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At least 19 recordsLinked to original sources
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↗
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↗
PubMed1992

Case report 725. Posterior displacement of proximal end of the right radius and capitulum with supracondylar fracture causing a displaced fracture rather than a fracture dislocation.

An 11-month-old boy with a swollen, painful right elbow demonstrated a supracondylar fracture on plain film radiographic studies. Sonography was subsequently performed to exclude dislocation of the elbow and demonstrated the supracondylar fracture as well as a normal relationship of the capitulum and radius, signifying a displaced fracture without associated dislocation. A bone dislocation would generally require dosed reduction alone, whereas distal humeral epiphyseal separation usually requires open reduction or percutaneous (pin) fixation. This case demonstrates the utility of ultrasound in the evaluation of physeal disruption and dislocation in the elbow prior to ossification of the secondary centers of ossification.

Diagnosis, Differential↗
PubMed1991

Pre-existing fractures and bone mass predict vertebral fracture incidence in women.

OBJECTIVE: To determine the independent contributions of bone mass and existing fractures as predictors of the risk for new vertebral fractures. SUBJECTS: Postmenopausal Japanese-American women. MEASUREMENTS: Baseline measurements of the distal radius, the proximal radius, and the calcaneus were obtained in 1981 using single-photon absorptiometry. Measurements of the lumbar spine were obtained in 1984 using dual-photon absorptiometry. Prevalent vertebral fractures were identified using dimensions measured on lateral radiographs; vertebral height values more than 3 SD below vertebra-specific means were considered to indicate fracture. Statistical models were used to evaluate the utility of bone mass and existing (prevalent) fractures to predict the risk for new fractures during an average follow-up of 4.7 years. MAIN RESULTS: Differences of 2 SD in bone mass were associated with fourfold to sixfold increases in the risk for new vertebral fractures. A single fracture at the baseline examination increased the risk for new vertebral fractures fivefold. Presence of two or more fractures at baseline increased the risk 12-fold. A combination of low bone mass (below the 33d percentile) and the presence of two or more prevalent fractures increased the risk 75-fold, relative to women with the highest bone mass (above the 67th percentile) and no prevalent fractures. Stature, body mass index, arm span, and spinal conditions such as scoliosis, osteoarthritis, and sacroiliitis did not predict fracture incidence (P greater than 0.05). Weight was marginally predictive (P = 0.04) of fracture incidence but became nonpredictive after adjusting for bone mass (P greater than or equal to 0.05). CONCLUSIONS: Both bone mass and prevalent vertebral fractures are powerful predictors of the risk for new vertebral fractures. Combining information about bone mass and prevalent fracture appears to be better for predicting new fractures than either variable alone. Physicians can use these risk factors to identify patients at greatest risk for new fractures.

Absorptiometry, Photon↗
PubMed1977

Condylar fractures of the mandible. I. Classification and relation to age, occlusion, and concomitant injuries of teeth and teeth-supporting structures, and fractures of the mandibular body.

In 123 individuals, 138 fractures of the mandibular condyle were classified with respect to fracture level, dislocation at the fracture level, and condylar head relation to the articular fossa. The age of the patient and the location of the most distal occlusal contact were recorded as well as teeth injuries and concomitant fractures of the mandibular body. The position of the most distal occlusal contact did not influence the dislocation of the condylar fragment. Teeth injuries such as fractures and luxation were found to be associated with condylar head or neck fractures, whereas the concomitant fractures of the mandibular body were mostly seen with the subcondylar fractures. Teeth injuries as well as concomitant fractures of the mandibular body were found more frequently in patients with bilateral than unilateral condylar fractures. Fractures of teeth in the molar and bicuspid regions were most frequent on the condylar fracture side, while the concomitant fractures of the mandibular body were located to the contralateral side. Medial angulation of the condylar fragment with lateral override at the fracture level was the typical fracture in adults, and angulation without override the characteristic fracture in growing individuals. Medical override occurred both in children and in adults and seemed to be the result of more severe trauma to the chin.

Accidents↗
PubMed1992

Fracture rates calculated from fracture histories in normal postmenopausal women.

STUDY OBJECTIVE: The aim was to estimate fracture rates and fracture prevalence from fracture histories in normal postmenopausal women. DESIGN: Apparently healthy postmenopausal women were recruited by advertising in the media. Fracture histories were obtained by personal interview in 1983 and again by interview or questionnaire in 1988. Fracture rates were calculated prospectively and retrospectively. PARTICIPANTS: 492 women (mean age 58.6 years) were selected from over 1000 applicants on the basis that they were suffering from no disease nor taking any therapy which might affect their bones. MEASUREMENTS AND MAIN RESULTS: Retrospective premenopausal and postmenopausal fracture rates were calculated in 1983, prospective rates calculated from 1983 to 1988, and retrospective rates checked again on the second occasion. The retrospective and prospective fracture rates were very similar. The five year fracture rates were low and steady until the menopause, when they rose by a factor of 10 and reached a new plateau after about 15 years. The results were comparable to those obtained from hospital statistics. CONCLUSIONS: The menopausal rise in fracture rates not only involves wrist fractures but most peripheral fractures, and probably reflects postmenopausal loss of trabecular bone. Meaningful fracture rates can be calculated from individual fracture histories in a well defined population. This technique may be particularly useful in developing countries where public health data may be incomplete.

Age Factors↗
PubMedDate not supplied

The significance of soft tissue trauma for fracture healing: a prospective study on 70 tibial shaft fractures.

In a prospective study, the significance of the fracture type, the dynamization of the external fixator, the soft tissue damage and the second osteosynthesis was evaluated for the fracture healing of 70 tibial shaft fractures. All fractures, included in the study, had a second or third degree closed or open soft tissue damage. In all fractures, a careful debridement was performed primarily. All fractures were stabilised with the Monofixator, and the fracture site was covered with vital soft tissues. If there was any sign of a delayed fracture healing after healing of the soft tissues, a secondary internal osteosynthesis was carried out as quick as possible. The mean hospital stay of the 70 patients was 32 days, the fixator was dynamized after an average of 9 weeks and removed after 18.4 weeks. Consolidation was registered after an average of 26.5 weeks. In 30% a secondary internal osteosynthesis was carried out after an average of 19.6 weeks. After this second osteosynthesis, no late problems were seen. In the statistical evaluation of the results, the paramount importance of the soft tissue damage for fracture healing became very clear; soft tissue damage had a significant influence on the duration of the hospital stay, on the consolidation time and on the frequency of the re-osteosynthesis. There was also an indirect influence on the functional end results: the quicker the fracture healing, the better the end results. A thorough clinical examination of the soft tissue damage in the early posttraumatic phase is of great importance to become a correct idea of the prognosis of a tibial shaft fracture. The more severe the soft tissue trauma, the more difficult the fracture healing will be.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Prediction of osteoporotic fractures in the general population by a fracture risk score. A 9-year follow-up among middle-aged women.

The possibility of predicting the occurrence of fractures on the basis of risk factors for osteoporosis was evaluated between 1975 and 1986 in a follow-up study of 1,014 women aged 45-64 years from a Dutch population sample. During the 9-year period of follow-up, 16% of the women experienced one or more fractures. Of 12 historical and radiologic risk factors for osteoporosis which are considered important in the biomedical literature, none were found to be strong indicators of future fractures. Complete information on risk factors was available for 742 women. A fracture risk score was calculated for each person by combining the simultaneous influence of several risk factors in a multivariate analysis. The risk score discriminated relatively well between women with high and low risks of fractures. The risk ratio between the highest and the lowest risk score quintiles was 6.4 for all fractures and 7.0 for type I osteoporotic fractures (fractures of the vertebral bodies and distal forearm). However, if belonging to the highest quintile was considered as a screening test for fracture prediction, the sensitivity and specificity were poor: 0.37 and 0.84, respectively, for all fractures and 0.48 and 0.83, respectively, for type I osteoporotic fractures. These results indicate that it might not be efficient to use risk factor status to select women for fracture prevention programs.

Age Factors↗
PubMed1990

Sequencing LeFort fracture treatment (Organization of treatment for a panfacial fracture).

The types of midfacial fractures and their complexity were evaluated in admissions to the Maryland Institute of Emergency Medical Service Systems (MIEMSS) during the years of 1984 to 1988. Two hundred and sixty-eight LeFort fractures were treated and followed (3.2 percent of admissions). One half (50 percent) had skull fractures and 40 patients (15 percent) had LeFort, skull and mandibular fractures. Isolated nasoethmoidal fractures were observed in 176 patients and in 107 patients (39 percent) of patients with LeFort fractures. Isolated mandibular fractures were observed in 321 patients and in 104 patients with LeFort fractures (39 percent). Eleven percent of patients had midfacial, nasoethmoidal and frontal sinus fractures. Six percent of patients had midfacial, frontal bone, frontal sinus and nasoethmoidal fractures (Cranial Base Crush Syndrome). Twenty two percent of patients had LeFort and frontal sinus fractures. Reconstruction of multiple area injuries is simplified by a highly organized treatment sequence that conceptualizes the face in two groups of two units. Each unit is divided into sections, and each section is assembled in three dimensions. Sections are integrated into units and units into a single reconstruction. Conceptually, in each unit, facial width must first be controlled by orientation from cranial base landmarks. Projection is then (and often reciprocally with width) established. Finally, facial length is set both in individual units and in the upper and lower face. Soft tissue is considered the "fourth dimension" of facial reconstruction. Bone reconstruction should be completed as early as possible to minimize soft tissue shrinkage, stiffness and scarring of soft tissues in nonantomic positions.(ABSTRACT TRUNCATED AT 250 WORDS)

Fracture Fixation↗
PubMed1991

Which fractures are associated with low appendicular bone mass in elderly women? The Study of Osteoporotic Fractures Research Group.

OBJECTIVE: To determine which types of fractures have an increased incidence in elderly women with low appendicular bone mass. DESIGN: Prospective cohort study. SETTING: Four clinical centers in the United States (Baltimore, Maryland; Minneapolis, Minnesota; Portland, Oregon; Monangehela Valley, Pennsylvania); and one coordinating center in San Francisco, California. SUBJECTS: Ambulatory, nonblack women (9704) aged 65 years or more who were recruited from population-based listings. MEASUREMENTS: We measured bone mass at the distal and proximal radius and calcaneus using single-photon absorptiometry. Fractures were verified radiographically. Associations were calculated as age-adjusted hazard ratios (with 95% Cls) per standard deviation decrease in bone mass. MAIN RESULTS: During a mean follow-up of 2.23 years, 841 nonspinal fractures occurred in 753 women. The risks for fractures of the wrist, foot, humerus, hip, rib, toe, leg, pelvis, hand, and clavicle were significantly related to reduced bone mass (P less than 0.05). These fractures represented 74% of nonspinal fractures. The overall hazard ratio for the occurrence of one or more of these fractures was 1.65 (Cl, 1.49 to 1.82) at the distal radius. In a subsample of the cohort, vertebral fractures were also related to low bone mass. Fractures of the ankle, elbow, finger, and face, however, were not associated with bone mass at any measurement site; the overall hazard ratio for these fractures was 1.12 (Cl, 0.96 to 1.30) at the distal radius. CONCLUSION: Most types of fractures have an increased incidence in elderly women with low bone mass.

Age Factors↗
PubMed1992

[A study of risk factor in osteoporosis, femoral neck fracture and colles' fracture].

This work studied risk factors of osteoporosis, femoral neck fracture and Colles' fracture. The results were compared with those of a healthy group. Milk intake was frequent in the healthy group, but rare in the femoral neck fracture or Colles' fracture group. Most of osteoporosis and femoral neck fracture group were bed ridden, or stayed indoors for a long time before injury. They weighed less and were thin as compared to the healthy group. Decrease of activities of daily living and less body weight were risk factors of osteoporosis and femoral neck fracture, but these risk factors were more predominant in the femoral neck fracture than osteoporosis group. In this study, 74.4% of the patients with femoral neck fracture also had osteoporosis and 33.3% with Colles' fracture had osteoporosis. Colles' fracture was related to injury force and femoral neck fracture was found to be closely related to osteoporosis.

Activities of Daily Living↗
PubMed1991

Operative treatment of ankle fractures in adults: correlation between types of fracture and final results.

By means of a simple and easy classification, namely uni, bi- and trimalleolar ankle fractures, and the localization of the fracture at the level of the fibula; all of the 612 ankle fractures that were surgically treated at the Leuven University Hospital were easily classified. In 590 cases the results were collected 1 year after the operation by means of an evaluation system based on symptoms, clinical findings and radiographic findings. The influence of the type of fracture was analysed and led to the following conclusion: 1. Unimalleolar fractures have a better prognosis than trimalleolar fractures. 2. An isolated medial malleolar fracture gives a worse final result than an isolated lateral malleolar fracture. 3. Multimalleolar fractures, including the medial malleolus, have a worse prognosis than multimalleolar fractures without medial malleolar fractures. 4. Even after perfect internal fixation, the presence of a posterior fragment larger than one-third of the articular surface leads to a worse final result than a small unfixed fragment. 5. Weber's classification may not be useful for prognosis.

Adult↗
PubMed1992

Risk factors for fractures of the distal forearm and proximal humerus. The Study of Osteoporotic Fractures Research Group.

The Study of Osteoporotic Fractures is a prospective cohort study begun in 1986 that includes 9,704 women aged 65 years and older from Maryland, Minnesota, Oregon, and Pennsylvania. A total of 171 women suffered fractures of the distal forearm, and 79 women had fractures of the proximal humerus during the first 2.2 years of follow-up. Most fractures at both sites occurred as a result of a fall. Low bone mineral density was a strong predictor of these fractures; comparing those in the lowest quintile of bone mineral density in the distal radius with those in the highest quintile, the rate ratio was 4.1 for fractures of the distal forearm and 7.5 for fractures of the proximal humerus. Other factors associated with an increased rate of distal forearm fracture independently of low bone mineral density included poor visual acuity, number of falls in the year before baseline, and frequent walking. Factors that appeared to be independently associated with an increased rate of fracture of the proximal humerus included a recent decline in health status, insulin-dependent diabetes mellitus, infrequent walking, and several indicators of neuromuscular weakness such as inability to stand with feet in a tandem position for more than a few seconds. These data support the hypothesis that distal forearm fractures often occur as a result of a fall in women with low bone mineral density who are relatively healthy and active and have good neuromuscular function, while fractures of the proximal humerus tend to occur as a result of a fall in women with low bone mineral density who are less healthy and less active than average and who have poor neuromuscular function.

Age Factors↗
PubMed1992

The significance of soft tissue trauma for fracture healing. A prospective study on 70 tibial shaft fractures following primary treatment with the Monofixateur.

In a prospective study, the significance of the fracture type, the dynamization of the external fixator, the soft tissue damage and the second osteosynthesis for the fracture healing of 70 tibial shaft fractures was evaluated. All fractures included in the study involved second- or third-degree closed or open soft-tissue damage. In all fractures, a careful debridement was performed primarily. All fractures were stabilized with the Monofixateur, and the fracture site was covered with vital soft tissues. If there was any sign of delayed fracture healing after healing of the soft tissues, a secondary internal osteosynthesis was carried out as soon as possible. The mean hospital stay of the 70 patients was 32 days, while the fixator was dynamized after an average of 9 weeks and removed after 18.4 weeks. Consolidation was observed after an average of 26.5 weeks. In 30% of cases a secondary internal osteosynthesis was carried out after an average of 19.6 weeks. After second osteosyntheses, no late problems were seen. Statistical evaluation of the results made the paramount importance of the soft tissue damage for fracture healing very clear: soft tissue damage had a significant influence on the duration of the hospital stay, on the consolidation time and on the frequency of second osteosynthesis operations. There was also an indirect influence on the functional end-results: the quicker the fracture healing, the better the end-results. Thorough clinical examination of the soft tissue damage in the early posttraumatic phase is of great importance to allow correct assessment of the prognosis of a tibial shaft fracture.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2026

Factors Associated With Accelerated Fracture Healing in Patients With Traumatic Brain Injury and Extremity Comminuted Fractures: A Retrospective Case-Control Study.

OBJECTIVE: Although traumatic brain injury (TBI) has been clinically associated with accelerated bone healing, the factors that determine which patients experience this phenomenon remain poorly defined, and previous findings are conflicting. This study aimed to investigate the clinical factors associated with accelerated fracture healing in patients with TBI combined with comminuted fractures of the limbs, so as to provide an evidence-based foundation for elucidating the clinical phenomenon of TBI-promoted fracture healing. METHODS: A retrospective case-control study design was employed. Patients between January 2020 and April 2024 with concurrent diagnoses of TBI and comminuted fractures were included. Based on radiographic findings and RUST/mRUST scores, patients were divided into an accelerated healing group (AHG) and a normal/delayed healing group (NDHG). Clinical data including demographics (age, sex, BMI), TBI characteristics (injury site, GCS score), admission laboratory indices (blood count, coagulation function, inflammatory markers), and fracture site/local soft tissue conditions, as well as functional outcomes assessed by the Short Musculoskeletal Function Assessment (SMFA) questionnaire at final follow-up were collected. Univariate analysis and multivariate logistic regression analysis were used to identify independent factors influencing accelerated fracture healing. Receiver operating characteristic (ROC) curves were plotted to evaluate their predictive value. RESULTS: A total of 119 patients were included, with 69 in the AHG and 50 in the NDHG. Significant differences were observed between the two groups in terms of age, BMI, GCS score, and platelet count (p&#x2009;<&#x2009;0.05). Univariate analysis showed that age, BMI, GCS score, red blood cell count, and platelet count were associated with accelerated fracture healing (p&#x2009;<&#x2009;0.20). Multivariate logistic regression analysis indicated that younger age (OR&#x2009;=&#x2009;0.875, 95% CI: 0.821-0.934) and lower GCS score (indicating more severe TBI; OR&#x2009;=&#x2009;0.490, 95% CI: 0.339-0.707) were independent predictors of accelerated fracture healing. ROC curve analysis showed that the area under the curve (AUC) for age and GCS score in predicting accelerated healing were 0.893 and 0.851, respectively. CONCLUSIONS: In patients with TBI combined with comminuted fractures, younger age and greater TBI severity (lower GCS score) are independent predictors of accelerated fracture healing. These findings assist clinicians in the early identification of patients with high healing potential to optimize treatment strategies, facilitate the early identification of high-risk patients, and provide clinical clues for further exploration of the molecular mechanisms underlying neurohumoral regulation of bone regeneration.

Humans↗
PubMed1992

Temporal bone fractures: longitudinal or oblique? The case for oblique temporal bone fractures.

Classical descriptions and illustrations of temporal bone fractures are misleading. Both oblique and longitudinal fractures produce a similar fracture line in the middle cranial fossa; however, externally, they are different. Oblique fractures cross the petrotympanic fissure while longitudinal fractures run within it. In a study of 150 temporal bone fractures, the majority were oblique. An array of fracture planes accounts for most of the fractures observed. Depending on the direction of trauma, fracture planes rotate around an anteroposterior axis. When they approach the horizontal (axial) plane, they result in oblique fractures. True longitudinal fractures are rare. They are vertical and perpendicular to the oblique planes.

Adolescent↗