the femoral head in rats with obesity induced by a high-fat diet

    PubMed Central

    Zhou, Lu; Jang, Kyu Yun; Moon, Young Jae; Wagle, Sajeev; Kim, Kyoung Min; Lee, Kwang Bok; Park, Byung-Hyun; Kim, Jung Ryul

    2015-01-01

    Obesity is a risk factor for ischemic necrosis of the femoral head (INFH). The purpose of this study was to determine if leptin treatment of INFH stimulates new bone formation to preserve femoral head shape in rats with diet-induced obesity. Rats were fed a high-fat diet (HFD) or normal chow diet (NCD) for 16 weeks to induce progressive development of obesity. Avascular necrosis of the femoral head (AVN) was surgically induced. Adenovirus-mediated introduction of the leptin gene was by intravenous injection 2 days before surgery-induced AVN. At 6 weeks post-surgery, radiologic and histomorphometric assessments were performed. Leptin signaling in tissues was examined by Western blot. Osteogenic markers were analyzed by real-time RT-PCR. Radiographs showed better preservation of femoral head architecture in the HFD-AVN-Leptin group than the HFD-AVN and HFD-AVN-LacZ groups. Histology and immunohistochemistry revealed the HFD-AVN-Leptin group had significantly increased osteoblastic proliferation and vascularity in infarcted femoral heads compared with the HFD-AVN and HFD-AVN-LacZ groups. Intravenous injection of leptin enhanced serum VEGF levels and activated HIF-1α pathways. Runx 2 and its target genes were significantly upregulated in the HFD-AVN-Leptin group. These results indicate that leptin resistance is important in INFH pathogenesis. Leptin therapy could be a new strategy for INFH. PMID:25797953

  1. Expression of HCA2 Receptors in Femoral Epiphysis and Metaphysis of Rats with Dexamethasone-Induced Osteoporosis

    PubMed Central

    Shomali, Tahoora; Kamalpour, Mohammad; Fazeli, Mehdi; Rafati, Alireza

    2016-01-01

    The present study describes the changes in expression of hydroxy- carboxylic acid receptor 2 (HCA2 receptor) in femoral epiphysis and metaphysis of rats with glucocorticoid-induced osteoporosis (GIO). 16 growing male Sprauge dawley rats were randomly divided into two equal groups consisting of normal control and rats that were rendered osteoporotic by receiving 0.1 mg/kg/day dexamethasone subcutaneously. After 4 weeks, all rats were sacrificed and immediately right and left femoral bones were removed for RT-qPCR and histological examination, respectively. Immunohistochemical parameters using a primary rabbit polyclonal GPR109A antibody in hematoxylin and eosin- counter stained slides were determined. HCA2 receptor expression was evaluated using RT- qPCR. Qualitative and histomorphometric evaluation of slides revealed the establishment of glucocorticoid- induced osteoporosis (GIO) in rats treated with dexamethasone. In immunohistochemical study, dexamethasone administration appreciably reduced receptor density in all evaluated cell types and in total slides as compared to control. mRNA level of HCA2 receptor gene was reduced in dexamethasone- treated group. GIO may be associated with down regulation of HCA2 receptors in proximal femoral bone of rats at mRNA as well as protein level in no- cell type-specific manner, although reduction in protein expression needs to be further confirmed by western blotting. PMID:27478807

  2. Expression of HCA2 Receptors in Femoral Epiphysis and Metaphysis of Rats with Dexamethasone-Induced Osteoporosis.

    PubMed

    Shomali, Tahoora; Kamalpour, Mohammad; Fazeli, Mehdi; Rafati, Alireza

    2016-01-01

    The present study describes the changes in expression of hydroxy- carboxylic acid receptor 2 (HCA2 receptor) in femoral epiphysis and metaphysis of rats with glucocorticoid-induced osteoporosis (GIO). 16 growing male Sprauge dawley rats were randomly divided into two equal groups consisting of normal control and rats that were rendered osteoporotic by receiving 0.1 mg/kg/day dexamethasone subcutaneously. After 4 weeks, all rats were sacrificed and immediately right and left femoral bones were removed for RT-qPCR and histological examination, respectively. Immunohistochemical parameters using a primary rabbit polyclonal GPR109A antibody in hematoxylin and eosin- counter stained slides were determined. HCA2 receptor expression was evaluated using RT- qPCR. Qualitative and histomorphometric evaluation of slides revealed the establishment of glucocorticoid- induced osteoporosis (GIO) in rats treated with dexamethasone. In immunohistochemical study, dexamethasone administration appreciably reduced receptor density in all evaluated cell types and in total slides as compared to control. mRNA level of HCA2 receptor gene was reduced in dexamethasone- treated group. GIO may be associated with down regulation of HCA2 receptors in proximal femoral bone of rats at mRNA as well as protein level in no- cell type-specific manner, although reduction in protein expression needs to be further confirmed by western blotting. PMID:27478807

  3. F 15845, a new blocker of the persistent sodium current prevents consequences of hypoxia in rat femoral artery

    PubMed Central

    Bocquet, A; Sablayrolles, S; Vacher, B; Le Grand, B

    2010-01-01

    BACKGROUND AND PURPOSE The persistent sodium current is involved in myocardial ischaemia and is selectively inhibited by the newly described 3-(R)-[3-(2-methoxyphenylthio-2-(S)-methylpropyl]amino-3,4-dihydro-2H-1,5-benzoxathiepine bromhydrate (F 15845). Here, we describe the pharmacological profile of F 15845 against the effects of hypoxia in femoral arteries in vitro. EXPERIMENTAL APPROACH Isometric tension measurement of rat isolated femoral arteries was used to characterize the protective effect of F 15845 against contraction of the vessels induced by veratrine (100 µg·mL−1) or hypoxia. KEY RESULTS Rat femoral artery expressed the Nav1.5 channel isoform. When exposed to veratrine (100 µg·mL−1), vessels developed a rapid and strong contraction that was abolished by both absence of sodium and blockade of the Na+/Ca++ exchanger by KB-R7943 (10 and 32 µmol·L−1) or treatment with F 15845. When used before veratrine exposure, the potency of F 15845 depended on the extracellular K+ concentration (IC50 = 11 and 0.77 µmol·L−1 for 5 and 20 mmol·L−1 KCl, respectively), whereas its potency was unaffected by extracellular K+ concentration when given after veratrine. F 15845 did not affect either KCl (80 mmol·L−1) or phenylephrine-induced femoral artery contraction. Moreover, endothelium disruption did not affect the protective effect of F 15845 against veratrine-induced femoral artery contraction, suggesting a mechanism of action dependent on smooth muscle cells. Finally, F 15845 prevented in a concentration-dependent manner rat femoral artery contraction induced by hypoxia. CONCLUSION AND IMPLICATIONS F 15845, a selective blocker of the persistent sodium current prevented vascular contraction induced by hypoxic conditions. PMID:20735424

  4. Effects of Sclerostin Antibody on the Healing of Femoral Fractures in Ovariectomised Rats.

    PubMed

    Liu, Yang; Rui, Yunfeng; Cheng, Tin Yan; Huang, Shuo; Xu, Liangliang; Meng, Fanbiao; Lee, Wayne Yuk Wai; Zhang, Ting; Li, Nan; Li, Chaoyang; Ke, Huazhu; Li, Gang

    2016-03-01

    The inhibition of sclerostin by the systemic administration of a monoclonal antibody (Scl-Ab) significantly increased bone mass and strength in fractured bones in animal models and non-fractured bones in ovariectomised (OVX) rats. In this study, the effects of Scl-Ab on healing were examined in a closed fracture model in OVX rats. Sixty Sprague-Dawley rats underwent an ovariectomy or a sham operation at 4 months of age, and a closed fracture of the right femur was performed 3 months later. Subcutaneous injections with Scl-Ab (25 mg/kg) or saline were then administered on day 1 after the fracture and twice a week for 8 weeks (n = 20 per group), at which time the fractured femurs were harvested for micro-computed tomography analysis, four-point bending mechanical testing and histomorphometric analysis to examine bone mass, bone strength and dynamic bone formation at the fracture site. The angiogenesis at the fracture site was also examined. Bone marrow stem cells were also isolated from the fractured bone to perform a colony-forming unit (CFU) assay and an alkaline phosphatase-positive (ALP(+)) CFU assay. OVX rats treated with Scl-Ab for 8 weeks had significantly increased bone mineral density and relative bone volume compared with OVX rats treated with saline. Similarly, maximum loading, energy to maximum load and stiffness in Scl-Ab-treated OVX rats were significantly higher than those in saline controls. The mineral apposition rate (MAR), mineralising surface (MS/BS) and bone formation rate (BFR/BS) were also significantly increased in Scl-Ab-treated group compared with the saline-treated group in OVX rats. Furthermore, the Scl-Ab-treated group had more CFUs and ALP(+) CFUs than the saline-treated group in OVX rats. No significant difference in angiogenesis at the fracture site was found between the groups. Our study demonstrated that Scl-Ab helped to increase bone mass, bone strength and bone formation at the fracture site in a closed femoral fracture

  5. Cortical Bone Morphological and Trabecular Bone Microarchitectural Changes in the Mandible and Femoral Neck of Ovariectomized Rats

    PubMed Central

    Hsu, Pei-Yu; Tsai, Ming-Tzu; Wang, Shun-Ping; Chen, Ying-Ju; Wu, Jay; Hsu, Jui-Ting

    2016-01-01

    Objective This study used microcomputed tomography (micro-CT) to evaluate the effects of ovariectomy on the trabecular bone microarchitecture and cortical bone morphology in the femoral neck and mandible of female rats. Materials and Methods Twelve female Wister rats were divided into two groups: the control and ovariectomized groups. The rats in the ovariectomized group received ovariectomy at 8 weeks of age; all the rats were sacrificed at 20 weeks of age, and their mandibles and femurs were removed and scanned using micro-CT. Four microstructural trabecular bone parameters were measured for the region below the first mandibular molar and the femoral neck region: bone volume fraction (BV/TV), trabecular thickness (TbTh), trabecular separation (TbSp), and trabecular number (TbN). In addition, four cortical bone parameters were measured for the femoral neck region: total cross-sectional area (TtAr), cortical area (CtAr), cortical bone area fraction (CtAr/TtAr), and cortical thickness (CtTh). The CtTh at the masseteric ridge was used to assess the cortical bone morphology in the mandible. The trabecular bone microarchitecture and cortical bone morphology in the femoral necks and mandibles of the control group were compared with those of the ovariectomized group. Furthermore, Spearman’s correlation (rs) was conducted to analyze the correlation between the osteoporosis conditions of the mandible and femoral neck. Results Regarding the trabecular bone microarchitectural parameters, the BV/TV of the trabecular bone microarchitecture in the femoral necks of the control group (61.199±11.288%, median ± interquartile range) was significantly greater than that of the ovariectomized group (40.329±5.153%). Similarly, the BV/TV of the trabecular bone microarchitecture in the mandibles of the control group (51.704±6.253%) was significantly greater than that of the ovariectomized group (38.486±9.111%). Furthermore, the TbSp of the femoral necks in the ovariectomized group

  6. Open reduction and plate fixation of femoral shaft fractures in children aged 4 to 10.

    PubMed

    Eren, Osman Tugrul; Kucukkaya, Metin; Kockesen, Caglar; Kabukcuoglu, Yavuz; Kuzgun, Unal

    2003-01-01

    A retrospective review of 40 children aged 4 to 10 years with 46 femur fractures treated with open reduction and plate fixation is presented. Follow-up time was 6.3 years (range 2.5-17.5). There were no nonunions. One case of osteomyelitis and one refracture occurred. Leg-length discrepancy averaging 1.2 cm (range 0.4-1.8), with lengthening on the operated side, was observed in 15 patients. Although there is some risk for complications, and although good early results have been reported with elastic intramedullary nails, plate fixation continues to be a viable alternative in the surgical treatment of femoral shaft fractures in children aged 4 to 10. PMID:12604949

  7. Hybrid Anterolateral Approach for Open Reduction and Internal Fixation of Femoral Neck Fractures.

    PubMed

    Vopat, Bryan G; Daniels, Alan H; Lareau, Craig R; Christino, Melissa A; Kane, Patrick M; Hayda, Roman A; Born, Christopher T

    2015-07-01

    Displaced femoral neck fractures in physiologically young patients are best treated with anatomic reduction and stable fixation. Several surgical approaches to the femoral neck have previously been described, although they are fraught with disadvantages such as poor visualization, the need for 2 incisions, and risk of injury to the lateral femoral cutaneous nerve and branches of the medial femoral circumflex artery. The authors' hybrid anterolateral approach to the hip allows for excellent visualization of femoral neck fractures and for placement of plate and/or screw constructs through a single incision. This surgical technique additionally minimizes risk to neurovascular structures. PMID:26186310

  8. Experimental rat model for alcohol-induced osteonecrosis of the femoral head

    PubMed Central

    Okazaki, Shunichiro; Nagoya, Satoshi; Tateda, Kenji; Katada, Ryuichi; Mizuo, Keisuke; Watanabe, Satoshi; Yamashita, Toshihiko; Matsumoto, Hiroshi

    2013-01-01

    Alcohol-induced osteonecrosis of the femoral head (ONFH) is observed in alcohol abusers and patients with alcoholic fatty liver disease. It has been reported that Toll-like receptor 4 (TLR4) signalling plays a crucial role in the pathogenesis of alcoholic fatty liver disease. We previously reported a corticosteroid-induced ONFH rat model, and suggested that TLR4 signalling contributes to the pathogenesis of ONFH. Thus, it is thought that the pathogenesis of alcohol-induced ONFH is probably similar to that of corticosteroid-induced ONFH. The aim of this study was to develop a new animal model for alcohol-induced ONFH and to evaluate the relationship between the pro-inflammatory response via TLRs and the development of ONFH in rats. Male Wistar rats were fed a Lieber–DeCarli liquid diet containing 5% ethanol (experimental group) or dextran (control group) for 1–24 weeks. Histopathological and biochemical analyses were performed. Feeding the ethanol-containing liquid diet resulted in the development of ONFH with hepatic steatosis, hepatic dysfunction and hyperlipidaemia, whereas feeding the dextran-containing diet did not cause ONFH. However, we could not recognize any relationship between the pro-inflammatory response via TLR4 and the development of alcohol-induced ONFH. Thus in this study we have developed a new rat model for alcohol-induced ONFH based on the feeding of an ethanol liquid diet. ONFH was observed within seven days from the start of feeding with 5% ethanol-containing liquid diet. Although this was linked to hepatic steatosis, a TLR4 association was not a feature of this model. PMID:24020403

  9. Multi-level femoral morphology and mechanical properties of rats of different ages.

    PubMed

    Zhang, Rui; Gong, He; Zhu, Dong; Ma, Renshi; Fang, Juan; Fan, Yobo

    2015-07-01

    A macro-micro-nano-multi-level study was conducted to explore age-related structural and mechanical properties of bone, as well as the effects of aging on bone properties. A total of 70 male Wistar rats were used, ranging in the ages of 1, 3, 5, 7, 9, 11, 14, 15, 16, and 17 months (n = 7/age group). After micro-computed tomography (CT) scanning, longitudinal cortical bone specimens with a length of 5mm were cut along the femoral shaft axis from left femur shafts for mechanical testing, and the cross-sectional areas were measured. The macro-mechanical properties obtained in mechanical testing and microarchitecture parameters measured by micro-CT were significantly correlated with the animal age (r(2) = 0.96, p < 0.001). Scanning electron microscopy was used for detecting the microarchitecture features of the fractured surfaces, which exhibited age-related plate-fibrous-mixed fibrous-plate texture, resulting in changes in macro-mechanical properties (r(2) > 0.90, p < 0.001). The mineral phase of the left femoral shaft and head was analyzed by atomic force microscopy. Longitudinal and transverse trabecular bone tissues, as well as longitudinal cortical bone tissue, were used for nanoindentation test, and the chemical composition was evaluated by quantitative chemical analyses. The correlations between mineral content and bone material properties (i.e., elastic properties of the bone tissue and size and roughness of bone mineral grains) were highly significant (r > 0.95, p < 0.001). Multi-level femur morphology, mechanical property, and mineral content were significantly correlated with the animal age. The correlations between bone mineral content and bone material morphological and mechanical properties may partly explain the increase in bone fragility with aging, which will provide a theoretical basis for the investigation of age-related bone properties in clinics. PMID:25857690

  10. The mechano-gated channel inhibitor GsMTx4 reduces the exercise pressor reflex in rats with ligated femoral arteries.

    PubMed

    Copp, Steven W; Kim, Joyce S; Ruiz-Velasco, Victor; Kaufman, Marc P

    2016-05-01

    Mechanical and metabolic stimuli arising from contracting muscles evoke the exercise pressor reflex. This reflex is greater in a rat model of simulated peripheral arterial disease in which a femoral artery is chronically ligated than it is in rats with freely perfused femoral arteries. The role played by the mechanically sensitive component of the exaggerated exercise pressor reflex in ligated rats is unknown. We tested the hypothesis that the mechano-gated channel inhibitor GsMTx4, a relatively selective inhibitor of mechano-gated Piezo channels, reduces the exercise pressor reflex in decerebrate rats with ligated femoral arteries. Injection of 10 μg of GsMTx4 into the arterial supply of the hindlimb reduced the pressor response to Achilles tendon stretch (a purely mechanical stimulus) but had no effect on the pressor responses to intra-arterial injection of α,β-methylene ATP or lactic acid (purely metabolic stimuli). Moreover, injection of 10 μg of GsMTx4 into the arterial supply of the hindlimb reduced both the integrated pressor area (control 535 ± 21, GsMTx4 218 ± 24 mmHg·s; P < 0.01), peak pressor (control 29 ± 2, GsMTx4 14 ± 3 mmHg; P < 0.01), and renal sympathetic nerve responses to electrically induced intermittent hindlimb muscle contraction (a mixed mechanical and metabolic stimulus). The reduction of the integrated pressor area during contraction caused by GsMTx4 was greater in rats with ligated femoral arteries than it was in rats with freely perfused femoral arteries. We conclude that the mechanically sensitive component of the reflex contributes to the exaggerated exercise pressor reflex during intermittent hindlimb muscle contractions in rats with ligated femoral arteries. PMID:26921442

  11. TRPA1 mediates amplified sympathetic responsiveness to activation of metabolically sensitive muscle afferents in rats with femoral artery occlusion

    PubMed Central

    Xing, Jihong; Lu, Jian; Li, Jianhua

    2015-01-01

    Autonomic responses to activation of mechanically and metabolically sensitive muscle afferent nerves during static contraction are augmented in rats with femoral artery occlusion. Moreover, metabolically sensitive transient receptor potential cation channel subfamily A, member 1 (TRPA1) has been reported to contribute to sympathetic nerve activity (SNA) and arterial blood pressure (BP) responses evoked by static muscle contraction. Thus, in the present study, we examined the mechanisms by which afferent nerves' TRPA1 plays a role in regulating amplified sympathetic responsiveness due to a restriction of blood flow directed to the hindlimb muscles. Our data show that 24–72 h of femoral artery occlusion (1) upregulates the protein levels of TRPA1 in dorsal root ganglion (DRG) tissues; (2) selectively increases expression of TRPA1 in DRG neurons supplying metabolically sensitive afferent nerves of C-fiber (group IV); and (3) enhances renal SNA and BP responses to AITC (a TRPA1 agonist) injected into the hindlimb muscles. In addition, our data demonstrate that blocking TRPA1 attenuates SNA and BP responses during muscle contraction to a greater degree in ligated rats than those responses in control rats. In contrast, blocking TRPA1 fails to attenuate SNA and BP responses during passive tendon stretch in both groups. Overall, results of this study indicate that alternations in muscle afferent nerves' TRPA1 likely contribute to enhanced sympathetically mediated autonomic responses via the metabolic component of the muscle reflex under circumstances of chronic muscle ischemia. PMID:26441669

  12. Norepinephrine responses in rat renal and femoral veins are reinforced by vasoconstrictor prostanoids.

    PubMed

    de Souza Rossignoli, Patrícia; Yamamoto, Fernanda Zocatelli; Pereira, Oduvaldo Câmara Marques; Chies, Agnaldo Bruno

    2015-09-01

    Norepinephrine (NE) responses are larger in renal and femoral veins compared to phenylephrine (PE). These differences may be due to the subtypes of adrenoceptor involved in these responses or to the involvement of local modulatory mechanisms. Therefore, the present study investigated in organ bath the adrenoceptor subtypes involved in the NE and PE responses in both renal and femoral veins as well as the influence of local mechanisms related to NO and to prostanoids upon these responses. The obtained data showed that the NE responses in these veins were not significantly modified by the selective inhibition of β1 or β2-adrenoceptors as well as AT1 or AT2 receptors. However, yohimbine reduced the NE Rmax in renal veins and, in parallel, right shifted the NE concentration-response curves in femoral veins. In both veins, prazosin reduced the NE Rmax and the clonidine induced a measurable contraction. The endothelium removal attenuated the NE responses in femoral veins, thereby abolishing the differences of NE and PE responses. Furthermore, the NE responses in renal and femoral veins were attenuated by indomethacin, which suppressed the statistical difference in relation to the PE response. In conclusion, a synergism between α1- and α2-adrenoceptors is essential to assure full NE contractile responses in both renal and femoral veins. Thus, by acting simultaneously in these adrenoceptors, NE induces more pronounced contractile responses, in comparison to PE, not only in renal but also in femoral veins. Moreover, this pronounced NE response in both renal and femoral veins appears to involve endothelium-derived vasoconstrictor prostanoids. PMID:26141930

  13. [Change in the properties of the femoral bones of rats due to exarticulation of the crus and hypokinesia].

    PubMed

    Stupakov, G P; Volozhin, A I; Korzhen'iants, V A; Korolev, V V; Iagodovskiĭ, V S

    1979-01-01

    Rat experiments demonstrated that unilateral calf exarticulation leading to the loss of the leg weight-bearing function resulted in a decrease of the density, ash content and mineral content in the femoral diaphysis. This manipulation reduced the mechanical strength and did not change the elastic properties of the bone. Histological examinations showed osteoporosis in the cortical plate. Partial maintenance of the weight-bearing function in the animals with bilateral exarticulation of the calf prevented these changes. The results suggest that special steps taken to provide static load on leg may be effective countermeasures against atropic changes in bones devoid of their weight-bearing function. PMID:423513

  14. Treatment of an open book pelvic fracture and bilateral femoral fractures with an external fixator in a 14-month-old: a case report.

    PubMed

    Atherton, Thomas G; Chase, Helen E; Stohr, Kuldeep; Melton, Joel T K

    2016-05-01

    A 14-month-old girl was involved in a road traffic accident that resulted in an open book pelvic fracture and bilateral femoral fractures. Acute treatment involved a novel collar and the cuff pelvic closure technique to tamponade the pelvis and reduce bleeding. The patient was treated surgically with an external fixator, which provided good reduction of the pelvic and femoral fractures. A literature search found no previous information on open book pelvic fractures in infants younger than 2 years. The success of this surgery led us to suggest that the use of an external fixator is a potential treatment method for open book pelvic fractures and bilateral femoral fractures in extremely young infants. PMID:26717190

  15. Morphometric and ultrastructural analysis of the effect of bromocriptine and cyclosporine on the vasospastic femoral artery of rats

    PubMed Central

    Tokmak, Mehmet; Başocak, Kahan; Canaz, Hüseyin; Canaz, Gökhan; İplikçioğlu, Celal

    2015-01-01

    Vasospasm is the main causes of mortality and morbidity in patiens with subarachnoid hemorrhage (SAH). The arterial narrowing mechanism that develops after SAH is not yet fully understood but many studies showed that hypotension, neurogenic reflexes, clots in the subarachnoidal space, spasmogenic agents, humoral and celluler immunity play a role in the etiology. In this study we investigate the effects of Bromocriptine and Cyclosporine A in vasospasm secondary to SAH on rat femoral artery from ultrastructural and morphometric perspectives. 120 male Sprague-Dawley rats divided into 12 groups: Vasospasm (V), control (K), surgical control (CK) groups, vasospasm+Bromocriptine and/or Cyclosporine-A groups (VCyA, VBr, VBr+CyA), Bromocriptine and/or Cyclosporine-A control groups (CK, BK, Br+CyAK), Bromocriptine and/or Cyclosporine-A surgical control groups (BCK, CyCK, Br+CyACK). In order to create SAH model, 0, 1 cm3 blood injected into silastic sheath wrapped rat femoral artery. Bromocriptine (2 mg/kg/d) and Cyclosporine A (10 mg/kg/d) combinations applied to control, surgical control and vasospastic models. Light microscopy, transmission electron microscopy and scanning electron microscopy used during this study. Statistical evaluation of the morphometric measurement data concerning vascular wall thickness and luminal cross-sectional areas of all groups were performed using Mann-Whitney U, Wilcoxon-signed rank, and Student-t tests. Cyclosporine A, whose effects in the prevention of vasospasm have been demonstrated in previous studies. In this study we discovered that Bromocriptine demonstrated strong effects similar to Cyclosporine-A. Bromocriptine and Cyclosporine A markedly prevent the development of chronic morphologic vasospasm following SAH. The combined use of both drugs does not change this preventive effect. PMID:26770311

  16. Systemic Treatment with Strontium Ranelate Does Not Influence the Healing of Femoral Mid-shaft Defects in Rats.

    PubMed

    Vegger, Jens Bay; Brüel, Annemarie; Sørensen, Thomas Givskov; Thomsen, Jesper Skovhus

    2016-02-01

    Strontium ranelate (SrR) has both bone anabolic and anti-resorption properties and has therefore the potential to increase the healing of bone defects. The aim of the present study was to investigate the effect of systemic treatment with SrR during the healing of cortical bone defects in rats. In addition, the vertebral bodies were examined in order to elucidate the effect of short-term treatment with SrR on intact trabecular bone. Sixty 16-week-old female Wistar rats were randomized into four groups. A cylindrical defect was drilled through the anterior cortex of the mid-femoral diaphysis in both hind limbs. Two of the groups were treated with SrR (900 mg/kg b.w.) mixed into the food and two groups served as controls. The animals were euthanized after either 3 or 8 weeks of treatment. Healing of the defects was analyzed with µCT, mechanical testing, and stereology. Treatment with SrR resulted in increased thickness of the defects after 3 weeks of treatment, whereas no effect on bone volume fraction (BV/TV), mechanical properties (maximum strength and maximum stiffness), periosteal callus volume, or osteoclast-covered bone surfaces (Oc.S/BS) after either 3 or 8 weeks of treatment was found. Furthermore, SrR increased the bone material density (ρ) of the vertebral bodies, and tended to increase BV/TV after 8 weeks of treatment (p = 0.087). The mechanical properties of the vertebral bodies were not influenced by SrR treatment. In conclusion, 3 weeks of treatment with SrR increased the thickness of the healing mid-femoral cortical bone defects in rats, but did not influence BV/TV, mechanical properties, periosteal callus volume, or Oc.S/BS after either 3 or 8 weeks. Furthermore, SrR had no effect on the microstructure and mechanical properties of the vertebral bodies. PMID:26543033

  17. Caveolar disruption causes contraction of rat femoral arteries via reduced basal NO release and subsequent closure of BKCa channels

    PubMed Central

    Al-Brakati, AY; Kamishima, T; Dart, C

    2015-01-01

    Background and Purpose. Caveolae act as signalling hubs in endothelial and smooth muscle cells. Caveolar disruption by the membrane cholesterol depleting agent methyl-β-cyclodextrin (M-β-CD) has various functional effects on arteries including (i) impairment of endothelium-dependent relaxation, and (ii) alteration of smooth muscle cell (SMC) contraction independently of the endothelium. The aim of this study was to explore the effects of M-β-CD on rat femoral arteries. Methods. Isometric force was measured in rat femoral arteries stimulated to contract with a solution containing 20 mM K+ and 200 nM Bay K 8644 (20 K/Bay K) or with one containing 80 mM K+(80 K). Results. Incubation of arteries with M-β-CD (5 mM, 60 min) increased force in response to 20 K/Bay K but not that induced by 80 K. Application of cholesterol saturated M-β-CD (Ch-MCD, 5 mM, 50 min) reversed the effects of M-β-CD. After mechanical removal of endothelial cells M-β-CD caused only a small enhancement of contractions to 20 K/Bay K. This result suggests M-β-CD acts via altering release of an endothelial-derived vasodilator or vasoconstrictor. When nitric oxide synthase was blocked by pre-incubation of arteries with L-NAME (250 µM) the contraction of arteries to 20 K/Bay K was enhanced, and this effect was abolished by pre-treatment with M-β-CD. This suggests M-β-CD is inhibiting endothelial NO release. Inhibition of large conductance voltage- and Ca2+-activated (BKCa) channels with 2 mM TEA+ or 100 nM Iberiotoxin (IbTX) enhanced 20 K/Bay K contractions. L-NAME attenuated the contractile effect of IbTX, as did endothelial removal. Conclusions. Our results suggest caveolar disruption results in decreased release of endothelial-derived nitric oxide in rat femoral artery, resulting in a reduced contribution of BKCa channels to the smooth muscle cell membrane potential, causing depolarisation and contraction. PMID:26038721

  18. Inhibiting myostatin signaling prevents femoral trabecular bone loss and microarchitecture deterioration in diet-induced obese rats.

    PubMed

    Tang, Liang; Yang, Xiaoying; Gao, Xiaohang; Du, Haiping; Han, Yanqi; Zhang, Didi; Wang, Zhiyuan; Sun, Lijun

    2016-02-01

    Besides resulting in a dramatic increase in skeletal muscle mass, myostatin (MSTN) deficiency has a positive effect on bone formation. However, the issue about whether blocking MSTN can inhibit obesity-induced bone loss has not been previously investigated. In the present study, we have evaluated the effects of MSTN blocking on bone quality in high-fat (HF), diet-induced obese rats using a prepared polyclonal antibody for MSTN (MsAb). Twenty-four rats were randomly assigned to the Control, HF and HF + MsAb groups. Rats in the HF + MsAb group were injected once a week with purified MsAb for eight weeks. The results showed that MsAb significantly reduced body and fat weight, and increased muscle mass and strength in the HF group. MicroCT analysis demonstrated that obesity-induced bone loss and architecture deterioration were significantly mitigated by MsAb treatment, as evidenced by increased bone mineral density, bone volume over total volume, trabecular number and thickness, and decreased trabecular separation and structure model index. However, neither HF diet nor MsAb treatment had an impact on femoral biomechanical properties including maximum load, stiffness, energy absorption and elastic modulus. Moreover, MsAb significantly increased adiponectin concentrations, and decreased TNF-α and IL-6 levels in diet-induced obese rats. Taken together, blocking MSTN by MsAb improves bone quality in diet-induced obese rats through a mechanotransduction pathway from skeletal muscle, and the accompanying changes occurring in the levels of circulating adipokines and pro-inflammatory cytokines may also be involved in this process. It indicates that the administration of MSTN antagonists may be a promising therapy for treating obesity and obesity-induced bone loss. PMID:26438721

  19. Mini-open versus closed reduction in titanium elastic nailing of paediatric femoral shaft fractures: a comparative study.

    PubMed

    Altay, Mehmet Akif; Erturk, Cemil; Cece, Hasan; Isikan, Ugur Erdem

    2011-04-01

    The purpose of this study is to compare retrospectively intraoperative fluoroscopy time and clinical-radiological results in pediatric femoral shaft fractures treated with titanium elastic nailing (TEN), with a mini-open "blind-hand" technique versus closed reduction. The study included 87 children (18 girls and 69 boys) who underwent surgical treatment with TEN for femoral shaft fractures. Patients were divided into two groups. Group 1 included 42 patients (mean age : 83 +/- 2.7 years) treated with a mini-open "blind-ha nd" technique (a 2-3 cm lateral incision at the level of the fracture ; reduction achieved with one or two fingers, without visualization of the fracture). Group 2 consisted of 45 patients (mean age: 8.8 +/- 2.6 years) treated with a closed reduction technique. Duration of surgery and intraoperative fluoroscopy time were recorded in both groups. Clinical and radiologic results were assessed using the TEN scoring system after mean follow-up periods of 213 +/- 5.8 months and 193 +/- 5.6 months in group 1 and group 2, respectively. Mean duration of surgery was 31.7 +/- 7.6 and 52.1 +/- 14.4 minutes, and mean fluoroscopy time 32.9 +/- 22.1 and 75.1 +/- 31.5 seconds in group 1 and group 2, respectively. Both surgical and fluoroscopy time were significantly longer in group 2 (p < 0.001). There was no significant difference between the two groups in terms of clinical and radiological results. All fractures healed with solid union, and there was no complication that was expected to cause permanent disability. Although successful clinical and radiological results were obtained with both techniques, duration of surgery and intraoperative fluoroscopy time were significantly higher in the closed reduction group 2. We suggest the "blind-hand" technique as an alternative to closed reduction to prevent extensive intraoperative radiation exposure and to decrease the length of the surgical procedure. PMID:21667733

  20. Quantification of Age-Related Tissue-Level Failure Strains of Rat Femoral Cortical Bones Using an Approach Combining Macrocompressive Test and Microfinite Element Analysis.

    PubMed

    Fan, Ruoxun; Gong, He; Zhang, Rui; Gao, Jiazi; Jia, Zhengbin; Hu, Yanjuan

    2016-04-01

    Bone mechanical properties vary with age; meanwhile, a close relationship exists among bone mechanical properties at different levels. Therefore, conducting multilevel analyses for bone structures with different ages are necessary to elucidate the effects of aging on bone mechanical properties at different levels. In this study, an approach that combined microfinite element (micro-FE) analysis and macrocompressive test was established to simulate the failure of male rat femoral cortical bone. Micro-FE analyses were primarily performed for rat cortical bones with different ages to simulate their failure processes under compressive load. Tissue-level failure strains in tension and compression of these cortical bones were then back-calculated by fitting the experimental stress-strain curves. Thus, tissue-level failure strains of rat femoral cortical bones with different ages were quantified. The tissue-level failure strain exhibited a biphasic behavior with age: in the period of skeletal maturity (1-7 months of age), the failure strain gradually increased; when the rat exceeded 7 months of age, the failure strain sharply decreased. In the period of skeletal maturity, both the macro- and tissue-levels mechanical properties showed a large promotion. In the period of skeletal aging (9-15 months of age), the tissue-level mechanical properties sharply deteriorated; however, the macromechanical properties only slightly deteriorated. The age-related changes in tissue-level failure strain were revealed through the analysis of male rat femoral cortical bones with different ages, which provided a theoretical basis to understand the relationship between rat cortical bone mechanical properties at macro- and tissue-levels and decrease of bone strength with age. PMID:26902102

  1. Ischemic-reperfusion of unilateral external iliac artery in rat: A new model for vasculitic femoral neuropathy.

    PubMed

    Muthuraman, Arunachalam; Ramesh, Muthusamy

    2016-08-15

    Clinically, ischemic environment during gynecological surgery at lithotomy position is most common causative factor for the development of vasculitic femoral neuropathy (VFN). The present study was designed to induce the clinically relevant rat model of VFN by ischemic-reperfusion (I/R) injury of unilateral external iliac artery (uEIA). The VFN was induced by 3, 4 and 5h occlusion of uEIA followed by reperfusion. The I/R of uEIA induced VFN was evaluated by (i) behavioral parameters i.e., hind limb temperature; weight bearing capacity; (ii) kinematic analysis i.e., paw posture, splay angle, static sciatic index (SSI), and ankle-angle tests; (iii) evaluation of pain perception i.e., plantar and pin prick; (iv) serum biochemical estimation i.e., nitrate, lipid peroxidation, TNF-α and calcium level; (v) evaluation of motor and sensory nerve conduction velocity; and (vi) measurement of nerve fiber density. The 4 and 5h occlusion of uEIA has produced the potential changes in behavioral, functional, electrophysiological, biochemical and histopathological assessment. The 5h occlusion of uEIA has shown to produce the mortality. Whereas, 3h occlusion does not produce the significant changes in the development of VFN. The 4h ischemic occlusion of uEIA has shown potential rat model of VFN due to its close mimicking capacity of VFN in human. Therefore, it can be useful to explore the newer anti-neuralgic medicine and with their pharmacodynamic action in the field of various neurovascular disorders. PMID:27288016

  2. Technique of Open Reduction and Internal Fixation of Comminuted Proximal Humerus Fractures With Allograft Femoral Head Metaphyseal Reconstruction.

    PubMed

    Parada, Stephen A; Makani, Amun; Stadecker, Monica J; Warner, Jon J P

    2015-10-01

    Proximal humerus fractures are common injuries that can require operative treatment. Different operative techniques are available, but the hallmark of fixation for 3- and 4-part fractures is a locking-plate-and-screw construct. Despite advances in this technology, obtaining anatomical reduction and fracture union can be difficult, and complications (eg, need for revision) are not uncommon. These issues can be addressed by augmenting the fixation with an endosteally placed fibular allograft. Although biomechanical and clinical results have been good, the technique can lead to difficulties in future revision to arthroplasty, a common consequence of failed open reduction and internal fixation. The technique described, an alternative to placing a long endosteal bone graft, uses a trapezoidal, individually sized pedestal of allograft femoral head to facilitate the reduction and healing of the humeral head and tuberosity fragments in a displaced 3- or 4-part fracture of the proximal humerus. It can be easily incorporated with any plate-and-screw construct and does not necessitate placing more than 1 cm of bone into the humeral intramedullary canal, limiting the negative effects on any future revision to arthroplasty. PMID:26447409

  3. Nonspecific collagenolytic activity of the femoral bone in immobilized rat extremities.

    PubMed

    Prokopová, D; Tesárek, B; Susta, A

    1975-01-01

    Nonspecific collagenolytic activity was studied in rat bones after immobilization. The left hind limb was immobilized by sectioning the sciatic nerve. Enzyme activity was determined by using synthetic pentapeptide substrate (Pz-Pro-Leu-Gly-Pro-D-Arg). After immobilization the activity of nonspecific collagenase increased and reached its maximum on the third day after the operation. The activity was decreased after one week and attained levels of control bones three weeks after sciatic nerve section. PMID:167392

  4. Bone fracture in a rat femoral fracture model is associated with the activation of autophagy

    PubMed Central

    ZHOU, QIANKUN; LUO, DEQING; LI, TENG; LIU, ZHIRONG; ZOU, WEITAO; WANG, LEI; LIN, DASHENG; LIAN, KEJIAN

    2015-01-01

    Autophagy, which is a mechanism for the turnover of intracellular molecules and organelles, protects cells during stress responses; however, the role of autophagy in the stages of bone fracture remains to be elucidated. The aim of the present study was to investigate the process of autophagy in bone tissue at different time-points after fracture. A femur fracture model was established in male adult Wistar rats via surgery. The protein expression of microtubule-associated protein II light chain 3 (LC3-II) was analyzed in a femur fracture (experimental) group and a sham-surgery group using immunofluorescence. The protein expression of proliferating cell nuclear antigen (PCNA) was used to investigate the cell proliferation in bone tissue following fracture via immunohistochemical analysis. The correlation between cell proliferation and autophagy was analyzed using linear regression. LC3-II protein was constitutively expressed in the sham-surgery group; however, compared with the expression in the sham-surgery group, the LC3-II expression in the experimental group was significantly increased at each time-point (P<0.05). Similarly, immunohistochemistry revealed that the number of PCNA-positive cells in each section was significantly increased following fracture injury (P<0.01). A comparison of the LC3-II- and PCNA-positive rates in the experimental group rats at each time-point revealed a linear correlation (R2=0.43, P<0.01). In conclusion, surgically induced fracture in rats is associated with an increase in LC3-II and PCNA protein expression during the initial stages of fracture injury, and a correlation exists between the expression of the two proteins. These results suggest that potential treatment aimed at improving fracture healing should target the process of autophagy. PMID:26640535

  5. Synergistic effect of exercise and statins on femoral strength in rats.

    PubMed

    Starnes, Joseph W; Neidre, Daria B; Nyman, Jeffry S; Roy, Anuradha; Nelson, Matthew J; Gutierrez, Gloria; Wang, Xiaodu

    2013-08-01

    It is now widely recognized that in order to optimize bone health in the later years, bone healthy behaviors should begin at a young age and continue throughout life. Prescribed orally to lower lipid levels in adults of all ages, statins have also been shown to stimulate bone formation in vitro by promoting bone morphogenic protein-2 (BMP-2) activity and to stimulate bone formation in vivo. Weight bearing exercise is well known to stimulate bone formation through a mechanism whereby mechanical loading is 'sensed' by the mechano-sensors leading to a cascade of events involving the activation of osteoblasts. For individuals with high cholesterol levels, both of these interventions are recommended throughout adult life. Since statins and exercise stimulate bone formation via different mechanisms, we hypothesized that exercise in combination with oral simvastatin synergistically increases bone mineral density and strength. Mature adult female, Sprague Dawley rats were divided into 4 groups: control (n=9), statin only (n=8), exercise only (n=11), and statin plus exercise (n=11). Simvastatin was given to the two groups at a dose of 10 mg/kg/day in standard rat chow for the entire 5 week period. All rats ate the same mass of food. The two exercise groups ran on a treadmill with progressively greater speeds and time, ending on week 5 at 30 m/min for 60 min. After 5 weeks, rats were euthanized, and excised femurs were scanned for areal bone mineral density (BMD) and tested by three point bending to obtain the following performance measures: maximum force (strength), stiffness, and work-to-fracture. Only the group treated with statins and exercise showed a positive effect on the biomechanical performance of the femurs. Compared to controls, this group had increased maximum force, stiffness, moment of inertia, and BMD. Linear regression analysis revealed that the increased performance was related to increased BMD. We conclude that the combination of oral statins and

  6. Pullulan/dextran/nHA Macroporous Composite Beads for Bone Repair in a Femoral Condyle Defect in Rats

    PubMed Central

    Schlaubitz, Silke; Derkaoui, Sidi Mohammed; Marosa, Lydia; Miraux, Sylvain; Renard, Martine; Catros, Sylvain; Le Visage, Catherine; Letourneur, Didier; Amédée, Joëlle; Fricain, Jean-Christophe

    2014-01-01

    The repair of bone defects is of particular interest for orthopedic, oral, maxillofacial, and dental surgery. Bone loss requiring reconstruction is conventionally addressed through bone grafting. Depending on the size and the location of the defect, this method has limits and risks. Biomaterials can offer an alternative and have features supporting bone repair. Here, we propose to evaluate the cellular penetration and bone formation of new macroporous beads based on pullulan/dextran that has been supplemented with nanocrystalline hydroxyapatite in a rat model. Cross-linked beads of 300–500 µm diameters were used in a lateral femoral condyle defect and analyzed by magnetic resonance imaging, micro-computed tomography, and histology in comparison to the empty defects 15, 30, and 70 days after implantation. Inflammation was absent for both conditions. For empty defects, cellularisation and mineralization started from the periphery of the defect. For the defects containing beads, cellular structures filling out the spaces between the scaffolds with increasing interconnectivity and trabecular-like organization were observed over time. The analysis of calcified sections showed increased mineralization over time for both conditions, but was more pronounced for the samples containing beads. Bone Mineral Density and Bone Mineral Content were both significantly higher at day 70 for the beads in comparison to empty defects as well as compared with earlier time points. Analysis of newly formed tissue around the beads showed an increase of osteoid tissue, measured as percentage of the defect surface. This study suggests that the use of beads for the repair of small size defects in bone may be expanded on to meet the clinical need for a ready-to-use fill-up material that can favor bone formation and mineralization, as well as promote vessel ingrowth into the defect site. PMID:25330002

  7. Stanozolol Decreases Bone Turnover Markers, Increases Mineralization, and Alters Femoral Geometry in Male Rats.

    PubMed

    Nebot, E; Aparicio, V A; Camiletti-Moirón, D; Martinez, R; Erben, R G; Kapravelou, G; Sánchez-González, C; De Teresa, C; Porres, J M; López-Jurado, M; Aranda, P; Pietschmann, P

    2016-06-01

    Stanozonol (ST) is a synthetic derivative of testosterone; it has anabolic/androgenic activity, increasing both the turnover of trabecular bone and the endocortical apposition of bone. The present study aimed to examine the effects of ST on bone status in rats by bone mineral content, markers of formation and resorption, bone density, and structural and microarchitectural parameters. Twenty male Wistar rats were randomly distributed into two experimental groups corresponding to placebo or ST administration, which consisted of weekly intramuscular injections of 10 mg/kg body weight of ST. Plasma parameters were analyzed by immunoassay. Bone mineral content was determined by spectrophotometry. Bone mineral density (BMD) and structural parameters were measured by peripheral quantitative computed tomography, and trabecular and cortical microarchitecture by micro-computed tomography. Plasma Ca, Mg, and alkaline phosphatase were higher, and urinary Ca excretion, corticosterone, and testosterone concentrations lower in the ST group. Femur Ca content was higher and P content was lower in the ST, whereas osteocalcin, aminoterminal propeptides of type I procollagen, and C-terminal telopeptides of type I collagen were lower. Total cross-sectional, trabecular, and cortical/subcortical areas were lower in the ST. No differences were observed on BMD and area parameters of the diaphysis as well as on trabecular and cortical microarchitecture. The use of ST increases bone mineralization, ash percentage, and Ca and Mg content in femur. In spite of an absence of changes in BMD, geometric metaphyseal changes were observed. We conclude that ST alters bone geometry, leads to low bone turnover, and thus may impair bone quality. PMID:26801156

  8. Mineral concentration gradients in rat femoral diaphyses measured by X-ray microtomography.

    PubMed

    Wong, F S; Elliott, J C; Anderson, P; Davis, G R

    1995-01-01

    The bone mineral concentrations of five rat femora were measured as a function of distance from the distal metaphysis by quantitative X-ray microtomography (XMT) at a resolution of approximately 23 x 23 x 15 microns3. Assuming the mineral phase of bone to be hydroxyapatite, Ca10 (PO4)6(OH)2, the mean cortical mineral concentration (CM) per transverse section was found to range from 1.33 to 1.47 g cm-3. Detectable variations in the bone mineral concentration between sections of femora from different animals could not be attributed to the age when the particular animal was sacrificed. An increase in CM with distance, L, from the distal growth plate was observed and a saturating exponential equation, CM = a - be-alpha L, was used to describe the changes. Each section of bone tissue was considered as a population of elementary volumes of bone (EVB) and L was related to the age of the EVB (TEVB). A simple model for the mineralization process of an EVB was then proposed. Each newly formed EVB accumulated mineral rapidly to give an initial mineral concentration of approximately 1.3 g cm-3 (parameter a-b). Their mineral concentrations then increased asymptotically to approximately 1.5 g cm-3 (parameter a) with a time constant of approximately 330 days. This slow maturation process is attributed to Ostwald ripening of the bone crystals with further crystal growth using ions from the extracellular fluid. PMID:7796349

  9. Comparison of the Efficiencies of Buffers Containing Ankaferd and Chitosan on Hemostasis in an Experimental Rat Model with Femoral Artery Bleeding

    PubMed Central

    Abacıoğlu, Serkan; Aydın, Kemal; Büyükcam, Fatih; Kaya, Ural; Işık, Bahattin; Karakılıç, Muhammed Evvah

    2016-01-01

    Objective: In the first assessment of trauma patients with major vascular injuries, we need effective and rapid-acting homeostatic materials. In this study we compare the efficiencies of Ankaferd Blood Stopper® and a chitosan linear polymer (Celox®) in an experimental rat model with femoral artery bleeding. Materials and Methods: Thirty male Wistar albino rats weighing 200-250 g were divided into 3 groups: control, Ankaferd, and chitosan. The femoral artery and vein were visualized and bleeding was started by an incision. The bleeding time was recorded and categorized as ‘bleeding stopped at the second minute’, ‘bleeding stopped at the fourth minute’, and ‘unsuccessful’ if bleeding continued after the fourth minute. Results: In the control group, 60% of the bleeding did not stop. In the first 4 min in the Ankaferd group, the bleeding stopped in all rats; only in 1 of the rats in the chitosan group did the bleeding not stop. In stopping the bleeding in the first 4 min, Ankaferd was similar to chitosan but better than the control group; the chitosan group was similar to the control, but the p-value was close to significance. Conclusion: For major arterial bleeding, the main treatment is surgical bleeding control, but outside of the hospital we can use buffers containing Ankaferd and chitosan on the bleeding region. The results of this study should be supported with larger studies. Furthermore, in our study, healthy rats were used. New studies are needed to evaluate the results of hypovolemic and hypotensive cases with major artery bleeding. PMID:25913214

  10. Knee megaprosthesis: a salvage solution for severe open and complex distal femoral fracture associated with an ipsilateral brachial plexus injury (a case report with literature review).

    PubMed

    Ennaciri, Badr; Vasile, Christian; Lebredonchel, Thierry; Berrada, Mohamed Saleh; Montbarbon, Eric; Beaudouin, Emmanuel

    2015-01-01

    Complex distal femoral fractures in the young patient often occur as a result of high velocity trauma. Timely recognition and treatment is everything in such a situation, and it needs a robust staged management pathway to optimize the chance of limb preservation. We report a case of a motorcyclist admitted to the department of orthopedics at Chambery hospital, France, with a complex comminuted and open distal femoral fracture of the left leg, associated with a brachial plexus injury to the ipsilateral upper limb. On arrival to the emergency department, damage control stabilization and surgery was commenced, debridement of contaminated non-viable tissue, abundant antiseptic lavage and application of external fixation coupled with the use of antibiotic spacer. Following normalization of inflammatory markers and ensuring no clinical signs of infection, subsequent management consisted of joint reconstruction to achieve a functional knee. The external fixator and femoral spacer was removed and a modular megaprosthesis was implanted with a lateral gastrocnemius flap to cover the exposed knee joint and reinforce the extensor apparatus. Nerve graft to the left brachial plexus injury was performed at University Hospital of Grenoble. Our patient entered an intensive rehabilitation program and at 1 year follow-up achieved good knee function and sensation to the left upper limb. PMID:26421102

  11. Dietary supplementation of fermented soybean, natto, suppresses intimal thickening and modulates the lysis of mural thrombi after endothelial injury in rat femoral artery.

    PubMed

    Suzuki, Yasuhiro; Kondo, Kazunao; Matsumoto, Yuji; Zhao, Bing-Qing; Otsuguro, Kenichi; Maeda, Tetsuya; Tsukamoto, Yoshinori; Urano, Tetsumei; Umemura, Kazuo

    2003-07-25

    We have previously demonstrated that natto-extracts containing nattokinase (NK) inactivates plasminogen activator inhibitor type 1 and then potentiates fibrinolytic activity. In the present study, we investigated the effects of dietary supplementation with natto-extracts on neointima formation and on thrombolysis at the site of endothelial injury. Endothelial damage in the rat femoral artery was induced by intravenous injection of rose bengal followed by focal irradiation by transluminal green light. Dietary natto-extracts supplementation containing NK of 50 or 100 CU/body was started 3 weeks before endothelial injury and then continued for another 3 weeks. Intimal thickening in animals given supplementation was significantly (P<0.01) suppressed compared with controls and the intima/media ratio in animals with 50 and 100 CU/body NK and control group was 0.09 +/- 0.03, 0.09 +/- 0.06 and 0.16 +/- 0.12, respectively. Although femoral arteries were reopened both in control animals and those treated with NK within 8 hours after endothelial injury, mural thrombi were histologically observed at the site of endothelial injury. In the control group, the center of vessel lumen was reopened and mural thrombi were attached on the surface of vessel walls. In contrast, in NK-treated groups, thrombi near the vessel wall showed lysis and most of them detached from the surface of vessel walls. In conclusion, dietary natto-extracts supplementation suppressed intimal thickening produced by endothelial injury in rat femoral artery. These effects may partially be attributable to NK, which showed enhanced thrombolysis near the vessel wall. PMID:12850244

  12. N-Substituted analogues of S-nitroso-N-acetyl-D,L-penicillamine: chemical stability and prolonged nitric oxide mediated vasodilatation in isolated rat femoral arteries.

    PubMed

    Megson, I L; Morton, S; Greig, I R; Mazzei, F A; Field, R A; Butler, A R; Caron, G; Gasco, A; Fruttero, R; Webb, D J

    1999-02-01

    Previous studies show that linking acetylated glucosamine to S-nitroso-N-acetyl-D,L-penicillamine (SNAP) stabilizes the molecule and causes it to elicit unusually prolonged vasodilator effects in endothelium-denuded, isolated rat femoral arteries. Here we studied the propanoyl (SNPP; 3 carbon side-chain), valeryl (SNVP; 5C) and heptanoyl (SNHP; 7C) N-substituted analogues of SNAP (2C), to further investigate other molecular characteristics that might influence chemical stability and duration of vascular action of S-nitrosothiols. Spectrophotometric analysis revealed that SNVP was the most stable analogue in solution. Decomposition of all four compounds was accelerated by Cu(II) and cysteine, and neocuproine, a specific Cu(I) chelator, slowed decomposition of SNHP. Generation of NO from the compounds was confirmed by electrochemical detection at 37 degrees C. Bolus injections of SNAP (10 microl; 10(-8)-10(-3) M) into the perfusate of precontracted, isolated rat femoral arteries taken from adult male Wistar rats (400-500 g), caused concentration-dependent, transient vasodilatations irrespective of endothelial integrity. Equivalent vasodilatations induced by SNVP and SNHP were transient in endothelium-intact vessels but failed to recover to pre-injection pressures at moderate and high concentrations (10(-6)-10(-3) M) in those denuded of endothelium. This sustained effect (> 1 h) was most prevalent with SNHP and was largely reversed by the NO scavenger, haemoglobin. We suggest that increased lipophilicity of SNAP analogues with longer sidechains facilitates their retention by endothelium-denuded vessels; subsequent slow decomposition within the tissue generates sufficient NO to cause prolonged vasodilatation. This is a potentially useful characteristic for targeting NO delivery to areas of endothelial damage. PMID:10188974

  13. N-substituted analogues of S-nitroso-N-acetyl-D,L-penicillamine: chemical stability and prolonged nitric oxide mediated vasodilatation in isolated rat femoral arteries

    PubMed Central

    Megson, I L; Morton, S; Greig, I R; Mazzei, F A; Field, R A; Butler, A R; Caron, G; Gasco, A; Fruttero, R; Webb, D J

    1999-01-01

    Previous studies show that linking acetylated glucosamine to S-nitroso-N-acetyl-D,L-penicillamine (SNAP) stabilizes the molecule and causes it to elicit unusually prolonged vasodilator effects in endothelium-denuded, isolated rat femoral arteries. Here we studied the propanoyl (SNPP; 3 carbon side-chain), valeryl (SNVP; 5C) and heptanoyl (SNHP; 7C) N-substituted analogues of SNAP (2C), to further investigate other molecular characteristics that might influence chemical stability and duration of vascular action of S-nitrosothiols. Spectrophotometric analysis revealed that SNVP was the most stable analogue in solution. Decomposition of all four compounds was accelerated by Cu(II) and cysteine, and neocuproine, a specific Cu(I) chelator, slowed decomposition of SNHP. Generation of NO from the compounds was confirmed by electrochemical detection at 37°C. Bolus injections of SNAP (10 μl; 10−8–10−3 M) into the perfusate of precontracted, isolated rat femoral arteries taken from adult male Wistar rats (400–500 g), caused concentration-dependent, transient vasodilatations irrespective of endothelial integrity. Equivalent vasodilatations induced by SNVP and SNHP were transient in endothelium-intact vessels but failed to recover to pre-injection pressures at moderate and high concentrations (10−6–10−3 M) in those denuded of endothelium. This sustained effect (>1 h) was most prevalent with SNHP and was largely reversed by the NO scavenger, haemoglobin. We suggest that increased lipophilicity of SNAP analogues with longer sidechains facilitates their retention by endothelium-denuded vessels; subsequent slow decomposition within the tissue generates sufficient NO to cause prolonged vasodilatation. This is a potentially useful characteristic for targeting NO delivery to areas of endothelial damage. PMID:10188974

  14. Pulsed electromagnetic fields protect the balance between adipogenesis and osteogenesis on steroid-induced osteonecrosis of femoral head at the pre-collapse stage in rats.

    PubMed

    Li, Jian-Ping; Chen, Sen; Peng, Hao; Zhou, Jian-Lin; Fang, Hong-Song

    2014-04-01

    This study was designed to investigate the effects of pulsed electromagnetic fields (PEMF) on the balance of adipogenesis and osteogenesis on steroid-induced osteonecrosis of the femoral head (OFH) in rats. Forty-two rats were divided into three groups: Steroid group (S, n = 16); Steroid + PEMF group (S + P, n = 16); and Control group (C, n = 10). For groups S and S + P, all rats were first intravenously given 10 µg/kg lipopolysaccharide on day 1, and then intramuscularly injected with 20 mg/kg methylprednisolone acetate on days 2, 3, and 4, with an interval of 24 h. After 4 weeks, the S + P group was treated with PEMF (4.5-ms square pulse, repeated at 15 Hz, with a peak of 1.2 mT) for 4 h a day for the next 8 weeks. Group S was not exposed to PEMF. Group C was chosen as the control group, without steroid use and exposure to PEMF. After 8 weeks of treatment, the histological changes, and mRNA and protein expressions of PPAR-γ2 and Runx2 were measured and analyzed. Compared with the S group, lower incidence of osteonecrosis (31% vs. 69%, P < 0.05) and empty osteocyte lacuna rate (36.16 ± 15.34 vs. 59.55 ± 21.70, P < 0.01) was observed in the S + P group. Furthermore, PEMF suppressed the expressions of PPAR-γ2 and improved the expressions of Runx2 in the femoral head (P < 0.05). All data suggest that PEMF is an effective physiotherapy in the treatment of steroid-induced ONFH, and the possible underlying mechanisms include protecting the balance between adipogenesis and osteogenesis. PMID:24421074

  15. Broad-range TRP channel inhibitors (2-APB, flufenamic acid, SKF-96365) affect differently contraction of resistance and conduit femoral arteries of rat.

    PubMed

    Bencze, Michal; Behuliak, Michal; Vavřínová, Anna; Zicha, Josef

    2015-10-15

    Transient receptor potential (TRP) channels are proposed to contribute to membrane depolarization and Ca2+ influx into vascular smooth muscle (VSM) cells. Our aim was to study the effects of widely used broad-range TRP channel inhibitors--2-aminoethoxydiphenyl borate (2-APB), flufenamic acid (FFA) and SKF-96365--on the contraction of freshly isolated small and large arteries. Endothelium-denuded resistance (≈250 µm) and conduit (≈1000 µm) femoral arteries were isolated from adult Wistar rats and mounted in wire myograph. The effects of the above mentioned TRP channel inhibitors and voltage-dependent calcium channel inhibitor nifedipine were studied on arterial contractions induced by phenylephrine, U-46619 or K+. Phenylephrine-induced contractions were also studied in the absence of extracellular Na+. mRNA expression of particular canonical and melastatin TRP channel subunits in femoral vascular bed was determined. TRP channel inhibitors attenuated K+-induced contraction less than nifedipine. Phenylephrine-induced contraction was more influenced by 2-APB in resistance arteries, while FFA completely prevented U-46619-induced contraction in both sizes of arteries. The absence of extracellular Na+ prevented the inhibitory effects of 2-APB, but not those of FFA. The observed effects of broad-range TRP channel inhibitors, which were dependent on the size of the artery, confirmed the involvement of TRP channels in agonist-induced contractions. The inhibitory effects of 2-APB (but not those of FFA or SKF-96365) were dependent on the presence of extracellular Na+. PMID:26384458

  16. Protective effect of genistein aglycone on the development of osteonecrosis of the femoral head and secondary osteoporosis induced by methylprednisolone in rats.

    PubMed

    Bitto, Alessandra; Polito, Francesca; Burnett, Bruce; Levy, Robert; Di Stefano, Vincenzo; Armbruster, Mary Ann; Marini, Herbert; Minutoli, Letteria; Altavilla, Domenica; Squadrito, Francesco

    2009-06-01

    Glucocorticoid (GC)-induced osteoporosis (GIO) is the most important secondary cause of bone loss. Clinical evidence suggests a role for genistein (GEN) aglycone in the prevention of osteoporosis. We investigated whether GEN could prevent GIO as well as the development of osteonecrosis in the femoral head using an experimental rat model. A total of 28 female Sprague-Dawley rats were used in the study. GIO and osteonecrosis were induced by daily s.c. injections of 30 mg/kg of methylprednisolone (MP; n=7). Another group of animals (MP+GEN; n=7) concomitantly received MP (30 mg/kg per s.c.) and GEN aglycone (5 mg/kg per i.p.) for 60 days. Control animals were administered daily with vehicle (VEH) or GEN (5 mg/kg per i.p.) only. At the beginning and end of the treatment, animals were examined for bone mineral density (BMD) and bone mineral content (BMC). After killing, serum was collected to determine bone-alkaline phosphatase (b-ALP), carboxy-terminal collagen crosslink (CTX) and osteoprotegerin (OPG) levels. Femurs were removed and tested for breaking strength and bone histology analyzed for structural quality of the femoral neck. GEN aglycone prevented bone loss as measured by BMD and BMC. Moreover, GEN significantly increased the bone formation markers b-ALP and OPG, reduced the bone resorption marker CTX and statistically maintained comparable strength versus the VEH only group. Finally, histological scoring revealed a protective effect of GEN on bone structure statistically comparable with the VEH control animals. Results suggest that the GEN aglycone might be a preventive treatment for GIO and complications of osteonecrosis with long-term GC treatment. PMID:19332450

  17. Femoral nerve damage (image)

    MedlinePlus

    The femoral nerve is located in the leg and supplies the muscles that assist help straighten the leg. It supplies sensation ... leg. One risk of damage to the femoral nerve is pelvic fracture. Symptoms of femoral nerve damage ...

  18. Femoral nerve dysfunction

    MedlinePlus

    Neuropathy - femoral nerve; Femoral neuropathy ... Craig EJ, Clinchot DM. Femoral neuropathy. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation . 3rd ...

  19. Vitamin K2 Ameliorates Damage of Blood Vessels by Glucocorticoid: a Potential Mechanism for Its Protective Effects in Glucocorticoid-induced Osteonecrosis of the Femoral Head in a Rat Model

    PubMed Central

    Zhang, Yuelei; Yin, Junhui; Ding, Hao; Zhang, Changqing; Gao, You-Shui

    2016-01-01

    Glucocorticoid has been reported to decrease blood vessel number and harm the blood supply in the femoral head, which is recognized to be an important mechanism of glucocorticoid-induced osteonecrosis of the femoral head (ONFH). To prevent glucocorticoid-induced ONFH, medication that promotes both bone formation and angiogenesis would be ideal. Vitamin K2 has been revealed to play an important role in bone metabolism; however, few studies have focused on the effect of Vitamin K2 on new vascular formation. Thus, this study aimed to investigate whether Vitamin K2 promoted new blood vessel formation in the presence of glucocorticoids, both in vitro and in vivo. The effect of Vitamin K2 on viability, migration, in vitro tube formation, and VEGF, vWF, CD31, KDR, Flt and PDGFB in EAhy926 incubated with or without dexamethasone were elucidated. VEGF, TGF-β and BMP-2, angiogenesis-related proteins secreted by osteoblasts, were also detected in the osteoblast-like cell line of MG63. In addition, blood vessels of the femoral head in rats administered with or without methylprednisolone and Vitamin K2 were evaluated using angiography and CD31 staining. In vitro studies showed that Vitamin K2 significantly protected endothelial cells from dexamethasone-induced apoptosis, promoted endothelial cell migration and in vitro tube formation. Angiogenesis-related proteins both in EAhy926 and MG63 were also upregulated by Vitamin K2 when cotreated with dexamethasone. In vivo studies showed enhanced blood vessel volume and CD31-positive staining cells in rats cotreated with VK2 and methylprednisolone compared to rats treated with methylprednisolone only. Collectively, Vitamin K2 has the ability to promote angiogenesis in vitro and to ameliorate vessels of the femoral head in glucocorticoid-treated rats in vivo, indicating that Vitamin K2 is a promising drug that may be used to prevent steroid-induced ONFH. PMID:27313492

  20. Prostaglandin E2 Prevents Bone Loss and Adds Extra Bone to Immobilized Distal Femoral Metaphysis in Female Rats

    NASA Technical Reports Server (NTRS)

    Akamine, T.; Jee, W. S. S.; Ke, H. Z.; Li, X. J.; Lin, B. Y.

    1992-01-01

    The object of this study was to determine whether prostaglandin E2 (PGE2) can prevent disuse (underloading)-induced cancellous bone loss. Thirteen-month-old retired female Sprague-Dawley breeders served as controls or were subjected to right hindlimb immobilization by bandaging and simultaneously treated subcutaneously daily with 0, 1, 3, or 6 mg PGE2/kg/d for two and six weeks. Histomorphometric analyses were performed on the cancellous bone using double-fluorescent labeled, 20 micron thick, undecalcified distal femoral metaphysis sections. We found that PGE2 administration not only prevented disuse-induced bone loss, but also added extra bone to disuse cancellous bone in a dose-response manner. PGE2 prevented the disuse-induced osteopenia by stimulating more bone formation than and shortening the period of bone remodeling. It activated woven bone formation, stimulated lamellar bone formation, and increased the eroded bone surface above that caused by disuse alone. While underloading increased the remodeling period (sigma), PGE2 treatment of underloaded bone shortened the time for osteoclastic bone resorption and bone remodeling, and thus reduced the remodeling space. The study shows that PGE2 is a powerful anabolic agent that prevents disuse-induced osteopenia and adds extra bone to these same bones.

  1. Ipsilateral common iliac artery plus femoral artery clamping for inducing sciatic nerve ischemia/reperfusion injury in rats: a reliable and simple method

    PubMed Central

    2008-01-01

    The aim of this study was to develop a practical model of sciatic ischemia reperfusion (I/R) injury producing serious neurologic deficits and being technically feasible compared with the current time consuming or ineffective models. Thirty rats were divided into 6 groups (n = 5). Animal were anesthetized by using ketamine (50 mg/kg) and xylazine (4 mg/kg). Experimental groups included a sham-operated group and five I/R groups with different reperfusion time intervals (0 h, 3 h, 1 d, 4 d, 7 d). In I/R groups, the right common iliac artery and the right femoral artery were clamped for 3 hrs. Sham-operated animals underwent only laparotomy without induction of ischemia. Just before euthanasia, behavioral scores (based on gait, grasp, paw position, and pinch sensitivity) were obtained and then sciatic nerves were removed for light-microscopy studies (for ischemic fiber degeneration (IFD) and edema). Behavioral score deteriorated among the ischemic groups compared with the control group (p < 0.01), with maximal behavioral deficit occurring at 4 days of reperfusion. Axonal swelling and IFD were found to happen only after 4 and 7 days, respectively. Our observations led to an easy-to-use but strong enough method for inducing and studying I/R injury in peripheral nerves. PMID:19102739

  2. 3D printed tricalcium phosphate scaffolds: Effect of SrO and MgO doping on in vivo osteogenesis in a rat distal femoral defect model

    PubMed Central

    Tarafder, Solaiman; Davies, Neal M.; Bandyopadhyay, Amit; Bose, Susmita

    2013-01-01

    The presence of interconnected macro pores is important in tissue engineering scaffolds for guided tissue regeneration. This study reports in vivo biological performance of interconnected macro porous tricalcium phosphate (TCP) scaffolds due to the addition of SrO and MgO as dopants in TCP. We have used direct three dimensional printing (3DP) technology for scaffold fabrication followed by microwave sintering. Mechanical strength was evaluated by scaffolds with 500 µm, 750 µm, and 1000 µm interconnected designed pore sizes. Maximum compressive strength of 12.01 ± 1.56 MPa was achieved for 500 µm interconnected designed pore size Sr-Mg doped scaffold. In vivo biological performance of the microwave sintered pure TCP and Sr-Mg doped TCP scaffolds was assessed by implanting 350 µm designed interconnected macro porous scaffolds in rat distal femoral defect. Sintered pore size of these 3D printed scaffolds were 311 ± 5.9 µm and 245 ± 7.5 µm for pure and SrO-MgO doped TCP scaffolds, respectively. These 3D printed scaffolds possessed multiscale porosity, i.e., 3D interconnected designed macro pores along with intrinsic micro pores. Histomorphology and histomorphometric analysis revealed a significant increase in osteoid like new bone formation, and accelerated mineralization inside SrO and MgO doped 3D printed TCP scaffolds as compared to pure TCP scaffolds. An increase in osteocalcin and type I collagen level was also observed in rat blood serum with SrO and MgO doped TCP scaffolds compared to pure TCP scaffolds. Our results show that these 3D printed SrO and MgO doped TCP scaffolds with multiscale porosity contributed to early healing through accelerated osteogenesis. PMID:24729867

  3. Treatment of neglected femoral neck fracture

    PubMed Central

    Jain, Anil K; Mukunth, R; Srivastava, Amit

    2015-01-01

    Intra-capsular femoral neck fractures are seen commonly in elderly people following a low energy trauma. Femoral neck fracture has a devastating effect on the blood supply of the femoral head, which is directly proportional to the severity of trauma and displacement of the fracture. Various authors have described a wide array of options for treatment of neglected/nonunion (NU) femoral neck fracture. There is lack of consensus in general, regarding the best option. This Instructional course article is an analysis of available treatment options used for neglected femoral neck fracture in the literature and attempt to suggest treatment guides for neglected femoral neck fracture. We conducted the “Pubmed” search with the keywords “NU femoral neck fracture and/or neglected femoral neck fracture, muscle-pedicle bone graft in femoral neck fracture, fibular graft in femoral neck fracture and valgus osteotomy in femoral neck fracture.” A total of 203 print articles were obtained as the search result. Thirty three articles were included in the analysis and were categorized into four subgroups based on treatment options. (a) treated by muscle-pedicle bone grafting (MPBG), (b) closed/open reduction internal fixation and fibular grafting (c) open reduction and internal fixation with valgus osteotomy, (d) miscellaneous procedures. The data was pooled from all groups for mean neglect, the type of study (prospective or retrospective), classification used, procedure performed, mean followup available, outcome, complications, and reoperation if any. The outcome of neglected femoral neck fracture depends on the duration of neglect, as the changes occurring in the fracture area and fracture fragments decides the need and type of biological stimulus required for fracture union. In stage I and stage II (Sandhu's staging) neglected femoral neck fracture osteosynthesis with open reduction and bone grafting with MPBG or Valgus Osteotomy achieves fracture union in almost 90% cases

  4. TREATMENT OF PARALYTIC HIP DISLOCATION AMONG SPASTIC QUADRIPLEGIC CEREBRAL PALSY PATIENTS BY MEANS OF FEMORAL AND PELVIC OSTEOTOMY, WITHOUT OPENING THE JOINT CAPSULE (CAPSULOPLASTY)

    PubMed Central

    Junior, Fernando Farcetta; Abreu, Fabio Peluzo; Neves, Daniella Lins; Kertzman, Paulo Facciola; Zuccon, Alexandre; De Oliveira Bittencourt, Simone; Lopes, Davi Moshe Leopold

    2015-01-01

    Objectives: To show the preoperative planning and results from surgical treatment for paralytic hip dislocation among patients with cerebral palsy. The techniques used were proximal femoral varus derotation osteotomy in association with Dega iliac osteotomy, without opening the joint capsule. Methods: We performed a retrospective review of ten hips in eight patients with spastic quadriplegic cerebral palsy who underwent surgical treatment between 2003 and 2005, with the same surgical technique. The pre and postoperative clinical and radiological parameters, and the preoperative planning using an image intensifier, were assessed. The clinical parameters analyzed were: pain, hygiene-related difficulties and positioning difficulties. The radiological parameters were Reimer's index, the acetabular index and the neck-shaft angle. These results were subjected to statistical analysis. Results: We obtained good results with this technique. After a mean follow-up of three years, all the hips were observed to be stable at the last assessment, and there was a high degree of satisfaction among the families in relation to the treatment. We also showed that preoperative planning using an image intensifier allowed us to reduce and stabilize these hips without the need for capsuloplasty. Conclusion: The authors conclude that in treating hip dislocation among spastic quadriplegic cerebral palsy patients, capsuloplasty is unnecessary for stabilizing the coxofemoral joint. PMID:27022539

  5. Slipped capital femoral epiphysis

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/000972.htm Slipped capital femoral epiphysis To use the sharing features on this page, please enable JavaScript. A slipped capital femoral epiphysis is a separation of the ball ...

  6. Effects of chronic passive smoking on the regeneration of rat femoral defects filled with hydroxyapatite and stimulated by laser therapy.

    PubMed

    Franco, G R; Laraia, I O; Maciel, A A W; Miguel, N M; Dos Santos, G R; Fabrega-Carvalho, C A; Pinto, C A L; Pettian, M S; Cunha, M R

    2013-07-01

    Defects associated with bone mass loss are frequently treated by autogenous bone grafting. However, synthetic biomaterials such as calcium phosphate ceramics can substitute autologous grafts as long as they are biocompatible with bone tissue. In addition, low-level laser therapy (LLLT) is used to enhance bone regeneration by stimulating the local microcirculation and increasing the synthesis of collagen by bone cells. However, bone health is fundamental for osseointegration of the graft and bone repair. In this respect, excessive tobacco consumption can compromise expected outcomes because of its deleterious effects on bone metabolism that predispose to the development of osteoporosis. The objective of this study was to evaluate the regeneration of bone defects implanted with biomaterial and stimulated by LLLT in rats submitted to passive cigarette smoking. Porous hydroxyapatite granules were implanted into critical-size defects induced experimentally in the distal epiphysis of the right femur of 20 female Wistar rats submitted to passive smoking for 8 months in a smoking box. The defect site was irradiated with a gallium-arsenide laser at an intensity of 5.0 J/cm2. The animals were divided into four groups: control (non-smoking) rates submitted (G2) or not (G1) to laser irradiation, and smoking rats submitted (G4) or not (G3) to laser irradiation. The animals were sacrificed 8 weeks after biomaterial implantation. The right femurs were removed for photodocumentation, radiographed, and processed for routine histology. The results showed good radiopacity of the implant site and of the hydroxyapatite granules. Histologically, formation of new trabecular bone was observed adjacent to the hydroxyapatite granules in G1 and G2. In G3 and G4, the granules were surrounded mainly by connective tissue. In conclusion, passive smoking compromised bone neoformation in the defects and the LLLT protocol was not adequate to stimulate local osteogenesis. PMID:23340234

  7. Structural and Material Mechanical Quality of Femoral Shafts in Rats Exposed to Simulated High Altitude from Infancy to Adulthood.

    PubMed

    Bozzini, Clarisa; Picasso, Emilio O; Champin, Graciela M; Alippi, Rosa Maria; Bozzini, Carlos E

    2016-03-01

    The growth of the body and bone mass and the mechanical properties of appendicular bone are impaired in immature rats exposed to different simulated high altitudes (SHA) (1850-5450 m) between the 32nd and the 74th days of postnatal life. Now, we report the effects of exposure to 4100 m on the above cited variables in female rats from infancy (age: 1 month) to adulthood (age: 8 months) to define the occurrence of catch up and to establish whether the effects of altitude are transient or permanent. The ex vivo right femur was mechanically tested in three-point bending. Body weight and length, and structural (loads at yielding and fracture, and stiffness) and architectural (diaphyseal cross-sectional area, cortical area, and cross-sectional moment of inertia) properties were measured at 2, 4, 6, and 8 months of exposure to SHA. The negative influence of hypoxia on all variables was similar at different ages or, in other words, the difference among ages was maintained at any extent of hypoxia. Hypoxia did not affect the elastic modulus, thus suggesting that the mechanical properties of the bone tissue were maintained. Catch up did not occur. The resulting osteopenic bone remained appropriate to its mechanical function during the entire exposure to SHA. PMID:26949914

  8. Prolonged effect of a novel S-nitrosated glyco-amino acid in endothelium-denuded rat femoral arteries: potential as a slow release nitric oxide donor drug

    PubMed Central

    Megson, I L; Greig, I R; Gray, G A; Webb, D J; Butler, A R

    1997-01-01

    The vasodilator properties of a novel S-nitrosated glyco-amino acid (RIG200) were investigated in isolated rat femoral arteries and compared with those of the parent S-nitrosothiol compound, S-nitroso-N-acetylpenicillamine (SNAP). Spectrophotometric analysis revealed that 2.5 mM solutions of RIG200 decomposed more slowly (half-life (t1/2)=216.2±26.7 min) than SNAP (t1/2=37.2±13.8 min) in Krebs buffer at 24°C. Furthermore, the rate of decomposition of SNAP, but not of RIG200, was significantly reduced by the Cu(I) chelator, neocuproine. We concluded that the relative stability of RIG200 is due, at least in part, to its resistance to trace Cu(I)-catalyzed decomposition. Nitric oxide (NO) generation from SNAP and RIG200 was confirmed by use of an NO electrode. Experiments to investigate the vasodilator effects of RIG200 were carried out on isolated femoral arteries taken from adult male Wistar rats (400–550 g). Lengths of artery (7–8 mm long) were cannulated, dissected free and perfused at constant flow rate (0.6 ml min−1) with Krebs buffer. Vessels were precontracted with phenylephrine (10.2±0.3 μM) and developed pressures of 91.8 ± 4 mmHg, detected upstream by a differential pressure transducer. Concentration-dependent vasodilator responses to bolus injections of SNAP or RIG200 (10 μl; 10−8–10−3 M) made into the perfusate of endothelium-intact vessels were transient, recovering the pre-injection pressure in <20 min. Responses to equivalent bolus injections of SNAP in endothelium-denuded vessels were also transient but those in response to concentrations of RIG200 >10−5 M were sustained. Responses to 10−3 M RIG200 were sustained for periods >4 h. Sustained vasodilatation was reversed by the NO scavenger, ferrohaemoglobin (10 μM) but was unaffected by the NO synthase inhibitor, Nω-nitro-L-arginine methyl ester (200 μM), indicating involvement of NO from a source other than NO synthase. We suggest that a

  9. Time course of bone screw fixation following a local delivery of Zoledronate in a rat femoral model - a micro-finite element analysis.

    PubMed

    Kettenberger, Ulrike; Latypova, Adeliya; Terrier, Alexandre; Pioletti, Dominique P

    2015-05-01

    A good fixation of osteosynthesis implants is crucial for a successful bone healing but often difficult to achieve in osteoporotic patients. One possible solution to this issue is the local delivery of bisphosphonates in direct proximity to the implants, A critical aspect of this method, that has not yet been well investigated, is the time course of the implant fixation following the drug release. Usual destructive mechanical tests require large numbers of animals to produce meaningful results. Therefore, a micro-finite element (microFE) approach was chosen to analyze implant fixation. In vivo micro computed tomography (microCT) scans were obtained, first weekly and later bi-weekly, after implantation of polymeric screws in the femoral condyles of ovariectomized rats. In one half of the animals, Zoledronate was released from a hydrogel matrix directly in the peri-implant bone stock, the other animals were implanted only with screws as control. The time course of the implant fixation was investigated with linear elastic microFE models that were created based on in vivo microCT scans. The numerical models were validated against experimental pullout-tests measurements in an additional cadaver study. The microFE analysis revealed a significant increase in force at yield of the Zoledronate treated group compared to the control group. The force of the treated group was 28% higher after 17 days of screw implantation, 42% higher after 31 days. The significant difference persisted until the end of the in vivo study at day 58 (p<0.01). The early onset and prolonged duration of the implant anchorage improvement that was found in this study indicates the great potential of Zoledronate-loaded hydrogel for an enhancement of osteosynthesis implant fixation in impaired bone. PMID:25679481

  10. Laparoscopic repair of an incarcerated femoral hernia

    PubMed Central

    Pillay, Yagan

    2015-01-01

    Introduction A femoral hernia is a rare, acquired condition, which has been reported in less than 5% of all abdominal wall hernias, with a female to male ratio of 4:1. Presentation of case We report a case in a female patient who had a previous open inguinal herniorrhaphy three years previously. She presented with right sided groin pain of one month duration. Ultrasound gave a differential diagnosis of a recurrent inguinal hernia or a femoral hernia. A transabdominal preperitoneal repair was performed and the patient made an uneventful recovery. Discussion Laparoscopic repair of a femoral hernia is still in its infancy and even though the outcomes are superior to an open repair, open surgery remains the standard of care. The decision to perform a laparoscopic trans abdominal preperitoneal (TAPP) repair was facilitated by the patient having previous open hernia surgery. The learning curve for laparoscopic femoral hernia repair is steep and requires great commitment from the surgeon. Once the learning curve has been breached this is a feasible method of surgical repair. This is demonstrated by the fact that this case report is from a rural hospital in Canada. Conclusion Laparoscopic femoral hernia repair involves more time and specialized laparoscopic skills. The advantages are a lower recurrence rate and lower incidence of inguinodynia. PMID:26581083

  11. Slipped capital femoral epiphysis

    MedlinePlus

    A slipped capital femoral epiphysis is a separation of the ball of the hip joint from the thigh bone (femur) at ... A slipped capital femoral epiphysis may affect both hips. An epiphysis is an area at the end of a long bone . ...

  12. BMP-2 delivered via sucrose acetate isobutyrate (SAIB) improves bone repair in a rat open fracture model.

    PubMed

    Cheng, Tegan L; Schindeler, Aaron; Little, David G

    2016-07-01

    Human bone morphogenetic proteins (BMPs) are an alternative to bone graft for the treatment of high-energy open fractures. The standard delivery system for BMP-2 is a porous collagen sponge, but we have previously found that the biocompatible, high viscosity carrier, Sucrose acetate isobutyrate (SAIB) is an effective and potentially less invasive alternative. The efficacy of SAIB as a BMP-2 delivery system was examined in an open fracture model featuring a femoral osteotomy with periosteal stripping in 9-week-old male Sprague Dawley rats. SAIB containing BMP-2 (SAIB/BMP-2) was delivered into the fracture site during surgery and an additional group was further co-treated with zoledronic acid and hydroxyapatite nanoparticles (SAIB/BMP-2/HA/ZA). These were compared to untreated fractures and SAIB carrier alone (negative controls), and BMP-2 loaded collagen sponge (positive control). The rate of radiographic union and the biomechanical properties of the healed fractures were compared after 6-week. Untreated and SAIB-treated fractures showed poor repair, with 53% and 64%, respectively, not bridged at 6 week. In contrast, collagen/BMP-2, SAIB/BMP-2, and SAIB/BMP-2/HA/ZA showed significantly increased union (100%, 100%, and 94%, respectively, p < 0.05). Four-point bend testing revealed that collagen/BMP-2 and SAIB/BMP-2/HA/ZA restored the strength of fractured femora to that of intact femora by 6 week, whereas untreated and SAIB remained less than intact controls by 60% and 67%, respectively (p < 0.05). Overall, the SAIB/BMP-2/HA/ZA formulation was comparable to BMP-2 infused collagen sponge in terms of promoting open fractures repair, but with the additional potential for less invasive delivery. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1168-1176, 2016. PMID:26679381

  13. [Isolated true aneurysm of the deep femoral artery].

    PubMed

    Salomon du Mont, L; Holzer, T; Kazandjian, C; Saucy, F; Corpataux, J M; Rinckenbach, S; Déglise, S

    2016-07-01

    Aneurysms of the deep femoral artery, accounting for 5% of all femoral aneurysms, are uncommon. There is a serious risk of rupture. We report the case of an 83-year-old patient with a painless pulsatile mass in the right groin due to an aneurysm of the deep femoral artery. History taking revealed no cardiovascular risk factors and no other aneurysms at other localizations. The etiology remained unclear because no recent history of local trauma or puncture was found. ACT angiography was performed, revealing a true isolated aneurysm of the deep femoral artery with a diameter of 90mm, beginning 1cm after its origin. There were no signs of rupture or distal emboli. Due to unsuitable anatomy for an endovascular approach, the patient underwent open surgery, with exclusion of the aneurysm and interposition of an 8-mm Dacron graft to preserve deep femoral artery flow. Due to their localization, the diagnosis and the management of aneurysms of the deep femoral artery can be difficult. Options are surgical exclusion or an endovascular approach in the absence of symptoms or as a bridging therapy. If possible, blood flow to the distal deep femoral artery should be maintained, the decision depending also on the patency of the superficial femoral artery. In case of large size, aneurysms of the deep femoral artery should be treated without any delay. PMID:27289256

  14. Social Effects on Rat Spatial Choice in an Open Field Task

    ERIC Educational Resources Information Center

    Keller, Matthew R.; Brown, Michael F.

    2011-01-01

    Pairs of rats foraged in trials either together or separately in an open field apparatus for pellets hidden in discreet locations in a 5 x 5 matrix. Trial duration was either 1 or 4 min. The tendency to choose locations that had earlier been visited by another rat was examined by comparing the choices made in the presence and absence of the other…

  15. Route finding by rats in an open arena.

    PubMed

    Reid, Rebecca A; Reid, Alliston K

    2005-01-31

    Rats were repeatedly exposed to an open arena containing two depletable food sources in a discrete-trials procedure. Their movement patterns were recorded and compared to adaptive foraging tactics such as minimizing distance or energy expenditure, thigmotaxis, and trail following. They were also compared to the predictions of the associative route-finder model of Reid and Staddon [Reid, A.K., Staddon, J.E.R., 1998. A dynamic route finder for the cognitive map. Psychol. Rev. 105 (3), 585-601]. We manipulated the presence/absence of food, goal cups, and a wooden runway to determine the influence of local and distal stimuli (visual, olfactory, and tactile) on movement patterns. Increased experience in the arena produced decreases in travel distance and time to the food sources. Local and distal stimuli influenced movement patterns in ways compatible with visual beacons and trail following. The route-finder model accurately predicted movement patterns except those that were influenced by local and distal stimuli. These results show how certain stimuli influence movement and provide a guide for the incorporation of local and distal stimuli in a future version of the dynamic route-finder model. PMID:15639386

  16. Incidence of Avascular Necrosis of the Femoral Head After Intramedullary Nailing of Femoral Shaft Fractures

    PubMed Central

    Kim, Ji Wan; Oh, Jong-Keon; Byun, Young-Soo; Shon, Oog-Jin; Park, Jai Hyung; Oh, Hyoung Keun; Shon, Hyun Chul; Park, Ki Chul; Kim, Jung Jae; Lim, Seung-Jae

    2016-01-01

    Abstract The goal of this study was to determine the incidence of avascular necrosis of the femoral head (AVNFH) after intramedullary nailing of femoral shaft fractures and to identify risk factors for developing AVNFH. We retrospectively reviewed all patients with femoral shaft fractures treated with antegrade intramedullary nailing at 10 institutions. Among the 703 patients enrolled, 161 patients were excluded leaving 542 patients in the study. Average age was 42.1 years with average follow-up of 26.3 months. Patient characteristics and fracture patterns as well as entry point of femoral nails were identified and the incidence of AVNFH was investigated. Patients were divided into 2 groups according to open versus closed physis, open versus closed fractures, and age (<20 versus ≥20 years). Overall incidence of AVNFH was 0.2% (1 of 542): the patient was 15-year-old boy. Of 25 patients with open physis, the incidence of AVNFH was 4%, whereas none of 517 patients with closed physis developed AVNFH (P < 0.001). The incidence of AVNFH in patients aged < 20 versus ≥20 years was 1.1% (1 of 93) and 0.0% (0 of 449), respectively (P = 0.172), which meant that the incidence of AVNFH was 0% in adult with femur shaft fracture. Of 61 patients with open fractures, the incidence of AVNFH was 0%. The number of cases with entry point at the trochanteric fossa or tip of the greater trochanter (GT) was 324 and 218, respectively, and the incidence of AVNFH was 0.3% and 0.0%, respectively (P = 0.412). In patients aged ≥20 years with isolated femoral shaft fracture, there was no case of AVNFH following antegrade intramedullary nailing regardless of the entry point. Therefore, our findings suggest that the risk of AVNFH following antegrade femoral nailing is extremely low in adult patients. PMID:26844518

  17. Ro15-4513 antagonizes depression of open-field horizontal activity by ethanol in rats.

    PubMed

    June, H L; Johnson, L T; Lewis, M J

    1989-01-01

    The imidazobenzodiazepine, Ro15-4513, has been shown to antagonize some of the behavioral effects of ethanol (ETOH). In rats having relatively little experience in the open field, the actions of ETOH (0.75 g/kg IP), Ro15-4513 (1.25 mg/kg and 2.5 mg/kg, IP), and Ro15-4513 in combination with ETOH were measured on horizontal activity. Rats receiving ETOH showed a significant depression in horizontal activity. Doses of Ro15-4513 given alone produced no significant differences in activity from baseline levels. Rats pretreated with Ro15-4513 prior to receiving ETOH, however, showed a significant attenuation of the ETOH induced depression of activity. These results indicate that Ro15-4513 is effective in attenuating the depressive effects of ETOH in the open field in rats having little experience in the apparatus. PMID:2765204

  18. [Trochanteric femoral fractures].

    PubMed

    Douša, P; Čech, O; Weissinger, M; Džupa, V

    2013-01-01

    At the present time proximal femoral fractures account for 30% of all fractures referred to hospitals for treatment. Our population is ageing, the proportion of patients with post-menopausal or senile osteoporosis is increasing and therefore the number of proximal femoral fractures requiring urgent treatment is growing too. In the age category of 50 years and older, the incidence of these fractures has increased exponentially. Our department serves as a trauma centre for half of Prague and part of the Central Bohemia Region with a population of 1 150 000. Prague in particular has a high number of elderly citizens. Our experience is based on extensive clinical data obtained from the Register of Proximal Femoral Fractures established in 1997. During 14 years, 4280 patients, 3112 women and 1168 men, were admitted to our department for treatment of proximal femoral fractures. All patients were followed up until healing or development of complications. In the group under study, 82% were patients older than 70 years; 72% of those requiring surgery were in their seventies and eighties. Men were significantly younger than women (p<0.001) and represented 30% of the group. The fractures were 2.3-times more frequent in women than in men. In the category under 60 years, men significantly outnumbered women (p<0.001). The patients with pertrochanteric fractures were, on the average, eight years older than the patients with intertrochanteric fractures, which is a significant difference (p<0.001). The mortality rate within a year of injury was about 30%. Trochanteric fractures accounted for 54.7% and femoral neck fractures for 45.3% of all fractures. The inter-annual increase was 5.9%, with more trochanteric than femoral neck fractures. There was a non-significant decrease in intertrochanteric (AO 31-A3) fractures. On the other hand, the number of pertrochanteric (AO 31-A1+2) fractures increased significantly (p<0.001). A total of 1 394 fractures were treated with a proximal

  19. Experimental study on cheng zai wan for treatment of necrosis of the femoral head.

    PubMed

    Chen, Yanping; Huang, Keqin; Lang, Fengping; Huang, Yongxun; Huang, Hui; Huang, Hong; Zhou, Chongguang; Zhang, Wanqiang

    2003-12-01

    Cheng Zai Wan ([symbol: see text]), a Chinese herbal preparation was administrated in the two-leg rat model of aseptic necrosis of the femoral head established by taking prednisone acetate for a long period and the osteoporosis model rat by castration in order to explore the effects of the prescription on necrosis of the femoral head. The results showed that after treatment, the pitting on the surface of the femoral head disappeared, the reticular structure with filling cells was restored; the fat droplets in bone cells or cartilage cells of the femoral head were significantly reduced; sparse capillaries were improved, density and width of the bone trabecula were increased somewhat; bone mineral density, bone weight, bone strength and rigidity were significantly increased; and the low level of estrin was improved. It is suggested that Cheng Zai Wan has definite therapeutic effects on aseptic necrosis of the femoral head. PMID:14719304

  20. Systemic and Local Administration of Antimicrobial and Cell Therapies to Prevent Methicillin-Resistant Staphylococcus epidermidis-Induced Femoral Nonunions in a Rat Model

    PubMed Central

    Drago, Lorenzo; Bottagisio, Marta; Bongio, Matilde; Ferrario, Marzia; Perego, Silvia; Sansoni, Veronica; De Vecchi, Elena; Romanò, Carlo L.

    2016-01-01

    S. epidermidis is responsible for biofilm-related nonunions. This study compares the response to S. epidermidis-infected fractures in rats systemically or locally injected with vancomycin or bone marrow mesenchymal stem cells (BMSCs) in preventing the nonunion establishment. The 50% of rats receiving BMSCs intravenously (s-rBMSCs) died after treatment. A higher cytokine trend was measured in BMSCs locally injected rats (l-rBMSCs) at day 3 and in vancomycin systemically injected rats (l-VANC) at day 7 compared to the other groups. At day 14, the highest cytokine values were measured in l-VANC and in l-rBMSCs for IL-10. µCT showed a good bony bridging in s-VANC and excellent both in l-VANC and in l-rBMSCs. The bacterial growth was lower in s-VANC and l-VANC than in l-rBMSCs. Histology demonstrated the presence of new woven bone in s-VANC and a more mature bony bridging was found in l-VANC. The l-rBMSCs showed a poor bony bridging of fibrovascular tissue. Our results could suggest the synergic use of systemic and local injection of vancomycin as an effective treatment to prevent septic nonunions. This study cannot sustain the systemic injection of BMSCs due to high risks, while a deeper insight into local BMSCs immunomodulatory effects is mandatory before developing cell therapies in clinics. PMID:27478310

  1. Subtrochanteric fractures after retrograde femoral nailing.

    PubMed

    Mounasamy, Varatharaj; Mallu, Sathya; Khanna, Vishesh; Sambandam, Senthil

    2015-10-18

    Secondary fractures around femoral nails placed for the management of hip fractures are well known. We report, two cases of a fracture of the femur at the interlocking screw site in the subtrochanteric area after retrograde femoral nailing of a femoral shaft fracture. Only a few reports in the existing literature have described these fractures. Two young men after sustaining a fall presented to us with pain, swelling and deformity in the upper thigh region. On enquiring, examining and radiographing them, peri-implant fractures of subtrochanteric nature through the distal interlocking screws were revealed in both patients who also had histories of previous falls for which retrograde intramedullary nailing was performed for their respective femora. Both patients were managed with similar surgical routines including removal of the existing hardware, open reduction and ace cephallomedullary antegrade nailing. The second case did show evidence of delayed healing and was additionally stabilized with cerclage wires. Both patients had uneventful postoperative outcomes and union was evident at the end of 6 mo postoperatively with a good range of motion at the hip and knee. Our report suggests that though seldom reported, peri-implant fractures around the subtrochanteric region can occur and pose a challenge to the treating orthopaedic surgeon. We suggest these be managed, after initial stabilization and resuscitation, by implant removal, open reduction and interlocking intramedullary antegrade nailing. Good results and progression to union can be expected in these patients by adhering to basic principles of osteosynthesis. PMID:26495251

  2. Adrenocortical response to open-field test in rats with anterodorsal thalami nuclei lesion.

    PubMed

    Suárez, M; Perassi, N; Dal Zotto, S

    1996-01-01

    The influence of limbic anterodorsal thalami nuclei (ADTN) on adrenocortical activity and on emotional reactivity were investigated in male and female rats. The emotional reactivity was evaluated by means of the open-field test and the corticoadrenal function by means of plasma and adrenal corticosterone concentration. The results demonstrate that ADTN lesion does not affect the behavioural patterns in the open-field test on the 29th and 30th day after lesion nor adrenal response when animals are exposed to a novel situation. PMID:8724884

  3. Spatial cognition: robot target localization in open arenas based on rat studies

    NASA Astrophysics Data System (ADS)

    Tejera, Gonzalo; Barrera, Alejandra; Fellous, Jean-Marc; Llofriu, Martin; Weitzenfeld, Alfredo

    2013-05-01

    We describe our latest work in understanding spatial localization in open arenas based on rat studies and corresponding modeling with simulated and physical robots. The studies and experiments focus on goal-oriented navigation where both rats and robots exploit distal cues to localize and find a goal in an open environment. The task involves training of both rats and robots to find the shortest path to the goal from multiple starting points in the environment. The spatial cognition model is based on the rat's brain neurophysiology of the hippocampus extending previous work by analyzing granularity of localization in relation to a varying number and position of landmarks. The robot integrates internal and external information to create a topological map of the environment and to generate shortest routes to the goal through path integration. One of the critical challenges for the robot is to analyze the similarity of positions and distinguish among different locations using visual cues and previous paths followed to reach the current position. We describe the robotics architecture used to develop, simulate and experiment with physical robots.

  4. Transcranial MRI-guided FUS-induced BBB opening in the rat brain

    NASA Astrophysics Data System (ADS)

    Treat, Lisa H.; McDannold, Nathan J.; Hynynen, Kullervo

    2001-05-01

    The blood-brain barrier (BBB) has been a major limitation in treating diseases of the brain because therapeutic agents are either unable to penetrate or have dose-limiting side effects in diffuse opening of the BBB. A previous study demonstrated that focused ultrasound (FUS) can locally open the BBB in a rabbit model when a piece of skull is removed and that magnetic resonance imaging (MRI) can be used to guide and monitor the procedure. This study examined whether the same desired effect of local BBB disruption can be achieved by applying FUS through an intact skull in a rat model. Twenty-eight Sprague-Dawley rats were anesthetized, shaved, and sonicated at four focal locations in the brain, using a 1.5-MHz focused transducer. Contrast-enhanced MR images were obtained before and after sonication. The images indicated contrast agent penetration at the focal coordinates following Optison-enhanced sonication. This study demonstrated that the distortion of the ultrasound beam by the rat skull was not significant enough to inhibit focal BBB opening. Subsequent experiments using MRI-guided FUS to aid in targeted drug delivery to brain tumors in a rodent model could thus be performed more efficiently without cranial surgery. [Research funded by NIH Grant No. CA76550.

  5. Femoral approach to lead extraction.

    PubMed

    Mulpuru, Siva K; Hayes, David L; Osborn, Michael J; Asirvatham, Samuel J

    2015-03-01

    Laser and radiofrequency energy-assisted lead extraction has greatly facilitated this complex procedure. Although success rates are high, in some instances alternate methods of extraction are required. In this review, we discuss techniques for femoral extraction of implanted leads and retained fragments. The major tools available, including commonly used snares and delivery tools, are discussed. We briefly describe combined internal jugular and femoral venous extraction approaches, as well as complimentary utilization of more than one technique via the femoral vein. Animated and procedural sequences are included to help the reader visualize the key components of these techniques. PMID:25311643

  6. [Pathogenesis of atypical femoral fracture].

    PubMed

    Iwata, Ken; Mashiba, Tasuku

    2016-01-01

    We demonstrated microdamage accumulation in the fracture sites in the patients of subtrochanteric atypical femoral fracture with long term bisphosphonate therapy and of incomplete shaft fracture of lateral femoral bowing without bisphosphonate therapy. Based on these findings, pathogenesis of atypical femoral fracture is revealed stress fracture caused by accumulation of microdamages between distal to the lesser trochanter and proximal to the supracondylar flare in the femur in association with severely suppressed bone turnover and/or abnormal lower limb alignment, that causes stress concentration on the lateral side cortex of the femur. PMID:26728533

  7. Efficacy of different irrigation solutions on the early debridement of open fracture in rats

    PubMed Central

    CHENG, QIAN; ZHANG, XIAO-FEI; DI, DONG-HUA; ZHAO, GUO-YANG; CUI, XUE-WEN

    2015-01-01

    Contaminating bacteria are only found on wound surfaces in the initial stages of open fractures; therefore, effective debridement is critical for bacterial infection prevention and the reduction of inflammatory reactions. Various irrigation solutions are currently being used; however, a comprehensive study on their efficacy is lacking. In the present study, a comparison of the effects of normal saline, iodophor and hydrogen peroxide as the irrigation solutions for debridement of open femur fractures in rat models was conducted. It was revealed that all three solutions were comparably effective in bacterial removal while normal saline was superior in minimizing adverse wound inflammation; therefore, the use of normal saline for routine debridement is recommended in the early-stage treatment of open fractures in the trauma clinic and in relief fieldwork. PMID:26136863

  8. Emergency Stenting of a Ruptured Infected Anastomotic Femoral Pseudoaneurysm

    SciTech Connect

    Klonaris, Chris Katsargyris, Athanasios; Matthaiou, Alexandros; Giannopoulos, Athanasios; Tsigris, Chris; Papadopouli, Katerina; Tsiodras, Sotiris; Bastounis, Elias

    2007-11-15

    A 74-year-old man presented with a ruptured infected anastomotic femoral pseudoaneurysm. Due to severe medical comorbidities he was considered unsuitable for conventional surgical management and underwent an emergency endovascular repair with a balloon-expandable covered stent. The pseudoaneurysm was excluded successfully and the patient had an uneventful postoperative recovery with long-term suppressive antimicrobials. He remained well for 10 months after the procedure with no signs of recurrent local or systemic infection and finally died from an acute myocardial infarction. To our knowledge, emergency endovascular treatment of a free ruptured bleeding femoral artery pseudoaneurysm has not been documented before in the English literature. This case illustrates that endovascular therapy may be a safe and efficient alternative in the emergent management of ruptured infected anastomotic femoral artery pseudoaneurysms when traditional open surgery is contraindicated.

  9. Unilateral Opening of Rat Blood-Brain Barrier Assisted by Diagnostic Ultrasound Targeted Microbubbles Destruction.

    PubMed

    Xu, Yali; Cui, Hai; Zhu, Qiong; Hua, Xing; Xia, Hongmei; Tan, Kaibin; Gao, Yunhua; Zhao, Jing; Liu, Zheng

    2016-01-01

    Objective. Blood-brain barrier (BBB) is a key obstacle that prevents the medication from blood to the brain. Microbubble-enhanced cavitation by focused ultrasound can open the BBB and proves to be valuable in the brain drug delivery. The study aimed to explore the feasibility, efficacy, and safety of unilateral opening of BBB using diagnostic ultrasound targeted microbubbles destruction in rats. Methods. A transtemporal bone irradiation of diagnostic ultrasound and intravenous injection of lipid-coated microbubbles were performed at unilateral hemisphere. Pathological changes were monitored. Evans Blue extravasation grades, extraction from brain tissue, and fluorescence optical density were quantified. Lanthanum nitrate was traced by transmission electron microscopy. Results. After diagnostic ultrasound mediated microbubbles destruction, Evans Blue extravasation and fluorescence integrated optical density were significantly higher in the irradiated hemisphere than the contralateral side (all p < 0.01). Erythrocytes extravasations were demonstrated in the ultrasound-exposed hemisphere (4 ± 1, grade 2) while being invisible in the control side. Lanthanum nitrate tracers leaked through interendothelial cleft and spread to the nerve fiber existed in the irradiation side. Conclusions. Transtemporal bone irradiation under DUS mediated microbubble destruction provides us with a more accessible, safer, and higher selective BBB opening approach in rats, which is advantageous in brain targeted drugs delivery. PMID:27579317

  10. Unilateral Opening of Rat Blood-Brain Barrier Assisted by Diagnostic Ultrasound Targeted Microbubbles Destruction

    PubMed Central

    Cui, Hai; Zhu, Qiong; Hua, Xing; Xia, Hongmei; Tan, Kaibin; Gao, Yunhua; Zhao, Jing

    2016-01-01

    Objective. Blood-brain barrier (BBB) is a key obstacle that prevents the medication from blood to the brain. Microbubble-enhanced cavitation by focused ultrasound can open the BBB and proves to be valuable in the brain drug delivery. The study aimed to explore the feasibility, efficacy, and safety of unilateral opening of BBB using diagnostic ultrasound targeted microbubbles destruction in rats. Methods. A transtemporal bone irradiation of diagnostic ultrasound and intravenous injection of lipid-coated microbubbles were performed at unilateral hemisphere. Pathological changes were monitored. Evans Blue extravasation grades, extraction from brain tissue, and fluorescence optical density were quantified. Lanthanum nitrate was traced by transmission electron microscopy. Results. After diagnostic ultrasound mediated microbubbles destruction, Evans Blue extravasation and fluorescence integrated optical density were significantly higher in the irradiated hemisphere than the contralateral side (all p < 0.01). Erythrocytes extravasations were demonstrated in the ultrasound-exposed hemisphere (4 ± 1, grade 2) while being invisible in the control side. Lanthanum nitrate tracers leaked through interendothelial cleft and spread to the nerve fiber existed in the irradiation side. Conclusions. Transtemporal bone irradiation under DUS mediated microbubble destruction provides us with a more accessible, safer, and higher selective BBB opening approach in rats, which is advantageous in brain targeted drugs delivery. PMID:27579317

  11. The Development of the Head Direction System before Eye Opening in the Rat

    PubMed Central

    Tan, Hui Min; Bassett, Joshua Pope; O’Keefe, John; Cacucci, Francesca; Wills, Thomas Joseph

    2015-01-01

    Summary Head direction (HD) cells are neurons found in the hippocampal formation and connected areas that fire as a function of an animal’s directional orientation relative to its environment [1, 2]. They integrate self-motion and environmental sensory information to update directional heading [3]. Visual landmarks, in particular, exert strong control over the preferred direction of HD cell firing [4]. The HD signal has previously been shown to appear adult-like as early as postnatal day 16 (P16) in the rat pup, just after eye opening and coinciding with the first spontaneous exploration of its environment [5, 6]. In order to determine whether the HD circuit can begin its organization prior to the onset of patterned vision, we recorded from the anterodorsal thalamic nucleus (ADN) and its postsynaptic target in the hippocampal formation, the dorsal pre-subiculum (PrSd), before and after eye opening in pre-weanling rats. We find that HD cells can be recorded at the earliest age sampled (P12), several days before eye opening. However, this early HD signal displays low directional information content and lacks stability both within and across trials. Following eye opening, the HD system matures rapidly, as more cells exhibit directional firing, and the quality and reliability of the directional signal improves dramatically. Cue-rotation experiments show that a prominent visual landmark is able to control HD responses within 24 hr of eye opening. Together, the results suggest that the directional network can be organized independently of visual spatial information while demonstrating the importance of patterned vision for accurate and reliable orientation in space. PMID:25660541

  12. The development of the head direction system before eye opening in the rat.

    PubMed

    Tan, Hui Min; Bassett, Joshua Pope; O'Keefe, John; Cacucci, Francesca; Wills, Thomas Joseph

    2015-02-16

    Head direction (HD) cells are neurons found in the hippocampal formation and connected areas that fire as a function of an animal's directional orientation relative to its environment. They integrate self-motion and environmental sensory information to update directional heading. Visual landmarks, in particular, exert strong control over the preferred direction of HD cell firing. The HD signal has previously been shown to appear adult-like as early as postnatal day 16 (P16) in the rat pup, just after eye opening and coinciding with the first spontaneous exploration of its environment. In order to determine whether the HD circuit can begin its organization prior to the onset of patterned vision, we recorded from the anterodorsal thalamic nucleus (ADN) and its postsynaptic target in the hippocampal formation, the dorsal pre-subiculum (PrSd), before and after eye opening in pre-weanling rats. We find that HD cells can be recorded at the earliest age sampled (P12), several days before eye opening. However, this early HD signal displays low directional information content and lacks stability both within and across trials. Following eye opening, the HD system matures rapidly, as more cells exhibit directional firing, and the quality and reliability of the directional signal improves dramatically. Cue-rotation experiments show that a prominent visual landmark is able to control HD responses within 24 hr of eye opening. Together, the results suggest that the directional network can be organized independently of visual spatial information while demonstrating the importance of patterned vision for accurate and reliable orientation in space. PMID:25660541

  13. Bone scintigraphy in slipped capital femoral epiphysis

    SciTech Connect

    Gelfand, M.J.; Strife, J.L.; Graham, E.J.; Crawford, A.H.

    1983-12-01

    Tc-/sub 99m/ diphosphonate bone scans were performed on 11 children with slipped capital femoral epiphysis. On pinhole hip images, seven hips in seven patients had increased radionuclide uptake in the physis and adjacent proximal femoral metaphysis where the slip had occurred. Three hips in three patients had decreased radionuclide uptake in the femoral head on the side of the slipped epiphysis, indicating compromise of the femoral head blood supply. Three or more months following internal fixation, three children had scintigraphy that showed loss of the usual focal uptake in the physis and adjacent proximal femoral metaphysis. Bone scintigraphy in pediatric patients with slipped capital femoral epiphysis is valuable in defining the metabolic status of the femoral head. Absence of radiopharmaceutical uptake in the affected femoral head indicates that the femoral head is at risk for development of radiographic changes associated with aseptic necrosis.

  14. [Comparative Analysis of Behavior in The Open-field Test in Wild Grey Rats (Rattus norvegicus) and in Grey Rats Subjected to Prolonged Selection for Tame And Aggressive Behavior].

    PubMed

    Kozhemyakina, R V; Konoshenko, M Yu; Sakharov, D G; Smagin, D A; Markel, A L

    2016-01-01

    The aim of this work is analysis of the open-field behavior in grey rats selected for the tame and aggressive behavior in comparison with the wild grey rats. Significant influences of the rat group factor on the 13 of 19 behavioral features studied in the open-field were found. This effect, in general, depends on existence of great differences between behaviors of the wild rats from the one hand and behaviors of the tame and aggressive rats from the other. The behaviors of the rats from the last two groups are practically identical. Multidimensional analysis confirms the distinct separation in coordinates of the two main components of the wild rat behavior from the behavior of both the tame and selectively bred aggressive rats. The first main component dimension corresponds to the grade of fear, which was significantly enhanced in the wild rats. So, in spite of the equality of behavioral aggressiveness of the wild rats and the rats selected for aggression with the glove test, the behavior of selected aggressive rats in the open-field is analogous to behavior of the rats selected for tameness. Comparison of behavioral features with the hormonal stress responsiveness allowed us to conclude that the aggressive behavior of the wild and se lected for aggression rats based on different motivational and neuroendocrine processes. PMID:27263279

  15. Arthroscopically confirmed femoral button deployment.

    PubMed

    Sonnery-Cottet, Bertrand; Rezende, Fernando C; Martins Neto, Ayrton; Fayard, Jean M; Thaunat, Mathieu; Kader, Deiary F

    2014-06-01

    The anterior cruciate ligament TightRope RT (Arthrex, Naples, FL) is a graft suspension device for cruciate ligament reconstruction. It is an adjustable-length graft loop cortical fixation device designed to eliminate the requirement for loop length calculation and to facilitate complete graft fill of short femoral sockets that are common with anatomic anterior cruciate ligament placement. The adjustable loop length means "one size fits all," thus removing the need for multiple implant sizes and allowing graft tensioning even after fixation. However, the device has been associated with the same complications that have been described with EndoButton (Smith & Nephew Endoscopy, Andover, MA) fixation. The button of the TightRope RT may remain in the femoral tunnel rather than flipping outside of the tunnel to rest on the lateral femoral cortex, or it may become jammed inside the femoral canal. Conversely, the button may be pulled too far off the femoral cortex into the overlying soft tissue and flip in the substance of the vastus lateralis. We describe a new and simple arthroscopic technique to directly visualize the deployment and seating of the TightRope button on the lateral cortex of the femur to avoid all the aforementioned complications. PMID:25126492

  16. The effects of gonadectomy and binge-like ethanol exposure during adolescence on open field behaviour in adult male rats.

    PubMed

    Yan, Wensheng; Kang, Jie; Zhang, Guoliang; Li, Shuangcheng; Kang, Yunxiao; Wang, Lei; Shi, Geming

    2015-09-14

    Binge drinking ethanol exposure during adolescence can lead to long-term neurobehavioural damage. It is not known whether the pubertal surge in testosterone that occurs during adolescence might impact the neurobehavioural effects of early ethanol exposure in adult animals. We examined this hypothesis by performing sham or gonadectomy surgeries on Sprague-Dawley rats around postnatal day (P) 23. From P28-65,the rats were administered 3.0g/kg ethanol using a binge-like model of exposure. Dependent measurements included tests of open field behaviour, blood ethanol concentrations, and testosterone levels. As adults, significant decreases in open field activity were observed in the GX rats. The open field behaviour of the GX rats was restored after testosterone administration. Binge-like ethanol exposure altered most of the parameters of the open field behaviour, suggestive of alcohol-induced anxiety, but rats treated with alcohol in combination with gonadectomy showed less motor behaviour and grooming behaviour and an increase in immobility, suggesting ethanol-induced depression. These results indicated that testosterone is required for ethanol-induced behavioural changes and that testicular hormones are potent stimulators of ethanol-induced behaviours. PMID:26238258

  17. Femoral head cartilage disarticulation disorder

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Femoral head cartilage disarticulation disorder and necrosis is a major skeletal problem in broiler breeders since they are maintained for a long time in the farm. The etiology of this disease is not well understood. A field study was conducted to understand the basis of this metabolic disease. Six ...

  18. Tibial hemimelia and femoral bifurcation.

    PubMed

    Ugras, Ali Akin; Sungur, Ibrahim; Akyildiz, Mustafa Fehmi; Ercin, Ersin

    2010-02-01

    Femoral bifurcation and tibial agenesis are rare anomalies and have been described in both the Gollop-Wolfgang complex and tibial agenesis-ectrodactyly syndrome. This article presents a case of Gollop-Wolfgang complex without hand ectrodactyly. Tibial agenesis-ectrodactyly syndrome and Gollop-Wolfgang complex are variants of tibial field defect, which includes distal femoral duplication, tibial aplasia, oligo-ectrodactylous toe defects, and preaxial polydactyly, occasionally associated with hand ectrodactyly.This article describes the case of a patient with bilateral tibial hemimelia and left femoral bifurcation. The proximal tibial anlage had not been identified in the patient's left leg. After failed fibular transfer procedure, the knee was disarticulated. The other leg was treated with tibiofibular synostosis and centralization of fibula to os calcis. At 7-year follow-up, the patient ambulates with an above-knee prosthesis and uses an orthopedic boot for ankle stability.In patients with a congenital absence of the tibia, accurate diagnosis is of the utmost importance in planning future treatment. In the absence of proximal tibial anlage, especially in patients with femoral bifurcation, the knee should be disarticulated. Tibiofibular synostosis is a good choice in the presence of a proximal tibial anlage and good quadriceps function. PMID:20192156

  19. Relative plasma levels of the cardioprotective drug dexrazoxane and its two active ring-opened metabolites in the rat.

    PubMed

    Hasinoff, B B; Aoyama, R G

    1999-02-01

    A postcolumn derivatization reversed-phase high-pressure liquid chromatography method has been developed to detect and separate the one-ring open intermediates of dexrazoxane (ICRF-187) in blood plasma. Dexrazoxane is clinically used as a doxorubicin cardioprotective agent and may act by preventing iron-based oxygen-free radical damage through the iron-chelating ability of its one-ring open intermediates and its fully rings opened hydrolysis product ADR-925. Little is known of the in vivo metabolism of dexrazoxane to its one-ring open intermediates, which may be two of the active forms of dexrazoxane. The one-ring open intermediates were detected within 5 min of i.v. administration of dexrazoxane to rats, suggesting that dexrazoxane is rapidly metabolized in vivo. The plasma concentrations of the one-ring open intermediates varied from 4 to 9% and 6 to 24% of the dexrazoxane concentrations at 5 and 120 min, respectively. The relatively small changes in the levels of the one-ring open intermediates with time suggest that a dynamic steady state is occurring. The ratio of the concentrations of the two one-ring open intermediates was similar to that previously seen for the in vitro dihydropyrimidine amidohydrolase-catalyzed hydrolysis of dexrazoxane. These results are consistent with the hypothesis that dihydropyrimidine amidohydrolase in the liver and kidney is responsible for the metabolism of dexrazoxane in the rat. PMID:9929514

  20. Distal Femoral Oblique Fracture in a Young Male Soldier

    PubMed Central

    Cohen, David Naji; Al Khateeb, Hesham; Safwat, Mohammed

    2016-01-01

    Abstract Here, we report a case of a distal femoral fracture in a 23-year-old male army cadet who presented to the Accident and Emergency department following a twisting injury while participating in a routine military marching exercise. A pathological fracture was considered but this suspicion was put to rest following thorough investigations, leaving only a diagnosis of a nontraumatic spontaneous femoral fracture. To our knowledge, there have been no reported cases of distal femoral fractures associated with nontraumatic military exercises, with the majority of injuries instead related to stress fractures. A vigilant literature search yielded no cases of similar injury nature, which is the primary reason we believe that those interested in orthopaedics or military doctors would find themselves drawn to this case. The patient presented with severe pain in his left thigh and on examination there was a deformity of his left thigh. In terms of investigations, a bone profile, plain film radiographs, C-reactive protein, erythrocyte sedimentation rate, and tumor markers were all preformed and proved unremarkable. The definitive treatment was by open reduction and internal fixation. Femoral fractures often require significant amounts of force, particularly in young, healthy individuals. Generally, these injuries in this demographic follow high-energy traumas, with the lion's share occurring following a road traffic accident or other high-speed impact. More often than not, the treatment is surgical. Given the extraordinary manner of this such, one must be attentive and exhaustive in their investigation of such presentations. PMID:27258509

  1. Complete Traumatic Separation of Proximal Femoral Epiphysis in A 2 Year Old Child

    PubMed Central

    Pal, Chandra Prakash; Kumar, Deepak; Singh, Pulkesh; Gaurav, Vishal

    2014-01-01

    Introduction: Hip fractures are very common in adults, but are rare in children, comprising less than 1% of all pediatric fractures. Separation of the proximal femoral epiphysis can occur in a child with a traumatic hip dislocation and an open epiphysis. Regardless of the mechanism of proximal femoral epiphyseal separation, the prognosis is poor secondary to the development of osteonecrosis. Case Report: Here we are reporting a case of complete separation of the proximal epiphysis of the femur in a 2 year old female child. She was treated by open reduction and internal fixation by a single k-wire of proximal femoral epiphysis. Regular follow up showed fusion of proximal femoral epiphysis at about 3 months of post operative period. After 8 months of follow up she can stand and walk without support. Long term outcome is awaited. Conclusion: Traumatic separation of the proximal femoral epiphysis is a rare but devastating injury because osteonecrosis occurs in most cases. In our study we found fusion of the proximal femoral epiphysis to the neck after 3 months of postoperative period. But to comment upon the final outcome a long follow up is awaited.

  2. Photoacoustic micro-imaging of focused ultrasound induced blood-brain-barrier opening in a rat model

    NASA Astrophysics Data System (ADS)

    Wang, Po-Hsun; Hsu, Po-Hung; Liu, Hao-Li; Wang, Churng-Ren Chris; Li, Meng-Lin

    2010-02-01

    Blood brain barrier (BBB) prevents most of the drug from transmitting into the brain tissue and decreases the treatment performance for brain disease. One of the methods to overcome the difficulty of drug delivery is to locally increase the permeability of BBB with high-intensity focused ultrasound. In this study, we have investigated the feasibility of photoacoustic microscopy of focused-ultrasound induced BBB opening in a rat model in vivo with gold nanorods (AuNRs) as a contrast agent. This study takes advantage of the strong near-infrared absorption of AuNRs and their extravasation tendency from BBB opening foci due to their nano-scale size. Before the experiments, craniotomy was performed on rats to provide a path for focused ultrasound beam. Localized BBB opening at the depth of about 3 mm from left cortex of rat brains was achieved by delivering 1.5 MHz focused ultrasound energy into brain tissue in the presence of microbubbles. PEGylated AuNRs with a peak optical absorption at ~800 nm were then intravenously administered. Pre-scan prior to BBB disruption and AuNR injection was taken to mark the signal background. After injection, the distribution of AuNRs in rat brains was monitored up to 2 hours. Experimental results show that imaging AuNRs reveals BBB disruption area in left brains while there are no changes observed in the right brains. From our results, photoacoustic imaging plus AuNRs shows the promise as a novel monitoring strategy in identifying the location and variation of focused-ultrasound BBB-opening in a rat model.

  3. Arthroplasty in Femoral Head Osteonecrosis

    PubMed Central

    Nam, Dong Cheol; Jung, Kwangyoung

    2014-01-01

    Osteonecrosis of the femoral head is a destructive joint disease requiring early hip arthroplasty. The polyethylene-metal design using a 22-mm femoral head component, introduced by Charnley in 1950, has been widely used for over half a century. Since then, different materials with the capacity to minimize friction between bearing surfaces and various cement or cementless insert fixations have been developed. Although the outcome of second and third generation designs using better bearing materials and technologies has been favorable, less favorable results are seen with total hip arthroplasty in young patients with osteonecrosis. Selection of appropriate materials for hip arthroplasty is important for any potential revisions that might become inevitable due to the limited durability of a prosthetic hip joint. Alternative hip arthroplasties, which include hemiresurfacing arthroplasty and bipolar hemiarthroplasty, have not been found to have acceptable outcomes. Metal-on-metal resurfacing has recently been suggested as a feasible option for young patients with extra physical demands; however, concerns about complications such as hypersensitivity reaction or pseudotumor formation on metal bearings have emerged. To ensure successful long-term outcomes in hip arthroplasty, factors such as insert stabilization and surfaces with less friction are essential. Understanding these aspects in arthroplasty is important to selection of proper materials and to making appropriate decisions for patients with osteonecrosis of the femoral head. PMID:27536561

  4. Conservative femoral stem revision: avoiding therapeutic escalation.

    PubMed

    Pinaroli, Alban; Lavoie, Frédéric; Cartillier, Jean-Claude; Neyret, Philippe; Selmi, Tarik Ait Si

    2009-04-01

    A conservative approach to femoral revision is assessed. We report on 41 femoral revisions using an extensively coated hydroxyapatite primary femoral stem. Clinical, operative, and radiological data were gathered. Harris hip scores increased from 65/100 to 90/100 at the minimal follow-up of 1 year (P < .05). All stems showed signs of osseous integration. No significant migration was measured. No patient had to be reoperated because of problems related to the stem. Good results are reported for femoral revision with Paprosky type I and II bone defects with no significant difference between the 2 subgroups, hereby proving that conservative femoral revision is a reasonable treatment alternative. Reproducible results with such a technique may bring surgeons to be more aggressive when noticing early signs of femoral loosening. PMID:18534426

  5. Bone sialoprotein-coated femoral implants are osteoinductive but mechanically compromised.

    PubMed

    O'Toole, Gary C; Salih, E; Gallagher, C; FitzPatrick, D; O'Higgins, N; O'Rourke, S K

    2004-05-01

    Aseptic loosening of femoral implants in total hip replacement remains an unsolved orthopaedic problem. This paper investigates the potential role of bone sialoprotein (BSP) in enhancing bone-implant adherence. As BSP is osteoinductive in rat calvarial models, we investigated whether BSP is similarly osteoinductive when coated onto intramedullary femoral implants. BSP-coated titanium implants were implanted into the femur of female 'Wistar' rats (average weight 215 g) that were sacrificed at days 10, 20 and 30. Harvested femoral implants were subjected to pullout testing and then examined histologically. BSP-coated implants demonstrate osteoinduction when examined histologically. Plugging the femoral canal with BSP prior to inserting the implant neither increased implant pullout strengths nor further increased osteoblastic activity. This study has demonstrated for the first time that BSP is osteoinductive when coated onto femoral implants and inserted into bones subjected to mechanical loading. However, we found that pullout strengths are a function of implant surface topographical characteristics and are not affected by BSP coating or histological osteoinduction. PMID:15099646

  6. Management of distal femoral periprosthetic fractures by distal femoral locking plate: A retrospective study.

    PubMed Central

    Thukral, Rajiv; Marya, SKS; Singh, Chandeep

    2015-01-01

    Background: Management of periprosthetic supracondylar femoral fractures is difficult. Osteoporosis, comminution and bone loss, compromise stability with delayed mobility and poor functional outcomes. Open reduction and internal fixation (ORIF) with anatomic distal femoral (DF) locking plate permits early mobilization. However, this usually necessitates bone grafting (BG). Biological fixation using minimally invasive techniques minimizes periosteal stripping and morbidity. Materials and Methods: 31 patients with comminuted periprosthetic DF fractures were reviewed retrospectively from October 2006 to September 2012. All patients underwent fixation using a DF locking compression plate (Synthes). 17 patients underwent ORIF with primary BG, whereas 14 were treated by closed reduction (CR) and internal fixation using biological minimally invasive techniques. Clinical and radiological followup were recorded for an average 36 months. Results: Mean time to union for the entire group was 5.6 months (range 3-9 months). Patients of ORIF group took longer (Mean 6.4 months, range 4.5-9 months) than the CR group (mean 4.6 months, range 3-7 months). Three patients of ORIF and one in CR group had poor results. Mean knee society scores were higher for CR group at 6 months, but nearly identical at 12 months, with similar eventual range of motion. Discussion: Locked plating of comminuted periprosthetic DF fractures permits stable rigid fixation and early mobilization. Fixation using minimally invasive biological techniques minimizes morbidity and may obviate the need for primary BG. PMID:26015610

  7. Successful Return to Sport Following Distal Femoral Varus Osteotomy

    PubMed Central

    Voleti, Pramod Babu; Degen, Ryan; Tetreault, Danielle; Krych, Aaron John; Williams, Riley J.

    2016-01-01

    Objectives: Distal femoral varus osteotomy is an effective treatment for unloading valgus knee malalignment; however, there is limited evidence on the ability for patients to return to athletics following this procedure. The purpose of this study is to report the functional outcomes and return to sport for athletic patients that underwent distal femoral varus osteotomy. Methods: A consecutive series of athletic patients that had undergone distal femoral varus osteotomy for symptomatic lateral compartment overload and valgus knee malalignment were prospectively reviewed. All patients had a minimum of 2-year follow-up. Radiographs were assessed to determine pre-operative and post-operative alignment. Details regarding sport of interest, ability to return to sport, and timing of return were obtained from the patients. Prospective institutional registries were utilized to collect pre-operative and post-operative Marx Activity Scale and International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC) scores; these values were compared using paired t-tests with p < 0.05 as the threshold for significance. Results: A total of 13 patients with a mean age of 24 years (range: 17-35) and a mean follow-up of 43 months (range: 24-74) were included in the study. Six patients underwent medial closing wedge osteotomy, and seven patients underwent lateral opening wedge osteotomy. The mean alignment correction was 8 degrees (range: 5-13). Nine patients underwent one or more concomitant procedures at the time of the osteotomy: 6 lateral femoral condyle osteochondral allografts, 2 partial lateral meniscectomies, 1 lateral meniscus allograft transplantation, and 1 revision anterior cruciate ligament reconstruction. All patients were able to successfully return to their sport of choice (4 soccer, 2 softball, 2 running, 1 football, 1 basketball, 1 ice hockey, 1 volleyball, 1 rowing) at a mean of 11 months (range: 9-13). Furthermore, all 13 patients demonstrated an

  8. Osteochondral Fractures of the Lateral Femoral Trochlea in Young Athletes

    PubMed Central

    Walsh, Stewart

    2016-01-01

    Method: Between May 2012 and September 2014 cluster of five patients with large osteochondral fractures of the lateral femoral trochlea were treated at our institution. These all occurred in high level male athletes, one at a decathlete and the other four soccer players. The MRI scan showed a characteristic appearance of a large subchondral fracture involving most of the lateral femoral trochlea. All patients were symptomatic. The patients were treated with open reduction and internal fixation using headless compression screws. The operative technique and short term results will be outlined. Results: Fixation appears successful in most cases. Conclusion: This appears to be a repetitive trauma related injury that occurs in young high-level athletes.

  9. A Case of Femoral Fracture in Klippel Trenaunay Syndrome

    PubMed Central

    Nahas, Sam; Wong, Fabian; Back, Diane

    2014-01-01

    We present a case of Klippel Trenaunay syndrome (KTS) who presented with severe bilateral knee osteoarthritis (OA). Preoperative planning was commenced for a total knee replacement (TKR). Whilst on the waiting list the patient suffered a fall and sustained a complete femoral diaphysis fracture. Conservative management in the form of skin traction was initially chosen as significant extra- and intramedullary vascular malformations posed an increased risk of perioperative bleeding. This failed to progress to union, and so open reduction and internal fixation was performed. This subsequently resulted in on-going delayed union, which was subsequently managed with low intensity pulsed ultrasound (LIPUS, otherwise known as Exogen (Bioventus. exogen. Secondary exogen, 2012)). There are only two previous documented cases of femoral fracture in KTS. This is the first report of a patient with this rare syndrome receiving this treatment. We discuss the management of fracture in this challenging group of patients. PMID:25478269

  10. Cardioprotective effects of nicorandil, a mitochondrial potassium channel opener against doxorubicin-induced cardiotoxicity in rats.

    PubMed

    Abdel-Raheem, Ihab T; Taye, Ashraf; Abouzied, Mekky M

    2013-09-01

    Doxorubicin is a chemotherapeutic drug used to treat solid and haematopoietic tumours. Its use is limited by a major side effect of cardiotoxicity. It was reported that doxorubicin-induced cardiotoxicity is mediated through oxidative stress coupled with impaired NO bioavailability and NF-κB activation. Nicorandil, a mitochondrial ATP-dependent potassium (KATP ) channel opener, was reported to be cardioprotective on ischaemic myocardium. However, the effect of nicorandil against doxorubicin-induced cardiotoxicity has not yet been clarified. Accordingly, six groups of rats were used. The first three groups were injected with vehicle, nicorandil (3 mg/kg) orally and doxorubicin (a single intraperitoneal injection of 20 mg/kg), respectively. Group four was treated with nicorandil, whereas group five was treated with glibenclamide and then nicorandil starting 2 days before doxorubicin and continued for five consecutive days. Group six was treated with glibenclamide alone. At the end of the experiment, the rats were killed. Cardiac enzyme indexes were measured in serum. Heart tissues were processed for determination of nitrite/nitrate, NF-κB protein expression, glutathione (GSH), lipid peroxide (TBARS) levels and superoxide production. In addition to body-weight reduction, doxorubicin produced cardiotoxicity as indicated from the increase in lactate dehydrogenase (LDH), creatine kinase (CK) activities, TBARS, superoxide production, NF-κB expression and caspase-3 activity. Moreover, doxorubicin decreased GSH and nitrite/nitrate levels. Histopathological examination of doxorubicin-treated hearts revealed degenerative changes. On the other hand, nicorandil protected cardiac tissues against doxorubicin cardiotoxicity as demonstrated from normalization of cardiac biochemical and oxidative stress parameters and amelioration of histopathological changes. Glibenclamide, a blocker of the KATP channel, reversed most of the cardiac effects of nicorandil. PMID:23621757

  11. Coherence among head direction cells before eye opening in rat pups.

    PubMed

    Bjerknes, Tale L; Langston, Rosamund F; Kruge, Ingvild U; Moser, Edvard I; Moser, May-Britt

    2015-01-01

    Mammalian navigation is thought to depend on an internal map of space consisting of functionally specialized cells in the hippocampus and the surrounding parahippocampal cortices. Basic properties of this map are present when rat pups explore the world outside of their nest for the first time, around postnatal day 16-18 (P16-P18). One of the first functions to be expressed in navigating animals is the directional tuning of the head direction cells. To determine whether head direction tuning is expressed at even earlier ages, before the start of exploration, and to establish whether vision is necessary for the development of directional tuning, we recorded neural activity in pre- and parasubiculum, or medial entorhinal cortex, from P11 onward, 3-4 days before the eyelids unseal. Head direction cells were present from the first day of recording. Firing rates were lower than in adults, and preferred firing directions were less stable, drifting within trials and changing completely between trials. Yet the cells drifted coherently, i.e., relative firing directions were maintained from one trial to the next. Directional tuning stabilized shortly after eye opening. The data point to a hardwired attractor network for representation of head direction in which directional tuning develops before vision and visual input serves primarily to anchor firing direction to the external world. PMID:25466682

  12. The edaravone and 3-n-butylphthalide ring-opening derivative 10b effectively attenuates cerebral ischemia injury in rats

    PubMed Central

    Hua, Kai; Sheng, Xiao; Li, Ting-ting; Wang, Lin-na; Zhang, Yi-hua; Huang, Zhang-jian; Ji, Hui

    2015-01-01

    Aim: Compound 10b is a hybrid molecule of edaravone and a ring-opening derivative of 3-n-butylphthalide (NBP). The aim of this study was to examine the effects of compound 10b on brain damage in rats after focal cerebral ischemia. Methods: SD rats were subjected to 2-h-middle cerebral artery occlusion (MCAO). At the onset of reperfusion, the rats were orally treated with NBP (60 mg/kg), edaravone (3 mg/kg), NBP (60 mg/kg)+edaravone (3 mg/kg), or compound 10b (70, 140 mg/kg). The infarct volume, motor behavior deficits, brain water content, histopathological alterations, and activity of GSH, SOD, and MDA were analyzed 24 h after reperfusion. The levels of relevant proteins in the ipsilateral striatum were examined using immunoblotting. Results: Administration of compound 10b (70 or 140 mg/kg) significantly reduced the infarct volume and neurological deficits in MCAO rats. The neuroprotective effects of compound 10b were more pronounced compared to NBP, edaravone or NBP+edaravone. Furthermore, compound 10b significantly upregulated the protein levels of the cytoprotective molecules Bcl-2, HO-1, Nrf2, Trx, P-NF-κB p65, and IκB-α, while decreasing the expression of Bax, caspase 3, caspase 9, Txnip, NF-κB p65, and P-IκB-α. Conclusion: Oral administration of compound 10b effectively attenuates rat cerebral ischemia injury. PMID:26073328

  13. Misdiagnosis of pathological femoral fracture in a patient with intramuscular hemangioma: A case report

    PubMed Central

    YU, XIAOLONG; NIE, TAO; ZHANG, BIN; DAI, MIN; LIU, HUCHENG; ZOU, FAN

    2016-01-01

    Hemangioma is a common disease; however, intramuscular hemangioma (IH) presenting with a pathological fracture is extremely rare. The present study reports a case of a 46-year-old male patient that suffered from IH of the right thigh, presenting with a pathological femoral fracture. The patient was initially diagnosed with a traumatic femoral fracture, and routine open reduction and internal fixation were performed at a local hospital. However, 20 days subsequent to surgery, gradual swelling and soreness around the incision were observed. The incision eventually ruptured during squatting for bowel movement, which led to extensive blood loss. Based on computed tomography (CT) and deep femoral artery arteriography, IH presenting with a pathological femoral fracture was diagnosed. The patient underwent artery embolization, from which he recovered well. At the 6-month follow-up, the femoral fracture was revealed to have healed, and a CT scan demonstrated no evidence of recurrence; however, continuous observation using CT is required in order to determine the long-term outcome. To the best of our knowledge, this is the first case of a misdiagnosed pathological femoral fracture in a patient with IH reported in the English literature. PMID:27347124

  14. [Aneurysm of the femoral and popliteal vein].

    PubMed

    Hansen, L G; Boris, P

    1986-04-01

    Aneurysms of the popliteal and femoral veins are rare and may be seen as casual findings with no clinical manifestations whatsoever. On the other hand they may be potential source of recurrent pulmonary embolism. A case is reported, where an aneurysm of the femoral vein was found in a clinically symptomless woman aged 48. PMID:3715020

  15. Unusual presentation of a femoral stress fracture

    PubMed Central

    Ejnisman, Leandro; Wajnsztejn, Andre; Queiroz, Roberto Dantas; Ejnisman, Benno

    2013-01-01

    Stress fractures are common injuries in sports medicine. Among these fractures, femoral neck stress fractures frequently have a benign course, especially when it happens in the medial aspect of the neck. This case report describes a stress fracture of the medial aspect of the femoral neck that developed a complete fracture and underwent surgical fixation. PMID:23283621

  16. Medial Closing-Wedge Distal Femoral Osteotomy: Fixation With Proximal Tibial Locking Plate.

    PubMed

    Tírico, Luís Eduardo Passarelli; Demange, Marco Kawamura; Bonadio, Marcelo Batista; Helito, Camilo Partezani; Gobbi, Riccardo Gomes; Pécora, José Ricardo

    2015-12-01

    Distal femoral varus osteotomy is a well-established procedure for the treatment of lateral compartment cartilage lesions and degenerative disease, correcting limb alignment and decreasing the progression of the pathology. Surgical techniques can be performed with a lateral opening-wedge or medial closing-wedge correction of the deformity. Fixation methods for lateral opening-wedge osteotomies are widely available, and there are various types of implants that can be used for fixation. However, there are currently only a few options of implants for fixation of a medial closing-wedge osteotomy on the market. This report describes a medial, supracondylar, V-shaped, closing-wedge distal femoral osteotomy using a locked anterolateral proximal tibial locking plate that fits anatomically to the medial side of the distal femur. This is a great option as a stable implant for a medial closing-wedge distal femoral osteotomy. PMID:26870647

  17. Diamide accelerates opening of the Tl(+)-induced permeability transition pore in Ca(2+)-loaded rat liver mitochondria.

    PubMed

    Korotkov, Sergey M; Konovalova, Svetlana A; Brailovskaya, Irina V

    Opening of the mitochondrial permeability transition pore (MPTP) in the inner membrane is due to matrix Ca(2+) overload and matrix glutathione loss. Fixing the 'm' conformation of the adenine nucleotide translocase (ANT) by ADP or N-ethylmaleimide (NEM) inhibits opening of the MPTP. Oxidants (diamide or tert-butylhydroperoxide (tBHP)) fix the ANT in 'c' conformation, and the ability of ADP to inhibit the MPTP is thus attenuated. Earlier we found (Korotkov and Saris, 2011) that calcium load of rat liver mitochondria resulted in Tl(+)-induced MPTP opening, which was accompanied by a decrease in state 3, state 4, and 2,4-dinitrophenol-uncoupled respiration, as well as increased swelling and membrane potential dissipation. These effects, which were increased by diamide and tBHP, were visibly reduced in the presence of the MPTP inhibitors (ADP, NEM, and cyclosporine A). Our data suggest that conformational changes of the ANT and matrix glutathione loss may be directly involved in opening the Tl(+)-induced MPTP in the inner membrane of Ca(2+)-loaded rat liver mitochondria. PMID:26518646

  18. Opening of ATP-sensitive K(+) (KATP) channels enhance hydroxyl radical generation induced by MPP(+) in rat striatum.

    PubMed

    Obata, Toshio; Nakashima, Michiko

    2016-07-15

    The present study examined whether opening of adenosine triphosphate (ATP) sensitive K(+) (KATP) channels can enhance 1-methyl-4-phenylpyridinium (MPP(+))-induced hydroxyl radical (OH) generation in rat striatum. Rats were anesthetized, and sodium salicylate in Ringer's solution (0.5nmol/ml per min) was infused through a microdialysis probe to detect the generation of OH as reflected by the non-enzymatic formation of 2.3-dihydroxybenzoic acid (DHBA) in the striatum. MPP(+) (5mM) enhanced generation of OH with concomitant increased efflux of dopamine (DA). Cromakalim (100μM), a KATP channel opener, through the microdialysis probe significantly increased both DA efflux and OH formation induced by MPP(+). Another KATP channel opener, nicorandil (1mM), also increased the level DA or DHBA, but these changes were not significant. However, in the presence of glibenclamide (10μM), a KATP channel antagonist, and the increase of MPP(+)-induced DA or DHBA were not observed. Cromakalim (10, 50 and 100μM) increased MPP(+)-induced DHBA formation in a concentration-dependent manner. However, the effects of cromakalim in the presence of glibenclamide were abolished. These results suggest that opening of KATP channels may cause OH generation by MPP(+). PMID:27288802

  19. Mechanism of chlorogenic acid treatment on femoral head necrosis and its protection of osteoblasts

    PubMed Central

    ZHANG, MINGJUAN; HU, XIANDA

    2016-01-01

    The aim of the present study was to investigate the therapeutic effect of chlorogenic acid on hormonal femoral head necrosis and its protection of osteoblasts. The study established a femoral head necrosis model in Wistar rats using Escherichia coli endotoxin and prednisolone acetate. The rats were divided into five groups and were treated with different concentrations of chlorogenic acid (1, 10 and 20 mg/kg). The main detected indicators were the blood rheology, bone mineral density, and the hydroxyproline and hexosamine (HOM) contents. At a cellular level, osteoblasts were cultured and treated by drug-containing serum. Subsequently, cell proliferation and the osteoblast cycle were measured using flow cytometry, and the protein expression levels of Bax and B-cell lymphoma 2 (Bcl-2) were detected using western blotting. Chlorogenic acid at a concentration of 20 mg/kg (high-dose) enhanced the bone mineral density of the femoral head and femoral neck following ischemia. Simultaneously, blood flow following the injection of prednisolone acetate was significantly improved, and the HOM contents of the high-dose chlorogenic acid group were significantly different. The results from the flow cytometry analysis indicated that chlorogenic acid can efficiently ameliorate hormone-induced necrosis. The osteoblasts were isolated and cultured. The MTT colorimetric assay showed that chlorogenic acid at different densities can increase the proliferation capabilities of osteoblasts and accelerate the transition process of G0/G1 phase to S phase, as well as enhance mitosis and the regeneration of osteoblasts. Western blotting detection indicated that chlorogenic acid may prohibit the decrease of Bcl-2 and the increase of Bax during apoptosis, thereby inhibiting osteoblast apoptosis and preventing the deterioration of femoral head necrosis. In conclusion, chlorogenic acid at the density of 20 mg/kg is effective in the treatment of hormonal femoral head necrosis, which may be

  20. Impaired fear extinction as displayed by serotonin transporter knockout rats housed in open cages is disrupted by IVC cage housing.

    PubMed

    Shan, Ling; Schipper, Pieter; Nonkes, Lourens J P; Homberg, Judith R

    2014-01-01

    Anxiety disorders are influenced by both environmental and genetic factors. A well-known example for gene x environment interactions in psychiatry is the low activity (s) allelic variant of the serotonin transporter (5-HTT) promoter polymorphism (5-HTTLPR) that in the context of stress increases risk for depression and post-traumatic stress disorder (PTSD). Previously, we observed robust anxiety-related phenotypes, such as an impairment in fear extinction, in 5-HTT knockout (5-HTT-/-) versus wild-type (5-HTT+/+) rats housed in open cages. Recently, housing conditions were changed from open cages to individually ventilated cages (IVC), which are associated with a high ventilation fold and noise. This switch in housing conditions prompted an unplanned 5-HTT gene x environment interaction study in our rats. The current study shows that lifetime stress by means of IVC cage housing abolished genotype differences in fear extinction between 5-HTT-/- and 5-HTT+/+ rats. Although this effect was not attributed specifically to either the 5-HTT+/+ or the 5-HTT-/- genotype, the findings are in agreement with the modulatory role of serotonin in the processing of environmental stimuli. Our findings also underline the possibility that housing conditions confound the interpretation of anxiety-related behaviours in rodents. PMID:24658187

  1. Lateral femoral cutaneous neuralgia: an anatomical insight.

    PubMed

    Dias Filho, L C; Valença, M M; Guimarães Filho, F A V; Medeiros, R C; Silva, R A M; Morais, M G V; Valente, F P; França, S M L

    2003-07-01

    A detailed anatomic study was carried out on the lateral femoral cutaneous nerve to better understand the etiology and treatment of lateral femoral cutaneous neuralgia. As it passed from the pelvis into the thigh, the lateral femoral cutaneous nerve ran through an "aponeuroticofascial tunnel," beginning at the iliopubic tract and ending at the inguinal ligament; as it passed through the tunnel, an enlargement in its side-to-side diameter was observed, suggesting that the fascial structures proximal to the inguinal ligament may be implicated in the genesis of lateral femoral cutaneous neuralgia. The finding of pseudoneuromas at this location, distant from the inguinal ligament, supports this hypothesis. The anterior superior iliac spine is located approximately 0.7 cm from the lateral femoral cutaneous nerve and serves as the bony landmark for nerve localization. Within the first 3 cm of leaving the pelvis, the lateral femoral cutaneous nerve was observed deep to the fascia lata; therefore, surgical dissection within the subcutaneous fascia may be conducted with relative impunity near the anterior superior iliac spine just inferior to the inguinal ligament. In 36% of cases there was no posterior branch of the nerve, which is correlated to lateral femoral cutaneous neuralgia symptoms often being limited to the anterior branch region. An accessory nerve was found in 30% of cases. PMID:12794914

  2. Distal femoral fractures: current concepts.

    PubMed

    Gwathmey, F Winston; Jones-Quaidoo, Sean M; Kahler, David; Hurwitz, Shepard; Cui, Quanjun

    2010-10-01

    The diversity of surgical options for the management of distal femoral fractures reflects the challenges inherent in these injuries. These fractures are frequently comminuted and intra-articular, and they often involve osteoporotic bone, which makes it difficult to reduce and hold them while maintaining joint function and overall limb alignment. Surgery has become the standard of care for displaced fractures and for patients who must obtain rapid return of knee function. The goal of surgical management is to promote early knee motion while restoring the articular surface, maintaining limb length and alignment, and preserving the soft-tissue envelope with a durable fixation that allows functional recovery during bone healing. A variety of surgical exposures, techniques, and implants has been developed to meet these objectives, including intramedullary nailing, screw fixation, and periarticular locked plating, possibly augmented with bone fillers. Recognition of the indications and applications of the principles of modern implants and techniques is fundamental in achieving optimal outcomes. PMID:20889949

  3. Unilateral Isolated Proximal Femoral Focal Deficiency

    PubMed Central

    Doğer, Emek; Köpük, Şule Y.; Çakıroğlu, Yiğit; Çakır, Özgür; Yücesoy, Gülseren

    2013-01-01

    Objective. To discuss a patient with a prenatal diagnosis of unilateral isolated femoral focal deficiency. Case. Antenatal diagnosis of unilateral isolated femoral focal deficiency was made at 20 weeks of gestation. The length of left femur was shorter than the right, and fetal femur length was below the fifth percentile. Proximal femoral focal deficiency was diagnosed. After delivery, the diagnosis was confirmed with skeletal radiographs and magnetic resonance imaging. In prenatal ultrasonographic examination, the early recognition and exclusion of skeletal dysplasias is important; moreover, treatment plans should be initiated, and valuable information should be provided to the family. PMID:23984135

  4. Meralgia Paresthetica and Femoral Acetabular Impingement: A Possible Association

    PubMed Central

    Ahmed, Aiesha

    2010-01-01

    Meralgia paresthetica consists of pain and dysesthesia in the anterolateral thigh. Etiology is divided into spontaneous and iatrogenic causes. To my knowledge this has never been attributed to femoral acetabular impingement. This case highlights the presence of lateral femoral cutaneous neuropathy in the setting of femoral acetabular impingement syndrome thus raising the possibility of an association. Keywords Femoral acetabular impingement; Lateral femoral cutaneous nerve; Dysesthesia; Nerve conduction studies PMID:22043261

  5. Effects of Crimping on Mechanical Performance of Nitinol Stent Designed for Femoral Artery: Finite Element Analysis

    NASA Astrophysics Data System (ADS)

    Nematzadeh, F.; Sadrnezhaad, S. K.

    2013-11-01

    Nitinol stents are used to minimize improper dynamic behavior, low twistability, and inadequate radial mechanical strength of femoral artery stents. In this study, finite element method is used to investigate the effect of crimping and Austenite finish temperature ( A f) of Nitinol on mechanical performance of Z-shaped open-cell femoral stent under crimping conditions. Results show that low A f Nitinol has better mechanical and clinical performance due to small chronic outward force, large radial resistive force, and appropriate superelastic behavior.

  6. Flows In Model Human Femoral Arteries

    NASA Technical Reports Server (NTRS)

    Back, Lloyd H.; Kwack, Eug Y.; Crawford, Donald W.

    1990-01-01

    Flow is visualized with dye traces, and pressure measurements made. Report describes experimental study of flow in models of human femoral artery. Conducted to examine effect of slight curvature of artery on flow paths and distribution of pressure.

  7. Atypical periprosthetic femoral fracture: a case report.

    PubMed

    Woo, S B; Choi, S T; Chan, W L

    2016-08-01

    We report an 82-year-old woman who underwent fixation with a long-spanning cable-plate for a bisphosphonate-induced Vancouver B1 periprosthetic femoral fracture. Non-union and breakage of the plate occurred at 16 months and necessitated revision surgery using a long-stem femoral prosthesis augmented with a cable-plate construct. Bone union was achieved eventually after 10 months. PMID:27574277

  8. The effect of AL0671, a novel potassium channel opener, on potassium current in rat aortic smooth muscle cells.

    PubMed

    Matzno, S; Sato, R; Takai, H; Aida, Y; Karasaki, S; Oyaizu, M; Nakamura, N; Katori, R

    1995-10-01

    1. We evaluated the mechanism of activation by AL0671, a novel potassium channel opener, of potassium current in rat aortic smooth muscle cells. 2. Under conditions of whole cell recording, AL0671 (1-1000 microM) markedly increased potassium current with a Hill coefficient of 2 and dissociation constant of 1.5 x 10(-4) M. This activation was completely inhibited by intracellular ATP. 3. Under inside-out patch conditions, the ATP-sensitive K+ channels (KATP) treated with AL0671 (100 microM) showed prolongation of the slower open time component and shortening of the slower closed time component without modification of channel conductance. PMID:7590127

  9. Use of the trochanteric flip osteotomy to facilitate internal fixation of a femoral head fracture.

    PubMed

    Gillespie, James A; Marsh, Andrew G; Patil, Sanjeev R

    2016-01-01

    We report the case of a 42-year-old male who suffered a fracture-dislocation of the femoral head. After a closed reduction of the hip, this proceeded to an open reduction with internal fixation of the fractured femoral head, in addition to labral repair and micro-fracture of an articular cartilage defect. After considering the risks to the femoral head blood supply, the trochanteric flip osteotomy was used. This provided ample and safe exposure. At 14 months follow-up, the patient-reported outcome measures are favourable: modified Harris Hip Score (81/100), the non-arthritic hip score (92.5/100) and SF-12 (41/48). PMID:27470013

  10. Use of the trochanteric flip osteotomy to facilitate internal fixation of a femoral head fracture

    PubMed Central

    Gillespie, James A.; Marsh, Andrew G.; Patil, Sanjeev R.

    2016-01-01

    We report the case of a 42-year-old male who suffered a fracture–dislocation of the femoral head. After a closed reduction of the hip, this proceeded to an open reduction with internal fixation of the fractured femoral head, in addition to labral repair and micro-fracture of an articular cartilage defect. After considering the risks to the femoral head blood supply, the trochanteric flip osteotomy was used. This provided ample and safe exposure. At 14 months follow-up, the patient-reported outcome measures are favourable: modified Harris Hip Score (81/100), the non-arthritic hip score (92.5/100) and SF-12 (41/48). PMID:27470013

  11. Expert tibia nail for subtrochanteric femoral fracture to prevent thermal injury

    PubMed Central

    Lee, Kyung-Jae; Min, Byung-Woo; Jung, Jae-Hoon; Kang, Mi-Kyung; Kim, Min-Ji

    2015-01-01

    Introduction Subtrochanteric femoral fractures are relatively uncommon, accounting for 7–15% of all hip fractures and treatment of these fractures are considered challenge for orthopaedic surgeons. Although several treatment options are reported with up to 90% of satisfactory results, the choice of the appropriate implant is still a matter of debate. Some authors reported thermal injury after reaming for intramedullary nail fixation in patients with narrow medullary canal. Presentation of case A 21-year-old female patient was admitted to our hospital because of right subtrochanteric femoral fracture. The narrowest diameter of medullary canal of her femur was about 7 mm but she refused open reduction and internal fixation with plate due to large scar formation. We used expert tibia nail instead of femoral intramedullary nail to prevent thermal injury. Discussion Subtrochanteric femoral fractures are difficult to treat because of their biomechanical and anatomical characteristics. Although several implants are reported for the surgical treatment of these fractures, intramedullary nails have been advocated due to their biological and biomechanical advantages. However, under certain circumstances with associated injury or anatomic difference we might consider another treatment options. Conclusion Expert tibia nail may be considered one of the treatment options for subtrochanteric femoral fracture with narrow medullary canal. We also emphasize the importance of preoperative evaluation of the medullary canal size for these risky fractures. PMID:25839435

  12. Safety Evaluation of Self-assembling Peptide Gel after Intracranial Administration to Rats Using the Open Field Test.

    PubMed

    Tsunoda, Masashi; Sugaya, Chiemi; Sugiura, Yumiko; Nagai, Yusuke; Sakanishi, Kotaro

    2016-01-01

    Self-assembling peptides have been developed as clinical materials, which could scaffold to regenerate nerve cells and hemostatic materials in vivo. However, there has not been enough information for their in vivo application. The safety of self-assembling peptides for the application on the brain was examined using behavioral tests for each rat in this study. Self-assembling peptide gel was administered to the surface of the brain at a volume of 20 µL at 1.5%. After 2 months, the open field test and the prepulse inhibition (PPI) test were performed. There were no significant differences between the peptide gel and the control groups in locomotor distances and in %PPIs in the PPI test. The mean values of the percentage of time the rats stayed in the central area of the open field during the first 5 min and instances of center rearing or face washing in the peptide gel group were significantly higher than those in the control. There were amorphous substance in the subarachnoid region, and infiltrations of mononuclear cells were also observed in the self-assembling peptide gel group. Although the meaning of the effects observed in this study was not fully elucidated, the self-assembling gel produced marginal but significant behavioral and histological effects. PMID:27582322

  13. Femoral neck shortening after internal fixation of a femoral neck fracture.

    PubMed

    Zielinski, Stephanie M; Keijsers, Noël L; Praet, Stephan F E; Heetveld, Martin J; Bhandari, Mohit; Wilssens, Jean Pierre; Patka, Peter; Van Lieshout, Esther M M

    2013-07-01

    This study assesses femoral neck shortening and its effect on gait pattern and muscle strength in patients with femoral neck fractures treated with internal fixation. Seventy-six patients from a multicenter randomized controlled trial participated. Patient characteristics and Short Form 12 and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were collected. Femoral neck shortening, gait parameters, and maximum isometric forces of the hip muscles were measured and differences between the fractured and contralateral leg were calculated. Variables of patients with little or no shortening, moderate shortening, and severe shortening were compared using univariate and multivariate analyses. Median femoral neck shortening was 1.1 cm. Subtle changes in gait pattern, reduced gait velocity, and reduced abductor muscle strength were observed. Age, weight, and Pauwels classification were risk factors for femoral neck shortening. Femoral neck shortening decreased gait velocity and seemed to impair gait symmetry and physical functioning. In conclusion, internal fixation of femoral neck fractures results in permanent physical limitations. The relatively young and healthy patients in our study seem capable of compensating. Attention should be paid to femoral neck shortening and proper correction with a heel lift, as inadequate correction may cause physical complaints and influence outcome. PMID:23823040

  14. Removal of a well-fixed cementless femoral component with an extended proximal femoral osteotomy.

    PubMed

    Younger, T I; Bradford, M S; Paprosky, W G

    1995-05-01

    Removal of a stable, well-fixed cementless femoral arthroplasty component occasionally is necessary because of infection, component malposition, persistent pain, or incompatibility with a femoral revision component. Restricted access to ingrowth surfaces may make implant removal exceedingly difficult and increases the risk of iatrogenic damage to the proximal femur. A new extended proximal femoral osteotomy technique is described for use in removing well-fixed cementless femoral components. Previous techniques have been modified to allow access to the bone-implant interface and to provide straight-shot access to the femoral canal for proper sizing and positioning of the revision implant. The osteotomy can be extended to accommodate the entire length of the porous coating on the revision component. If a shorter osteotomy is desired, access to the prosthesis for transection with a metal-cutting burr is possible. The osteotomy is easily repositioned with cerclage wires or cables and reliable healing has been demonstrated. PMID:10150358

  15. Femoral tunnel malposition in ACL revision reconstruction.

    PubMed

    Morgan, Joseph A; Dahm, Diane; Levy, Bruce; Stuart, Michael J

    2012-11-01

    The Multicenter Anterior Cruciate Ligament (ACL) Revision Study (MARS) group was formed to study a large cohort of revision ACL reconstruction patients. The purpose of this subset analysis study of the MARS database is to describe specific details of femoral tunnel malposition and subsequent management strategies that surgeons chose in the revision setting. The design of this study is a case series. The multicenter MARS database is compiled from a questionnaire regarding 460 ACL reconstruction revision cases returned by 87 surgeons. This subset analysis described technical aspects and operative findings in specifically those cases in which femoral tunnel malposition was cited as the cause of primary ACL reconstruction failure. Of the 460 revisions included for study, 276 (60%) cases cited a specific "technical cause of failure." Femoral tunnel malposition was cited in 219 (47.6%) of 460 cases. Femoral tunnel malposition was cited as the only cause of failure in 117 cases (25.4%). Surgeons judged the femoral tunnel too vertical in 42 cases (35.9%), too anterior in 35 cases (29.9%), and too vertical and anterior in 31 cases (26.5%). Revision reconstruction involved the drilling of an entirely new femoral tunnel in 91 cases (82.1%). For primary reconstruction, autograft tissue was used in 82 cases (70.1%). For revision reconstruction, autograft tissue was used in 61 cases (52.1%) and allograft tissue in 56 cases (47.9%). Femoral tunnel malposition in primary ACL reconstruction was the most commonly cited reason for graft failure in this cohort. Graft selection is widely variable among surgeons. PMID:23150344

  16. Femoral Tunnel Malposition in ACL Revision Reconstruction

    PubMed Central

    Morgan, Joseph A.; Dahm, Diane; Levy, Bruce; Stuart, Michael J.

    2013-01-01

    The Multicenter Anterior Cruciate Ligament (ACL) Revision Study (MARS) group was formed to study a large cohort of revision ACL reconstruction patients. The purpose of this subset analysis study of the MARS database is to describe specific details of femoral tunnel malposition and subsequent management strategies that surgeons chose in the revision setting. The design of this study is a case series. The multicenter MARS database is compiled from a questionnaire regarding 460 ACL reconstruction revision cases returned by 87 surgeons. This subset analysis described technical aspects and operative findings in specifically those cases in which femoral tunnel malposition was cited as the cause of primary ACL reconstruction failure. Of the 460 revisions included for study, 276 (60%) cases cited a specific “technical cause of failure.” Femoral tunnel malposition was cited in 219 (47.6%) of 460 cases. Femoral tunnel malposition was cited as the only cause of failure in 117 cases (25.4%). Surgeons judged the femoral tunnel too vertical in 42 cases (35.9%), too anterior in 35 cases (29.9%), and too vertical and anterior in 31 cases (26.5%). Revision reconstruction involved the drilling of an entirely new femoral tunnel in 91 cases (82.1%). For primary reconstruction, autograft tissue was used in 82 cases (70.1%). For revision reconstruction, autograft tissue was used in 61 cases (52.1%) and allograft tissue in 56 cases (47.9%). Femoral tunnel malposition in primary ACL reconstruction was the most commonly cited reason for graft failure in this cohort. Graft selection is widely variable among surgeons. PMID:23150344

  17. Femoral Varus Osteotomy for Hip Instability after Traumatic Fracture Dislocations of the Hip Associated with Femoral Head Fractures: A Report of Two Cases

    PubMed Central

    Nakamura, Junichi; Takahashi, Kazuhisa

    2016-01-01

    Fracture of the femoral head and the acetabulum with traumatic dislocation of the hip is a severe injury representing various types and unfavorable outcome. We showed a 45-year-old man with Pipkin type-IV fracture and coxa valga. An immediate closed reduction was achieved followed by open reduction and internal fixation via a posterior approach 6 days later. However, dislocation occurred three times without traumatic events after three weeks. CT demonstrated no displacement of posterior fragments or implant failure. Femoral intertrochanteric varus osteotomy was performed to gain concentric stability and successfully resolved recurrent dislocation. Another 45-year-old woman with Pipkin type-IV fracture and coxa valga also underwent closed reduction initially and then continued conservative treatment. After eight weeks, when she started gait training, progressive pain became symptomatic. Persistent hip pain at weight bearing was not improved in spite of arthroscopic synovectomy and osteochondroplasty. Two years after injury, femoral intertrochanteric varus osteotomy was indicated and her refractory pain was resolved gradually. We suggest that femoral varus osteotomy should be considered for superolateral subluxation associated fracture dislocation of the hip in Pipkin type-IV and coxa valga. PMID:27293934

  18. Femoral Varus Osteotomy for Hip Instability after Traumatic Fracture Dislocations of the Hip Associated with Femoral Head Fractures: A Report of Two Cases.

    PubMed

    Miyamoto, Shuichi; Nakamura, Junichi; Iida, Satoshi; Suzuki, Chiho; Ohtori, Seiji; Orita, Sumihisa; Takahashi, Kazuhisa

    2016-01-01

    Fracture of the femoral head and the acetabulum with traumatic dislocation of the hip is a severe injury representing various types and unfavorable outcome. We showed a 45-year-old man with Pipkin type-IV fracture and coxa valga. An immediate closed reduction was achieved followed by open reduction and internal fixation via a posterior approach 6 days later. However, dislocation occurred three times without traumatic events after three weeks. CT demonstrated no displacement of posterior fragments or implant failure. Femoral intertrochanteric varus osteotomy was performed to gain concentric stability and successfully resolved recurrent dislocation. Another 45-year-old woman with Pipkin type-IV fracture and coxa valga also underwent closed reduction initially and then continued conservative treatment. After eight weeks, when she started gait training, progressive pain became symptomatic. Persistent hip pain at weight bearing was not improved in spite of arthroscopic synovectomy and osteochondroplasty. Two years after injury, femoral intertrochanteric varus osteotomy was indicated and her refractory pain was resolved gradually. We suggest that femoral varus osteotomy should be considered for superolateral subluxation associated fracture dislocation of the hip in Pipkin type-IV and coxa valga. PMID:27293934

  19. Femoral lipectomy increases postprandial lipemia in women.

    PubMed

    Hernandez, Teri L; Bessesen, Daniel H; Cox-York, Kimberly A; Erickson, Christopher B; Law, Christopher K; Anderson, Molly K; Wang, Hong; Jackman, Matthew R; Van Pelt, Rachael E

    2015-07-01

    Femoral subcutaneous adipose tissue (SAT) appears to be cardioprotective compared with abdominal SAT, possibly through better triglyceride (TG) sequestration. We hypothesized that removal of femoral SAT would increase postprandial TG through a reduction in dietary fatty acid (FA) storage. Normal-weight (means ± SD; BMI 23.9 ± 2.6 kg/m(2)) women (n = 29; age 45 ± 6 yr) were randomized to femoral lipectomy (LIPO) or control (CON) and followed for 1 yr. Regional adiposity was measured by DEXA and CT. A liquid meal labeled with [(14)C]oleic acid was used to trace the appearance of dietary FA in plasma (6-h postprandial TG), breath (24-h oxidation), and SAT (24-h [(14)C]TG storage). Fasting LPL activity was measured in abdominal and femoral SAT. DEXA leg fat mass was reduced after LIPO vs. CON (Δ-1.4 ± 0.7 vs. 0.1 ± 0.5 kg, P < 0.001) and remained reduced at 1 yr (-1.1 ± 1.4 vs. -0.2 ± 0.5 kg, P < 0.05), as did CT thigh subcutaneous fat area (-39.6 ± 36.6 vs. 4.7 ± 14.6 cm(2), P < 0.05); DEXA trunk fat mass and CT visceral fat area were unchanged. Postprandial TG increased (5.9 ± 7.7 vs. -0.6 ± 5.3 × 10(3) mg/dl, P < 0.05) and femoral SAT LPL activity decreased (-21.9 ± 22.3 vs. 10.5 ± 26.5 nmol·min(-1)·g(-1), P < 0.05) 1 yr following LIPO vs. CON. There were no group differences in (14)C-labeled TG appearing in abdominal and femoral SAT or elsewhere. In conclusion, femoral fat remained reduced 1 yr following lipectomy and was accompanied by increased postprandial TG and reduced femoral SAT LPL activity. There were no changes in storage of meal-derived FA or visceral fat. Our data support a protective role for femoral adiposity on circulating TG independent of dietary FA storage and visceral adiposity. PMID:25968576

  20. Robotic-assisted femoral osteochondroplasty is more precise than a freehand technique in a Sawbone model

    PubMed Central

    Ranawat, Anil S.

    2015-01-01

    Robotic-assistance has the potential to improve the accuracy of bony resections, when performing femoral osteochondroplasty in the treatment of cam-type femoroacetabular impingement (FAI). The purpose of this study was to determine the accuracy of robotic-assisted femoral osteochondroplasty and compare this to a conventional open, freehand technique. We hypothesized that robotic-assistance would increase the accuracy of femoral head-neck offset correction in cam FAI. Sixteen identical sawbones models with a cam-type impingement deformity were resected by a single surgeon, simulating an open femoral osteochondroplasty. Eight procedures were performed using an open freehand technique and eight were performed using robotic-assistance, through the creation of a three-dimensional haptic volume. A desired arc of resection of 117.7° was determined pre-operatively using an anatomic plan. Post-resection, all 16 sawbones were laser scanned to measure the arc of resection, volume of bone removed and depth of resection. For each sawbone, these measurements were compared with the pre-operatively planned desired resection, to determine the resection error. Freehand resection resulted in a mean arc of resection error of 42.0 ± 8.5° compared with robotic-assisted resection which had a mean arc of resection error of 1.2 ± 0.7° (P < 0.0001). Over-resection occurred with every freehand resection with a mean volume error of 758.3 ± 477.1 mm3 compared with a mean robotic-assisted resection volume error of 31.3 ± 220.7 mm3 (P < 0.01). This study has shown that robotic-assisted femoral osteochondroplasty in the treatment of cam-type FAI is more accurate than a conventional, freehand technique, which are currently in widespread use. PMID:27011830

  1. Micromotion of cemented and uncemented femoral components.

    PubMed

    Burke, D W; O'Connor, D O; Zalenski, E B; Jasty, M; Harris, W H

    1991-01-01

    We evaluated the initial stability of cemented and uncemented femoral components within the femoral canals of cadaver femurs during simulated single limb stance and stair climbing. Both types were very stable in simulated single limb stance (maximum micromotion of 42 microns for cemented and 30 microns for uncemented components). However, in simulated stair climbing, the cemented components were much more stable than the uncemented components (76 microns as against 280 microns). There was also greater variation in the stability of uncemented components in simulated stair climbing, with two of the seven components moving 200 microns or more. Future implant designs should aim to improve the initial stability of cementless femoral components under torsional loads; this should improve the chances of bony ingrowth. PMID:1991771

  2. Guide wire migration during femoral vein catheterization.

    PubMed

    Khatami, Mohammad Reza; Abbasi, Rozita; Sadigh, Gelareh

    2010-10-01

    Central vein catheterization is a routine and relatively safe procedure in critically ill patients. Complications with this procedure depend to the site of catheterization and the skill of the operator. In addition to the common complications with femoral vein catheterization there are some rare usually preventable side effects related to guide wire and catheter. In our patient who underwent femoral catheterization for acute hemodialysis, we report migration of guide wire through the systemic circulation from the femoral vein to the jugular vein. This is a very rare complication that is a human error and is totally preventable by doing the procedure by a skilled doctor and considering the standards described for central vein catheter insertion. PMID:20852377

  3. Optimizing Stability in Femoral Neck Fracture Fixation.

    PubMed

    Ye, Ye; Hao, Jiandong; Mauffrey, Cyril; Hammerberg, E Mark; Stahel, Philip F; Hak, David J

    2015-10-01

    Optimizing stability of femoral neck fracture fixation is important in obtaining a successful outcome. The mechanical problems and strategies for achieving optimal stability differ depending on patients' age and degree of osteoporosis. Femoral neck fractures in younger adults usually result from high-energy trauma and have a vertical fracture pattern. Strategies for optimizing fixation stability in this group include placing additional screws at right angles to the fracture plane and medial buttress plate augmentation. In elderly patients, screw position relative to the intact cortical femoral neck bone is of critical importance. Additional strategies for optimizing fixation stability in this group include the concept of length stable fixation, use of adjunctive calcium phosphate cement, and use of novel fixed angle fixation implants. PMID:26488776

  4. Emergency intravenous access through the femoral vein.

    PubMed

    Swanson, R S; Uhlig, P N; Gross, P L; McCabe, C J

    1984-04-01

    A study was undertaken to assess the efficacy and safety of femoral venous catheterization for resuscitation of critically ill patients in the emergency department setting. From May 1982 to April 1983, 100 attempts were made at percutaneous insertion of a large-bore catheter into the femoral veins of patients presenting to our emergency department in cardiac arrest or requiring rapid fluid resuscitation. Eighty-nine attempts were successful. Insertion was generally considered easy, and flow rates were excellent. The only noted complications were four arterial punctures and one minor groin hematoma. This study suggests that short-term percutaneous catheterization of the femoral vein provides rapid, safe, and effective intravenous access. PMID:6703430

  5. Adventitial cystic disease of common femoral vein

    PubMed Central

    Suh, Bo-Yang

    2011-01-01

    Adventitial cystic disease (ACD) of venous system is an extremely rare condition. Very few reports of ACD in venous system have been described. In this report we discuss two cases of common femoral vein ACD that presented with a swollen leg by the obstruction of the vein. Ultrasound imaging showed the typical hypoechoic fluid filled cyst with a posterior acoustic window. Computed tomography scan and ascending venogram showed a stenosis to flow in the common femoral vein caused by an extrinsic mass. Trans-adventitial evacuation of cyst with removal of vein wall was performed for both cases. During operation we found the gelatinous material in the cysts arising in the wall of the common femoral vein and compressing the lumen. The patients were released after short hospitalization and have remained symptom free with no recurrence. PMID:22066091

  6. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures

    PubMed Central

    Dumbre Patil, Sampat S; Karkamkar, Sachin S; Patil, Vaishali S Dumbre; Patil, Shailesh S; Ranaware, Abhijeet S

    2016-01-01

    Background: When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN) or surface implants like Dynamic Condylar Screw (DCS) are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP) of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Materials and Methods: Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22–65 years) and mean followup period was 52.1 months (range 27–72 months). Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. Results: All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Conclusions: Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion. PMID:27512218

  7. Management of femoral head osteonecrosis: Current concepts

    PubMed Central

    Tripathy, Sujit Kumar; Goyal, Tarun; Sen, Ramesh Kumar

    2015-01-01

    Osteonecrosis of femoral head (ONFH) is a disabling condition of young individuals with ill-defined etiology and pathogenesis. Remains untreated, about 70-80% of the patients progress to secondary hip arthritis. Both operative and nonoperative treatments have been described with variable success rate. Early diagnosis and treatment is the key for success in preserving the hip joint. Once femoral head collapses (>2 mm) or if there is secondary degeneration, hip conservation procedures become ineffective and arthroplasty remains the only better option. We reviewed 157 studies that evaluate different treatment modalities of ONFH and then a final consensus on treatment was made. PMID:25593355

  8. Intramedullary nailing of pediatric femoral shaft fracture.

    PubMed

    Hosalkar, Harish S; Pandya, Nirav K; Cho, Robert H; Glaser, Diana A; Moor, Molly A; Herman, Martin J

    2011-08-01

    Intramedullary nail fixation of pediatric long bone fracture, particularly femoral shaft fracture, has revolutionized the care and outcome of these complex injuries. Nailing is associated with a high rate of union and a low rate of complications. Improved understanding of proximal femoral vascularity has led to changes in nail insertion methodology. Multiple fixation devices are available; selection is based on fracture type, patient age, skeletal maturity, and body mass index. A thorough knowledge of anatomy and biomechanics is required to achieve optimal results without negatively affecting skeletal development. PMID:21807915

  9. Openings

    PubMed Central

    Selwyn, Peter A.

    2015-01-01

    Reviewing his clinic patient schedule for the day, a physician reflects on the history of a young woman he has been caring for over the past 9 years. What starts out as a routine visit then turns into a unique opening for communication and connection. A chance glimpse out the window of the exam room leads to a deeper meditation on parenthood, survival, and healing, not only for the patient but also for the physician. How many missed opportunities have we all had, without even realizing it, to allow this kind of fleeting but profound opening? PMID:26195687

  10. Openings.

    PubMed

    Selwyn, Peter A

    2015-01-01

    Reviewing his clinic patient schedule for the day, a physician reflects on the history of a young woman he has been caring for over the past 9 years. What starts out as a routine visit then turns into a unique opening for communication and connection. A chance glimpse out the window of the exam room leads to a deeper meditation on parenthood, survival, and healing, not only for the patient but also for the physician. How many missed opportunities have we all had, without even realizing it, to allow this kind of fleeting but profound opening? PMID:26195687

  11. Effects of pantethine, cysteamine and pantothenic acid on open-field behavior and brain catecholamines in rats.

    PubMed

    Vécsei, L; Widerlöv, E; Alling, C

    1989-01-01

    Cysteamine (1.95 mM/kg) markedly decreased the locomotor, rearing and grooming activities, as well as the number of defecation boluses in an open-field test. An equimolar dose of pantethine reduced the locomotor activity to a lesser extent, but has the same potency in decreasing the number of defecation boluses, whereas pantothenic acid did not affect the behavior of the rats. Cysteamine, and to a lesser extent pantethine, reduced the noradrenaline and increased the dopamine and DOPAC concentrations in the hypothalamus. Pantothenic acid itself did not influence the hypothalamic catecholamine concentrations. These results suggest that the lower efficacy of pantethine compared to cysteamine on both behavioral and neurochemical parameters is probably due to a rate-limiting activity of the enzyme pantetheinase in the conversion of pantetheine to cysteamine. PMID:2619420

  12. Effects of amphetamine on striatal dopamine release, open-field activity, and play in Fischer 344 and Sprague-Dawley rats.

    PubMed

    Siviy, Stephen M; McDowell, Lana S; Eck, Samantha R; Turano, Alexandra; Akopian, Garnik; Walsh, John P

    2015-12-01

    Previous work from our laboratories has shown that juvenile Fischer 344 (F344) rats are less playful than other strains and also appear to be compromised in dopamine (DA) functioning. To determine whether the dysfunctional play in this strain is associated with deficits in the handling and delivery of vesicular DA, the following experiments assessed the extent to which F344 rats are differentially sensitive to the effects of amphetamine. When exposed to amphetamine, striatal slices obtained from F344 rats showed a small increase in unstimulated DA release when compared with slices from Sprague-Dawley rats; they also showed a more rapid high K+-mediated release of DA. These data provide tentative support for the hypothesis that F344 rats have a higher concentration of cytoplasmic DA than Sprague-Dawley rats. When rats were tested for activity in an open field, F344 rats presented a pattern of results that was consistent with either an enhanced response to amphetamine (3 mg/kg) or a more rapid release of DA (10 mg/kg). Although there was some indication that amphetamine had a dose-dependent differential effect on play in the two strains, play in F344 rats was not enhanced to any degree by amphetamine. Although these results are not consistent with our working hypothesis that F344 rats are less playful because of a deficit in vesicular release of DA, they still suggest that this strain may be a useful model for better understanding the role of DA in social behavior during the juvenile period. PMID:26397758

  13. Immune response associated with Toll-like receptor 4 signaling pathway leads to steroid-induced femoral head osteonecrosis

    PubMed Central

    2014-01-01

    Background Femoral head osteonecrosis is frequently observed in patients treated with excessive corticosteroids. The objective of the current study was to establish a rat model to investigate the disruption of immune response in steroid-induced femoral head osteonecrosis via Toll-like receptor 4 (TLR4) signaling pathway. Methods Male SD rats were divided into the treatment group (group A) and the model group (group B) consisting of 24 rats each, and were injected intramuscularly with 20 mg/kg methylprednisolone (MP) for 8 weeks, once a week. The rats in group A were injected intravenously with 7.5 mg/kg TAK242 before each MP administration. A control group (group N) consisted of 12 rats were received saline injection. All animals were sacrificed 8, 10 and 12 weeks from the first MP injection, respectively. Histopathological analysis was performed and the concentration of tartrate-resistant acid phosphatase (TRAP) in serum was tested. The signaling molecules including TLR4, MyD88, NF-κB p65 and MCP-1 were detected by immunohistochemistry, quantitative real-time PCR and Western blot. Results Femoral head osteonecrosis was observed in the model rats, and the concentration of TRAP and positive staining of all signaling molecules increased significantly in group B compared with that in group A and group N. Compare with the control group, the mRNA expressions and protein levels of all signaling molecules were enhanced significantly in group B, but no significant in group A. Conclusions Corticosteroids can induce femoral head osteonecrosis by disturbing the immune response via TLR4 signaling pathway. These findings suggest that the disruption of immune response play a role in the pathogenesis of osteonecrosis. PMID:24428851

  14. Potentiation of P1075-induced K+ channel opening by stimulation of adenylate cyclase in rat isolated aorta.

    PubMed Central

    Linde, C.; Quast, U.

    1995-01-01

    1. The effects of analogues and stimulators of cyclic AMP on the 86Rb+ efflux-stimulating and binding properties of P1075, an opener of ATP-dependent potassium channels, were studied in rat aortic rings. The increase in 86Rb+ efflux stimulated by P1075 was taken as a qualitative measure of K+ channel opening. 2. Forskolin, a direct activator of adenylate cyclase, isobutylmethylxanthine (IBMX), a phosphodiesterase inhibitor, and dibutyryl-cyclic AMP (db-cyclic AMP), a membrane permeant cyclic AMP-analogue, relaxed rat aortic rings contracted by noradrenaline with EC50 values of 0.06, 2 and 10 microM, respectively. 3. Forskolin, IBMX and db-cyclic AMP produced concentration-dependent increases of the 86Rb+ efflux induced by P1075 (50 nM) by up to twofold with EC50 values of about 0.1, 1.7 and 81 microM. At these concentrations the agents had little effect on the basal rate of 86Rb+ efflux. 4. The 86Rb+ efflux produced by P1075 in the presence of the cyclic AMP stimulators was inhibited by glibenclamide, a blocker of ATP-sensitive potassium channels. 5. IBMX (100 microM) induced a leftward shift of the concentration-86Rb+ efflux curve of P1075 without increasing the maximum. The enhancements of P1075-stimulated 86Rb+ efflux produced by combinations of forskolin and IBMX were either additive or less than additive. 6. The protein kinase A inhibitor, H-89, inhibited P1075-stimulated 86Rb+ efflux in the presence of IBMX significantly more than in the absence of IBMX, suggesting that the effect of increased cyclic AMP levels is mediated by protein kinase A.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7582466

  15. History of femoral head fracture and coronal fracture of the femoral condyles.

    PubMed

    Bartoníček, Jan; Rammelt, Stefan

    2015-06-01

    The first known description of the coronal fracture of the lateral femoral condyle was published by Busch in 1869. Hoffa used Busch's drawing in the first edition of his book in 1888 and accompanied it only with one sentence. A full case history of this fracture pattern was described by Braun in 1891. However, Braun's article fell into oblivion and so the fracture was popularized only in the fourth edition of Hoffa's textbook, particularly thanks to the drawing, rather than the brief description. Therefore, a fracture of the posterior femoral condyle, or more specifically, of the lateral condyle, could properly be called "Busch-Hoffa fracture". Femoral head fracture was initially described by Birkett in 1869. Of essential importance in this respect were the publications by Christopher in 1924 and, particularly, Pipkin's study of 1957, including his classification that is still in use today. A historically correct eponym for a femoral head fracture would therefore be "Birkitt-Pipkin fracture". PMID:25787681

  16. Transplantation of mesenchymal stem cells, recombinant human BMP-2,and their combination in accelerating the union after osteotomy and increasing, the mechanical strength of extracorporeally irradiated femoral autograft in rat models

    PubMed Central

    Fauzi Kamal, Achmad; Hadisoebroto Dilogo, Ismail; Untung Hutagalung, Errol; Iskandriati, Diah; Susworo, R.; Chaerani Siregar, Nurjati; Aulia Yusuf, Achmad; Bachtiar, Adang

    2014-01-01

    Background: Delayed union, nonunion, and mechanical failure is still problems encountered in limb salvage surgery (LSS) using extracorporeal irradiation (ECI). This study aimed to determine whether bone marrow mesenchymal stem cells (MSC) and recombinant human bone morphogenetic protein-2 (rhBMP-2) improve hostgraft union after osteotomy and also increase its mechanical strength. Methods: Thirty Sprague Dawley rats were randomly divided into five groups. Group I (control) underwent LSS using ECI method with 150 Gy single doses. Similar procedures were applied to other groups. Group II received hydroxyapatite (HA) scaffold. Group III received HA scaffold and MSC. Group IV received HA scaffold and rhBMP-2. Group V received HA scaffolds, MSC, and rhBMP-2. Radiograph were taken at week-2, 4, 6, and 8; serum alkaline phosphatase and osteocalcin were measured at week-2 and 4. Histopathological evaluation and biomechanical study was done at week-8. Results: The highest radiological score was found in group IV and V Similar result was obtained in histological score and ultimate bending force. These results were found to be statistically significant. There was no significant difference among groups in serum alkaline phosphatase and osteocalcin level. Conclusion: Combination of MSC and rhBMP-2 was proven to accelerate union and improve mechanical strength of ECI autograft. PMID:25679008

  17. EPIDEMIOLOGICAL STUDY OF CHILDREN DIAPHYSEAL FEMORAL FRACTURES

    PubMed Central

    Hoffmann, Cassiano Ricardo; Traldi, Eduardo Franceschini; Posser, Alexandre

    2015-01-01

    Objective: To evaluate the personal, fracture, treatment and complication characteristics among patients with pediatric femoral shaft fractures attended at the pediatric orthopedic service of the Joana de Gusmão Children's Hospital. Methods: This was a retrospective cross-sectional study on a population consisting of patients with femoral shaft fractures, aged between birth and 14 years and 11 months, who were divided into four age groups. Information was obtained from medical records and was transferred to a survey questionnaire to present personal, fracture, treatment and complication variables. Results: The study population consisted of 96 patients. Their mean age was 6.8 years. The cases were predominantly among males, comprising closed fractures on the right side, in the middle third with a single line. Regarding fracture etiology, traffic accidents predominated overall in the sample. Most of the patients (74 to 77.1%) presented femoral fractures as their only injury. Conservative treatment predominated in the group younger than six years of age, and surgical treatment in the group aged 6 to 14 years and 11 months. The complications observed until bone union were: discrepancy, infection and movement limitation. The mean time taken for consolidation was 9.6 ± 2.4 weeks, varying with age. Conclusion: The features of these fractures were similar to those described in the literature and the treatment used showed good results. The Joana de Gusmão Children's Hospital has used the treatment proposed in the literature for pediatric femoral shaft fractures. PMID:27042619

  18. Femoral neck version affects medial femorotibial loading.

    PubMed

    Papaioannou, T A; Digas, Georgios; Bikos, Ch; Karamoulas, V; Magnissalis, E A

    2013-01-01

    The aim of this study was to provide a preliminary evaluation of the possible effect that femoral version may have on the bearing equilibrium conditions developed on the medial tibiofemoral compartment. A digital 3D solid model of the left physiological adult femur was used to create morphological variations of different neck-shaft angles (varus 115, normal 125, and valgus 135 degrees) and version angles (-10, 0, and +10 degrees). By means of finite element modeling and analysis techniques (FEM-FEA), a virtual experiment was executed with the femoral models aligned in a neutral upright position, distally supported on a fully congruent tibial tray and proximally loaded with a vertical only hip joint load of 2800 N. Equivalent stresses and their distribution on the medial compartment were computed and comparatively evaluated. Within our context, the neck-shaft angle proved to be of rather indifferent influence. Reduction of femoral version, however, appeared as the most influencing parameter regarding the tendency of the medial compartment to establish its bearing equilibrium towards posteromedial directions, as a consequence of the corresponding anteroposterior changes of the hip centre over the horizontal tibiofemoral plane. We found a correlation between femoral anteversion and medial tibiofemoral compartment contact pressure. Our findings will be further elucidated by more sophisticated FEM-FEA and by clinical studies that are currently planned. PMID:24959355

  19. Dose- and time-response effects of pantethine on open-field behavior, and on central neurotransmission in rats.

    PubMed

    Vécsei, L; Widerlöv, E; Ekman, R; Alling, C

    1990-01-01

    In this study the dose- and time-related effects of pantethine on open-field behavior and central neurotransmissions were investigated in rats. Pantethine administered in low doses (0.48-0.96 mM/kg SC) only marginally influenced the activity of the animals, but induced a significant decrease of hypothalamic noradrenaline level without influencing the concentrations of dopamine and DOPAC. Injected in higher doses (1.95-3.90 mM/kg SC), the compound produced a marked depression of both open-field activity and noradrenaline levels, but increased the concentrations of dopamine and DOPAC in the hypothalamus. Twelve hr after the administration of the substance, its effect was attenuated, and 24 hr after the treatment neither the behavioral nor the monoamine parameters differed significantly from the control values. Concerning the somatostatin, pantethine administered in high doses (1.95-3.90 mM/kg SC) decreased the striatal concentration of somatostatin 4 hr after the injection, and this effect was attenuated 24 hr after the treatment. These data suggest that the pantethine-induced behavioral changes are correlated with its effect on central catecholaminergic and somatostatinergic transmission. PMID:1969162

  20. Differential mechanical response and microstructural organization between non-human primate femoral and carotid arteries

    PubMed Central

    Raykin, Julia; Li, Haiyan; Gleason, Rudolph L.

    2014-01-01

    Unique anatomic locations and physiologic functions predispose different arteries to varying mechanical responses and pathologies. However, the underlying causes of these mechanical differences are not well understood. The objective of this study was to first identify structural differences in the arterial matrix that would account for the mechanical differences between healthy femoral and carotid arteries and second to utilize these structural observations to perform a microstructurally motivated constitutive analysis. Femoral and carotid arteries were subjected to cylindrical biaxial loading and their microstructure was quantified using two-photon microscopy. The femoral arteries were found to be less compliant than the carotid arteries at physiologic loads, consistent with previous studies, despite similar extracellular compositions of collagen and elastin (P > 0.05). The femoral arteries exhibited significantly less circumferential dispersion of collagen fibers (P < 0.05), despite a similar mean fiber alignment direction as the carotid arteries. Elastin transmural distribution, in vivo axial stretch, and opening angles were also found to be distinctly different between the arteries. Lastly, we modeled the arteries’ mechanical behaviors using a microstructural-based, distributed collagen fiber constitutive model. With this approach, the material parameters of the model were solved using the experimental microstructural observations. The findings of this study support an important role for microstructural organization in arterial stiffness. PMID:24532266

  1. Linked opening angle and histological and mechanical aspects of the proximal pulmonary arteries of healthy and pulmonary hypertensive rats and calves.

    PubMed

    Tian, Lian; Lammers, Steven R; Kao, Philip H; Reusser, Mark; Stenmark, Kurt R; Hunter, Kendall S; Qi, H Jerry; Shandas, Robin

    2011-11-01

    Understanding how arterial remodeling changes the mechanical behavior of pulmonary arteries (PAs) is important to the evaluation of pulmonary vascular function. Early and current efforts have focused on the arteries' histological changes, their mechanical properties under in vitro mechanical testing, and their zero-stress and no-load states. However, the linkage between the histology and mechanical behavior is still not well understood. To explore this linkage, we investigated the geometry, residual stretch, and histology of proximal PAs in both adult rat and neonatal calf hypoxic models of pulmonary hypertension (PH), compared their changes due to chronic hypoxia across species, and proposed a two-layer mechanical model of artery to relate the opening angle to the stiffness ratio of the PA outer to inner layer. We found that the proximal PA remodeling in calves was quite different from that in rats. In rats, the arterial wall thickness, inner diameter, and outer layer thickness fraction all increased dramatically in PH and the opening angle decreased significantly, whereas in calves, only the arterial wall thickness increased in PH. The proposed model predicted that the stiffness ratio of the calf proximal PAs changed very little from control to hypertensive group, while the decrease of opening angle in rat proximal PAs in response to chronic hypoxia was approximately linear to the increase of the stiffness ratio. We conclude that the arterial remodeling in rat and calf proximal PAs is different and the change of opening angle can be linked to the change of the arterial histological structure and mechanics. PMID:21856906

  2. Induction of rat hepatic mitochondrial membrane permeability transition pore opening by leaf extract of Olax subscorpioidea

    PubMed Central

    Adegbite, Oluwatobi Samuel; Akinsanya, Yetunde Ifeoma; Kukoyi, Ayobami Jahdahunsi; Iyanda-Joel, Wisdom O.; Daniel, Oluwatoyin O.; Adebayo, Abiodun Humphrey

    2015-01-01

    Background: The induction of the mitochondrial membrane permeability transition (MMPT) pore has been implicated in the cascade of events involved in apoptosis (programmed cell death). Olax subscorpioidea is traditionally used for the treatment of several diseases and infection. However, its role on MMPT is not yet established. This study was aimed at evaluating the effects of varying concentrations of the methanol leaf extract of O. subscorpioidea (MEOS) on MMPT pore opening, mitochondrial adenosine triphosphatase (ATPase), and mitochondrial lipid peroxidation. Materials and Methods: Opening of the pore was spectrophotometrically assayed under succinate-energized conditions. Results: In the absence of triggering agent (calcium), MEOS induced MMPT pore opening by 350, 612, 827, 845% at 36, 60, 86 and 112 μg/ml, respectively. MEOS further induced MMPT pore opening in the presence of a triggering agent by 866, 905, 831, 840, 949% at 12, 36, 60, 86 and 112 μg/ml, respectively. The extract significantly induced mitochondrial membrane lipid peroxidation in all the concentration used. MEOS also significantly increased mitochondrial ATP hydrolysis by mitochondrial ATPase in all concentration of the extract used. Conclusion: It may be deduced from this results, that MEOS contains certain bioactive components that may find use in pathological conditions that require an enhanced rate of apoptosis. PMID:26109790

  3. Femoral mononeuropathy caused by a malignant sarcoma: two case reports.

    PubMed

    Montoliu, Patrícia; Pumarola, Martí; Zamora, Angels; Espada, Ivonne; Lloret, Albert; Añor, Sònia

    2008-11-01

    A 9-year old miniature poodle and a 6-year old American Staffordshire terrier were evaluated for slowly progressive lameness and atrophy of the left pelvic limb. Neurological examinations of both animals were consistent with femoral nerve lesions. In both cases, neoplastic masses were identified within the left psoas muscle, invading the left femoral nerve or, in one case, its nerve roots. Ultrasound-guided fine needle aspirate and histopathological examination of the masses revealed that these were malignant sarcomas. Femoral mononeuropathies are very rare in dogs, and most descriptions of femoral nerve lesions are caused by traumatic injuries. Descriptions of neoplastic processes affecting the femoral nerve are limited to peripheral nerve sheath tumours (PNST). These cases provide the first descriptions of malignant neoplasms other than PNSTs that infiltrate the femoral nerve or its nerve roots and cause unilateral femoral mononeuropathy and lameness of obscure origin. PMID:17889576

  4. Postcatheterization Femoral Arteriovenous Fistulas: Endovascular Treatment with Stent-Grafts

    SciTech Connect

    Onal, Baran Kosar, Sule; Gumus, Terman; Ilgit, Erhan T.; Akpek, Sergin

    2004-09-15

    Purpose: To report our results of stent-graft implantation for the endovascular treatment of postcatheterization femoral arteriovenous fistulas (AVFs) occurring between the deep femoral artery and the femoral vein.Methods: Endovascular treatment of iatrogenic femoral AVFs as a result of arterial puncture for coronary angiography and/or angioplasty was attempted in 10 cases. Balloon-expandable stent-grafts, one for each lesion, were used to repair the fistulas, which were between the deep femoral artery and the femoral vein in all cases. Stent-graft implantation to the deep femoral artery was performed by a contralateral retrograde approach.Results: All stent-grafts were deployed successfully. Complete closure of the fistulas was accomplished immediately in nine of 10 cases. In one case, complete closure could not be obtained but the fact that the complaint subsided was taken to indicate clinical success. In three cases, side branch occlusion of the deep femoral artery occurred. No complications were observed after implantation. Follow-up for 8-31 months (mean 18.5 months) with color Doppler ultrasonography revealed patency of the stented arterial segments without recurrent arteriovenous shunting in those nine patients who had successful immediate closure of their AVFs.Conclusion: Our results with a mean follow-up 18.5 months suggest that stent-graft implantation for the closure of postcatheterization femoral AVFs originating from the deep femoral artery is an effective, minimally invasive alternative procedure.

  5. Bone morphogenetic protein-7 accelerates fracture healing in osteoporotic rats

    PubMed Central

    Diwan, Ashish D; Leong, Anthony; Appleyard, Richard; Bhargav, Divya; Fang, Zhi Ming; Wei, Aiqun

    2013-01-01

    Background: Osteoporosis is characterized by low bone mass, bone fragility and increased susceptibility to fracture. Fracture healing in osteoporosis is delayed and rates of implant failure are high with few biological treatment options available. This study aimed to determine whether a single dose of bone morphogenetic protein-7 (BMP-7) in a collagen/carboxy-methyl cellulose (CMC) composite enhanced fracture healing in an osteoporotic rat model. Materials and Methods: An open femoral midshaft osteotomy was performed in female rats 3 months post-ovarectomy. Rats were randomized to receive either BMP-7 composite (n = 30) or composite alone (n = 30) at the fracture site during surgery. Thereafter calluses were collected on days 12, 20 and 31. Callus cross-sectional area, bone mineral density, biomechanical stiffness and maximum torque, radiographic bony union and histological callus maturity were evaluated at each time point. Results: There were statistically significant increases in bone mineral density and callus cross-section area at all time points in the BMP-7 group as compared to controls and biomechanical readings showed stronger bones at day 31 in the BMP-7 group. Histological and radiographic evaluation indicated significant acceleration of bony union in the BMP-7 group as compared to controls. Conclusion: This study demonstrated that BMP-7 accelerates fracture healing in an oestrogen-deficient environment in a rat femoral fracture healing model to scientific relevance level I. The use of BMP-7 composite could offer orthopedic surgeons an advantage over oestrogen therapy, enhancing osteoporotic fracture healing with a single, locally applied dose at the time of surgery, potentially overcoming delays in healing caused by the osteoporotic state. PMID:24379457

  6. Carbon dioxide contrast medium for endovascular treatment of ilio-femoral occlusive disease

    PubMed Central

    de Almeida Mendes, Cynthia; de Arruda Martins, Alexandre; Teivelis, Marcelo Passos; Kuzniec, Sergio; Varella, Andrea Yasbek Monteiro; Fioranelli, Alexandre; Wolosker, Nelson

    2015-01-01

    OBJECTIVES: Compare the use of carbon dioxide contrast medium with iodine contrast medium for the endovascular treatment of ilio-femoral occlusive disease in patients without contraindications to iodine. MATERIALS AND METHODS: From August 2012 to August 2014, 21 consecutive patients with ilio-femoral occlusive disease who were eligible for endovascular treatment and lacked contraindications to either iodine contrast or carbon dioxide were randomized into the carbon dioxide or iodine groups and subjected to ilio-femoral angioplasty. We analyzed the feasibility of the procedures, the surgical and clinical outcomes, the procedure lengths, the endovascular material costs, the contrast costs and the quality of the angiographic images in each group. RESULTS: No conversions to open surgery and no contrast media related complications were noted in either group. A post-operative femoral pulse was present in 88.9% of the iodine group and 80% of the carbon dioxide group. No differences in procedure length, endovascular material cost or renal function variation were noted between the groups. Four patients in the carbon dioxide group required iodine supplementation to complete the procedure. Contrast media expenses were reduced in the carbon dioxide group. Regarding angiographic image quality, 82% of the carbon dioxide images were graded as either good or fair by observers. CONCLUSIONS: The use of carbon dioxide contrast medium is a good option for ilio-femoral angioplasty in patients without contraindications to iodine and is not characterized by differences in endovascular material costs, procedure duration and surgical outcomes. In addition, carbon dioxide has lower contrast expenses compared with iodine. PMID:26598079

  7. Spontaneous stress fractures of the femoral neck

    SciTech Connect

    Dorne, H.L.; Lander, P.H.

    1985-02-01

    The diagnosis of spontaneous stress fractures of the femoral neck, a form of insufficiency stress fracture, can be missed easily. Patients present with unremitting hip pain without a history of significant trauma or unusual increase in daily activity. The initial radiographic features include osteoporosis, minor alterations of trabecular alignment, minimal extracortical or endosteal reaction, and lucent fracture lines. Initial scintigraphic examinations performed in three of four patients showed focal increased radionuclide uptake in two and no focal abnormality in one. Emphasis is placed on the paucity of early findings. Evaluation of patients with persistent hip pain requires a high degree of clinical suspicion and close follow-up; the sequelae of undetected spontaneous fractures are subcapital fracture with displacement, angular deformity, and a vascular necrosis of the femoral head.

  8. Atypical femoral fracture following zoledronic acid treatment.

    PubMed

    Ataoğlu, Baybars; Kaptan, Ahmet Yiğit; Eren, Toygun Kağan; Yapar, Ali Ekber; Berkay, Ahmet Fırat

    2016-04-01

    A 68-year-old female patient admitted to our clinic with right anterior thigh pain ongoing for six months and which increased in last two months. The patient had no trauma history. The patient had been followed-up for 15 years because of osteoporosis and administrated alendronate and ibandronate treatment for 10 years. Patient had three shots of zoledronate once a year during the last three years. Her pain was increasing when she was walking. Physical examination revealed pain in her right thigh. Radiogram showed thickened lateral cortex of the subtrochanteric area. Magnetic resonance imaging also showed thickening and edema of the same area. These images were correlated with atypical fracture in right femoral subthrochanteric zone. Dual energy X-ray absorptiometry revealed that T score was -3.3 in lumbar region and -2.5 in femoral neck. Zoledronate treatment was ended. Prophylactic surgical fixation was performed with titanium elastic nails. PMID:26874637

  9. To involvement the conformation of the adenine nucleotide translocase in opening the Tl(+)-induced permeability transition pore in Ca(2+)-loaded rat liver mitochondria.

    PubMed

    Korotkov, Sergey M; Konovalova, Svetlana A; Brailovskaya, Irina V; Saris, Nils-Erik L

    2016-04-01

    The conformation of adenine nucleotide translocase (ANT) has a profound impact in opening the mitochondrial permeability transition pore (MPTP) in the inner membrane. Fixing the ANT in 'c' conformation by phenylarsine oxide (PAO), tert-butylhydroperoxide (tBHP), and carboxyatractyloside as well as the interaction of 4,4'-diisothiocyanostilbene-2,2'-disulfonate (DIDS) with mitochondrial thiols markedly attenuated the ability of ADP to inhibit the MPTP opening. We earlier found (Korotkov and Saris, 2011) that calcium load of rat liver mitochondria in medium containing TlNO3 and KNO3 stimulated the Tl(+)-induced MPTP opening in the inner mitochondrial membrane. The MPTP opening as well as followed increase in swelling, a drop in membrane potential (ΔΨmito), and a decrease in state 3, state 4, and 2,4-dinitrophenol-uncoupled respiration were visibly enhanced in the presence of PAO, tBHP, DIDS, and carboxyatractyloside. However, these effects were markedly inhibited by ADP and membrane-penetrant hydrophobic thiol reagent, N-ethylmaleimide (NEM) which fix the ANT in 'm' conformation. Cyclosporine A additionally potentiated these effects of ADP and NEM. Our data suggest that conformational changes of the ANT may be directly involved in the opening of the Tl(+)-induced MPTP in the inner membrane of Ca(2+)-loaded rat liver mitochondria. Using the Tl(+)-induced MPTP model is discussed in terms finding new transition pore inhibitors and inducers among different chemical and natural compounds. PMID:26835787

  10. Femoral midshaft fractures: expandable versus locked nailing.

    PubMed

    Zhou, Zhen-Tao; Song, Yu-Chen; Zhou, Xiao-Zhong; Zhou, Hai-Bin; Luo, Zong-Ping; Dong, Qi-Rong

    2015-04-01

    Femoral midshaft fracture is one of the most common clinical injuries and is often caused by high-energy traffic accidents. Intramedullary nailings, plates, and external fixators are all used as treatment alternatives for a variety of patients depending on fracture location, displacement, comminution, soft tissue condition, and local tradition. Locked intramedullary nailing is currently the preferred treatment method for most diaphyseal fractures and has good clinical results. The goal of this study was to compare expandable and locked intramedullary nailing for the treatment of AO type 32A and 32B1 femoral midshaft fractures. The authors performed a retrospective analysis of 46 patients (33 men and 13 women; mean age, 32.3 years; range, 22-52 years) with femoral midshaft fractures who were divided into 2 groups-one treated with an expandable intramedullary nailing method and the other with a conventional locked intramedullary nailing. The 2 groups were compared with respect to operation time, fluoroscopic time, amount of estimated blood loss, hospitalization time, healing time, and complications. Patients were followed for at least 1 year. The results of this study showed that all of the patients achieved bone union within 12 to 24 months. Expandable nailing performed better than locked nailing in operation time, fluoroscopic time, amount of estimated blood loss, and healing time (P<.001). There was no difference in hospitalization time and no visible shortening or severe complications were observed in either group. Based on the results of this study, the expandable intramedullary nailing is an easy and effective treatment for AO type 32A and 32B1 diaphyseal femoral fractures. PMID:25901625

  11. Compartmental analysis of washout effect in rat brain: in-beam OpenPET measurement using a 11C beam

    NASA Astrophysics Data System (ADS)

    Hirano, Yoshiyuki; Kinouchi, Shoko; Ikoma, Yoko; Yoshida, Eiji; Wakizaka, Hidekazu; Ito, Hiroshi; Yamaya, Taiga

    2013-12-01

    In-beam positron emission tomography (PET) is expected to enable visualization of a dose verification using positron emitters (β+ decay). For accurate dose verification, correction of the washout of the positron emitters should be made. In addition, the quantitative washout rate has a potential usefulness as a diagnostic index, but modeling for this has not been studied yet. In this paper, therefore, we applied compartment analyses to in-beam PET data acquired by our small OpenPET prototype, which has a physically opened field-of-view (FOV) between two detector rings. A rat brain was located at the FOV and was irradiated by a 11C beam. Time activity curves of the irradiated field were measured immediately after the irradiations, and the washout rate was obtained based on two models: the two-washout model (medium decay, k2m; slow decay, k2s) developed in a study of rabbit irradiation; and the two-compartment model used in nuclear medicine, where efflux from tissue to blood (k2), influx (k3) and efflux (k4) from the first to second compartments in tissue were evaluated. The observed k2m and k2s were 0.34 and 0.005 min-1, respectively, which was consistent with the rabbit study. Also k2m was close to the washout rate in cerebral blood flow (CBF) measurements by dynamic PET with 15O-water, while, k2, k3, and k4 were 0.16, 0.15 and 0.007 min-1. Our present work suggested the dynamics of 11C might be relevant to CBF or permeability of a molecule containing 11C atoms might be regulated by a transporter because the k2 was relatively low compared with a simple diffusion tracer.

  12. Regional arterial stress-strain distributions referenced to the zero-stress state in the rat.

    PubMed

    Zhao, Jingbo; Day, Judd; Yuan, Zhuang Feng; Gregersen, Hans

    2002-02-01

    Morphometric and stress-strain properties were studied in isolated segments of the thoracic aorta, abdominal aorta, left common carotid artery, left femoral artery, and the left pulmonary artery in 16 male Wistar rats. The mechanical test was performed as a distension experiment where the proximal end of the arterial segment was connected via a tube to the container used for applying pressures to the segment and the distal end was left free. Outer wall dimensions were obtained from digitized images of the arterial segments at different pressures as well as at no-load and zero-stress states. The results showed that the morphometric data, such as inner and outer circumference, wall and lumen area, wall thickness, wall thickness-to-inner radius ratio, and normalized outer diameter, as a function of the applied pressures, differed between the five arteries (P < 0.01). The opening angle was largest in the pulmonary artery and smallest in thoracic aorta (P < 0.01). The absolute value of both the inner and outer residual strain and the residual strain gradient were largest in the femoral artery and smallest in the thoracic aorta (P < 0.01). In the circumferential and longitudinal direction, the arterial wall was stiffest in the femoral artery and in the thoracic aorta, respectively, and most compliant in the pulmonary artery. These results show that the morphometric and biomechanical properties referenced to the zero-stress state differed between the five arterial segments. PMID:11788411

  13. Clinical Instability of the Knee and Functional Differences Following Tibial Plateau Fractures Versus Distal Femoral Fractures

    PubMed Central

    Ebrahimzadeh, Mohammad Hosein; Birjandinejad, Ali; Moradi, Ali; Fathi Choghadeh, Maysam; Rezazadeh, Jafar; Omidi-Kashani, Farzad

    2015-01-01

    Background: Fractures of the knee account for about 6% of all trauma admissions. While its management is mostly focused on fracture treatment, it is not the only factor that defines the final outcome. Objectives: This study aimed to study objective and subjective outcomes after proximal tibial versus distal femoral fractures in terms of knee instability and health-related quality of life. Patients and Methods: This retrospective, cross-sectional, cohort study was carried out on 80 patients with either isolated proximal tibial (n = 42) or distal femoral (n = 38) fractures, who underwent open reduction and internal fixation. All the fractures were classified based on the Schatzker and AO classification for tibial plateau and distal femoral fractures, respectively. The patients were followed and examined by an orthopedic knee surgeon for clinical assessment of knee instability. In their last follow-up visit, these patients completed a Lysholm knee score and the short-form (SF) 36 health survey. Results: Among the 42 tibial plateau fractures, 25% were classified as Schatzker type 2. Of the 38 distal femoral fractures, we did not find any type B1 or B3 fractures. The overall prevalence of anterior and posterior instability was 42% and 20%, respectively. Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL) injuries were detected clinically in 50% and 28%, respectively. The incidence rates of ligament injuries in tibial plateau fractures were as follows: Anterior Collateral Ligament (ACL) 26%, Posterior Collateral Ligament (PCL) 7%, MCL 24%, and LCL 14%. Medial collateral ligament injury was the most common in the Schatzker type 2 (50% of the injuries). Distal femoral fractures were associated with ACL injury in 16%, PCL in 13%, MCL in 26% and LCL in 14%. However, final knee range of motion (ROM) and function (Lysholm score) were not associated with fracture location. No statistically significant difference was observed between the two groups, except for

  14. Pro-healing effects of bilirubin in open excision wound model in rats.

    PubMed

    Ahanger, Azad A; Leo, Marie D; Gopal, Anu; Kant, Vinay; Tandan, Surendra K; Kumar, Dinesh

    2016-06-01

    Bilirubin, a by-product of heme degradation, has an important role in cellular protection. Therefore, we speculated that bilirubin could be of potential therapeutic value in wound healing. To validate the hypothesis, we used a full-thickness cutaneous wound model in rats. Bilirubin (30 mg/kg) was administered intraperitoneally every day for 9 days. The surface area of the wound was measured on days 0, 2, 4, 7 and 10 after the creation of the wound. The granulation tissue was collected on day 10 post-wounding for analysing various parameters of wound healing. Bilirubin treatment accelerated wound contraction and increased hydroxyproline and glucosamine contents. mRNA expression of pro-inflammatory factors such as intercellular cell adhesion molecule-1 (ICAM-1) and tumour necrosis factor-α (TNF-α) were down-regulated and that of anti-inflammatory cytokine interleukin-10 (IL-10) was up-regulated. The findings suggest that bilirubin could be a new agent for enhancing cutaneous wound healing. PMID:24947136

  15. The cytosolic inactivation domains of BKi channels in rat chromaffin cells do not behave like simple, open-channel blockers.

    PubMed Central

    Solaro, C R; Ding, J P; Li, Z W; Lingle, C J

    1997-01-01

    Most BK-type voltage- and Ca(2+)-dependent K+ channels in rat chromaffin cells exhibit rapid inactivation. This inactivation is abolished by brief trypsin application to the cytosolic face of membrane patches. Here we examine the effects of cytosolic channel blockade and pore occupancy on this inactivation process, using inside-out patches and whole-cell recordings. Occupancy of a superficial pore-blocking site by cytosolic quaternary blockers does not slow inactivation. Occupancy of a deeper pore-blocking site by cytosolic application of Cs+ is also without effect on the onset of inactivation. Although the rate of inactivation is relatively unaffected by changes in extracellular K+, the rate of recovery from inactivation (at -80 and -140 mV with 10 microM Ca2+) is faster with increases in extracellular K+ but is unaffected by the impermeant ion, Na+. When tail currents are compared after repolarization, either while channels are open or after inactivation, no channel reopening is detectable during recovery from inactivation. BK inactivation appears to be mechanistically distinct from that of other inactivating voltage-dependent channels. Although involving a trypsin-sensitive cytosolic structure, the block to permeation does not appear to occur directly at the cytosolic mouth or inner half of the ion permeation pathway. PMID:9251798

  16. A Review of Periprosthetic Femoral Fractures Associated With Total Hip Arthroplasty

    PubMed Central

    Marsland, Daniel; Mears, Simon C.

    2012-01-01

    Periprosthetic fractures of the femur in association with total hip arthroplasty are increasingly common and often difficult to treat. Patients with periprosthetic fractures are typically elderly and frail and have osteoporosis. No clear consensus exists regarding the optimal management strategy because there is limited high-quality research. The Vancouver classification facilitates treatment decisions. In the presence of a stable prosthesis (type-B1 and -C fractures), most authors recommend surgical stabilization of the fracture with plates, strut grafts, or a combination thereof. In up to 20% of apparent Vancouver type-B1 fractures, the femoral stem is loose, which may explain the high failure rates associated with open reduction and internal fixation. Some authors recommend routine opening and dislocation of the hip to perform an intraoperative stem stability test to rule out a loose component. Advances in plating techniques and technology are improving the outcomes for these fractures. For fractures around a loose femoral prosthesis (types B2 and 3), revision using an extensively porous-coated uncemented long stem, with or without additional fracture fixation, appears to offer the most reliable outcome. Cement-in-cement revision using a long-stem prosthesis is feasible in elderly patients with a well-fixed cement mantle. It is essential to treat the osteoporosis to help fracture healing and to prevent further fractures. We provide an overview of the causes, classification, and management of periprosthetic femoral fractures around a total hip arthroplasty based on the current best available evidence. PMID:23569704

  17. Incomplete transposition of the common femoral artery and vein.

    PubMed

    Leite, J O; Carvalho Ventura, I; Botelho, F E; Costa Galvao, W

    2010-02-01

    Anatomical variations of the great saphenous vein, femoral artery and femoral vein at the inguinal level are rare. Modifications in the anatomical relationships among theses vessel can cause technical difficulties. There are two reports in the literature of the complete transposition of the femoral artery and vein. Both patients had large varicose veins only in the limb that presented the variation, which suggested an extrinsic compression. In the present paper, we report a case study of a patient with an incomplete transposition of the femoral artery and vein. Specifically, the common femoral vein and the saphenofemoral junction were completely overlapped by the common femoral artery. Although this anatomical variation did not present any clinical signs, it required a more complex surgical procedure. PMID:20224538

  18. Femoral neck structure and function in early hominins.

    PubMed

    Ruff, Christopher B; Higgins, Ryan

    2013-04-01

    All early (Pliocene-Early Pleistocene) hominins exhibit some differences in proximal femoral morphology from modern humans, including a long femoral neck and a low neck-shaft angle. In addition, australopiths (Au. afarensis, Au. africanus, Au. boisei, Paranthropus boisei), but not early Homo, have an "anteroposteriorly compressed" femoral neck and a small femoral head relative to femoral shaft breadth. Superoinferior asymmetry of cortical bone in the femoral neck has been claimed to be human-like in australopiths. In this study, we measured superior and inferior cortical thicknesses at the middle and base of the femoral neck using computed tomography in six Au. africanus and two P. robustus specimens. Cortical asymmetry in the fossils is closer overall to that of modern humans than to apes, although many values are intermediate between humans and apes, or even more ape-like in the midneck. Comparisons of external femoral neck and head dimensions were carried out for a more comprehensive sample of South and East African australopiths (n = 17) and two early Homo specimens. These show that compared with modern humans, femoral neck superoinferior, but not anteroposterior breadth, is larger relative to femoral head breadth in australopiths, but not in early Homo. Both internal and external characteristics of the australopith femoral neck indicate adaptation to relatively increased superoinferior bending loads, compared with both modern humans and early Homo. These observations, and a relatively small femoral head, are consistent with a slightly altered gait pattern in australopiths, involving more lateral deviation of the body center of mass over the stance limb. PMID:23341246

  19. Operative Management of Crossover Femoral-femoral Graft Erosion into Bladder: A Case Report.

    PubMed

    Motiani, Karan; Mahdy, Ayman

    2016-09-01

    Erosion of vascular grafts is not uncommon as seen in the recent literature. There have been many case reports documenting the work up and management of erosion of these grafts into bowel. We report a case of a crossover femoral-femoral graft that eroded into the anterior bladder wall and was incidentally found as an adherent bladder stone during cystoscopy. We demonstrate the importance of having a high level of clinical suspicion for eroding vascular grafts when preoperative imaging shows close proximity of graft to bladder. PMID:27462547

  20. Transient Receptor Potential Channel Opening Releases Endogenous Acetylcholine, which Contributes to Endothelium-Dependent Relaxation Induced by Mild Hypothermia in Spontaneously Hypertensive Rat but Not Wistar-Kyoto Rat Arteries.

    PubMed

    Zou, Q; Leung, S W S; Vanhoutte, P M

    2015-08-01

    Mild hypothermia causes endothelium-dependent relaxations, which are reduced by the muscarinic receptor antagonist atropine. The present study investigated whether endothelial endogenous acetylcholine contributes to these relaxations. Aortic rings of spontaneously hypertensive rats (SHRs) and normotensive Wistar-Kyoto (WKY) rats were contracted with prostaglandin F2 α and exposed to progressive mild hypothermia (from 37 to 31°C). Hypothermia induced endothelium-dependent, Nω-nitro-l-arginine methyl ester-sensitive relaxations, which were reduced by atropine, but not by mecamylamine, in SHR but not in WKY rat aortae. The responses in SHR aortae were also reduced by acetylcholinesterase (the enzyme responsible for acetylcholine degradation), bromoacetylcholine (inhibitor of acetylcholine synthesis), hemicholinium-3 (inhibitor of choline uptake), and vesamicol (inhibitor of acetylcholine release). The mild hypothermia-induced relaxations in both SHR and WKY rat aortae were inhibited by AMTB [N-(3-aminopropyl)-2-[(3-methylphenyl)methoxy]-N-(2-thienylmethyl)-benzamide; the transient receptor potential (TRP) M8 inhibitor]; only those in SHR aortae were inhibited by HC-067047 [2-methyl-1-[3-(4-morpholinyl)propyl]-5-phenyl-N-[3-(trifluoromethyl)phenyl]-1H-pyrrole-3-carboxamide; TRPV4 antagonist] while those in WKY rat aortae were reduced by HC-030031 [2-(1,3-dimethyl-2,6-dioxo-1,2,3,6-tetrahydro-7H-purin-7-yl)-N-(4-isopropylphenyl)acetamide; TRPA1 antagonist]. The endothelial uptake of extracellular choline and release of cyclic guanosine monophosphate was enhanced by mild hypothermia and inhibited by HC-067047 in SHR but not in WKY rat aortae. Compared with WKY rats, the SHR preparations expressed similar levels of acetylcholinesterase and choline acetyltransferase, but a lesser amount of vesicular acetylcholine transporter, located mainly in the endothelium. Thus, mild hypothermia causes nitric oxide-dependent relaxations by opening TRPA1 channels in WKY rat aortae

  1. Clinical Results of Internal Fixation of Subcapital Femoral Neck Fractures

    PubMed Central

    Moon, Kyoung Ho; Shin, Joong Sup; Shin, Eun Ho; Ahn, Chi Hoon; Choi, Geon Hong

    2016-01-01

    Background Subcapital femoral neck is known to cause many complications, such as avascular necrosis (AVN) of the femoral head or nonunion, compared with other femoral neck fractures. The purpose of this study was to analyze the incidence of AVN and fixation failures in patients treated with internal fixation using cannulated screws for the subcapital femoral neck fractures. Methods This study targeted a total of 84 cases of subcapital femoral neck fractures that underwent internal fixation using cannulated screws. The average follow-up time after surgery was 36.8 months (range, 24 to 148 months). Results Nine hips (10.7%) showing AVN of the femoral head and 6 hips (7.1%) showing fixation failures were observed. The factors affecting the incidence of AVN of the femoral head after sustaining fractures correlated well with fracture types in the Garden classification (p = 0.030). The factors affecting fixation failure were the degree of reduction (p = 0.001) measured by the Garden alignment index and firm fixation (p = 0.009) assessed using the technique of 3-point fixation through the inferomedial cortical bone of the femoral neck. Conclusions The complication rates for subcapital femoral neck fractures were lower than those previously reported; hence, internal fixation could be a primary treatment option for these fractures. PMID:27247738

  2. Operative management of Hoffa fracture of the femoral condyle.

    PubMed

    Sahu, Ramji Lal; Gupta, Pratiksha

    2014-01-01

    Hoffa fracture is a rare injury consisting of unicondylar tangential posterior fracture of the distal femur and only very few cases have been reported in the literature. These fractures are due to high energy trauma and conservative treatment generally yields poor results, but rigid internal fixation allows early functional rehabilitation and decreases the incidence of complications. The purpose of the study was to prospectively analyse the clinico-radiological and functional outcome following open surgical treatment. From July 2005 to July 2010, 22 patients (14 males and 8 females) were recruited from Emergency and outpatient department having closed and open Hoffa fracture of the femoral condyle. All patients were operated under general or spinal anesthesia. Post-operatively, all the patients were followed for 12 months. Fractures were united in a mean time of 10 weeks (range from 6 - 16 weeks) depending on the type of fracture pattern. Fractures were reduced anatomically in all except in one patient. During follow-up, there were no losses of reduction or fixation. Full weight bearing were started in the mean time of 8.8 weeks. Mean duration of hospital stay were 9.8 days. Complications were stiffness and pain in one patient, collateral laxity in one patient and progression of arthritis in one patient. The results were excellent in 90.90% and good in 9.09% patients. Finally, we conclude that the early anatomical reduction and rigid fixation with screws provide best results and minimal complications. PMID:25130151

  3. Intermittent exposure to social defeat and open-field test in rats: acute and long-term effects on ECG, body temperature and physical activity.

    PubMed

    Sgoifo, Andrea; Pozzato, Chiara; Meerlo, Peter; Costoli, Tania; Manghi, Massimo; Stilli, Donatella; Olivetti, Giorgio; Musso, Ezio

    2002-02-01

    This study investigated the effects of exposure to an intermittent homotypic stressor on: (i) habituation of acute autonomic responsivity (i.e. cardiac sympathovagal balance and susceptibility to arrhythmias), and (ii) circadian rhythmicity of heart rate, body temperature, and physical activity. After implantation of a transmitter for the radiotelemetric recording of electrocardiogram (ECG), body temperature and physical activity, adult male rats (Rattus norvegicus, Wild Type Groningen strain) were repeatedly exposed (10 consecutive times, on alternate days) to either a social stressor (defeat by a con-specific, n = 15) or an open-field, control challenge (transfer to a new cage; n = 8). ECGs, body temperature and physical activity were continuously recorded in baseline, test and recovery periods (each lasting 15 min), at the 1st and 10th episodes of both defeat and open-field challenge. The circadian rhythms of heart rate, body temperature and physical activity were monitored before (5 days), during (16 days) and after (21 days) the intermittent stress protocol. This study indicates that there is no clear habituation of either acute cardiac autonomic responsivity (as estimated by means of time-domain indexes of heart rate variability) or arrhythmia occurrence to a brief, intermittent, homotypic challenge, regardless of the nature of the stressor (social or non-social). On the other hand, rats exposed to social challenge also failed to show adaptation of acute temperature and activity stress responsiveness, whereas rats facing open-field challenge developed habituation of activity and sensitization of temperature responses. Repeated social challenge produced remarkable reductions of the heart rate circadian rhythm amplitude (this effect being significantly greater than that produced by intermittent open-field), but only minor changes in the daily rhythms of body temperature and physical activity. PMID:12171764

  4. Non-NMDA glutamate receptor occupancy and open probability at a rat cerebellar synapse with single and multiple release sites.

    PubMed Central

    Silver, R A; Cull-Candy, S G; Takahashi, T

    1996-01-01

    1. Excitatory postsynaptic currents (EPSCs) were recorded under whole-cell voltage clamp from granule cells in slices of rat cerebellum. EPSCs from individual mossy fibre inputs were identified by their all-or-none appearance in response to a graded stimulus. Excitatory synaptic transmission was investigated at room temperature (approximately 24 degrees C) and at near-physiological temperature (approximately 34 degrees C) by analysing current fluctuations in the peak and decay of the non-N-methyl-D-aspartate (non-NMDA) component of EPSCs. 2. In a subset of synapses the mean EPSC amplitude remained unchanged as the probability of transmitter release was substantially lowered by raising the extracellular [Mg2+] and lowering [Ca2+]. These synapses were considered to have only one functional release site. Single-site synapses had small EPSCs (139 +/- 16 pS, n = 5, at 24 degrees C) with a large coefficient of variation (c.v. = 0.23 +/- 0.02, n = 5) and an amplitude distribution that was well fitted by a Gaussian distribution in four out of five cases. The EPSC latency had a unimodal distribution and its standard deviation had a temperature dependence with a temperature coefficient (Q10; range, 24-35 degrees C) of 2.4 +/- 0.4 (n = 4). 3. Peak-scaled non-stationary fluctuation analysis of single-site EPSCs indicated that the mean conductance of the underlying non-NMDA channels was 12 +/- 2 pS (n = 4) at 35 degrees C. Upper and lower limits for mean channel open probability (Po), calculated from fluctuations in the EPSC peak amplitude, were 0.51 and 0.38, respectively. These estimates, together with the open probability of the channel when bound by transmitter, suggest that only about 50% of the non-NMDA channels were occupied following the release of a quantum of transmitter. 4. At some multi-site synapses EPSCs had a low c.v. (0.4 +/- 0.01, n = 5) at 34 degrees C and non-stationary fluctuation analysis gave a parabolic variance-mean current relationship. This suggests

  5. Effectiveness of Fulkerson Osteotomy with Femoral Nerve Stimulation for Patients with Severe Femoral Trochlear Dysplasia

    PubMed Central

    Crebs, D.T.; Anthony, C.A.; McCunniff, P.T.; Nieto, M.J.; Beckert, M.W.; Albright, J.P.

    2015-01-01

    Background Patients with femoral trochlear dysplasia are at risk for chronic recurrent patellofemoral dislocations, with extreme cases often requiring a surgical procedure. Anteromedialization of the tibial tubercle with intraoperative femoral nerve stimulation and concurrent medial patella-femoral ligament (MPFL) reconstruction is a previously reported method of maximizing patello-femoral congruency. We hypothesize the Fulkerson osteotomy with intraoperative femoral nerve stimulation and concurrent MPFL reconstruction in patients with severe trochlear dysplasia provides equivalent postoperative clinical outcomes to the same procedure in patients with low level trochlear dysplasia. Methods 48 knees underwent Fulkerson osteotomy with intraoperative femoral nerve stimulation and concurrent MPFL reconstruction for recurrent lateral patellar dislocations. MRI, surgeon intraoperative assessment, and X-ray were used to assess degrees of trochlear dysplasia; inter-observer and intra-observer error were measured. The knees positive for severe dysplasia on MRI, intraoperative assessment, and X-ray were considered as a comparison cohort to the rest of the study population. We considered postoperative dislocation events and patellar tracking kinematics as outcome measures. Independent student t tests and Fisher exact tests were used to evaluate differences between groups. Significance was set at P<0.05. Results 11 knees were positive for severe dysplasia (SD) by combined MRI, surgeon intraoperative assessment, and X-ray with the remaining 37 knees categorized as low dysplasia (LD). No patients in either group exhibited apprehension or required re-operation. Mean sulcus angle in the SD group was 175.8 +−2.45 degrees (95% CI 171.0–180.6); the LD group mean sulcus angle was 154.3 +− 0.98 degrees (95% CI 152.4–156.2) (P<.001). Postoperatively there was no significant difference in dislocation events between the SD group (0/11) and the LD group (2/37) (P>0.999). Patellar

  6. Slipped capital femoral epiphysis: what's new?

    PubMed

    Peck, Kathryn; Herrera-Soto, José

    2014-01-01

    Slipped capital femoral epiphysis (SCFE) is a common hip disorder among adolescents, whereby the epiphysis is displaced posteriorly and inferiorly to the metaphysis. Treatment modalities aim to stabilize the epiphysis, prevent further slippage, and avoid complications associated with long-term morbidity, such as osteonecrosis and chondrolysis. Controversy exists with SCFE regarding prophylactic fixation of the contralateral, painless, normal hip, the role of femoroacetabular impingement with SCFE, and whether in situ fixation is the best treatment method for SCFE. This article presents and discusses the latest diagnostic and treatment modalities for SCFE. PMID:24267209

  7. Osteosynthesis of ununited femoral neck fracture by internal fixation combined with iliac crest bone chips and muscle pedicle bone grafting

    PubMed Central

    Baksi, D D; Pal, A K; Baksi, D P

    2016-01-01

    Background: Ununited femoral neck fracture is seen commonly in developing countries due to delayed presentation or failure of primary internal fixation. Such fractures, commonly present with partial or total absorption of femoral neck, osteonecrosis of femoral head in 8–30% cases with upward migration of trochanter posing problem for osteosynthesis, especially in younger individuals. Several techniques for treatment of such conditions are described like osteotomies or nonvascularied cortical or cancellous bone grafting provided varying degrees of success in terms of fracture union but unsatisfactory long term results occurred due to varying incidence of avascular necrosis (AVN) of femoral head. Moreover, in presence of AVN of femoral head neither free fibular graft nor cancellous bone graft is satisfactory. The vascularied bone grafting by deep circumflex iliac artery based on iliac crest bone grafting, free vascularied fibular grafting and muscle pedicle periosteal grafting showed high incidence of success rate. Osteosynthesis is the preferred treatment of choice in ununited femoral neck fracture in younger individuals. Materials and Methods: Of the 293 patients operated during the period from June 1977 to June 2009, 42 were lost to followup. Seven patients with gluteus medius muscle pedicle bone grafting (MPBG) were excluded. Thus, out of 244 patients, 208 (85.3%) untreated nonunion and 36 (14.7%) following failure of primary internal fixation were available for studies. Time interval between the date of injury and operation in untreated nonunion cases was mean 6.5 months and in failed internal fixation cases was mean 11.2 months. Ages of the patients varied from 16 to 55 years. Seventy patients had partial and 174 had subtotal absorption of the femoral neck. Evidence of avascular necrosis (AVN) femoral head was found histologically in 135 (54.3%) and radiologically in 48 (19.7%) patients. The patients were operated by open reduction of fracture, cannulated hip

  8. Correlation Between Asymmetric Resection of Posterior Femoral Condyles and Femoral Component Rotation in Total Knee Arthroplasty

    PubMed Central

    Güngör, Harun Reşit; Ök, Nusret; Ağladıoğlu, Kadir; Akkaya, Semih; Kıter, Esat

    2014-01-01

    Objectives: Pertaining to peculiar designs of current knee prostheses, more bone is removed from posteromedial femoral condyle than posterolateral condyle to obtain desired femoral component rotation. The aim of our study was to evaluate whether there is a correlation between the asymmetry of the cuts and the femoral component rotation in total knee arthroplasty. Methods: We built a model to simulate anterior chamfer cut (ACC) performed during total knee arthroplasty for measuring posterior condylar offset (PCO). Right knee axial MRI slices of a total 290 consecutive patients (142 male, 138 female, and mean age 31.39 ± 6.6) were examined. A parallel line to surgical transepiphyseal axis was drawn, and placed at the deepest part of trochlear groove. Posteromedial and posterolateral condylar offsets were measured by drawing perpendicular lines to ACC beginning from the intersection points of both anteromedial and anterolateral cortices to posterior joint line (PJL), respectively. Differences between posteromedial and posterolateral PCO were calculated, and femoral rotation angles (FRA) relative to PJL were measured. Results: The mean surgical FRA was 4.76 ± 1.16 degrees and the mean PCO differencesss- was 4.35 ± 1.04 mm for the whole group and there was no statistically significant difference between genders. There was a strong correlation between surgical FRA and PCO difference (p<0.0001, r=0.803). Linear regression analyses revealed that 0.8 mm of difference between the anteroposterior dimensions of medial and lateral PCO corresponds to 1 degree of surgical FRA (p<0.0001, R2=0.645). Conclusion: Correlation between the asymmetry of posterior chamfer cuts and achieved femoral component rotation can verify the accuracy of desired rotation, intraoperatively. However, further clinical investigations should be planned to test the results of our morphometric study.

  9. Accuracy of femoral templating in reproducing anatomical femoral offset in total hip replacement.

    PubMed

    Davies, H; Foote, J; Spencer, R F

    2007-01-01

    Restoration of hip biomechanics is a crucial component of successful total hip replacement. Preoperative templating is recommended to ensure that the size and orientation of implants is optimised. We studied how closely natural femoral offset could be reproduced using the manufacturers' templates for 10 femoral stems in common use in the UK. A series of 23 consecutive preoperative radiographs from patients who had undergone unilateral total hip replacement for unilateral osteoarthritis of the hip was employed. The change in offset between the templated position of the best-fitting template and the anatomical centre of the hip was measured. The templates were then ranked according to their ability to reproduce the normal anatomical offset. The most accurate was the CPS-Plus (Root Mean Square Error 2.0 mm) followed in rank order by: C stem (2.16), CPT (2.40), Exeter (3.23), Stanmore (3.28), Charnley (3.65), Corail (3.72), ABG II (4.30), Furlong HAC (5.08) and Furlong modular (7.14). A similar pattern of results was achieved when the standard error of variability of offset was analysed. We observed a wide variation in the ability of the femoral prosthesis templates to reproduce normal femoral offset. This variation was independent of the seniority of the observer. The templates of modern polished tapered stems with high modularity were best able to reproduce femoral offset. The current move towards digitisation of X-rays may offer manufacturers an opportunity to improve template designs in certain instances, and to develop appropriate computer software. PMID:19197861

  10. Rat sightings in New York City are associated with neighborhood sociodemographics, housing characteristics, and proximity to open public space

    PubMed Central

    2014-01-01

    Rats are ubiquitous in urban environments and, as established reservoirs for infectious pathogens, present a control priority for public health agencies. New York City (NYC) harbors one of the largest rat populations in the United States, but surprising little study has been undertaken to define rat ecology across varied features of this urban landscape. More importantly, factors that may contribute to increased encounters between rats and humans have rarely been explored. Using city-wide records of rat sightings reported to the NYC Department of Health and Mental Hygiene, this investigation sought to identify sociodemographic, housing, and physical landscape characteristics that are associated with increased rat sightings across NYC census tracts. A hierarchical Bayesian conditional autoregressive Poisson model was used to assess these associations while accounting for spatial heterogeneity in the variance. Closer proximity to both subway lines and recreational public spaces was associated with a higher concentration of rat sightings, as was a greater presence of older housing, vacant housing units, and low education among the population. Moreover, these aspects of the physical and social landscape accurately predicted rat sightings across the city. These findings have identified specific features of the NYC urban environment that may help to provide direct control targets for reducing human–rat encounters. PMID:25237595

  11. Rat sightings in New York City are associated with neighborhood sociodemographics, housing characteristics, and proximity to open public space.

    PubMed

    Walsh, Michael G

    2014-01-01

    Rats are ubiquitous in urban environments and, as established reservoirs for infectious pathogens, present a control priority for public health agencies. New York City (NYC) harbors one of the largest rat populations in the United States, but surprising little study has been undertaken to define rat ecology across varied features of this urban landscape. More importantly, factors that may contribute to increased encounters between rats and humans have rarely been explored. Using city-wide records of rat sightings reported to the NYC Department of Health and Mental Hygiene, this investigation sought to identify sociodemographic, housing, and physical landscape characteristics that are associated with increased rat sightings across NYC census tracts. A hierarchical Bayesian conditional autoregressive Poisson model was used to assess these associations while accounting for spatial heterogeneity in the variance. Closer proximity to both subway lines and recreational public spaces was associated with a higher concentration of rat sightings, as was a greater presence of older housing, vacant housing units, and low education among the population. Moreover, these aspects of the physical and social landscape accurately predicted rat sightings across the city. These findings have identified specific features of the NYC urban environment that may help to provide direct control targets for reducing human-rat encounters. PMID:25237595

  12. [The changes of bone architecture in atypical femoral fracture].

    PubMed

    Yamamoto, Noriaki; Shimakura, Taketoshi; Takahash, Hideaki

    2013-07-01

    The feature of atypical femoral fracture is stress induced cortical bone reaction. It was considered to be the accumulation of microdamage which come from increasing of mechanical stress by femoral lateral bowing, and the decreased of ability of microdamage repair system. PMID:23811584

  13. The femoral head–neck contour varies as a function of physeal development

    PubMed Central

    Vo, A.; Beaule, P. E.; Sampaio, M. L.; Rotaru, C.; Rakhra, K. S.

    2015-01-01

    Objectives The purpose of this study was to investigate whether the femoral head–neck contour, characterised by the alpha angle, varies with the stage of physeal maturation using MRI evaluation of an asymptomatic paediatric population. Methods Paediatric volunteers with asymptomatic hips were recruited to undergo MRI of both hips. Femoral head physes were graded from 1 (completely open) to 6 (completely fused). The femoral head–neck contour was evaluated using the alpha angle, measured at the 3:00 (anterior) and 1:30 (anterosuperior) positions and correlated with physeal grade, with gender sub-analysis performed. Results A total of 43 asymptomatic paediatric volunteers (26 male, 17 female) with mean age 13.0 years (eight to 18) were included with review of bilateral hip MRIs. Correlation between the physeal grade and alpha angle was moderate in males at both the 3:00 (r = 0.477, p < 0.001) and 1:30 (r = 0.509, p < 0.001) positions, whereas there was no significant correlation in females. A significant difference was found between the alpha angles of all the physeal grades (3:00, p = 0.030, 1:30, p = 0.005), but only in males, with the angle increasing with higher grades. For physeal grading, the inter-reader reliability was substantial (intraclass correlation coefficient (ICC) = 0.694), and the intra-reader reliability was also substantial (ICC = 0.788). Conclusion The femoral head–neck contour varies and correlates with the stage of physeal development, but only in males, with the alpha angle increasing with progressive physeal maturation. This suggests that gender differences exist in the natural physiological growth, development or remodelling of femoral head–neck junction. In males, pre-physeal fusion may be a critical period of vulnerability for development of morphologic abnormalities of the femoral head–neck junction. Cite this article: Bone Joint Res 2015;4:17–22 PMID:25673625

  14. Continuous blood gas monitoring in femoral arteries

    NASA Astrophysics Data System (ADS)

    Schlain, Les A.; Spar, Steven M.; Dellinger, Bart

    1995-05-01

    Continuous intra-arterial blood gas monitoring is a potentially valuable tool in the surgical and intensive care arenas. Patient oxygenation and acid base status can change rapidly and without warning. The ability to monitor pHa, PaCO2 and PaO2 in arterial blood will be a major medical advance for the anesthesiologist and intensivist. Intra-arterial blood gas sensors are typically placed in radial arteries. In certain patient populations accurate monitoring is not possible in radial arteries due to arterial environmental factors such as hypotension, vasoconstriction and atherosclerotic disease. These same factors can make radial cannulation difficult resulting in traumatic catheter insertion, thereby further compromising flow conditions. In situations where radial artery flow is expected to be compromised, selecting a large vessel for sensor placement is desirable. We report an initial feasibility study of our blood gas monitoring system using the femoral artery as the sensing site. Clinical results are presented as well as potential advantages and disadvantages associated with monitoring in the femoral artery.

  15. Complete guidewire retention after femoral vein catheterization.

    PubMed

    Cat, Bahar Gulcay; Guler, Sertac; Soyuduru, Murat; Guven, Ibrahim; Ramadan, Hayri

    2015-01-01

    Central venous catheters (CVCs) are often used for various purposes in the emergency departments (ED). The main uses of CVCs in the EDs are emergent hemodialysis, in situations where peripheral vein catheterization cannot be achieved, and continuous invasive hemodynamic monitoring. The complications related to CVC insertion are usually mechanical and observed in the near term after the procedure. Retained CVC guidewire after catheterization is a rare complication in the published reports and usually related with intra- or postoperative settings and jugular or subclavian vein. The present study reported a young female patient who underwent left femoral vein catheterization 6 months earlier in an intensive care unit of another hospital and was diagnosed with complete guidewire retention in the ED. To the best of the authors' knowledge, this is the first case in published reports with a diagnosis of retained CVC guidewire with retrograde migration into the femoral vein. Surprisingly, the patient developed no thrombotic or embolic complication during this 6-month period. PMID:26657235

  16. Current concepts in total femoral replacement

    PubMed Central

    Ramanathan, Deepak; Siqueira, Marcelo BP; Klika, Alison K; Higuera, Carlos A; Barsoum, Wael K; Joyce, Michael J

    2015-01-01

    Total femoral replacement (TFR) is a salvage arthroplasty procedure used as an alternative to lower limb amputation. Since its initial description in the mid-20th century, this procedure has been used in a variety of oncologic and non-oncologic indications. The most compelling advantage of TFR is the achievement of immediate fixation which permits early mobilization. It is anticipated that TFR will be increasingly performed as the rate of revision arthroplasty rises worldwide. The existing literature is mainly composed of a rather heterogeneous mix of retrospective case series and a wide assortment of case reports. Numerous TFR prostheses are currently available and the surgeon must understand the unique implications of each implant design. Long-term functional outcomes are dependent on adherence to proper technique and an appropriate physical therapy program for postoperative rehabilitation. Revision TFR is mainly performed for periprosthetic infection and the severe femoral bone loss associated with aseptic revisions. Depending on the likelihood of attaining infection clearance, it may sometimes be advisable to proceed directly to hip disarticulation without attempting salvage of the TFR. Other reported complications of TFR include hip joint instability, limb length discrepancy, device failure, component loosening, patellar maltracking and delayed wound healing. Further research is needed to better characterize the long-term functional outcomes and complications associated with this complex procedure. PMID:26716087

  17. Clinical outcomes of locked plating of distal femoral fractures in a retrospective cohort

    PubMed Central

    2013-01-01

    Purpose Locked plating (LP) of distal femoral fractures has become very popular. Despite technique suggestions from anecdotal and some early reports, knowledge about risk factors for failure, nonunion (NU), and revision is limited. The purpose of this study was to analyze the complications and clinical outcomes of LP treatment for distal femoral fractures. Materials and methods From two trauma centers, 243 consecutive surgically treated distal femoral fractures (AO/OTA 33) were retrospectively identified. Of these, 111 fractures in 106 patients (53.8% female) underwent locked plate fixation. They had an average age of 54 years (range 18 to 95 years): 34.2% were obese, 18.9% were smokers, and 18.9% were diabetic. Open fractures were present in 40.5% with 79.5% Gustilo type III. Fixation constructs for plate length, working length, and screw concentration were delineated. Nonunion and/or infection, and implant failure were used as outcome complication variables. Outcome was based on surgical method and addressed according to Pritchett for reduction, range of motion, and pain. Results Eighty-three (74.8%) of the fractures healed after the index procedure. Twenty (18.0%) of the patients developed a NU. Four of 20 (20%) resulted in a recalcitrant NU. Length of comminution did not correlate to NU (p = 0.180). Closed injuries had a higher tendency to heal after the index procedure than open injuries (p = 0.057). Closed and minimally open (Gustilo/Anderson types I and II) fractures healed at a significantly higher rate after the index procedure compared to type III open fractures (80.0% versus 61.3%, p = 0.041). Eleven fractures (9.9%) developed hardware failure. Fewer nonunions were found in the submuscular group (10.7%) compared to open reduction (32.0%) (p = 0.023). Fractures above total knee arthroplasties had a significantly greater rate of failed hardware (p = 0.040) and worse clinical outcome according to Pritchett (p = 0.040). Loss of

  18. Changes in blood CD4+T and CD8+T lymphocytes in stressed rats pretreated chronically with desipramine are more pronounced after chronic open field stress challenge.

    PubMed

    Listowska, Magdalena; Glac, Wojciech; Grembecka, Beata; Grzybowska, Maria; Wrona, Danuta

    2015-05-15

    The present study examines the influence of a chronic (14 consecutive days) desipramine (10mg/kg i.p.) pretreatment by itself vs. after chronic (7 consecutive day) open-field (OF) on immune system alterations in response to acute (30 min) OF in Wistar rats (n=60). Opposing to the effect of desipramine injected alone, the combined pretreatment after chronic OF challenge exerts suppressive effects on peripheral blood T/B, CD4(+)T-helper/inducer and CD8(+)T-cytotoxic/suppressor but not NK cell number, decreased interferon-γ/interleukin-10 ratio and thymus weight in the stressed rats. It suggests that chronic stress exposure is important for the immunomodulatory effects of pretreatment with antidepressants. PMID:25903729

  19. [Infection following centro-medullary nailing of diaphyseal femoral and tibial fractures].

    PubMed

    Lortat-Jacob, A; Sutour, J M; Beaufils, P

    1986-01-01

    The authors have treated 51 cases of infection arising after intramedullary nailing of the femur or tibia. In 3 cases amputation was required, 48 united, but 10 were still draining. The final result was obtained after an average of 15 months. An average of four procedures per patient were needed. All the cases were septic non-unions at the onset of treatment, except 18 cases which had already united. In these cases, simple removal of the femoral nail led to rapid healing. In contrast, healing was less easy to obtain in the tibia. In 33 septic non-unions, 12 femoral and 21 tibial, the best results at the femoral level were obtained by retaining the nail in situ. At the tibial level, retention of the nail was rarely followed by bony union. Removal of the nail and the use of external fixation gave good results for the infection, but rarely resulted in bony union (1 case out of 14). The failures were treated by further operation of bone resection and grafting. The authors recommend, in cases of tibial septic non-union after nailing that primary removal of the nail should be associated with bony resection and external fixation, followed by reconstructive grafting, either by open cancellous grafting extending to the fibula or conventional tibio fibular grafting. In 8 cases, 7 in the femur and 1 in the tibia, the infection extended throughout the entire diaphysis and in 3 of these cases, a large diaphyseal resection was required. PMID:3823510

  20. Medial patellofemoral ligament reconstruction procedure using a suspensory femoral fixation system.

    PubMed

    Nakagawa, Shuji; Arai, Yuji; Kan, Hiroyuki; Ueshima, Keiichiro; Ikoma, Kazuya; Terauchi, Ryu; Kubo, Toshikazu

    2013-11-01

    Recurrent patellar dislocation has recently been treated with anatomic medial patellofemoral ligament (MPFL) reconstruction using a semitendinosus muscle tendon. Although it is necessary to add tension to fix the tendon graft without loading excess stress on the patellofemoral joint, adjustment of the tension can be difficult. To resolve this problem, we developed an MPFL reconstruction procedure using the ToggleLoc Fixation Device (Biomet, Warsaw, IN), in which the semitendinosus muscle tendon is folded and used as a double-bundle tendon graft and 2 bone tunnels and 1 bone tunnel are made on the patellar and femoral sides, respectively. The patellar side of the tendon graft is fixed with an EndoButton (Smith & Nephew, London, England), and the femoral side is fixed with the ToggleLoc. Stepless adjustment of tension of the tendon graft is possible by reducing the size of the loop of the ToggleLoc hung onto the tendon graft. It may be useful to position the patella in the center of the femoral sulcus by confirming the patellofemoral joint fitting. Stability can be confirmed by loading lateral stress on the patella in the extended knee joint. This procedure is less invasive because opening of the lateral side of the femur is not necessary, and it may be useful for MPFL reconstruction. PMID:24892014

  1. ANALYSIS OF THE SEGMENTAL IMPACTION OF FEMORAL HEAD FOLLOWING AN ACETABULAR FRACTURE SURGICALLY MANAGED

    PubMed Central

    Guimarães, Rodrigo Pereira; Kaleka, Camila Cohen; Cohen, Carina; Daniachi, Daniel; Keiske Ono, Nelson; Honda, Emerson Kiyoshi; Polesello, Giancarlo Cavalli; Riccioli, Walter

    2015-01-01

    Objective: Correlate the postoperative radiographic evaluation with variables accompanying acetabular fractures in order to determine the predictive factors for segmental impaction of femoral head. Methods: Retrospective analysis of medial files of patients submitted to open reduction surgery with internal acetabular fixation. Within approximately 35 years, 596 patients were treated for acetabular fractures; 267 were followed up for at least two years. The others were excluded either because their follow up was shorter than the minimum time, or as a result of the lack of sufficient data reported on files, or because they had been submitted to non-surgical treatment. The patients were followed up by one of three surgeons of the group using the Merle d'Aubigné and Postel clinical scales as well as radiological studies. Results: Only tow studied variables-age and amount of postoperative reductionshowed statistically significant correlation with femoral head impaction. Conclusions: The quality of reduction-anatomical or with up to 2mm residual deviation-presents a good radiographic evolution, reducing the potential for segmental impaction of the femoral head, a statistically significant finding. PMID:27004191

  2. Technique of Arthroscopically Assisted Transtrochanteric Drilling for Femoral Head Chondral Defects.

    PubMed

    Chandrasekaran, Sivashankar; Lindner, Dror; Martin, Timothy J; Lodhia, Parth; Suarez-Ahedo, Carlos; Domb, Benjamin G

    2015-08-01

    Microfracture is a marrow-stimulation technique in which damaged cartilage is drilled or punched, perforating the subchondral bone and generating a blood clot within the defect that matures into fibrocartilage. Microfracture for the treatment of small cartilage defects of the hip has shown good results. Arthroscopic procedures are less invasive than open procedures and have a reduced incidence of complications such as infection or avascular necrosis of the femoral head. Furthermore, arthroscopic procedures allow for a shorter recovery time, resulting in not only lower overall treatment costs but also higher patient satisfaction. Medial and parafoveal cartilage defects of the femoral head can be challenging to effectively microfracture using standard arthroscopy portals because of the acute angles required for instrument manipulation. This report describes a technique for microfracturing these challenging areas of the femoral head using a 2.7-mm K-wire and drilling in a transtrochanteric direction using arthroscopic and imaging guidance to target the area of chondral damage. PMID:26759764

  3. Technique of Arthroscopically Assisted Transtrochanteric Drilling for Femoral Head Chondral Defects

    PubMed Central

    Chandrasekaran, Sivashankar; Lindner, Dror; Martin, Timothy J.; Lodhia, Parth; Suarez-Ahedo, Carlos; Domb, Benjamin G.

    2015-01-01

    Microfracture is a marrow-stimulation technique in which damaged cartilage is drilled or punched, perforating the subchondral bone and generating a blood clot within the defect that matures into fibrocartilage. Microfracture for the treatment of small cartilage defects of the hip has shown good results. Arthroscopic procedures are less invasive than open procedures and have a reduced incidence of complications such as infection or avascular necrosis of the femoral head. Furthermore, arthroscopic procedures allow for a shorter recovery time, resulting in not only lower overall treatment costs but also higher patient satisfaction. Medial and parafoveal cartilage defects of the femoral head can be challenging to effectively microfracture using standard arthroscopy portals because of the acute angles required for instrument manipulation. This report describes a technique for microfracturing these challenging areas of the femoral head using a 2.7-mm K-wire and drilling in a transtrochanteric direction using arthroscopic and imaging guidance to target the area of chondral damage. PMID:26759764

  4. Occult fracture of the femoral neck associated with extensive osteonecrosis of the femoral head: A case report

    PubMed Central

    Fukui, Kiyokazu; Kaneuji, Ayumi; Matsumoto, Tadami

    2015-01-01

    Introduction Although the subchondral portion of the femoral head is a common site for collapse in osteonecrosis of the femoral head (ONFH), femoral-neck fracture rarely occurs during the course of ONFH. We report a case of occult insufficiency fracture of the femoral neck without conditions predisposing to insufficiency fractures, occurring in association with ONFH. Presentation of case We report a case of occult fracture of the femoral neck due to extensive ONFH in a 60-year-old man. No abnormal findings suggestive of ONFH were identified on radiographs, and the fracture occurred spontaneously without any trauma or unusual increase in activity. The patient’s medical history, age, and good bone quality suggested ONFH as a possible underlying cause. Contrast-enhanced magnetic resonance imaging was useful in determining whether the fracture was caused by ONFH or was instead a simple insufficiency fracture caused by steroid use. Discussion The patient was treated with bipolar hemiarthroplasty, but if we had not suspected ONFH as a predisposing condition, the undisplaced fracture might have been treated by osteosynthesis, and this would have led to nonunion or collapse of the femoral head. To avoid providing improper treatment, clinicians should consider ONFH as a predisposing factor in pathologic fractures of the femoral neck. Conclusion ONFH should be included in the differential diagnosis of insufficiency fracture of the femoral neck. PMID:26275737

  5. Rat Model of Parkes Weber Syndrome.

    PubMed

    Bojakowski, Krzysztof; Janusz, Gabriela; Grabowska, Iwona; Zegrocka-Stendel, Oliwia; Surowiecka-Pastewka, Agnieszka; Kowalewska, Magdalena; Maciejko, Dorota; Koziak, Katarzyna

    2015-01-01

    The Parkes Weber syndrome is a congenital vascular malformation, characterized by varicose veins, arterio-venous fistulas and overgrown limbs. No broadly accepted animal model of Parkes Weber syndrome has been described. We created side-to-side arterio-venous fistula between common femoral vessels with proximal non-absorbable ligature on common femoral vein limiting the enlargement of the vein diameter in Wistar rats. Contralateral limb was sham operated. Invasive blood pressure measurements in both iliac and inferior cava veins were performed in rats 30 days after fistula creation. Tight circumference and femoral bone length were measured. Histopathology and morphology of soleus muscle, extensor digitorum longus muscle, and the common femoral vessel were analyzed. 30 days following arterio-venous fistula creation, a statistically significant elevation of blood pressure in common iliac vein and limb overgrowth was observed. Limb enlargement was caused by muscle overgrowth, varicose veins formation and bone elongation. Arterio-venous fistula with proximal outflow limitation led to significant increase of femoral vein circumference and venous wall thickness. Our study indicates that the described rat model mimics major clinical features characteristic for the human Parkes Weber syndrome: presence of arterio-venous fistula, venous hypertension and dilatation, varicose veins formation, and the limb hypertrophy. We reveal that limb overgrowth is caused by bone elongation, muscle hypertrophy, and venous dilatation. The newly established model will permit detailed studies on the mechanisms underlying the disease and on the efficacy of novel therapeutic strategies for the Parkes Weber syndrome treatment. PMID:26217941

  6. Rat Model of Parkes Weber Syndrome

    PubMed Central

    Bojakowski, Krzysztof; Janusz, Gabriela; Grabowska, Iwona; Zegrocka-Stendel, Oliwia; Surowiecka-Pastewka, Agnieszka; Kowalewska, Magdalena; Maciejko, Dorota; Koziak, Katarzyna

    2015-01-01

    The Parkes Weber syndrome is a congenital vascular malformation, characterized by varicose veins, arterio-venous fistulas and overgrown limbs. No broadly accepted animal model of Parkes Weber syndrome has been described. We created side-to-side arterio-venous fistula between common femoral vessels with proximal non-absorbable ligature on common femoral vein limiting the enlargement of the vein diameter in Wistar rats. Contralateral limb was sham operated. Invasive blood pressure measurements in both iliac and inferior cava veins were performed in rats 30 days after fistula creation. Tight circumference and femoral bone length were measured. Histopathology and morphology of soleus muscle, extensor digitorum longus muscle, and the common femoral vessel were analyzed. 30 days following arterio-venous fistula creation, a statistically significant elevation of blood pressure in common iliac vein and limb overgrowth was observed. Limb enlargement was caused by muscle overgrowth, varicose veins formation and bone elongation. Arterio-venous fistula with proximal outflow limitation led to significant increase of femoral vein circumference and venous wall thickness. Our study indicates that the described rat model mimics major clinical features characteristic for the human Parkes Weber syndrome: presence of arterio-venous fistula, venous hypertension and dilatation, varicose veins formation, and the limb hypertrophy. We reveal that limb overgrowth is caused by bone elongation, muscle hypertrophy, and venous dilatation. The newly established model will permit detailed studies on the mechanisms underlying the disease and on the efficacy of novel therapeutic strategies for the Parkes Weber syndrome treatment. PMID:26217941

  7. Fast-onset lidocaine block of rat NaV1.4 channels suggests involvement of a second high-affinity open state.

    PubMed

    Gingrich, Kevin J; Wagner, Larry E

    2016-06-01

    Local anesthetics (LAs) block resting, open, and inactivated states of voltage-gated Na(+) channels where inactivated states are thought to bind with highest affinity. However, reports of fast-onset block occurring over milliseconds hint at high-affinity block of open channels. Movement of voltage-sensor domain IV-segment 4 (DIVS4) has been associated with high affinity LA block termed voltage-sensor block (VSB) that also leads to a second open state. These observations point to a second high-affinity open state that may underlie fast-onset block. To test for this state, we analyzed the modulation of Na(+) currents by lidocaine and its quaternary derivative (QX222) from heterologously expressed (Xenopus laevis oocytes) rat skeletal muscle μ1 NaV1.4 (rSkM1) with β1 (WT-β1), and a mutant form (IFM-QQQ mutation in the III-IV interdomain, QQQ) lacking fast inactivation, in combination with Markov kinetic gating models. 100 μM lidocaine induced fast-onset (τonset≈2 ms), long-lived (τrecovery≈120 ms) block of WT-β1 macroscopic currents. Lidocaine blocked single-channel and macroscopic QQQ currents in agreement with our previously described mechanism of dual, open-channel block (DOB mechanism). A DOB kinetic model reproduced lidocaine effects on QQQ currents. The DOB model was extended to include trapping fast-inactivation and activation gates, and a second open state (OS2); the latter arising from DIVS4 translocation that precedes inactivation and exhibits high-affinity, lidocaine binding (apparent Kd=25 μM) that accords with VSB (DOB-S2VSB mechanism). The DOB-S2VSB kinetic model predicted fast-onset block of WT-β1. The findings support the involvement of a second, high-affinity, open state in lidocaine modulation of Na(+) channels. PMID:26922882

  8. Morphological Study of the Newly Designed Cementless Femoral Stem

    PubMed Central

    Baharuddin, Mohd Yusof; Salleh, Sh-Hussain; Zulkifly, Ahmad Hafiz; Lee, Muhammad Hisyam; Mohd Noor, Alias

    2014-01-01

    A morphology study was essential to the development of the cementless femoral stem because accurate dimensions for both the periosteal and endosteal canal ensure primary fixation stability for the stem, bone interface, and prevent stress shielding at the calcar region. This paper focused on a three-dimensional femoral model for Asian patients that applied preoperative planning and femoral stem design. We measured various femoral parameters such as the femoral head offset, collodiaphyseal angle, bowing angle, anteversion, and medullary canal diameters from the osteotomy level to 150 mm below the osteotomy level to determine the position of the isthmus. Other indices and ratios for the endosteal canal, metaphyseal, and flares were computed and examined. The results showed that Asian femurs are smaller than Western femurs, except in the metaphyseal region. The canal flare index (CFI) was poorly correlated (r < 0.50) to the metaphyseal canal flare index (MCFI), but correlated well (r = 0.66) with the corticomedullary index (CMI). The diversity of the femoral size, particularly in the metaphyseal region, allows for proper femoral stem design for Asian patients, improves osseointegration, and prolongs the life of the implant. PMID:25025068

  9. Comparison of the Sliding and Femoral Head Rotation among Three Different Femoral Head Fixation Devices for Trochanteric Fractures

    PubMed Central

    Chinzei, Nobuaki; Niikura, Takahiro; Tsuji, Mitsuo; Kuroda, Ryosuke; Doita, Minoru; Kurosaka, Masahiro

    2015-01-01

    Background Recently, various femoral head fixation devices (HFDs) for trochanteric fractures have become available. However, there are some cases in which femoral head rotation with excessive sliding of the HFD is observed and it is often followed by cutout. The purpose of this study is to compare the ability of the three types of HFDs to prevent femoral head rotation. Methods Between July 2005 and December 2009, 206 patients aged over 60 years with trochanteric fractures who had undergone surgical treatment using a short femoral nail in our institution were enrolled into the study. We used the gamma 3 nail (GMN) as the screw-type HFD in 66 cases, the gliding nail (GLN) as a non-cylindrical blade in 76 cases, and the proximal femoral nail antirotation (PFNA) as a cylindrical blade in 64 cases. The sliding length of HFDs and the occurrence of femoral head rotation were evaluated by assessing radiographs as the main outcome, and the results were compared among these devices. Results A comparison of the degree of sliding in the GMN group showed that femoral head rotation was observed significantly more frequently in cases with rotation. Further, it appeared that femoral head rotation occurred more frequently in comminuted fractures. However, no significant differences between the sliding lengths of the different HFDs were observed among three groups. Femoral head rotation was observed in 15 cases of GMN (22.7%), 0 case of GLN, and 5 case of PFNA (7.8%). Significant differences with regard to the occurrence of femoral head rotation were observed among the three groups. Furthermore, significant differences were also observed between GLN and PFNA with respect to the occurrence of femoral head rotation. Conclusions The ability to stabilize femoral head appears to be greater with blade-type materials than with screw-type materials. Furthermore, we believe that a non-cylindrical blade is preferable to a cylindrical blade for the surgical treatment of comminuted, unstable

  10. Painful Spastic Hip Dislocation: Proximal Femoral Resection

    PubMed Central

    Albiñana, Javier; Gonzalez-Moran, Gaspar

    2002-01-01

    The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despite routine post-operative skeletal traction in all cases and careful soft tissue interposition. One case showed significant heterotopic ossification which restricted prolonged sitting. This patient needed some occasional medication for pain. PMID:12180614

  11. Femoral lengthening with a motorized intramedullary nail

    PubMed Central

    Horn, Joachim; Grimsrud, Øyvind; Dagsgard, Anita Hoddevik; Huhnstock, Stefan; Steen, Harald

    2015-01-01

    Purpose We assessed whether an intramedullary lengthening device would reduce the problems normally associated with the external fixation technique. We also wanted to determine whether it is a reliable construct for limb lengthening and deformity correction in the femur. Patients and methods We conducted a matched-pair comparison of 30 femoral lengthenings, 15 with a motorized intramedullary nail (the nail group) and 15 lengthenings with an external ring fixator (the fixator group). The patients were matched based on age, sex, amount of lengthening, and the etiology of leg length discrepancy. Mean lengthening was 35 (25–55) mm in the nail group and 38 (15–75) mm in the fixator group. Outcome measures were: lengthening and alignment achieved, consolidation index, knee range of motion (ROM), and complications. Results The pairs in this matched-pair study were similar in terms of age, sex, diagnosis, and amount of lengthening. The planned amount of lengthening was achieved in all patients in both groups and axis correction was considered sufficient. The mean radiographic consolidation index in the nail group, at 1.5 (0.9–3.0) months/cm, was better than the mean value for the fixator group (1.9 (0.9–3.4) months/cm) (p = 0.01). Knee ROM was better in the nail group during the lengthening, 6 weeks after lengthening was completed, and 6 months after lengthening was completed (p < 0.001). A larger number of complications were observed in the fixator group than in the nail group. Interpretation A lengthening nail may be superior to external fixation in femoral lengthening, when the anatomical conditions and the complexity of the deformity allow the use of an intramedullary nail. PMID:25191936

  12. Risk of Anterior Femoral Notching in Navigated Total Knee Arthroplasty

    PubMed Central

    Lee, Ju Hong

    2015-01-01

    Background We retrospectively investigated the prevalence of femoral anterior notching and risk factors after total knee arthroplasty (TKA) using an image-free navigation system. Methods We retrospectively reviewed 148 consecutive TKAs in 130 patients beginning in July 2005. Seventy knees (62 patients) underwent conventional TKA, and 78 knees (68 patients) received navigated TKA. We investigated the prevalence of femoral anterior notching and measured notching depth by conventional and navigated TKA. Additionally, the navigated TKA group was categorized into two subgroups according to whether anterior femoral notching had occurred. The degree of preoperative varus deformity, femoral bowing, and mediolateral suitability of the size of the femoral component were determined by reviewing preoperative and postoperative radiographs. The resection angle on the sagittal plane and the angle of external rotation that was set by the navigation system were checked when resecting the distal femur. Clinical outcomes were compared using range of motion (ROM) and the Hospital for Special Surgery (HSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAX) scores between the two groups. Results The prevalence of anterior femoral notching by conventional TKA was 5.7%, and that for navigated TKA was 16.7% (p = 0.037). Mean notching depth by conventional TKA was 2.92 ± 1.18 mm (range, 1.8 to 4.5 mm) and 3.32 ± 1.54 mm (range, 1.55 to 6.93 mm) by navigated TKA. Preoperative anterior femoral bowing was observed in 61.5% (p = 0.047) and both anterior and lateral femoral bowing in five cases in notching group during navigated TKA (p = 0.021). Oversized femoral components were inserted in 53.8% of cases (p = 0.035). No differences in clinical outcomes for ROM or the HSS and WOMAX scores were observed between the groups. A periprosthetic fracture, which was considered a notching-related side effect, occurred in one case each in the conventional and navigated TKA groups

  13. Techniques and Results for Open Hip Preservation

    PubMed Central

    Levy, David M.; Hellman, Michael D.; Haughom, Bryan; Stover, Michael D.; Nho, Shane J.

    2015-01-01

    While hip arthroscopy grows in popularity, there are still many circumstances under which open hip preservation is the most appropriately indicated. This article specifically reviews open hip preservation procedures for a variety of hip conditions. Femoral acetabular impingement may be corrected using an open surgical hip dislocation. Acetabular dysplasia may be corrected using a periacetabular osteotomy. Acetabular protrusio may require surgical hip dislocation with rim trimming and a possible valgus intertrochanteric osteotomy. Legg–Calve–Perthes disease produces complex deformities that may be better served with osteotomies of the proximal femur and/or acetabulum. Chronic slipped capital femoral epiphysis may also benefit from a surgical hip dislocation and/or proximal femoral osteotomy. PMID:26649292

  14. Significantly lower femoral neck growth in screw fixation of the asymptomatic contralateral hip in unilateral slipped capital femoral epiphysis.

    PubMed

    Wölfle-Roos, Julia V; Urlaub, Stefanie; Reichel, Heiko; Taurman, Rita

    2016-05-01

    There is an ongoing debate on which fixation technique should be preferred for the prophylactic fixation of the asymptomatic contralateral hip in slipped capital femoral epiphysis (SCFE). In the case of Kirschner-wire (K-wire) fixation, there is a possibility of secondary loss of fixation because of longitudinal growth of the physis, whereas in screw fixation, physeal growth of the femoral neck might be impaired. The aim of this matched-pair study was to compare the longitudinal growth of the femoral neck in screw fixation versus K-wire fixation of the asymptomatic contralateral hip in SCFE. All 18 patients (female : male=3 : 15), who had undergone screw fixation of the asymptomatic contralateral hip between 9/2001 and 9/2011, were matched according to age, bone age, sex, and time to follow-up to another 18 patients with K-wire fixation. The length of the femoral neck of the contralateral hip was measured in parallel to either screw or K-wire from the apex of the femoral head to the opposite cortical bone. The ratio of the femoral neck length measured directly after surgery and on follow-up was defined as femoral neck growth. There was no significant difference between groups with respect to age, modified Oxford Bone age score, and time to follow-up. We found a significant difference in femoral neck growth between patients with screw fixation (5.5±4.3%) compared with K-wire fixation (8.9±5.7%, P=0.048 matched Wilcoxon test). The difference in femoral neck growth of patients with K-wire or screw fixation of the contralateral asymptomatic hip in SCFE was small, but statistically significant. Thus, despite high rates of secondary loss of fixation, K-wire fixation should still be considered, especially in very young patients. PMID:26919622

  15. [How to determine the rotation of the femoral component].

    PubMed

    Matziolis, G; Roehner, E

    2015-04-01

    The different landmarks for determination of the rotation of the femoral component are shown and specific pros and cons are discussed. The videos demonstrate how to identify them intraoperatively. PMID:25874402

  16. Editorial Commentary: Anatomic Femoral Tunnel Drilling: Does It Really Matter?

    PubMed

    Hohmann, Erik

    2016-01-01

    An anatomic anteromedial portal and outside-in technique for creating the anterior cruciate ligament femoral tunnel may improve rotational stability but shows no published differences in clinical outcomes. PMID:26743417

  17. Tissue response to the components of a hydroxyapatite-coated composite femoral implant.

    PubMed

    Hacking, S A; Pauyo, T; Lim, L; Legoux, J G; Bureau, M N

    2010-09-01

    Bone loss around femoral implants used for THA is a persistent clinical concern. It may be caused by stress shielding, generally attributed to a mismatch in stiffness between the implants and host bone. In this regard, a fatigue resistant, carbon fiber (CF) composite femoral implant with bone-matching stiffness has been developed. This study evaluated the tissue response to the three material components of this implant in normal and textured (blasted with 24 grit alumina) surfaces: the hydroxyapatite (HA) coating, the CF composite and the intermediate crystalline HA particulate composite layer to bond to the HA coating (blended). Sprague-Dawley rats underwent bilateral femoral implantation each receiving two rod-like implants. Bone apposition to the HA (37%) and textured Ti (41%) implants was not significantly different. Bone apposition to the untextured CF (14%) and blended (19%) implants and polished Ti (8%) implants was significantly lower. Bone apposition to the textured CF (9%) and blended (11%) implants was lower (but not statistically from the as received or untextured counterparts). Nearly all sections from femurs containing CF implants presented CF debris. There was no evidence of localized bone loss or any strong immune response associated with any of the implant materials. All materials were well tolerated with minimal inflammation despite the presence of particulate debris. The high degree of bone apposition to the HA-coated composite implants and the lack of short-term inflammation and adverse tissue response to the three material implant component support continued evaluation of this composite technology for use in THA. PMID:20730932

  18. Circumflex femoral vein thrombosis misinterpreted as acute hamstring strain.

    PubMed

    Papastergiou, Stergios G; Koukoulias, Nikolaos E; Tsitouridis, Ioannis; Natsis, Constantinos; Parisis, Constantinos A

    2007-07-01

    The case of a 24-year-old female professional, long-distance runner who presented with acute proximal posterior thigh pain is reported. History and clinical findings were consistent with acute hamstring strain but MRI demonstrated circumflex femoral vein thrombosis. This is the first case of proximal posterior thigh pain caused by circumflex femoral vein thrombosis reported in the literature. Doctors dealing with sports injuries should be aware of this clinical entity that mimics hamstring strain. PMID:17224439

  19. Circumflex femoral vein thrombosis misinterpreted as acute hamstring strain

    PubMed Central

    Papastergiou, Stergios G; Koukoulias, Nikolaos E; Tsitouridis, Ioannis; Natsis, Constantinos; Parisis, Constantinos A

    2007-01-01

    The case of a 24‐year‐old female professional, long‐distance runner who presented with acute proximal posterior thigh pain is reported. History and clinical findings were consistent with acute hamstring strain but MRI demonstrated circumflex femoral vein thrombosis. This is the first case of proximal posterior thigh pain caused by circumflex femoral vein thrombosis reported in the literature. Doctors dealing with sports injuries should be aware of this clinical entity that mimics hamstring strain. PMID:17224439

  20. CIRCUMFERENTIAL PROXIMAL FEMORAL ALLOGRAFTS IN TOTAL HIP ARTHROPLASTY REVISION SURGERY

    PubMed Central

    Roos, Bruno Dutra; Roos, Milton Valdomiro; Júnior, Antero Camisa; Lampert, Henrique Bonotto; da Silva, Matheus Luis

    2015-01-01

    Objective: To evaluate the clinical and radiographic results from patients who underwent femoral reconstruction secondary to loosening of total hip arthroplasty, using circumferential proximal femoral allografts and cemented implants. Methods: A retrospective study was conducted on 32 patients (33 hips) who underwent femoral reconstruction secondary to loosening of total hip arthroplasty, using circumferential proximal femoral allografts and cemented implants. Among these patients, 28 (29 hips) fulfilled all the requirements for this study. The mean follow-up was five years and two months. The clinical evaluation was done in accordance with the Harris Hip Score. Radiographically, the patients were assessed regarding reabsorption and consolidation of the allograft, migration of the greater trochanter, stability of the femoral component and heterotypic calcification. Results: The average preoperative Harris Hip Score was 32 points. At the last postoperative follow-up, the average score was 82 points. Allograft resorption of some degree was seen in nine hips (31%). Regarding consolidation, 24 cases (82.8%) showed full consolidation, three (10.3%) showed partial consolidation and two (6.9%) showed pseudarthrosis. All femoral components were stable. According to the criteria established, 27 cases (93.1%) were considered to be successful reconstructions after a mean follow-up of five years and two months. Conclusion: From the results obtained, it was concluded that use of circumferential proximal femoral allografts in selected cases of femoral reconstruction secondary to loosening of arthroplasty presented a high survival rate from the reconstruction over an average follow-up of five years and two months. PMID:27047896

  1. Proximal femoral reconstruction with a constrained acetabulum in oncologic patients.

    PubMed

    Jawad, Muhammad Umar; Brien, Earl W

    2014-02-01

    Metallic endoprostheses are used for oncological reconstruction around the proximal femur and hip joint. Common modes of failure with hemiarthroplasty or standard hip arthroplasty after proximal femoral replacement include dislocation, late hip pain, and infection. The authors reviewed hospital records to identify patients undergoing constrained tripolar hip arthroplasty for oncological reasons between 2002 and 2012. Inclusion criterion was at least 12-cm proximal femoral resection, including patients with total femur reconstruction. A total of 33 patients were reviewed. Information regarding demographics, length of follow-up, treatment characteristics, and patient outcomes was extracted. Average follow-up for all patients was 912.33 days (30.4 months). Average follow-up was 1396.1 days for living patients and 428.6 days for deceased patients. Average estimated blood loss was 462.12 cc: an average of 1080 cc for patients undergoing total femoral resection and replacement and 315.8 cc for patients undergoing proximal femoral resection and replacement. Average operative time was 137.7 minutes: an average of 205 minutes for patients undergoing total femoral resection and replacement and 119.1 minutes for patients undergoing proximal femoral resection and replacement. Average Musculoskeletal Tumor Society score was 21.7. There were no dislocations in the cohort. A constrained tripolar device can be safely used for oncological proximal femoral reconstructions while minimizing the risk of dislocation. Positioning of the acetabular implant in neutral anatomic version in conjunction with a neutral-placed femoral component provides the greatest range of motion, reduction of liner impingement, and improved hip stability. PMID:24679207

  2. Modulation of vasorelaxant responses to potassium channel openers by basal nitric oxide in the rat isolated superior mesenteric arterial bed.

    PubMed Central

    McCulloch, A. I.; Randall, M. D.

    1996-01-01

    1. We have used the isolated buffer-perfused mesenteric arterial bed of the rat to assess the modulation of vasorelaxation to potassium channel openers (KCOs) by basal nitric oxide. 2. The dose-response curves to the KCOs, levcromakalim and pinacidil, in preconstricted preparations were significantly shifted to the left in the presence of the nitric oxide synthase inhibitor (100 microM) NG-nitro-L-arginine methyl ester (levcromakalim, ED50 = 4.47 +/- 0.70 nmol vs. 1.73 +/- 0.26 nmol, P < 0.001; pinacidil, ED50 = 16.1 +/- 4.8 nmol vs. 5.43 +/- 1.10 nmol, P < 0.001). The vasorelaxant responses to papaverine, a vasodilator which acts independently of potassium channels was unaffected by NG-nitro-L-arginine methyl ester (L-NAME). 3. Removal of the endothelium, by perfusion with the detergent CHAPS (0.3%), significantly (P < 0.001) increased the potency of levcromakalim as a vasodilator (ED50 4.47 +/- 0.70 nmol vs. 2.59 +/- 0.31 nmol). The subsequent administration of L-NAME following perfusion with CHAPS did not lead to any additional enhancement of responses to levcromakalim. 4. The presence of the non-selective adenosine antagonist, 8-phenyltheophylline (8-PT, 10 microM) significantly (P < 0.001) shifted the dose-response curve to levcromakalim to the left (ED50 4.47 +/- 0.70 nmol vs. 1.11 +/- 0.32 nmol). In the presence of both L-NAME and 8-PT, the dose-response curve to levcromakalim was also significantly (P < 0.01) shifted to the left compared with control (ED50 in the presence of both L-NAME and 8-PT was 0.42 +/- 0.08 nmol). 5. The presence of 8-bromo cyclic GMP (10 microM) reversed the increase potency of levcromakalim, observed following inhibition of nitric oxide synthase (ED50 in the presence of L-NAME was 0.59 +/- 0.01 nmol and in the presence of 8-bromo cyclic GMP plus L-NAME the ED50 was 3.17 +/- 0.80 nmol). However in the absence of L-NAME, the cell permeable analogue of cyclic GMP, 8-bromo cyclic GMP, did not affect the dose-response curve to

  3. Femoral Component Survival in Hybrid Total Knee Arthroplasty.

    PubMed

    Perry, Clayton R; Perry, Kevin I

    2016-05-01

    Although the majority of North American surgeons perform total knee arthroplasty by cementing both the femoral and the tibial components, hybrid fixation with a press-fit femur and cemented tibia is an alternative form of total knee arthroplasty performed by some. Currently, there is a paucity of literature evaluating long-term outcomes after hybrid total knee arthroplasty. As such, the purpose of the current study was to describe the long-term results of total knee arthroplasty performed using the hybrid technique. The authors retrospectively reviewed a total of 77 hybrid total knee arthroplasties with at least 12 years of follow-up. Clinical and radiographic evaluations were performed to determine patient function and the incidence of femoral component failure after hybrid total knee arthroplasty. At the time of last follow-up, 76 of 77 (99%) of the femoral components remained in place without evidence of loosening. One femoral component failed due to aseptic loosening and was ultimately revised to a cemented femoral component without further complication. In addition, 1 tibial component and 2 patellar components failed due to aseptic loosening. Four tibial polyethylene liners were revised for polyethylene wear. In conclusion, press-fit fixation of the femoral component is a reliable and durable alternative to cemented fixation. [Orthopedics. 2016; 39(3):181-186.]. PMID:27135453

  4. Prevascular femoral hernia and its relation with inferior epigastric vessels: a rare presentation of the femoral hernia sac.

    PubMed

    Boshnaq, Mohamed; Phan, Yih Chyn; Akhtar, Mansoor; Hamade, Ayman

    2016-01-01

    A 61-year-old man presented to the emergency department, with a 2-week history of a painful lump on his right groin. A diagnosis of an irreducible right femoral hernia was made. As such, an urgent operation was carried out on the same day, and the patient was found to have a rare prevascular femoral hernia in which the sac was lying over the femoral vessels and split by the inferior epigastric vessels into 2 components resembling 2 trouser limbs. The hernia sac presented in a different and challenging way that necessitated meticulous dissection and full orientation of the anatomy of the femoral triangle. Complete dissection and control of the inferior epigastric vessels, and complete reduction of the sac followed by repair with a prosthetic mesh plug were performed successfully. The patient was discharged home the next day. PMID:27090547

  5. A PERIPHERAL CHOLINERGIC PATHWAY MODULATES STRESS-INDUCED HYPERTHERMIA IN THE RAT EXPOSED TO AN OPEN FIELD.

    EPA Science Inventory

    Exposure to an open-field is psychologically stressful and leads to an elevation in core temperature (Tc). This increase in Tc associated with open-field is usually referred to as stress-induced hyperthermia (SIH) and can be blocked centrally with cyclooxygenase inhibitors suc...

  6. [Release of unidentified substances of mitochondrial origin--evidence of mitochondrial permeability transition pore opening in the heart mitochondria of rats ].

    PubMed

    Sahach, V F; Vavilova, H L; Rudyk, O V; Strutyns'ka, N A

    2003-01-01

    In experiments in vitro on isolated heart mitochondria of rats, an activation of mitochondrial permeability transition pore (PTP) was induced by either modelling an oxidative stress with PTP-inductor phenylarsine oxide (PAO) or by calcium overload (CaCl2). PTP-opening was determined spectrophotometrically (lambda = 520 nm) by a decrease in an optical density (OD), resulting from mitochondrial swelling. We also observed a release of mitochondrial unidentified substances (mitochondrial factor, MF) registered spectrophotometrically in a range of waves lambda = 230-260 nm. Both correlation between mitochondrial swelling and a release of the mitochondrial factor have been found in experiments with PAO at concentrations 10(-7)-10(-4) mol/l, and in those with CaCl2 at concentrations 10(-6)-10(-4) mol/l. The classical inhibitor of mitochondrial PTP cyclosporin A (Cs A, 10(-5) mol/l) inhibited mitochondrial swelling and a release of that factor completely. Our experimental data give evidence for mitochondrial origin of the factor and its release following PTP-opening by PTP-inductors--PAO and CaCl2. Mitochondrial swelling that accompanied the factor's release might contribute to PTP-opening and be useful in defining the mitochondrial sensitivity either with inductors or inhibitors of mitochondrial PTP in different tissues under normal and pathological states of organism. PMID:14663885

  7. Rupture of the Deep Femoral Artery during Proximal Femoral Nailing Following an Intertrochanteric Fracture: A Case Report

    PubMed Central

    Yoon, Han Kook; Park, Junyoung; Oyunbat, Choidog; Kim, Taehwan

    2016-01-01

    Recently, we experienced a case where the diagnosis and management of a deep femoral artery rupture was delayed. This vascular complication occurred during the insertion of a distal interlocking screw of a proximal femoral nail for the fixation of an intertrochanteric femur fracture. A 79-year-old male patient was diagnosed with a right intertrochanteric fracture after a fall. We fixed the fracture with a proximal femoral nail (Zimmer® Natural Nail™ System). One day after the procedure, the patient complained of pain and swelling on the anteromedial side of his middle thigh followed by hypotension, anemia and prolonged thigh swelling. Computed tomography angiography was performed 7 days after the procedure. We found a pseudoaneurysm of the perforating artery caused by injury to the deep femoral artery and an intramuscular hematoma in the anterior thigh muscle. We successfully treated the pseudoaneurysm using coil embolization. Throughout the management of intertrochanteric femoral fractures, it is important to be aware and monitor signs and symptoms related to the possibility of blood vessel damage. When a patient presents with swelling and pain on the middle thigh and/or unexplained anemia postoperatively, the possibility that these symptoms are caused by an injury to the femoral artery must be considered.

  8. Seasonal variation of slipped capital femoral epiphysis.

    PubMed

    Maffulli, Nicola; Douglas, A Stuart

    2002-01-01

    During the 18-year period 1980-1997, 1103 patients were treated as in-patients for slipped capital femoral epiphysis (SCFE) in Scottish hospitals. This paper reports a significant seasonal variation, especially in male patients, with an excess admitted in the autumn. Examining the physiological seasonality of the monthly increment of growth in height and weight in childhood, we hypothesised that these physiological rhythms, while not pathogenetic, may be responsible for the timing of the seasonal features of SCFE. Previously published studies suggest that the average time between first symptoms and diagnosis is 3 to 5 months. The condition may start with the spring peak in growth and become more symptomatic with the autumn peak in weight. In conclusion, we report a new epidemiological finding, but, in accordance with other studies, we cannot provide a certain aetiological explanation. The timing, but not the pathogenesis, of admission to hospital for a SCFE might be related to the timing in the year of seasonal increments of height in spring and weight in autumn. It is tempting to draw attention to associations with environmental features. For example, in autumn there is the most rapid annual fall in temperature, and the hours of darkness are increasing from the autumn equinox to the winter solstice. However, there is no reason to conclude that these associations have anything to do with aetiology. PMID:11866078

  9. Intraosseous Lipoma of the Femor: Image Findings

    PubMed Central

    Yazdi, Hadi Rokni; Rasouli, Bahman; Borhani, Ali; Noorollahi, Mohammad Mahdi

    2014-01-01

    Introduction: Intraosseous lipoma is a rare benign bone disease. Long and cancellous bones are the most locationsthat can be affected. Almost all lesions were discovered incidentally on imaging modalities that were done during an unrelated investigation. As it is rare, it may be mistaken for nonossifying fibroma, aneurismal bone cyst, simple bone cyst, bone infarct or chondroid tumors. Recently with the high quality imaging modalities such as CT scan and/or MR imaging, the diagnosis of intramedullary lipoma and some other bone lesions can be done without the need for bone biopsy and surgery. Case Report: We’re reporting a rare case of intraosseous lipoma of the distal femur. Plain film radiography showed barely visible medullary expansion and lucency in the distal left femoral diaphysis. The patient underwent further evaluation with computed tomographic (CT) and magnetic resonance Imaging (MRI). According to the MRI and CT scan findings, intraosseous lipoma was confirmed and the need for more diagnostic tests were eliminated. Conclusion: Although Intraosseous lipoma doesn’t have any manifestations clinically but it should be considered in the differential diagnosis of bone pains. MRI has an important role in characterization of soft tissue and bone marrow lesions therefore non-surgical approach for most of the patients with intraosseous lipoma would be beneficial. PMID:27298943

  10. Ruptured mycotic common femoral artery pseudoaneurysm: fatal pulmonary embolism after emergency stent-grafting in a drug abuser.

    PubMed

    Karkos, Christos D; Kalogirou, Thomas E; Giagtzidis, Ioakeim T; Papazoglou, Konstantinos O

    2014-12-01

    The rupture of a mycotic femoral artery pseudoaneurysm in an intravenous drug abuser is a limb- and life-threatening condition that necessitates emergency intervention. Emergency stent-grafting appears to be a viable, minimally invasive alternative, or a bridge, to subsequent open surgery. Caution is required in cases of suspected concomitant deep vein thrombosis in order to minimize the possibility of massive pulmonary embolism during stent-grafting, perhaps by omitting stent-graft postdilation or by inserting an inferior vena cava filter first. We describe the emergency endovascular management, in a 60-year-old male intravenous drug abuser, of a ruptured mycotic femoral artery pseudoaneurysm, which was complicated by a fatal pulmonary embolism. PMID:25593530

  11. Full circle: 3D femoral mapping demonstrates age-related changes that influence femoral implant positioning.

    PubMed

    Tucker, Damien; Surup, Timm; Petersik, Andreas; Kelly, Michael

    2016-02-01

    The geometry of the femur is important in the final position of an intramedullary implant; we hypothesised that the femoral geometry changes with age and this may predispose the elderly to anterior mal-positioning of these implants. We used CT DICOM data of 919 intact left femora and specialist software that allowed us to defined landmarks for measurement reference - such as the linea aspera - on a template bone that could be mapped automatically to the entire database. We found that older (>80 years) cortical bone is up to 1.5 mm thinner anteriorly and 2 mm thinner posteriorly than younger (<40 years) bone but the rate of change of posterior to anterior cortex thickness is greater in the older bone. We also found the isthmus in the elderly to be more distal and less substantial than in the younger bone. This study has demonstrated femoral geometry changes with age that may explain our perception that the elderly are at increased risk for anterior mal-positioning of intramedullary implants. PMID:26686594

  12. Radiological assessment of the femoral bowing in Japanese population

    PubMed Central

    Abdelaal, Ahmed Hamed Kassem; Yamamoto, Norio; Hayashi, Katsuhiro; Takeuchi, Akihiko; Morsy, Ahmad Fawaz; Miwa, Shinji; Kajino, Yoshitomo; Rubio, Donnel A.; Tsuchiya, Hiroyuki

    2016-01-01

    Introduction: Differences in the magnitude of bowing between races are well-known characteristics of the femur. Asian races have an increased magnitude of femoral bowing but most of the orthopedic implants designed for the femur do not match this exaggerated bowing. We calculated the sagittal and coronal femoral bowing in the Japanese population at different levels of the femur and addressed its surgical significance. Material and methods: We calculated the sagittal and coronal bowing of 132 Japanese femora using CT scan of the femur. A mathematical calculation of the radius of curvature at proximal, middle, and distal regions of the femur was used to determine the degree of femoral bowing. Results: Mean sagittal bowing of the femur was 581, 188, and 161 mm for the proximal, middle, and distal thirds of the femur and mean lateral bowing was 528, 5092, and 876 mm, respectively. Mean sagittal and coronal bowing for the whole femur was 175 and 2640 mm, respectively. No correlation was found between age, gender, length of femur, and the degree of bowing. Conclusion: Our study reveals that femoral bowing in the Japanese population is 175 mm in the sagittal plane and 2640 mm in the coronal plane; these values are greater than the femoral bowing in other ethnic groups studied in the literature. This may result in varying degrees of mismatch between the western-manufactured femoral intramedullary implants and the Japanese femur. We recommend that orthopedic surgeons to accurately perform preoperative evaluation of the femoral bowing to avoid potential malalignment, rotation, and abnormal stresses between the femur and implant. PMID:27163091

  13. Structural and functional studies of bioobjects prepared from femoral heads

    SciTech Connect

    Kirilova, I. A. Podorozhnaya, V. T.; Sharkeev, Yu. P.; Popova, K. S. Uvarkin, P. V.

    2015-11-17

    Results of examination of physicomechanical characteristics of samples of medial femoral head cuts are presented. The samples of medial femoral head cuts resected in 6 patients with coxarthrosis in primary endoprosthetic replacement of a coxofemoral joint have been tested for micro- and nanohardness. Young’s modulus and elemental composition of bone tissue have been investigated. To estimate the architectonics of cancellous tissue of the femoral head, adjacent cuts of the same patient have been analyzed. The porosity of bone tissue was estimated from macroscopic images obtained using macrophotography. The total porosity is calculated as the ratio of the total length of straight line segments overlapping pores to the total length of secants. A three-point bending test of the samples has shown that their strength changed from 0.187 to 1.650 MPa and their elasticity modulus changes from 1.69 to 8.15 MPa. The microhardness of the samples changes in the range 220–265 MPa and the average microhardness of medial femoral head cuts is 240 MPa. The elemental composition of medial femoral head cuts is represented by basic Ca, P, O, Na and Mg elements as well as by Sn, S, Fe, Cr, and C in microamounts. The atomic Ca to P ratio for bone tissue is 1.55. It is revealed that pores of the upper part of the femoral head have a more regular shape and in the lower part they are more elongated along the cut and occupy a larger volume. The lower part of the femoral head has a higher porosity (39 and 33%) than the upper part (34 and 30%). The total porosity of all samples does not exceed 37%.

  14. Structural and functional studies of bioobjects prepared from femoral heads

    NASA Astrophysics Data System (ADS)

    Kirilova, I. A.; Sharkeev, Yu. P.; Podorozhnaya, V. T.; Popova, K. S.; Uvarkin, P. V.

    2015-11-01

    Results of examination of physicomechanical characteristics of samples of medial femoral head cuts are presented. The samples of medial femoral head cuts resected in 6 patients with coxarthrosis in primary endoprosthetic replacement of a coxofemoral joint have been tested for micro- and nanohardness. Young's modulus and elemental composition of bone tissue have been investigated. To estimate the architectonics of cancellous tissue of the femoral head, adjacent cuts of the same patient have been analyzed. The porosity of bone tissue was estimated from macroscopic images obtained using macrophotography. The total porosity is calculated as the ratio of the total length of straight line segments overlapping pores to the total length of secants. A three-point bending test of the samples has shown that their strength changed from 0.187 to 1.650 MPa and their elasticity modulus changes from 1.69 to 8.15 MPa. The microhardness of the samples changes in the range 220-265 MPa and the average microhardness of medial femoral head cuts is 240 MPa. The elemental composition of medial femoral head cuts is represented by basic Ca, P, O, Na and Mg elements as well as by Sn, S, Fe, Cr, and C in microamounts. The atomic Ca to P ratio for bone tissue is 1.55. It is revealed that pores of the upper part of the femoral head have a more regular shape and in the lower part they are more elongated along the cut and occupy a larger volume. The lower part of the femoral head has a higher porosity (39 and 33%) than the upper part (34 and 30%). The total porosity of all samples does not exceed 37%.

  15. Washout rate in rat brain irradiated by a 11C beam after acetazolamide loading using a small single-ring OpenPET prototype

    NASA Astrophysics Data System (ADS)

    Hirano, Yoshiyuki; Takuwa, Hiroyuki; Yoshida, Eiji; Nishikido, Fumihiko; Nakajima, Yasunori; Wakizaka, Hidekatsu; Yamaya, Taiga

    2016-03-01

    In dose verification techniques of particle therapies based on in-beam positron emission tomography (PET), the causes of washout of positron emitters by physiological effects should be clarified to correct washout for accurate verification. As well, the quantitative washout rate has a potential usefulness as a diagnostic index which should be explored. Therefore, we measured washout rates of rat brain after vasodilator acetazolamide loading to investigate the possible effects of blood flow on washout. Six rat brains were irradiated by a radioisotope 11C beam and time activity curves on the whole brains were obtained with a small single-ring OpenPET prototype. Then, washout rates were calculated with the Mizuno model, where two washout rates (k 2m and k 2s ) were assumed, and a two-compartment model including efflux from tissue to blood (k 2) and influx (k 3) and efflux (k 4) between the two tissue compartments. Before the irradiations, we used laser-Doppler flowmetry to confirm that acetazolamide increased cerebral blood flow (CBF) of a rat. We compared means of k 2m , k 2s and k 2, k 3 and k 4 without acetazolamide loading (Rest) and with acetazolamide loading (ACZ). For all k values, ACZ values were lower than Rest values. In other words, though CBF increased, washout rates were decreased. This may be attributed to the implanted 11C reacting to form 11CO2. Because acetazolamide increased the concentration of CO2 in brain, suppressed diffusion of 11CO2 and decomposition of 11CO2 into ions were prevented.

  16. Data supporting the involvement of the adenine nucleotide translocase conformation in opening the Tl+-induced permeability transition pore in Ca2+-loaded rat liver mitochondria

    PubMed Central

    Korotkov, Sergey M.

    2016-01-01

    There we made available information about the effects of the adenine nucleotide translocase (ANT) ‘c’ conformation fixers (phenylarsine oxide (PAO), tert-butylhydroperoxide (tBHP), and carboxyatractyloside) as well as thiol reagent (4,4′-diisothiocyanostilbene-2,2′-disulfonate (DIDS)) on isolated rat liver mitochondria. We observed a decrease in A540 (mitochondrial swelling) and respiratory control rates (RCRADP [state 3/state 4] and RCRDNP [2,4-dinitrophenol-uncoupled state/basal state or state 4]), as well as an increase in Ca2+-induced safranin fluorescence (F485/590, arbitrary units), showed a dissipation in the inner membrane potential (ΔΨmito), in experiments with energized rat liver mitochondria, injected into the buffer containing 25–75 mM TlNO3, 125 mM KNO3, and 100 µM Ca2+. The fixers and DIDS, in comparison to Ca2+ alone, greatly increased A540 decline and the rate of Ca2+-induced ΔΨmito dissipation. These reagents also markedly decreased RCRADP and RCRDNP. The MPTP inhibitors (ADP, cyclosporin A, bongkrekic acid, and N-ethylmaleimide) fixing the ANT in ‘m’ conformation significantly hindered the above-mentioned effects of the fixers and DIDS. A more complete scientific analysis of these findings may be obtained from the manuscript “To involvement the conformation of the adenine nucleotide translocase in opening the Tl+-induced permeability transition pore in Ca2+-loaded rat liver mitochondria” (Korotkov et al., 2016 [1]). PMID:27054168

  17. NMDA Receptor Subunits in the Adult Rat Hippocampus Undergo Similar Changes after 5 Minutes in an Open Field and after LTP Induction

    PubMed Central

    Baez, Maria Veronica; Oberholzer, Maria Victoria; Aguirre, Alejandra Ines; Jerusalinsky, Diana Alicia

    2013-01-01

    NMDA receptor subunits change during development and their synaptic expression is modified rapidly after synaptic plasticity induction in hippocampal slices. However, there is scarce information on subunits expression after synaptic plasticity induction or memory acquisition, particularly in adults. GluN1, GluN2A and GluN2B NMDA receptor subunits were assessed by western blot in 1) adult rats that had explored an open field (OF) for 5 minutes, a time sufficient to induce habituation, 2) mature rat hippocampal neuron cultures depolarized by KCl and 3) hippocampal slices from adult rats where long term potentiation (LTP) was induced by theta-burst stimulation (TBS). GluN1 and GluN2A, though not GluN2B, were significantly higher 70 minutes –but not 30 minutes- after a 5 minutes session in an OF. GluN1 and GluN2A total immunofluorescence and puncta in neurites increased in cultures, as evaluated 70 minutes after KCl stimulation. Similar changes were found in hippocampal slices 70 minutes after LTP induction. To start to explore underlying mechanisms, hippocampal slices were treated either with cycloheximide (a translation inhibitor) or actinomycin D (a transcription inhibitor) during electrophysiological assays. It was corroborated that translation was necessary for LTP induction and expression. The rise in GluN1 depends on transcription and translation, while the increase in GluN2A appears to mainly depend on translation, though a contribution of some remaining transcriptional activity during actinomycin D treatment could not be rouled out. LTP effective induction was required for the subunits to increase. Although in the three models same subunits suffered modifications in the same direction, within an apparently similar temporal course, further investigation is required to reveal if they are related processes and to find out whether they are causally related with synaptic plasticity, learning and memory. PMID:23383317

  18. Data supporting the involvement of the adenine nucleotide translocase conformation in opening the Tl(+)-induced permeability transition pore in Ca(2+)-loaded rat liver mitochondria.

    PubMed

    Korotkov, Sergey M

    2016-06-01

    There we made available information about the effects of the adenine nucleotide translocase (ANT) 'c' conformation fixers (phenylarsine oxide (PAO), tert-butylhydroperoxide (tBHP), and carboxyatractyloside) as well as thiol reagent (4,4'-diisothiocyanostilbene-2,2'-disulfonate (DIDS)) on isolated rat liver mitochondria. We observed a decrease in A540 (mitochondrial swelling) and respiratory control rates (RCRADP [state 3/state 4] and RCRDNP [2,4-dinitrophenol-uncoupled state/basal state or state 4]), as well as an increase in Ca(2+)-induced safranin fluorescence (F485/590, arbitrary units), showed a dissipation in the inner membrane potential (ΔΨmito), in experiments with energized rat liver mitochondria, injected into the buffer containing 25-75 mM TlNO3, 125 mM KNO3, and 100 µM Ca(2+). The fixers and DIDS, in comparison to Ca(2+) alone, greatly increased A540 decline and the rate of Ca(2+)-induced ΔΨmito dissipation. These reagents also markedly decreased RCRADP and RCRDNP. The MPTP inhibitors (ADP, cyclosporin A, bongkrekic acid, and N-ethylmaleimide) fixing the ANT in 'm' conformation significantly hindered the above-mentioned effects of the fixers and DIDS. A more complete scientific analysis of these findings may be obtained from the manuscript "To involvement the conformation of the adenine nucleotide translocase in opening the Tl(+)-induced permeability transition pore in Ca(2+)-loaded rat liver mitochondria" (Korotkov et al., 2016 [1]). PMID:27054168

  19. Conceptualization and validation of an open-source closed-loop deep brain stimulation system in rat

    PubMed Central

    Wu, Hemmings; Ghekiere, Hartwin; Beeckmans, Dorien; Tambuyzer, Tim; van Kuyck, Kris; Aerts, Jean-Marie; Nuttin, Bart

    2015-01-01

    Conventional deep brain stimulation (DBS) applies constant electrical stimulation to specific brain regions to treat neurological disorders. Closed-loop DBS with real-time feedback is gaining attention in recent years, after proved more effective than conventional DBS in terms of pathological symptom control clinically. Here we demonstrate the conceptualization and validation of a closed-loop DBS system using open-source hardware. We used hippocampal theta oscillations as system input, and electrical stimulation in the mesencephalic reticular formation (mRt) as controller output. It is well documented that hippocampal theta oscillations are highly related to locomotion, while electrical stimulation in the mRt induces freezing. We used an Arduino open-source microcontroller between input and output sources. This allowed us to use hippocampal local field potentials (LFPs) to steer electrical stimulation in the mRt. Our results showed that closed-loop DBS significantly suppressed locomotion compared to no stimulation, and required on average only 56% of the stimulation used in open-loop DBS to reach similar effects. The main advantages of open-source hardware include wide selection and availability, high customizability, and affordability. Our open-source closed-loop DBS system is effective, and warrants further research using open-source hardware for closed-loop neuromodulation. PMID:25897892

  20. Conceptualization and validation of an open-source closed-loop deep brain stimulation system in rat.

    PubMed

    Wu, Hemmings; Ghekiere, Hartwin; Beeckmans, Dorien; Tambuyzer, Tim; van Kuyck, Kris; Aerts, Jean-Marie; Nuttin, Bart

    2015-01-01

    Conventional deep brain stimulation (DBS) applies constant electrical stimulation to specific brain regions to treat neurological disorders. Closed-loop DBS with real-time feedback is gaining attention in recent years, after proved more effective than conventional DBS in terms of pathological symptom control clinically. Here we demonstrate the conceptualization and validation of a closed-loop DBS system using open-source hardware. We used hippocampal theta oscillations as system input, and electrical stimulation in the mesencephalic reticular formation (mRt) as controller output. It is well documented that hippocampal theta oscillations are highly related to locomotion, while electrical stimulation in the mRt induces freezing. We used an Arduino open-source microcontroller between input and output sources. This allowed us to use hippocampal local field potentials (LFPs) to steer electrical stimulation in the mRt. Our results showed that closed-loop DBS significantly suppressed locomotion compared to no stimulation, and required on average only 56% of the stimulation used in open-loop DBS to reach similar effects. The main advantages of open-source hardware include wide selection and availability, high customizability, and affordability. Our open-source closed-loop DBS system is effective, and warrants further research using open-source hardware for closed-loop neuromodulation. PMID:25897892

  1. [Delayed hypoxia after the surgical correction of femoral neck fracture].

    PubMed

    Goh, R; Mori, K; Abe, T; Kohyama, A; Minato, A

    1996-11-01

    We investigated perioperative blood gas changes in 26 patients scheduled for surgical correction of femoral neck fracture under epidural anesthesia. Arterial blood gases during spontaneous air respiration were measured eight times during the femoral neck prosthetic replacements (n = 16), and four times during osteosynthesis (n = 10). In the patients who received femoral neck replacements using bone cement (n = 8), arterial oxygen tension decreased significantly four hours after insertion of prosthesis, and did not recover during two postoperative days. In contrast, in the patients who received cementless femoral neck replacements (n = 8), arterial oxygen tension tended to decrease but not significantly, and returned to normal on the second postoperative day. In the patients who received osteosynthesis, arterial oxygen tension did not change. We suspected that the causes of delayed hypoxia in the femoral neck replacements were vascular endothelial cell injury in the lung by free fatty acid originating from fat embolism, and/or microthrombosis resulting from activated coagulation system. Bone cement was thought to intensify fat embolism because of elevated intramedullary pressure in the femur. PMID:8953864

  2. The peripheral-type benzodiazepine receptor is involved in control of Ca2+-induced permeability transition pore opening in rat brain mitochondria.

    PubMed

    Azarashvili, Tamara; Grachev, Dmitry; Krestinina, Olga; Evtodienko, Youri; Yurkov, Igor; Papadopoulos, Vassilios; Reiser, Georg

    2007-07-01

    The peripheral-type benzodiazepine receptor (PBR) is an 18 kDa mitochondrial membrane protein with still elusive function in cell death. Here, we studied whether PBR is involved in Ca2+-induced permeability transition pore (PTP) opening in isolated rat brain mitochondria (RBM). PTP opening is important in mitochondrial events leading to programmed cell death. Immunoblots revealed a single 18 kDa anti-PBR antibody-immunoreactive band in purified RBM. Adenine nucleotide transporter, a key PTP component, was found in the PBR-immunoprecipitate. In isolated intact RBM, addition of a specific anti-PBR antibody [H. Li, Z. Yao, B. Degenhardt, G. Teper, V. Papadopoulos, Cholesterol binding at the cholesterol recognition/interaction amino acid consensus (CRAC) of the peripheral-type benzodiazepine receptor and inhibition of steroidogenesis by an HIV TAT-CRAC peptide, Proc. Natl. Acad. Sci. U.S.A. 98 (2001) 1267-1272] delayed Ca2+-induced dissipation of membrane potential (psi(m)) and diminished cyclosporine A-sensitive Ca2+ efflux, which are both indicative for the suppression of PTP opening. Moreover, anti-PBR antibody caused partial retention of Ca2+ in the mitochondrial matrix in spite of psi(m) dissipation, and reduced activation of respiratory rate at Ca2+-induced PTP opening. A release of pro-apoptotic factors, AIF and cytochrome c, from RBM was shown at threshold Ca2+ load. Anti-PBR antibody blocked the release of AIF but did not affect the cytochrome c release. Addition of ATP was able to initiate PTP closing, associated with psi(m) restoration and Ca2+ re-accumulation. At the same time mitochondrial protein phosphorylation (incorporation of 32P from [gamma-32P]ATP) occurred and anti-PBR antibody was able to inhibit phosphorylation of these proteins. The endogenous PBR ligand, protoporphyrin IX, facilitated PTP opening and phosphorylation of the mitochondrial proteins, thus, inducing effects opposite to anti-PBR antibody. This study provides evidence for PBR

  3. Rapid resolution of femoral head osteonecrosis after rotational acetabular osteotomy.

    PubMed

    Nozawa, Masahiko; Matsuda, Keiji; Maezawa, Katsuhiko; Kim, Sungon; Maeda, Kouichi; Ikegami, Takashi; Kubota, Reiko; Hayashi, Kentaro; Nagayama, Masataka; Kaneko, Haruka

    2008-12-01

    The natural history of osteonecrosis of the femoral head is generally thought to be one of progressive deterioration if no intervention is undertaken. However, it is unknown whether surgical intervention is beneficial for patients with a small region of osteonecrosis. We observed rapid improvement of MRI findings after rotational acetabular osteotomy (RAO) was performed in a young patient with osteonecrosis of the femoral head. The band-like low signal area on T2-weighted images almost resolved by six months after surgery. He returned to work as an electrician by six months after surgery. Early surgical intervention such as RAO that alters the mechanical force acting on the necrotic region of the femoral head may accelerate the recovery of osteonecrosis and the improvement of symptoms. PMID:19384490

  4. Bilateral midshaft femoral fractures in an adolescent baseball player.

    PubMed

    Ju, D G; Mogayzel, P J; Sponseller, P D; Familiari, F; McFarland, E G

    2016-07-01

    Bone disease, specifically low bone mineral density, is a common and undertreated complication that begins during childhood in patients with cystic fibrosis (CF). This case describes a male baseball player, aged 14years, with undiagnosed CF who sustained a left midshaft femoral fracture while running toward base; 8months later, he sustained a right midshaft femoral fracture under similar conditions. After the second fracture, further evaluation revealed low bone mineral density and CF. There is no previously published report of pathologic fractures occurring in the femoral shaft in an athlete with undiagnosed CF. Patients with CF have a higher fracture rate. Low-energy fractures of major bones in athletically active individuals should be viewed with suspicion for an underlying process. PMID:26927602

  5. A Case of Late Femoral Pseudoaneurysm Caused by Stent Disconnection

    SciTech Connect

    Rivolta, Nicola; Fontana, Federico; Piffaretti, Gabriele Tozzi, Matteo; Carrafiello, Gianpaolo

    2010-10-15

    We present the case of a late superficial femoral artery stent disconnection causing an asymptomatic pseudoaneurysm successfully treated with a stent-graft. A 67-year-old female was referred to our department for evaluation of claudication of the left lower limb and was diagnosed to have a total occlusion of the superficial femoral artery. Three nitinol stents were used to revascularize this artery. At 48 months, duplex-ultrasonography control revealed the presence of a 45-mm saccular femoral dilatation; X-rays and CT angiography showed fractures of the proximal stents and the presence of a pseudoaneurysm at the site of the distal stents disconnection. The pseudoaneurysm was excluded using two stent-grafts. We conclude that patients and surgeons should be aware of structural complications with all stents. Rigorous follow-up controls should be mandatory. Endovascular repair proved to be feasible and durable to manage a previous endovascular procedure.

  6. Venting during prophylactic nailing for femoral metastases: current orthopedic practice

    PubMed Central

    Dalgorf, Dustin; Borkhoff, Cornelia M.; Stephen, David J.G.; Finkelstein, Joel; Kreder, Hans J.

    2003-01-01

    Introduction Reamed intramedullary nailing, recommended for impending fracture of a femur weakened by bone metastases, causes a rise in intramedullary pressure and increases the risk of a fat embolism syndrome. The pressure can be equalized by the technique of venting — drilling a hole into the distal cortex of the femur. Our objective was to study the current practice of orthopedic surgeons in Ontario with respect to venting during prophylactic intramedullary nailing for an impending femoral fracture due to bone metastases. Methods We mailed a questionnaire to all orthopedic surgeons from the Province of Ontario listed in the 1999 Canadian Medical Directory or on the Canadian Orthopaedic Association membership list, asking if they vent when prophylactically nailing an impending pathologic femoral fracture. The responses were modelled as a function of surgeon volume and year of graduation. Results Of the 415 surveys mailed, 223 (54%) surgeons responded. Of these, 81% reported having prophylactically treated a femoral metastatic lesion during the previous year; 67% treated 1 to 3 metastatic lesions and 14% treated more than 3; 19% did not treat a metastatic femoral lesion prophylactically. Over two-thirds of surgeons had never considered venting, whereas one-third always or sometimes vented the femoral canal. More recent graduates were 3 times more likely to vent than earlier (before 1980) graduates (odds ratio [OR] = 3.2, 95% confidence interval [CI] 1.6–6.5) as were those who treat a greater number of impending fractures (OR = 1.4, 95% CI 1.1–1.7). Conclusions Although there is a theoretical rationale for routine venting, there is disagreement among Ontario orthopedic surgeons regarding the use of this technique during prophylactic nailing for femoral metastatic lesions. Prospective evidence will be required to warrant a change in the standard of care. PMID:14680349

  7. Biophysical stimulation in osteonecrosis of the femoral head

    PubMed Central

    Leo, Massari; Milena, Fini; Ruggero, Cadossi; Stefania, Setti; GianCarlo, Traina

    2009-01-01

    Osteonecrosis of the femoral head is the endpoint of a disease process that results from insufficient blood flow and bone-tissue necrosis, leading to joint instability, collapse of the femoral head, arthritis of the joint, and total hip replacement. Pain is the most frequent clinical symptom. Both bone tissue and cartilage suffer when osteonecrosis of the femoral head develops. Stimulation with pulsed electromagnetic fields (PEMFs) has been shown to be useful for enhancing bone repair and for exerting a chondroprotective effect on articular cartilage. Two Italian studies on the treatment of avascular necrosis of the femoral head with PEMFs were presented in this review. In the first study, 68 patients suffering from avascular necrosis of the femoral head were treated with PEMFs in combination with core decompression and autologous bone grafts. The second one is a retrospective analysis of the results of treatment with PEMFs of 76 hips in 66 patients with osteonecrosis of the femoral head. In both studies clinical information and diagnostic imaging were collected at the beginning of the treatment and at the time of follow up. Statistical analysis was performed using chi-square test. Both authors hypothesize that the short-term effect of PEMF stimulation may be to protect the articular cartilage from the catabolic effect of inflammation and subchondral bone-marrow edema. The long-term effect of PEMF stimulation may be to promote osteogenic activity at the necrotic area and prevent trabecular fracture and subchondral bone collapse. PEMF stimulation represents an important therapeutic opportunity to resolve the Ficat stage-I or II disease or at least to delay the time until joint replacement becomes necessary. PMID:19753174

  8. Spontaneous modular femoral head dissociation complicating total hip arthroplasty.

    PubMed

    Talmo, Carl T; Sharp, Kinzie G; Malinowska, Magdalena; Bono, James V; Ward, Daniel M; LaReau, Justin

    2014-06-01

    Modular femoral heads have been used successfully for many years in total hip arthroplasty. Few complications have been reported for the modular Morse taper connection between the femoral head and trunnion of the stem in metal-on-polyethylene bearings. Although there has always been some concern over the potential for fretting, corrosion, and generation of particulate debris at the modular junction, this was not considered a significant clinical problem. More recently, concern has increased because fretting and corrosive debris have resulted in rare cases of pain, adverse local tissue reaction, pseudotumor, and osteolysis. Larger femoral heads, which have gained popularity in total hip arthroplasty, are suspected to increase the potential for local and systemic complications of fretting, corrosion, and generation of metal ions because of greater torque at the modular junction. A less common complication is dissociation of the modular femoral heads. Morse taper dissociation has been reported in the literature, mainly in association with a traumatic event, such as closed reduction of a dislocation or fatigue fracture of the femoral neck of a prosthesis. This report describes 3 cases of spontaneous dissociation of the modular prosthetic femoral head from the trunnion of the same tapered titanium stem because of fretting and wear of the Morse taper in a metal-on-polyethylene bearing. Continued clinical and scientific research on Morse taper junctions is warranted to identify and prioritize implant and surgical factors that lead to this and other types of trunnion failure to minimize complications associated with Morse taper junctions as hip implants and surgical techniques continue to evolve. PMID:24972443

  9. Effect of cannabidiol on sleep disruption induced by the repeated combination tests consisting of open field and elevated plus-maze in rats.

    PubMed

    Hsiao, Yi-Tse; Yi, Pei-Lu; Li, Chia-Ling; Chang, Fang-Chia

    2012-01-01

    Patients with post-traumatic stress disorder (PTSD) frequently complain of having sleep disturbances, such as insomnia and rapid eye movement (REM) sleep abnormality. Cannabidiol (CBD), a psycho-inactive constituent of marijuana, reduces physiological non-REM (NREM) sleep and REM sleep in normal rats, in addition to generating its anxiolytic effect. However, the effects of CBD on anxiety-induced sleep disturbances remain unclear. Because anxiety progression is caused by persistent stress for a period of time, we employed the repeated combination tests (RCT) consisting of a 50-min open field (OF) and a subsequent 10-min elevated plus-maze (EPM) for four consecutive days to simulate the development of anxiety. Time spent in the centre arena of OF and during open arms of the EPM was substantially decreased in latter days of RCT, suggesting the habituation, which potentially lessens anxiety-mediated behavioural responses, was not observed in current tests. CBD microinjected into the central nucleus of amygdala (CeA) significantly enhanced time spent in centre arena of OF, increased time during the open arms and decreased frequency of entry to the enclosed arms of EPM, further confirming its anxiolytic effect. The decrease of NREM sleep during the first hour and the suppression of REM sleep during hours 4-10 after the RCT represent the similar clinical observations (e.g. insomnia and REM sleep interruption) in PTSD patients. CBD efficiently blocked anxiety-induced REM sleep suppression, but had little effect on the alteration of NREM sleep. Conclusively, CBD may block anxiety-induced REM sleep alteration via its anxiolytic effect, rather than via sleep regulation per se. This article is part of a Special Issue entitled 'Anxiety and Depression'. PMID:21867717

  10. Patellofemoral dysbalance due to femoral deformities - diagnostic, therapy and results

    PubMed Central

    Dickschas, Jörg; Strecker, Wolf; Harrer, Jörg; Ferner, Felix

    2016-01-01

    Aims and Objectives: Anterior knee pain or patellofemoral instability are typical symptoms of patellofemoral dysbalance. Beside other reasons, this pathology can be caused by a femoral deformity. The two dimensions leading to this problems are torsional- and valgus deformities. This constellation often stays unrecognized. When diagnosed and analyzed, a femoral torsional or varization-osteotomy is the adequate treatment. Aim of this study was to show the diagnostic approach, the gold standard of therapy and the follow up results. Can patellofemoral stability be archived? Is the pain relief significant and how do clinical scores develop at the follow up? Materials and Methods: 33 femoral torsional osteotomies and 18 femoral varization osteotomies were included in this study, 5 of these were combined femoral varization and torsional corrections so that 46 knees are included in 41 patients, as 5 patients were operated on both legs. Major symptoms were patellofemoral dislocations in 28 cases and anterior knee pain in 26 cases. Beside clinical and radiographic evaluation full weight bearing long leg views and a torsional computertomography was always performed. Follow up examination was after 41 (6-113) months. Visual analog scala score, Japanese Knee Society Score, Tegner activity score and Lysholm score were taken before surgery and at the follow up. Results: Mechanical femorotibial valgus was on average 6,4° (5°-10°), femoral internal torsion was in average 40,9° (29°-66°; normal: 24°). Surgical treatment was performed with an arthroscopy followed by an acute femoral varization 7,2°(5°-10°) and / or external torsion osteotomy of 13.8° (5°-26°). Tegner activity score, Japanese knee society score and Lysholm score all significantly improved. Pain relief could be demonstrated as shown by a significant decrease of the VAS score. No further dislocation was reported during the follow up period. Conclusion: Valgus or torsional deformities of the femur frequently

  11. Parallel manipulator robot assisted femoral fracture reduction on traction table.

    PubMed

    Lin, H; Wang, J Q; Han, W

    2013-01-01

    The principle of femoral shaft fracture reduction is to restore its pre-fractured limb length and mechanical axis. The current documented treatment method with traction table reduction does not conform to the quantitative alignment and reduction. There is also a great amount of X-Ray radiation exposure to both surgeon and patient during the procedure. For this reason, we introduced an innovated Parallel Manipulator Robot (PMR) application: A Femoral Shaft Fracture Reduction with Parallel Manipulator Robot on Traction Table. With this application, the quantitative control on fracture reduction and alignment can be achieved and the radiation exposure to both surgeons and patients can be greatly reduced. PMID:24110820

  12. Intramedullary locking femoral nails. Experience with the AO nail.

    PubMed Central

    Fogarty, A. B.; Yeates, H. A.

    1991-01-01

    The AO interlocking nail was introduced to the Ulster Hospital, Dundonald in 1988 and since then has been used in over 50 patients with femoral shaft fractures. We have reviewed 45 patients with 46 femoral shaft fractures treated between June 1988 and April 1990. These included four compound fractures and 13 comminuted fractures. The results compare favourably with other series. The union rate was 98% and there were no instances of deep infection. The alternative treatment methods available are discussed along with a review of the relevant literature. Images Fig 3 Fig 5 PMID:1785145

  13. Bone SPECT/CT of Femoral Head Subchondral Insufficiency Fracture.

    PubMed

    Motomura, Goro; Yamamoto, Takuaki; Karasuyama, Kazuyuki; Iwamoto, Yukihide

    2015-09-01

    Subchondral insufficiency fracture of the femoral head may be confused with osteonecrosis, mainly because of radiological overlap. SPECT/CT with Tc-99 m hydroxymethylene diphosphonate images in 7 patients with subchondral insufficiency fracture were retrospectively reviewed and compared with those from 11 patients with symptomatic early osteonecrosis. In all of the hips with subchondral insufficiency fracture, SPECT/CT showed increased uptake at the subchondral lesions of the femoral head. On the other hand, in all of the hips with osteonecrosis, absence of uptake was confirmed at the subchondral lesions. SPECT/CT may assist in differentiating subchondral insufficiency fracture from osteonecrosis. PMID:26164176

  14. Current concepts in management of slipped capital femoral epiphysis.

    PubMed

    Bittersohl, Bernd; Hosalkar, Harish S; Zilkens, Christoph; Krauspe, Rüdiger

    2015-01-01

    Slipped capital femoral epiphysis (SCFE) is a common hip condition that can be disabling. In this review, we provide an orientation on current trends in the clinical management of SCFE including conventional procedures and specialised surgical developments. Different methods of fixation of the epiphysis, risks of complications, and the rationale of addressing deformity, primarily or secondarily, are presented. Although improved understanding of the anatomy, vascularity and implications of residual deformity have changed management strategies, the best modality of treatment that would restore complete vascularity to the femoral head and prevent any residual deformity, impingement and early osteoarthritis remains elusive. PMID:25362879

  15. Traumatic Hip Dislocation with Associated Femoral Head Fracture

    PubMed Central

    Dortaj, H.; Emamifar, A.

    2015-01-01

    Dislocation of the hip is a critical injury that results from high-energy trauma. This paper describes a case of posterior dislocation of the right hip in a 35-year-old woman with associated ipsilateral femoral head fracture. Initial treatment included reduction of the right hip through posterior approach and fixation of the femoral head fracture with three absorbable screws. After 15-month follow-up, a full range of motion has been achieved and there are no signs of avascular necrosis, hip instability, or limping. The authors describe their method of surgery. PMID:25874147

  16. A rare case of femoral herniation of female internal genitalia

    PubMed Central

    Ambedkar, Vivek; Singh, Abhilash; Bain, Jayanta; Singh, Lal Mani

    2015-01-01

    We report a rare case with herniation of the uterus, fallopian tube, and ovary in a femoral hernia. A female patient was admitted with complain of the painful lump in the left groin. Clinical examination indicated strangulated femoral hernia, which necessitated an emergency surgery. During surgical procedure, the uterine tube, left fallopian tube and left ovary, were observed as the contents of the hernia. The contents were reduced back into the pelvic cavity, and the hernia was repaired. The patient made good recovery postsurgery. PMID:26283851

  17. Hydrophobic bile acids relax rat detrusor contraction via inhibiting the opening of the Na+/Ca2+ exchanger

    PubMed Central

    Zhu, Jingzhen; Dong, Xingyou; Liu, Qian; Wu, Chao; Wang, Qingqing; Long, Zhou; Li, Longkun

    2016-01-01

    Hydrophobic bile acids (BAs) are thought to inhibit smooth muscle contractility in several organs. The present study was undertaken to investigate the effects of hydrophobic BAs on the detrusor contractility of rat bladder and to explore the possible mechanism. Lithocholic acid (LCA) treatment increased the micturition interval and induced a concentration-dependent relaxation of bladder detrusor strips. In addition, LCA reduced the concentration of intracellular free Ca2+([Ca2+]i) and inhibited both the outward and inward Na+/Ca2+ exchanger (NCX) current (INCX) in primary isolated smooth muscle cells (SMCs). To further investigate the mechanism of action of LCA, several pharmacologic agents were used. We found that the NCX inhibitor 3′,4′-Dichlorobenzamil (DCB) can significantly inhibit the relaxation of detrusor strips and a reduction of the [Ca2+]i induced by LCA, while the antagonist of muscarinic receptor and the agonist of the G protein-coupled bile acid receptor (TGR5) and the farnesoid X receptor (FXR) had no effect. In conclusion, these data suggest that the relaxation of rat detrusor induced by hydrophobic BAs is mediated by NCX. Further research is needed to carry out to demonstrate the possible pathway and provide a potential new strategy to investigation for the treatment of the low urinary tract syndromes. PMID:26892434

  18. Osteochondral Autograft from the Ipsilateral Femoral Head by Surgical Dislocation for Treatment of Femoral Head Fracture Dislocation: A Case Report.

    PubMed

    Won, Yougun; Lee, Gi Soo; Kim, Sang Bum; Kim, Sun Joong; Yang, Kyu Hyun

    2016-11-01

    As anatomical reduction of the articular surface of femoral head fractures and restoration of damaged cartilage are essential for good long-term results, many treatment options have been suggested, including fixation of the fracture using various surgical exposures and implants, as well as arthroscopic irrigation and debridement, bone marrow stimulating techniques, osteochondral allograft, autograft, and autogenous chondrocyte implantation. We report a case of osteochondral autograft harvested from its own femoral articular surface through surgical hip dislocation. The osteochondral graft was harvested from the inferior non-weight-bearing articular surface and grafted to the osteochondral defect. One year later, the clinical and radiological results were good, without the collapse of the femoral head or arthritic change. This procedure introduced in our case is considered convenient and able to lessen surgical time without morbidity of the donor site associated with the harvest. PMID:27593886

  19. The treatment of femoral bone loss by axial external fixation and susbequent locking plate application: a case report.

    PubMed

    Boero, Emanuele; Mogollo, Maria del Amparo Paredes

    2015-12-01

    A 20-year-old man was admitted to our hospital having sustianed bilateral high-energy femoral fractures. The right femoral fracture was an open grade 3B with OTA grade 3 bone loss. The patient had also a brain contusion with a subdural haematoma and a closed fracture of the left clavicle. Initial management included temporarily stabilisation of the femoral fractures wth external fixators and prompt transfer to the intensive care unit. Three weeks later the external fixator of the right femur was converted to an hybrid system, and the fixator of the left side was removed and a reamed intramedullary locking nail was applied. Two months after the accident the patient underwent bone transport (11 cm long) of the right femur with an monolateral external fixation. When the final length was achieved there were knee stiffness (ROM 0° to 30°) and non-union of the docking site. Therefore, the patient underwent a Judet's procedure to treat the knee stiffness and stabilisation of the non united femur with a locking plate (LISS). After the operation the patient started progressive weight bearing. A year after trauma and following union of the femur, the patient underwent soft tissue reconstruction of the anterior side of the thigh with a free vascularised flap. At final follow upo the patient had a good functional recovery with return to his previous occupation. PMID:26738458

  20. Improve the Efficiency of Surgery for Femoral Shaft Fractures with A Novel Instrument: A Randomized Controlled Trial

    PubMed Central

    Hsu, Peichun; Qin, Hui; An, Zhiquan; Zhang, Changqing; Sheng, Jiagen

    2016-01-01

    Objective To improve the efficacy of closed reduction and wire guiding during intramedullary nail internal fixation in femoral shaft fractures. Methods A novel instrument was designed and manufactured. Sixty-eight patients were enrolled from February 2011 to December 2013. The instrument designed was used during the operation in the experimental group, but not in the control group. Results All patients exhibited fracture union, excluding 1 patient in the experimental group and 2 in the control group who had non-union; all of whom achieved fracture union with reoperation. There were no statistically significant differences in operative blood loss or duration of hospital stay between the groups (P > 0.05). The operative time, frequency of wire drilling, and number of open reduction cases, were significantly smaller in the experimental group than in the control group (P < 0.05). Conclusion Femoral shaft fractures are difficult to reduce using general methods; the novel instrument showed high clinical value and proved effective and safe in assisting with closed reduction and intramedullary nail fixation for femoral shaft fractures. Trial Registration ChiCTR ChiCTR-ICR-15007335 PMID:27115752

  1. 21 CFR 888.3570 - Knee joint femoral (hemi-knee) metallic uncemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Knee joint femoral (hemi-knee) metallic uncemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3570 Knee joint femoral (hemi-knee) metallic uncemented prosthesis. (a) Identification. A knee joint femoral...

  2. 21 CFR 888.3570 - Knee joint femoral (hemi-knee) metallic uncemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Knee joint femoral (hemi-knee) metallic uncemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3570 Knee joint femoral (hemi-knee) metallic uncemented prosthesis. (a) Identification. A knee joint femoral...

  3. 21 CFR 888.3570 - Knee joint femoral (hemi-knee) metallic uncemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Knee joint femoral (hemi-knee) metallic uncemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3570 Knee joint femoral (hemi-knee) metallic uncemented prosthesis. (a) Identification. A knee joint femoral...

  4. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint femoral (hemi-hip) metallic resurfacing... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3400 Hip joint femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral...

  5. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) metallic resurfacing... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3400 Hip joint femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral...

  6. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hip joint femoral (hemi-hip) metallic resurfacing... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3400 Hip joint femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral...

  7. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint femoral (hemi-hip) metallic resurfacing... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3400 Hip joint femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral...

  8. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint femoral (hemi-hip) metallic cemented or... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  9. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint femoral (hemi-hip) metallic cemented or... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  10. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint femoral (hemi-hip) metallic resurfacing... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3400 Hip joint femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral...

  11. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint femoral (hemi-hip) metallic cemented or... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  12. [Risk of infection in centro-medullary locking nailing of open fractures of the femur and tibia].

    PubMed

    Jenny, J Y; Jenny, G; Gaudias, J; Kempf, I

    1995-01-01

    Intramedullary reamed locking nail of open fractures remains controversial because of the risk of infection. 1,474 closed reamed locked nailings were performed between 1974 and 1989 for femoral (744 cases) or tibial (730 cases) fractures. 349 fractures were open: 100 femoral fractures (51 Gustilo and Anderson Grade I and 49 Grade II) and 249 tibial fractures (140 Grade I, 99 Grade II et 10 Grade III). 24 femoral (3.2%) and 46 tibial (6.3%) nails were followed by infection. This difference is significant (p < 0.01). Reoperations for infection occur more frequently for femoral than tibial fractures (p < 0.05). There is no difference between the results of infection treatment between femoral or tibial fractures. Traumatic opening of the femoral fracture site does not affect the occurrence of an infection, its severity or the results of its treatment. Traumatic opening of the tibial fracture site significantly increases the infection rate (p < 0.001), and the incidence of infection increases with the severity of the soft tissue lesions; but the severity of the infection and the results of its treatment are not modified. Acute closed reamed intramedullary locking nail is the best treatment for open femoral or tibial fractures with respect to the bone healing and infection rate for Grade I and II fractures. For Grade III fractures, nailing must be followed by a coverage flap. PMID:8623602

  13. Femoral Condyles Tangential Views: An Effective Method to Detect the Screw Penetration of Femoral Condyles After Retrograde Nailing

    PubMed Central

    Zheng, Zhan-Le; Yu, Xian; Chen, Wei; Liu, Yue-Ju; Yu, Kun-Lun; Wu, Tao; Zhang, Ying-Ze

    2015-01-01

    Background: Postoperative knee soft tissue irritation is a common complication after retrograde nail fixation of femoral fractures. Distal locking screw prominence is one of the causes for soft tissue irritation. This study aimed to determine whether the use of the femoral condyles tangential views improve the diagnostic accuracy compared with anteroposterior (A-P) view in detecting distal locking screw penetrations during retrograde femoral nailing. Methods: The angle between the sagittal plane and lateral aspect of the condyle and the angle between the sagittal plane and medial aspect of condyle were measured on computed tomography (CT) images. After the angles were measured and recorded, cadaveric femurs were used in a simulated surgical procedure. The retrograde femoral nail was inserted into the femur and placed distal locking screws, which were left 2, 4, and 6 mm proud of the medial and lateral condyles for each femur. A-P view, lateral condyle tangential view and medial condyle tangential view were obtained. All fluoroscopic images were recorded and sent to three observers blinded to the experimental procedure to determine whether screws penetrated the condyle cortex or not. Results: According to the results of CT scan, the lateral condyle view was 20.88 ± 0.98° and the medial condyle view was 40.46 ± 3.14°. In the A-P view, we detected 0% at 2 mm penetration, 16.7% (lateral condyle screw) and 25.0% (medial condyle screw) at 4 mm, and 41.7% (lateral condyle screw) and 58.3% (medial condyle screw) at 6 mm. In the lateral tangential view, we detected 91.7% at 2 mm penetration of the lateral condyle and 100% at 4 mm and 6 mm. In the medial tangential view, we detected 66.7% at 2 mm penetration of the medial condyle and 100% at 4 mm and 6 mm. The femoral condyle tangential views provided significant improvement in detecting screw penetrations at all lengths (2, 4, and 6 mm) compared with the A-P view (P < 0.05). Conclusions: The femoral condyles tangential

  14. Hyperosmolar opening of the blood-brain barrier in the energy-depleted rat brain. Part 1. Permeability studies

    SciTech Connect

    Greenwood, J.; Luthert, P.J.; Pratt, O.E.; Lantos, P.L.

    1988-02-01

    A simple saline perfusion system was used to investigate the effects of hyperosmolar solutions of arabinose and mannitol upon the permeability of the blood-brain barrier. The small, polar molecule (/sup 14/C)mannitol and the larger, visual marker Evans blue were used as indicators of barrier integrity in the perfused energy-depleted brain. One-minute perfusion of hyperosmolar solutions consistently opened the barrier suggesting that the mechanism of osmotic barrier opening is independent of energy-producing metabolism. The accumulation of radiolabel in the brain was expressed as the ratio of tissue to perfusate radioactivity (Rt/Rp) and, for cerebrum, this increased from a control value of 0.0022 +/- 0.0007 (mean +/- SEM; n = 4) to a value of 0.0124 +/- 0.0008 (n = 4) following 0.9 M arabinose and to 0.0495 +/- 0.0072 (n = 4) following 1.8 M arabinose. There was a significant reduction of water content of hyperosmolar perfused brains. These findings support the hypothesis that osmotic barrier opening is the result of the passive shrinkage of endothelial cells and the surrounding tissue.

  15. Multi-echo susceptibility-weighted imaging and histology of open-field blast-induced traumatic brain injury in a rat model.

    PubMed

    Verma, Sanjay Kumar; Kan, Enci Mary; Lu, Jia; Ng, Kian Chye; Ling, Eng Ang; Seramani, Sankar; Kn, Bhanu Prakash; Wong, Yong Chiat; Tan, Mui Hong; Velan, S Sendhil

    2015-09-01

    Blast-induced traumatic brain injury is on the rise, predominantly as a result of the use of improvised explosive devices, resulting in undesirable neuropsychological dysfunctions, as demonstrated in both animals and humans. This study investigated the effect of open-field blast injury on the rat brain using multi-echo, susceptibility-weighted imaging (SWI). Multi-echo SWI provided phase maps with better signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), making it a sensitive technique for brain injury. Male Sprague-Dawley rats were subjected to a survivable blast of 180 kPa. The visibility of blood vessels of varying sizes improved with multi-echo SWI. Reduced signal intensity from major vessels post-blast indicates increased deoxyhaemoglobin. Relative cerebral blood flow was computed from filtered phase SWI images using inferred changes in oxygen saturation from major blood vessels. Cerebral blood flow decreased significantly at day 3 and day 5 post-blast compared with that pre-blast. This was substantiated by the upregulation of β-amyloid precursor protein (β-APP), a marker of ischaemia, in the neuronal perikaya of the cerebral cortex, as observed by immunofluorescence, and in the cortical tissue by western blot analysis. Our findings indicate the presence of brain ischaemia in post-blast acute phase of injury with possible recovery subsequently. Our results from cerebrovascular imaging, histology and staining provide an insight into the ischaemic state of the brain post-blast and may be useful for prognosis and outcome. PMID:26152641

  16. Iptakalim, an ATP-sensitive potassium channel opener, confers neuroprotection against cerebral ischemia/reperfusion injury in rats by protecting neurovascular unit cells

    PubMed Central

    Ran, Yu-hua; Wang, Hai

    2011-01-01

    Objective: To investigate the role of iptakalim, an ATP-sensitive potassium channel opener, in transient cerebral ischemia/reperfusion (I/R) injury and its involved mechanisms. Methods: Intraluminal occlusion of middle cerebral artery (MCAO) in a rat model was used to investigate the effect of iptakalim at different time points. Infarct volume was measured by staining with 2,3,5-triphenyltetrazolium chloride, and immunohistochemistry was used to evaluate the expressions of Bcl-2 and Bax. In vitro, neurovascular unit (NVU) cells, including rat primary cortical neurons, astrocytes, and cerebral microvascular endothelial cells, were cultured and underwent oxygen-glucose deprivation (OGD). The protective effect of iptakalim on NVU cells was investigated by cell viability and injury assessments, which were measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and release of lactate dehydrogenase. Caspase-3, Bcl-2 and Bax mRNA expressions were evaluated by real-time polymerase chain reaction (PCR). Results: Administration of iptakalim 0 or 1 h after reperfusion significantly reduced infarct volumes, improved neurological scores, and attenuated brain edema after cerebral I/R injury. Iptakalim treatment (0 h after reperfusion) also reduced caspase-3 expression and increased the ratio of Bcl-2 to Bax by immunohistochemistry. Iptakalim inhibited OGD-induced cell death in cultured neurons and astrocytes, and lactate dehydrogenase release from cerebral microvascular endothelial cells. Iptakalim reduced mRNA expression of caspase-3 and increased the ratio of Bcl-2 to Bax in NVU cells. Conclusions: Iptakalim confers neuroprotection against cerebral I/R injury by protecting NVU cells via inhibiting of apoptosis. PMID:21960347

  17. Exactech Opteon Femoral Component Fracture 12 Years after Arthroplasty

    PubMed Central

    Patel, Shaun P.; Antoci, Valentin; Kadzielski, John J.; Vrahas, Mark S.

    2016-01-01

    Arthroplasty implant fracture is a rare but critical complication that requires difficult revision surgery, often with poor results, patient disability, and significant cost. Several reports show component fracture either at the stem or at the neck interface after a relatively short postoperative course. We report such failure after 12 years, suggesting no safe period after which femoral implant fracture does not occur. PMID:26955493

  18. Chronic common femoral vein occlusion secondary to endometriosis

    PubMed Central

    Ju, Mila H.; Keldahl, Mark L.; Rodriguez, Heron E.

    2016-01-01

    Venous occlusion is sometimes caused by external compression due to adjacent masses. Endometriosis, the presence of functioning endometrial tissue outside the uterine cavity, is a rare cause of venous occlusion. We report a case of chronic common femoral vein occlusion due to endomctrioma causing severe leg edema and groin pain that was treated with resection and venous bypass. PMID:26993188

  19. Rotational alignment of the femoral component in total knee arthroplasty

    PubMed Central

    Falvo, Daniele Antonio; Iapicca, Mario Luigi; Gotti, Valerio

    2016-01-01

    We describe here various surgical options to obtain a correct rotational alignment of femoral component in total knee arthroplasty (TKA). The correct rotational alignment is the key point to obtain a rectangular balanced flexion gap as well to have a good patellar tracking. For that reason, rotation alignment largely affects postoperative kinematic results particularly during flexion. PMID:26855940

  20. Quantifying lateral femoral condyle ellipticalness in chimpanzees, gorillas, and humans.

    PubMed

    Sylvester, Adam D; Pfisterer, Theresa

    2012-11-01

    Articular surfaces of limb bones provide information for understanding animal locomotion because their size and shape are a reflection of habitual postures and movements. Here we present a novel method for quantifying the ellipticalness (i.e., departure from perfectly circular) of the lateral femoral condyle (LFC), applying this technique to hominid femora. Three-dimensional surface models were created for 49 Homo sapiens, 34 Pan troglodytes and 25 Gorilla gorilla femora. Software was developed that fit separate cylinders to each of the femoral condyles. These cylinders were constrained to have a single axis, but could have different radii. The cylinder fit to the LFC was allowed to assume an elliptical cross-section, while the cylinder fit to the medial condyle was constrained to remain circular. The shape of the elliptical cylinder (ratio of the major and minor axes of the ellipse) was recorded, and the orientation of the elliptical cylinder quantified as angles between the major axis of the ellipse and the anatomical and mechanical axes of the femur. Species were compared using analysis of variance and post hoc multiple comparisons tests. Confirming qualitative descriptions, human LFCs are more elliptical than those of chimpanzees and gorillas. Human femora exhibit a narrow range for the angle between the major axis of the elliptical cylinder and femoral axes. Conversely, the chimpanzee sample is bimodal for these angles, exhibiting two ellipse orientations, while Gorilla shows no preferred angle. Our results suggest that like modern human femora, chimpanzee femoral condyles have preferentially used regions. PMID:23042636

  1. Spontaneous capital femoral physeal fracture in a cat

    PubMed Central

    Schwartz, Galya

    2013-01-01

    A young neutered male cat was presented with a 1-week history of left hind limb lameness. Pain and crepitus were identified on manipulation of the left coxofemoral joint. Radiographic evaluation led to the diagnosis of physeal dysplasia with slipped capital femoral epiphysis of the left femur, which did not respond to conservative management. PMID:24155467

  2. Scaling in Theropod Dinosaurs: Femoral Bone Strength and Locomotion II

    ERIC Educational Resources Information Center

    Lee, Scott

    2015-01-01

    In the second paper of this series, the effect of transverse femoral stresses due to locomotion in theropod dinosaurs of different sizes was examined for the case of an unchanging leg geometry. Students are invariably thrilled to learn about theropod dinosaurs, and this activity applies the concepts of torque and stress to the issue of theropod…

  3. Does vitamin D affect femoral cartilage thickness? An ultrasonographic study.

    PubMed

    Malas, Fevziye Unsal; Kara, Murat; Aktekin, Lale; Ersöz, Murat; Ozçakar, Levent

    2014-09-01

    This study aims to investigate the association between vitamin D levels and distal femoral cartilage thickness in healthy subjects. Eighty patients who were admitted to our outpatient clinic between May and July 2013 were classified into three subgroups according to their 25-OH vitamin D levels of <10, 10-20, and ≥20 ng/mL. Distal femoral cartilage thickness was measured from the midpoints of the right medial condyle (RMC), right lateral condyle (RLC), right intercondylar area (RIA), left medial condyle (LMC), left lateral condyle (LLC), and left intercondylar area (LIA) by using musculoskeletal ultrasound (US). The group with severe vitamin D deficiency (<10 ng/mL) had thinner femoral cartilage thickness at LMC (p = 0.005). Positive correlations were determined only between vitamin D levels and US measurements in the severe vitamin D deficiency group at RLC (r = 444, p = 0.020), LMC (r = 357, p = 0.067), and LLC (r = 568, p = 0.002). Low levels of vitamin D seem to affect the femoral cartilage thickness, adversely. Further studies are necessary to ascertain the clinical relevance of this change in cartilage thickness and whether vitamin D supplementation can reverse the cartilage thinning process or the allied clinical symptoms in the course of knee osteoarthritis. PMID:24221506

  4. Postmortem angiography using femoral cannulation and postmortem microbiology.

    PubMed

    Palmiere, Cristian; Egger, Coraline; Grabherr, Silke; Jaton-Ogay, Katia; Greub, Gilbert

    2015-07-01

    Despite the undeniable advantages of postmortem angiography, numerous questions have arisen concerning the influence that the injected contrast media may exercise on biological fluids and tissues collected for toxicological and biochemical investigations. Moreover, cardiac blood for microbiological investigations cannot be obtained post-angiography. In this study, we examined whether the peripheral blood collected prior to postmortem angiography, using percutaneous access to femoral vessels after skin surface disinfection, could be suitable for microbiological investigations when postmortem angiography with femoral vessel cannulation is also performed. A total of 66 cases were included in the study and were divided into two subgroups (angiography and bacteriology group, 33 cases and control group, 33 cases). Autopsies, histology, toxicology, bacteriology, and biochemical investigations (procalcitonin, C-reactive protein, interleukin-6, and soluble triggering receptors expressed on myeloid cells type 1) were performed in all cases. No statistically significant differences between the two groups were noted, and identified category distribution (death unrelated to infection, true infection, false positive, and undetermined) was rather similar in both studied populations. These preliminary results suggest that postmortem angiography using a femoral approach does not constitute an impediment to the collection of peripheral blood for microbiology and vice versa. Moreover, the use of femoral blood for microbiology does not lead to an increased risk of doubtful results. PMID:25381195

  5. Risk factors in selected patients undergoing femoral embolectomy.

    PubMed Central

    Scott, D. J.; Davies, A. H.; Horrocks, M.

    1989-01-01

    Mortality rates after femoral embolectomy (FE) in patients with an acutely ischaemic leg vary from 20-40%. In the last 3 years we have adopted a policy of proceeding directly to femoral embolectomy in those patients with a strong clinical suspicion of an embolus. Where doubt exists about the diagnosis, arteriography is performed in combination with local streptokinase, balloon dilatation and/or reconstruction. In a prospective study between September 1984 and March 1987, 43 patients underwent femoral embolectomy with a limb salvage rate of 87%. The early mortality (within 30 days) was 16%, the late mortality was 26%, with a mean follow-up of 22 months. Of the seven patients who died within 30 days, one had a successful embolectomy but died from a cerebrovascular accident. The remaining six failed to improve clinically, all had poor backbleeding and no return of the peripheral pulses. None of these patients had an amputation. We recommend that femoral embolectomy be performed in those patients with a short history of ischaemia (less than 72 h), a risk factor suggesting an embolic source and no past history of intermittent claudication. If all three criteria are not met, arteriography should be performed with a view to fibrinolytic therapy or vascular reconstruction. In those patients who have had a failed embolectomy or where the circulation cannot be restored promptly, despite fibrinolytic therapy and/or distal reconstruction, early major amputation may be life-saving. PMID:2774451

  6. Quadratus lumborum block for femoral–femoral bypass graft placement

    PubMed Central

    Watanabe, Kunitaro; Mitsuda, Shingo; Tokumine, Joho; Lefor, Alan Kawarai; Moriyama, Kumi; Yorozu, Tomoko

    2016-01-01

    Abstract Introduction: Atherosclerosis has a complex etiology that leads to arterial obstruction and often results in inadequate perfusion of the distal limbs. Patients with atherosclerosis can have severe complications of this condition, with widespread systemic manifestations, and the operations undertaken are often challenging for anesthesiologists. Case report: A 79-year-old woman with chronic heart failure and respiratory dysfunction presented with bilateral gangrene of the distal lower extremities with obstruction of the left common iliac artery due to atherosclerosis. Femoral–femoral bypass graft and bilateral foot amputations were planned. Spinal anesthesia failed due to severe scoliosis and deformed vertebrae. General anesthesia was induced after performing multiple nerve blocks including quadratus lumborum, sciatic nerve, femoral nerve, lateral femoral cutaneous nerve, and obturator nerve blocks. However, general anesthesia was abandoned because of deterioration in systemic perfusion. The surgery was completed; the patient remained comfortable and awake without the need for further analgesics. Conclusion: Quadratus lumborum block may be a useful anesthetic technique to perform femoral–femoral bypass. PMID:27583851

  7. Femoral mycotic aneurysm presenting as arthritis and purpura.

    PubMed

    Feldman, C; Mason, P; Jones, R R; Kelley, C

    1985-11-01

    A case is described with recurrent arthritis and skin rash confined to the right lower limb and exacerbated on each occasion by exercise. Investigation established this to be due to a mycotic aneurysm of the right common femoral artery. Treatment with excision and grafting and antibiotics resulted in full recovery. Mycotic aneurysm and the unusual presenting features in this case are discussed. PMID:3840709

  8. Late Complication after Superficial Femoral Artery (SFA) Aneurysm: Stent-graft Expulsion Outside the Skin

    SciTech Connect

    Pecoraro, Felice Sabatino, Ermanno R.; Dinoto, Ettore; Rosa, Giuliana La; Corte, Giuseppe; Bajardi, Guido

    2015-10-15

    A 78-year-old man presented with a 7-cm aneurysm in the left superficial femoral artery, which was considered unfit and anatomically unsuitable for conventional open surgery for multiple comorbidities. The patient was treated with stent-graft [Viabhan stent-graft (WL Gore and Associates, Flagstaff, AZ)]. Two years from stent-graft implantation, the patient presented a purulent secretion and a spontaneous external expulsion through a fistulous channel. No claudication symptoms or hemorrhagic signs were present. The pus and device cultures were positive for Staphylococcus aureus sensitive to piperacillin/tazobactam. Patient management consisted of fistula drainage, systemic antibiotic therapy, and daily wound dressing. At 1-month follow-up, the wound was closed. To our knowledge, this is the first case of this type of stent-graft complication presenting with external expulsion.

  9. Intra-Operative Tissue Oxygen Tension Is Increased by Local Insufflation of Humidified-Warm CO2 during Open Abdominal Surgery in a Rat Model

    PubMed Central

    Marshall, Jean K.; Lindner, Pernilla; Tait, Noel; Maddocks, Tracy; Riepsamen, Angelique; van der Linden, Jan

    2015-01-01

    Introduction Maintenance of high tissue oxygenation (PtO2) is recommended during surgery because PtO2 is highly predictive of surgical site infection and colonic anastomotic leakage. However, surgical site perfusion is often sub-optimal, creating an obstructive hurdle for traditional, systemically applied therapies to maintain or increase surgical site PtO2. This research tested the hypothesis that insufflation of humidified-warm CO2 into the abdominal cavity would increase sub-peritoneal PtO2 during open abdominal surgery. Materials and Methods 15 Wistar rats underwent laparotomy under general anesthesia. Three sets of randomized cross-over experiments were conducted in which the abdominal cavity was subjected to alternating exposure to 1) humidified-warm CO2 & ambient air; 2) humidified-warm CO2 & dry-cold CO2; and 3) dry-cold CO2 & ambient air. Sub-peritoneal PtO2 and tissue temperature were measured with a polarographic oxygen probe. Results Upon insufflation of humidified-warm CO2, PtO2 increased by 29.8 mmHg (SD 13.3; p<0.001), or 96.6% (SD 51.9), and tissue temperature by 3.0°C (SD 1.7 p<0.001), in comparison with exposure to ambient air. Smaller, but significant, increases in PtO2 were seen in experiments 2 and 3. Tissue temperature decreased upon exposure to dry-cold CO2 compared with ambient air (-1.4°C, SD 0.5, p = 0.001). Conclusions In a rat model, insufflation of humidified-warm CO2 into the abdominal cavity during open abdominal surgery causes an immediate and potentially clinically significant increase in PtO2. The effect is an additive result of the delivery of CO2 and avoidance of evaporative cooling via the delivery of the CO2 gas humidified at body temperature. PMID:25835954

  10. Outcomes of Surgical Treatment of Periprosthetic Femoral Fractures in Cementless Hip Arthroplasty

    PubMed Central

    Kim, Min-Wook; Lee, Jung-Ho; Park, Ji-Hoon

    2015-01-01

    Purpose We aimed to evaluate the results of surgical treatment of periprosthetic femoral fractures in cementless total hip arthroplasty (THA). Materials and Methods From June 2002 to May 2012, 40 patients who could be followed-up for more than 1 year after surgery were enrolled in this study. The mean duration of follow-up was 28.5 months (range, 15-97 months) and the average age at the time of surgery was 71.5 years (range, 38-89 years). The fracture types were determined by using the Vancouver classification. Among intraoperative fractures, there were type A in 3 hips, type B2 in 2 hips and type B3 in one. Among postoperative fractures, type AG was present in 5 hips, type AL in 2 hips, type B1 in 15 hips, type B2 in 6 hips, type B3 in 3 hips, and type C in 3 hips. Evaluation of the results was based on bony union, stability of the prosthesis, postoperative complications, and Harris hip score at the final follow-up. Results Bony union was achieved in all but one case and the average time for bony union was 21 weeks. The mean Harris hip score was 86 at the final follow-up. Clinical results were above good in 34 of 40 hips (85.0%). Stem loosening occurred in one patient with a type B1 fracture treated with open reduction and plate fixation. Nonunion was observed in 1 patient with an AG type fracture. Conclusion Open reduction and fixation using a plate with a screw and cerclage wiring provided good results for periprosthetic fractures in patients who had a stable femoral stem without bone defects. Revision surgery with a cementless long stem should be considered in patients with an unstable stem or suspected stability in B1 type of THA using a proximal fixation type. PMID:27536618

  11. Autograft Transfer from the Ipsilateral Femoral Condyle in Depressed Tibial Plateau Fractures

    PubMed Central

    Sferopoulos, N.K

    2014-01-01

    Introduction : The rationale for operative treatment of depressed tibial plateau fractures is anatomic reduction, stable fixation and grafting. Grafting options include autogenous bone graft or bone substitutes. Methods : The autograft group included 18 patients with depressed tibial plateau fractures treated with autogenous bone grafting from the ipsilateral femoral condyle following open reduction and internal fixation. According to Schatzker classification, there were 9 type II, 4 type III, 2 type IV and 3 type V lesions. The average time to union and the hospital charges were compared with the bone substitute group. The latter included 17 patients who had an excellent outcome following treatment of split and/or depressed lateral plateau fractures, using a similar surgical technique but grafting with bone substitutes (allografts). Results : Excellent clinical and radiological results were detected in the autograft group after an average follow-up of 28 months (range 12-37). The average time to union in the autograft group was 14 weeks (range 12-16), while in the bone substitute group it was 18 weeks (range 16-20). The mean total cost was 1276 Euros for the autograft group and 2978 Euros for the bone substitute group. Discussion : The use of autogenous graft from the ipsilateral femoral condyle following open reduction and internal fixation of depressed tibial plateau fractures provided enough bone to maintain the height of the tibial plateau and was not associated with any donor site morbidity. Using this method, the surgical time was not significantly elongated and the rehabilitation was not affected. It also exhibited faster fracture healing without postoperative loss of reduction and it was less expensive than the use of bone substitutes. PMID:25317215

  12. Current concepts on osteonecrosis of the femoral head

    PubMed Central

    Moya-Angeler, Joaquin; Gianakos, Arianna L; Villa, Jordan C; Ni, Amelia; Lane, Joseph M

    2015-01-01

    It is estimated that 20000 to 30000 new patients are diagnosed with osteonecrosis annually accounting for approximately 10% of the 250000 total hip arthroplasties done annually in the United States. The lack of level 1 evidence in the literature makes it difficult to identify optimal treatment protocols to manage patients with pre-collapse avascular necrosis of the femoral head, and early intervention prior to collapse is critical to successful outcomes in joint preserving procedures. There have been a variety of traumatic and atraumatic factors that have been identified as risk factors for osteonecrosis, but the etiology and pathogenesis still remains unclear. Current osteonecrosis diagnosis is dependent upon plain anteroposterior and frog-leg lateral radiographs of the hip, followed by magnetic resonance imaging (MRI). Generally, the first radiographic changes seen by radiograph will be cystic and sclerotic changes in the femoral head. Although the diagnosis may be made by radiograph, plain radiographs are generally insufficient for early diagnosis, therefore MRI is considered the most accurate benchmark. Treatment options include pharmacologic agents such as bisphosphonates and statins, biophysical treatments, as well as joint-preserving and joint-replacing surgeries. the surgical treatment of osteonecrosis of the femoral head can be divided into two major branches: femoral head sparing procedures (FHSP) and femoral head replacement procedures (FHRP). In general, FHSP are indicated at pre-collapse stages with minimal symptoms whereas FHRP are preferred at post-collapse symptomatic stages. It is difficult to know whether any treatment modality changes the natural history of core decompression since the true natural history of core decompression has not been delineated. PMID:26396935

  13. Femoral head diameter considerations for primary total hip arthroplasty.

    PubMed

    Girard, J

    2015-02-01

    The configuration of total hip arthroplasty (THA) implants has constantly evolved since they were first introduced. One of the key components of THA design is the diameter of the prosthetic femoral head. It has been well established that the risk of dislocation is lower as the head diameter increases. But head diameter impacts other variables beyond joint stability: wear, cam-type impingement, range of motion, restoration of biomechanics, proprioception and groin pain. The introduction of highly cross-linked polyethylene and hard-on-hard bearings has allowed surgeons to implant large-diameter heads that almost completely eliminate the risk of dislocation. But as a result, cup liners have become thinner. With femoral head diameters up to 36 mm, the improvement in joint range of motion, delay in cam-type impingement and reduction in dislocation risk have been clearly demonstrated. Conversely, large-diameter heads do not provide any additional improvements. If an "ecologically sound" approach to hip replacement is embraced (e.g. keeping the native femoral head diameter), hip resurfacing with a metal-on-metal bearing must be carried out. The reliability of large-diameter femoral heads in the longer term is questionable. Large-diameter ceramic-on-ceramic bearings may be plagued by the same problems as metal-on-metal bearings: groin pain, squeaking, increased stiffness, irregular lubrication, acetabular loosening and notable friction at the Morse taper. These possibilities require us to be extra careful when using femoral heads with a diameter greater than 36 mm. PMID:25596984

  14. Current concepts on osteonecrosis of the femoral head.

    PubMed

    Moya-Angeler, Joaquin; Gianakos, Arianna L; Villa, Jordan C; Ni, Amelia; Lane, Joseph M

    2015-09-18

    It is estimated that 20000 to 30000 new patients are diagnosed with osteonecrosis annually accounting for approximately 10% of the 250000 total hip arthroplasties done annually in the United States. The lack of level 1 evidence in the literature makes it difficult to identify optimal treatment protocols to manage patients with pre-collapse avascular necrosis of the femoral head, and early intervention prior to collapse is critical to successful outcomes in joint preserving procedures. There have been a variety of traumatic and atraumatic factors that have been identified as risk factors for osteonecrosis, but the etiology and pathogenesis still remains unclear. Current osteonecrosis diagnosis is dependent upon plain anteroposterior and frog-leg lateral radiographs of the hip, followed by magnetic resonance imaging (MRI). Generally, the first radiographic changes seen by radiograph will be cystic and sclerotic changes in the femoral head. Although the diagnosis may be made by radiograph, plain radiographs are generally insufficient for early diagnosis, therefore MRI is considered the most accurate benchmark. Treatment options include pharmacologic agents such as bisphosphonates and statins, biophysical treatments, as well as joint-preserving and joint-replacing surgeries. the surgical treatment of osteonecrosis of the femoral head can be divided into two major branches: femoral head sparing procedures (FHSP) and femoral head replacement procedures (FHRP). In general, FHSP are indicated at pre-collapse stages with minimal symptoms whereas FHRP are preferred at post-collapse symptomatic stages. It is difficult to know whether any treatment modality changes the natural history of core decompression since the true natural history of core decompression has not been delineated. PMID:26396935

  15. Analysis of Femoral Components of Cemented Total Hip Arthroplasty

    NASA Astrophysics Data System (ADS)

    Singh, Shantanu; Harsha, A. P.

    2015-10-01

    There have been continuous on-going revisions in design of prosthesis in Total Hip Arthroplasty (THA) to improve the endurance of hip replacement. In the present work, Finite Element Analysis was performed on cemented THA with CoCrMo trapezoidal, CoCrMo circular, Ti6Al4V trapezoidal and Ti6Al4V circular stem. It was observed that cross section and material of femoral stem proved to be critical parameters for stress distribution in femoral components, distribution of interfacial stress and micro movements. In the first part of analysis, designs were investigated for micro movements and stress developed, for different stem materials. Later part of the analysis focused on investigations with respect to different stem cross sections. Femoral stem made of Titanium alloy (Ti6Al4V) resulted in larger debonding of stem at cement-stem interface and increased stress within the cement mantle in contrast to chromium alloy (CoCrMo) stem. Thus, CoCrMo proved to be a better choice for cemented THA. Comparison between CoCrMo femoral stem of trapezium and circular cross section showed that trapezoidal stem experiences lesser sliding and debonding at interfaces than circular cross section stem. Also, trapezium cross section generated lower peak stress in femoral stem and cortical femur. In present study, femur head with diameter of 36 mm was considered for the analysis in order to avoid dislocation of the stem. Also, metallic femur head was coupled with cross linked polyethylene liner as it experiences negligible wear compared to conventional polyethylene liner and unlike metallic liner it is non carcinogenic.

  16. Mechanical Behaviour of Umbrella-Shaped, Ni-Ti Memory Alloy Femoral Head Support Device during Implant Operation: A Finite Element Analysis Study

    PubMed Central

    Yi, Wei; Tian, Qing; Dai, Zhipeng; Liu, Xiaohu

    2014-01-01

    A new instrument used for treating femoral head osteonecrosis was recently proposed: the umbrella-shaped, Ni-Ti memory femoral head support device. The device has an efficacy rate of 82.35%. Traditional radiographic study provides limited information about the mechanical behaviour of the support device during an implant operation. Thus, this study proposes a finite element analysis method, which includes a 3-step formal head model construction scheme and a unique material assignment strategy for evaluating mechanical behaviour during an implant operation. Four different scenarios with different constraints, initial positions and bone qualities are analyzed using the simulation method. The max radium of the implanted device was consistent with observation data, which confirms the accuracy of the proposed method. To ensure that the device does not unexpectedly open and puncture the femoral head, the constraint on the impact device should be strong. The initial position of sleeve should be in the middle to reduce the damage to the decompression channel. The operation may fail because of poor bone quality caused by severe osteoporosis. The proposed finite element analysis method has proven to be an accurate tool for studying the mechanical behaviour of umbrella-shaped, Ni-Ti memory alloy femoral head support device during an implant operation. The 3-step construct scheme can be implemented with any kind of bone structure meshed with multiple element types. PMID:24960038

  17. Psychological prenatal stress reduced the number of BrdU immunopositive cells in the dorsal hippocampus without affecting the open field behavior of male and female rats at one month of age.

    PubMed

    Odagiri, Kei; Abe, Hiroshi; Kawagoe, Chika; Takeda, Ryuichiro; Ikeda, Testuya; Matsuo, Hisae; Nonaka, Hiroi; Ebihara, Kosuke; Nishimori, Toshikazu; Ishizuka, Yuta; Hashiguchi, Hiroyuki; Ishida, Yasushi

    2008-11-28

    We examined whether prenatal psychological stress with little physical stress causes changes in the behavior and neurogenesis of the offspring of Sprague-Dawley rats at one month. Dams in the last trimester of gestation were psychologically stressed by placing them in a social communication box and shocking a rat on the other side of a transparent wall. They suffered little physical stress. Male and female offspring from the dams showed little change in an open field test at postnatal day (PND) 30. To evaluate neurogenesis in the brain, BrdU was intraperitoneally injected at PND 35 into offspring not used in the open field test. Immunohistochemical examinations of BrdU in their dorsal hippocampus at PNDs 42 and 112 revealed that the number of BrdU immunopositive cells in the offspring of prenatally stressed rats was significantly smaller than in the offspring of unstressed ones. These results together with our previous finding that prenatal psychological stress can alter specific behaviors suggest that prenatal psychological stress can suppress neurogenesis in the dorsal hippocampus of rats of both sexes at PND 35 even though impairment in the behavioral task has not yet appeared. PMID:18817847

  18. Resected femoral anthropometry for design of the femoral component of the total knee prosthesis in a Korean population

    PubMed Central

    Kwak, Dai-Soon; Han, Suhyoun; Han, Chang Whan

    2010-01-01

    We measured the mediolateral (ML) and anteroposterior (AP) length, height and widths of the anterior, posterior and inferior section of the resected distal femurs using three dimensional computer tomographic measurements in 200 knees from 100 cadavers. We also calculated the aspect ratio (ML/AP) and compared the measured parameters with that of six conventionally used total knee femoral prostheses. We found that the average ML (70.2±5.5 mm) and AP (53.9±3.8 mm) dimensions from our study were lower than those reported from Western populations. The aspect ratio showed a progressive decline with an increasing antero-posterior dimension. All of the compared designs showed undersizing for the mediolateral dimension distally and for the widths of the resected medial and lateral posterior femoral condyles. But some of the compared designs showed oversizing for the height of the resected medial and lateral posterior femoral condyles. This study provides guidelines for designing a suitable femoral component for total knee prostheses that fit Asian populations. PMID:21212865

  19. THA Retrievals: The Need to Mark the Anatomic Orientation of the Femoral Head.

    PubMed

    Heiner, Anneliese D; Kruger, Karen M; Tikekar, Nishant M; Callaghan, John J; Lannutti, John J; Brown, Thomas D

    2015-06-01

    The hypothesis of this study was that the rotational orientation of femoral head damage would greatly affect the volumetric wear rate of the opposing polyethylene (PE) liner. Damage on twenty retrieved cobalt-chromium femoral heads was simulated in a validated damage-feature-based finite element model. For each individual retrieval, the anatomic orientation of the femoral head about the femoral neck axis was systematically varied, in 30° increments. The PE wear rate differential between the maximum- versus minimum-wear orientations was often sizable, as high as 7-fold. Knowing the correct femoral head anatomic orientation is therefore important when analyzing the effects of femoral head damage on PE liner wear. Surgeons retrieving modular femoral heads should routinely mark the anatomic orientation of those components. PMID:25682206

  20. Denervation in Femoral Artery-Ligated Hindlimbs Diminishes Ischemic Recovery Primarily via Impaired Arteriogenesis

    PubMed Central

    Qin, Yuansen; Liu, Ruiming; Wang, Huijin; Zhou, Yu; Wang, Shenming; Hu, Zuojun

    2016-01-01

    Aims Multiple factors regulate arteriogenesis. Peripheral nerves play a crucial role in vascular remodeling, but the function of peripheral nerves during arteriogenesis is obscure. Our study investigated the contribution of denervation to arteriogenesis during post-ischemic recovery from hindlimb femoral artery ligation. Methods and Results Sprague-Dawley rats were randomly allocated into four groups of normal control (NC), hindlimb ischemia (HI), hindlimb ischemia with denervation (HID) and hindlimb simple denervation (HD). Hindlimb ischemic recovery was assessed by clinical assessment and tibialis anterior muscle remodeling on day 28 post-surgery. Blood flow was determined by laser Doppler imaging on day 0, 3, 7, 14 and 28 post-surgery. Collateral number of hindlimb was observed by angiography and gracilis muscles were tested by immunostaining on day 7 and 28 post-surgery. Angiogenesis was accessed by counting CD31 positive capillaries in tibialis anterior muscles on day 28 post-surgery. Group HID showed impaired ischemic recovery compared with the other 3 groups and impaired blood flow recovery compared with group HI on day 28 post-surgery. The collateral number and capillary density of group HID were lower than group HI. The collateral diameter of both group HID and group HI significantly increased compared with group NC. However, the lumen diameter was much narrower and the vessel wall was much thicker in group HID than group HI. We also demonstrated that the thickened neointima of collaterals in group HID comprised of smooth muscle cells and endothelial cells. Conclusions Denervation of the ligated femoral artery in the hindlimb impairs ischemic recovery via impaired perfusion. The possible mechanisms of impaired perfusion are lower collateral number, lower capillary density and most likely narrower lumen, which damage ischemic recovery. This study illustrates the crucial role of peripheral nerves in arteriogenesis using a model combined ischemia with

  1. Proximal Femoral Nail Antirotation Versus Reverse Less Invasive Stabilization System-distal Femur for Treating Proximal Femoral Fractures

    PubMed Central

    Jiang, Xuan; Wang, Ying; Ma, XinLong; Ma, JianXiong; Wang, Chen; Zhang, ChengBao; Han, Zhe; Sun, Lei; Lu, Bin

    2016-01-01

    Abstract The aim of this study was to compare the effectiveness and safety of 2 surgical techniques that are used to treat proximal femoral fractures. A systematic literature search (up to December 2014) was conducted in Medline, Embase, PubMed, and The Cochrane Central Register of Controlled Trials to screen for studies comparing proximal femoral nail antirotation (PFNA) with less invasive stabilization system–distal femur (LISS-DF) for proximal femoral fractures. Two authors independently assessed the methodological quality of the included studies and extracted data. Surgical information and postoperative outcomes were analyzed. A total of 7 studies with 361 patients who satisfied the eligibility criteria included 3 randomized controlled trials and 4 case-controlled trials associated with PFNA versus LISS in treating proximal femoral fractures. Our results demonstrated that there was a significant reduction in hospital stay and time to weight-bearing ambulation and bone healing for PFNA compared with LISS (odds ratio [OR] −1.48, 95% confidence interval [CI] −2.92 to −0.05; OR −7.08, 95% CI −8.32 to −5.84; OR −2.71, 95% CI −4.76 to 0.67). No statistically significant difference was observed between the 2 groups for operative time, blood loss volume, Harris hip score, and incidence of complications. Based on the results of this analysis, we inferred that PFNA is safer and more effective than reverse LISS-DF in patients undergoing osteosynthesis for proximal femoral fractures, and that PFNA is associated with reduced hospital stays and reduced time to weight-bearing ambulation and bone healing. Nonetheless, in certain cases in which PFNA is not suitable due to abnormal structure of the proximal femur or particularly unstable fractures, the LISS plate technique could be a useful alternative. PMID:27057840

  2. Statistical Shape Modeling of Proximal Femoral Shape Deformities in Legg-Calvé-Perthes Disease and Slipped Capital Femoral Epiphysis

    PubMed Central

    Chan, Elaine F.; Farnsworth, Christine L.; Koziol, James A.; Hosalkar, Harish S.; Sah, Robert L.

    2013-01-01

    Introduction The current understanding of morphological deformities of the hip such as femoroacetabular impingement (FAI), Legg-Calve-Perthes disease (LCPD), and slipped capital femoral epiphysis (SCFE) is based on 2-dimensional metrics, primarily involving the femoral head, that only partially describe the complex skeletal morphology. Objective This study aimed to improve the 3-dimensional understanding of shape variations during normal growth, and in LCPD and SCFE, through statistical shape modeling. Design Thirty-two patients with asymptomatic, LCPD, and SCFE hips, determined from physical and radiographic examination, were scanned using 3-D CT at a voxel size of (0.5–0.9mm)2 in-plane and 0.63mm slice thickness. Statistical shape modeling was performed on segmented proximal femoral surfaces to determine modes of variation and shape variables quantifying 3-D shape. In addition, conventional variables were determined for all femora. Results Proximal femur shape was described by 8 modes of variation and corresponding shape variables. Statistical shape variables were distinct with age and revealed coordinated, growth-associated differences in neck length-to-width ratio, femoral head medialization, and trochanter protrusion. After size and age-based shape adjustment, diseased proximal femora were characterized by shape variables distinct from those of asymptomatic hips. The shape variables defined morphology in health and disease, and were correlated with certain conventional variables of shape, including neck-shaft angle, head diameter, and neck diameter. Conclusion 3-D quantitative analyses of proximal femoral bone shape during growth and in disease are useful for furthering the understanding of normal and abnormal shape deviations which affect cartilage biomechanics and risk of developing osteoarthritis. PMID:23274103

  3. Estimating blood-brain barrier opening in a rat model of hemorrhagic transformation with Patlak plots of Gd-DTPA contrast-enhanced MRI.

    PubMed

    Fenstermacher, J D; Knight, R A; Ewing, J R; Nagaraja, T; Nagesh, V; Yee, J S; Arniego, P A

    2003-01-01

    Patlak plot processing of Gd-shifted T1 relaxation-time images from a rat model of hemorrhagic transformation yielded estimates and maps of the blood-to-brain influx rate constant of Gd-DTPA (K1). The Patlak plots also produced a heretofore unrecognized parameter, the distribution space of the intravascular-Gd-shifted protons (Vp), an index of blood-to-tissue transfer of water. The K1 values for Gd-DTPA were very high for the regions of blood-brain barrier (BBB) opening and were similar to those of 14C-sucrose concurrently obtained by quantitative autoradiographic (QAR) analysis. In these same ROI's, Vp was five-fold greater than normal, which suggests that the permeability of the BBB to water was also increased. The 14C-sucrose space of distribution in the ischemic ROI's was around 8%, thus indicating a sizable interstitial space. The spatial resolving power of Gd-DTPA-deltaT1 imaging was rather good, although no match for 14C-sucrose-QAR. This study shows that quantitative deltaT1-MRI estimates of regional blood-brain transfer constants of Gd-DTPA and water distribution are possible when Patlak plots are employed to process the data. This approach may be useful for tracking the time-course of BBB barrier function in both animals and humans. PMID:14753399

  4. (/sup 3/H)Methotrexate loss from the rat brain following enhanced uptake by osmotic opening of the blood-brain barrier

    SciTech Connect

    Ohata, M.; Fredericks, W.R.; Neuwelt, E.A.; Sundaram, U.; Rapoport, S.I.

    1985-03-01

    Right brain regions of anesthetized rats were loaded with (3,5,7-/sup 3/H)methotrexate ((/sup 3/H)MTX) or with (/sup 14/C)sucrose by infusing the tracers into the right carotid artery, after the blood-brain barrier had been opened by right carotid infusion of a hypertonic arabinose solution. During the 6 hr following the procedure, the (/sup 3/H)MTX concentration in 7 right-sided brain regions, when normalized to the plasma concentration integral during tracer infusion, fell, with an average half-time of 4.8 hr as compared to less than 20 min for the initial rate of loss (/sup 14/C)sucrose. Right-left brain concentration differences 3 hr after treatment were statistically significant (p less than 0.05) for (/sup 3/H)MTX but not for (/sup 14/C)sucrose. The results indicate that intracerebral (/sup 3/H)MTX is lost more slowly than is intracerebral (/sup 14/C)sucrose, possibly because (/sup 3/H)MTX enters brain cells, whereas (/sup 14/C)sucrose remains largely extracellular.

  5. The opening of the inositol 1,4,5-trisphosphate-sensitive Ca2+ channel in rat cerebellum is inhibited by caffeine.

    PubMed Central

    Brown, G R; Sayers, L G; Kirk, C J; Michell, R H; Michelangeli, F

    1992-01-01

    Ins(1,4,5)P3(InsP3)-induced Ca2+ release and [3H]InsP3 binding were measured in rat cerebellar microsomes in the presence or absence of caffeine. The quantal Ca2+ release was shown to occur in an apparently co-operative fashion with a Hill coefficient (h) of 2.2. Half-maximal Ca2+ release was observed at 900 nM-InsP3. Addition of caffeine caused changes both to the concentration of InsP3 required to cause half-maximal Ca2+ release (3.9 microM at 50 mM-caffeine) and to the apparent co-operativity (h = 1.0 at 50 mM-caffeine). Under standard conditions for [3H]InsP3 binding, caffeine had no effect, and it had no effect on InsP3 metabolism. Cyclic AMP also had no effect on the quantal release induced by InsP3. These results are consistent with the view that caffeine affects the opening (Ca2+ release) events rather than the ligand-binding events in the operation of the InsP3-sensitive Ca2+ channel. PMID:1312323

  6. The effects of ATP-dependent potassium channel opener; pinacidil, and blocker; glibenclamide, on the ischemia induced arrhythmia in partial and complete ligation of coronary artery in rats

    PubMed Central

    Yaşar, Selçuk; Bozdoğan, Ömer; Kaya, Salih Tunç; Orallar, Hayriye Soytürk

    2015-01-01

    Objective(s): Electrical inhomogeneity between ischemic and non ischemic myocardium is the basis of arrhythmia which occurs following coronary artery occlusion. The leakage of potassium from the ischemic region to the non ischemic region is very effective in the generation of these arrhythmias. The aim of this study is to research the effect of ATP-dependent potassium (KATP) channel blocker (glibenclamide) and opener (pinacidil) on ischemia induced arrhythmia in the presence of small and large infarct sizes. Materials and Methods: In this study Sprague-Dawley male rats of 8-9 months of age were used. Ischemia was produced by the partial ligation of left coronary artery ramus descending (PL) for smaller infarct and complete ligation of this artery (CL) for larger infarct for 30 min. The arrhythmia score which was calculated from the duration and type of arrhythmia was significantly higher in animals which had a larger infarct area than the animals which had a smaller infarct. Results: Glibenclamide increased the rate of arrhythmia in animals having smaller infarct but not in animals having larger infarct. Pinacidil did not affect the occurrence of arrhythmia in either group. There was a significant difference in the infarct size and risk of infarct zone between animals which had small and large infarct sizes. The effect of glibenclamide and pinacidil on the arrhythmias differed depend on decrease of infarct size. Conclusion: Glibenclamide is not effective to decrease ischemia induced arrhythmia in the presence of small and pinacidil in large ischemic zone. PMID:25810894

  7. Efficacy and safety of memantine, an NMDA-type open-channel blocker, for reduction of retinal injury associated with experimental glaucoma in rat and monkey.

    PubMed

    Hare, W; WoldeMussie, E; Lai, R; Ton, H; Ruiz, G; Feldmann, B; Wijono, M; Chun, T; Wheeler, L

    2001-05-01

    Glutamatergic excitotoxicity has been implicated as a mechanism for injury in a variety of central nervous system pathologies, including glaucoma. Memantine, an NMDA-type glutamatergic open-channel blocker, has pharmacologic properties that make its efficacy greater under excitotoxic conditions, but lesser under normal conditions. Daily oral dosing for approximately 15 months with 4.0 mg/kg memantine in monkeys yielded plasma concentrations similar to those found in patients who received memantine treatment for Parkinson's disease. This same dose of memantine was not associated with any evidence of an effect on the normal function of the retina and central visual pathways, as indicated by measures of the electroretinogram (ERG) and visually-evoked cortical potential (VECP). Amplitude of the VECP response was reduced in eyes with experimentally induced glaucoma. When compared to vehicle-treated control animals, memantine-treated glaucoma eyes suffered significantly less reduction of VECP amplitude. Preliminary results in a rat model for experimental glaucoma also show that, when compared to control animals, systemic treatment with memantine (10 mg/kg/day) was associated with a significant reduction in glaucoma-induced loss of retinal ganglion cells. PMID:11377450

  8. Differences in Femoral Geometry and Structure Due to Immobilization

    NASA Technical Reports Server (NTRS)

    Kiratli, Beatrice Jenny; Yamada, M.; Smith, A.; Marcus, R. M.; Arnaud, S.; vanderMeulen, M. C. H.; Hargens, Alan R. (Technical Monitor)

    1996-01-01

    Reduction in bone mass of the lower extremity is well documented in individuals with paralysis resulting from spinal cord injury (SCI). The consequent osteopenia leads to elevated fracture risk with fractures occurring more commonly in the femoral shaft and supracondylar regions than the hip. A model has recently been described to estimate geometry and structure of the femoral midshaft from whole body scans by dual X-ray absorptiometry (DXA). Increases in femoral geometric and structural properties during growth were primarily related to mechanical loading as reflected by body mass. In this study, we investigate the relationship between body mass and femoral geometry and structure in adults with normal habitual mechanical loading patterns and those with severely reduced loading. The subjects were 78 ambulatory men (aged 20-72 yrs) and 113 men with complete paralysis from SCI of more than 4 years duration (aged 21 73 yrs). Subregional analysis was performed on DXA whole body scans to obtain bone mineral content (BMC, g), cortical thickness (cm), crosssectional moment of inertia (CSMI, cm4), and section modulus (cm3) of the femoral midshaft. All measured bone variables were significantly lower in SCI compared with ambulatory subjects: -29% (BMC), -33% (cortical thickness), -23% (CSMI), and -22% (section modulus) while body mass was not significantly different. However, the associations between body mass and bone properties were notably different; r2 values were higher for ambulatory than SCI subjects in regressions of body mass on BMC (0.48 vs 0.20), CSMI (0.59 vs 0.32), and section modulus (0.59 vs 0.31). No association was seen between body mass and cortical thickness for either group. The greatest difference between groups is in the femoral cortex, consistent with reduced bone mass via endosteal expansion. The relatively lesser difference in geometric and structural properties implies that there is less effect on mechanical integrity than would be expected from

  9. Cardiopulmonary bypass model in the rat: a new minimal invasive model with a low flow volume†

    PubMed Central

    Lebreton, Guillaume; Tamion, Fabienne; Bessou, Jean-Paul; Doguet, Fabien

    2012-01-01

    Numerous cardiopulmonary bypass (CPB) models in the rat have already been described, but these models often have an important mortality and differ a lot from human clinical conditions thus making them hardly usable. The CPB model in the rat we describe allows a femoro-femoral support CPB with a low priming volume, minimal surgical approach and excellent peroperative survival. This CPB model in the rat allows evaluating extracorporeal circulation effects. PMID:22345055

  10. Eldecalcitol prevents endothelial dysfunction in postmenopausal osteoporosis model rats.

    PubMed

    Serizawa, Kenichi; Yogo, Kenji; Tashiro, Yoshihito; Takeda, Satoshi; Kawasaki, Ryohei; Aizawa, Ken; Endo, Koichi

    2016-02-01

    Postmenopausal women have high incidence of cardiovascular events as estrogen deficiency can cause endothelial dysfunction. Vitamin D is reported to be beneficial on endothelial function, but it remains controversial whether vitamin D is effective for endothelial dysfunction under the treatment for osteoporosis in postmenopausal women. The aim of this study was to evaluate the endothelial protective effect of eldecalcitol (ELD) in ovariectomized (OVX) rats. ELD (20  ng/kg) was orally administrated five times a week for 4 weeks from 1 day after surgery. After that, flow-mediated dilation (FMD) as an indicator of endothelial function was measured by high-resolution ultrasound in the femoral artery of living rats. ELD ameliorated the reduction of FMD in OVX rats. ELD inhibited the increase in NOX4, nitrotyrosine, and p65 and the decrease in dimer/monomer ratio of nitric oxide synthase in OVX rat femoral arteries. ELD also prevented the decrease in peroxisome proliferator-activated receptor gamma (PPARγ) in femoral arteries and cultured endothelial cells. Although PPARγ is known to inhibit osteoblastogenesis, ELD understandably increased bone mineral density of OVX rats without increase in PPARγ in bone marrow. These results suggest that ELD prevented the deterioration of endothelial function under condition of preventing bone loss in OVX rats. This endothelial protective effect of ELD might be exerted through improvement of endothelial nitric oxide synthase uncoupling, which is mediated by an antioxidative effect through normalization of vascular PPARγ/NF-κB signaling. PMID:26537128

  11. What is the role of bosentan in healing of femur fractures in a rat model?

    PubMed

    Aydin, Ali; Halici, Zekai; Akpinar, Erol; Aksakal, A Murat; Saritemur, Murat; Yayla, Muhammed; Kunak, C Semih; Cadirci, Elif; Atmaca, H Tarik; Karcioglu, S Sena

    2015-09-01

    The purpose of this study was to examine the effects bosentan (which is a strong vasoconstrictor) on bone fracture pathophysiology, and investigate the roles of the nonselective endothelin 1 receptor blocker bosentan on the bone fractures formed in rats through radiographic, histopathologic, and immunohistochemical methods. The rats were divided into three groups (six rats in each group): a femoral fracture control group, a femoral fracture plus bosentan at 50 mg/kg group, and a femoral fracture plus bosentan at 100 mg/kg group. The femoral fracture model was established by transversely cutting the femur at the midsection. After manual reduction, the fractured femur was fixed with intramedullary Kirschner wires. The radiographic healing scores of the bosentan 100 and 50 mg/kg groups were significantly better that those of the fracture control group. The fracture callus percent of new bone in the bosentan 100 mg/kg group was significantly greater than that in the control group. Also, semiquantitative analysis showed higher positive vascular endothelial growth factor and osteocalcin staining and lower positive endothelin receptor type A staining in the treatment groups than in the control group. Bosentan treatment also decreased tissue endothelin 1 expression relative to that in the fracture control group. As a result of our study, the protective effect of bosentan was shown in experimental femoral fracture healing in rats by radiographic, histopathologic, and molecular analyses. PMID:25298328

  12. Three-Dimensional Analysis of the Characteristics of the Femoral Canal Isthmus: An Anatomical Study

    PubMed Central

    Su, Xiu-yun; Zhao, Jing-xin; Zhao, Zhe; Zhang, Li-cheng; Li, Chen; Li, Jian-tao; Zhou, Jian-feng; Zhang, Li-hai; Tang, Pei-fu

    2015-01-01

    Purpose. To establish a new approach for measuring and locating the femoral intramedullary canal isthmus in 3-dimensional (3D) space. Methods. Based on the computed tomography data from 204 Chinese patients, 3D models of the whole femur and the corresponding femoral isthmus tube were reconstructed using Mimics software (Materialise, Haasrode, Belgium). The anatomical parameters of the femur and the isthmus, including the femur length and radius, and the isthmus diameter and height, were measured accordingly. Results. The mean ratio of the isthmus height versus the femoral height was 55 ± 4.8%. The mean diameter of the isthmus was 10.49 ± 1.52 mm. The femoral length, the isthmus diameter, and the isthmus tube length were significantly larger in the male group. Significant correlations were observed between the femoral length and the isthmus diameter (r = 0.24, p < 0.01) and between the femoral length and the isthmus height (r = 0.6, p < 0.01). Stepwise linear regression analyses demonstrated that the femoral length and radius were the most important factors influencing the location and dimension of the femoral canal isthmus. Conclusion. The current study developed a new approach for measuring the femoral canal and for optimization of customer-specific femoral implants. PMID:26137483

  13. Glucocorticoid-induced osteoporosis in growing rats.

    PubMed

    Lin, Sien; Huang, Jianping; Zheng, Liang; Liu, Yanzhi; Liu, Guihua; Li, Nan; Wang, Kuixing; Zou, Liyi; Wu, Tie; Qin, Ling; Cui, Liao; Li, Gang

    2014-10-01

    This study evaluated whether growing rats were appropriate animal models of glucocorticoid-induced osteoporosis. The 3-month-old male rats were treated with either vehicle or prednisone acetate at 1.5, 3.0, and 6.0 mg/kg/day by oral gavage, respectively. All rats were injected with tetracycline and calcein before sacrificed for the purpose of double in vivo labeling. Biochemistry, histomorphometry, mechanical test, densitometry, micro-CT, histology, and component analysis were performed. We found that prednisone treatments dose dependently decreased body weight, serum biomarkers, biomechanical markers, bone formation, and bone resorption parameters in both tibial and femoral trabecular bone without trabecular bone loss. We also found that significant bone loss happened in femoral cortical bone in the glucocorticoid-treated rats. The results suggested that prednisone not only inhibited bone formation, but also inhibited bone resorption which resulted in poor bone strength but with no cancellous bone loss in growing rats. These data also suggested that the effects of glucocorticoid on bone metabolism were different between cortical bone and trabecular bone, and different between tibia and femur. Growing rats may be a glucocorticoid-induced osteoporosis animal model when evaluated the effects of drugs upon juvenile patients exposed to GC for a long time. PMID:25086673

  14. Simulation of human atherosclerotic femoral plaque tissue: the influence of plaque material model on numerical results

    PubMed Central

    2015-01-01

    Background Due to the limited number of experimental studies that mechanically characterise human atherosclerotic plaque tissue from the femoral arteries, a recent trend has emerged in current literature whereby one set of material data based on aortic plaque tissue is employed to numerically represent diseased femoral artery tissue. This study aims to generate novel vessel-appropriate material models for femoral plaque tissue and assess the influence of using material models based on experimental data generated from aortic plaque testing to represent diseased femoral arterial tissue. Methods Novel material models based on experimental data generated from testing of atherosclerotic femoral artery tissue are developed and a computational analysis of the revascularisation of a quarter model idealised diseased femoral artery from a 90% diameter stenosis to a 10% diameter stenosis is performed using these novel material models. The simulation is also performed using material models based on experimental data obtained from aortic plaque testing in order to examine the effect of employing vessel appropriate material models versus those currently employed in literature to represent femoral plaque tissue. Results Simulations that employ material models based on atherosclerotic aortic tissue exhibit much higher maximum principal stresses within the plaque than simulations that employ material models based on atherosclerotic femoral tissue. Specifically, employing a material model based on calcified aortic tissue, instead of one based on heavily calcified femoral tissue, to represent diseased femoral arterial vessels results in a 487 fold increase in maximum principal stress within the plaque at a depth of 0.8 mm from the lumen. Conclusions Large differences are induced on numerical results as a consequence of employing material models based on aortic plaque, in place of material models based on femoral plaque, to represent a diseased femoral vessel. Due to these large

  15. Isolated common femoral artery injury caused by blunt trauma.

    PubMed

    Avaro, J P; Biance, N; Savoie, P H; Peycru, T; Bonnet, P M; Balandraud, P

    2008-01-01

    The authors report an isolated common femoral artery injury caused by blunt trauma with dissection and secondary ischaemia. A 21-year-old man was admitted to hospital after being stabbed during acute alcoholic intoxication. He presented with a stab wound on the left leg and blunt trauma in the right groin. The surgical exploration of the left-sided wound did not disclose any vascular injury. After a 12-hour period of observation, the patient was discharged. Six hours later, he came back with severe ischaemia on the right leg caused by a femoral artery dissection. The patient underwent surgical revascularization, and fully recovered. Isolated artery blunt trauma is a rare event. In this observation, the absence of early symptoms resulted in delayed diagnosis. PMID:19241930

  16. Periprosthetic Femur Fracture Occuring after Contralateral Neglected Femoral Neck Fracture

    PubMed Central

    Cankaya, Deniz; Toprak, Ali; IKilic, Enver; Bingol, Olgun; Tabak, Yalcin

    2016-01-01

    Introduction: Periprosthetic fractures of the femur are uncommon, but at times may lead to complications especially in elderly patients. As treatment of these fractures is difficult, prevention by identifying the risk factors is the best way to overcome these complex problems. Case Report: A periprosthetic right femur fracture associated with a neglected left femoral neck fracture in the contralateral femur in a 78-year-old elder woman patient is reported in the present article. We discuss the prevention of periprosthetic fractures after hip arthroplasty and address the risk factors associated with this complication. Conclusion: The present case emphasizes the importance of investigating and treating the cause of sudden onset of restriction on full weight-bearing in the contralateral limb, to prevent periprosthetic femoral fracture after hip arthroplasty in elderly patients. PMID:27299115

  17. Bilateral Simultaneous Femoral Neck and Shafts Fractures - A Case Report

    PubMed Central

    Sadeghifar, Amirreza; Saied, Alireza

    2014-01-01

    Simultaneous fractures of the femoral neck and shaft are not common injuries, though they cannot be considered rare. Herein, we report our experience with a patient with bilateral occurance of this injury. Up to the best of our knowkedge this is the first case reported in literature in which correct diagnosis was made initially. Both femurs were fixed using broad 4.5 mm dynamic compression plate and both necks were fixed using 6.5 mm cannulated screws. Femur fixation on one side was converted to retrograde nailing because of plate failure. Both neck fractures healed uneventfully. In spite of rarity of concomitant fractures of femoral neck and shaft, this injury must be approached carefully demanding especial attention and careful device selection. PMID:25692158

  18. Hip Arthroscopy for Excision of Osteoid Osteoma of Femoral Neck

    PubMed Central

    Said, Hatem Galal; Abdulla Babaqi, AbdulRahman; AbdelSalam El-Assal, Maher

    2014-01-01

    Osteoid osteoma (OO) is the most commonly seen benign bone-forming lesion. It can occur anywhere, including the metaphyseal regions of small and large bones. We present 2 cases that underwent an arthroscopic technique for removal of OO of the femoral neck. The diagnosis was confirmed by computed tomography in addition to magnetic resonance imaging. The lesions were accessed arthroscopically and excised by unroofing and curettage. The clinical and radiographic findings are presented, along with the surgical management. The patients improved dramatically postoperatively. OO of the femoral neck should be included in the differential diagnosis of hip pain in young patients. Arthroscopic excision and curettage provide a good choice for management, with low morbidity and rapid recovery. PMID:24749036

  19. Confronting Hip Resurfacing and Big Femoral Head Replacement Gait Analysis

    PubMed Central

    Karampinas, Panagiotis K.; Evangelopoulos, Dimitrios S.; Vlamis, John; Nikolopoulos, Konstantinos; Korres, Dimitrios S.

    2014-01-01

    Improved hip kinematics and bone preservation have been reported after resurfacing total hip replacement (THRS). On the other hand, hip kinematics with standard total hip replacement (THR) is optimized with large diameter femoral heads (BFH-THR). The purpose of this study is to evaluate the functional outcomes of THRS and BFH-THR and correlate these results to bone preservation or the large femoral heads. Thirty-one patients were included in the study. Gait speed, postural balance, proprioception and overall performance. Our results demonstrated a non-statistically significant improvement in gait, postural balance and proprioception in the THRS confronting to BFH-THR group. THRS provide identical outcomes to traditional BFH-THR. The THRS choice as bone preserving procedure in younger patients is still to be evaluated. PMID:24744841

  20. Extracorporeal shockwave therapy for avascular necrosis of femoral head.

    PubMed

    Wang, Ching-Jen; Cheng, Jai-Hong; Huang, Chung-Cheng; Yip, Han-Kan; Russo, Sergio

    2015-12-01

    The etiology of osteonecrosis of the femoral head (ONFH) is multifactorial. Treatment of ONFH is disease stage dependent. For early stages, femoral head preservation procedures are preferred including core decompression, muscle pedicle grafting and de-rotational osteotomy. Core decompression with bone grafting is considered the gold standard. However, the results are inconsistence and unpredictable. An effective non-invasive method of treatment is imperative. Recently, extracorporeal shockwave therapy (ESWT) has shown beneficial effects in ONFH. ESWT improves pain and function of the hip and regression of the ONFH lesion. ESWT is more effective than core decompression with or without bone grafting, cocktail therapy that combined HBO, ESWT and oral alendronate is shown effective for patients with early osteonecrosis. The purpose of the article is to review, update and summarize the clinical treatment of ONFH using shockwave therapy. PMID:26188081

  1. PROXIMAL FEMORAL EPIPHYSIOLYSIS AND SUBCLINICAL HYPOTHYROIDISM: CASE REPORT

    PubMed Central

    de Mello, Grasiele Correa; Grossi, Gabriela; Coelho, Sílvio Pereira

    2015-01-01

    Proximal femoral epiphysiolysis is an orthopedic disease that is prevalent during adolescence, because this coincides with the time of greatest growth of osteomuscular structures. Curiously, some patients present this disease early, and this outcome converts to the possible etiological explanation that the slippage might occur through a growth spurt. For these patients, the genesis of the slippage has not yet been elucidated, but endocrine disorders have been noted as possible causes. In an attempt to strengthen the theory of endocrinological etiology and present the results from surgical treatment for this pathological condition, the case of a male patient aged 9 years and 3 months with proximal femoral epiphysiolysis and subclinical hypothyroidism who was diagnosed and treated at our university's teaching hospital is reported here. PMID:27047883

  2. Osteomyelitis of Bilateral Femoral Heads After Childbirth: A Case Report

    PubMed Central

    Lee, Kyung Soo; Kong, Sangwon; Kim, Junho; Kim, Taikon; Choi, Chan Beom; Kim, Yee-Suk

    2015-01-01

    Hip and pelvic pain during pregnancy or after delivery is a common problem in young females, and in most cases this problem has a self-limiting course. The patient described in this case suffered from severe hip pain after childbirth. MR imaging study was performed and it showed arthritis of bilateral hip joints and osteomyelitis of femoral heads with an abscess in the surrounding muscle. Infection, such as septic arthritis or osteomyelitis, is an extremely rare cause of peripartum joint pain. The patient's clinical symptoms and laboratory findings improved with antibiotic therapy. However, limitation of motion of the bilateral hip joints persisted although the patient continued rehabilitative therapy for 15 months, and the patient had to undergo bilateral total hip replacement. Hereby, we present a case of severe osteomyelitis and pyogenic arthritis of bilateral femoral heads and hip joints after delivery, which eventually required bilateral total hip replacement. PMID:26161359

  3. [Treatment of early stage avascular necrosis of the femoral head].

    PubMed

    Zhu, He-Yu; Zhu, Bing

    2012-07-01

    Avascular necrosis is a progressively devastating disease and primarily affects weight-bearing joints. The hip is the most commonly affected joint. In early stage, nonoperative (including pharmacologic intervention and biophysical treatments) and operative modalities for protecting hip joint have become the main therapeutic methods. However there is still no satisfied mothod with reasonable effect. According to the treatment of the avascular necrosis of the femoral head of the pre-collapse stage, core decompression with modification of technique is still one of the safest and most commonly employed procedures. Recently there have been attempts to enhance the effect of core decompression with use of various growth and differentiation factors. Which is the hot spot of current research. Early diagnosis is the key to the treatment of the avascular necrosis of the femoral head. Comprehensive treatment which is based on the core decompression is still the main treatment of today. PMID:23116002

  4. Computer assisted measurement of femoral cortex thickening on radiographs

    NASA Astrophysics Data System (ADS)

    Yao, Jianhua; Liu, Yixun; Chen, Foster; Summers, Ronald M.; Bhattacharyya, Timothy

    2013-03-01

    Radiographic features such as femoral cortex thickening have been frequently observed with atypical subtrochanteric fractures. These features may be a valuable finding to help prevent fractures before they happen. The current practice of manual measurement is often subjective and inconsistent. We developed a semi-automatic tool to consistently measure and monitor the progress of femoral cortex thickening on radiographs. By placing two seed points on each side of the femur, the program automatically extracts the periosteal and endosteal layers of the cortical shell by active contour models and B-spline fitting. Several measurements are taken along the femur shaft, including shaft diameter, cortical thickness, and integral area for medial and lateral cortex. The experiment was conducted on 52 patient datasets. The semi-automatic measurements were validated against manual measurements on 52 patients and demonstrated great improvement in consistency and accuracy (p<0.001).

  5. Hydrocele of Femoral Hernial Sac-an Extremely Rare Case.

    PubMed

    Madhivanan, S; Jain, Ravindra Kumar

    2016-06-01

    A previously healthy 40-year-old woman presented with a right groin swelling for the last 2 years. Diagnosed preoperatively as uncomplicated, irreducible epiplocele of right femoral hernia, later per-operatively was diagnosed as hydrocele of femoral hernial sac also known as "femorocele"; ultrasound abdomen and groin demonstrated as a cystic mass right groin with no precise origin. All other basic line investigations within normal limits, except anemia 7 gm %, corrected to 10 gm %, by preoperative transfusions of 2 units of complete fresh blood. After low approach incision, excision of hydrocele sac, and feormal hernia repair were done with approximation of iliopectineal ligament to inguinal ligament, patient was discharged on 5th postoperative day with satisfactory wound healing and uneventful hospitalization. PMID:27358521

  6. Development of phantom limb pain after femoral nerve block.

    PubMed

    Siddiqui, Sadiah; Sifonios, Anthony N; Le, Vanny; Martinez, Marc E; Eloy, Jean D; Kaufman, Andrew G

    2014-01-01

    Historically, phantom limb pain (PLP) develops in 50-80% of amputees and may arise within days following an amputation for reasons presently not well understood. Our case involves a 29-year-old male with previous surgical amputation who develops PLP after the performance of a femoral nerve block. Although there have been documented cases of reactivation of PLP in amputees after neuraxial technique, there have been no reported events associated with femoral nerve blockade. We base our discussion on the theory that symptoms of phantom limb pain are of neuropathic origin and attempt to elaborate the link between regional anesthesia and PLP. Further investigation and understanding of PLP itself will hopefully uncover a relationship between peripheral nerve blocks targeting an affected limb and the subsequent development of this phenomenon, allowing physicians to take appropriate steps in prevention and treatment. PMID:24872817

  7. Femoral neck erosions: sign of hip joint synovial disease

    SciTech Connect

    Goldberg, R.P.; Weissman, B.N.; Naimark, A.

    1983-07-01

    Pathologic synovial processes in the hip joint can cause characteristic extrinsic erosions of the femoral neck, which in extreme cases produce an ''apple core'' appearance. Nine such cases of synovial diseases, including synovial osteochondromatosis, pigmented villonodular synovitis, rheumatoid arthritis, and amyloidosis, that demonstrate this radiographic finding are presented. The anatomic relations of the hip joint that result in theis appearance, differential diagnosis, and radiographic techniques useful in diagnosis are discussed.

  8. Femoral neck non-union treatment by valgus intertrochanteric osteotomy

    PubMed Central

    Schwartsmann, Carlos Roberto; Spinelli, Leandro de Freitas; Yépez, Anthony Kerbes; Boschin, Leonardo Carbonera; Silva, Marcelo Faria

    2015-01-01

    ABSTRACT OBJECTIVE : The purpose of this study was to evaluate the performance of valgus intertrochanteric osteotomy in femoral neck non-union. METHODS : Forty-two patients with femoral neck fractures with non-union treated using Pauwels' intertrochanteric osteotomy were reviewed. Demographics, time elapsed between fracture and surgery, follow--up, osteosynthesis used, Garden's classification, limb shortening, and x-rays were evaluated. RESULTS : Twenty-two men and 20 women were reviewed. The youngest patient was 18 years old and the oldest 65 years old, with a mean age of 42.4 years (±11.2). The minimum follow-up was 2 years, with a mean of 10.2 years. The average time elapsed between initial fracture and osteotomy was 6.5 months. Twel-ve cases were neglected femoral neck fractures. Nineteen patients were classified as Garden III, and 23 patients as Garden IV. After valgus osteotomy, non-union healing was observed in 38 patients (38/42; 90.4%). Healing of thirty-seven cases of pseudoarthrosis were obtained after the first-attempt osteotomy, and one case required two operations for healing. The osteotomy failed in four cases. Conside-ring the healed osteotomies, good to excellent functional results were achieved in 80.9% (34/42) of the patients. Total hip replacement was subsequently performed in 14.2% (6/42) of the patients for unfavoura-ble outcomes (two for cutting out, two for osteonecrosis, and two for osteoarthritis). CONCLUSIONS : Valgus intertrochanteric osteotomy has a high success rate in archiving healing in femoral neck non-union with good functional results. It is a biological and effective method. Level of Evidence IV, Therapeutic Study. PMID:27057146

  9. Slipped capital femoral epiphysis caused by neurogenic heterotopic ossification.

    PubMed

    Chang, Sam Yeol; Yoo, Won Joon; Park, Moon Seok; Chung, Chin Youb; Choi, In Ho; Cho, Tae-Joon

    2013-11-01

    Slipped capital femoral epiphysis (SCFE) is rare in nonambulatory patients, as mechanical factors play important roles in the development of the disease. We report a case of SCFE, which occurred in a 12-year-old girl with a nonambulatory status after cerebral infarction. SCFE occurred after she received passive range of motion exercise and extracorporeal shock wave treatment for neurogenic heterotopic ossification around the hip joint. The patient was successfully managed by a stepwise approach, with radiological and clinical improvements. PMID:23969564

  10. Robotic assisted reduction of femoral shaft fractures using Stewart platform.

    PubMed

    Majidifakhr, Kamran; Kazemirad, Siavash; Farahmand, Farzam

    2009-01-01

    A robotic system with 6 DOF mobility was proposed for reduction of femoral shaft fractures based on Stewart platform. A plan for implementing the platform on bone fragments was introduced and a step by step strategy for performing the reduction procedure, based on the system's inverse kinematic solution, was proposed. The efficacy of the system was evaluated in some case studies and it was shown that it can be locked to act as an external fixator. PMID:19377143

  11. Pathogenesis, Management and Prevention of Atypical Femoral Fractures

    PubMed Central

    Jeong, Seung-Hyo

    2015-01-01

    Much attention has been paid to the relationship between atypical femoral fractures (AFF) and use of bisphosphonates (BPs). While a significant cause-effect relationship was not established in earlier studies, more recent data shows a growing relationship between AFF and BPs use. The definition of an 'AFF' has also undergone significant changes. This review briefly summarizes the definition, pathogenesis, and management of AFF. PMID:25774358

  12. Femoral prosthesis subsidence in asymptomatic patients. A stereophotogrammetric assessment.

    PubMed

    Chafetz, N; Baumrind, S; Murray, W R; Genant, H K

    1984-01-01

    A radiographic stereophotogrammetric technique (SPG) was used to evaluate quantitatively the presence of early femoral prosthesis subsidence after total hip arthroplasty (THA). This paper focuses on the measurement of subsidence in 12 patients who remained asymptomatic during the first two years after surgery. Only one of these had SPG estimated subsidence in excess of one millimeter at any timepoint. These findings are consistent with the conclusion that early postoperative subsidence is not a common finding among asymptomatic THA patients. PMID:6469528

  13. Endovascular Treatment of Complications of Femoral Arterial Access

    SciTech Connect

    Tsetis, Dimitrios

    2010-06-15

    Endovascular repair of femoral arterial access complications is nowadays the treatment of choice in a group of patients who cannot tolerate vascular reconstruction and bleeding due to advanced cardiovascular disease. Endovascular procedures can be performed under local anesthesia, are well tolerated by the patient, and are associated with a short hospitalization time. Ninitinol stent technology allows for safe stent and stent-graft extension at the common femoral artery (CFA) level, due to increased resistance to external compression and bending stress. Active pelvic bleeding can be insidious, and prompt placement of a stent-graft at the site of leakage is a lifesaving procedure. Percutaneous thrombin injection under US guidance is the treatment of choice for femoral pseudoaneurysms (PAs); this can theoretically be safer with simultaneous balloon occlusion across the entry site of a PA without a neck or with a short and wide neck. In a few cases with thrombin failure due to a large arterial defect or accompanying arteriovenous fistula (AVF), a stent-graft can be deployed. The vast majority of catheter-induced AVFs can be treated effectively with stent-graft implantation even if they are located very close to the femoral bifurcation. Obstructive dissection flaps localized in the CFA are usually treated with prolonged balloon inflation; however, in more extensive dissections involving iliac arteries, self-expanding stents should be deployed. Iliofemoral thrombosis can be treated effectively with catheter-directed thrombolysis (CDT) followed by prolonged balloon inflation or stent placement. Balloon angioplasty and CDT can occasionally be used to treat stenoses and occlusions complicating the use of percutaneous closure devices.

  14. Cortical bone distribution in the femoral neck of strepsirhine primates.

    PubMed

    Demes, B; Jungers, W L; Walker, C

    2000-10-01

    The thickness of the inferior and superior cortices of the femoral neck was measured on X-rays of 181 strepsirhine primate femora representing 24 species. Neck length, neck depth and neck-shaft angle were also measured. The strength of the femoral neck in frontal bending was estimated by modeling the neck as a hollow cylinder, with neck depth as the outer diameter and cortical thickness representing the superior and inferior shell dimensions. Results indicate that the inferior cortex is always thicker than the superior cortex. The ratio of superior to inferior cortical thickness is highly variable but distinguishes two of the three locomotor groups in the sample. Vertical clingers and leapers have higher ratios (i.e., a more even distribution of cortical bone) than quadrupeds. The slow climbers tend to have the lowest ratios, although they do not differ significantly from the leapers and quadrupeds. These results do not confirm prior theoretical expectations and reported data for anthropoid primates that link greater asymmetry of the cortical shell to more stereotypical hip excursions. The ratio of superior to inferior cortical thickness is unrelated to body mass, femoral neck length, and neck-shaft angle, calling into question whether the short neck of strepsirhine primates acts as a cantilever beam in bending. On the other hand, the estimated section moduli are highly correlated with body mass and neck length, a correlation that is driven primarily by body mass. In conclusion, we believe that an alternative interpretation to the cantilever beam model is needed to explain the asymmetry in bone distribution in the femoral neck, at least in strepsirhine primates (e.g., a thicker inferior cortex is required to reinforce the strongly curved inferior surface). As in prior studies of cross-sectional geometry of long bones, we found slightly positive allometry of cortical dimensions with body mass. PMID:11006046

  15. The antidepressant bupropion exerts alleviating properties in an ovariectomized osteoporotic rat model

    PubMed Central

    Abuohashish, Hatem M; Ahmed, Mohammed M; Al-Rejaie, Salim S; Eltahir, Kamal EH

    2015-01-01

    Aim: Depression is a risk factor for impaired bone mass and micro-architecture, but several antidepressants were found to increase the incidence of osteoporotic fractures. In the present study we used ovariectomized (OVX) rats as a model of osteoporosis to investigate the effects of the antidepressant bupropion on the femoral bones. Methods: OVX animals were treated with bupropion (30, 60 mg·kg−1·d−1) for six weeks. Bone turnover biomarkers (urinary DPD/Cr ratio, serum BALP, OC, TRAcP 5b, CTX and sRANKL levels) and inflammatory cytokines (TNF-α, IL-1β and IL-6) were determined using ELISA. Inductively coupled plasma mass spectroscopy (ICP-MS) was used to determine the femoral bone mineral concentrations. The cortical and trabecular morphometric parameters of femoral bones were determined using micro-CT scan and histopathology. Results: In OVX rats, the levels of bone turnover biomarkers and inflammatory cytokines were significantly elevated and femoral bone Ca2+ and PO43− concentrations were significantly reduced. Moreover, cortical and trabecular morphometric parameters and histopathology of femoral bones were severely altered by ovariectomy. Bupropion dose-dependently inhibited the increases in bone turnover biomarkers and inflammatory cytokines. OVX rats treated with the high dose of bupropion showed normal mineral concentrations in femoral bones. The altered morphometric parameters and histopathology of femoral bones were markedly attenuated by the treatment. Conclusion: Bupropion exerts osteo-protective action in OVX rats through suppressing osteoclastogenesis-inducing factors and inflammation, which stabilize the osteoclasts and decrease bone matrix degradation or resorption. PMID:25544359

  16. An Advanced Quantitative Echosound Methodology for Femoral Neck Densitometry.

    PubMed

    Casciaro, Sergio; Peccarisi, Marco; Pisani, Paola; Franchini, Roberto; Greco, Antonio; De Marco, Tommaso; Grimaldi, Antonella; Quarta, Laura; Quarta, Eugenio; Muratore, Maruizio; Conversano, Francesco

    2016-06-01

    The aim of this paper was to investigate the clinical feasibility and the accuracy in femoral neck densitometry of the Osteoporosis Score (O.S.), an ultrasound (US) parameter for osteoporosis diagnosis that has been recently introduced for lumbar spine applications. A total of 377 female patients (aged 61-70 y) underwent both a femoral dual X-ray absorptiometry (DXA) and an echographic scan of the proximal femur. Recruited patients were sub-divided into a reference database used for ultrasound spectral model construction and a study population for repeatability assessments and accuracy evaluations. Echographic images and radiofrequency signals were analyzed through a fully automatic algorithm that performed a series of combined spectral and statistical analyses, providing as a final output the O.S. value of the femoral neck. Assuming DXA as a gold standard reference, the accuracy of O.S.-based diagnoses resulted 94.7%, with k = 0.898 (p < 0.0001). Significant correlations were also found between O.S.-estimated bone mineral density and corresponding DXA values, with r(2) up to 0.79 and root mean square error = 5.9-7.4%. The reported accuracy levels, combined with the proven ease of use and very good measurement repeatability, provide the adopted method with a potential for clinical routine application in osteoporosis diagnosis. PMID:27033331

  17. Hip replacement in femoral head osteonecrosis: current concepts

    PubMed Central

    Scaglione, Michelangelo; Fabbri, Luca; Celli, Fabio; Casella, Francesco; Guido, Giulio

    2015-01-01

    Summary Osteonecrosis of the femoral head is a destructive disease that usually affects young adults with high functional demands and can have devastating effects on hip joint. The treatment depends on extent and location of the necrosis lesion and on patient’s factors, that suggest disease progression, collapse probability and also implants survival. Non-idiopathic osteonecrosis patients had the worst outcome. There is not a gold standard treatment and frequently it is necessary a multidisciplinary approach. Preservation procedures of the femoral head are the first choice and can be attempted in younger patients without head collapse. Replacement procedure remains the main treatment after failure of preserving procedures and in the late-stage ONFH, involving collapse of the femoral head and degenerative changes to the acetabulum. Resurfacing procedure still has good results but the patient selection is a critical factor. Total hip arthroplasties had historically poor results in patients with osteonecrosis. More recently, reports have shown excellent results, but implant longevity and following revisions are still outstanding problems. PMID:27134633

  18. Natural frequency analysis of osseointegration for trans-femoral implant.

    PubMed

    Shao, F; Xu, W; Crocombe, A; Ewins, D

    2007-05-01

    Osseointegration trans-femoral implants are a new orthopaedic anchoring method to attach prosthetic limbs. The clinical success of this promising technique depends on the effectiveness of osseointegration achieved after implantation. The aim of this study is to use the resonant characteristics of the implant system to determine the changes in stability as a reflection of boundary condition of the implant. With a small mechanical excitation, Vibration responses of the trans-femoral implant to a small mechanical excitation were measured using an accelerometer and the vibration signal was analyzed using Fast Fourier Transform (FFT) software to obtain the fundamental natural frequency (NF) of the implant system. In-vitro study was conducted using different silicone rubbers to simulate the interface condition. The result showed that a high NF corresponded to a high elastic modulus of the interface material between the implant and bone. A preliminary in-vivo study with one osseointegration trans-femoral implant patient showed that there was a decrease of NF after initial weight bearing rehabilitation. After continued weight bearing, the NF gradually returned to the pre-loading level at around day 24 and the general trend of the NF reached a stable state 38 days after the first weight bearing exercise. PMID:17377843

  19. The suitability of the femoral vein for permanent vascular access.

    PubMed

    Pecorari, M

    2004-01-01

    In our dialysis unit, we commonly position permanent catheters (the Tesio twin catheter) in femoral veins with 'high' exit sites, in the abdominal area. We prefer this method because of its intrinsic safety in patients immediately requiring hemodialysis (HD), because there is no need for ultrasound guidance and a low incidence of complications during and after positioning. In addition, we consider that this method is suitable for older patients without good native vessels for an arteriovenous fistula (AVF). Sixty-nine femoral catheters were positioned in 61 patients (mean age 70.8 yrs): 307 observational months/patients (mean duration 4.45 months) demonstrated the following results: a) no incidents during catheter positioning; b) four iliac-femoral thromboses (in three cases complete recanalization with heparin treatment); c) two catheters were removed due to an infection of the tunnel; d) no generalized, life-threatening sepsis. Therefore, we recommend this solution as a 'bridge-access' between the immediate need for HD and the successive best strategy for the treatment of end-stage renal disease (ESRD). PMID:16596552

  20. Variations in treatment of femoral neck fractures in Alberta

    PubMed Central

    Cree, Marilyn; Yang, Qian; Scharfenberger, Angela; Johnson, David; Carrière, K.C.

    2002-01-01

    Objectives To examine, in the province of Alberta, temporal trends, regional variations in treatment options and in-hospital death rates after a femoral neck fracture. Design A retrospective cohort study. Patients Six years’ data were abstracted from the Alberta Morbidity File, the Alberta Health Stakeholder File and the Alberta Health Care Claims File. Patients were included if they were Alberta residents, aged 65 years or older, had sustained a femoral neck fracture and had undergone internal fixation, hemiarthroplasty or total hip arthroplasty. Main outcome measures Death rates, arthroplasty rates and hospital stay. Results In-hospital death rates were similar across hospitals, with risks being higher for men, patients aged 80 years or older and those with more comorbid conditions. Arthroplasty rates varied from 58% to 77% among hospitals, and hospital stays associated with arthroplasty were significantly longer than those associated with internal fixation. The chance of undergoing arthroplasty varied from hospital to hospital by gender and by the number of comorbid conditions. Conclusion Regional variations suggest lack of agreement among Alberta’s surgeons as to how best to treat femoral neck fractures. PMID:12174977

  1. Necrosis of the femoral head after kidney transplantation.

    PubMed

    Lausten, G S; Lemser, T; Jensen, P K; Egfjord, M

    1998-12-01

    We reviewed the medical records of 750 patients (445 men, 305 women), who had received a kidney transplant during the period 1968-1995, for any sign of necrosis of the femoral head. For post-operative immunosuppression, 374 patients had received high-dose corticosteroids (average 12.5 g during the first year post-operatively), while 376 patients had received low-dose corticosteroids (average 6.5 g during the first year post-operatively) and cyclosporin A. Survival curves according to Kaplan and Meier (J Am Stat Ass 1958: 53: 457-481) were constructed. In the high-dose steroid group, 42/374 patients (11.2%) developed femoral head necrosis, at an average of 26.2 months post-transplantation. In the low-dose steroid group, only 19/376 (5.1%) patients developed this complication, at an average of 20.5 months post-transplantation. This difference in numbers of femoral head necroses was highly significant (p < 0.005). We conclude that steroid doses should be minimized whenever feasible in post-transplant immunosuppression therapy. PMID:9850453

  2. Patient doses in abdominal aortogram and aorta femoral runoff examinations.

    PubMed

    Chu, R Y; Parry, C; Thompson, W; Loeffler, C

    1998-11-01

    Radiation doses to adult male patients from abdominal aortogram and aorta femoral runoff examinations in a medical center were determined with the help of a dose-area product meter. The abdominal aortogram and aorta femoral runoff examination consisted of scout radiographs, fluoroscopy (to position a catheter near the area of interest), and serial films (to record the flow of contrast media). Measurements were converted to effective doses with the help of published results from Monte Carlo simulation calculations. Data from 19 male adult patients weighing 53 to 86 kg were analyzed. The resulting total effective dose had a value of 14.0 +/- 4A mSv (mean and standard deviation). The percent contribution by fluoroscopy was 18.5 +/- 9.9%. The fluoroscopy effective dose had a stronger correlation with the dose-area product (correlation coefficient of 0.97) than with duration of exposure (correlation coefficient of 0.84). Most of the radiation exposure in the observed abdominal aortogram and aorta femoral runoff examination was attributed to radiography. PMID:9790557

  3. Large diameter femoral heads: is bigger always better?

    PubMed

    Cooper, H J; Della Valle, C J

    2014-11-01

    Dislocation remains among the most common complications of, and reasons for, revision of both primary and revision total hip replacements (THR). Hence, there is great interest in maximising stability to prevent this complication. Head size has been recognised to have a strong influence on the risk of dislocation post-operatively. As femoral head size increases, stability is augmented, secondary to an increase in impingement-free range of movement. Larger head sizes also greatly increase the 'jump distance' required for the head to dislocate in an appropriately positioned cup. Level-one studies support the use of larger diameter heads as they decrease the risk of dislocation following primary and revision THR. Highly cross-linked polyethylene has allowed us to increase femoral head size, without a marked increase in wear. However, the thin polyethylene liners necessary to accommodate larger heads may increase the risk of liner fracture and larger heads have also been implicated in causing soft-tissue impingement resulting in groin pain. Larger diameter heads also impart larger forces on the femoral trunnion, which may contribute to corrosion, metal release, and adverse local tissue reactions. Alternative large bearings including large ceramic heads and dual mobility bearings may mitigate some of these risks, and several of these devices have been used with clinical success. PMID:25381403

  4. Femoral head viability following hip fracture. Prognostic role of radionuclide bone imaging

    SciTech Connect

    Drane, W.E.; Rudd, T.G.

    1985-03-01

    A retrospective study was made of all radionuclide (RN) bone images performed at our institution over a two-year period to evaluate femoral head viability after nonpathologic fracture of the femoral neck. Twelve patients had avascular femoral heads during the perioperative period, of which nine had adequate follow-up. Seven of these nine patients had follow-up bone images. Revascularization occurred in four patients, while three had persistent absence of femoral head uptake. With clinical follow-up ranging from four to 29 months (median: 14 months), only two of these nine patients developed clinical or radiographic evidence of osteonecrosis. RN bone imaging performed in the perioperative period does not reliably predict the development of post-traumatic osteonecrosis of the femoral head and, at present, should not be used to determine prospectively method of treatment of femoral neck fracture.

  5. Comparison of vertebral and femoral bone mineral density in adult females

    PubMed Central

    Choe, Han Seong; Lee, Jae Hong; Min, Dong Ki; Shin, So Hong

    2016-01-01

    [Purpose] This study assessed vertebral and femoral bone mineral density in adult females. [Subjects and Methods] A total of 314 females in their 40s to 70s were divided into normal, osteopenia, and osteoporosis groups and their vertebral and femoral bone mineral densities were compared. [Results] Comparisons of T scores revealed significant differences among measurements of the third lumbar vertebra, femoral neck, Ward’s triangle, and femoral trochanter. Pearson correlation coefficients were used to assess differences between the vertebral and femoral measurements, and significant differences and positive correlations were observed among third lumbar vertebra, femoral neck, Ward’s triangle, and femur trochanter in the normal group. [Conclusion] Females in the normal, osteopenia, and osteoporosis groups showed significant differences in their third lumbar vertebrae. The lack of significant differences among measurements in the osteoporosis group in this study suggests that patients with osteoporosis require careful and accurate diagnosis. PMID:27390449

  6. Perthes’ disease and femoroacetabular impingement in a child with proximal femoral focal deficiency

    PubMed Central

    Pun, Terence; Stokes, Oliver M; Chow, Wang; To, Michael

    2012-01-01

    A girl with known proximal femoral focal deficiency presented with Perthes’ disease at 5 years of age. Her treatment involved a Salter osteotomy. This in conjunction with articular incongruence, due to deformity of the femoral head, resulted in mixed type femoroacetabular impingement when she was 10 years old. Surgical hip dislocation and femoral neck osteochondroplasty successfully relieved her symptoms of impingement. This is the first reported case of Perthes’ disease in a patient with proximal femoral focal deficiency. The case highlights the importance of thoroughly investigating pain in patients with proximal femoral focal deficiency, a condition which is normally painless. Timely diagnosis of Perthes’ disease and containment procedures can prevent collapse of the femoral head and the resultant sequelae. Acetabular over-coverage should be avoided in pelvic osteotomy to prevent the development of femoroacetabular impingement. PMID:23148394

  7. Comparison of vertebral and femoral bone mineral density in adult females.

    PubMed

    Choe, Han Seong; Lee, Jae Hong; Min, Dong Ki; Shin, So Hong

    2016-06-01

    [Purpose] This study assessed vertebral and femoral bone mineral density in adult females. [Subjects and Methods] A total of 314 females in their 40s to 70s were divided into normal, osteopenia, and osteoporosis groups and their vertebral and femoral bone mineral densities were compared. [Results] Comparisons of T scores revealed significant differences among measurements of the third lumbar vertebra, femoral neck, Ward's triangle, and femoral trochanter. Pearson correlation coefficients were used to assess differences between the vertebral and femoral measurements, and significant differences and positive correlations were observed among third lumbar vertebra, femoral neck, Ward's triangle, and femur trochanter in the normal group. [Conclusion] Females in the normal, osteopenia, and osteoporosis groups showed significant differences in their third lumbar vertebrae. The lack of significant differences among measurements in the osteoporosis group in this study suggests that patients with osteoporosis require careful and accurate diagnosis. PMID:27390449

  8. Retigabine, a K(V)7 (KCNQ) potassium channel opener, attenuates L-DOPA-induced dyskinesias in 6-OHDA-lesioned rats.

    PubMed

    Sander, S E; Lemm, C; Lange, N; Hamann, M; Richter, A

    2012-02-01

    L-DOPA-induced dyskinesias (LID) represent a severe complication of long-time pharmacotherapy in Parkinson's disease that necessitates novel therapeutics. The acute and chronic effects of K(V)7.2-7.5 channel openers (retigabine, flupirtine) on the severity of LID and parkinsonian signs were examined in comparison to the glutamate receptor antagonist amantadine (positive control) in a rat model of LID. Acute treatment with retigabine (2.5, 5 mg/kg i.p.) and flupirtine (5, 10 mg/kg i.p.) significantly reduced the severity of abnormal involuntary movements (AIM) to a comparable extent as amantadine (20, 40 mg/kg s.c.), but flupirtine delayed the disappearance of AIM. Chronic treatment with retigabine (daily 5 mg/kg i.p. over 19 days combined with l-DOPA 10 mg i.p.) did not prevent or delay the development of LID, but reduced the severity of AIM, while antidyskinetic effects of amantadine (40 mg/kg i.p.) were restricted to the first day of treatment. Retigabine caused sedation and ataxia which declined during the chronic treatment, but did not reduce the antiparkinsonian effects of l-DOPA in these experiments. Acute co-injections of retigabine (5 mg) together with l-DOPA (10 mg/kg) neither reduced the motor performance in the rotarod test nor exerted negative effects on the antiparkinsonian efficacy of l-DOPA in the block and stepping test. Nevertheless, the sedative effects of retigabine may limit its therapeutic potential for the treatment of LID. The present data indicate that K(V)7 channels deserve attention in the research of the pathophysiology of dyskinesias. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'. PMID:22079161

  9. Atypical femoral fractures bilaterally in a patient receiving bisphosphonate: a case report

    PubMed Central

    Moghnie, Alessandro; Scamacca, Veronica; De Fabrizio, Giovanni; Valentini, Roberto

    2016-01-01

    Summary Atypical femoral fractures are often associated with prolonged bisphosphonate use. The American Society for Bone and Mineral Research (ASBMR) has set the diagnosis criteria for atypical subtrochanteric and diaphyseal femoral fractures by classifying them according to their major and minor criteria. Prolonged bisphosphonate use is correlated with AFF, but the pathogenetic mechanism that causes this kind of fracture has not been defined yet. We describe simultaneous bilaterally femoral fractures in a 76-year-old woman. PMID:27252749

  10. A low-energy femoral shaft fracture from performing a yoga posture.

    PubMed

    Moriarity, Andrew; Ellanti, Prasad; Hogan, Niall

    2015-01-01

    The femoral shaft is rarely the site of a low-energy fracture in a healthy individual. The vast majority of these fractures are due to major trauma such as motor vehicle accidents. Although low-energy femoral shaft fractures do occur, they are typically in patients with osteoporotic bone, or prosthesis related. In this case report, we present a man in his late 30s who was practising a specific yoga stance when he experienced a femoral shaft fracture. PMID:26452743

  11. Monitoring the healing process of rat bones using Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Gamulin, O.; Serec, K.; Bilić, V.; Balarin, M.; Kosović, M.; Drmić, D.; Brčić, L.; Seiwerth, S.; Sikirić, P.

    2013-07-01

    The healing effect of BPC 157 on rat femoral head osteonecrosis was monitored by Raman spectroscopy. Three groups of rats were defined: an injured group treated with BPC 157 (10 μg/kg/daily ip), an injured control group (treated with saline, 5 ml/kg/daily ip), and an uninjured healthy group. The spectra were recorded and the healing effect assessed on samples harvested from animals which were sacrificed 3 and 6 weeks after being injured. The statistical analysis of the recorded spectra showed statistical differences between the BPC 157-treated, control, and healthy groups of animals. In particular, after 6 weeks the spectral resemblance between the healthy and BPC 157 samples indicated a positive BPC 157 influence on the healing process of rat femoral head.

  12. Use of an anatomic long-stemmed component in femoral impaction grafting.

    PubMed

    Westerman, Richard W; Timperley, Andrew J

    2016-01-01

    We describe a challenging femoral revision for aseptic loosening in a relatively young and active man. The femur had gross osteolysis, an absent calcar and a cortical diaphyseal defect at the level of the isthmus (Paprosky 3b defect). The cortical defects were repaired and the whole femur then restored with Femoral Impaction Grafting (FIG) using custom-made impaction instruments and an anatomic shaped collarless, polished, tapered femoral component.In the active adult, bone restoring revision techniques such as impaction grafting should be considered to give a realistic prospect of host bone augmentation rather than simply aiming for a distally fixed stem in a patulous femoral canal. PMID:26692247

  13. Periprosthetic Atypical Femoral Fracture-like Fracture after Hip Arthroplasty: A Report of Three Cases.

    PubMed

    Lee, Kyung-Jae; Min, Byung-Woo; Jang, Hyung-Kyu; Ye, Hee-Uk; Lim, Kyung-Hwan

    2015-09-01

    Atypical femoral fractures are stress or insufficient fractures induced by low energy trauma or no trauma and have specific X-ray findings. Although the American Society for Bone and Mineral Research has excluded periprosthetic fractures from the definition of an atypical femoral fracture in 2013, this is still a matter of controversy because some authors report periprosthetic fractures showing specific features of atypical fractures around a well-fixed femoral stem. We report 3 cases of periprosthetic femur fractures that had specific radiographic features of atypical femoral fractures in patients with a history of prolonged bisphosphonate use; we also review relevant literature. PMID:27536624

  14. Investigation of creep mechanical characteristics of femoral prostheses by simulated hip replacement

    PubMed Central

    LIU, GUANG-YAO; JIN, YAN; LI, PENG

    2013-01-01

    In order to provide creep mechanical parameters for the clinical application of both traditional and reserved anatomy femoral artificial joint replacements, simulated hip replacement femoral stress relaxation and creep experiments were performed. Twenty-four corpse femoral specimens were obtained, with 8 specimens being randomly assigned to the control group and 8 specimens being randomly assigned to the traditional prosthesis group. Our results showed that the retaining femoral neck prosthesis and traditional prosthesis groups have different stress relaxation and creep mechanical properties. PMID:23596489

  15. Subtrochanteric femur fracture after removal of screws for femoral neck fracture in a child.

    PubMed

    Song, Kwang Soon; Lee, Si Wook

    2015-01-01

    Displaced femoral neck fractures are rare in children and are associated with a high rate of complications. Subtrochanteric fractures after cannulated screw fixation of femoral neck fractures in adults are well recognized, and there are several reports on the topic. However, there are no reports on complications related to hardware or subtrochanteric fractures after removal of the screws in the treatment of femoral neck fractures in children. Here we report the case of a 10-year-old boy who sustained a subtrochanteric fracture after the screw removal and healing that followed a femoral neck fracture. PMID:25566556

  16. Periprosthetic Atypical Femoral Fracture-like Fracture after Hip Arthroplasty: A Report of Three Cases

    PubMed Central

    Lee, Kyung-Jae; Jang, Hyung-Kyu; Ye, Hee-Uk; Lim, Kyung-Hwan

    2015-01-01

    Atypical femoral fractures are stress or insufficient fractures induced by low energy trauma or no trauma and have specific X-ray findings. Although the American Society for Bone and Mineral Research has excluded periprosthetic fractures from the definition of an atypical femoral fracture in 2013, this is still a matter of controversy because some authors report periprosthetic fractures showing specific features of atypical fractures around a well-fixed femoral stem. We report 3 cases of periprosthetic femur fractures that had specific radiographic features of atypical femoral fractures in patients with a history of prolonged bisphosphonate use; we also review relevant literature.

  17. Outcome of Kidney Allografts in Recipients With a Femoral Arteriovenous Fistula: Report of Two Cases.

    PubMed

    Özdemir-van Brunschot, Denise M D; de Sévaux, Ruud G L; van Hamersvelt, Henk W; Warlé, Michiel C

    2016-09-01

    Two patients, who were on hemodialysis over a femoral arteriovenous fistula, were transplanted in our center. Despite adequate blood pressure, perfusion of the renal allograft remained poor after completion of the vascular anastomoses. Ligation of the femoral arteriovenous fistula (1.6 L/min) led to adequate perfusion. Initial graft function was good. Although it remains unclear whether ischemia of a renal allograft is caused by venous hypertension or vascular steal due to a femoral arteriovenous fistula, it might be necessary to ligate a femoral arteriovenous fistula to obtain adequate graft perfusion. PMID:27313989

  18. Development of Femoral Head Interior Supporting Device and 3D Finite Element Analysis of its Application in the Treatment of Femoral Head Avascular Necrosis

    PubMed Central

    Xiao, Dongmin; Ye, Ming; Li, Xinfa; Yang, Lifeng

    2015-01-01

    Background The aim of this study was to develop and perform the 3D finite element analysis of a femoral head interior supporting device (FHISD). Material/Methods The 3D finite element model was developed to analyze the surface load of femoral head and analyze the stress and strain of the femoral neck, using the normal femoral neck, decompressed bone graft, and FHISD-implanted bone graft models. Results The stress in the normal model concentrated around the femoral calcar, with displacement of 0.3556±0.1294 mm. In the decompressed bone graft model, the stress concentrated on the femur calcar and top and lateral sides of femoral head, with the displacement larger than the normal (0.4163±0.1310 mm). In the FHISD-implanted bone graft model, the stress concentrated on the segment below the lesser trochanter superior to the femur, with smaller displacement than the normal (0.1856±0.0118 mm). Conclusions FHISD could effectively maintain the biomechanical properties of the femoral neck. PMID:26010078

  19. Modifications of histamine receptor signaling affect bone mechanical properties in rats.

    PubMed

    Folwarczna, Joanna; Janas, Aleksandra; Pytlik, Maria; Śliwiński, Leszek; Wiercigroch, Marek; Brzęczek, Anna

    2014-02-01

    Histamine receptors are expressed on bone cells and histamine may be involved in regulation of bone metabolism. The aim of the present study was to investigate the effects of loratadine (an H(1) receptor antagonist), ranitidine (an H(2) receptor antagonist) and betahistine (an H(3) receptor antagonist and H(1) receptor agonist) on bone mechanical properties in rats. Loratadine (5 mg/kg/day, po), ranitidine (50 mg/kg/day, po), or betahistine dihydrochloride (5 mg/kg/day, po), were administered for 4 weeks to non-ovariectomized and bilaterally ovariectomized (estrogen-deficient) 3-month-old rats, and their effects were compared with appropriate controls. Serum levels of bone turnover markers, bone mineralization and mechanical properties of the proximal tibial metaphysis, femoral diaphysis and femoral neck were studied. In rats with normal estrogen level, administration of loratadine slightly favorably affected mechanical properties of compact bone, significantly increasing the strength of the femoral neck (p < 0.05), and tending to increase the strength of the femoral diaphysis. Ranitidine did not significantly affect the investigated parameters, and betahistine decreased the strength of the tibial metaphysis (cancellous bone, p < 0.01). There were no significant effects of the drugs on serum bone turnover markers. In estrogen-deficient rats, the drugs did not significantly affect the investigated skeletal parameters. In conclusion, the effects of histamine H(1), H(2) and H(3) receptor antagonists on the skeletal system in rats were differential and dependent on estrogen status. PMID:24905313

  20. Effects of methimepip and JNJ-5207852 in Wistar rats exposed to an open-field with and without object and in Balb/c mice exposed to a radial-arm maze

    PubMed Central

    Abuhamdah, Rushdie M. A.; van Rensburg, Ruan; Lethbridge, Natasha L.; Ennaceur, Abdel; Chazot, Paul L.

    2012-01-01

    The role of the histamine H3 receptor (H3R) in anxiety is controversial, due to limitations in drug selectivity and limited validity of behavioral tests used in previous studies. In the present report, we describe two experiments. In the first one, Wistar rats were treated with an H3R agonist (methimepip), and exposed to an open-field. In the second one, Balb/c mice were treated with H3R agonist (methimepip) or antagonist (JNJ-5207852), and exposed to an open space 3D maze which is a modified version of the radial-arm maze. C57BL/6J saline treated mice were included for comparisons. When exposed to an empty open field, Wistar rats spent more time in the outer area and made very low number of brief crossings in the central area. However, when an object occupied the central area, rats crossed frequently into and spent a long time in the central area. Administration of a range of different doses of methimepip (selective H3R agonist) reduced the entries into the central area with a novel object, indicating enhanced avoidance response. In the 3D maze, both Balb/c and C57BL/6J saline-treated mice crossed frequently onto the bridges that radiate from the central platform but only C57BL/6J mice crossed onto the arms which extend the bridges. This suggests that Balb/c mice are more anxious than C57BL/6J mice. Neither methimepip nor JNJ-5207852 (selective H3R antagonist/inverse agonist) induced entry into the arms of the maze, indicative of lack of anxiolytic effects. PMID:22811660

  1. Automated segmentation of necrotic femoral head from 3D MR data.

    PubMed

    Zoroofi, Reza A; Sato, Yoshinobu; Nishii, Takashi; Sugano, Nobuhiko; Yoshikawa, Hideki; Tamura, Shinichi

    2004-07-01

    Segmentation of diseased organs is an important topic in computer assisted medical image analysis. In particular, automatic segmentation of necrotic femoral head is of importance for various corresponding clinical tasks including visualization, quantitative assessment, early diagnosis and adequate management of patients suffering from avascular necrosis of the femoral head (ANFH). Early diagnosis and treatment of ANFH is crucial since the disease occurs in relatively young individuals with an average age of 20-50, and since treatment options for more advanced disease are frequently unsuccessful. The present paper describes several new techniques and software for automatic segmentation of necrotic femoral head based on clinically obtained multi-slice T1-weighted MR data. In vivo MR data sets of 50 actual patients are used in the study. An automatic method built up to manage the segmentation task according to image intensity of bone tissues, shape of the femoral head, and other characters. The processing scheme consisted of the following five steps. (1) Rough segmentation of non-necrotic lesions of the femur by applying a 3D gray morphological operation and a 3D region growing technique. (2) Fitting a 3D ellipse to the femoral head by a new approach utilizing the constraint of the shape of the femur, and employing a principle component analysis and a simulated annealing technique. (3) Estimating the femoral neck location, and also femoral head axis by integrating anatomical information of the femur and boundary of estimated 3D ellipse. (4) Removal of non-bony tissues around the femoral neck and femoral head ligament by utilizing the estimated femoral neck axis. (5) Classification of necrotic lesions inside the estimated femoral head by a k-means technique. The above method was implemented in a Microsoft Windows software package. The feasibility of this method was tested on the data sets of 50 clinical cases (3000 MR images). PMID:15249072

  2. An integrated CAD/CAM/robotic milling method for custom cementless femoral prostheses.

    PubMed

    Wen-ming, Xi; Ai-min, Wang; Qi, Wu; Chang-hua, Liu; Jian-fei, Zhu; Fang-fang, Xia

    2015-09-01

    Aseptic loosening is the primary cause of cementless femoral prosthesis failure and is related to the primary stability of the cementless femoral prosthesis in the femoral cavity. The primary stability affects both the osseointegration and the long-term stability of cementless femoral prostheses. A custom cementless femoral prosthesis can improve the fit and fill of the prosthesis in the femoral cavity and decrease the micromotion of the proximal prosthesis such that the primary stability of the custom prosthesis can be improved, and osseointegration of the proximal prosthesis is achieved. These results will help to achieve long-term stability in total hip arthroplasty (THA). In this paper, we introduce an integrated CAD/CAM/robotic method of milling custom cementless femoral prostheses. The 3D reconstruction model uses femoral CT images and 3D design software to design a CAD model of the custom prosthesis. After the transformation matrices between two units of the robotic system are calibrated, consistency between the CAM software and the robotic system can be achieved, and errors in the robotic milling can be limited. According to the CAD model of the custom prosthesis, the positions of the robotic tool points are produced by the CAM software of the CNC machine. The normal vector of the three adjacent robotic tool point positions determines the pose of the robotic tool point. In conclusion, the fit rate of custom pig femur stems in the femoral cavities was 90.84%. After custom femoral prostheses were inserted into the femoral cavities, the maximum gaps between the prostheses and the cavities measured less than 1 mm at the diaphysis and 1.3 mm at the metaphysis. PMID:26210779

  3. Proximal Femoral Geometry as Fracture Risk Factor in Female Patients with Osteoporotic Hip Fracture

    PubMed Central

    Han, Jun

    2016-01-01

    Background Proximal femoral geometry may be a risk factor of osteoporotic hip fractures. However, there existed great differences among studies depending on race, sex and age of subjects. The purpose of the present study is to analyze proximal femoral geometry and bone mineral density (BMD) in the osteoporotic hip fracture patients. Furthermore, we investigated proximal femoral geometric parameters affecting fractures, and whether the geometric parameters could be an independent risk factor of fractures regardless of BMD. Methods This study was conducted on 197 women aged 65 years or more who were hospitalized with osteoporotic hip fracture (femur neck fractures ; 84, intertrochanteric fractures; 113). Control group included 551 women who visited to check osteoporosis. Femur BMD and proximal femoral geometry for all subjects were measured using dual energy X-ray absorptiometry (DXA), and compared between the control and fracture groups. Besides, proximal femoral geometric parameters associated with fractures were statistically analyzed. Results There were statistically significant differences in the age and weight, cross-sectional area (CSA)/length/width of the femoral neck and BMD of the proximal femur between fracture group and control group. BMD of the proximal femur in the control group was higher than in the fracture group. For the femoral neck fractures group, the odds ratio (OR) for fractures decrease in the CSA and neck length (NL) of the femur increased by 1.97 times and 1.73 times respectively, regardless of BMD. The OR for fractures increase in the femoral neck width increased by 1.53 times. In the intertrochanteric fracture group, the OR for fractures increase in the femoral neck width increased by 1.45 times regardless of BMD. Conclusions We found that an increase of the femoral neck width could be a proximal femoral geometric parameter which plays important roles as a risk factor for fracture independently of BMD. PMID:27622182

  4. [Local vascular complications after iatrogenic femoral artery puncture].

    PubMed

    Fruhwirth, J; Pascher, O; Hauser, H; Amann, W

    1996-01-01

    Over a period of 5 years 81 vascular complications after 15,460 catheterizations of the femoral artery for diagnostic (n = 11,883) or therapeutic (n = 3577) procedures were registered. The following complications were observed in declining frequency: 1. False aneurysm (n = 65), 2. arterial occlusion (dissection, embolia, thrombosis) (n = 8), 3. vascular lesion causing profuse bleeding (n = 7), 4. AV-fistula (n = 1). The total complication rate was 0.52%. The complication rate was significantly higher in therapeutical procedures (1,03%) than in diagnostic investigations (0.37%). Pseudoaneurysms were complicated by thrombosis of the femoral vein (n = 3), lymphatic fistula (n = 3) and deep wound infection (n = 9); secondary complication rate 18.5%. Risk factors for local vascular complications are old age, female gender, high grade arteriosclerosis at the puncture site, overweight, manifest arterial hypertension and medication with cumarin, acetylsalicylic acid or heparin. Further complicating factors are connected with technical risks such as duration of the procedure. French size of the catheter, the catheter sheath and multiple punctures. Vascular repair was performed by simple angiography in most cases, but in 14.8% more extensive surgical procedures were required. In patients with signs of occlusive vascular disease the external iliac artery was replaced by a PTFE-vascular access graft in 4 cases and an arterioplasty of the deep femoral artery was performed in 2 patients. 36% of the operations were undertaken as emergencies. Reintervention was necessary for a postoperative bleeding complication in 1 case (surgical complication rate 1.2%). A female patient suffering from aortic valve stenosis died during emergency operation due to massive retroperitoneal hemorrhage after cardiac catheterization (mortality rate 1.2%). Over a median follow-up period of 37 months no late complications of the intervention were recorded, nor recurrences of peripheral arterial occlusive

  5. Multiple cannulated screw fixation of young femoral neck fractures

    PubMed Central

    Kim, Joo Yong; Kong, Gyu Min; Park, Dae Hyun; Kim, Dae Yoo

    2015-01-01

    Objective: We wanted to analyze the factors affecting the results of multiple cannulated screws fixation in patients less than 60 years old with femoral neck fracture (FNF). Methods: We reviewed 52 patients (30 males, 22 females) who were treated with multiple cannulated screws fixation for FNFs. They were followed up for more than one year during January 2002 to December 2012. They were classified by Garden’s classification. The anatomic reduction was evaluated by Garden’s alignment index on hip both anteroposterior and lateral images. Postoperative complications were analyzed during follow up periods. Results: By Garden’s classification, 6 cases were in stage I, 13 cases in stage II, 30 cases in stage III and 3 cases in stage IV. During follow up periods, avascular necrosis of the femoral head was observed in 12 cases (23%) and nonunion was observed in 5 cases (9%). The 16 patients who had complications underwent total hip arthroplasty (31%). In non-displaced fracture groups (Garde I, II) did not have AVN nor nonunion. The incidence of complications in displaced fracture group was 51.5%. The complicated cases showed tendency for increased apex anterior angulation of femoral neck on hip lateral images and the result was statistically significant. (p=0.0260). Conclusion: The patients less than 60 years old who were treated with multiple cannulated screws fixation for displaced FNFs showed the incidence of complications was more than 50%. It needs a cautious approach for anatomical reduction, especially related to anterior angulation on hip lateral image. PMID:26870127

  6. Risk of atypical femoral fracture during and after bisphosphonate use

    PubMed Central

    Schilcher, Jörg; Koeppen, Veronika; Aspenberg, Per; Michaëlsson, Karl

    2015-01-01

    Background and purpose Use of bisphosphonates in women is associated with higher risk of atypical femoral fractures. The risk in terms of timing of use and type of bisphosphonate, and in men, remains unclear. Patients and methods We reviewed radiographs of 5,342 Swedish women and men aged 55 years or more who had had a fracture of the femoral shaft in the 3-year period 2008–2010 (97% of those eligible), and found 172 patients with atypical fractures (93% of them women). We obtained data on medication and comorbidity. The risk of atypical fracture associated with bisphosphonate use was estimated in a nationwide cohort analysis. In addition, we performed a case-control analysis with comparison to 952 patients with ordinary shaft fractures. A short report of the findings has recently been presented (Schilcher et al. 2014a). Here we provide full details. Results The age-adjusted relative risk (RR) of atypical fracture associated with bisphosphonate use was 55 (95% CI: 39–79) in women and 54 (CI: 15–192) in men. In bisphosphonate users, women had a 3-fold higher risk than men (RR = 3.1, CI: 1.1–8.4). Alendronate users had higher risk than risedronate users (RR = 1.9, CI: 1.1–3.3). The RR after 4 years or more of use reached 126 (CI: 55–288), with a corresponding absolute risk of 11 (CI: 7–14) fractures per 10,000 person-years of use. The risk decreased by 70% per year since last use. Interpretation Women have a higher risk of atypical femoral fracture than men. The type of bisphosphonate used may affect risk estimates and the risk decreases rapidly after cessation. PMID:25582459

  7. Complications With Long Cemented Stems in Proximal Femoral Replacement.

    PubMed

    Naik, Amish A; Lietman, Steven A

    2016-05-01

    This study attempted to determine whether patients undergoing cemented long-stem proximal femoral replacement had: (1) an increased short-term mortality rate; (2) greater intraoperative hemodynamic instability; (3) a greater need for resuscitation; and (4) a decreased risk of periprosthetic fracture. The current study reviewed intraoperative and short-term events related to clinical outcomes in 24 consecutive patients who were treated at a single institution over a 5-year period. These patients underwent primary long-stem (≥250 mm, n=13) vs short-stem (<250 mm, n=11) cemented proximal femoral replacement. Other than stem length, the 2 groups were not significantly different in terms of patient age, sex, height, weight, body mass index, diagnosis, or preoperative American Society of Anesthesiologists functional score. Primary outcomes were intraoperative death, blood loss, blood transfusions, fluid resuscitation, hypotension, oxygen desaturation, mortality up to 1 year, and need for revision surgery. At 1 year, a significantly increased mortality rate (77% vs 27%, P=.03) was noted in patients receiving long-stem vs short-stem arthroplasty. Patients who received longer stems also required more intraoperative blood transfusions and fluid resuscitation (P=.04) for greater hypotension (P=.04) and oxygen desaturation (P=.04). Two intraoperative deaths occurred in the long-stem group, and none occurred in the short-stem group. The findings suggest that there is an increased risk of intraoperative hemodynamic instability with long-stem vs short-stem proximal femoral replacement, with a need for greater resuscitative efforts and an increased risk of mortality at 1 year. [Orthopedics. 2016; 39(3):e423-e429.]. PMID:27064780

  8. Femoral neck anteversion measurement using linear slot scanning radiography.

    PubMed

    Chimhundu, Chipo; Sivarasu, Sudesh; Steiner, Stefan; Smit, Julian; Douglas, Tania S

    2016-02-01

    Measurements between anatomical landmarks on radiographs are useful for diagnosis and treatment planning in the orthopedic field. Direct measurement on single radiographic images, however, does not truly reflect spatial relationships, as depth information is lost. We used stereo images from a slot scanning X-ray machine to estimate coordinates of three-dimensional (3D) bony landmarks for femoral neck anteversion (FNA) measurement. A set of 7 landmarks consisting of the centre of the femoral head; the centre of the base of the femoral neck; the medial and lateral condyles; the medial and lateral posterior condyles; and finally the centre of the knee; were found to be identifiable and suitable for radiographic measurement. The reconstructed 3D coordinates were then used to define the 3D geometry of the anatomical axes required to estimate FNA. Stereophotogrammetric measurements on a sample of 30 dry right adult femurs were compared to reference values obtained using the Kingsley Olmstead method applied to photographic images. A strong positive correlation (0.998) was found and the mean ± standard deviation of the stereophotogrammetric approach (13.08 ± 6.87)° was comparable to that of the Kingsley Olmstead method (13.14 ± 6.88)°. Intra- and inter-observer reliability were high, with the lower bound of the 95% confidence interval above 0.98 for the intra-class correlation coefficient. The results merit further validation against three dimensional imaging technology such as computed tomography, to confirm stereophotogrammetry as a suitable alternative for FNA measurement. PMID:26776374

  9. Possible Platelet Thrombi Formation in Dog and Human Femoral Arteries

    PubMed Central

    Folts, John D.; Detmer, Donald E.; Nadler, Robert

    1982-01-01

    Atherosclerosis is a ubiquitous condition that commonly produces vessel stenosis and progresses ultimately to vascular occlusion. It is thought by many that platelets collect on sites of atherosclerosis and exacerbate its progression. We have previously shown that platelet thrombi can form within 10 minutes in the stenosed coronary arteries of a dog and can produce acute cyclical reduction in blood flow measured with an electromagnetic flowmeter (EMF). This is followed by sudden restoration of flow as the platelet thrombus breaks loose and is carried distally (Circulation 54:365-370, 1976). In five dogs, blood flow was measured simultaneously in a femoral artery stenosed 70%, exposed proximally with an EMF, and monitored distally over intact skin with a Doppler ultrasonic flowmeter (DUF). Cyclical reductions in blood flow were detected by both the EMF and the DUF, presumably due to platelet thrombi forming in the stenosed femoral artery and then breaking loose and moving distally. These flow reductions could be consistently abolished with aspirin (ASA). In ten patients with angiographically proven substantial stenoses of the femoral or popliteal arteries who were not taking ASA, the popliteal blood flow velocity was measured with a DUF. Six of the ten patients showed cyclical blood flow velocity reductions during 30 minutes of observation. These flow velocity reductions were similar to those observed in the stenosed dog femoral arteries. One hour after taking 600 mg ASA orally, five of the six patients no longer showed flow velocity reductions. Eight male control subjects who were not on ASA and had no known stenoses had no flow velocity reductions when studied with the DUF. Since many factors, such as cigarette smoking, diabetes, and elevated plasma lipids, are known to increase human platelet aggregation, we postulate that platelet thrombi may form in stenosed peripheral arteries, hasten the development of atherosclerosis, and reduce blood flow. This postulate

  10. Femoral metastases from ovarian serous/endometroid adenocarcinoma

    PubMed Central

    Beresford–Cleary, NJA; Mehdi, SA; Magowan, B

    2012-01-01

    Bony metastases from ovarian cancer are rare, tend to affect the axial skeleton and are associated with abdomino-pelvic disease. The median time interval between diagnosis of ovarian carcinoma and presentation of bony metastases is 44 months (1). We describe a rare case of high grade left ovarian serous / endometrioid adenocarcinoma presenting with a pathological right femoral fracture 4 weeks following diagnosis and optimal debulking of the ovarian tumour. Orthopaedic surgeons must be vigilant when planning treatment of fractures presenting in patients with a history of ovarian cancer. PMID:24960734

  11. Rat posterior facial vein interpositional graft: a more relevant training model.

    PubMed

    Lee, Nicolas; Daley, Roger A; Cooley, Brian C

    2014-11-01

    Microvascular training models for vein grafting most often use the rat epigastric vein interpositioned to the femoral artery. We describe the rat posterior facial vein as an alternative vein graft model; it has at least a 2:1 diametric ratio to the femoral artery and a tougher connective tissue, making it more similar to clinical vein grafting for reconstructive microsurgery. A series of 24 grafts interpositioned to the femoral artery were done using 11-12 sutures per end-to-end anastomosis and yielded early patency rates of 96% at 20 min and 92% at 2 and 4 weeks for subsets of 12 grafts. As a training model the diametric disparity provides unique challenges with clinical relevance, for which a number of different techniques for matching arterial to venous circumferences can be done. PMID:24848809

  12. A Comparison of Internal Fixation and Bipolar Hemiarthroplasty for the Treatment of Reverse Oblique Intertrochanteric Femoral Fractures in Elderly Patients

    PubMed Central

    Park, Bong-Ju; Min, Woong-Bae

    2015-01-01

    Purpose To compare the clinical and radiological results between internal fixation using the proximal femoral nail system and bipolar hemiarthroplasty (BHA) in reverse oblique intertrochanteric hip fractures in elderly patients. Materials and Methods From January 2005 to July 2012, we reviewed the medical records of 53 patients who had been treated surgically for reverse oblique intertrochanteric fracture and had been followed-up on for a minimum of two years. All patients were ≥70 years of age, and divided into two groups for retrospective evaluation. One group was treated with internal fixation using the proximal femoral nail system (31 cases), and the other group was treated with BHA (22 cases). Results Early ambulation postoperatively and less pain at postoperative three month were significantly superior in the BHA group. However, by 24 months postoperatively, the internal fixation group exhibited higher Harris scores and correspondingly less pain than the BHA group. There were no significant differences in union rate, duration of hospitalization or lateral wall fracture healing between the two groups. Four patients in the internal fixation group underwent reoperation. Conclusion In the treatment of intertrochanteric fracture of the reverse oblique type, open reduction and internal fixation should be considered to be the better choice for patients with good health and bone quality. However, in cases of severe comminition of fracture and poor bone quality, BHA is an alternative offering advantages including early ambulation, less pain at early stages, and a lower risk of reoperation.

  13. Successful management of simple fractures of the femoral neck with femoral head and neck excision arthroplasty in two free-living avian species.

    PubMed

    Burgdorf-Moisuk, Anne; Whittington, Julia K; Bennett, R Avery; McFadden, Mike; Mitchell, Mark; O'Brien, Robert

    2011-09-01

    A red-tailed hawk (Buteo jamaicensis) and a Canada goose (Branta canadensis) were evaluated for unilateral pelvic limb lameness. Physical examination findings and results of diagnostic imaging revealed femoral neck fractures in both birds. Both birds were treated with a femoral head and neck excision arthroplasty. The affected legs were not immobilized, and the birds were encouraged to use the legs immediately after surgery to encourage formation of a pseudoarthrosis. Within 2 weeks, both birds were using the affected limb well enough to be either successfully released or transferred to a wildlife rehabilitation facility. Femoral head and neck excision arthroplasty without immobilization of the limb is recommended for managing avian femoral neck fractures, especially in free-ranging species in which a rapid and complete or near complete return to function is vital for survival in the wild. PMID:22216722

  14. Limited femoral navigation versus conventional intramedullary femoral jig based instrumentation for achieving optimal restoration of mechanical axis post total knee arthroplasty: a prospective comparative study of 200 knees.

    PubMed

    Shah, Nilen A; Patil, Hitendra G; Dhawale, Amol S; Khedkar, Bipin M

    2015-04-01

    A prospective comparative study was conducted to compare the mechanical axis post total knee arthroplasty (TKA) between two groups: In the first group of 100 knees (ASM group) Articular Surface Mounted navigation system was used to guide the distal femoral cut. In the second group of 100 knees (JIG group) conventional intramedullary femoral jig was used. The postoperative mechanical axis of the leg was within 3° of neutral alignment in 90% of the TKA in the ASM group (mean 178.12°) as compared to 74% in the JIG group (mean 177.02°). This difference was statistically significant (P<0.05). The data presented show that the use of limited femoral navigation leads to more accurate restoration of mechanical axis alignment when compared to conventional intramedullary femoral jigs. PMID:25466168

  15. Efficacies of surgical treatments based on Harris hip score in elderly patients with femoral neck fracture

    PubMed Central

    Liang, Chengwei; Yang, Fengjian; Lin, Weilong; Fan, Yongqian

    2015-01-01

    Aim: To compare the efficacies of four surgical treatments, i.e., total hip arthroplasty (THA), internal fixation (IF), hemiarthroplasty (HA), and artificial femoral head replacement (artificial FHR), by performing a network meta-analysis based on Harris hip score (HHS) in elderly patients with femoral neck fracture. Methods: In strict accordance with specific inclusion and exclusion criteria, randomized controlled trails (RCTs) were screened and selected from a larger group of studies that were retrieved through a comprehensive search of scientific literature databases, further complimented by manual search. The resultant high-quality data from final selected studies were analyzed using Stata 12.0 software. Results: A total of 3680 studies were initially retrieved from database search, and 15 RCTs were eventually incorporated into this meta-analysis, containing 1781 elderly patients who had undergone various surgical treatments for femoral neck fracture (THA group = 604; HA group = 604; IF group = 495; artificial FHR group = 78). Our major result revealed a statistically significant difference in HHS of femoral neck fracture when HA and IF groups were compared with THA. No differences were detected in the HHS of femoral neck fracture undergoing artificial FHR and THA. The surface under the cumulative ranking curves (SUCRA) value of HHS, in elderly patients with femoral neck fracture after surgery, revealed that IF has the highest value. Conclusions: The current network meta-analysis results suggest that IF is the superlative surgical procedure for femoral neck fracture patients, and IF significantly improves the HHS in femoral neck fracture patients. PMID:26221216

  16. Proteomic changes in plasma of broiler chickens with femoral head necrosis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Femoral head necrosis (FHN) is a skeletal problem in broiler chickens where the proximal femoral head cartilage shows susceptibility to separation from its growth plate. The FHN selected birds showed higher bodyweights and reduced plasma cholesterol. The proteomic differences in the plasma of health...

  17. [Treatment strategy for posttraumatic complex deformity : After bilateral femoral shaft fractures].

    PubMed

    Ahrend, M; Ateschrang, A; Stöckle, U; Schröter, S

    2016-02-01

    A case of complex posttraumatic deformity after bilateral femoral shaft fractures is reported. Different possibilities for correction in cases of valgus malalignment combined with internal rotation deformity as well as shortening combined with external rotation deformity are presented. Oblique osteotomy and a motorized femoral extension nail were used. PMID:26187430

  18. Simultaneous Bilateral Fracture of Femoral Neck in Korea: A Case Report

    PubMed Central

    Jeong, Hwa-Jae; Shin, Hun-Kyu; Kim, Eugene; Ko, Taeg Su; Choi, Young-Min

    2015-01-01

    Unilateral femoral neck factures are common and their incidence is increasing. However, simultaneous bilateral femoral neck fractures are rare. Although cases of simultaneous bilateral femoral neck fractures have been reported, most were caused by strong muscle contractions during electroconvulsive therapy. Simultaneous bilateral femoral neck fractures caused by a simple fall are an extremely rare injury; therefore, limited literature is available, and no case has been reported in Korea. We report herein a case of simultaneous bilateral femoral neck fractures caused by a simple fall. An 83-year-old woman visited the emergency department with bilateral hip joint pain and gait disturbance, which developed 1 day after a fall. Tenderness and severe limitation in left hip joint range of motion and mild limitation in right hip joint range of motion were observed on a physical examination. A Garden type IV femoral neck fracture in the left hip joint and a Garden type I femoral neck fracture in the right hip joint were observed on plain radiography. She underwent right screw fixation and left bipolar hemiarthroplasty 2 days after admission. The patient could walk using a walker 4 weeks postoperatively. Bone union in the right femoral neck was observed at the 3 month follow-up. No specific findings were observed at the left hip hemiarthroplasty site.

  19. Fracture of the femoral component associated with polyethylene wear and osteolysis after total knee arthroplasty.

    PubMed

    Huang, C H; Yang, C Y; Cheng, C K

    1999-04-01

    Fracture of the femoral component associated with polyethylene wear and osteolysis after total knee arthroplasty (TKA) has not been well reported before. A 63-year-old man with osteoarthritis of the right knee underwent TKA with a New Jersey LCS Knee, with cementing on the tibia and patella but not on the femoral component. After 42 months, in addition to wearing of polyethylene of the tibia and patella, severe osteonecrosis of the medial femoral condyle was noted. Osteonecrosis caused loss of osseous support of the medial flange of the femoral component, and the bone ingrowth of the central and lateral flange to the distal femur was so good that it overcame the yield stress of the metal of the femoral component and caused fracture of the femoral component. The osteolytic area was filled with autogenous iliac bone, and a new femoral component was inserted and cemented. The patient's condition became satisfactory with relief of pain. Although uncommon, fracture of the femoral component does occur associated with polyethylene wear and osteolysis. PMID:10220194

  20. Effect of the high femoral osteotomy upon the vascularity and blood supply of the hip joint

    SciTech Connect

    Day, B.; Shim, S.S.; Leung, G.

    1984-05-01

    This investigation was done to study the effects of high femoral osteotomy upon the vascularity and blood supply of the hip and to further our knowledge of its physiologic basis. We have used established methods of study, including bone scans, microangiography, isotope clearance and perosseous venography, and based upon the results of these studies, we have reached certain conclusions. First, high femoral osteotomy increases the blood flow and vascularity in the hip joint, the femoral head and neck and the great trochanter. Second, bone scanning techniques using /sup 99m/Tc labeled diphosphonate have shown increased uptake in the femoral head and neck after high femoral osteotomy. The localization was done using a Digital Gamma III computer, and the activity on the osteotomy side at two weeks was 3.5 times as great as on the control side. By 16 weeks postoperatively, there was still two times as much activity on the osteotomy side. Third, microangiography showed increased vascularity both at the osteotomy site and in the femoral head and neck and the greater trochanter on that side. Such an increase in vascularity first became evident two weeks after osteotomy and persisted during the four month period studied. Fourth, the results of the /sup 99m/Tc diphosphonate clearance study showed a 25 per cent increase in femoral head blood flow on the operative side. Fifth, perosseous venography of the femoral head and neck showed a marked increase in venous drainage through the osteotomy site in the immediate postosteotomy stage.

  1. Serum chemistry and histopathology of broiler femoral head necrosis and tibial dyschondroplasia

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Femoral head necrosis (FHN) and tibial dyschondroplasia (TD) are two major leg problems in young meat type poultry which cause lameness, bone deformity and infections. Whereas FHN results from disarticulation of the femoral growth plate from the articular cartilage, TD lesions are characterized by i...

  2. The effect of postural control and balance on femoral anteversion in children with spastic cerebral palsy

    PubMed Central

    Karabicak, Gul Oznur; Balcı, Nilay Comuk; Gulsen, Mustafa; Ozturk, Basar; Cetin, Nuri

    2016-01-01

    [Purpose] The aim of the study was to investigate the relationships between femoral anteversion and functional balance and postural control in children with spastic cerebral palsy. [Subjects and Methods] Twenty children with spastic cerebral palsy (mean age=12.4 ± 4.5) with grosss motor functional classification system levels I, II, and III were recruited for this study. Functional balance was evaluated using the Pediatric Balance Scale, postural control was evaluated using the Trunk Control Measurement Scale, and femoral anteversion was assessed with a handheld goniometer using the great trochanter prominence method. [Results] The results indicated that there was significant correlation between femoral anteversion and Trunk Control Measurement Scale dynamic reaching score. There were no significant correlation between femoral anteversion and the Trunk Control Measurement Scale static sitting balance, Trunk Control Measurement Scale selective movement control, total Trunk Control Measurement Scale and Pediatric Balance Scale results. [Conclusion] Increased femoral anteversion has not correlation with functional balance, static sitting, and selective control of the trunk. Femoral anteversion is related to dynamic reaching activities of the trunk, and this may be the result of excessive internal pelvic rotation. It is important for the health professionals to understand that increased femoral anteversion needs to be corrected because in addition to leading to femoral internal rotation during walking, it also effects dynamic reaching activities of spastic children with cerebral palsy. PMID:27390397

  3. Ultrasonographic Measurement of the Femoral Cartilage Thickness in Hemiparetic Patients after Stroke

    ERIC Educational Resources Information Center

    Tunc, Hakan; Oken, Oznur; Kara, Murat; Tiftik, Tulay; Dogu, Beril; Unlu, Zeliha; Ozcakar, Levent

    2012-01-01

    The aim of the study was to evaluate the femoral cartilage thicknesses of hemiparetic patients after stroke using musculoskeletal ultrasonography and to determine whether there is any correlation between cartilage thicknesses and the clinical characteristics of the patients. Femoral cartilage thicknesses of both knees were measured in 87 (33…

  4. A simplified technique of distal femoral screw insertion for the Grosse-Kempf interlocking nail.

    PubMed

    MacMillan, M; Gross, R H

    1988-01-01

    Failure accurately to determine distal femoral screw hole position can sometimes prolong operating time for placing an interlocking Grosse-Kempf rod. The described technique allows the distal femoral screw holes to be localized accurately with minimal radiation exposure. This technique utilizes readily available instruments and is not technically demanding. PMID:3335100

  5. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... uncemented prosthesis. 888.3360 Section 888.3360 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  6. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... uncemented prosthesis. 888.3360 Section 888.3360 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  7. Fracture of the femoral alignment stem of a hip resurfacing arthroplasty. A case report.

    PubMed

    Bhutta, Mohammed A; Shah, Vinod B

    2011-02-01

    Metal-on-metal hip resurfacing arthroplasty has become increasingly popular for the treatment of osteoarthritis in a younger patient population. While the initial complication of femoral neck fracture is being addressed, we describe a fracture of the femoral alignment stem in a component two years from the primary procedure. PMID:21473460

  8. Histopathology and serum clinical chemistry evaluation of broilers with femoral head separation disorder

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Femoral head disarticulation (FHD) and necrosis is a sporadic leg problem of unknown etiology in broiler breeders. To determine the underlying physiology of FHD, the blood chemistry and the histopathology of the femoral heads of the affected chickens were compared with their age matched controls. Ch...

  9. Large Diameter Femoral Heads Impose Significant Alterations on the Strains Developed on Femoral Component and Bone: A Finite Element Analysis

    PubMed Central

    Theodorou, E.G; Provatidis, C.G; Babis, G.C; Georgiou, C.S; Megas, P.D

    2011-01-01

    Total Hip Arthroplasty aims at fully recreating a functional hip joint. Over the past years modular implant systems have become common practice and are widely used, due to the surgical options they provide. In addition Big Femoral Heads have also been implemented in the process, providing more flexibility for the surgeon. The current study aims at investigating the effects that femoral heads of bigger diameter may impose on the mechanical behavior of the bone-implant assembly. Using data acquired by Computed Tomographies and a Coordinate Measurement Machine, a cadaveric femur and a Profemur-E modular stem were fully digitized, leading to a three dimensional finite element model in ANSYS Workbench. Strains and stresses were then calculated, focusing on areas of clinical interest, based on Gruen zones: the calcar and the corresponding below the greater trochanter area in the proximal femur, the stem tip region and a profile line along linea aspera. The performed finite elements analysis revealed that the use of large diameter heads produces significant changes in strain development within the bone volume, especially in the lateral side. The application of Frost’s law in bone remodeling, validated the hypothesis that for all diameters normal bone growth occurs. However, in the calcar area lower strain values were recorded, when comparing with the reference model featuring a 28mm femoral head. Along line aspera and for the stem tip area, higher values were recorded. Finally, stresses calculated on the modular neck revealed increased values, but without reaching the yield strength of the titanium alloy used. PMID:21792381

  10. A biomechanical evaluation of proximal femoral nail antirotation with respect to helical blade position in femoral head: A cadaveric study

    PubMed Central

    Hwang, Jin-Ho; Garg, Anant Kumar; Oh, Jong-Keon; Oh, Chang-Wug; Lee, Sung-Jae; Myung-Rae, Cho; Kim, Min-Keun; Kim, Hyun

    2012-01-01

    Objective: Despite new developments in the management of osteoporotic fractures, complications like screw cutout are still found in the fixation of proximal femur fractures even with biomechanically proven better implants like proximal femoral nail antirotation (PFNA). The purpose of this cadaveric study was to investigate the biomechanical stability of this device in relation to two common positions (center-center and inferior-center) of the helical blade in the femoral head in unstable trochanteric fractures. Materials and Methods: Eight pairs of human cadaveric femurs were used; in one group [center-center (C-C) group], the helical blade of PFNA was fixed randomly in central position both in anteroposterior and lateral view, whereas in the other group it was fixed in inferior one-third position in anteroposterior and in central position in lateral view [inferior-center (I-C) group]. Unstable intertrochanteric fracture was created and each specimen was loaded cyclically till load to failure Results: Angular and rotational displacements were significantly higher within the C-C group compared to the I-C group in both unloaded and loaded condition. Loading to failure was higher in the I-C group compared to the C-C group. No statistical significance was found for this parameter. Correlations between tip apex distance, cyclic loading which lead to femoral head displacement, and ultimate load to failure showed a significant positive relationship. Conclusion: The I-C group was superior to the C-C group and provided better biomechanical stability for angular and rotational displacement. This study would be a stimulus for further experimental studies with larger number specimens and complex loading protocols at multicentres. PMID:23325963

  11. Intercepting the first rat ashore.

    PubMed

    Russell, James C; Towns, David R; Anderson, Sandra H; Clout, Mick N

    2005-10-20

    A single Norway rat released on to a rat-free island was not caught for more than four months, despite intensive efforts to trap it. The rat first explored the 9.5-hectare island and then swam 400 metres across open water to another rat-free island, evading capture for 18 weeks until an aggressive combination of detection and trapping methods were deployed simultaneously. The exceptional difficulty of this capture indicates that methods normally used to eradicate rats in dense populations are unlikely to be effective on small numbers, a finding that could have global implications for conservation on protected islands. PMID:16237434

  12. [Joint and sensory branch block of the obturator and femoral nerves in a case of femoral head osteonecrosis and arthritis].

    PubMed

    Cortiñas-Sáenz, M; Salmerón-Velez, G; Holgado-Macho, I A

    2014-01-01

    The sensory innervation of the hip joint is complex. The joint and sensory branch block of the obturator and femoral nerves is effective for treating the pain caused due to different hip diseases. This could be an option to be considered in certain circumstances such as, being a surgical-anaesthetic high risk, or if there is significant overweight, It could also be useful on other occasions if the traumatoligist considers that it is better to delay hip replacement for a limited period. PMID:24656423

  13. Cannabinoids alter endothelial function in the Zucker rat model of type 2 diabetes.

    PubMed

    Stanley, Christopher P; Wheal, Amanda J; Randall, Michael D; O'Sullivan, Saoirse E

    2013-11-15

    Circulating levels of anandamide are increased in diabetes, and cannabidiol ameliorates a number of pathologies associated with diabetes. The aim of the present study was to examine how exposure to anandamide or cannabidiol might affect endothelial dysfunction associated with Zucker Diabetic Fatty rats. Age-matched Zucker Diabetic Fatty and Zucker lean rats were killed by cervical dislocation and their arteries mounted on a myograph at 37 °C. Arteries were incubated for 2h with anandamide, cannabidiol or vehicle, contracted, and cumulative concentration-response curves to acetylcholine were constructed. Anandamide (10 µM, 2h) significantly improved the vasorelaxant responses to acetylcholine in aortae and femoral arteries from Zucker Diabetic Fatty rats but not Zucker lean rats. By contrast, anandamide (1 µM, 2h) significantly blunted acetylcholine-induced vasorelaxation in third-order mesenteric arteries (G3) from Zucker Diabetic Fatty rats. Cannabidiol incubation (10 µM, 2h) improved acetylcholine responses in the arteries of Zucker Diabetic Fatty rats (aorta and femoral) and Zucker lean (aorta, femoral and G3 mesenteric), and this effect was greater in the Zucker Diabetic Fatty rat. These studies suggest that increased circulating endocannabinoids may alter vascular function both positively and negatively in type 2 diabetes, and that part of the beneficial effect of cannabidiol in diabetes may be due to improved endothelium-dependent vasorelaxation. PMID:24120371

  14. A simple new technique for the removal of fractured femoral stems: a case report

    PubMed Central

    2014-01-01

    Introduction The removal of broken femoral stems has become a major issue in revision surgery, and is a technically difficult and time-consuming procedure. Case presentation We present a case of a fracture of a cementless long femoral stem in a 65-year-old, white Caucasian man. The distal part was removed with a special longitudinal osteotomy through the anterior cortex extending distally for 10cm. It was then followed by a transversal osteotomy 2cm below the tip of the femoral stump to allow enough space for two locking pliers. Simultaneously using a lamina spreader on the distal part, the broken stem was extracted while hammering on two locking pliers. Conclusions We developed a simple and easy technique for the removal of a broken femoral stem that can be applied to all kinds of femoral stems and intramedullary nails regardless of their cross section. We used ordinary surgical instruments and spared the remaining bone stock. PMID:24886067

  15. Traumatic subchondral fracture of the femoral head in a healed trochanteric fracture

    PubMed Central

    Lee, Sang Yang; Niikura, Takahiro; Iwakura, Takashi; Kurosaka, Masahiro

    2014-01-01

    An 82-year-old woman sustained a trochanteric fracture of the left femur after a fall. Fracture fixation was performed using proximal femoral nail antirotation (PFNA) II, and she was able to walk with a T-cane after 3 months. Eleven months following the operation, the patient presented with left hip pain after a fall. Radiographs showed a subchondral collapse of the femoral head located above the blade tip. The authors removed the PFNA-II and subsequently performed cemented bipolar hemiarthroplasty. Histological evaluation of the femoral head showed osteoporosis with no evidence of osteonecrosis. Repair tissue, granulation tissue and callus formation were seen at the collapsed subchondral area. Based on these findings, a traumatic subchondral fracture of the femoral head in a healed trochanteric fracture was diagnosed. A traumatic subchondral fracture of the femoral head may need to be considered as a possible diagnosis after internal fixation of the trochanteric fracture. PMID:25015169

  16. Intraoperative measurement of rotational stability of femoral components of total hip arthroplasty.

    PubMed

    Harris, W H; Mulroy, R D; Maloney, W J; Burke, D W; Chandler, H P; Zalenski, E B

    1991-05-01

    High out-of-plane forces acting on the hip joint can produce important rotational micromotion of the femoral component. This micromotion at the prosthesis interface may be detrimental to the stability of the implant. In cementless femoral implants this could prevent bone ingrowth, and in the cemented component this could cause generation of particulate debris, lysis, and loosening. The introduction of the torque wrench micrometer for assessment of intraoperative femoral component stability can quantify the initial stability of primary cementless femoral components and critically evaluate the stability (at either the initial or revision arthroplasty) of both cemented and cementless femoral components. It allows the surgeon to produce a known torque in the direction and magnitude of the out-of-plane forces that load the hip in vivo. PMID:2019039

  17. Spontaneous and bilateral necrosis of the femoral head in a young experimental beagle dog

    PubMed Central

    Kobayashi, Ryosuke; Kurotaki, Tetsuro; Yamada, Naoaki; Kumabe, Shino; Doi, Takuya; Wako, Yumi; Tsuchitani, Minoru

    2015-01-01

    This report describes the pathological characterizations of a rare case of necrosis of the femoral head that was spontaneous, bilateral, avascular and nontraumatic. A 14-month-old beagle dog was presented with pain in the hind limbs. At necropsy, the articular surface in the bilateral femoral head was markedly irregular. There were no gross abnormalities other than in the hip joints. Microscopically, a wide range of trabecular bone necrosis localized in the subchondral area was observed in both femoral heads. In the right femoral head, fibrosis and proliferative vessels were noted in the subchondral area. The articular cartilage was thickened irregularly, but there was no evidence of cartilage necrosis. The bone marrow adjacent to the affected area showed severe depression. In the metaphysis, atrophic bone marrow, but not bone necrosis, was observed. This was a rare case of spontaneous necrosis of the femoral head in an experimental beagle dog. PMID:26028821

  18. The development of a validated checklist for femoral venous catheterization: preliminary results.

    PubMed

    Riesenberg, Lee Ann; Berg, Katherine; Berg, Dale; Davis, Joshua; Schaeffer, Arielle; Justice, Ellen M; Tinkoff, Glen

    2014-01-01

    Femoral venous catheterization is a common, invasive procedure, which may lead to serious complications. Validated checklists are central to teaching and assessing procedural skills and may result in improved health care quality. The results of the first step of the validation of a femoral venous catheterization checklist are described. A comprehensive literature review of articles published on femoral venous catheterization did not yield a checklist validated by the Delphi method. A modified Delphi technique, involving a panel of 8 interdisciplinary, interinstitutional experts, was used to develop a femoral venous catheterization checklist. The internal consistency coefficient using Cronbach α was .99. Developing a 29-item checklist for teaching and assessing femoral venous catheterization is the first step in the validation process. For this checklist to become further validated, it should be implemented and studied in the simulation and clinical environments. PMID:24045368

  19. Hip Arthroscopic Osteochondral Autologous Transplantation for Treating Osteochondritis Dissecans of the Femoral Head

    PubMed Central

    Kubo, Takanori; Utsunomiya, Hajime; Watanuki, Makoto; Hayashi, Hidetoshi; Sakai, Akinori; Uchida, Soshi

    2015-01-01

    Osteochondritis dissecans (OCD) of the femoral head is not a common source of hip pain. Hip arthroscopy is becoming a more frequent indication for intra-articular pathologies of the hip. Osteochondral autologous transplantation is a promising technique that theoretically can reconstruct osteochondral lesions of the femoral head. We describe our technique for arthroscopic antegrade osteochondral autologous transplantation for the treatment of OCD of the femoral head. The advantages of this technique include that it is a less invasive method with the ability to assess and treat intra-articular pathologies associated with OCD of the femoral head at same time. Case series and outcomes after this technique are not currently reported in the literature; however, it could be a less invasive method and provide favorable clinical outcomes for patients with OCD lesions of the femoral head. PMID:26870645

  20. Do larger femoral heads improve the functional outcome in total hip arthroplasty?

    PubMed

    Allen, Charlotte L; Hooper, Gary J; Frampton, Christopher M A

    2014-02-01

    Use of larger diameter femoral heads has been popularised in total hip arthroplasty (THA). Recent studies have implicated larger femoral heads in early failure. We evaluated what effect the size of the femoral head had on the early functional outcome in order to determine the optimal head size for the maximal functional outcome. There were 726 patients who underwent elective THA and were divided into 3 groups according to head size then compared with respect to functional outcome scores and dislocation rates. This study failed to show that increasing the size of the femoral head significantly improved the functional outcome at 1 year after total hip arthroplasty but that the use of a 36 mm or greater femoral head did reduce the dislocation rate. PMID:23891058

  1. Distal Femoral Complications Following Antegrade Intramedullary Nail Placement

    PubMed Central

    Fantry, Amanda J.; Elia, Gregory; Vopat, Bryan G.; Daniels, Alan H.

    2015-01-01

    While antegrade nailing for proximal and diaphyseal femur fractures is a commonly utilized fixation method with benefits including early mobilization and high rates of fracture union, both intraoperative and postoperative complications may occur. Intraoperative errors include leg length discrepancy, anterior cortical perforation, malreduction of the fracture, and neurovascular injury, and postoperative complications include nonunion, malunion, infection, and hardware failure. This case series reviews complications affecting the distal femur after intramedullary nailing including fracture surrounding a distal femoral interlocking screw (Case #1), nonunion after dynamization with nail penetration into the knee joint (Case #2), and anterior cortical perforation (Case #3). Prevention of intraoperative and postoperative complications surrounding intramedullary nailing requires careful study of the femoral anatomy and nail design specifications (radius of curvature), consideration of the necessity of distal interlocking screws, the need for close radiographic follow-up after nail placement with X-rays of the entire length of the nail, and awareness of possible nail penetration into the knee joint after dynamization. PMID:25874066

  2. FEMORAL INSERTION OF THE POSTERIOR CRUCIATE LIGAMENT: AN ANATOMICAL STUDY

    PubMed Central

    de Paula Leite Cury, Ricardo; Severino, Nilson Roberto; Camargo, Osmar Pedro Arbix; Aihara, Tatsuo; Neto, Leopoldo Viana Batista; Goarayeb, Dedley Nelson

    2015-01-01

    Objective: To identify objective parameters to guide correct location of the posterior cruciate ligament (PCL) in the femur. Methods: The PCLs of 20 human cadavers were resected. The following portions were measured: distance from the most distal portion of the PCL, close to the roof, to the most anterior edge of the cartilage (AB); distance from the most proximal portion of the PCL, close to the roof, to the most anterior cartilage (AC); distance between the two parts of the ligament close to the roof (BC); distance from the distal edge in its posterior portion, to the more posterior joint edge (DE); distance from the distal edge of the ligament in its posterior portion, to the intercondylar roof (DF); and finally, the format of the ligament insertion and area of coverage on the femoral condyle. Results: The PCL has the shape of a quarter ellipse, with an average area of 153.5mm2. The mean distances found were: AB of 2.1mm, AC of 10.7mm, BC of 8.6mm DE of 12.4mm and DF of 16.8mm. Conclusions: The edge close to the roof of the anterolateral bundle is closer to the joint cartilage (2.1mm) than the posteromedial bundle is, which is 12.4mm from the edge proximal to the cartilage. These references should assist in better and more accurate positioning of femoral tunnels in PCL reconstruction. PMID:27027059

  3. BLEEDING OF FEMORAL HEAD DURING TOTAL HIP ARTHROPLASTY FOR OSTEOARTHROSIS

    PubMed Central

    Schwartsmann, Carlos Roberto; Spinelli, Leandro de Freitas; Sotomayor, Marco Yánez; Yépez, Anthony Kerbes; Boschin, Leonardo Carbonera; Silva, Marcelo Faria

    2015-01-01

    ABSTRACT Objective: To evaluate the bleeding of the femoral head on hip osteoarthritis in patients who underwent total hip arthroplasty. Methods: One hundred and three hips affected by primary hip osteoarthritis were evaluated. After surgical dislocation, the femoral head was divided into four quadrants, and micro perforations were made in order to observe and assess the presence of bleeding, as early type (EB), late type (LB) or without bleeding (WB). Results: We observed early bleeding (EB) in the upper quadrant in 16 hips (15.5%), late bleeding in 14 hips (13.6%) and no bleeding (WB) in 73 hips (70.9%). The anterior quadrant showed EB in 24 hips (23.3%), LB in 7 hips (6.8%) and WB in 72 hips (69.9%). The lower quadrant presented EB in 40 hips (38.8%), LB 14 hips (13.6%) and WB in 49 hips (47.6%). The posterior quadrant showed EB in 39 hips (37.9%), LB 19 hips (18.4%) and WB in 45 hips (43.7%). Comparing BMI and gender, we found no association between these parameters (p> 0.05). Conclusions: The inferior and posterior quadrant had the highest bleeding levels, following the path of the medial circumflex artery. Level of Evidence III, Therapeutic Study. PMID:26981036

  4. Mechanical properties of femoral cortical bone following cemented hip replacement.

    PubMed

    Ni, G X; Lu, W W; Chiu, P K Y; Wang, Y; Li, Z Y; Zhang, Y G; Xu, B; Deng, L F; Luk, K D K

    2007-11-01

    Femoral bone remodeling following total hip replacement is a big concern and has never been examined mechanically. In this study, six goats underwent unilateral cemented hip hemiarthroplasty with polymethyl methacrylate (PMMA) bone cement. Nine months later animals were sacrificed, and the femoral cortical bone slices at different levels were analysed using microhardness testing and microcomputed tomography (micro-CT) scanning. Implanted femurs were compared to contralateral nonimplanted femurs. Extensive bone remodeling was demonstrated at both the proximal and middle levels, but not at the distal level. Compared with the nonimplanted side, significant decreases were found in the implanted femur in cortical bone area, bone mineral density, and cortical bone hardness at the proximal level, as well as in bone mineral density and bone hardness at the middle level. However, no significant difference was observed in either variable for the distal level. In addition, similar proximal-to-distal gradient changes were revealed both in cortical bone microhardness and bone mineral density. From the mechanical point of view, the results of the present study suggested that stress shielding is an important mechanical factor associated with bone adaptation following total hip replacement. PMID:17506504

  5. Normalization of chromium and cobalt values after femoral head replacement

    PubMed Central

    Iacobellis, Claudio; Berizzi, Antonio; Pozzuoli, Assunta; Biz, Carlo

    2015-01-01

    Introduction Adverse reaction to metal debris (ARMD) can be caused by metal-on-metal total hip arthoplasty. We treated a case of ARMD in a 61-year-old patient by limited prosthetic revision, replacing the metal head with a polyethylene one. Presentation of case Two years after metal-on-metal total arthoplasty of the left hip, radiographic control showed osteolysis of the patient’s greater trochanter. He underwent surgical curettage and the application of demineralized bone matrix. After a few months, blood Co and Cr increased, and at clinical evaluation, the patient had worsening paresthesias. He agreed to prosthetic revision after 14 months. Discussion During surgery, the acetabular cup and femoral stem appeared correctly osteointegrated; therefore, the cup was maintained, while the prosthetic femoral head was removed and replaced with a 50 mm polyethylene head. Conclusion Blood Cr and urinary Cr and Co decreased and normalized 3 months after surgery, and the patient no longer suffered paresthesias. Blood Co normalized 7 months after revision. Radiographic follow-up showed no change after 30 months post-operatively. We believe this case report could be a starting point for a future randomized clinical trial to test the efficacy of the procedure used compared with complete implant revision. PMID:25841157

  6. Management of Osteochondritis Dissecans of the Femoral Condyle.

    PubMed

    Shea, Kevin G; Carey, James L; Brown, Gregory A; Murray, Jayson N; Pezold, Ryan; Sevarino, Kaitlyn S

    2016-09-01

    The American Academy of Orthopaedic Surgeons has developed the Appropriate Use Criteria (AUC) document Management of Osteochondritis Dissecans of the Femoral Condyle. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain the best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The AUC clinical patient scenarios were derived from patient indications that generally accompany osteochondritis dissecans of the femoral condyle, as well as from current evidence-based clinical practice guidelines and supporting literature. The 64 patient scenarios and 12 treatments were developed by the Writing Panel, a group of clinicians who are specialists in this AUC topic. Lastly, a separate, multidisciplinary Voting Panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3). PMID:27479835

  7. Wear and degradation on retrieved zirconia femoral heads.

    PubMed

    Nogiwa-Valdez, A A; Rainforth, W M; Stewart, T D

    2014-03-01

    Zirconia femoral heads retrieved from patients after different implantation periods (up to 13 years) were analysed using vertical scanning interferometry, atomic force microscopy and Raman microspectroscopy. A range of topographical and compositional changes on the surface of the retrievals are reported in this work. The study revealed that changes in roughness are the result of a combination of factors, i.e. scratching, surface upheaval due to transformation to the monoclinic phase and grain pull-out. Clusters of transformed monoclinic grains were observed on heads implanted for more than 3 years. The phase composition of these clusters was confirmed by Raman microspectroscopy. Increased abrasive wear and a higher monoclinic phase content concentrated on the pole of the femoral heads, confirming that the tetragonal to monoclinic phase transformation was not only induced by the tetragonal phase metastability and environmental conditions but mechanical and tribological factors, also affected the transformation kinetics. Additionally, the head implanted for 13 years showed evidence of a self-polishing mechanism leading to a considerable smoothening of the surface. These observations provide an insight into the interrelated mechanisms underlying the wear and transformation process on zirconia ceramics during implantation. PMID:24140384

  8. Proximal femoral diaphyseal cross-sectional geometry in Orrorin tugenensis.

    PubMed

    Bleuze, M

    2012-06-01

    Functional adaptations in femora attributed to Orrorin tugenensis provide a unique opportunity to examine locomotor behavior very early in the hominin lineage. This study examines relative cortical thickness, cortical area (CA) relative to the polar moment of area (J), and J relative to femoral head superoinferior diameter (FHD) in the proximal femur of O. tugenensis (BAR 1002'00 and BAR 1003'00), and compares patterns in this early hominin with those in a sample of modern humans (N=31), Plio-Pleistocene fossil hominins (N=8), Pan troglodytes troglodytes (N=13), and Pan paniscus (N=3). Relative cortical thickness and CA relative to J in the proximal femur of O. tugenensis are comparable to patterns generally found in other fossil hominins. Proximal femoral diaphyseal J relative to FHD in BAR 1002'00 is similar to patterns found in fossil hominins typically attributed to a non-Homo genus (i.e. SK 82, SK 97, and KNM-ER 738). Cross-sectional geometric patterns in the proximal femur of Orrorin are not unlike those generally found in australopithecines and fossil Homo. While the results of this study cannot confirm unequivocally that Orrorin was an obligate biped, a mode of locomotion comparable to that proposed for australopithecines cannot be ruled out. PMID:22609080

  9. Effect of Equal Daily Doses Achieved by Different Power Densities of Low-Level Laser Therapy at 635 nm on Open Skin Wound Healing in Normal and Diabetic Rats

    PubMed Central

    Kilík, Róbert; Lakyová, Lucia; Sabo, Ján; Lacjaková, Kamila; Vasilenko, Tomáš; Vidová, Martina; Longauer, František; Radoňak, Jozef

    2014-01-01

    Background and Objective. Despite the fact that the molecular mechanism of low-level laser therapy (LLLT) is not yet known, the exploitation of phototherapy in clinical medicine and surgery is of great interest. The present study investigates the effects of LLLT on open skin wound healing in normal and diabetic rats. Materials and Methods. Four round full-thickness skin wounds on dorsum were performed in male adult nondiabetic (n = 24) and diabetic (n = 24) Sprague–Dawley rats. AlGaInP (635 nm, wavelength; 5 J/cm2, daily dose) was used to deliver power densities of 1, 5, and 15 mW/cm2 three times daily until euthanasia. Results. PMNL infiltration was lower in the irradiated groups (15 mW/cm2). The synthesis and organisation of collagen fibres were consecutively enhanced in the 5 mW/cm2 and 15 mW/cm2 groups compared to the others in nondiabetic rats. In the diabetic group the only significant difference was recorded in the ratio PMNL/Ma at 15 mW/cm2. A significant difference in the number of newly formed capillaries in the irradiated group (5, 15 mW/cm2) was recorded on day six after injury compared to the control group. Conclusion. LLLT confers a protective effect against excessive inflammatory tissue response; it stimulates neovascularization and the early formation of collagen fibres. PMID:24551842

  10. Small diameter acetabulum and femoral head in total hip arthroplasty for developmental dysplasia of the hip, with no femoral osteotomy.

    PubMed

    Verettas, Dionysios-Alexandros; Chloropoulou, Pelagia; Xarchas, Konstantinos; Drosos, Georgios; Ververidis, Athanasios; Kazakos, Konstantinos

    2015-01-01

    We present the results of 66 total hip arthroplasties in 62 patients of mean age 46 years (24-74 years), with developmental dysplasia of the hip. In all cases the centre of rotation of the new hip was positioned at the site of the true acetabulum. In all patients cementless press fit acetabular components of small diameter (42-44 mm) were used, articulating exclusively with a 22.25 mm modular metal femoral head, without the use of bone grafts or shortening osteotomies of the femur. Despite the use of small diameter femoral heads the rate of dislocation was 3%. After an average follow-up period of 9 years (4-18 years), no revisions were required for infection, loosening or wear or implant migration. Osteolytic lesions were seen in the periacetabular region in 3 patients who were symptom free. A total of 2 revisions were required for instability and 2 patients had the wires of their trochanteric osteotomy removed because of bursitis. Leg length inequality was improved in 55% of the patients and one postoperative transient sciatic nerve lesion settled within 4 months. We believe that in patients with painful dysplastic hips, the use of small diameter implants with the centre of rotation at the true acetabulum, can give very satisfactory results, without any supplementary procedures. PMID:25907394

  11. The modified Dunn procedure for slipped capital femoral epiphysis does not reduce the length of the femoral neck

    PubMed Central

    Cosma, Dan; Vasilescu, Dana Elena; Corbu, Andrei; Văleanu, Mădălina; Vasilescu, Dan

    2016-01-01

    Objective: The treatment of slipped capital femoral epiphysis (SCFE) is evolving, with the development of new surgical techniques. |We wanted to study if modified Dunn procedure restores the normal alignment of the proximal femur and the risk of avascular necrosis is increased. Methods: This is a single centre, retrospective study, comparing the outcomes of in situ pinning and modified Dunn procedure. Between 2001 and 2014, 7 children (7 hips) underwent the modified Dunn procedure and 10 children (10 hips) pinning in situ for stable and unstable SCFE. Mean age of the patients was 12.7 years with a median follow-up of 18 months. Results: The radiological parameters improved in the modified Dunn procedure group, while the length of the femoral neck didn’t change significantly (p=0.09). Postoperative clinical outcomes were slightly better in the modified Dunn procedure group (6 hips out of 7 had good and excellent results) compared to the pinning in situ group (8 good and excellent results out of 10 hips) (p=0.04). No avascular necrosis was found and there were no cases of chondrolysis. Conclusion: Radiographic parameters of the proximal femur assessed in our study improved in all hips that underwent modified Dunn procedure, without the creation of secondary deformities. PMID:27182244

  12. Distal femoral derotational osteotomy with external fixation for correction of excessive femoral anteversion in patients with cerebral palsy.

    PubMed

    Skiak, Eyad; Karakasli, Ahmet; Basci, Onur; Satoglu, Ismail S; Ertem, Fatih; Havitcioglu, Hasan

    2015-09-01

    Patients with cerebral palsy (CP) disorder often develop rotational hip deformity. Increasing deformities impair already diminished walking abilities; femoral osteotomies are often performed to maintain and improve walking abilities. Fixation of osteotomies with condylar plates has been used successfully, but does not often enable immediate postoperative full weight-bearing. To avoid considerable postoperative rehabilitation deficit and additional bone loss because of inactivity, a postoperative treatment with full weight-bearing, is therefore, desirable. Self-tapping Schanz screws with a unilateral external fixator crossing the knee joint providing stronger anchoring in osteopenic bone might fulfill these demands. A retrospective study was carried out on 27 ambulatory CP patients, mean age 17.5 years (range 9-22 years); 11 patients with bilateral severe intoeing deformities underwent a supracondylar femoral osteotomy between September 2008 and April 2012. All patients were allowed to bear their full weight postoperatively. The aim of this study was to describe the technique, the results of this technique, to evaluate the time required for bone healing, and the type of complications associated with a distal derotational femoral osteotomy fixed with a uniaxial external fixator crossing the knee joint. A total of 27 patients were studied [mean weight 48.8 kg (range 29.8-75 kg)]. The mean preoperative rotation included internal rotation of 69° and external rotation of 17°. All patients were evaluated clinically and radiographically for a minimum of 1 year after surgery. There was a significant decrease in the mean medial rotation from 69° to 32° (P=0.00034). The lateral rotation increased significantly from preoperative 17° to postoperative 45° (P=0.0011). The femoral anteversion decreased significantly from a mean of 55° preoperatively to a mean 17° postoperatively (P=0.030). All patients, except one, achieved solid fusion uneventfully. One patient was a

  13. Fixation of supraglenoid tubercle fractures using distal femoral locking plates in three Warmblood horses.

    PubMed

    Frei, Sina; Fürst, Anton E; Sacks, Murielle; Bischofberger, Andrea S

    2016-05-18

    Three horses that were presented with supraglenoid tubercle fractures were treated with open reduction and internal fixation using distal femoral locking plates (DFLP). Placing the DFLP caudal to the scapular spine in order to preserve the suprascapular nerve led to a stable fixation, however, it resulted in infraspinatus muscle atrophy and mild scapulohumeral joint instability (case 1). Placing the DFLP cranial to the scapular spine and under the suprascapular nerve resulted in a stable fixation, however, it resulted in severe atrophy of the supraspinatus and infraspinatus muscles and scapulohumeral joint instability (case 2). Placing the DFLP cranial to the scapular spine and slightly overbending it at the suprascapular nerve passage site resulted in the best outcome (case 3). Only a mild degree of supraspinatus and infraspinatus muscle atrophy was apparent, which resolved quickly and with no effect on scapulohumeral joint stability. In all cases, fixation of supraglenoid tubercle fractures using DFLP in slightly different techniques led to stable fixations with good long-term outcome. One case suffered from a mild incisional infection and plates were removed in two horses. Placement of the DFLP cranial to the scapular spine and slightly overbending it at the suprascapular nerve passage prevented major nerve damage. Further cases investigating the degree of muscle atrophy following the use of the DFLP placed in the above-described technique are justified to improve patient outcome. PMID:27070124

  14. A new automatic landmark extraction framework on ultrasound images of femoral condyles

    NASA Astrophysics Data System (ADS)

    Masson-Sibut, Agnès; Nakib, Amir; Petit, Eric; Leitner, François

    2012-03-01

    In Computer Assisted Orthopaedic Surgery (CAOS), surgeons have to acquire some anatomical landmarks as inputs to the system. To do so, they use manual pointers that are localized in the Operating Room (OR) space using an infrared camera. When the needed landmark is not reachable through an opening, it is palpated directly on skin and there is a loss of precision that can vary from several millimeters to centimeters depending on the thickness of soft tissues. In this paper, we propose a new framework based on three main steps to register the bone surface and extract automatically anatomical landmarks with an ultrasound probe. This framework is based on an oriented gradient calculation, a simulated-compound and a contour closure using a graph representation. The oriented gradient allows extracting a set of pixels that probably belong to the bone surface. The simulatedcompound step allows using ultrasound images properties to define a set of small segments which may belong to the bone surface, and the graph representation allows eliminating false positive detection among remaining segments. The proposed method has been validated on a database of 230 ultrasound images of anterior femoral condyles (on the knee). The average computation time is 0.11 sec per image, and average errors are: 0.54 mm for the bone surface extraction, 0.31 mm for the condylar line, and 1.4 mm for the trochlea middle.

  15. [Stereological analysis of rat bone tissue after a flight on the Kosmos-1129 biosatellite].

    PubMed

    Prokhonchukov, A A; Peschanskiĭ, V S

    1982-01-01

    Stereological measurements of volume fractions of 53 samples of compact and spongy structures of bones of 15 rats were carried out. The measurements were performed on cortical lamellae, trabecules and lacunae, channels of osteons and matrices of femoral, tibial and fibular bones of rats. Postflight no significant changes were seen in the above parameters as compared to the vivarium controls. During readaptation to I g a slight increase in the volume fraction of spongy bones was noted. PMID:6750237

  16. Symptomatic atypical femoral fractures are related to underlying hip geometry.

    PubMed

    Taormina, David P; Marcano, Alejandro I; Karia, Raj; Egol, Kenneth A; Tejwani, Nirmal C

    2014-06-01

    The benefits of bisphosphonates are well documented, but prolonged use has been associated with atypical femur fractures. Radiographic markers for fracture predisposition could potentially aid in safer medication use. In this case-control designed study, we compared hip radiographic parameters and the demographic characteristics of chronic bisphosphonate users who sustained an atypical femoral fracture with a group of chronic bisphosphonate users who did not sustain an atypical femur fracture and also a group who sustained an intertrochanteric hip fracture. Radiographic parameters included were neck-shaft angle (NSA), hip-axis length (HAL) and center-edge angle (CE). Multivariate regression was used to evaluate the relationship between radiographic measures and femur fracture. Receiver-operating characteristic analysis determined cut-off points for neck-shaft angle and risk of atypical femur fracture. Ultimately, pre-fracture radiographs of 53 bisphosphonate users who developed atypical fracture were compared with 43 asymptomatic chronic bisphosphonate users and 64 intertrochanteric fracture patients. Duration of bisphosphonate use did not statistically differ between users sustaining atypical fracture and those without fracture (7.9 [±3.5] vs. 7.7 [±3.3] years, p=0.7). Bisphosphonate users who fractured had acute/varus pre-fracture neck-shaft angles (p<0.001), shorter hip-axis length (p<0.01), and narrower center-edge angles (p<0.01). Regression analysis revealed associations between neck-shaft angle (OR=0.89 [95% CI=0.81-0.97; p=0.01), center edge angle (OR=0.89 [95% CI=0.80-0.99]; p=0.03), and BMI (OR=1.15 [95% CI=1.02-1.31; p=0.03) with fracture development. ROC curve analysis (AUC=0.67 [95% CI=0.56-0.79]) determined that a cut-off point for neck-shaft angle <128.3° yielded 69% sensitivity and 63% specificity for development of atypical femoral fracture. Ultimately, an acute/varus angle of the femoral neck, high BMI, and narrow center-edge angle were

  17. Management of osteonecrosis of the femoral head: A novel technique

    PubMed Central

    Samy, Ahmed M

    2016-01-01

    Background: Osteonecrosis of the femoral head (ONFH) is a debilitating disease in orthopedics, frequently progressing to femoral head collapse and osteoarthritis. It is thought to be a multifactorial disease. ONFH ultimately results in femoral head collapse in 75–85% of untreated patients. Total hip arthroplasty (THA) yields satisfactory results in the treatment of the end stage of the disease. However, disease typically affects males between the ages of 20 and 40 years and joint replacement is not the ideal option for younger patients. Recently, mesenchymal stem cells and platelet rich plasma (PRP) have been used as an adjunct to core decompression to improve clinical success in the treatment of precollapse hips. Materials and Methods: A prospective study of 40 hips in 30 patients was done. There were 19 males and 11 females with a mean age 36.7 ± 6.93 years. The indication for the operation was restricted primarily to modified Ficat stages IIb and III. 16 hips (40%) had stage IIb and 24 hips (60%) had stage III ONFH. The period of follow up ranged between 36–50 months with a mean 41.4 ± 3.53 months. All patients were assessed clinically during pre- and post-operative period according to the Harris Hip Score (HHS), Visual Analog Score (VAS) and radiologically by X-rays. Magnetic resonance imaging (MRI) was done preoperatively to confirm the diagnosis and every 6 months postoperatively for assessment of healing. The operative procedure include removal of necrotic area with drilling then the cavity was filled with a composite of bone graft mixed with PRP. Results: The mean HHS improved from 46.0 ± 7.8 preoperatively to 90.28 ± 19 at the end of followup (P < 0.0001). The mean values of VAS were 78 ± 21 and 35 ± 19 at preoperatively period and final followup, respectively, with an average reduction of 43 points. Conclusion: We found that the use of PRP with collagen sheet can increase the reparable capacity after drilling of necrotic segment in stage IIb and

  18. Nonoperative treatment of slipped capital femoral epiphysis: a scientific study

    PubMed Central

    2011-01-01

    Background Treatment of the Slipped Capital Femoral Epiphysis remains a cause of concern due to the fact that the true knowledge of the etiopathogeny is unknown, as well as one of its major complications: chondrolysis. The conservative treatment remains controversial; it has been overlooked in the studies and subjected to intense criticism. The purpose of this study is to investigate the results of treatment on the hip of patients displaying slipped capital femoral epiphysis, using the plaster cast immobilization method and its link to chondrolysis. Methods The research was performed based on the study of the following variables: symptomatology, and the degree of slipping. A hip spica cast and bilateral short/long leg casts in abduction, internal rotation with anti-rotational bars were used for immobilizing the patient's hip for twelve weeks. Statistical analysis was accomplished by Wilcoxon's marked position test and by the Fisher accuracy test at a 5% level. Results A satisfactory result was obtained in the acute group, 70.5%; 94%; in the chronic group (chronic + acute on chronic). Regarding the degree of the slipping, a satisfactory result was obtained in 90.5% of hips tested with a mild slip; in 76% with moderate slip and 73% in the severe slip. The statistical result revealed that a significant improvement was found for flexion (p = 0.0001), abduction (p = 0.0001), internal rotation (p = 0.0001) and external rotation (p = 0.02). Chondrolysis was present in 11.3% of the hips tested. One case of pseudoarthrosis with aseptic capital necrosis was presented. There was no significant variation between age and chondrolysis (p = 1.00).Significant variation between gender/non-white patients versus chondrolysis (p = 0.031) and (p = 0.037), respectively was verified. No causal association between plaster cast and chondrolysis was observed (p = 0.60). In regard to the symptomatology group and the slip degree versus chondrolysis, the p value was not statistically

  19. Endoperoxide 4 receptors play a role in evoking the exercise pressor reflex in rats with simulated peripheral artery disease.

    PubMed

    Yamauchi, Katsuya; Kim, Joyce S; Stone, Audrey J; Ruiz-Velasco, Victor; Kaufman, Marc P

    2013-06-01

    Ligating the femoral artery for 72 h in decerebrated rats exaggerates the exercise pressor reflex. The sensory arm of this reflex is comprised of group III and IV afferents, which can be either sensitized or stimulated by PGE2. In vitro studies showed that endoperoxide (EP) 3 and 4 receptors were responsible for the PGE2-induced sensitization of rat dorsal root ganglion cells. This in vitro finding prompted us to test the hypothesis that blockade of EP3 and/or EP4 receptors attenuated the exaggerated exercise pressor reflex in rats with ligated femoral arteries. We measured the cardiovascular responses to static hindlimb contraction or tendon stretch before and after femoral arterial injection of L798106 (an EP3 antagonist) or L161982 (an EP4 antagonist). The pressor and cardioaccelerator responses to either contraction or tendon stretch were not attenuated by L798106 in either the ligated or freely perfused rats. Likewise in five rats whose hindlimb muscles were freely perfused, the pressor and cardioaccelerator responses to either contraction or tendon stretch were not attenuated by L161982. In the six ligated rats, however, the pressor response to contraction was attenuated by L161982, averaging 37 ± 3 mmHg before, 18 ± 2 mmHg afterward (P < 0.05). Western blotting analysis revealed that ligation of the femoral artery for 72 h increased the EP4 receptor protein in the L4 and L5 dorsal root ganglia over their freely perfused counterparts by 24% (P < 0.05). We conclude that EP4 receptors, but not EP3 receptors, play an important role in the exaggerated exercise pressor reflex found in rats with ligated femoral arteries. PMID:23568893

  20. Effect of triple pelvic osteotomy on the proximal femoral geometry in dysplastic dogs.

    PubMed

    Sarierler, Murat; Yildirim, Ismail Gokce; Ocal, Mehmet Kamil

    2012-02-01

    Triple pelvic osteotomy (TPO) is one of the surgical procedures for use to try to reduce subsequent degenerative joint disease or modify the progress of hip dysplasia in young dogs. Joint force and pressure distribution were changed by this procedure. Therefore, the aim of this study was to find out whether the remodeling of proximal femur exists or not after TPO in dysplastic dogs. Ten femora from five young dysplastic mongrel dogs, treated unilaterally with TPO using 20° canine pelvic osteotomy plates, were used. One year after TPO, neck-proximal shaft angle, femoral head, neck, diaphyseal and mid-shaft diameters, total femoral, femoral neck axis, and intertrochanteric, femoral head offset lengths as well as the lengths from head center to lateral margin of greater trochanter and to proximal femoral axis were measured from the bone. The significant differences between treatment and control side were determined in Norberg angle, neck-proximal shaft angle, neck diameter, diaphyseal diameter, mid-shaft diameter, length from head center to proximal femoral axis and femoral head offset length. In conclusion, although small number of cases was used, it was determined that the aforementioned variables are affected by TPO. So, these variables may be supply additional information about the changes to the joint following TPO in dysplastic dogs. PMID:21176929

  1. Identification of femoral head center of bipolar hemiarthroplasy in radiostereometric analysis with elementary geometrical shape models.

    PubMed

    Tsukanaka, Masako; Röhrl, Stephan M; von Schewelov, Thord; Nordsletten, Lars

    2016-02-01

    Elementary geometrical shape (EGS) models are useful in radiostereometric analysis (RSA) on hip stems because tantalum markers attached to the stems can be omitted. In order to create an EGS model of a femoral stem, the center of the femoral head has to be identified. The contour of the femoral head is recommended to be used. However, the contour of the femoral head cannot be detected exclusively by computer if it is combined with a bipolar head or a metal cup. We therefore hypothesized that the contour of the outer head of bipolar hemiarthroplasty can be included in the EGS model as well as the femoral head contour. We calculated the time required for the detection of the contour, the precision of analysis and the stem micromotion at 2 years using the two different methods in the same picture set and compared the results. The detection of the bipolar head contour was 10 times faster than that of the femoral head contour. The precision for subsidence was 0.16 mm in EGS RSA with the femoral head contour, and 0.15 mm with the bipolar head contour (p=0.68). The precisions were comparable and clinically acceptable. There was no significant difference between the results of the 2-year micromotion with the two different methods. We conclude that this new method is applicable to measure stem micromotion of hemi-arthroplasty with EGS RSA and the method facilitates the Radiostereometric analysis. PMID:26705109

  2. [Progress in diagnosis and treatment of ipsilateral femoral neck and shaft fracture].

    PubMed

    Du, C G; Zhang, Y Z; Chen, W

    2016-07-01

    Ipsilateral femoral neck and shaft fractures are rare injuries, which are often caused by high-energy trauma and combined with multiple injuries, such as thoracic and abdominal injury, head injuries, and fractures of other sites.Delayed or missed diagnosis of the ipsilateral femoral neck fracture often occurs.When patients with femoral shaft fractures caused by high-energy trauma are admitted into hospital, physical examination should be conducted carefully.In addition to femoral shaft fractures, radiographs of the ipsilater hip and knee joints should been taken, simultaneously taking into consideration the potential effect of anteversion angle on the demonstration of femoral neck fracture.Computed tomograph and magnetic resonance imaging are advised to perform if necessary to facilitate early and accurate diagnosis of ipsilateral femoral neck fracture.Comprehensive evaluation should be done based on age, physical condition, associated injuries as well as fracture site, classification and injury severity.Accordingly, proper and reasonable surgical plan is made.During the operation, anatomical reduction of the fractures, especially femoral neck fractures, should be achieved, and then fixed with appropriate internal implants.Besides, attention should also be paid to the treatment of associated injuries as well as the prevention and management of complications. PMID:27373484

  3. Management of femoral neck fractures in the young patient: A critical analysis review

    PubMed Central

    Pauyo, Thierry; Drager, Justin; Albers, Anthony; Harvey, Edward J

    2014-01-01

    Femoral neck fractures account for nearly half of all hip fractures with the vast majority occurring in elderly patients after simple falls. Currently there may be sufficient evidence to support the routine use of hip replacement surgery for low demand elderly patients in all but non-displaced and valgus impacted femoral neck fractures. However, for the physiologically young patients, preservation of the natural hip anatomy and mechanics is a priority in management because of their high functional demands. The biomechanical challenges of femoral neck fixation and the vulnerability of the femoral head blood supply lead to a high incidence of non-union and osteonecrosis of the femoral head after internal fixation of displaced femoral neck fractures. Anatomic reduction and stable internal fixation are essentials in achieving the goals of treatment in this young patient population. Furthermore, other management variables such as surgical timing, the role of capsulotomy and the choice of implant for fixation remain controversial. This review will focus both on the demographics and injury profile of young patients with femoral neck fractures and the current evidence behind the surgical management of these injuries as well as their major secondary complications. PMID:25035822

  4. Femoral head diameter in subcapital fracture of the femur in Ibadan, Nigeria.

    PubMed

    Ogunlade, S O; Omololu, A B; Alonge, T O; Obajimi, M O

    2004-09-01

    Subcapital fracture of the femur is common in the elderly patients though the incidence is less in our environment than in the western world. Primary prosthetic replacement is the method of treatment in the majority of the patients. To facilitate this, a foreknowledge of the femoral head diameter is necessary. To determine the diameter of the femoral head and its magnification on radiograph among patients with hip fractures seen in South-West Nigeria, all patients with subcapital fracture of the neck of femur seen between March 1997 and February 2002 were included in the study. The femoral heads were measured on the radiographic film using a transparent ruler and after extraction of the femoral head during surgery using callipers. There were 25 patients in all, the mean age of patients was 73.2 years. Fall at home accounted for 70% of the cases. The femoral head diameter was between 42 mm and 50 mm in 92% of patients while magnification of femoral head diameter on radiograph was 10-14% in 92% of cases. The usaof 10-14% magnification of femoral head on radiograph would help the surgeon determine the size of prosthetic head before commencement of surgery. PMID:15819470

  5. Ultrasound-Guided Diagnosis of Femoral Osteomyelitis and Abscess.

    PubMed

    Hayden, Geoffrey E; Upshaw, Jana E; Bailey, Stephanie; Park, Daniel B

    2015-09-01

    Skin and soft tissue infections are common disease presentations to the pediatric emergency department, and rapid and accurate identification of potentially serious skin and soft tissue infections is critical. In cases of atraumatic musculoskeletal pain with systemic complaints, a bacterial etiology must be ruled out. Point-of-care ultrasonography is increasingly common in the pediatric emergency department and assists in rapid and accurate identification of a variety of disease processes. We present a case of a 14-year-old adolescent boy with atraumatic right knee pain to illustrate the benefits of point-of-care ultrasonography in the timely diagnosis of musculoskeletal and soft tissue pathology. Moreover, we describe the use of ultrasound in procedural guidance of deep-space fluid aspiration, with an eventual diagnosis of femoral osteomyelitis. Ultrasonographic techniques and the emergent work-up and management of osteomyelitis are reviewed. PMID:26335234

  6. Patella dislocation following distal femoral replacement after bone tumour resection

    PubMed Central

    Akiyama, Toru; Kanda, Shotaro; Maeda, Akinori; Endo, Minoru; Saita, Kazuo

    2014-01-01

    We report the case of a 16-year-old girl with patella dislocation following distal femur replacement for a malignant tumour. We performed a medial plication and lateral release procedure to treat her persistent patellar dislocation after distal femur replacement following malignant tumour resection. This treatment improved the patient's gait ability dramatically. A distal femur reconstruction with a total knee arthroplasty (TKA) system for tumour resection is a frequently performed procedure. The reported incidence of patella dislocation following distal femur reconstruction with a TKA is 2.3%. However, treatment procedures for patella dislocation following a distal femur replacement after malignant tumour resection have not been studied extensively. To the best of our knowledge, this is the first English case report about patella dislocation following distal femoral replacement focusing on surgical treatment. Our experience suggests that treatment for patella dislocation following distal femur reconstruction with a TKA should be considered positively. PMID:25073529

  7. The Vascularized Medial Femoral Corticoperiosteal Flap for Thumb Reconstruction

    PubMed Central

    Amin, Kavit; Darhouse, Nagham; Sivakumar, Bran; Floyd, David

    2015-01-01

    Summary: We present an interesting method of shaping a vascularized medial femoral condyle (MFC) flap into a “neophalanx” for phalangeal reconstruction. Our patient presented with limited strength and function secondary to fracture nonunion of the proximal phalanx of the dominant thumb. Following excision of the pseudarthrosis, an MFC corticoperiosteal flap was harvested, sculpted into a prism shape and inset. The superomedial genicular pedicle was anastomosed to the princeps pollicis artery and a cephalic tributary. On follow-up, new bone growth was seen on radiographs and the patient had substantially improved function, with full metacarpophalangeal extension, a Kapandji score of 9, and a markedly reduced Disabilities of the Arm, Shoulder and Hand score of 2.68. The MFC flap is useful for reconstruction of bony defects, with minimal donor morbidity. This versatile vascularized flap can be crafted to requisite shapes and is useful for small defects in the hand, including phalangeal reconstruction. PMID:26495205

  8. Staining and histomorphometry of microcracks in the human femoral head.

    PubMed

    Villanueva, A R; Longo, J A; Weiner, G

    1994-03-01

    We developed staining techniques that permit identification and histomorphometric analysis of microcracks in the human femoral head 1) from thick, ground bone sections (100 microns) by prestaining with the Villanueva mineralized bone stain (MIBS), and 2) from plastic embedded, undecalcified thin bone sections (5-15 microns) by staining in gallocyanin chrome alum-Villanueva blood stain methods. Both methods represent a significant improvement in the stainability of the microcracks, cellular and tissue elements, and the simultaneous assessment of osteoid seams and tetracycline markers by histomorphometry. Shrinkage and other artifacts were minimized, which helped to clarify some of the uncertainties arising from artifacts resulting from some bone staining methods. Histomorphometric analyses of microcracks were conducted on thick, ground sections of subchondral and trabecular bone. Microcracks were more prevalent in the subchondral bone and osteochondral junction than in the more distant trabeculae. We have consistently localized microcrack areas in bone tissues prepared in these ways. PMID:7515700

  9. Orrorin tugenensis femoral morphology and the evolution of hominin bipedalism.

    PubMed

    Richmond, Brian G; Jungers, William L

    2008-03-21

    Bipedalism is a key human adaptation and a defining feature of the hominin clade. Fossil femora discovered in Kenya and attributed to Orrorin tugenensis, at 6 million years ago, purportedly provide the earliest postcranial evidence of hominin bipedalism, but their functional and phylogenetic affinities are controversial. We show that the O. tugenensis femur differs from those of apes and Homo and most strongly resembles those of Australopithecus and Paranthropus, indicating that O. tugenensis was bipedal but is not more closely related to Homo than to Australopithecus. Femoral morphology indicates that O. tugenensis shared distinctive hip biomechanics with australopiths, suggesting that this complex evolved early in human evolution and persisted for almost 4 million years until modifications of the hip appeared in the late Pliocene in early Homo. PMID:18356526

  10. [The sulcus angle of the femoral trochlea: ultrasonographic evaluation].

    PubMed

    Martino, F; De Serio, A; Macarini, L; Colaianni, P; Solarino, M; Fracella, M R

    1995-03-01

    The sulcus angle of femoral trochlea is particularly important to evaluate the femoro-patellar joint. Our study was aimed at studying the normal trochlea, and especially the sulcus angle, with US. The right knees of 11 normal subjects were examined with US and Computed Tomography (CT) on the same section planes. The US measurements of the sulcus angle were correlated with CT results, which were considered the gold standard. The US and CT data were compared and a direct correlation was found (r = 0.832). The intraobserver difference in US measurements was r = 0.943. The mean sulcus angle value was 132 degrees, in agreement with literature data. We conclude that the US measurements of the sulcus angle are reproducible and as sensitive as CT. PMID:7754110

  11. Modeling polyethylene wear acceleration due to femoral head dislocation damage.

    PubMed

    Kruger, Karen M; Tikekar, Nishant M; Heiner, Anneliese D; Lannutti, John J; Callaghan, John J; Brown, Thomas D

    2014-08-01

    Scratching, scraping, and metal transfer to femoral heads commonly accompany acetabular shell contact during dislocation and closed reduction maneuvers. While head damage conceptually leads to accelerated wear, reports on this subject are mainly anecdotal, and differ widely on the potency of such effect. Towards better understanding this relationship, a physically validated finite element (FE) model was used to compute polyethylene wear acceleration propensity of specific head damage patterns on thirteen retrievals. These FE models estimated wear increases averaging half an order of magnitude when compared to simulations for undamaged heads. There was no correlation between the number of dislocations sustained and wear acceleration. These results underscore the importance of implant-gentle closed reduction, and heightened wear monitoring of successfully reduced dislocation patients. PMID:24851789

  12. Bilateral Femoral Nutrient Foraminal Cement Penetration during Total Hip Arthroplasty

    PubMed Central

    Coomber, Ross; Bhumbra, Rej S; Marston, Robert

    2012-01-01

    Introduction: Cement pressurisation is important for the insertion of both the acetabular and femoral components during Total Hip Arthroplasty (THA). Secondary to pressurization the rare phenomenon of unilateral cement incursion into the nutrient foramen has previously been reported. No bilateral case has been reported to date. This has implications both for misdiagnosis of periprosthetic fractures and for medico-legal consequences due to a presumed adverse intra-operative event. Case Report: We present a case report of a 59 year old, caucasian female who underwent staged bilateral cemented Stanmore THA. The post-operative radiographs demonstrate evidence of bilateral nutrient foramen penetration intra-operatively by standard viscosity cement. The patient suffered no adverse consequences. Conclusions: In summary, cement extravasation into the nutrient foramen is an important differential to be considered in presence of posterior-medial cement in the diaphysis of femur following THA. This requires no further intervention and has no effect on the outcome.

  13. Femoral neck fracture fixation: rigidity of five techniques compared.

    PubMed Central

    Mackechnie-Jarvis, A C

    1983-01-01

    Artificial cadaveric femoral neck fractures were internally fixed with five different devices and subjected to cyclical loading of 0-1.0 kilonewtons (approximately one body weight) whilst in an anatomical position. Displacement of the proximal fragment was detected by a transducer and charted. Bone strength was assessed by a preliminary control loading phase on the intact bone. Efficiency of each fracture fixator could then be directly compared by the relative movement in each case. Five specimens each were tested with Moore's Pins, Trifin Nail, Garden Screws and a sliding screw-plate (OEC Ltd). By the criteria of the experiment, which put a severe shearing load on the implant, none of these devices reliably bore the representative body weight. An extended barrel-plate, which supported the sliding screw almost up to the fracture line, was then made. This device, employing some of Charnley's concepts, tolerated body weight in four cases out of five. PMID:6887186

  14. Scaling in Theropod Dinosaurs: Femoral Bone Strength and Locomotion II

    NASA Astrophysics Data System (ADS)

    Lee, Scott

    2015-03-01

    In the second paper1 of this series, the effect of transverse femoral stresses due to locomotion in theropod dinosaurs of different sizes was examined for the case of an unchanging leg geometry. Students are invariably thrilled to learn about theropod dinosaurs, and this activity applies the concepts of torque and stress to the issue of theropod locomotion. In this paper, our model calculation of Ref. 1 is extended to incorporate the fact that larger animals run with straighter legs. As in Ref. 1, students use geometric data for the femora of theropod dinosaurs to analyze their locomotion abilities. This can either be an in-class activity or given as a homework problem. Larger theropods are found to be less athletic in their movements than smaller theropods since the stresses in the femora of large theropods are closer to breaking their legs than smaller theropods.

  15. Imaging evaluation of patients with osteonecrosis of the femoral head.

    PubMed

    Pierce, Todd P; Jauregui, Julio J; Cherian, Jeffrey J; Elmallah, Randa K; Mont, Michael A

    2015-09-01

    Imaging modalities for the diagnosis of osteonecrosis (ON) of the femoral head have been studied extensively, but there have been few reports strictly addressing radiographic evaluation. The purpose of this report is to examine the use and role of (1) plain radiographs, (2) magnetic resonance imaging (MRI), (3) computerized tomography (CT), (4) bone scanning, and (5) positron emission topography (PET) for the diagnostic evaluation of ON. Plain radiographs are a mainstay in diagnosis but have very low sensitivity for early ON. MRI is the gold standard for diagnostic evaluation but may not identify subchondral fractures on collapse as well as CT scan or tomogram. Bone scanning should not be used for diagnosis due to its low sensitivity. PET scanning does not have a definitive role in diagnosis yet. Future research should focus on the role of new imaging technologies in evaluation. PMID:26045084

  16. Subsidence of the femoral prosthesis. A stereophotogrammetric evaluation.

    PubMed

    Chafetz, N; Baumrind, S; Murray, W R; Genant, H K; Korn, E L

    1985-12-01

    A quantitative three-dimensional measurement method, radiographic stereophotogrammetry (SPG), was employed to assess the relation between early subsidence of the femoral prosthesis after total hip arthroplasty (THA) and subsequent clinical course. The SPG technique and the authors' error control mechanisms are described in 15 patients in the early postoperative period, and the findings are correlated with those of follow-up clinical examinations. Among the 12 patients who remained clinically asymptomatic with respect to pain, only one had an SPG estimate of subsidence in excess of 1 mm at any point in time. Each of the three patients who later became symptomatic had SPG estimates of subsidence in excess of 1.75 mm within six months of the operation. Thus far, the patient with the largest estimate of subsidence is the only one who required surgical revision. PMID:4064420

  17. A critical assessment of proximal macrotexturing on cemented femoral components.

    PubMed

    Duffy, G P; Muratoglu, O K; Biggs, S A; Larson, S L; Lozynsky, A J; Harris, W H

    2001-12-01

    We analyzed the cement-metal interface of 3 different types of femoral components that had proximal macrotexturing after in vitro insertion and after fatigue testing designed to produce debonding and micromotion. These components were compared with clinical retrieval specimens. The cement did not flow into the macrotexturing; rather, hollow, brittle volcanoes or calderas were formed. These fragile protrusions of cement become worn down or abraded by debonded components. This abrasion of cement may contribute to the early and aggressive osteolysis seen in some of these early failures with proximal macrotextured components. The formation of these volcanos and calderas can be aborted by placing bone-cement onto the macrotexturing before stem insertion. This simple technique allows the macrotexturing to be filled with cement. PMID:11742450

  18. HEMIARTHROPLASTY IN THE TREATMENT FRACTURES OF THE FEMORAL NECK

    PubMed Central

    Ono, Nelson Keiske; de Andrade Lima, Guilherme Didier; Honda, Emerson Kiyoshi; Polesello, Giancarlo Cavalli; Guimarães, Rodrigo Pereira; Júnior, Walter Ricioli; de Queiroz, Marcelo Cavalheiro

    2015-01-01

    Objective: To epidemiologically and clinically evaluate patients with displaced femoral neck fractures that were surgically treatment with cemented hip hemiarthroplasty. Methods: All patients with displaced femoral neck fractures (Garden III and IV) who underwent cemented hip hemiarthroplasty using a unipolar prosthesis (Thompson), by means of a posterolateral access between June 2005 and September 2008 were retrospectively evaluated. Results: Seventy patients were initially evaluated. Their mean age was 83.1 years. The patients were predominantly female (84.3%). Thirty-six patients were monitored as outpatients for periods ranging from 10 to 48 months (mean of 26.5 months). Fifteen patients were lost to follow-up. Nineteen patients died, and the mortality rate within the first year was 25.4%. Patients classified as ASA III had a mortality rate of 25.7% and ASA II patients, a rate of 12.1%. Two patients had symptomatic deep vein thrombosis; one patient had an operative wound infection; and none of the patients presented hip dislocation. Most of the patients did not experience pain. Twelve patients (33%) showed deterioration of their walking ability. Conclusion: There were no cases of hip dislocation. Patients classified as ASA III had a higher mortality rate than did patients with ASA I or II. There was a worsening of walking ability in 33% of the patients. No revision due to loosening or pain was needed for any patient. Thirty patients did not present any pain (83.3%), four presented moderate pain (11.1%) and two presented intense pain (5.5%). PMID:27022567

  19. Calcar Preservation Arthroplasty for Unstable Intertrochanteric Femoral Fractures in Elderly

    PubMed Central

    Togrul, Emre; Kose, Ozkan

    2015-01-01

    Background The treatment of unstable intertrochanteric fractures in elderly is still controversial. The purpose of this study is to present treatment strategies for unstable intertrochanteric fractures with hemiarthroplasty using standard uncemented collared femoral stems and at the same time preserving the fractured calcar fragment. Methods Fifty-four patients aged 75 years or older with unstable intertrochanteric fractures were included in this prospective cohort study. All patients were treated with calcar preserving hemiarthroplasty using cementless collored femoral stems. Fractured calcar fragment was stabilized either by compaction between the implant and femur or fixed with cable grip system. Follow-up evaluations were performed at least 24 months and later. Palmer and Parker mobility score and visual analogue scale (VAS) pain score were assessed. We also analyzed radiographs of the operated hip at each follow-up visit. Results The patients were 15 males and 39 females with a mean age of 81.3 years (range, 75 to 93 years). The average operative time was 86.6 minutes. The mean transfused blood units were 1.2 units. The average duration of hospital stay was 5.3 days. The preoperative mean mobility score was 6.20. This score was found to be 4.96 on postoperative third day and 5.90 at 24 months postoperatively. The results of the statistical analysis revealed significant increase in the mobility scores at each follow-up after three days. Radiological interpretation revealed no loosening in the cable-grip systems, and no significant subsidence (> 5 mm) of prosthesis was observed. Conclusions Calcar preservation arthroplasty is a good option for elderly patients with severe osteoporosis, frail constitution and the patients who are at higher risk for second operation due to unstable intertrochanteric fractures. PMID:26640625

  20. Femoral Artery Stenosis Following Percutaneous Closure Using a Starclose Closure Device

    SciTech Connect

    Bent, Clare Louise; Kyriakides, Constantinos; Matson, Matthew

    2008-07-15

    Starclose (Abbott Vascular Devices, Redwood City, CA) is a new arterial closure device that seals a femoral puncture site with an extravascular star-shaped nitinol clip. The clip projects small tines into the arterial wall which fold inward, causing the arterial wall to pucker, producing a purse-string-like seal closing the puncture site. The case history is that of a 76-year-old female patient who underwent day-case percutaneous diagnostic coronary angiography. A Starclose femoral artery closure device was used to achieve hemostasis with subsequent femoral artery stenosis.

  1. Subchondral Insufficiency Fracture of the Femoral Head Caused by Excessive Lateralization of the Acetabular Rim

    PubMed Central

    Kimura, Tetsuya; Goto, Tomohiro; Hamada, Daisuke; Tsutsui, Takahiko; Wada, Keizo; Fukuta, Shoji; Nagamachi, Akihiro; Sairyo, Koichi

    2016-01-01

    We present a case of a 53-year-old woman with subchondral insufficiency fracture (SIF) of the femoral head without history of severe osteoporosis or overexertion. Plain radiographs showed acetabular overcoverage with excessive lateralization of the acetabular rim. A diagnosis of SIF was made by typical MRI findings of SIF. The lesion occurred at the antipodes of the extended rim. Increased mechanical stress over the femoral head due to impingement against the excess bone was suspected as a cause of SIF. The distinct femoral head deformity is consistent with this hypothesis. This is the first report of SIF associated with acetabular overcoverage. PMID:27293935

  2. Postcatheterization Femoral Arteriovenous Fistula: Endovascular Treatment with N-Butyl-Cyanoacrylate Embolization

    SciTech Connect

    Onal, Baran Ilgit, Erhan T.; Akpek, Sergin; Coskun, Bilgen

    2006-04-15

    We report a case of an iatrogenic femoral arteriovenous fistula (AVF) in a 67-year-old man presenting with right femoral bruit on the day after sheath removal for cardiac catheterization. This was successfully treated with embolization using N-butyl-cynoacrylate (NBCA) through a coaxial microcatheter. Transcatheter embolization of iatrogenic femoral AVFs with NBCA in selected cases may be a safe and effective treatment in the presence of long fistula tracts. It is then easy to perform in experienced hands and relatively inexpensive.

  3. Effects of pulsed infra-red low level-laser irradiation on open skin wound healing of healthy and streptozotocin-induced diabetic rats by biomechanical evaluation.

    PubMed

    Dadpay, Masoomeh; Sharifian, Zanelabedien; Bayat, Mohammad; Bayat, Mehrnoush; Dabbagh, Ali

    2012-06-01

    Diabetes is one of the most common causes of delayed wound healing. Low-level laser therapy (LLLT) are one of the therapeutic modalities used for the treatment of wounds. The aim of present study is to evaluate the effect of LLLT in experimentally-induced diabetic rats. Two full thickness skin incisions were made on dorsal regions of each rat. The wounds were randomly divided into laser-treated and placebo. Laser-treated wounds of the healthy (non-diabetic) animals were submitted to a pulsed-infrared 890nm laser with an 80Hz frequency and 0.03J/cm(2) for each wound point in the first healthy group and 0.2J/cm(2) in the second healthy group. Laser-treated wounds of the diabetic animals received the same pulsed-infrared laser treatments as the second group for each wound point. On day 15, a sample from each wound was extracted and submitted for tensile strength evaluation. Laser irradiation with 0.03J/cm(2) significantly decreased the maximum load for wound repair in healthy rats (p=0.015). Laser irradiation with 0.2J/cm(2) significantly increased the maximum load in wounds from the healthy control (p=0.021) and diabetic (p<001) groups. Laser treatments with a pulsed infrared laser at 0.2J/cm(2) significantly accelerated wound healing in both healthy and diabetic rats. PMID:22494918

  4. Suture-mediated closure of antegrade femoral arteriotomy following infrainguinal intervention.

    PubMed

    Khosla, Sandeep; Kunjummen, Binu; Guerrero, Mayra; Manda, Ravi; Razminia, Mansoor; Ahmed, Aziz

    2002-12-01

    Antegrade femoral arterial access has been less commonly adopted for infrainguinal intervention due to increased risk of retroperitoneal hemorrhage secondary to noncompressibility of arteriotomy site. We evaluated the efficacy and safety of suture-mediated closure of antegrade femoral arteriotomy using the Closer device. Twelve consecutive patients undergoing infrainguinal intervention (females, 5; mean body weight, 69 +/- 16 kg; limb threatening ischemia, 50%) underwent repair of the antegrade femoral arteriotomy immediately postprocedure using the Closer. Indications for antegrade access were excessive iliac tortuosity (6/12), long femoral artery occlusion (5/12), and bilateral aortoiliac bifurcation stents (1/12). The acute procedural success (immediate hemostasis without need for manual compression) was 100%. The mean time to ambulation was 3.9 +/- 1.5 hr and the procedure-related length of stay was 18 +/- 5.5 hr. In conclusion, repair of antegrade arterial puncture is safe and effective following infrainguinal intervention. PMID:12455086

  5. Comparison of femoral inclination angle measurements in dysplastic and nondysplastic dogs of different breeds.

    PubMed

    Sarierler, M

    2004-01-01

    In this study, inclination angle of the femoral head and neck was measured on 484 limbs of 242 dogs belonging to 7 breeds, examined for hip dysplasia. These inclination angles were compared according to age, sex and joint laxity, evaluated with Subluxation Index (SI) and Norberg angle (NA) results. The findings indicate that (a) there was a minimal (nonsignificant) difference in femoral inclination angle between the dysplastic and nondysplastic dogs belonging to 7 breeds; (b) although there was no significant difference in femoral inclination angle between the nondysplastic dogs belonging to 4 breeds (Pointer, Irish Setter, Golden Retriever and German Shepherd), a significant difference was observed between Doberman and Labrador, and between Anatolian Karabash and the other six breeds (p < 0.001). Age and sex did not affect the femoral neck angle. PMID:15168756

  6. Cross-match protocols for femoral neck fractures--finding one that can work.

    PubMed Central

    Khan, A. M.; Mushtaq, N.; Giannakas, K.; Sochart, D. H.; Andrews, J. G.

    2004-01-01

    BACKGROUND: Cross-match practice for patients with femoral neck fractures continues to cause concern due to a failure of compliance to the existing protocols. To address this issue, a number of studies were conducted over a 3-year period. METHODS: First, the existing cross-match practice for patients admitted with femoral neck fractures was reviewed to demonstrate the deficiencies within the system. Second, the opinion of anaesthetic and orthopaedic trainees was assessed regarding blood requirements for different femoral neck fractures following surgery and the justification of their perceptions. RESULTS: A summation of the studies is reported which demonstrates the reasons for the poor compliance to previous protocols. CONCLUSIONS: A simple and effective protocol is provided that has helped reduce pre-operative cross-matching of femoral neck fractures from 71% to 16.7% when assessed 2 years after its introduction. PMID:15005938

  7. Iatrogenic Femoral Pseudoaneurysm and Secondary Ipsilateral Deep Vein Thrombosis: An Indication for Early Surgical Exploration.

    PubMed

    Papadakis, Marios; Zirngibl, Hubert; Floros, Nikolaos

    2016-07-01

    Pseudoaneurysm formation often complicates transfemoral interventional procedures. Nonsurgical treatment consists of femoral compression and thrombin injection under ultrasound guidance. We report a 74-year-old man who was diagnosed with a pseudoaneurysm, following coronary angiography. Duplex ultrasound revealed deep vein thrombosis of the ipsilateral common femoral vein. Ultrasound-guided thrombin injection was unsuccessfully performed, and the patient subsequently underwent surgical exploration for repair of the pseudoaneurysm and release of the venous compression. The increased local inflammation, because of the thrombosis, added in surgical difficulties. We conclude that early surgical intervention should be considered as a primary strategy in patients with femoral pseudoaneurysms and deep vein thrombosis secondary to femoral compression. PMID:27174354

  8. A three-dimensional axis for the study of femoral neck orientation

    PubMed Central

    Bonneau, Noémie; Libourel, Paul-Antoine; Simonis, Caroline; Puymerail, Laurent; Baylac, Michel; Tardieu, Christine; Gagey, Olivier

    2012-01-01

    A common problem in the quantification of the orientation of the femoral neck is the difficulty to determine its true axis; however, this axis is typically estimated visually only. Moreover, the orientation of the femoral neck is commonly analysed using angles that are dependent on anatomical planes of reference and only quantify the orientation in two dimensions. The purpose of this study is to establish a method to determine the three-dimensional orientation of the femoral neck using a three-dimensional model. An accurate determination of the femoral neck axis requires a reconsideration of the complex architecture of the proximal femur. The morphology of the femoral neck results from both the medial and arcuate trabecular systems, and the asymmetry of the cortical bone. Given these considerations, two alternative models, in addition to the cylindrical one frequently assumed, were tested. The surface geometry of the femoral neck was subsequently used to fit one cylinder, two cylinders and successive cross-sectional ellipses. The model based on successive ellipses provided a significantly smaller average deviation than the two other models (P < 0.001) and reduced the observer-induced measurement error. Comparisons with traditional measurements and analyses on a sample of 91 femora were also performed to assess the validity of the model based on successive ellipses. This study provides a semi-automatic and accurate method for the determination of the functional three-dimensional femoral neck orientation avoiding the use of a reference plane. This innovative method has important implications for future studies that aim to document and understand the change in the orientation of the femoral neck associated with the acquisition of a bipedal gait in humans. Moreover, the precise determination of the three-dimensional orientation has implications in current research involved in developing clinical applications in diagnosis, hip surgery and rehabilitation. PMID:22967192

  9. Adventitial cystic disease of the common femoral vein presenting as deep vein thrombosis.

    PubMed

    Kim, Young-Kyun; Chun, Ho Jong; Hwang, Jeong Kye; Kim, Ji Il; Kim, Sang Dong; Park, Sun-Cheol; Moon, In Sung

    2016-07-01

    Adventitial cystic disease of the common femoral vein is a rare condition. We herein report the case of a 50-year-old woman who presented with painless swelling in her left lower leg that resembled deep vein thrombosis. She underwent femoral exploration and excision of the cystic wall. The presentation, investigation, treatment, and pathology of this condition are discussed with a literature review. PMID:23978427

  10. Curvature analysis of femoral shaft in total knee arthroplasty patient and control group.

    PubMed

    Lim, Ki Seon; Oh, Wang Kyun; Shin, Ji Yun; Cho, Byung Ki; Lee, Tae Soo

    2013-01-01

    For some patients with joint illnesses such as rheumarthritis or varus deformity, the total knee arthroplasty (TKA) procedures are performed. However, when inserting metal cutting guide for the procedures, due to the femoral shaft bowing, complications such as the cortex of the femoral shaft damages or secondary fractures can be caused. If the central coordinate value of the femoral shaft is known, the metal cutting guide could be inserted into the anatomical center, so such complications can be prevented. In this study, CT images of femoral shafts of 10 individuals in the experiment group who are in need of receiving the total knee arthroplasty procedures and those of 10 individuals in the control group without illness in the femoral shaft have been utilized to locate the 3-dimensional coordinate values. Then, Matlab was utilized to identify the central coordinate value in order to obtain a graph reflecting the anatomical shapes as well as to acquire the 3-dimensional curvature values by section. As a result, the average curvature range of femoral shafts of the experiment group was determined to be 631.2 mm whereas the average curvature range of femoral shafts of the control group was determined to be 1430.4 mm. The statistical significant of the measured results was verified through ANOVA analysis. Based on these results, it was verified that the level of curvature of the femoral shaft of the experiment group was higher. If the anatomical central points are located and analyzed using this methodology, it would be helpful in performing orthopedic operations such as the total knee arthroplasty. PMID:24110202

  11. Extraluminal lipoma with common femoral vein obstruction: a cause of chronic venous insufficiency.

    PubMed

    Gasparis, Antonios P; Tsintzilonis, Stylianos; Labropoulos, Nicos

    2009-02-01

    A 49-year-old man, with a misdiagnosis of common femoral vein deep vein thrombosis presented with advanced chronic venous insufficiency. Further imaging revealed a patent common femoral vein with augmentation that was compressed by an extrinsic mass. Exploration identified a lipoma that was extravascular and was resulting in venous outflow obstruction. Excision of the lipoma resulted in clinical improvement and ulcer healing. PMID:19216966

  12. USE OF CORTICAL STRUCTURAL HOMOLOGOUS BONE GRAFT IN FEMORAL RECONSTRUCTIVE SURGERY

    PubMed Central

    Roos, Milton Valdomiro; Roos, Bruno Dutra; Giora, Taís Stedile Busin; Taglietti, Thiago Martins

    2015-01-01

    To perform a clinical and radiographic assessment of patients undergoing surgical treatment using a cortical structural homologous bone graft for femoral reconstruction following mechanical failure of total hip arthroplasty and periprosthetic fractures. Methods: A retrospective study was conducted on 27 patients who underwent surgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty (12 cases) and periprosthetic fractures (15 cases), using a cortical structural homologous bone graft and cemented implants, between June 1999 and February 2008. Of these, 21 fulfilled all the criteria required for this study. The patients underwent pre and postoperative clinical assessments using the Harris Hip Score. Preoperative, immediate postoperative and late postoperative radiographs were also evaluated, with comparisons of fracture consolidation, radiographic signs of graft consolidation, changes to the bone stock and femoral bone quality, and femoral alignment. Results: Nine patients (42.9%) underwent femoral reconstruction following mechanical failure of total hip arthroplasty and 12 cases (57.1%) underwent femoral reconstruction following periprosthetic fracture. Regarding the postoperative clinical classification, the results were considered satisfactory in 85.7% of the cases and unsatisfactory in 14.3%. Radiographic signs of graft consolidation were seen in all cases. There was an increase in bone stock in 90.5% of the hip reconstructions, as measured by the cortical index. Furthermore, the changes to femoral bone quality were considered good in 66.7% of the cases. Conclusion: The use of cortical structural homologous bone grafts for both femoral reconstructive surgery on total hip arthroplasty and periprosthetic fractures is a good treatment option for selected cases, enabling satisfactory clinical and radiographic results. PMID:27026955

  13. A complication during femoral broaching in total hip arthroplasty: a case report.

    PubMed

    Waldstein, Wenzel; Boettner, Friedrich

    2013-01-01

    Press-fit component fixation is one of the primary goals in uncemented total hip arthroplasty. When aiming at proximal load transfer, the stem size has to be selected with regard to the shape of the proximal femoral canal. This can be challenging in patients with 'champagne flute' femurs with a relatively narrow diaphysis, especially when a long stem femoral component is used. The present case report describes a complication during femoral broaching for a primary uncemented femoral component. Because of the narrow diaphysis, the distal portion of the broach got caught in the narrow canal and it became impossible to remove the broach with conventional techniques. Via a second distal incision, the femur was split from the distal tip of the broach to approximately 5 cm distal of the femoral neck cut along the posterior aspects of the femur. This loosened the broach enough to allow for an uncomplicated removal. The longitudinal split was secured with cables before a similar size primary implant was press fitted into the femoral canal. PMID:23961301

  14. RigidFix femoral fixation: a test for detecting inaccurate cross pin positioning.

    PubMed

    Papastergiou, Stergios G; Koukoulias, Nikolaos E; Dimitriadis, Theofilos; Pappis, Georgios; Parisis, Constantinos A

    2007-11-01

    The RigidFix Cross Pin System (DePuy Mitek, Raynham, MA) is a popular technique for femoral fixation of graft in ACL reconstruction. In some cases, though, cross pins miss the femoral tunnel resulting in inadequate proximal graft fixation. We present a simple test to detect the incorrect placement of cross pins. The pinholes are drilled through the guide frame, leaving 2 sleeves for cross pins insertion. The manufacturer's recommendations, at this stage, are to reinsert the femoral tunnel guidewire, remove the guide frame, and insert the graft without verifying accurate pinhole positioning. We reinsert the femoral tunnel guidewire without removing the guide frame, and a second guidewire is introduced through each of the sleeves in turn. In case of appropriate pinhole placement, the 2 guidewires will meet in the cannulated rod of the guide frame and the surgeon will have the metal-to-metal feeling. If the pinhole misses the femoral tunnel, the 2 guidewires will not meet and the surgeon will not have the metal-to-metal feeling. In our practice, 9 cases of inaccurate pinhole placement were detected with this test and verified by direct vision of the femoral tunnel with the arthroscope. We find this test simple, reliable, and not time consuming. PMID:17986419

  15. What is the optimal alignment of the tibial and femoral components in knee arthroplasty?

    PubMed Central

    Gromov, Kirill; Korchi, Mounim; Thomsen, Morten G; Husted, Henrik; Troelsen, Anders

    2014-01-01

    Background Surgeon-dependent factors such as optimal implant alignment are thought to play a significant role in outcome following primary total knee arthroplasty (TKA). Exact definitions and references for optimal alignment are, however, still being debated. This overview of the literature describes different definitions of component alignment following primary TKA for (1) tibiofemoral alignment in the AP plane, (2) tibial and femoral component placement in the AP plane, (3) tibial and femoral component placement in the sagittal plane, and (4) rotational alignment of tibial and femoral components and their role in outcome and implant survival. Methods We performed a literature search for original and review articles on implant positioning following primary TKA. Definitions for coronal, sagittal, and rotational placement of femoral and tibial components were summarized and the influence of positioning on survival and functional outcome was considered. Results Many definitions exist when evaluating placement of femoral and tibial components. Implant alignment plays a role in both survival and functional outcome following primary TKA, as component malalignment can lead to increased failure rates, maltracking, and knee pain. Interpretation Based on currently available evidence, surgeons should aim for optimal alignment of tibial and femoral components when performing TKA. PMID:25036719

  16. Simulated knee wear with cobalt chromium and oxidized zirconium knee femoral components.

    PubMed

    White, S E; Whiteside, L A; McCarthy, D S; Anthony, M; Poggie, R A

    1994-12-01

    A knee simulator that mimics the plowing/rolling wear mechanisms of the knee was used to compare wear properties of cobalt chromium and oxidized zirconium femoral components. The simulator flexes and extends the knee so that the femoral components travels from 0 degrees to 30 degrees while applying axial loads from 130 to 1300 lb. Three oxidized zirconium and 3 cobalt chromium femoral components were tested with 10-mm tibial polyethylene components. The oxidized zirconium femoral components caused significantly less ultra high molecular weight polyethylene wear than cobalt chromium femoral components. Tibial inserts that were articulated against the cobalt chromium components had evidence of scratching, burnishing, and delamination, but none of the surfaces that were articulated against oxidized zirconium components had evidence of delamination. Cobalt chromium surface roughness significantly increased during the 2,000,000 cycle test, but oxidized zirconium surface roughness was not affected. Polyethylene wear was correlated to a significant degree with the surface roughness of the femoral components. The improved wear characteristics of the ceramic articular surfaces can be explained by the wettability of the ceramic surface, which minimized adhesive wear, and the resistance of the hard, ceramic surface to roughening. PMID:7994957

  17. Microstructure analysis and wear behavior of titanium cermet femoral head with hard TiC layer.

    PubMed

    Luo, Yong; Ge, Shirong; Liu, Hongtao; Jin, Zhongmin

    2009-12-11

    Titanium cermet was successfully synthesized and formed a thin gradient titanium carbide coating on the surface of Ti6Al4V alloy by using a novel sequential carburization under high temperature, while the titanium cermet femoral head was produced. The titanium cermet phase and surface topography were characterized with X-ray diffraction (XRD) and backscattered electron imaging (BSE). And then the wear behavior of titanium cermet femoral head was investigated by using CUMT II artificial joint hip simulator. The surface characterization indicates that carbon effectively diffused into the titanium alloys and formed a hard TiC layer on the Ti6Al4V alloys surface with a micro-porous structure. The artificial hip joint experimental results show that titanium cermet femoral head could not only improve the wear resistance of artificial femoral head, but also decrease the wear of UHMWPE joint cup. In addition, the carburized titanium alloy femoral head could effectively control the UHMWPE debris distribution, and increase the size of UHMWPE debris. All of the results suggest that titanium cermet is a prospective femoral head material in artificial joint. PMID:19836751

  18. Hip contact stress and femoral neck retroversion: a biomechanical study to evaluate implication of femoroacetabular impingement

    PubMed Central

    Satpathy, Jibanananda; Kannan, Arun; Owen, John R.; Wayne, Jennifer S.; Hull, Jason R.; Jiranek, William A.

    2015-01-01

    The current literature on femoroacetabular impingement (FAI) is focused on acetabular orientation and femoral head asphericity, with little emphasis on the effect of version of the femoral neck. A biomechanical model was developed to determine the causative effect, if any, of femoral retroversion on hip contact stress and, if present, delineate the type of FAI with femoral neck retroversion. Five pairs of cadaveric hips (n = 10) were tested by loading the hip in 90° of flexion and measured the peak joint pressure and the location of the peak joint pressure. The experiment was repeated after performing a subtrochanteric osteotomy and retroverting the proximal femur by 10°. Ten hips were successfully tested, with one hip excluded due to an outlier value for peak joint pressure. Retroversion of the proximal femur significantly increased the magnitude of mean peak joint pressure. With retroversion, the location of the peak joint pressure was shifted posteroinferiorly in all cases. In conclusion, femoral neck retroversion increases peak joint pressure in the flexed position and may act as a cause of femoroacetabular impingement. The location of peak joint pressure suggests a pincer-type impingement with retroversion. The version of femoral neck should be assessed as a possible causative factor in patients with FAI, especially those with pincer-type impingement. PMID:27011851

  19. Arthroscopic repair of "peel-off" lesion of the posterior cruciate ligament at the femoral condyle.

    PubMed

    Rosso, Federica; Bisicchia, Salvatore; Amendola, Annunziato

    2014-02-01

    Posterior cruciate ligament (PCL) injuries are uncommon, and most occur in association with other lesions. The treatment of PCL injuries remains controversial; in addition, PCL injuries have been documented to have a propensity to heal. In the literature several different patterns of PCL injury have been described including midsubstance tears/injuries, tibial bony avulsions, femoral bony avulsions, and femoral "peel-off" injuries. A peel-off injury is a complete or incomplete soft-tissue disruption of the PCL at its femoral attachment site without associated bony avulsion. In recent years arthroscopic repair of femoral avulsion and peel-off lesions of the PCL has been reported. In most of these articles, a transosseous repair with sutures passed through 2 bone tunnels into the medial femoral condyle has been described. We present a case of a femoral PCL avulsion in a 20-year-old collegiate football player with an associated medial collateral ligament injury, and we report about a novel technique for PCL repair using 2 No. 2 FiberWire sutures and two 2.9-mm PushLock anchors (Arthrex) to secure tensioning the ligament at its footprint. PMID:24749037

  20. Avascular necrosis of the femoral head at 2 years after pertrochanteric fracture surgery: Case report

    PubMed Central

    Deleanu, Bogdan; Prejbeanu, Radu; Vermesan, Dinu; Honcea, Lucian; Mioc, Mihail Lazar; Tsiridis, Eleftherios; Predescu, Vlad

    2015-01-01

    Introduction The avascular necrosis of the femoral head represents the death of bone tissue due to the lack of blood supply. The disease has a progressive evolution and left untreated leads to femoral head collapse and severe arthritis. Case presentation We present a case of a pertrochanteric fracture which has been successfully operated with a dynamic interlocking trochanteric gamma nail on the right hip. At 2 years after surgery the patient developed an incipient avascular necrosis of the femoral head. Despite the good positioning of the implant, we considered that the source of the pain was an intolerance of the implant, and thus we removed it. After implant removal, the patient was kept under observation and conservative treatment, to prevent further damage to the right hip and allow the healing to occur. At 6 months after the gamma nail was removed the X-rays revealed advanced avascular necrosis of the femoral head and secondary osteoarthritis on the right hip. The patient underwent surgery with an uncemented total hip arthroplasty. Discussion There are a few discussions regarding the avascular necrosis of the femoral head. These discussions may include the predisposing risk factors, the treatment of choice and the postoperative complications. Conclusion The avascular necrosis of the femoral head is a complication of pertrochanteric fractures that can not be foreseen or avoided. The optimal treatment in these cases is uncemented total hip arthroplasty. PMID:26900462

  1. Predictors of atypical femoral fractures during long term bisphosphonate therapy: A case series & review of literature

    PubMed Central

    Bhadada, Sanjay Kumar; Sridhar, Subbiah; Muthukrishnan, Jeyaram; Mithal, Ambrish; Sharma, Dinesh C.; Bhansali, Anil; Dhiman, Vandana

    2014-01-01

    Background & objectives: Bisphosphonates (BPs) are the most widely prescribed medicines for the treatment of osteoporosis because of their efficacy and favourable safety profile. There have been, several reports on an increased incidence of atypical femoral fractures after long term treatment with BPs. The objective of this study was to evaluate the clinical presentation including prodromal symptoms, skeletal radiograph findings, type and duration of BPs received and treatment outcome of patients who developed atypical femoral fractures during bisphosphonate therapy. Methods: In this retrospective study, eight patients with atypical femoral fractures were analysed based on clinical features, biochemical and radiological investigations. Results: Of the eight patients, who sustained atypical femoral fractures, six were on alendronate and two were on zoledronate therapy before the fractures. In addition to BPs, two patients were on long term corticosteroid therapy for rheumatoid arthritis and Addison's disease. Three patients had bilateral atypical femoral fractures. Except one, all of them had prodromal symptoms prior to fracture. Skeletal radiograph showed cortical thickening, pointed (beaking of) cortical margin and transverse fracture in meta-diaphyseal location. Serum calcium, phosphate, alkaline phosphatase (ALP) and intact parathyroid hormone (iPTH) concentrations were within the reference range in all patients. Interpretation & conclusions: Long term bisphosphonate therapy may increase the risk of atypical femoral fractures. Presence of prodromal pain, thickened cortex with cortical beaking may be an early clue for predicting the atypical fractures. High risk patients need periodical skeletal survey and a close follow up for early detection of cases. PMID:25222777

  2. Biomechanical optimization of subject-specific implant positioning for femoral head resurfacing to reduce fracture risk.

    PubMed

    Miles, Brad; Kolos, Elizabeth; Appleyard, Richard; Theodore, Willy; Zheng, Keke; Li, Qing; Ruys, Andrew J

    2016-07-01

    Peri-prosthetic femoral neck fracture after femoral head resurfacing can be either patient-related or surgical technique-related. The study aimed to develop a patient-specific finite element modelling technique that can reliably predict an optimal implant position and give minimal strain in the peri-prosthetic bone tissue, thereby reducing the risk of peri-prosthetic femoral neck fracture. The subject-specific finite element modelling was integrated with optimization techniques including design of experiments to best possibly position the implant for achieving minimal strain for femoral head resurfacing. Sample space was defined by varying the floating point to find the extremes at which the cylindrical reaming operation actually cuts into the femoral neck causing a notch during hip resurfacing surgery. The study showed that the location of the maximum strain, for all non-notching positions, was on the superior femoral neck, in the peri-prosthetic bone tissue. It demonstrated that varus positioning resulted in a higher strain, while valgus positioning reduced the strain, and further that neutral version had a lower strain. PMID:27098752

  3. Haemodynamic analysis of femoral artery bifurcation models under different physiological flow waveforms.

    PubMed

    Javadzadegan, Ashkan; Lotfi, Azadeh; Simmons, Anne; Barber, Tracie

    2016-08-01

    Thrombus in a femoral artery may form under stagnant flow conditions which vary depending on the local arterial waveform. Four different physiological flow waveforms - poor (blunt) monophasic, sharp monophasic, biphasic and triphasic - can exist in the femoral artery as a result of different levels of peripheral arterial disease progression. This study aims to examine the effect of different physiological waveforms on femoral artery haemodynamics. In this regard, a fluid-structure interaction analysis was carried out in idealised models of bifurcated common femoral artery. The results showed that recirculation zones occur in almost all flow waveforms; however, the sites at where these vortices are initiated, the size and structure of vortices are highly dependent on the type of flow waveform being used. It was shown that the reverse diastolic flow in biphasic and triphasic waveforms leads to the occurrence of a retrograde flow which aids in 'washout' of the disturbed flow regions. This may limit the likelihood of thrombus formation, indicating the antithrombotic role of retrograde flow in femoral arteries. Furthermore, our data revealed that the flow particles experience considerably higher residence time under blunt and sharp monophasic waveforms than under biphasic and triphasic waveforms. This confirms that the risk of atherothrombotic plaque initiation and development in femoral arteries is higher under blunt and sharp monophasic waveforms than under biphasic and triphasic flow waveforms. PMID:26582544

  4. Patency of Femoral Tunneled Hemodialysis Catheters and Factors Predictive of Patency Failure

    SciTech Connect

    Burton, Kirsteen R.; Guo, Lancia L. Q.; Tan, Kong T.; Simons, Martin E.; Sniderman, Kenneth W.; Kachura, John R.; Beecroft, John R.; Rajan, Dheeraj K.

    2012-12-15

    Purpose: To determine the patency rates of and factors associated with increased risk of patency failure in patients with femoral vein tunneled hemodialysis catheters. Methods: All femoral tunneled catheter insertions from 1996 to 2006 were reviewed, during which time 123 catheters were inserted. Of these, 66 were exchanges. Patients with femoral catheter failure versus those with femoral catheter patency were compared. Confounding factors, such as demographic and procedural factors, were incorporated and assessed using univariate and multivariable Cox proportional hazards regression analyses. Results: Mean catheter primary patency failure time was 96.3 days (SE 17.9 days). Primary patency at 30, 60, 90, and 180 days was 53.8%, 45.4%, 32.1%, and 27.1% respectively. Crude rates of risk of catheter failure did not suggest a benefit for patients receiving catheters introduced from one side versus the other, but more cephalad location of catheter tip was associated with improved patency. Multivariate analysis showed that patients whose catheters were on the left side (p = 0.009), were of increasing age at the time of insertion (p = 0.002) and that those who had diabetes (p = 0.001) were at significantly greater risk of catheter failure. The catheter infection rate was 1.4/1000 catheter days. Conclusion: Patients who were of a more advanced age and had diabetes were at greater risk of femoral catheter failure, whereas those who received femoral catheters from the right side were less at risk of catheter failure.

  5. Contact stress distributions on the femoral head of the emu (Dromaius novaehollandiae).

    PubMed

    Troy, Karen L; Brown, Thomas D; Conzemius, Michael G

    2009-11-13

    Osteonecrosis of the femoral head remains a challenging orthopaedic problem. The disease frequently progresses to femoral head collapse, leading to debilitating osteoarthritis in the affected hip(s). Since a major goal of pre-collapse interventions is to forestall the need for hip arthroplasty, it is important that any animal models used to develop or study such interventions also have a natural history of progression to femoral head collapse. The emu (Dromaius novaehollandiae), a large flightless bird native to Australia, consistently progresses to femoral head collapse when osteonecrosis is experimentally induced cryogenically. Full biomechanical characterization of the demands this animal places on its hip is an important consideration in future usage of this model. This study reports in vitro measurement of the contact stress distributions on the emu femoral head during stance phase of the gait cycle, using Fuji pressure-sensitive film. Applied hip loadings were based upon ground reaction forces and hip flexion angles recorded in vivo. The contact stress data showed reasonable homology with the human hip, both in terms of stress magnitude and sites of habitual loading on the femoral head. PMID:19665715

  6. Excessive distal migration of fiber-mesh coated femoral stems

    PubMed Central

    2011-01-01

    Background The surface texture, localization, and magnitude of the surface material applied to the femoral stem can facilitate bone ingrowth and influence the survival of total hip arthroplasties. Clinical and radiographic studies have shown superior bone ingrowth in proximally porous-coated stems with a diaphyseal grit-blasted surface in comparison to a smooth diaphyseal surface. Surface textures—especially porous surface material—have been suggested to have a sealing effect against migration of polyethylene debris along the implant-bone interface and to reduce the inflammatory response, leading to a prolonged implant survival. Patients and methods Between 2004 and 2006, we conducted a randomized, controlled trial (RCT) involving 50 patients with non-inflammatory arthritis. They received either a distally tapered, extended coated stem or a straight, proximally coated stem. During surgery, tantalum markers were inserted into the greater and lesser trochanter. Implant migration was evaluated at 3, 12, and 24 months postoperatively by radiostereometric analysis. The primary endpoint was stem migration 2 years after surgery. Results All femoral components in both groups showed pronounced distal translation, with the highest rate of translation occurring between 0 and 3 months. After 2 years, the mean distal translation was 2.67 (95% CI: –3.93 to –1.42) mm for the tapered, extended coated stem and 1.80 (–2.45 to –1.15) mm for the straight, proximally coated stem. Half of the tapered, extended coated stems and two-thirds of the straight, proximally coated stems had migrated more than 1 mm. No difference between the 2 stems could be seen with regard to translation or rotation at any time point. After 2 years, 2 hips have been reoperated due to mechanical loosening of the stem. Interpretation An excessive amount of migration of both stem types was seen 2 years postoperatively. It is of vital importance to follow this patient cohort since radiostereometric

  7. Effects of long-term rotation and hypergravity on developing rat femurs

    NASA Technical Reports Server (NTRS)

    Smith, S. D.

    1975-01-01

    Male and female Sprague-Dawley rats derived from a single mating were raised for three generations under constant centrifugation at 1.03 G (Rotation Controls) and at 2 G. When the third generation rats were 3 months old, they were sacrificed, and their femurs removed. After fixation and cleaning, the femurs were then measured for length and diameter. Then right femurs were sectioned longitudinally, left femurs transversely. After staining with Hematoxylin and Eosin, right femurs were examined for ossification patterns and left femurs were measured for cortical thickness. All rotation control rats showed marked stimulation of ossification in the femoral head, and males showed significant cortical thinning when compared to non-rotated earth gravity controls. All 2 G femurs showed decreased length and aspect (L/D) ratios, and increased cortical thickness/diameter ratios when compared to earth controls or rotation controls. Ossification of the femoral head was slightly advanced, while the distal epiphyseal plate was thinned.

  8. The effectiveness of the antegrade reamed technique: the experience and complications from 415 traumatic femoral shaft fractures

    PubMed Central

    Papadimitriou, George; Theodoratos, Gerasimos; Papanikolaou, Anastasios; Maris, John

    2009-01-01

    This retrospective study presents the experience gained through use of reamed femoral nails and reports results and respective complications. This study included 415 femur fractures (312 men and 101 women with a mean age of 27.8 years) that were treated from 1993 to 2004. The fractures were classified according to AO, and 74 open fractures were included and typed according to the Gustilo classification. Dynamic nailing was performed for nearly all type A fractures and static nailing for types B and C. After a mean follow-up of 1.5 years, union rate was 97.8%. The complications were: 9 non-unions, 14 delayed-unions, 4 torsional malunions, 6 limb length discrepancies (shortening) and 30 nerve pareses due to traction. Deep venous thrombosis (DVT) occurred below the knee in 4 patients, while there were recorded 3 pulmonary and 2 fat embolisms, 1 superficial and 1 deep infection. There were 28 broken screws identified postoperatively. Logistic regression analysis revealed that type B and C were associated with increased risk of complications, with respective odds ratios of 3.1 (95% CI = 1.3–7.2, P = 0.011) and 4.3 (95% CI = 1.8–10.3, P = 0.001) when compared to type A patterns. All patients returned to their activities in a mean time of 10 months. Intramedullary nailing is still the treatment of choice for femoral shaft fractures, but knowledge of potential complications and their association with certain fracture patterns is needed. PMID:19936887

  9. Behavior modulation of rats to a robotic rat in multi-rat interaction.

    PubMed

    Shi, Qing; Ishii, Hiroyuki; Tanaka, Katsuaki; Sugahara, Yusuke; Takanishi, Atsuo; Okabayashi, Satoshi; Huang, Qiang; Fukuda, Toshio

    2015-10-01

    In this paper, we study the behavioral response of rats to a robotic rat during multi-rat interaction. Experiments are conducted in an open-field where a robotic rat called WR-5 is put together with three laboratory rats. WR-5 is following one rat (target), while avoiding the other two rats (outside observers) during interaction. The behavioral characteristics of each target rat is evaluated by scoring its locomotor activity and frequencies of performing rearing, body grooming and mounting actions. Additionally, the frequency of being mounted by other rats is also measured. Experimental results show that the target becomes more active after interaction. The rat species, with more active behavioral characteristics, is more susceptible to being adjusted by the robot. The increased time spent by the outside observers in the vicinity of the robot indicates that a biomimetic robot has the promise for modulating rat behavior even without direct interaction. Thus, this study provide a novel approach to shaping the sociality of animals living in groups. PMID:26414400

  10. Interactions between concentrations of chemical elements in human femoral heads.

    PubMed

    Brodziak-Dopierala, Barbara; Kwapulinski, Jerzy; Kusz, Damian; Gajda, Zbigniew; Sobczyk, Krzysztof

    2009-07-01

    Environmental and occupational exposure to various metals has been a major public health concern and the subject of many studies. With the development of industry and transportation, environmental pollution has markedly worsened. As a result, metals are now ubiquitous and are absorbed into the body with food, drinking water, and polluted air. Exposure to these elements leads to numerous health problems, affecting almost every system of the human body, including the skeletal system. Bone is a specific research material that is difficult to obtain, therefore chemical analyses of metal concentrations in this tissue are rarely found in the literature. Nevertheless, bone, due to its long regeneration period, can serve as a biomarker of a long-term metal accumulation resulting from environmental or occupational exposure. Our study was conducted on bone samples harvested from inhabitants of the Upper Silesia region during hip replacement surgery. Femoral heads removed during surgery were sectioned into slices and further subdivided into samples comprising articular cartilage, cortical bone, and trabecular bone. Concentrations of 12 trace elements were measured with an atomic absorption spectrophotometry method. We found significant correlation between concentrations of these metal elements in the samples of cortical bone. This is determined not only by the physiological functions of these metals in hydroxyapatite, but also by the specific mineral structure of the bone tissue. PMID:18776997

  11. Unique plasma metabolomic signature of osteonecrosis of the femoral head.

    PubMed

    Liu, Xiaolin; Li, Qing; Sheng, Jiagen; Hu, Bin; Zhu, Zhenzhong; Zhou, Shumin; Yin, Junhui; Gong, Qiang; Wang, Yang; Zhang, Changqing

    2016-07-01

    Metabolomic analysis was performed to determine the metabolomic signature of osteonecrosis of the femoral head (ONFH), and to investigate the underlying relationship between the metabolomic signature and the pathogenesis of ONFH. Plasma samples were collected from 30 ONFH patients and 30 normal subjects. The global metabolomic profile was obtained through a combination of high-throughput liquid- and gas-chromatography-based mass spectrometry analyses. All statistical analyses were conducted using the R software. The results showed clear differences in the metabolomic signature between the plasma of ONFH patients compared with normal subjects. Among the 354 identified metabolites, the expression of 123 metabolites were significantly changed in ONFH patients compared with normal subjects (p < 0.05, q < 0.10). Bioinformatics analysis revealed that these abnormal metabolites were mainly involved in lipid-, glutathione-, nucleotide-, and energy-associated pathways, which might be related to enhanced inflammation, oxidative stress, and energy deficiency due to ONFH. This study provides the first metabolomic analysis of ONFH, and identifies a previously unrecognized metabolic signature in ONFH plasma. The results offer new insights into the pathological mechanisms of ONFH through its influence on metabolic pathways, providing the requisite framework for identifying biomarkers or novel targets for therapeutic intervention. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1158-1167, 2016. PMID:26662932

  12. Femoral/humeral strength in early African Homo erectus.

    PubMed

    Ruff, Christopher

    2008-03-01

    Lower-to-upper limb-bone proportions give valuable clues to locomotor behavior in fossil taxa. However, to date only external linear dimensions have been included in such analyses of early hominins. In this study, cross-sectional measures of femoral and humeral diaphyseal strength are determined for the two most complete early Homo erectus (or ergaster) associated skeletons--the juvenile KNM-WT 15000 and the adult KNM-ER 1808. Modern comparative samples include an adult human skeletal sample representative of diverse body shapes, a human longitudinal growth series, and an adult chimpanzee sample. When compared to appropriately age-matched samples, both H. erectus specimens fall very close to modern human mean proportions and far from chimpanzee proportions (which do not overlap with those of humans). This implies very similar mechanical load-sharing between the lower and upper limbs, and by implication, similar locomotor behavior in early H. erectus and modern humans. Thus, by the earliest Pleistocene (1.7 Ma), completely modern patterns of bipedal behavior were fully established in at least one early hominin taxon. PMID:17977577

  13. Periprosthetic Femoral Fracture With Broken Implant Insitu: - A Treatment Prospect

    PubMed Central

    Pal, Chandra Prakash; Singh, Pulkesh; Kumar, Deepak; Singh, Arpit

    2014-01-01

    Introduction: Fractures involving bones containing a component of a prosthetic joint are becoming more common. The causation is multifactorial but most of these injuries are associated with trivial trauma. The options available for operative management of these fractures include internal fixation of the fracture alone, fixation of the fracture with revision of the prosthesis, and reconstruction of proximal femur with either modified impaction bone grafting or proximal femoral replacement. Case Report: We present here a case of periprosthetic fracture Vancouver type B1 with a broken cemented bipolar prosthesis insitu, in which the broken implant was firmly fixed in the proximal fragment and could not be removed following which the whole of the proximal fragment along with the broken implant was removed and replaced by a customized steel long stem cemented mega prosthesis. Conclusion: This case is being presented on account of its unusual presentation and fracture pattern. A broken prosthesis along with a periprosthetic fracture is not a common incident. Thus the treatment had to be individualized. Since the prosthesis was well fixed, its broken stem could not be removed from the proximal fragment and so the whole of the proximal fragment along with stem was removed and replaced with a long stem custom made bipolar prosthesis. PMID:27298972

  14. Knee range of motion in isolated femoral lengthening.

    PubMed

    Herzenberg, J E; Scheufele, L L; Paley, D; Bechtel, R; Tepper, S

    1994-04-01

    Twenty-five patients underwent isolated Ilizarov femoral lengthenings (mean lengthening, 6 cm). A retrospective review of the charts showed the specific changes in knee range of motion (ROM) during lengthening, after removal of the frame, and at the final follow-up examination. A decrease in ROM was seen during lengthening to an average minimum of 37 degrees +/- 15 degrees. Toward the end of the consolidation phase, improvement to 69 degrees +/- 28 degrees was noted. A progressive increase in ROM was seen after frame removal. Mean preoperative flexion was 127 degrees +/- 16 degrees, and at follow-up flexion was 122 degrees +/- 23 degrees (p = 0.191). Of the five patients who did not achieve 120 degrees flexion at the final follow-up examination, three had a diminished ROM (average, 107 degrees) at the outset. Two patients lost more than 15% of their preoperative flexion. There was no correlation noted between worst ROM (during lengthening) and final ROM at the last follow-up examination. PMID:8156696

  15. Deep wound infection after proximal femoral fracture: consequences and costs.

    PubMed

    Pollard, T C B; Newman, J E; Barlow, N J; Price, J D; Willett, K M

    2006-06-01

    The purpose of this study was to assess the impact of deep wound infection after surgery for proximal femoral fracture (PFF) on the patient in terms of mortality and social consequences, and on the National Health Service in terms of financial burden. Sixty-one cases of PFF over a six-year period were complicated with deep surgical wound infection. These cases were compared with a matched control group of 122 patients without infection. Infected cases had greatly increased hospital stay (P<0.001), were 4.5 times less likely to survive to discharge (P=0.002), and if they survived, were three times less likely to return to their original residence (P=0.05). The total cost of treatment per infected case was 24,410 pound sterling compared with 7210 pound sterling for controls (P<0.001). Meticillin-resistant Staphylococcus aureus (MRSA) infection increased admission length and cost compared with non-MRSA infection (P=0.02). Deep wound infection after PFF is a devastating and costly complication for both the patient and the healthcare services. The cost consequences should be considered when allocating resources to trauma services to ensure adequate provision to minimize infection risks and to accommodate treatment costs in this vulnerable group. PMID:16621145

  16. Best estimation of spectrum profiles for diagnosing femoral prostheses loosening.

    PubMed

    Díaz-Pérez, Francisco; García-Nieto, Evelyn; Ros, Antonio; Claramunt, Rafael

    2014-02-01

    For the past few years, some authors have proposed several vibration analysis techniques to detect the prosthetic femoral stem loosening, having found some differences in the frequency response between secure and loose stems. Classical methods like periodogram have been used in most studies for the spectral estimation, and their conclusions have been reached only by visual inspection. A new metric called Non-linear Logarithmic Weighted Distance (NLWD), based on log-spectral distance is presented. As its name suggests, the spectral power is weighted in order to highlight discriminatory patterns of the spectral profiles. A Generalized Discriminant Ratio (GDR) based on NLWD metric has been also defined. In this study, experiments on a cadaveric dried bone with two kinds of fixation, Loose Stem class (LS) and Secure Stem class (SS), have been analyzed. To select the most discriminating approach to spectral estimation, five well known algorithms (Welch's, Burg's Auto-Regressive (AR), Auto-Regressive Moving Average (ARMA), Multiple Signal Classification (MUSIC) and Thomson's Multi-taper (MTM)) have been compared by using GDR. Finally, the use of the MTM method is proposed for the analysis of bone-stem interface vibratory signals, since it yields the most discriminatory profiles. PMID:24332977

  17. Midterm Outcome of Femoral Artery Stenting and Factors Affecting Patency

    PubMed Central

    Yu, Jae Seoung; Park, Keun-Myoung; Jeon, Yong Sun; Cho, Soon Gu; Hong, Kee Chun; Shin, Woo Young; Choe, Yun-Mee; Shin, Seok-Hwan; Kim, Kyung Rae

    2015-01-01

    Purpose: The purpose of this study was to evaluate the early and midterm results of superficial femoral artery (SFA) stenting with self-expanding nitinol stents and to identify the factors affecting patency. Materials and Methods: SFA stenting was performed in 165 limbs of 117 patients from January 2009 to December 2013. Patients were followed-up for the first occurrence of occlusion or stenosis based on computed tomography and duplex scan results and a decrease in ankle brachial index of >15%. Results: During the follow-up period (mean, 15.3±3.2 months), no early thrombotic reocclusions occurred within 30 days, but in-stent restenosis developed in 78 limbs. The primary patency rates at 6, 12, 18, and 24 months were 78%, 66%, 42%, and 22%, respectively, and the secondary patency rates were 85%, 72%, 58%, and 58%, respectively. TASC II C or D lesions, stent length >8 cm, number of patent tibial arteries and diabetes were significantly associated with reintervention. Conclusion: The midterm results of stenting for SFA occlusive disease were disappointing because the primary and secondary patency rates at two years were 22% and 58%, respectively. Reintervention after SFA stenting remains a major problem, particularly in patients with diabetes mellitus or long TASC II C or D lesions. PMID:26719837

  18. Injectable biocomposites for bone healing in rabbit femoral condyle defects.

    PubMed

    Liu, Jianheng; Mao, Kezheng; Liu, Zhengsheng; Wang, Xiumei; Cui, Fuzhai; Guo, Wenguang; Mao, Keya; Yang, Shuying

    2013-01-01

    A novel biomimetic bone scaffold was successfully prepared in this study, which was composed of calcium sulfate hemihydrate (CSH), collagen and nano-hydroxyapatite (nHAC). CSH/nHAC was prepared and observed with scanning electron microscope and rhBMP-2 was introduced into CSH/nHAC. The released protein content from the scaffold was detected using high performance liquid chromatography at predetermined time interval. In vivo bone formation capacity was investigated by means of implanting the scaffolds with rhBMP-2 or without rhBMP-2 respectively into a critical size defect model in the femoral condyle of rabbit. The releasing character of rhBMP-2 was that an initial burst release (37.5%) was observed in the first day, followed by a sustained release and reached 100% at the end of day 20. The CSH/nHAC showed a gradual decrease in degradation with the content of nHAC increase. The results of X-rays, Micro CT and histological observation indicated that more new bone was formed in rhBMP-2 group. The results implied that this new injectable bone scaffold should be very promising for bone repair and has a great potential in bone tissue engineering. PMID:24146770

  19. Computerized fluoroscopy with zero-dose image updates for minimally invasive femoral diaphyseal fracture reduction

    NASA Astrophysics Data System (ADS)

    Zheng, Guoyan; Dong, Xiao

    2006-03-01

    In this paper, a computerized fluoroscopy with zero-dose image updates for femoral diaphyseal fracture reduction is proposed. It is achieved with a two-step procedure. Starting from a few (normally 2) calibrated fluoroscopic image, the first step, data preparation, automatically estimates the size and the pose of the diaphyseal fragments through three-dimensional morphable object fitting using a parametric cylinder model. The projection boundary of each estimated cylinder, a quadrilateral, is then fed to a region information based active contour model to extract the fragment contours from the input fluoroscopic images. After that, each point on the contour is interpolated relative to the four vertices of the corresponding quadrilateral, which resulted in four interpolation coefficients per point. The second step, image updates, repositions the fragment projection on each acquired image during bony manipulation using a computerized method. It starts with interpolation of the new position of each point on the fragment contour using the interpolation coefficients calculated in the first step and the new position of the corresponding quadrilateral. The position of the quadrilateral is updated in real time according to the positional changes of the associated bone fragments, as determined by the navigation system during fracture reduction. The newly calculated image coordinates of the fragment contour are then fed to a OpenGL® based texture warping pipeline to achieve a real-time image updates. The presented method provides a realistic augmented reality for the surgeon. Its application may result in great reduction of the X-ray radiation to the patient and to the surgical team.

  20. Adolescent Femoral Chondral Fragment Fixation With Poly-L-Lactic Acid Chondral Darts.

    PubMed

    Morris, John K; Weber, Alexander E; Morris, Mark S

    2016-01-01

    Large chondral injuries without attached bone are uncommon. This report describes a 14-year-old boy who had a unique stress reaction between the bone and the overlying cartilage, predominantly of the anterior lateral femoral condyle, during a week-long basketball camp, resulting in complete displacement of a 2.5 × 2.5-cm full-thickness articular cartilage lesion. There was a 6-day interval from the time of the injury to the first office appointment. Scheduling of magnetic resonance imaging and insurance approval took another week, and then surgery scheduling, including insurance approval and arranging for surgical supplies, took another week. Three weeks after the initial injury, the patient underwent diagnostic arthroscopy and open arthrotomy, and the cartilage-free fragment was returned to the donor site and fixed with poly-L-lactic acid chondral darts. Considerable delamination of the shoulders of the defect was noted on preoperative magnetic resonance imaging and at the time of surgery, suggesting an unusual prodromal stress reaction. Although there was no underlying subchondral bone on the free cartilage fragment, the injury healed. The patient had return of full knee range of motion and strength. Magnetic resonance imaging performed 3 months postoperatively showed healed cartilage. At 1 year of clinical follow-up, the patient had no clinical sequelae from the initial injury and had returned to competitive basketball. Prompt recognition of this injury pattern and subsequent surgical repair are necessary because the window of opportunity closes as fibrous healing occurs and the cartilage fragment deforms. The poly-L-lactic acid chondral dart system was instrumental to the success of this case. PMID:26840696

  1. Effects of cysteamine and pantethine on open-field behavior, hypothalamic catecholamine concentrations, and somatostatin-induced barrel rotation in rats.

    PubMed

    Vécsei, L; Alling, C; Heilig, M; Widerlöv, E

    1989-03-01

    Cysteamine administered in a dose of 1.95 mM/kg subcutaneously (SC) markedly reduced several open-field behaviors (locomotion, rearing, grooming and defecation), while pantethine, administered in an equimolar dose, reduced the locomotion only. However, administered in a dose of 3.90 mM/kg (SC), pantethine also markedly reduced all open-field parameters. Cysteamine, and to less extent pantethine, reduced noradrenaline, and increased dopamine and DOPAC concentrations in the hypothalamus. It is discussed whether the lower potency of pantethine on open-field behaviors and hypothalamic catecholaminergic neurotransmission is connected with the limited activity of pantetheinase, the cysteamine-generating enzyme. Intracerebroventricularly (ICV) administered somatostatin did not influence the pantethine-induced (1.95 mM/kg SC) behavioral changes in the open-field test. It is possible that the peptide did not reach at the receptor sites in a sufficient concentration because of the reduced endogenous somatostatin content, or that the pantethine-induced noradrenaline depletion is connected with the ineffectiveness of somatostatin. Furthermore, pretreatment with cysteamine (1.95 mM/kg SC) or pantethine (1.95 mM/kg or 3.90 mM/kg SC) attenuated the somatostatin-induced (10 micrograms ICV) barrel rotation, suggesting that the level of endogenous somatostatin may play a role in the pathogenesis of this motor disturbance. PMID:2568000

  2. Custom stems for femoral deformity in patients less than 40 years of age

    PubMed Central

    Akbar, Michael; Aldinger, Guenther; Krahmer, Knut; Bruckner, Thomas

    2009-01-01

    Background and purpose Femoral deformity associated with osteoarthritis is a challenge for both the surgeon and the implant. Many of the patients with these deformities are young. Standard implants can be difficult to fit into these femurs. We prospectively evaluated the outcome of custom uncemented femoral stems in young patients. Methods 61 consecutive patients (72 hips) underwent surgery for osteoarthritis because of femoral deformity at a mean age of 35 (22–40) years. The patients received a CT3D-A custom-made femoral stem and an uncemented cup. The mean follow-up time was 14 (10–16) years. 2 patients died at 7 and 8 years after surgery, otherwise, none of the patients were lost to follow-up. Results At follow-up, the femoral prosthesis had not been revised in 59 patients (70 hips). 3 patients (3 hips) had required revision surgery due to loosening of the acetabular component; 2 hips were awaiting revision surgery for loosening of the acetabular cup. There were no cases of dislocation or infection. At review, all stems were considered stable according to the radiographic criteria. No migration or subsidence was observed on plain radiographs. Interpretation Our results are comparable to published results of custom stems regarding survival and outcome. Considering the young age and the deformities in this series of uncemented custom femoral stems, and the fact that there was follow-up of up to 16 years, the survival is remarkable. This technique appears to be a reasonable alternative in younger patients with femoral deformities. PMID:19513891

  3. Anterior Hip Fracture Dislocation with Intrapelvic Retention of the Femoral Head and Ureter Fistula

    PubMed Central

    Patrascanu, Calin; Cibu, Dan

    2014-01-01

    Introduction: The anterior dislocation of the hip represents only a small percentage of all hip dislocations: 85% are posterior. Most commonly associated with this dislocation is a fracture of the femoral head and, in rare cases, a femoral neck fracture. We have found in literature no report of an anterior dislocation of the hip associated with femoral neck fracture, pelvic retention of the head and ureteral fistula. We report such a case of a 68 year old male. Case Report: A 68 year old male was presented to our attention, following a severe injury of the hip when falling from a high bridge, with severe pain in the hip and a clinical aspect of femoral neck fracture. The X-ray confirmed the femoral neck fracture but following an anterior dislocation with the head retained into the pelvis. The patient also had hematuria. An Austin Moore prosthesis was implanted for the femoral neck fracture and the head was extracted by the urologist by a new abdominal incision. Urological evaluation revealed a fistula of the ureter, treated by an internal drainage for three months. One month later the Moore prosthesis was extracted and the patient had a Girldestone hip for 5 months. Revision with a Muller cemented prosthesis had a normal evolution. Conclusion: The anterior fracture dislocation of the hip with pelvic retention of the femoral head and ureteral fistula is a rare condition resulting from high energy trauma. A multidisciplinary team is necessary to diagnose and treat fracture and soft tissue lesions. Early diagnosis and treatment is necessary to avoid septic complications. PMID:27298980

  4. Bilateral avascular necrosis of the femoral head due to the use of heroin: A case report

    PubMed Central

    Ozkunt, Okan; Sarıyılmaz, Kerim; Sungur, Mustafa; Ilen, Ferhat; Dikici, Fatih

    2015-01-01

    Introduction Femoral head avascular necrosis is caused by disruption of the blood supply of the femoral head, which finally results in hip dysfunction. Non traumatic osteonecrosis may related with corticosteroid use, alcohol abuse, SLE, hemoglobinopathies or exposure to cytotoxic agents. But avascular necrosis of the femoral head (ANFH) due to heroin use is a rare condition. We report a patient with bilateral ANFH due to heroin use treated by simultaneous bilateral hip arthroplasty. Presentation of case 37 year-old male patient presented with bilateral hip pain that had been occurring for four years. The patient had no history of smoking, excessive drinking, using corticosteroid and the other drugs or trauma but used heroin for 10 years. In clinic and radiologic examination indicated advanced degenerative changes on both hip due to femoral head avascular necrosis. The patient was treated with simultaneous bilateral total hip arthroplasty. After 6 months postoperatively the active hip range of motion was painless. Discussion Avascular femoral head necrosis caused by the using of heroin is rare. Ultimately, osteonecrosis of the femoral head occurs through one final common pathway, which is decreased blood flow to the femoral head that leads bone ischemia and death. But it is still unknown that heroin’s systemic effects. Intravenous drug use more as a serious problem for today. There is a need for comprehensive studies to demonstrate effects of heroin on bone and vascularity metabolism. Conclusion Heroin use will be important problem for population. That’s why is crucial to understand the effect of heroin. PMID:26595896

  5. How much hamstring graft needs to be in the femoral tunnel? A MOON cohort study

    PubMed Central

    Mariscalco, Michael W.; Magnussen, Robert A.; Mitchell, Joshua; Pedroza, Angela D.; Jones, Morgan H.; Andrish, Jack T.; Parker, Richard D.; Kaeding, Christopher C.; Flanigan, David C.

    2014-01-01

    Background Recent evidence that smaller hamstring graft diameter is associated with increased failure risk following anterior cruciate ligament (ACL) reconstruction has increased the popularity of graft configurations that increase graft diameter at the expense of graft length. A key question is how much graft needs to be in contact with the femoral tunnel to ensure that healing occurs. We hypothesize that no difference in two-year patient-reported outcomes or failure risk exists based on the amount of graft in the femoral tunnel. Methods Through the use of prospectively collected cohort data augmented with retrospective chart review, 120 of 181 consecutive patients (66.3 %) undergoing primary ACL reconstruction with hamstring autograft were evaluated. Patient and surgical factors along with pre-operative and two-year postoperative knee injury and osteoarthritis outcome score (KOOS) and International Knee Documentation Committee (IKDC) scores and whether each patient underwent revision ACL reconstruction during the two-year follow-up period were recorded. Results No differences in two-year patient-reported outcome scores were noted between patients with graft length in the femoral tunnel less than 25 mm and those with graft length in the femoral tunnel of at least 25 mm. Controlling for age, sex, BMI, and femoral tunnel technique, no correlation was noted between KOOS or IKDC scores and either the length of graft in the femoral tunnel or the contact area between the graft and the tunnel. Conclusions Variation of the length of hamstring autograft in the femoral tunnel between 14 and 35 mm does not predict KOOS or IKDC scores at 2 years postoperative. PMID:25984246

  6. Computed tomography for femoral and tibial torsion in children with clubfoot.

    PubMed

    Cuevas de Alba, C; Guille, J T; Bowen, J R; Harcke, H T

    1998-08-01

    Forty-seven children with 70 clubfeet had computed tomography studies performed to determine the degree of femoral, tibial, and total limb torsion in both lower limbs. The total limb torsion angle (angle between the axis of the femoral neck and the axis of the ankle), which describes the relationship between femoral and tibial torsion, was used to evaluate the whole rotational deformity of the lower limb. The children were between the ages of 2 and 10 years (mean, 5 years) at the time of the computed tomography study. The mean femoral torsion was 25 degrees in the limbs with a clubfoot and 23 degrees in the contralateral limbs of patients with a unilateral clubfoot. The mean tibial torsion was 25 degrees in the limbs with a clubfoot and 24 degrees in the contralateral limb of patients with a unilateral clubfoot. The authors observed decreases of anterior femoral torsion corresponding to increases in age, consistent with the observations made by other authors of studies of children without clubfoot. External tibial torsion increased with age, with similar values in limbs with and without clubfoot. Ten limbs (nine with clubfoot, one without clubfoot) had femoral torsion greater than the means plus one standard deviation and 12 limbs (eight with clubfoot, four without clubfoot) had tibial torsion less than the means minus one standard deviation. The authors found four limbs (all with clubfoot) in three patients with lower than the mean minus one standard deviation of the total limb torsion angle (intoeing). Overall, there was no appreciable difference in the amount of femoral or tibial torsion in limbs with and without a clubfoot. PMID:9728175

  7. Reduction of Femoral Fractures in Long-Term Care Facilities: The Bavarian Fracture Prevention Study

    PubMed Central

    Becker, Clemens; Cameron, Ian D.; Klenk, Jochen; Lindemann, Ulrich; Heinrich, Sven; König, Hans-Helmut; Rapp, Kilian

    2011-01-01

    Background Hip fractures are a major public health burden. In industrialized countries about 20% of all femoral fractures occur in care dependent persons living in nursing care and assisted living facilities. Preventive strategies for these groups are needed as the access to medical services differs from independent home dwelling older persons at risk of osteoporotic fractures. It was the objective of the study to evaluate the effect of a fall and fracture prevention program on the incidence of femoral fracture in nursing homes in Bavaria, Germany. Methods In a translational intervention study a fall prevention program was introduced in 256 nursing homes with 13,653 residents. The control group consisted of 893 nursing homes with 31,668 residents. The intervention consisted of staff education on fall and fracture prevention strategies, progressive strength and balance training, and on institutional advice on environmental adaptations. Incident femoral fractures served as outcome measure. Results In the years before the intervention risk of a femoral fracture did not differ between the intervention group (IG) and control group (CG). During the one-year intervention period femoral fracture rates were 33.6 (IG) and 41.0/1000 person years (CG), respectively. The adjusted relative risk of a femoral fracture was 0.82 (95% CI 0.72-0.93) in residents exposed to the fall and fracture prevention program compared to residents from CG. Conclusions The state-wide dissemination of a multi-factorial fall and fracture prevention program was able to reduce femoral fractures in residents of nursing homes. PMID:21918688

  8. A method to quantify and visualize femoral head intraosseous arteries by micro-CT.

    PubMed

    Qiu, Xing; Shi, Xiaotian; Ouyang, Jun; Xu, Dachuan; Zhao, Dewei

    2016-08-01

    We describe a technique for perfusing a barium sulphate suspension into the intraosseous artery. Following the perfusion of abarium sulphate suspension into 14 fresh lower limbs of Chinese cadavers, micro-CT scanning was applied to digitize, quantify and visualize the intraosseous arteries in the human femoral heads. Then, the femoral heads were removed and subjected to micro-CT scanning. The data were imported into the amira and mimics programs to reconstruct and quantify the intraosseous arteries. The femoral head intraosseous artery lengths, areas, volumes, and femoral head bone volumes were quantified. The artery densities and artery ratios were calculated and analysed with independent-samples t-tests. The intraosseous vasculature volume renderings were displayed as screenshots and videos made with amira. Many intraosseous artery study technologies were compared. The barium sulphate suspension was milky white in colour. The perfusion of the barium sulphate suspension followed by micro-CT scanning provided a good representation of the intraosseous artery. The femoral head intraosseous artery lengths, areas and volumes, and the femoral head bone volumes were displayed as the X¯±S . No differences were observed between the left and right femoral head intraosseous arteries in terms of the artery densities or artery ratios. The volume renderings and 3-D orthogonal projections displayed the overall distributions of the intraosseous arteries. The videos clearly demonstrated the entry sites of the nutrition-carrying arteries, their courses and branches, and the intraosseous arterial anastomoses. Our technique is the simplest and least time-consuming method of producing accurate vascular three-dimensional reconstructions. The perfusion of a barium sulphate suspension into intraosseous arteries combined with micro-CT scanning can deliver high-resolution 3-D digitized data and images of intraosseous arteries. This technique does not require bone decalcification or bone

  9. Proximal Femoral Shortening after Operation with Compression Hip Screws for Intertrochanteric Fracture in Patients under the Age of 60 Years

    PubMed Central

    Choi, Won-Kee; Kim, Dong-Young

    2015-01-01

    Purpose We aimed to quantify proximal femoral shortening after operation with compression hip screws for intertrochanteric fracture in patients under the age of 60 years. Materials and Methods We followed 37 consecutive patients with intertrochanteric fractures treated with compression hip screws from March 2005 to February 2014. We designated the aspect of the fracture, a defect of the postero-medial wall, a defect of the lateral wall, and the degree of reduction as four potentially important factors we assumed would strongly affect proximal femoral shortening. We quantified proximal femoral shortening and compared the effects of above factors. We divided femoral shortening into two plane vectors; femoral offset in the horizontal plane and leg length discrepancy in the vertical plane. We measured shortening separately during two periods: during operation and after weight bearing (called dynamic compression). Results After bone union, the average femoral offset shortening was 5.45 mm. Patient groups with anatomic reduction and intact postero-medial wall showed lower femoral offset shortening than the respective opposite groups. As to functional score using modified Harris hip score, low femoral offset shortening group showed more 2.35 scores than high groups. None of the factors significantly affected leg length shortening. Conclusion We found that a stable medial buttress is involved in lower femoral offset shortening. Thus, surgeons need to attempt to recover the defect of the medial wall and to reduce anatomically when operating intertrochanteric fractures with compression hip screws.

  10. Evaluation of proximal femoral locking plate in unstable extracapsular proximal femoral fractures: Surgical technique & mid term follow up results☆

    PubMed Central

    Kumar, Nishikant; Kataria, Himanshu; Yadav, Chandrashekhar; Gadagoli, Bharath S.; Raj, Rishi

    2014-01-01

    Background Stable trochanteric femur fractures can be treated successfully with conventional implants such as sliding hip screw, cephalomedullary nails, angular blade plates. However comminuted and unstable inter or subtrochanteric fractures with or without osteoporosis are challenging & prone to complications. The PF-LCP is a new implant that allows angular stability by creating fixed angle block for treatment of complex, comminuted proximal femoral fractures. Method We reviewed 30 patients with unstable inter or subtrochanteric fractures, which were stabilized with PF-LCP. Mean age of patient was 65 years, and average operative time was 80 min. Patients were followed up for a period of 3 years (June 2010–June 2013). Patients were examined regularly at 3 weekly interval for signs of union (radiological & clinical), varus collapse (neck-shaft angle), limb shortening, and hardware failure. Result All patients showed signs of union at an average of 9 weeks (8–10 weeks), with minimum varus collapse (<10°), & no limb shortening and hardware failure. Results were analysed using IOWA (Larson) hip scoring. Average IOWA hip score was 77.5. Conclusion PF-LCP represents a feasible alternative for treatment of unstable inter- or subtrochanteric fractures. PMID:25983487

  11. Histological evidence of increased turnover in bone from spontaneously hypertensive rats.

    PubMed

    Barbagallo, M; Quaini, F; Baroni, M C; Barbagallo, C M; Boiardi, L; Passeri, G; Arlunno, B; Delsignore, R; Passeri, M

    1991-03-01

    24 weeks-old spontaneously hypertensive male rats and normotensive genetic controls were subjected to: histomorphometry of the proximal tibiae, assay of mineral density of the femurs by dual photon absorptiometry, and measurement of the calcium content of the femoral bone ash by atomic absorption spectophotometry. Compared with the controls, the hypertensive rats showed osteopenia and increased bone turnover; their osteoid volumes and the surface area of both osteoclasts and osteoblasts were all increased. The data suggest that, during aging, spontaneously hypertensive rats both lose bone mass more rapidly and also have an increased skeletal metabolic rate with respect to the controls. PMID:1888878

  12. Factors affecting the outcome of fractures of the femoral neck in children and adolescents: a systematic review.

    PubMed

    Yeranosian, M; Horneff, J G; Baldwin, K; Hosalkar, H S

    2013-01-01

    Fractures of the femoral neck in children are rare, high-energy injuries with high complication rates. Their treatment has become more interventional but evidence of the efficacy of such measures is limited. We performed a systematic review of studies examining different types of treatment and their outcomes, including avascular necrosis (AVN), nonunion, coxa vara, premature physeal closure (PPC), and Ratliff's clinical criteria. A total of 30 studies were included, comprising 935 patients. Operative treatment and open reduction were associated with higher rates of AVN. Delbet types I and II fractures were most likely to undergo open reduction and internal fixation. Coxa vara was reduced in the operative group, whereas nonunion and PPC were not related to surgical intervention. Nonunion and coxa vara were unaffected by the method of reduction. Capsular decompression had no effect on AVN. Although surgery allows a more anatomical union, it is uncertain whether operative treatment or the type of reduction affects the rate of AVN, nonunion or PPC, because more severe fractures were operated upon more frequently. A delay in treatment beyond 24 hours was associated with a higher incidence of AVN. PMID:23307688

  13. Risk of septic knee following retrograde intramedullary nailing of open and closed femur fractures

    PubMed Central

    2012-01-01

    Background One potential complication of retrograde femoral nailing in the treatment of femur fractures is the risk of septic knee. This risk theoretically increases in open fractures as a contaminated fracture site has the potential to seed the instrumentation being passed in and out of the sterile intraarticular starting point. There are few studies examining this potential complication in a relatively commonly practiced technique. Methods All patients who received a retrograde femoral nail for femur fracture between September 1996 and November 2006 at a Level 1 trauma center were retrospectively reviewed. This yielded 143 closed fractures, 38 open fractures and 4 closed fractures with an ipsilateral traumatic knee arthrotomy. Patient follow-up records were reviewed for documentation of septic knee via operative notes, wound culture or knee aspirate data, or the administration of antibiotics for suspected septic knee. Results No evidence of septic knee was found in the 185 fractures examined in the dataset. Utilizing the Wilson confidence interval, the rate of septic knee based on our population was no greater than 2%, with that of the open fracture group alone being 9%. Conclusions Based on these results and review of the literature, the risk of septic knee in retrograde femoral nailing of both open and closed femoral shaft fractures appears low but potentially not insignificant. Funding There was no outside source of funding from either industry or other organization for this study. PMID:22340770

  14. Proximal Femoral Nail Antirotation Versus Reverse Less Invasive Stabilization System-distal Femur for Treating Proximal Femoral Fractures: A Meta-analysis.

    PubMed

    Jiang, Xuan; Wang, Ying; Ma, XinLong; Ma, JianXiong; Wang, Chen; Zhang, ChengBao; Han, Zhe; Sun, Lei; Lu, Bin

    2016-04-01

    The aim of this study was to compare the effectiveness and safety of 2 surgical techniques that are used to treat proximal femoral fractures.A systematic literature search (up to December 2014) was conducted in Medline, Embase, PubMed, and The Cochrane Central Register of Controlled Trials to screen for studies comparing proximal femoral nail antirotation (PFNA) with less invasive stabilization system-distal femur (LISS-DF) for proximal femoral fractures. Two authors independently assessed the methodological quality of the included studies and extracted data. Surgical information and postoperative outcomes were analyzed.A total of 7 studies with 361 patients who satisfied the eligibility criteria included 3 randomized controlled trials and 4 case-controlled trials associated with PFNA versus LISS in treating proximal femoral fractures. Our results demonstrated that there was a significant reduction in hospital stay and time to weight-bearing ambulation and bone healing for PFNA compared with LISS (odds ratio [OR] -1.48, 95% confidence interval [CI] -2.92 to -0.05; OR -7.08, 95% CI -8.32 to -5.84; OR -2.71, 95% CI -4.76 to 0.67). No statistically significant difference was observed between the 2 groups for operative time, blood loss volume, Harris hip score, and incidence of complications.Based on the results of this analysis, we inferred that PFNA is safer and more effective than reverse LISS-DF in patients undergoing osteosynthesis for proximal femoral fractures, and that PFNA is associated with reduced hospital stays and reduced time to weight-bearing ambulation and bone healing. Nonetheless, in certain cases in which PFNA is not suitable due to abnormal structure of the proximal femur or particularly unstable fractures, the LISS plate technique could be a useful alternative. PMID:27057840

  15. Hydrophobic bile acids relax rat detrusor contraction via inhibiting the opening of the Na⁺/Ca²⁺ exchanger.

    PubMed

    Zhu, Jingzhen; Dong, Xingyou; Liu, Qian; Wu, Chao; Wang, Qingqing; Long, Zhou; Li, Longkun

    2016-01-01

    Hydrophobic bile acids (BAs) are thought to inhibit smooth muscle contractility in several organs. The present study was undertaken to investigate the effects of hydrophobic BAs on the detrusor contractility of rat bladder and to explore the possible mechanism. Lithocholic acid (LCA) treatment increased the micturition interval and induced a concentration-dependent relaxation of bladder detrusor strips. In addition, LCA reduced the concentration of intracellular free Ca(2+)([Ca(2+)]i) and inhibited both the outward and inward Na(+)/Ca(2+) exchanger (NCX) current (INCX) in primary isolated smooth muscle cells (SMCs). To further investigate the mechanism of action of LCA, several pharmacologic agents were used. We found that the NCX inhibitor 3',4'-Dichlorobenzamil (DCB) can significantly inhibit the relaxation of detrusor strips and a reduction of the [Ca(2+)]i induced by LCA, while the antagonist of muscarinic receptor and the agonist of the G protein-coupled bile acid receptor (TGR5) and the farnesoid X receptor (FXR) had no effect. In conclusion, these data suggest that the relaxation of rat detrusor induced by hydrophobic BAs is mediated by NCX. Further research is needed to carry out to demonstrate the possible pathway and provide a potential new strategy to investigation for the treatment of the low urinary tract syndromes. PMID:26892434

  16. Open Anterior Dislocation of the Hip in Togo

    PubMed Central

    Anani, Abalo; Yannick, Dellanh; Gamal, Ayouba; Assang, Dossim

    2016-01-01

    Anterior traumatic dislocations of the hip are much less common than posterior dislocations. To date, 14 cases of open anterior dislocation of the hip associated with such injuries, acetabular and femoral head fractures and femoral vascular and nerve damage have been reported. We present a case of a 23-year-old male who sustained open anterior dislocation of the hip with ipsilateral fracture of the greater trochanter after an accident on the public highway. Additional lesions included an iliac wing fracture and a perineal wound. We report this case because of the rarity and seriousness of this injury due to its progressive complications and difficulties related to its management, which are typical to a developing country like ours. PMID:27247749

  17. An occult acetabular fracture preceding a femoral neck fracture.

    PubMed

    Lasanianos, Nikolaos; Kanakaris, Nikolaos; Giannoudis, Peter V

    2009-08-01

    This article describes the case of a 69-year-old patient with an occult acetabular fracture complicated by an ipsilateral femoral neck fracture occurring within 2 months. The acetabular fracture remained undiagnosed at examination due to insufficient clinical and radiographic data interpretation. The patient was assured of early mobilization that led to a fall and subsequent hip fracture. We focus on the potential reasons for the nondiagnosis of the acetabular fracture. Acetabular fractures in the elderly may occur after low-energy injuries. The lack of history of violent injury may lead to an incorrect diagnosis. Plain anteroposterior (AP) pelvis radiographs alone may prove an insufficient tool, especially in the hands of inexperienced personnel. As is characteristic, a retrospective review of the AP pelvis radiograph obtained after the first fall in our case revealed the undisplaced fracture of the anterior column that was missed initially. Combined fractures of the hip and the acetabulum are rarely described in the literature and are usually addressed by total hip arthroplasty (THA) alone. Similar fracture patterns that develop in 2 stages (2 injuries), as the 1 presented herein, are even more rare. The uniqueness of this combined fracture required a unique surgical treatment. The senior surgeon (P.V.G.) addressed the acetabular fracture separately to graft the anterior column fracture and facilitate union, as it was already 8 weeks old and the second fall had generated a further gap between the fragments. Stable fixation was felt appropriate prior to the THA. Thus, a double surgical approach was used. Six weeks postoperatively, the patient was able to perform full weight-bearing mobilization without an antalgic gait pattern. At 6-month follow-up, radiographs showed the metalwork to be in place with no displacement, and the fracture had progressed to union. PMID:19708620

  18. Femoral lengths and stature in Plio-Pleistocene hominids.

    PubMed

    McHenry, H M

    1991-06-01

    This study reports the femoral lengths of 31 Plio-Pleistocene hominids dated between 3.1 and 0.7 million years ago, and uses those lengths to estimate stature by way of the femur-stature ratio reported by Feldesman et al. (Am. J. Phys. Anthropol