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At least 73 records · Page 4Linked to original sources
PubMed2002

Factors influencing bone fractures in severely disabled persons.

OBJECTIVES: Factors affecting bone fracture in severely disabled persons were evaluated. DESIGN: Bone mineral density was measured, and the ratio against the average values in healthy subjects was calculated. Seventy-three subjects were selected from among 113 inpatients with severe mental and physical handicaps. The subjects were classified into four levels of mobility. RESULTS: Multiple logistic regression analysis was conducted to determine the contribution of variables to the history of bone fracture. Age, medication of sodium valproate, and bone mineral density percentage were found to significantly affect bone fracture. CONCLUSIONS: Increase of bone mineral density is the protective or preventive factor in bone fracture.

Activities of Daily Living↗
PubMed1994

Histopathology of temporal bone fractures: implications for cochlear implantation.

Temporal bone fractures often cause loss of audiovestibular function. Those patients with bilateral profound sensorineural hearing losses secondary to temporal bone fractures become candidates for cochlear implantation. The authors present the histopathology of five temporal bone fractures in three patients, evaluating specifically the traumatic effects on the neural elements of the inner ear. Transverse fractures of the temporal bone result in severe loss of hair cells, ganglion cells, and other supporting cells in the inner ear. Occasionally labyrinthitis ossificans may occur as a consequence of trauma or infection. While longitudinal fractures do not violate the otic capsule, these same neural elements may be damaged by concussion.

Adult↗
PubMed2005

Isolated hyoid bone fracture. Review of an unusual entity.

Fractures of hyoid bone resulting from trauma other than strangulation are very rare, isolated hyoid bone fractures are even rarer, and occur more frequently in young individuals, and in men more than in women. A comprehensive review of the world literature, also two rare cases of isolated hyoid bone fractures induced by direct trauma onto the anterior neck are presented. Additionally, a table summarizing 31 cases from 1954 to 2003, is included. Mechanism of injury, diagnosis, complications, prognosis, and treatment are discussed.

Adult↗
PubMed2002

Perioperative considerations in major orthopedic trauma: pelvic and long bone fractures.

Although pelvic fractures constitute a small percentage of total orthopedic injuries, they are associated with highest mortality rate. Pelvic fractures, along with long bone fractures, frequently are the result of significant blunt trauma often encountered in high-speed motor vehicle accidents. However, other types of trauma can cause these devastating injuries. Early recognition and a high index of suspicion are necessary to ensure that effective and aggressive resuscitation is instituted immediately. Expeditious assessment in the emergency department and care of the patient with pelvic and long bone fractures will greatly enhance the ongoing resuscitation in the operating room. Potentially life-threatening associated injuries in these patients make resuscitation even more challenging. Therefore, a basic knowledge of the mechanisms of injury, early treatment in the emergency department, and the factors that affect intraoperative management will help optimize the outcome for patients with these injuries. This course describes the perioperative concerns and the evaluation and treatment of a patient with a pelvic or a long bone fracture.

Bone and Bones↗
PubMed2001

[Research on the relationship between populations' long-term exposure to fluoride in drinking water and bone fracture in China].

There are contradictory reports on the prevalence of bone fractures associated with long-term fluoride exposure from drinking water. The prevalence of bone fracture in six rural areas of China and the exposure of fluoride in drinking water was investigated. The data including medical history and demographic information, bone fractures, fluoride content in drinking water, physical activity, cigarette smoking, alcohol consumption and dietary intakes were collected. A retrospective epidemiological study by using the same design, method, quality control and the same questionnaire was conducted. A total of 8266 male and female over 50 years of age were divided into 6 groups by the fluoride concentrations in drinking water. The subjects in each group exposed to different levels of fluoride (0.25-0.34, 0.58-0.73, 1.00-1.06, 1.45-2.19, 2.62-3.58 and 4.32-7.97 mg/L) were 1363, 1407, 1370, 1574, 1051 and 1501 respectively. It has been confirmed that drinking water was the only major source of fluoride exposure in the studied populations. The total bone fracture rates were 7.41%, 6.40%, 5.11%, 6.04%, 6.09% and 7.40% in each group. Natural bone fracture rates in each group were 3.01%, 2.21%, 1.31%, 1.65%, 1.43% and 3.66% respectively. The prevalence of bone fracture and water fluoride level appeared a U-shaped relationship. The prevalence of total bone fracture and natural bone fracture in the population with fluoride 1.00-1.06 mg/L in drinking water was the lowest, compared with the groups exposed to fluoride higher than 4.32 mg/L and lower than 0.73 mg/L. The highest prevalence of hip fracture was in the group with higher water fluoride (4.32-7.97 mg/L) exposure. In general, the prevalence of hip fracture was lower and stable up to 1.06 mg/L of fluoride in drinking water, and then it appeared to rise. Based on the data collected in this investigation, it is concluded that the long-term fluoride exposure from drinking water higher than 4.32 mg/L might increase the risk of overall fractures as well as hip fractures. The risk of overall fractures and natural fractures might be lower while the water fluoride level is at 1.00-1.06 mg/L, however, no protective benefits of fluoride for the risk of hip fracture was observed.

Aged↗
PubMed2001

[Stimulation of bone fracture healing in rats under the support load deficit].

Experiment with rats the hind limbs of which were deprived of support loads (tail suspension) for two weeks following operational fracture of fibular bones evidenced inhibited callus formation and lowered strength of bone fragments consolidation. Injection of anabolic steroid retabolite to the traumatized animals together with limited support loading was favorable to the bone callus formation and consolidation of fragments. This measure also distinctly increased the functional activity of adenohypophysial somatotrophs (growth hormone producers) and thyroid C-cells (calcitonine producers). The direct dependence of bone fracture healing on the somatotropic function of the adenohypophysis suggests that the favorable effect of retabolite combined with the support loading is at least partly achieved through the somatorophic function of the adenohypophysis.

Animals↗
PubMed1996

[The influence on radioulnar joints after single-bone fracture of the forearm in children].

For the sake of researching overgrowth after single-bone fracture of the forearm in children, 179 patients were reviewed, the range of follow-up was 5-8 years, mean 7.5 yrs. (Not including Montaggia's, Galeazzi fracture's and physeal injuries). Bilateral comparative X-ray assessments were as follows: length of ulna and radius, radioulnar angle, ulnar deviation angle and anteversion angle of the radius, radial capitular line, position of the humeral head, and the movement of wrist and elbow joint. Overgrowth of the fractured bones existed only in 4 patients' by the length of 2-4 mm. Movements of wrist and elbow joints were normal. As the forearm is a double-bone balanced extremity, the injury is not very severe after single-bone fracture and overgrowth is usually hard to be observed.

Adolescent↗
PubMed2003

Biophysical stimulation of bone fracture repair, regeneration and remodelling.

Biophysical stimulation to enhance bone fracture repair and bone regenerate maturation to restore its structural strength must rely on both the biological and biomechanical principle according to the local tissue environment and the type of mechanical stress to be born by the skeletal joint system. This paper reviews the possible interactions between biophysical stimuli and cellular responses in healing bone fractures and proceeds to speculate the prospects and limitations of different experimental models in evaluating and optimising such non-invasive interventions. It is important to realize that bone fracture repair has several pathways with various combinations of bone formation mechanisms, but there may only be one bone remodeling principle regulated by the hypothesis proposed by Wolff. There are different mechanical and biophysical stimuli that could provide effective augmentation of fracture healing and bone regenerate maturation. The key requirements of establishing these positive interactions are to define the precise cellular response to the stimulation signal in an in vitro environment and to use well-established animal models to quantify and optimise the therapeutic regimen in a time-dependent manner. This can only be achieved through research collaboration among different disciplines using scientific methodologies. In addition, the specific forms of biophysical stimulation and its dose effect and application timing must be carefully determined and validated. Technological advances in achieving focalized stimulus delivery with adjustable signal type and intensity, in the ability to monitor healing callus mechanical property non-invasively, and in the establishment of a robust knowledge base to develop effective and reliable treatment protocols are the essential pre-requisites to make biophysical stimulation acceptable in the main arena of health care. Finally, it is important to bear in mind that successful fracture repair or bone regeneration through callus distraction without adequate remodeling process through physiological loading would seriously undermine the value of biophysical stimulation in meeting the biomechanical demand of a long bone.

Animals↗
PubMedDate not supplied

Assessment of stiffness and strength of 4 different implants available for equine fracture treatment: a study on a 20 degrees oblique long-bone fracture model using a bone substitute.

OBJECTIVE: To compare the mechanical properties of 4 stabilization methods for equine long-bone fractures: dynamic compression plate (DCP), limited contact-DCPlate (LC-DCP), locking compression plate (LCP), and the clamp-rod internal fixator (CRIF--formerly VetFix). STUDY DESIGN: In vitro mechanical study. SAMPLE POPULATION: Bone substitute material (24 tubes) was cut at 20 degrees to the long axis of the tube to simulate an oblique mid-shaft fracture. METHODS: Tubes were divided into 4 groups (n=6) and double plated in an orthogonal configuration, with 1 screw of 1 implant being inserted in lag fashion through the "fracture". Thus, the groups were: (1) 2 DCP implants (4.5, broad, 10 holes); (2) 2 LC-DCP implants (5.5, broad, 10 holes); (3) 2 LCP implants (4.5/5.0, broad, 10 holes) and 4 head locking screws/plate; and (4) 2 CRIF (4.5/5.0) and 10 clamps in alternating position left and right of the rod. All constructs were tested in 4-point bending with a quasi-static load until failure. The implant with the interfragmentary screw was always positioned on the tension side of the construct. Force, displacement, and angular displacement at the "fracture" line were determined. Construct stiffness under low and high loads, yield strength, ultimate strength, and maximum angular displacement were determined. RESULTS: None of the implants failed; the strength of the bone substitute was the limiting factor. At low loads, no differences in stiffness were found among groups, but LCP constructs were stiffer than other constructs under high loads (P=.004). Ultimate strength was lowest in the LCP group (P=.01), whereas yield strength was highest for LCP constructs (409 N m, P=.004). CRIF had the lowest yield strength (117 N m, P=.004); no differences in yield strength (250 N m) were found between DCP and LC-DCP constructs. Differences were found for maximum angular displacement at the "fracture" line, between groups: LPC<DCP<LC-DCP<CRIF (P< or =.037). CONCLUSIONS: DCP, LC-DCP, and LCP constructs provided sufficient biomechanical stability to withstand single-cycle loads that might be experienced postoperatively. LCP constructs showed the best performance because of the highest yield strength, above which irreversible deformation occurred. Inadequate biomechanical properties, excessive motion, and shape of the device create concern about the use of CRIF in these large sizes. CLINICAL RELEVANCE: CRIF does not meet the demands for equine long-bone fracture treatment. With respect to biomechanical properties, DCP, LC-DCP, and LCP constructs did not show critical differences so other factors may direct clinical selection of these implants. We prefer the LCP implants because of the high yield strength, high stiffness under high-load application, and the least movement at the fracture line.

Animals↗
PubMed1979

Bilateral longitudinal temporal bone fractures: a retrospective review of seventeen cases.

The types of temporal bone fractures, longitudinal and transverse, are reviewed. All cases of bilateral temporal bone fractures at Parkland Memorial Hospital in Dallas over a 10-year period from 1968 to 1978 are reivewed and discussed by the authors. One hundred sixty patients with the diagnosis of base of skull fractures were studied. Fifty-nine of these were temporal bone fractures and 17 of the 59 were bilateral. Of all the base of skull fractures, 10% were bilateral temporal bone fractures and 29% of all temporal bone fractures were bilateral. For each case the method of injury, the extent of damage to hearing and facial nerve function, presence of CSF otorrhea, X-ray findings, and additional complications are summarized and the results discussed. The operative findings of facial nerve decompressions are carefully reviewed. The authors' method of caring for temporal bone fractures is presented.

Facial Paralysis↗
PubMed2007

Clinical epidemiology of long-bone fractures in patients receiving hemodialysis.

Although prevention of metabolic bone disease is a principal component of management of end-stage renal disease, the clinical epidemiology of long-bone fractures is not completely understood. Hospital discharge claims from 1994 through 1999 for 7159 subjects in the Dialysis Morbidity and Mortality Study were used to quantify incidence and risk factors of long-bone fractures and to test the hypothesis that long-bone fractures are associated with cardiovascular and infectious events and death in patients receiving hemodialysis. The incidence of long-bone fractures was 16.93 per 1000 patient-years, with the femoral neck being the most common site (59.8%); multivariate analysis revealed greater risk with older age, female gender, diabetes, more years receiving dialysis, and cardiovascular disease, and lower risk with African American race, increasing body mass index, parathyroid hormone values in the fourth quintile (227.1-538.0 pg/mL), and renal transplantation during followup. Postfracture mortality rates were 522.57 per 1000 patient years (versus 215.35 in the overall population). Time-dependent analysis suggested the adverse prognosis of long-bone fractures was related to subsequent congestive heart failure, stroke, pulmonary embolism, pneumonia, and septicemia. Long-bone fractures are common in patients receiving dialysis; their adverse prognostic implications may be linked to major cardiovascular and infectious events.

Aged↗
PubMed1989

Role of natural frequency of bone as a guide for detection of bone fracture healing.

The natural frequency of bone is studied in normal and fractured bones, in vitro as well as in vivo, by recording the outputs of microphone pick-ups, attached at proximal and distal ends to the bone defect. Natural frequency of bone is determined for an optimum output displayed on a cathode ray oscilloscope with respect to different stress wave frequencies. A comparative study of normal and fractured bone in vivo in 25 patients was made to diagnose the size of the fracture and its rate of healing. The natural frequency and intensity of sound in the injured bone was reduced while the output voltage increased with respect to the normal bone. The investigation reports a simple, reliable and rapid technique for the assessment of bone fracture.

Animals↗
PubMed2006

Vibrational characteristics of bone fracture and fracture repair: application to excised rat femur.

BACKGROUND: The vibrational characteristics of any object are directly dependent on the physical properties of that object. Therefore, changing the physical properties of an object will cause the object to adopt changed natural frequencies. A fracture in a bone results in the loss of mechanical stability of the bone. This change in mechanical properties of a bone should result in a change of the resonant frequencies of that bone. A vibrational method for bone evaluation has been introduced. METHOD OF APPROACH: This method uses the radiation force of focused amplitude-modulated ultrasound to exert a vibrating force directly, and remotely, on a bone. The vibration frequency is varied in the range of interest to induce resonances in the bone. The resulting bone motion is recorded and the resonance frequencies are determined. Experiments are conducted on excised rat femurs and resonance frequencies of intact, fractured, and bonded (simulating healed) bones are measured. RESULTS: The experiments demonstrate that changes in the resonance frequency are indicative of bone fracture and healing, i.e., the fractured bone exhibits a lower resonance frequency than the intact bone, and the resonance frequency of the bonded bone approaches that of the intact bone. CONCLUSION: It is concluded that the proposed radiation force method may be used as a remote and noninvasive tool for monitoring bone fracture and healing process, and the use of focused ultrasound enables one to selectively evaluate individual bones.

Animals↗
PubMed1997

Management of complications from 820 temporal bone fractures.

OBJECTIVE: To review the incidence of complications resulting from temporal bone fractures and analyze the outcomes from surgical and nonsurgical management. STUDY DESIGN: A retrospective review of 699 patients with 820 temporal bone fractures occurring over a 5-year period. SETTING: A single level 1 trauma center. PATIENTS: All patients with clinical or radiologic evidence of a temporal bone fracture. RESULTS: A total of 820 fractured temporal bones resulted in 58 facial nerve injuries, 122 CSF fistulae, and 15 cases of meningitis. The two most important prognostic factors in recovery of facial paralysis were severity and delay of onset. All patients with incomplete paralysis recovered. All but one of the delayed onset palsies had good recovery of function. A total of 40% of patients with immediate onset complete paralysis had poor recovery of function. Ninety-five of the 122 CSF fistulae closed spontaneously within 1 week. CSF fistulae persisting for > 7 days had a significantly increased risk of developing meningitis (23%) compared with patients whose fistulae closed within 7 days (3%) (p = 0.001). Another important risk factor for the development of meningitis was concurrent infection. CONCLUSIONS: Facial function following temporal bone fractures should be evaluated in the emergency room. If facial motion is noted at any time after the injury, surgical intervention is rarely indicated. Prophylactic antibiotics should be considered in temporal bone fractures when CSF fistulae are present. Surgical closure of a CSF fistula is indicated if it persists for > 7-10 days.

Adolescent↗
PubMed1998

Pediatric temporal bone fractures.

OBJECTIVE: To examine the etiology, presentation, and management of temporal bone fractures in children. STUDY DESIGN: Case control. METHOD: Retrospective review of a level I pediatric trauma center from July 1, 1990 to November 1, 1996 identified 680 patients. Inclusion criteria of age less than 14 years and only blunt temporal bone trauma identified 122 patients, with 97 charts available for review. The criteria for temporal bone fracture consisted of both clinical and radiologic information. Only patients with temporal bone fractures confirmed by computed tomography, a complete otolaryngology examination, and audiometric evaluations were included in the study. The data were analyzed with the Kruskal-Wallis analysis of variance (ANOVA) for examining the three separate age groups of fractures. Chi-squared analysis was used to compare these data with previously published adult and pediatric temporal bone fracture series and to examine the three separate age groups of fractures. RESULTS: The review identified 72 children with 79 temporal bone fractures: 47 boys and 25 girls. The patients ranged from 6 months to 14 years of age, with a bimodal distribution of patients with peaks at 3 years and 12 years of age. The most common causes of fractures were motor vehicle accidents (47%), falls (40%), biking accidents (8%), and blows to the head (7%). Common presenting signs and symptoms included hearing loss (82%), hemotympanum (81%), loss of consciousness (63%), intracranial injuries (58%), bloody otorrhea (58%), extremity fractures (8%), and facial nerve weakness (3%). The most common causes of temporal bone fractures were falls and motor vehicle accidents. Forty-two patients were noted to have bloody otorrhea and possible cerebrospinal fluid leak. Twenty-four received intravenous antibiotics. No patient developed prolonged otorrhea or meningitis during hospitalization and the follow-up period. The classification of fracture patterns was longitudinal, 54%; transverse, 6%; oblique, 10%; squamous, 27%; and other, 3%. Hearing loss was found in 59 patients, with conductive hearing loss being the most common finding in 56% of the patients, followed by sensorineural hearing loss in 17% and mixed hearing loss in 10%. CONCLUSIONS: Pediatric temporal bone fractures are associated with falls and motor vehicle accidents. There is a high incidence of associated intracranial injuries and hearing loss, but facial nerve injuries are uncommon. Timely management minimizes complications.

Accidental Falls↗
PubMed1991

[Diagnosis of carpal bone fractures].

The diagnosis of carpal bone fractures has been facilitated by new radiological projections and by the advent of modern imaging methods. Fractures of the scaphoid bone still account for 75% of carpal fractures with their complications (pseudarthrosis, malunion) and their sequelae of arthrosis. However, the frequency of other fractures appears to be increasing due to a better knowledge of their mechanism and to the possibilities of the new imaging methods.

Carpal Bones↗