When a thor- Take final radiographs. The long, straight part of the femur is called the femoral shaft. The long, straight part of the femur is called the femoral shaft. Geriatric hip-proximal femur 2-5% 5% 7.5Intertrochanteric FX Subtrochanteric FX Femur, shaft and subtrochanteric 1-3% 3% 4.5Femoral Shaft FX Adolescent femur 0.5-1% 1% 1.5Femoral Shaft FX - Pediatric Distal femur 1-3% 3% 4.5Distal Femur FX Distal Femoral Physeal FX - Pediatric Knee-patella and extensor mechanism 0.5-1% 1% 1.5Patella Fracture 1. A. Outpatient Evaluation and Management. Femoral neck fractures are common injuries to the proximal femur associated with increased risk of avascular necrosis, and high levels of patient morbidity and mortality. Pediatrics | Proximal Femur Fractures - Pediatric. Patients were categorized into five groups . Minimal or no trauma 2. femoral shaft fractures. femoral shaft fractures 6-9% associated with femoral neck fractures treat femoral neck first followed by shaft Anatomy Osteology normal neck shaft-angle 130 +/- 7 degrees normal anteversion 10 +/- 7 degrees Blood supply to femoral head major contributor is medial femoral circumflex (lateral epiphyseal artery) after fracture reduction check size, length, and rotation of plate on distal radius. femoral shaft fracture on length of hospitalization. In general, femur fractures occurring under the age of 10 are most commonly caused by a fall, whereas . If the degree of fracture does not match the mechanism of injury then a pathologic fracture must be suspected (2). Ipsilateral femoral neck and shaft fractures typically occur as a result of high-energy trauma in young adults. Setting: Four level 1 trauma centers. Treatment may be palvic harness, spica casting or operative depending on the fracture pattern and age of the patient. 1 Since the effect is caused by a reduction of bone turnover, long-term use is associated with an altered bone structure and biomechanics. Femoral fractures account for around 2% of all pediatric fractures and about 70% involve the shaft. Rosen's Emergency Medicine Concepts and Clinical Practice(link) Tintinalli's Emergency Medicine(link) References. Femoral shaft fractures (FSF) typically occur in . Retrograde versus antegrade nailing of femoral shaft fractures Sager or CT). . Orthobullets Open Fracture Classification . Open fractures, Infection, Compartment syndrome 3; Simple fractures. Initial examination in the emergency room reveals a clean 2 c New to Orthobullets? Because the femur is so strong, it usually takes a lot of force to break it. Fracture of the tibial shaft is among the most common long bone fracture. 3. Patients: Two hundred eighty-three consecutive adult patients with 293 fractures of the femoral shaft who underwent stabilization with antegrade or retrograde inserted femoral . TECHNIQUE VIDEO TECHNIQUE STEPS Technique Video 0% Fibular head fracture orthobullets — femoral head fractures Femoral shaft fractures. The patient has a type IA (based on the classification of Pires et al 17) oblique interprosthetic femur fracture through the cement mantle of the total hip arthroplasty implant and distal to a cabled trochanteric hook plate. . a fracture above the syndesmosis results from external rotation or abduction forces that also disrupt the joint; usually associated with an injury to the medial side Ankle fractures trauma orthobullets com tibia shaft Symptoms. 0; Femoral Shaft Fracture Retrograde Intramedullary Nailing. Medial clavicle fracture orthobullets — midshaft clavicle ... PDF Intramedullary Nailing of Femoral Shaft Fractures: Current ... View Distal Radius Fractures - Trauma - Orthobullets.pdf from AA 1 Topics Elbow Dislocation Terrible Triad Injury of Trauma Elbow FOREARM Techniques Monteggia FX Radius and Ulnar Shaft FX QBank JOIN . raise leg up off of bed, 90° bend in knee, then take final AP and lateral radiograph of proximal, middle, and distal aspects of femur. Femoral Shaft Nonunion : Wheeless' Textbook of Orthopaedics Femoral shaft fractures are high energy injuries to the femur that are associated with life-threatening injuries (pulmonary, cerebral) and ipsilateral femoral neck fractures. Femoral shaft stress fractures are overuse injuries in which abnormal stresses are placed on trabecular bone of the femoral shaft resulting in microfractures. gastrocnemius and tensor fascia lata can be an initiating point leading to femoral shaft fracture Type III fractures are divided into two subgroups: those with lateral depression (type IIIA) and those with central depression (type IIIB). Spiral. A 71-year-old woman presented with pain for four months around her left hip. Femoral Shaft Fractures Pathway Updated: 10/9/2017. - femoral shaft that has not healed in 26 wks signals a delayed union; - may be more common in segmental fractures and in winquest type IV fractures ; - most common iatrogenic risk factor is failure to ream the canal; (see femoral reaming) These may be broadly grouped as 'half ring' splints (e.g. Listen to Pediatrics | Proximal Femur Fractures - Pediatric - The Orthobullets Podcast podcast for free on GetPodcast. Diagnosis can be made by pelvis/hip radiographs but frequently require CT scan for surgical planning. They commonly result from high-energy mechanisms such as motor vehicle collisions (MVC) with sequelae of limb shortening and deformities if not treated appropriately. ntramedullary (IM) nailing is the standard of care for the manage- ment of femoral shaft fracture in adults.1This technique can be done with closed or open reduction in conjunction with reaming and inter- locked IM nailing. Type IV is a medial tibial plateau fracture with a split or . 3. 2/10/2022. Patient 3. MB BULLETS Step 1 For 1st and 2nd Year Med Students. In this way, the second to the last screw hole at each plate end, as well as one plate hole over the fracture, can be left unoccupied. In less than 18 minutes, we cover everything you'll need to know about femoral shaft fractures. (OBQ06.229) An otherwise healthy 30-year-old male sustains a left forearm injury as a result of a fall from a ladder. Principles of Treatment for Periprosthetic Femoral Shaft Fractures Around Well-fixed Total Hip Arthroplasty 678 Journal of the American Academy of Orthopaedic Surgeons. High union rates and early limb mobilization are two advantages of IM nail fixation. In this episode, we review the high-yield topic of Pediatric Proximal Femur Fractures from the Pediatrics section. Femoral Shaft Fractures Hiren M Divecha FTSTA1 T&O. We reviewed radiographs of 1234 of the 1271 women who had a subtrochanteric or shaft fracture and identified 59 patients with atypical . Team Orthobullets (D) Boston % TECHNIQUE VIDEO 0 % TECHNIQUE STEPS 0. For transverse fractures of the femoral midshaft, at least three bicortical screws must be inserted into each fragment. 7. Femoral Shaft Fractures are one of the most common pediatric orthopedic fractures and are the most common reason for pediatric hospitalization due to orthopedic injury. to reduction . She was on BP (alendronate) for 10 years. Colles fracture orthobullets. Tibial Shaft Fractures Exam Review - Jan Szatkowski, MD. Femoral shaft fractures are high energy injuries to the femur that are associated with life-threatening injuries (pulmonary, cerebral) and ipsilateral femoral neck fractures. Summary. In less than 18 minutes, we cover everything you'll need to know about femoral shaft fractures. Awareness of this association and the use of a protocolized approach to diagnosis and management can help … Follow Orthobullets on Social Media: The medial condyle is the longer and, when the femur is held with its body perpendicular, projects to a lower level. Treatment may be palvic harness, spica casting or operative depending on the fracture pattern and age of the patient. Obtains focused history and performs focused exam . For incomplete fractures accompanied by pain, prophylactic intramedullary nail fixation is recommended. 42:17. Femoral Shaft Nonunion. These fractures are often associated with polytrauma and can be life-threatening. Follow Orthobullets on Social Media: I. Proximal Femur Fractures - Pediatric - The Orthobullets Podcast podcast for free on GetPodcast. treat femoral neck first followed by shaft. There is a bimodal distribution affecting toddlers ages 2-4 and adolescents: additionally males are more commonly affected than females (2.5:1). Objectives: To compare union rates and complications of retrograde intramedullary nailing of femoral shaft fractures with those of antegrade intramedullary nailing. 1. 12:02. The insertion site is colinear with the long axis of the femur. Children, elastic stable intramedullary nailing, femoral shaft, fractures. Preferably, a nine-hole broad 4.5 mm plate is chosen. FX Hip Dislocation LOWER EXTREMITY FEMUR Femoral Head FX Femoral Neck FX Intertrochanteric FX Subtrochanteric FX Femoral Shaft . Fracture originates at lateral cortex and is substantially transverse in orientation 3. infection of 43% for CRP level and 31% for ESR in 204 periprosthetic hip fracture patients. Motor vehicle collisions, for example, are the number one cause of femur fractures. 0. Femoral shaft fractures are common injuries in orthopedic su. Femoral head fractures are rare traumatic injuries that are usually associated with hip dislocations. A, Preoperative oblique radiograph of the right hip and femur in a 65-year-old woman with rheumatoid arthritis and a history of multiple revision hip arthroplasty procedures. Take hip through a range of motion to assess for fracture. Femur • Tubular with slight anterior bow • Average femur is 48 cm x 2.34 cm • Longest and strongest bone • Support up to 30 times weight of an adult • Blood supply - Nutrient artery - Medullary arteries. Background: Studies show conflicting results regarding the possible excess risk of atypical fractures of the femoral shaft associated with bisphosphonate use. Introduction. ORTHO BULLETS Orthopaedic Surgeons & Providers The radiograph showed mild thickening and beaking of the lateral cortex of the upper shaft of femur, below the level of the trochanter [Figure 3].She was managed with withdrawal of BP and limitation of weight bearing to prevent development of a fracture. Diagnosis is made with plain radiographs of the femur. Open Fractures Management - Trauma - Orthobullets Top www.orthobullets.com. Join for free. The body of the femur or shaft is long, slender and frcature cylindrical in form. fluoroscopic evaluation is key, whether static or dynamic at the end of the procedure. In this episode, we . Plate selection. Donway, Thomas) and 'non half ring' splints (e.g. Over 200,000 physicians learn and collaborate together in our online community. . Femoral Neck Stress Fractures. Femoral Neck Fractures Exam Review - Bohannon Mason, MD. Treatment may be nonoperative or operative depending on the location of the fracture and degree of fracture displacement. Open subtypes (3) Oblique (≥30°) Open subtypes (3) Transverse (<30°) Open subtypes (3) Wedge fractures. Summary. Design: Retrospective. . Arneson TJ et al Epidemiology of diaphyseal and distal femoral fractures in Rochester, Minnesota, 1965-1984. 26:14. When conducting the workup, it is important to remember that ipsilateral femoral neck fractures have a 2-6% incidence with femoral shaft fractures and these are missed 19-31% of the time (3). Figure 1 Dr. Ricci or a member of his immediate family serves as a board member, owner, officer, or committee member of the Orthopaedic Femur Fracture Reaming • Reaming of the femoral shaft fracture - Multiple studies demonstrate that the thoracic injury is the major determinant of pulmonary complications, NOT the use of a reamed IM nail • Charash J Trauma 1994 • Van Os J Trauma 1994 • Ziran J Trauma 1997 • Bone Clin Orthop 1998 • Bosse JBJS 79A 1997 Femoral diaphyseal fracture w/ at least 4 of the following major criteria: 1. Methods: A retrospective review of registry data from a Level I trauma center identified 1362 patients with a femoral shaft fracture over a 12-year period. Comminuted Distal Femoral Fracture Kevin Sok 7/13/2020 RAD 4001 Dr. Manickam Kumaravel 2 As a direct consequence, the occurrence of atypical femoral . Femoral Shaft Fracture Antegrade Intramedullary Nailing - Trauma - Orthobullets Subtrochanteric Fractures Pathway Updated: 10/9/2017 3 Femoral Shaft Fracture Antegrade Intramedullary Nailing Andrew Hsu University of California-Irvine Benjamin C. Taylor Grant Medical Center, Ohio Health Orthop. Femur Fracture Reaming • Reaming of the femoral shaft fracture - Multiple studies demonstrate that the thoracic injury is the major determinant of pulmonary complications, NOT the use of a reamed IM nail • Charash J Trauma 1994 • Van Os J Trauma 1994 • Ziran J Trauma 1997 • Bone Clin Orthop 1998 • Bosse JBJS 79A 1997 In this episode, we review multiple-choice questions related to the high-yield topics of Femoral Neck Fractures & Pediatric Femoral Shaft Fractures. Design: Prospective cohort study. A Daily High-Yield review podcast by Orthobullets⏤the Free Learning & Collaboration Community for Orthopaedic Surgery Education. Diagnosis is made with plain radiographs of the femur. Posted on March 21, 2022 by . Patients: One-hundred and eight patients treated by 1 of 4 surgeons for a femoral . Distal femur fractures are traumatic injuries involving the region extending from the distal metaphyseal-diaphyseal junction to the articular surface of the femoral condyles. 2. Medial clavicle fracture orthobullets. Diagnosis is made radiographically with radiographs of the femur as well as the hip to rule out ipsilateral femoral neck fractures. There are a number of different femur splints available. Polytrauma patients with femoral shaft fractures that are most at-risk should have their definitive surgical procedure, such as nailing, delayed until after initial stabilization is achieved. Fractures of the femoral shaft are one of the most common injuries treated by orthopedic surgeons. fibular head fracture, a break near the knee avulsion fracture, a fracture in which a small part of the bone gets pulled off stress fracture, a hairline fracture due to repetitive injury shaft.. undisplaced fracture fibular head and was complicated with fracture shaft tibia. Femoral Shaft Fractures are one of the most common pediatric orthopedic fractures and are the most common reason for pediatric hospitalization due to orthopedic injury. proximal femur in a patient treated for femoral shaft fracture with femoral nailing begun at the piriformis fossa. Up to 9% of femoral shaft fractures will have an associated femoral neck fracture. istal femoral fractures currently account for <1% of all fractures and about 3% to 6% of all femoral fractures;however,theincidencelikely will increase as the population ages.1,2 An elderly patient with poor bone quality may sustain a distal fem-oral fracture in a simple fall, whereas a high-energy mechanism, such as a motor vehicle crash, is . we review the high-yield topic of Tibial Shaft Stress Fractures from the Knee & Sports section. Fracture of the distal radius can occur with injuries that exert much less force, e.g. Rather than using a simple dichotomy at twelve or twenty-four hours, we provided more clinically relevant categories with five time periods based on commonly used cut-points from the literature [10-12]: t 0 (twelve hours or less), t Femur Shaft Fractures (Broken Thighbone) Your thighbone (femur) is the longest and strongest bone in your body. Orthobullets - femoral shaft fractures; Orthobullets - distal femur fractures; Femur Splints. MB BULLETS Step 2 & 3 For 3rd and 4th Year Med Students. Humeral shaft fractures are common fractures of the diaphysis of the humerus, which may be associated with radial nerve injury. Distal femoral fractures involve the femoral condyles and the metaphyseal region and are often the result of high energy trauma such as motor vehicle accidents or a fall from a height. The Tillaux fracture is an uncommon injury to the anterolateral distal tibial epiphysis Femoral Neck Stress Fractures Femoroacetabular Impingement Hip Arthroscopy Hamstring Injuries Tibial Shaft Stress Fractures Femoral Shaft Fractures - Pediatric • Fracture 1.9% 2.8 Distal Femur Fractures • Arthritis, inflammatory 1.9% 2.8 Patella Fracture . Posterolateral Corner Injury - Knee & Sports - Orthobullet. NSW Ambulance use only the CT-6 splint (an advanced, lightweight . Summary. 0:00. TECHNIQUE STEPS Preoperative Patient Care. The introduction of bisphosphonates into osteoporosis therapy was a great breakthrough, leading to a remarkable reduction of fracture incidence and improvement of prognosis. Share. Because the femur is so strong, it usually takes a lot of force to break it. Orthobullets Team Fracture is noncomminuted or minimally comminuted 5. Diagnosis can often be made on radiographs alone but MRI studies should be obtained in patients with normal radiographs with a high degree of suspicion for stress fracture. 6-9% associated with femoral neck fractures. Objectives: The purpose of this study was to compare results of femoral shaft fracture treatment with nailing through the greater trochanter to nailing through the piriformis fossa with nails specifically designed for each starting point. 19-22,88,89 Femoral radiographs with cortical thickening and stress reaction should be examined for the presence of a radiolucent fracture line across the lateral cortex, which is a poor prognostic indicator warranting prophylactic fixation . Diagnosis is made radiographically with CT studies often required to assess for intra-articular extension. We help you diagnose your Femur shaft case and provide detailed descriptions of how to manage this and hundreds of other pathologies. Setting: Level I trauma center. Diagnosis is made with orthogonal radiographs of the humerus. . Diagnosis is made radiographically with radiographs of the femur as well as the hip to rule out ipsilateral femoral neck fractures. Femoral Shaft Stress Fractures - Knee & Sports - Orthobullets ORTHO BULLETS Join nowLogin Select a Community ORTHOHealth for Patients IMInternal Medicine MBPreclinical Medical Students MBClinical Medical Students ENTEar, Nose and Throat SURGERYSurgery Bullets About Bullet Health Join Our Team ORTHOBULLETS Home Topics Diagnosis can made with pelvis radiographs but frequently require pelvic CT scan for full characterization. Technique Video TECHNIQUE STEPS . - Discussion: - general discussion of non union / infected femoral nails. Motor vehicle collisions, for example, are the number one cause of femur fractures. Orthobullets Femoral Shaft Fracture. . Methods: In Sweden, 12,777 women 55 years of age or older sustained a fracture of the femur in 2008. Femoral Shaft Fracture Antegrade Intramedullary Nailing - Trauma - Orthobullets Subtrochanteric Fractures Pathway Updated: Oct 9 2017 Femoral Shaft Fracture Antegrade Intramedullary Nailing Andrew Hsu University of California-Irvine Benjamin C. Taylor Grant Medical Center, Ohio Health Orthop. He . Complete fractures may be associated with a medial spike, incomplete fractures are lateral cortex only 4. The Orthobullets Podcast. distal radius fracture classification orthobullets. In the elderly, they may occur as a domestic accident 1-3. Treatment can be nonoperative or operative depending on location of fracture, fracture morphology, and association with other ipsilateral injuries. Femur Shaft Fractures (Broken Thighbone) Your thighbone (femur) is the longest and strongest bone in your body. This study examines the association between the timing of femur fracture fixation and outcome in patients with concomitant chest and head injuries. 8. 2. 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