Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “FRACTURES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed1999

Prevalent vertebral deformities predict hip fractures and new vertebral deformities but not wrist fractures. Study of Osteoporotic Fractures Research Group.

Although vertebral deformities are known to predict future vertebral deformities, little is known about their ability to predict other osteoporotic fractures. We examined the association between prevalent vertebral deformities and incident osteoporotic fractures in the Study of Osteoporotic Fractures, a prospective study of 9704 women aged 65 years and older. Prevalent vertebral deformities were determined morphometrically from spinal radiographs at baseline and incident deformities from repeat spinal radiographs after a mean of 3.7 years. Appendicular fractures were collected by postcard every 4 months for a mean of 8.3 years. During follow-up, 389 women with new vertebral deformities, 464 with hip fractures, and 574 with wrist fractures were identified. Prevalent vertebral deformities were associated with a 5-fold increased risk (relative risk 5.4, 95% confidence interval [CI] 4.4, 6.6) of sustaining a further vertebral deformity; the risk increased dramatically with both the number and severity of the prevalent deformities. Similarly, the risks of hip and any nonvertebral fractures were increased with baseline prevalent deformity, with relative risks of 2.8 (95% CI 2.3, 3.4) and 1.9 (95% CI 1.7, 2.1), respectively. Risk increased with number and severity of deformities. These associations remained significant after adjustment for age and calcaneal bone mineral density (BMD). Although there was a small increased risk of wrist fracture, this was not significant after adjusting for age and BMD. In conclusion, the presence of prevalent morphometrically defined vertebral deformities predicts future vertebral and nonvertebral fractures, including hip but not wrist fractures. Spinal radiographs identifying prevalent vertebral deformities may be a useful additional measurement to classify further a woman's risk of future fracture.

Aged↗
PubMed1993

Bone-healing patterns affected by loading, fracture fragment stability, fracture type, and fracture site compression.

The major factors determining the mechanical milieu of a healing fracture are the rigidity of the selected fixation device, the fracture configuration, the accuracy of fracture reduction, and the amount and type of stresses occurring at the bone ends dictated by functional activity and loading at the fracture gap. Of the effects of these factors on fracture healing and remodeling in the canine tibia under unilateral external fixation, the two most significant factors in promoting periosteal callus formation were the amount of physiologic loading as dictated by the body weight and the presence of a significant fracture gap. Uniform axial loading and motion, performed at two or four weeks, did not increase callus formation but did reduce the existing fracture gap. The time-related diminution of periosteal callus (external remodeling) was related to the progress of cortical healing. Cortical reconstruction was fast in stable transverse fractures and delayed in unstable oblique fractures. Motion with loading tended to promote external callus maturation in secondary bone healing. Intracortical new bone formation and porosity were related to the healing pattern and not to the loading magnitude. Endosteal new bone formation showed a strong correlation with the presence of a fracture gap. In terms of torsional strength and energy absorption at failure, the fractures healing through a combination of primary and secondary bone union mechanisms showed the mechanical strength of the healing bone closest to intact bone.

Animals↗
PubMed1976

[An infantile skull fracture followed by the enlarging of the fracture line ("enlarging skull fracture") (author's transl)].

We experience sometimes an infantile skull fracture which is followed by the skull fracture line and bulging of the fractured area day by day after the head injury. Since John Howship reported the case of the partial absorption of the right parietal bone, arising from a blow on the head in a child aged 9 month in 1816, this phenomenon was variously described meningocele spuria, traumatic cephalohydrocele, leptomeningeal cyst, fibrosing osteitis, cerebrocranial erosion, traumatic meningocele, die wachsende Schädelfrakture, growing skull fracture, etc. So called "growing skull fracture" has generally the triad of the symptoms which are the parietal skull fracture in infancy or childhood, traumatic dural tears, and subsequent enlargement of the fractures. And it is said that the dural tear is an indispensable condition for the developing of the "growing skull fracture". But we recently had the case of a 14 day old male infant who had neither traumatic dural tear nor subdural hematoma, but the progressive enlarging of the fracture line in the left parietal bone. The authors suggest that there should be the difference between the growing skull fracture (with the dural teat) and the enlarging skull fracture (without the dural tear).

Fractures, Ununited↗
PubMed2000

The clavicular fracture: a biomechanical study of the mechanism of clavicular fracture and modes of the fracture.

A clavicle is an S-shaped long bone whose biomechanical behavior is unlike that of a straight tubular long bone. When a clavicle is under a compression load along the axis, the force produces a middle one-third clavicular fracture. The present study is a biomechanical study to confirm the clinical observations of the mechanism of the fracture and to discover the tension site and compression site of the fracture, using 12 fresh cadaveric clavicles, a universal testing machine and two special grips. One grip was constructed with a contour like a sternoclavicular articulation. The grip was mounted at the medial end of the clavicle. Another grip was constructed with a contour like an acromioclavicular articulation. The grip was mounted at the lateral end of the clavicle. A load was applied to the lateral clavicle like a force transmitting from the weight of the shoulder girdle. A load was also applied to the medial clavicle like a force from the sternocleidomastoid muscle. A compression load was applied along the axis of the testing clavicle through the upper grips by using a universal testing machine. The result found that the average load of the clavicular fracture was 1526.19 N. The fracture occurred at the middle one-third of the clavicle in the region of the curve of the lateral clavicle changing to the curve of the medial clavicle. While primatic cross section of the clavicle at the fracture site determined a tension and a compression site of the fracture, the fracture took the superoanterior aspect of the clavicle as a tension site and posteroinferior aspect as a compression site. The fracture had a ratio of length of the lateral fragment to the total length of the clavicle of 0.49. This study confirmed that a compression load along the axis of the clavicle produces a middle one-third clavicular fracture as in clinical observation and the fracture took the superoanterior aspect of the clavicle as a tension site.

Adolescent↗
PubMed1999

Clarifying proximal diaphyseal fifth metatarsal fractures. The acute fracture versus the stress fracture.

This article discusses the classification and treatment of proximal diaphyseal fifth metatarsal fractures. There are two types of proximal diaphyseal fracture of the fifth metatarsal: the acute proximal diaphyseal fracture and the proximal diaphyseal stress fracture. Confusion between the two types of fractures is probably due to their similar location and the historical practice of referring to all fractures in this location as Jones fractures. Both fractures are prone to delayed union and require long periods of nonweightbearing immobilization or internal fixation for healing. However, because the mechanism of injury is different for each fracture, the treatment plan may need to be tailored to the particular type of fracture.

Acute Disease↗
PubMed2000

[Magnetic resonance tomography in the diagnosis of intra-articular tibial plateau fractures: value of fracture classification and spectrum of fracture associated soft tissue injuries].

PURPOSE: To compare magnetic resonance imaging (MRI) and X-ray tomography in assessing the type of fracture, degree of comminution and amount of articular surface depression in acute tibial condylar fractures and to describe the associated soft tissue injuries diagnosed with MRI. METHOD: 27 patients with acute tibial plateau fractures were investigated using linear X-ray tomography and MRI employing T1-weighted and proton density turbo spin echo, STIR, and T2-weighted gradient echo images. Fractures were classified according to the AO classification system. The degrees of depression and comminution were measured and soft tissue injuries were recorded. RESULTS: Fractures were classified as type B1 in 7, as B2 in 6, and as B3 in 6 cases by MRI. More complex C-type fractures were diagnosed in 8 cases. MR and X-ray grading were consistent with the exception of two B3 fractures, which were graded as B1 by X-ray tomography. X-ray tomography under-estimated the degree of comminution 63% of the patients had either meniscal tears or complete ruptures of their cruciate or collateral ligaments. Ten meniscal tears were diagnosed in 9 of 27 patients. Complete tears of the anterior cruciate ligament were seen in 4, and avulsions of the posterior cruciate ligament in 2 patients. CONCLUSION: MRI allows a detailed assessment of acute tibial plateau fractures and can replace conventional X-ray tomography. The high rate of fracture-associated soft tissue lesions makes MRI an especially valuable tool.

Adult↗
PubMed1989

[Clinical study on mandibular condylar fracture. 1. Retrospective study in 100 patients with 130 temporomandibular joint fractures with special consideration in the treatment for the various locations and forms of the fractures].

Clinical retrospective investigation was conducted on mandibular condylar fractures of 100 hospitalized cases at the Department of Oral Surgery, Kyoto University Hospital during the period from 1973 to 1983. The following results were obtained, 1. There were 74 males and 26 females. The age of the patients at the time of injury ranged from 4 to 78 years old. The average age was 28.1 years old. 2. Twenty-six patients were treated within a week of injury, 22 cases within 2-weeks and 33 cases were treated after more tham 3 weeks. 3. Of the 100 cases, 70 were unilateral fractures and 30 were bilateral. The incidence of the concomitant fractures of the mandible were higher in bilateral than in unilateral condylar fractures. 4. On fracture level and form 130-site in 100 patients were divided according to the classification of Maclennan and Kubo. Dislocated and high condylar fractures were most frequently observed. 5. Surgical reduction was mainly achieved in low neck fracture, and the contrary conservative treatment was observed in the higher level fracture. On the other hand condylectomy was infrequently indicated in the dislocated head fracture.

Adolescent↗
PubMed1994

Thoracic and lumbar fractures associated with femoral shaft fractures in the multiple trauma patient. Occult presentations and implications for femoral fracture stabilization.

Two-hundred-and-one patients with femoral shaft fractures were identified in a 5 year period at three institutions. Seven patients (3.5%) were found to have associated thoracic or lumbar fractures of various types. All resulted from high-velocity trauma. Four (57%) of these patients had thoracic or lumbar fractures that were undiagnosed on admission and before femoral fracture stabilization. A neurologic deficit persisted in four patients, and the possible contribution of femoral intramedullary rodding with positioning and traction must be considered. A high index of suspicion for thoracic and lumbar fractures is required when evaluating the high velocity trauma patient with a femoral shaft fracture. Presence of the thoracic or lumbar fracture may require initial spine stabilization or alter the method of femoral fracture treatment.

Adult↗
PubMed2001

The epidemiology of elbow fracture in children: analysis of 355 fractures, with special reference to supracondylar humerus fractures.

We present a study of the pattern of elbow fractures in children under 15 years of age, during a 5-year period, with special reference to supracondylar humerus fractures. The incidence was 308/100 000 per year; 58% of the children had a fracture in the supracondylar area of the humerus. There were 355 elbow fractures, and there were 164 boys (46%) and 191 girls (54%). The mean age for the entire group was 7.9 years (for boys, 7.2 years; for girls, 8.5 years). Of 209 supracondylar fractures (including 5 combination fractures), 134 were type I, 40 were type II, and 35 were type III (as classified by Gartland). Associated temporary nerve injuries involving the median, radial, and ulnar nerves were seen in 15 patients with type III supracondylar fractures. Associated brachial artery injuries were seen in 6 patients, 5 of whom had type III fractures.

Adolescent↗
PubMed1998

Closed tibia fracture. "The effect of an intact fibula and the location of tibia fracture on fracture union".

Tibial fractures are common and complications occur more frequently than any other long bone fractures. The effect of fibula and location of fracture on union of Tibia fracture remain controversial. A retrospective study of unilateral closed tibial shaft fractures without any associated injury was done. From 1988 to 1992, 74 out of 103 patients were available for the study. There were 60 males and 14 females with the age ranges from 3 to 75 years with an average of 29.7 years. The differences of fractures healing were analyses with respect to the status of the fibula and the location of the tibial fracture. This study concludes that the location of the fracture and the status of the fibula have no significant influence on healing (p > 0.05).

Adolescent↗
PubMed2002

A randomized trial of sodium fluoride (60 mg) +/- estrogen in postmenopausal osteoporotic vertebral fractures: increased vertebral fractures and peripheral bone loss with sodium fluoride; concurrent estrogen prevents peripheral loss, but not vertebral fractures.

Postmenopausal Caucasian women aged less than 80 years (n = 99) with one or more atraumatic vertebral fracture and no hip fractures, were treated by cyclical administration of enteric coated sodium fluoride (NaF) or no NaF for 27 months, with precautions to prevent excessive stimulation of bone turnover. In the first study 65 women, unexposed to estrogen (-E study), age 70.8 +/- 0.8 years (mean +/- SEM) were all treated with calcium (Ca) 1.0-1.2 g daily and ergocalciferol (D) 0.25 mg per 25 kg once weekly and were randomly assigned to cyclical NaF (6 months on, 3 months off, initial dose 60 mg/day; group F CaD, n = 34) or no NaF (group CaD, n = 31). In the second study 34 patients, age 65.5 +/- 1.2 years, on hormone replacement therapy (E) at baseline, had this standardized, and were all treated with Ca and D and similarly randomized (FE CaD, n = 17; E CaD, n = 17) (+E study). The patients were stratified according to E status and subsequently assigned randomly to +/- NaF. Seventy-five patients completed the trial. Both groups treated with NaF showed an increase in lumbar spinal density (by DXA) above baseline by 27 months: FE CaD + 16.2% and F CaD +9.3% (both p = 0.0001). In neither group CaD nor E CaD did lumbar spinal density increase. Peripheral bone loss occurred at most sites in the F CaD group at 27 months: tibia/fibula shaft -7.3% (p = 0.005); femoral shaft -7.1% (p = 0.004); distal forearm -4.0% (p=0.004); total hip -4.1% (p = 0.003); and femoral neck -3.5% (p = 0.006). No significant loss occurred in group FE CaD. Differences between the two NaF groups were greatest at the total hip at 27 months but were not significant [p < 0.05; in view of the multiple bone mineral density (BMD) sites, an alpha of 0.01 was employed to denote significance in BMD changes throughout this paper]. Using Cox's proportional hazards model, in the -E study there were significantly more patients with first fresh vertebral fractures in those treated with NaF than in those not so treated (RR = 24.2, p = 0.008, 95% CI 2.3-255). Patients developing first fresh fractures in the first 9 months were markedly different between groups: -23% of F CaD, 0 of CaD, 29% of FE CaD and 0 of E CaD. The incidence of incomplete (stress) fractures was similar in the two NaF-treated groups. Complete nonvertebral fractures did not occur in the two +E groups; there were no differences between groups F CaD and CaD. Baseline BMD (spine and femoral neck) was related to incident vertebral fractures in the control groups (no NaF), but not in the two NaF groups. Our results and a literature review indicate that fluoride salts, if used, should be at low dosage, with pretreatment and co-treatment with a bone resorption inhibitor.

Adult↗
PubMed2002

Percutaneous screw fixation of fractures of the iliac wing and fracture-dislocations of the sacro-iliac joint (OTA Types 61-B2.2 and 61-B2.3, or Young-Burgess "lateral compression type II" pelvic fractures).

A technique for closed reduction and percutaneous screw fixation of fractures of the iliac wing and fracture-dislocations of the sacro-iliac joint is presented. Twenty-seven pelvic fractures were treated with attempted closed reduction followed by percutaneous screw fixation. Closed reduction failed in two patients. In the other twenty-five, closed reduction to within one centimeter of residual displacement was obtained, and was followed by stabilization with percutaneously placed cannulated screws. Complications included dislodgment of a screw from the superior pubic ramus in one patient, and partial cut-out of a screw along the inner cortex of the iliac wing in another. Two patients were lost to follow-up before fracture union occurred. The remaining twenty-three patients were followed-up for an average of twenty-seven months (range, 18-48 months). All of the fractures healed in the twenty-three patients who were not lost to follow-up. All but two of the patients who were working before injury returned to work. All but one of the patients was satisfied with the outcome of their pelvic fracture treatment. Closed reduction and percutaneous screw fixation of fractures of the posterior portion of the iliac wing yields acceptable reductions, with minimal blood loss and limited damage to the surrounding soft tissues.

Adolescent↗
PubMed1993

Risk of hip fracture after osteoporosis fractures. 451 women with fracture of lumbar spine, olecranon, knee or ankle.

In a follow-up study during 1976-1984, the risk of a subsequent hip fracture was investigated in women aged 60-99 years, hospitalized for the following fractures: lumbar spine (n 70), olecranon (n 52), knee (n 129) and ankle (n 200). Follow-up ranged from 0 to 9 years. Observation time of the 4 different fractures were 241, 180, 469, and 779, person-years, respectively. In women aged 60-79 years with one of the following fractures the relative risk of a subsequent hip fracture was increased by 4.8 (lumbar spine), 4.1 (olecranon), 3.5 (knee) and 1.5 (ankle). The relative risk of hip fracture showed a tendency to level off 3 years after the primary fracture.

Aged↗
PubMed1999

The effect of alendronate therapy on osteoporotic fracture in the vertebral fracture arm of the Fracture Intervention Trial.

Results from the now-complete Vertebral Fracture Study have been reported elsewhere. The purpose of this report is to review these results in the context of the overall design and implementation of the Fracture Intervention Trial (FIT), and to comment on their implications for clinical practice. The FIT results have important implications for the treatment of osteoporosis in clinical practice. The 51% decrease in the incidence of hip fracture represents the first documentation of any medication's ability to prevent fractures of the hip in community-dwelling women. The 48% reduction in the incidence of morphometrically documented vertebral fracture is also important, as these types of fracture are associated with significant pain and disability and are predictive of future vertebral and hip fractures.

Aged↗
PubMedDate not supplied

Reconstructive surgery for complex midface trauma using titanium miniplates: Le Fort I fracture of the maxilla, zygomatico-maxillary complex fracture and nasomaxillary complex fracture, resulting from a motor vehicle accident.

Maxillofacial injuries resulting from trauma can be a challenge to the Maxillo-Facial Surgeon. Frequent causes of these injuries are attributed to automobile accidents, physical altercations, gunshot wounds, home accidents, athletic injuries, work injuries and other injuries. Motor vehicle accidents tend to be the primary cause of most midface fractures and lacerations due to the face hitting the dashboard, windshield and steering wheel or the back of the front seat for passengers in the rear. Seatbelts have been shown to drastically reduce the incidence and severity of these injuries. In the United States seatbelt laws have been enacted in several states thus markedly impacting on the reduction of such trauma. In the Philippines rare is the individual who wears seat belts. Metro city traffic, however, has played a major role in reducing daytime MVA related trauma, as usually there is insufficient speed in traffic areas to cause severe impact damage, the same however cannot be said for night driving, or for driving outside of the city proper where it is not uncommon for drivers to zip into the lane of on-coming traffic in order to overtake the car in front ... often at high speeds. Thus, the potential for severe maxillofacial injuries and other trauma related injuries increases in these circumstances. It is however unfortunate that outside of Metro Manila or other major cities there is no ready access to trauma or tertiary care centers, thus these injuries can be catastrophic if not addressed adequately. With the exception of Le Fort II and III craniofacial fractures, most maxillofacial injuries are not life threatening by themselves, and therefore treatment can be delayed until more serious cerebral or visceral, potentially life threatening injuries are addressed first. Our patient was involved in an MVA in Zambales, seen and stabilized in a provincial primary care center initially, then referred to a provincial secondary care center for further stabilization before his transfer to Manila and then ultimately to our Maxillo-Facial Unit. There was a two week-plus delay in the definitive management because of this. As a result of the delay, fibrous tissue and bone callus formation occurred between the various fracture lines, thus once definitive fracture management was attempted, it took on a more reconstructive nature. Hospital based Oral and Maxillo-Facial Surgeons are uniquely trained to manage all aspects of the maxillo-facial trauma, and their dental background uniquely qualifies them in functional restoration of lower and midface fractures where occlusion plays a most important role. Likewise, their training in clinical medicine which is usually integrated into their residency education (12 months or more) puts them in a unique position to comfortably manage the basic medical needs of these patients. In instances where trauma may affect other regions of the body, an inter-multi-disciplinary approach may be taken or consults called for. In this instance, an opthalmology consult was important. In fresh trauma, often seen in major trauma centers (i.e. overseas), a "Trauma Team" is on standby 24 hours a day, and is prepared to assess and manage trauma patients almost immediately upon their arrival in the ER. The trauma team is usually composed of a Trauma Surgeon who is a general surgeon with subspecialty training in traumatology who assesses and manages the visceral injuries, an Orthopedic Surgeon who manages fractures of the extremities, a Neurosurgeon for cerebral injuries and an Oral and Maxillo-Facial Surgeon for facial injuries. In some institutions, facial trauma call is alternated between the "three major head and neck specialty services", namely Oral and Maxillo-facial Surgery, Otolaryngology-Head & Neck Surgery and Plastic & Reconstructive Surgery. (ABSTRACT TRUNCATED)

Accidents, Traffic↗
PubMed1986

[Butel's hip screw-plate in osteosynthesis of fractures of the upper end of the femur. Apropos of 241 osteosyntheses (100 true cervical fractures and 141 fractures of the trochanter)].

Butel's hip plate was used for osteosynthesis of 241 fractures of upper end of femur (100 true cervical - 141 trochanteric and subtrochanteric fractures). Results for true cervical fractures were assessed as satisfactory in 89.5% of cases, with only 3 pseudarthroses and 4 cases of femoral head necrosis (2 septic, 2 aseptic), a total complication rate of 7.5%. These clinical results confirm the value of screw fixation at several cephalic anchorage sites (demonstrated biomechanically) in true cervical fractures. Results in trochanteric and subtrochanteric fractures were rated as satisfactory in 86.9% of cases, complications including 2 ruptures of plate, 1 sepsis and 4 early loosening of plate. The latter sequela was avoided by an improved choice of indication for the procedure and by substitution of this compound material (screw-plate) for a monobloc piece ("anti-loosening cervicocephalic screw apparatus"), in compound fractures of trochanter.

Adult↗