PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “bone fracture”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original 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
PubMed2000

Antibiotic prophylaxis for surgery for proximal femoral and other closed long bone fractures.

BACKGROUND: Antibiotic prophylaxis has been established policy for major surgical operations for many years. In fracture fixation, the effectiveness, and the duration of administration, have been a matter of debate. OBJECTIVES: To assess the effects of the prophylactic administration of antibiotics in patients undergoing surgical management of hip or other long bone fractures. SEARCH STRATEGY: We searched MEDLINE, EMBASE, Current Contents, Dissertation Abstracts, and Index to UK Theses, and bibliographies of identified articles. Trials were also obtained from the Cochrane Musculoskeletal Injuries Group trials register. Date of the most recent search: end of 1997. SELECTION CRITERIA PARTICIPANTS: Any patients with a hip or other closed long bone fracture undergoing surgery for internal fixation or replacement arthroplasty. INTERVENTIONS: Any regimen of systemic antibiotic prophylaxis administered at the time of surgery. OUTCOME MEASURES: Wound infection (deep and superficial), urinary tract infection, respiratory tract infection, adverse effects of prophylaxis, economic evaluations. DATA COLLECTION AND ANALYSIS: Both reviewers independently selected trials for inclusion, and assessed methodological quality and extracted data. Where possible, data were pooled and Peto odds ratios and absolute risk reductions, each with 95% confidence intervals, calculated. MAIN RESULTS: Twenty one randomised trials of only poor or moderate quality were included. The comparisons tested fell within six comparison groups, principally multiple dose or a single dose of antibiotic versus a placebo or no treatment. Antibiotic prophylaxis reduces wound, urinary and respiratory tract infections in patients undergoing surgery for closed fracture fixation. Economic modelling has indicated that this is a cost-effective intervention. There are limited data for the incidence of adverse effects, but as expected they appear to be more common in those receiving antibiotics. REVIEWER'S CONCLUSIONS: Antibiotic prophylaxis should be offered to those undergoing surgery for closed fracture fixation. On ethical grounds, further placebo controlled randomised trials of the effectiveness of antibiotic prophylaxis in closed fracture surgery are unlikely to be justified. Trials addressing the cost-effectiveness of different effective antibiotic regimens would need to be very large and may not be feasible.

Antibiotic Prophylaxis↗
PubMed2002

[Pediatric temporal bone fractures].

Temporal bone trauma are more common nowadays related to sports. We report 2 cases with temporal bone fractures in patients younger than 14 years. They were two male, 9 and 12-year-old respectively, that presented traumatism after accidental falls from lowe height. The first case had a longitudinal temporal bone fracture without hypoacusia or vertigo, whereas the second one had an oblique fracture involving the otic capsule, provoking permanent neurosensorial hearing loss, as well as vertigo and unsteadiness that resolved later, related to a vestibular hyporreflexia. Neither case had facial paresia or paralysis. CT scanning was essential to determine the importance of the trauma. Despite the otic capsule rupture, hearing loss in the second case was only significant over 2 KHz, suggesting a selective cochlear trauma. We present clinical and imaging findings, as well as correlation of audiological and vestibular alterations, reviewing the clinical presentation of temporal bone trauma in children.

Cerebrospinal Fluid Otorrhea↗
PubMed2004

[Diagnosis and treatment of zygomatic bone fractures].

Zygomatic bone fractures are the second most often injury of facial skeleton and sometimes cause diagnostic and treatment problems. Authors of this article present diagnostic and treatment methods applied in 165 patients (139 men, 22 women, 4 children) treated in I Department of Maxillofacial Surgery in Zabrze, in year 1996-2000. Closed repositioning was performed in 70 patients with fractures with single bone fragment. In multiple fractures complicated with sight disorders (diplopia) and in case of old fractures, open repositioning and fixation using mini- and microplates was a method of choice. Achieved clinical and radiological results of treatment show that both close repositioning with single-toothed hook and open repositioning and fixation are effective methods of treatment. Early diagnosis and treatment of zygomatic fractures make treatment easier and prevent from vision and mastication complication.

Adult↗
PubMed1994

The influence of dichloromethylene bisphosphonate on the healing of a long bone fracture, composition of bone mineral and histology of bone in the rat.

The effects of dichloromethylene bisphosphonate (clodronate) on the composition of bone mineral, morphology and histology of a long bone with an artificial femoral fracture were studied in a 22 week experiment. Two hundred twenty-four female rats were allocated to dose groups of 0, 3, 10, and 30 mg/kg clodronate daily subcutaneously. Bone calcium, phosphorus and magnesium concentrations remained stable and fluoride concentration rose with time. There were no statistical differences between different groups. Clodronate did not alter the histology of the callus nor delayed the healing of the fracture. It caused mild to moderate prominence of the metaphyseal area in the fractured bone in a dose- and time-dependent manner. Serum osteocalcin levels were lowered in the treated animals dose-dependently. Other serological as well as haematological values were within normal range. Clodronate seems in this experimental arrangement to be a safe agent to administer in different pathological conditions of bone even when they are complicated by fractures of long bones.

Animals↗
PubMed1995

Temporal bone fractures.

Temporal bone fractures are clinically interesting because of the rich anatomy across which they traverse. These fractures most often present after blunt head trauma and may present with a variety of symptoms including facial nerve paralysis, hearing loss, and vertigo. This paper will classify these fractures and discuss their associated clinical findings.

Humans↗
PubMed1997

Women with past history of bone fracture have low spinal bone density before menopause.

AIMS: Recent work from our laboratory has demonstrated that young girls with bone fractures have low spinal bone density more often than girls who have never fractured. This study was undertaken to determine whether adult women approaching menopause who have any past history of fracture have lower spinal density than women who have never fractured. METHODS: A lifetime fracture history was taken from all premenopausal women (n = 59) enrolled in a clinical trial examining the effect of menopause on cardiac risk. Bone mineral density of the lumbar spine was measured at study entry by dual energy x-ray absorptiometry (Lunar DPX-L) and results from patients with and without fracture were compared. RESULTS: Women with a previous history of fracture (n = 23) had significantly lower bone density (6% less) than the women who had never broken a bone (n = 36). CONCLUSIONS: We conclude that women who report a previous history of fracture, either as young adults or in childhood, should be targeted for perimenopausal screening for osteoporosis since they are likely to have lower bone density and a greater risk of future fracture than women with no past history of fracture.

Absorptiometry, Photon↗
PubMed1979

[An experimental study on the effects of the plating method for bone fractures--with reference to bone union and bone strength (author's transl)].

The plating method for bone fractures is in wide use. The author studied both new bone formation and bone atrophy of the cortex of fracture site after long periods of plating. This study is concerned with the bone strength of the fracture site as influenced by rigid plate fixation, and also with bone union after the removal of the plate. The experimental results, using mature rabbits as subjects, showed the following: X-rays of the bone union at the fracture site treated by the plating method confirmed evident union at 8 weeks after surgery. The bone strength at the region of this union, as tested by the bending method (an Instron Type Testing Machine was used), showed its highest values at 28 weeks after surgery. Yet, this was only 60% of the bone strength as measured at a non-fracture site; it then gradually declined in strength. On the other hand, in the case where the plate had been removed 8 weeks after surgery, bone strength was recovered to the same level as that of non-fracture sites 16 weeks after surgery. In conclusion, rigid plate fixation for a long period may result not only in progressive bone atrophy of the cortex but also in a delayed remodeling of the bone at the region of the bone union. It is, therefore, very important to remove the plate as early as possible once union has been achieved. Careful observation, however, is necessary during the short time between plate removal and the period when bone strength becomes again normal.

Animals↗
PubMed1979

Changes in connective tissue metabolism due to bone fractures in children aged 10--14 years. III. Urinary hydroxyproline and glycosaminoglycan excretion following bone fractures treated in different ways.

Urinary hydroxyproline and glycosaminoglycan excretion was studied in the course of fracture healing in twenty 10--14-year-old children with fracture of the femur or of the tibia and fibula. In 11 children reduction and plaster cast were used, in 5 osteosynthesis, and in 4 extension of 6--21 days duration combined with immobilization by plaster cast. In the state of resorption, an increase was observed in the urinary excretion of hydroxyproline and total glycosaminoglycans and in the six glycosaminoglycan fractions studied. As a result of the soft tissue damage accompanying the fracture, the excretion of hyaluronic acid, heparan sulphate, and dermatan sulphate showed the most marked increase. No statistically significant relationship could be demonstrated between the mode of treatment and the amounts of urinary hydroxyproline and glycosaminoglycan, but the stage of resorption was prolonged in the case of treatment with traction. At the beginning of regeneration, a decrease in hydroxyproline excretion and then an increase corresponding to the intensive synthesis of collagen were demonstrated. Glycosaminoglycan excretion during the development of fibrous callus was considerably below the control value. Excretion of the metabolites decreased markedly in the five operated patients. in the case of extension, the stage of regeneration prolonged by 4 to 10 days. In the stage of calcification, urinary hydroxyproline excretion was increased while the excretion of glycosaminoglycan and its fractions was the same as in the controls except in the patients treated with traction. No statistically significant relationship was found between the urinary amounts of hydroxyproline and glycosaminoglycan and the mode of treatment. In the case of traction, fracture repair and the formation of connective tissue callus were prolonged.

Adolescent↗
PubMed1989

Floating petrous bone fracture.

Floating petrous bone fracture appears to occur when the elastic pediatric skull is subjected to large compressive forces. Unlike a longitudinal fracture, a floating petrous bone fracture does not involve the ear canal and squamous cortex. Rather, the fracture line runs through the middle ear, separating the petrous apex from its lateral and inferior bony attachments. Characteristic clinical findings include immediate onset of conductive hearing loss, with ipsilateral sixth and seventh cranial nerve paralysis. This article details the third known occurrence of this type of fracture, and includes a discussion of the pathophysiologic mechanism and treatment rationale.

Child↗
PubMed1989

Strain rate dependence of the mechanical properties of reindeer antler and the cumulative damage model of bone fracture.

Carter and Caler have produced a 'cumulative damage' model for the fracture of bone, based on creep experiments on human bone, which has been corroborated by monotonic tensile tests on bone, loaded at various strain rates. Monotonic tensile tests on reindeer's antler, which has a lower modulus of elasticity than human bone, produce very similar results. Unlike human bone, reindeer antler always shows a large post-yield strain, and it is possible to distinguish pre-yield and post-yield behaviour. The 'final stiffness' (ultimate stress/ultimate strain) is invariant with strain rate. This is confirmation that bone fractures when a certain amount of damage has accumulated. However, reindeer antler shows a considerable post-yield increase in stress. This is difficult to accommodate in a cumulative damage model.

Animals↗
PubMed1989

[Pathologic bone fractures: definition and classification].

A bone fracture is a complete or incomplete discontinuity of bone caused by a direct or indirect force. A pathological bone fracture is a bone fracture which occurs without adequate trauma and is caused by a preexistent pathological bone lesion. Causes include resorption of bone mass (osteoporosis), reduction of bone quality (osteomalacia, osteonecrosis), insufficient bone production (osteogenesis imperfecta, fibrous dysplasia), augmented bone resorption (giant cell granulomas, aneurysmal bone cyst), pathological bone remodelling (Paget's disease), or local bone destruction due to tumorous growths. A pathological bone fracture has to be detected clinically as well as radiologically and its cause diagnosed histologically in order to ensure adequate therapy.

Bone and Bones↗
PubMed2001

[Analysis and experimental study of reasons for breakage in the bone fracture plate during internal fixation].

Bone fracture plate has been in clinical use for internal fixation of fracture, however, during healing, the steel plate breaks occasionally. This paper applied the static strength theory to imitate the pressed down combination out of shape that was borne by single limb of human body standing. Fracture was made on low limbs of the fresh dead body, fixed with a bone fracture plate. Strain measure was made on a bone fracture plate. Additionally, fatigue experiment and four-point bending experiment were carried out on a bone fracture plate. The reason for a breakage in the bone fracture plate was analyzed with static strength theory and low period fatigue theory.

Bone Plates↗
PubMed2005

Lymphoscintigraphic monitoring of the lower limb lymphatic system response to bone fracture and healing.

Closed bone fractures, and torn muscles and tendons are "internal wounds". What kind of reaction do they evoke in the local and systemic immune system? Cellular debris of damaged tissue and extravasated blood cells are removed by scavenger cells. They are transported via lymphatics to the lymph nodes. There elimination of self antigens takes place. Clinically, no enlargement of lymph nodes is observed after closed fractures and soft tissue damage. The question arises whether there is really no enlargement of regional lymph nodes, in other words, no reaction to damaged cell antigens. This question was studied by using lymphoscintigraphy to visualize lymphatics and lymph nodes draining the site of closed bone fracture. The lymphoscintigraphic pictures of two groups of patients, those with a rapid noncomplicated healing of leg fractures, and those with protracted healing and undergoing surgical reconstructions, were evaluated. The surface area of lymphatic pathways and inguinal lymph nodes on the injured and contralateral normal limb were measured. Enlarged superficial lymphatics and inguinal lymph nodes were found in limbs with healed bone fractures, and decreased inguinal lymph nodes and visualization of deep lymphatics and popliteal nodes in the majority of patients with nonhealing fractures. There was a lack of correlation between age of patients, duration of healing, and surgical interventions and the lymphoscintigraphic changes. These findings suggest that the fracture gap tissue is a dominant source of signals to the lymph nodes, releasing cellular and humoral regulatory factors. Taken together, there is a strong immune reaction of lymph node to the fracture, although it cannot be recognized clinically.

Adult↗
PubMed1996

Depressed osteoblast activity and increased osteocyte necrosis after closed bone fracture and hemorrhagic shock.

BACKGROUND: Although bone fracture and hemorrhagic shock are frequent complications in trauma patients, it remains unknown whether hemorrhagic shock after bone fracture produces any deleterious effects on osteoblast function and osteocyte necrosis. METHODS: Sham-operation, closed bone fracture (right tibia) with and without hemorrhagic shock (mean arterial blood pressure 35 +/- 5 mm Hg for 90 minutes followed by fluid resuscitation) were induced in 18 male C3H/HeN mice (25 g body weight) At 72 hours after the experiment, all animals were killed, whole blood was obtained by cardiac puncture, and plasma assayed for circulating levels of osteocalcin. RESULTS: Plasma osteocalcin levels were found to be significantly depressed after closed bone fracture in conjunction with hemorrhagic shock. Closed bone fracture alone increased plasma osteocalcin. Histologic analysis of the fracture sites revealed that hemorrhagic shock after closed bone fracture significantly increased osteocyte necrosis adjacent to the fracture site, when compared to animals with closed bone fracture alone. CONCLUSIONS: These findings suggest that severe hemorrhage after closed bone fracture depresses osteoblast activity and increases osteocyte necrosis, which should compromise fracture healing under those conditions.

Animals↗
PubMed1976

Use of the dynamic compression plate for treatment of equine long-bone fractures.

Long-bone fractures of 6 foals admitted consecutively to the Ohio State University Veterinary Hospital were treated successfully with ASIF dynamic compression plating. The cases included 2 foals with closed fracture of the metacarpus, and 1 foal each with open nonunion of the metatarsus, closed fracture of the radius, open fracture of the tibia, and open fracture of the ulna. Five of these foals became sound, with no deformity, so they could be trained for racing or showing. The 6th foal, a filly with nonunion, became "pasture-sound" and was scheduled for breeding. It was concluded that the dynamic compression plates have many advantages over conventional ASIF plates. These advantages include: the plates can be put near the end of bones; screws can be put at an angle other than 90 degrees to the plate; cancellous screws can be used in any hole; plates can be shaped and the screw heads will still fit the holes; less exposure is required; and operating time is shorter.

Animals↗
PubMed1985

Retinal lesions following long bone fractures.

Patients with long bone fractures are at risk for the fat embolism syndrome (FES). Although an estimated 50% of patients with overt FES have retinal abnormalities, the overall incidence of fundus lesions in patients with long bone fractures has not been studied. We examined 100 consecutive patients who had suffered long bone or pelvic fractures in the absence of head, abdominal, or thoracic injury, and who had no other diseases associated with retinopathy. Only one patient had visual symptoms. Cotton-wool spots and retinal hemorrhages were observed in four patients, none of whom were suspected of FES prior to our examination. Subclinical FES may be found by ophthalmoscopy in patients with long bone fractures.

Adolescent↗