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Displaying publications 21 - 26 of 26 in total

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Bilateral atypical femoral diaphyseal fractures in a patient treated with alendronate sodium

Lee JK

Int J Rheum Dis, 2009 Jul;12(2):149-54.
PMID: 20374333 DOI: 10.1111/j.1756-185X.2009.01396.x

Antiresorptive agents have been used as primary or first-line therapy in managing patients with osteoporosis. Bisphosphonates in particular are used widely to reduce bone resorption, increase bone mineral density, improve bone quality and therefore reduce fracture risk. However, prolonged use of bisphosphonates may cause over-suppression of bone resorption, leading on to accumulation of micro-damage in bone. This in turn might lead on to atypical femoral fractures. A patient treated with alendronate sodium for 8 years, and presenting with bilateral atypical femoral diaphyseal fractures is reported. X-rays of both femurs showed typical horizontal fracture line involving the thick lateral cortex with short oblique fracture pattern over the medial cortex. This fracture pattern was further confirmed with intra-operative examination of the fracture ends. Histopathological examination of the endocortical fragment removed from the proximal fracture end showed absence of osteoclasts and osteoblasts. Bone mineral density with dual energy X-ray absorptiometry (DXA) scan showed osteopenia over the femoral neck. Blood investigations did not show significant abnormalities. Bone turnover marker levels were not reliable, as presence of fracture might have altered the marker levels. Both femoral fractures united well. The patient reported here had complete pictures on X-ray examination, intra-operative findings, histopathological examination, DXA, as well as blood test results. Complete data should be collected from patients treated with alendronate sodium presenting with atypical femoral fractures to show any link between the use of alendronate sodium with atypical fracture of femur.

Matched MeSH terms: Femur/surgery
Letter to the editor regarding "Important tips and numbers on using the cortical step and diameter difference sign in assessing femoral rotation - Should we abandon the technique?"

Hwang PX, Wang CK

Injury, 2023 Nov;54(11):111038.
PMID: 37741171 DOI: 10.1016/j.injury.2023.111038

We have read the paper "Important tips and numbers on using the cortical step and diameter difference sign in assessing femoral rotation - Should we abandon the technique?" [1] with great interest. Restoring femoral rotation during intramedullary nailing can pose challenges to many experienced surgeons. Femur rotational side-to-side asymmetry which is greater than 10 ° will cause functional deficit. We propose a surgical technique which allows surgeons to evaluate and reduce the malrotated femur intraoperatively. This technique also improves the ergonomics of the surgery and can be used simultaneously with other femoral rotation evaluation techniques. LEVEL OF EVIDENCE: V.

Matched MeSH terms: Femur/surgery
Fulltext Prospects of implant with locking plate in fixation of subtrochanteric fracture: experimental demonstration of its potential benefits on synthetic femur model with supportive hierarchical nonlinear hyperelastic finite element analysis

Latifi MH, Ganthel K, Rukmanikanthan S, Mansor A, Kamarul T, Bilgen M

Biomed Eng Online, 2012;11:23.
PMID: 22545650 DOI: 10.1186/1475-925X-11-23

Effective fixation of fracture requires careful selection of a suitable implant to provide stability and durability. Implant with a feature of locking plate (LP) has been used widely for treating distal fractures in femur because of its favourable clinical outcome, but its potential in fixing proximal fractures in the subtrochancteric region has yet to be explored. Therefore, this comparative study was undertaken to demonstrate the merits of the LP implant in treating the subtrochancteric fracture by comparing its performance limits against those obtained with the more traditional implants; angle blade plate (ABP) and dynamic condylar screw plate (DCSP).

Matched MeSH terms: Femur/surgery
Fulltext Design process of cementless femoral stem using a nonlinear three dimensional finite element analysis

Baharuddin MY, Salleh ShH, Zulkifly AH, Lee MH, Noor AM, A Harris AR, et al.

BMC Musculoskelet Disord, 2014;15:30.
PMID: 24484753 DOI: 10.1186/1471-2474-15-30

Minimal available information concerning hip morphology is the motivation for several researchers to study the difference between Asian and Western populations. Current use of a universal hip stem of variable size is not the best option for all femur types. This present study proposed a new design process of the cementless femoral stem using a three dimensional model which provided more information and accurate analysis compared to conventional methods.

Matched MeSH terms: Femur/surgery*
Fulltext Case report: migration of a broken screw to the knee joint after hardware failure following closing wedge distal femoral osteotomy

Lee YS, Lee SH, Lee ES, Fong TS

BMC Musculoskelet Disord, 2019 Mar 20;20(1):118.
PMID: 30894158 DOI: 10.1186/s12891-019-2505-4

BACKGROUND: We report a case of hardware failure after distal femoral osteotomy (DFO) with a broken screw pulled out from the locking hole and positioned within the knee joint.
CASE PRESENTATION: A 57-year-old man presented to our orthopedic outpatient department with 3-months history of an unusual painful swelling at the operated area following DFO. The leakage of joint fluid from the penetrated suprapatellar pouch was assumed to be the reason for this complication.
CONCLUSIONS: The overall aim of this case report is to provide a lesson to budding surgeons who might experience a similar situation that cannot be easily explained, like the unexpected complication in the present case.

Matched MeSH terms: Femur/surgery
Effect of geometrical parameters on the performance of longitudinal functionally graded femoral prostheses

Oshkour AA, Talebi H, Seyed Shirazi SF, Yau YH, Tarlochan F, Abu Osman NA

Artif Organs, 2015 Feb;39(2):156-64.
PMID: 24841371 DOI: 10.1111/aor.12315

This study aimed to assess the performance of different longitudinal functionally graded femoral prostheses. This study was also designed to develop an appropriate prosthetic geometric design for longitudinal functionally graded materials. Three-dimensional models of the femur and prostheses were developed and analyzed. The elastic modulus of these prostheses in the sagittal plane was adjusted along a gradient direction from the distal end to the proximal end. Furthermore, these prostheses were composed of titanium alloy and hydroxyapatite. Results revealed that strain energy, interface stress, and developed stress in the femoral prosthesis and the bone were influenced by prosthetic geometry and gradient index. In all of the prostheses with different geometries, strain energy increased as gradient index increased. Interface stress and developed stress decreased. The minimum principal stress and the maximum principal stress of the bone slightly increased as gradient index increased. Hence, the combination of the femoral prosthetic geometry and functionally graded materials can be employed to decrease stress shielding. Such a combination can also be utilized to achieve equilibrium in terms of the stress applied on the implanted femur constituents; thus, the lifespan of total hip replacement can be prolonged.

Matched MeSH terms: Femur/surgery*