1/11. hip fracture and bone histomorphometry in a young adult with cystic fibrosis.A 25-yr-old male with cystic fibrosis sustained a fragility fracture of the left femoral neck, which required surgical correction. He had several risk factors for the development of low bone density and despite treatment with an oral bisphosphonate, his bone mineral density reduced further. The patient died 2 yrs after sustaining the fracture. Bone specimens obtained at post mortem demonstrated severe cortical and trabecular osteopenia, but the histological features were not typical of osteoporosis or osteomalacia. osteoporosis is thought to be a common complication of cystic fibrosis. The novel histomorphometric appearances reported here suggest that the bone disease of cystic fibrosis may be more complex and possibly unique. Labelled bone biopsies are required to clarify the bone defect leading to low bone density in cystic fibrosis patients so that appropriate therapeutic strategies can be developed.- - - - - - - - - - ranking = 1keywords = bisphosphonate (Clic here for more details about this article) |
2/11. Progressive bone resorption after pathological fracture of the femoral neck in Hunter's syndrome.We report a case of Hunter's syndrome associated with a transverse fracture of the left femoral neck after minor trauma, followed by progressive resorption of the femoral head at 12 years of age and a stress fracture of the right femoral neck at 16 years of age. MRI performed at 15 years of age revealed intra-articular low intensity on T1-weighted and T2-weighted images of both hip joints. The MR finding may represent fibrous synovial thickening, which caused pressure erosion of the femoral neck, resultant pathological and/or stress fractures, and subsequent osteonecrosis with rapid absorption of the femoral head.- - - - - - - - - - ranking = 18.997644317544keywords = osteonecrosis (Clic here for more details about this article) |
3/11. Subchondral insufficiency fracture of the femoral head and medial femoral condyle.This case report documents the clinical, radiographic, and histologic findings in a 69-year-old obese man, who had subchondral insufficiency fracture both in the femoral head and medial femoral condyle. On plain radiographs, both lesions underwent subchondral collapse. Magnetic resonance images of the left hip showed a bone marrow edema pattern with associated low-intensity band on T1-weighted images, which was convex to the articular surface. The histopathologic findings in the hip and knee were characterized by the presence of a subchondral fracture with associated callus and granulation tissue along both sides of a fracture line. There was no evidence of antecedent osteonecrosis. To our knowledge, this is the first case report to describe the multiple occurrence of collapsed subchondral insufficiency fracture.- - - - - - - - - - ranking = 18.997644317544keywords = osteonecrosis (Clic here for more details about this article) |
4/11. Pathological fracture of the femoral neck as the first manifestation of osteonecrosis of the femoral head.We describe two cases of pathological fracture of the femoral neck occurring as the first manifestation of osteonecrosis of the femoral head (ONFH). No abnormal findings suggestive of ONFH were identified on the radiographs for either of the patients, and the fractures occurred like spontaneous fractures without any trauma or unusually increased activity. The patients' medical history, age, and good bone quality suggested ONFH as a possible underlying cause of the fractures. If we had not suspected ONFH as a predisposing condition, these minimally displaced fractures might have been fixed internally with multiple pins, and this would have led to nonunion or collapse of the femoral head. To avoid inappropriate treatment, ONFH should be considered as a predisposing factor in pathological fractures of the femoral neck.- - - - - - - - - - ranking = 94.98822158772keywords = osteonecrosis (Clic here for more details about this article) |
5/11. Prediction of osteonecrosis by magnetic resonance imaging after femoral neck fractures.Thirty-one patients undergoing internal fixation for femoral neck fractures who were examined by magnetic resonance imaging at 2, 6, and 12 months after surgery and who could be followed up more than 2 years were enrolled in the current study. The items investigated were timing of the appearance of the band image on T1 weighted images, magnetic resonance imaging classification, and plain radiographs. Band images were observed 2 months after surgery in eight patients and 6 months in 12 patients (39% of all patients). According to the location and extent of the band image on magnetic resonance imaging, one patient was classified in the B1 Group (lateral type), four patients in the B2 Group (surface type), three patients in the B3 Group (intermediate type), and four patients in the B4 Group (extended type). Band images appeared in all patients in the B4 Group 6 months after surgery. Femoral heads of the patients in the B3 and B4 Groups by magnetic resonance imaging classification all were collapsed. On plain radiographs, osteonecrosis of the femoral head could be diagnosed in eight patients between 11 and 24 months after injury. The interval giving the greatest sensitivity, specificity, and accuracy of the diagnosis of osteonecrosis of the femoral head by magnetic resonance imaging was 6 months after surgery.- - - - - - - - - - ranking = 113.98586590526keywords = osteonecrosis (Clic here for more details about this article) |
6/11. Dynamic magnetic resonance imaging of femoral head perfusion in femoral neck fracture.A prospective followup study of 36 femoral neck fractures according to the assessment of femoral head perfusion using dynamic magnetic resonance imaging is reported. patients were divided into three groups based on the dynamic magnetic resonance imaging findings (dynamic curve pattern and relative enhancement ratio) that were conducted within 48 hours of the injury. traction was used to achieve anatomic reduction and to prevent additional damage to vascularity until minimally invasive internal fixation could be done. The fractures of all 17 patients whose femoral head perfusion was normal (Type A; n = 11) or was impaired but not totally absent (Type B; n = 6) healed without complications. Among the 19 patients whose femoral head perfusion was absent (Type C), 15 had complications (osteonecrosis, n = 10; nonunion, n = 5). Assuming that fractures with a Type A or Type B curve pattern would unite successfully and that those with a Type C curve pattern would not, the sensitivity, specificity, and accuracy of the predictions of successful osteosynthesis of the femoral neck fractures using this method were 81%, 100%, and 89%, respectively. The current classification of femoral neck fractures using dynamic magnetic resonance imaging may be useful in selecting an appropriate treatment method for the fractures.- - - - - - - - - - ranking = 18.997644317544keywords = osteonecrosis (Clic here for more details about this article) |
7/11. fatigue subcapital fracture of the femur after the removal of the hip plate in transtrochanteric rotational osteotomy.We report two cases of fatigue subcapital fracture of the femur after the removal of the hip plate used for fixation in transtrochanteric rotational osteotomy for osteonecrosis. Two patients, a 42-year-old man and a 43-year-old man, underwent transtrochanteric rotational osteotomy, and bony union was achieved in both patients. However, fatigue subcapital fracture of the femur occurred in both patients 15 months after the removal of the hip plate. Transtrochanteric rotational osteotomy greatly changes the trabecular bone structure in the proximal femur, thus affecting the strength of the femoral neck. Therefore, for the trabecular bone to be remodeled and for the proximal femur to achieve sufficient strength, a sufficient period is necessary after complete bony union has occurred in the transtrochanteric lesion, before removal of the plate.- - - - - - - - - - ranking = 18.997644317544keywords = osteonecrosis (Clic here for more details about this article) |
8/11. osteonecrosis 15 years after femoral neck fracture and long-term low-dose inhaled corticosteroid therapy.Posttraumatic avascular necrosis of the femoral head typically occurs immediately or within a few years after a femoral neck injury, and non-traumatic avascular necrosis is often related to systemic glucocorticoid therapy. We report an unusual case in which avascular necrosis of the femoral head occurred 15 years after a transcervical femoral fracture in a woman with a 20-year history of daily inhaled glucocorticoid therapy for chronic bronchitis. She had not taken glucocorticoids by any other route and had no other risk factors for osteonecrosis. To our knowledge, this is the first report of osteonecrosis associated with inhaled glucocorticoid therapy in a patient with a local cause of diminished vascular reserve. Inhaled glucocorticoid therapy should be added to the list of risk factors for osteonecrosis.- - - - - - - - - - ranking = 56.992932952632keywords = osteonecrosis (Clic here for more details about this article) |
9/11. A pathological fracture of the femoral neck associated with osteonecrosis of the femoral head and a stress fracture of the contralateral femoral neck.A pathological fracture of the right femoral neck associated with osteonecrosis of the right femoral head and a stress fracture of the contralateral femoral neck occurred in a 47-year-old man. osteonecrosis was noted in almost the entire femoral head, and the pathological fracture occurred at the subcapital area. Six months later, a stress fracture was detected in the contralateral femoral neck. The stress fracture of the left femoral neck might have been caused by the incremental repetitive mechanical loading in the left hip as a result of the pathological fracture in the right hip. Therefore, it might be necessary to conduct a careful examination, using either a magnetic resonance imaging scan or a bone scan, of patients with extensive osteonecrosis of the femoral head because of the risk of osteonecrosis in the contralateral femoral head as well stress fractures in the contralateral femoral neck.- - - - - - - - - - ranking = 132.98351022281keywords = osteonecrosis (Clic here for more details about this article) |
10/11. Delayed osteonecrosis following reduction and internal fixation of a femoral neck fracture.osteonecrosis (ON) is a common complication following femoral neck fracture and most studies have reported the incidence of ON after less than 3 years follow-up. Here we report a case of delayed osteonecrosis 7 years after initial treatment for a femoral neck fracture. This example supports the need for continued clinical and radiographic follow-up over an extended period after femoral neck fracture and suggests that 3 years is too short a time to reliably rule out ON as a postoperative complication.- - - - - - - - - - ranking = 94.98822158772keywords = osteonecrosis (Clic here for more details about this article) |
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