-
American Family Physician Oct 2003Lower extremity stress fractures are common injuries most often associated with participation in sports involving running, jumping, or repetitive stress. The initial... (Review)
Review
Lower extremity stress fractures are common injuries most often associated with participation in sports involving running, jumping, or repetitive stress. The initial diagnosis can be made by identifying localized bone pain that increases with weight bearing or repetitive use. Plain film radiographs are frequently unrevealing. Confirmation of a stress fracture is best made using triple phase nuclear medicine bone scan or magnetic resonance imaging. Prevention of stress fractures is most effectively accomplished by increasing the level of exercise slowly, adequately warming up and stretching before exercise, and using cushioned insoles and appropriate footwear. Treatment involves rest of the injured bone, followed by a gradual return to the sport once free of pain. Recent evidence supports the use of air splinting to reduce pain and decrease the time until return to full participation or intensity of exercise.
Topics: Fractures, Stress; Humans; Lower Extremity; Risk Factors
PubMed: 14596439
DOI: No ID Found -
PloS One 2021Foot health in zoo giraffe has been a topic of recent research, although little is known about the foot health of free-ranging giraffe. This study describes the foot...
Foot health in zoo giraffe has been a topic of recent research, although little is known about the foot health of free-ranging giraffe. This study describes the foot shape and radiographic pathological changes in 27 young adult Nubian giraffe (Giraffa camelopardalis camelopardalis) from a translocation in Uganda (August 2017). Giraffe feet were observed to have a concave sole, the hoof wall was longest by the toe tip, and the weight-bearing surface of the foot was primarily along the periphery of the foot including hoof wall, parts of the heel, and the edge of the sole. Radiographs showed that pedal osteitis and sesamoid bone cysts were relatively uncommon (3/24 giraffe with osteitis, 1/24 giraffe with sesamoid cysts), and that no giraffe in the study had P3 joint osteoarthritis, P3 rotation, or P3 fractures. Radiographs consistently demonstrated a positive palmar/plantar angle with the sole of the hoof thicker at the heel than by the toe tip, with the non weight-bearing palmar/plantar angle measuring 1.6°- 4.3°. This is the first systematic review of foot shape and radiographs in free-ranging giraffe and demonstrates a low prevalence of foot pathologies. This study suggests qualitative differences in foot shape, foot health, radiographic anatomy, and foot pathologies when comparing free-ranging and zoo giraffe. Further research is needed to identify why these differences occur and whether husbandry modifications could help improve zoo giraffe foot health and prevent associated lameness.
Topics: Animals; Fractures, Bone; Giraffes; Hoof and Claw; Lower Extremity; Osteitis; Uganda
PubMed: 34914724
DOI: 10.1371/journal.pone.0252929 -
British Journal of Hospital Medicine... Feb 2024Supracondylar fractures of the distal humerus are the most common fracture around the elbow in children. A thorough initial assessment must be conducted to identify any...
Supracondylar fractures of the distal humerus are the most common fracture around the elbow in children. A thorough initial assessment must be conducted to identify any associated neurovascular injury and carefully documented. The assessment should include a vascular examination of the radial pulse, temperature, colour and capillary refill time. A neurological examination must comment on the motor and sensory function of the radial, median and ulnar nerves. X-rays allow an evaluation of the fracture location and type, and the degree of displacement. Immobilisation in plaster is the gold standard treatment for paediatric supracondylar fracture of the humerus where the degree of displacement is within acceptable parameters. Casting should be followed by orthogonal radiographs and a repeat neurovascular assessment of the limb. Oral analgesia and safety netting information should be provided on discharge, and the child reviewed in a fracture clinic within 1 week of the injury. The British Orthopaedic Association Standards for Trauma and Orthopaedics for supracondylar fractures of the humerus in children are useful for junior orthopaedic and emergency medicine clinicians to refer to when dealing with these injuries.
Topics: Humans; Child; Fractures, Bone; Extremities; Ambulatory Care Facilities; Analgesia; Elbow Joint
PubMed: 38416526
DOI: 10.12968/hmed.2023.0112 -
Deutsches Arzteblatt International Dec 2023Fractures of the fingers and metacarpal bones are the most common fracture type in the upper limb, with an incidence of 114 to 1483 per 100 000 persons per year. The... (Review)
Review
BACKGROUND
Fractures of the fingers and metacarpal bones are the most common fracture type in the upper limb, with an incidence of 114 to 1483 per 100 000 persons per year. The clinical importance of closed finger and metacarpal fractures is often underestimated; inadequate diagnostic and therapeutic measures may result in serious harm. This review concerns the basic elements of the diagnosis and treatment of finger and metacarpal fractures.
METHODS
This review of the incidence, diagnosis and treatment of finger and metacarpal fractures is based on pertinent publications retrieved by a selective search of the literature.
RESULTS
The main focus of treatment lies on restoration of hand function in consideration of the requirements of the individual patient. The currently available evidence provides little guidance to optimal treatment (level II evidence). Although most closed fractures can be managed conservatively, individualized surgical treatment is advisable in comminuted fractures and fractures with a relevant degree of torsional malposition, axis deviation, or shortening, as well as in intra-articular fractures. Minimally invasive techniques are, in principle, to be performed wherever possible, yet open surgery is sometimes needed because of fracture morphology. Postsurgical complication rates are in the range of 32-36%, with joint fusion accounting for 67-76% of the complications. 15% involve delayed fracture healing and pseudarthrosis.
CONCLUSION
Individualized treatment for finger and metacarpal fractures can improve patients' outcomes, with major socioeconomic and societal benefits. Further high-quality studies evaluating the relative merits of the available treatments are needed as a guide to optimized therapy.
Topics: Humans; Metacarpal Bones; Fractures, Bone; Hand Injuries; Fracture Fixation, Internal; Upper Extremity; Treatment Outcome
PubMed: 37963039
DOI: 10.3238/arztebl.m2023.0226 -
Bone Mar 1996Although much is known about hip fracture epidemiology, there are relatively little data regarding fractures at other peripheral sites. Epidemiological differences... (Review)
Review
Although much is known about hip fracture epidemiology, there are relatively little data regarding fractures at other peripheral sites. Epidemiological differences between fractures are important, since they imply that an understanding of the consequences and clinical expression of osteoporosis requires the study of many different fracture types. Recent data regarding the basic epidemiology of limb fractures among the elderly in industrialized countries have made some patterns clear. Fractures outside the hip are relatively common events, and before age 70 to 75, ankle and distal forearm fractures occur more commonly than fractures of the hip. Among the elderly, fractures at the most proximal and most distal ends of the limbs have the highest incidence. Thus, in the upper extremity, fractures of the proximal humerus and distal forearm are the most common, while in the lower extremity, those at the hip and ankle predominate. Outside the axial skeleton, females have higher rates for most fracture types, and at most fracture sites whites have higher rates than blacks. In each limb, the most proximal fractures tend to have the most pronounced age-related increases in risk.
Topics: Aged; Aged, 80 and over; Aging; Extremities; Fractures, Bone; Humans; Osteoporosis; Risk Factors; Sex Factors; United States
PubMed: 8777090
DOI: 10.1016/8756-3282(95)00504-8 -
Frontiers in Public Health 2022To comparatively analyze the effect of early external fixator and plate internal fixation treatment on postoperative complications and lower limb function recovery of...
Application of Smart Healthcare in Comparative Analysis of Effect of Early External Fixator and Plate Internal Fixation Treatment on Postoperative Complications and Lower Limb Function Recovery of Patients With Unstable Pelvic Fracture.
OBJECTIVE
To comparatively analyze the effect of early external fixator and plate internal fixation treatment on postoperative complications and lower limb function recovery of patients with unstable pelvic fracture based on smart healthcare.
METHODS
The clinical data of 98 patients with unstable pelvic fractures treated in our hospital from August 2018 to August 2021 were collected for retrospective analysis, and the patients were split into group A (plate internal fixation, = 49) and group B (early external fixator treatment, = 49) according to the surgical modalities. The time of operation, intraoperative blood loss, postoperative complications, etc. were compared between the two groups.
RESULTS
Between the two groups, group B had significantly better clinical indicators ( < 0.001), a greatly higher good rate of fracture reduction and postoperative Harris score ( < 0.05), and obviously lower VAS score and total incidence rate of postoperative complications ( < 0.05).
CONCLUSION
Through the analysis based on smart healthcare, it is found that compared with plate internal fixation treatment, early external fixator treatment presents a better effect in treating patients with unstable pelvic fracture, because it is a reliable method to accelerate fracture healing, reduce postoperative complications, and improve lower limb function.
Topics: Delivery of Health Care; External Fixators; Fractures, Bone; Humans; Lower Extremity; Postoperative Complications; Recovery of Function; Retrospective Studies; Treatment Outcome
PubMed: 35570973
DOI: 10.3389/fpubh.2022.887123 -
American Family Physician Feb 2003Patients with hip fracture typically present to the emergency department or their physician's office after a fall. They are often unable to walk, and they may exhibit... (Review)
Review
Patients with hip fracture typically present to the emergency department or their physician's office after a fall. They are often unable to walk, and they may exhibit shortening and external rotation of the affected limb. Frequently, they have hip pain. In some instances, however, patients with hip fracture may complain only of vague pain in their buttocks, knees, thighs, groin, or back. Their ability to walk may be unaffected, and initial radiographic findings may be indeterminate. In these patients, additional studies, such as magnetic resonance imaging or bone scanning, may be necessary to confirm the presence of hip fracture. A high index of suspicion often is required for prompt diagnosis and treatment of an occult hip fracture. Even when a patient is able to walk and has no documented trauma, localized hip pain, or typical shortening and malrotation deformity, the family physician should be alert to the possibility of hip fracture, particularly in a patient who is older than 65 years, presents with nonspecific leg discomfort, and complains of difficulty bearing weight on the affected limb. A heightened suspicion for hip fracture should lead to further diagnostic evaluation, especially if the patient has additional risk factors, such as use of a complicated drug regimen, impaired vision, physical or neurologic impairment, or comorbid condition (e.g., osteoporosis, malignancy). When hip fracture is detected early, appropriate treatment can minimize morbidity and mortality and prevent the rapid decline in quality of life that often is associated with this injury.
Topics: Diagnosis, Differential; Diagnostic Imaging; Hip; Hip Fractures; Humans; Leg; Osteoporosis; Pain
PubMed: 12588076
DOI: No ID Found -
American Family Physician Apr 2012Finger fractures and dislocations are common injuries that are often managed by family physicians. A systematic physical examination is imperative to avoid complications... (Review)
Review
Finger fractures and dislocations are common injuries that are often managed by family physicians. A systematic physical examination is imperative to avoid complications and poor outcomes following these injuries. Radiography (commonly anteroposterior, true lateral, and oblique views) is required in the evaluation of finger fractures and dislocations. Dorsal dislocation of the proximal interphalangeal joint is the most common type of finger dislocation. Finger dislocations should be reduced as quickly as possible and concurrent soft tissue injuries treated appropriately. Referral to a hand specialist is needed if a dislocation cannot be reduced; is unstable following reduction; or involves significant ligament, tendon, or soft tissue injury. Some common finger fractures can be treated conservatively with appropriate reduction and immobilization. Referral to a hand specialist is required if a fracture is unstable, involves a large portion (greater than 30 percent) of the intra-articular surface, or has significant rotation.
Topics: Finger Injuries; Finger Joint; Fingers; Fractures, Bone; Humans; Joint Dislocations; Manipulation, Orthopedic; Medical History Taking; Physical Examination; Radiography; Referral and Consultation; Splints
PubMed: 22534390
DOI: No ID Found -
Deutsches Arzteblatt International Dec 2010The treatment of fractures in children and adolescents must be based on an adequate knowledge of the physiology of the growing skeleton. Treatment failures usually do... (Review)
Review
BACKGROUND
The treatment of fractures in children and adolescents must be based on an adequate knowledge of the physiology of the growing skeleton. Treatment failures usually do not result from technical deficiencies, but rather from a misunderstanding of the special considerations applying to the treatment of fractures in this age group.
METHODS
We selectively reviewed recent publications on the main types of long bone fracture occurring in the period of skeletal development.
RESULTS
Alleviating pain is the first step in fracture management, and due attention must be paid to any evidence of child abuse. The goals of treatment are to bring about healing of the fracture and to preserve the function of the wounded limb. The growth that has yet to take place over the remaining period of skeletal development also has to be considered. Predicting the growth pattern of fractured bones is a basic task of the pediatric traumatologist. During the period of skeletal development, conservative and surgical treatments are used in complementary fashion. Particular expertise is needed to deal with fractures around the elbow, especially supracondylar humeral fractures, displaced fractures of the radial condyle of the humerus, radial neck fractures, and radial head dislocations (Monteggia lesions). These problems account for a large fraction of the avoidable cases of faulty fracture healing leading to functional impairment in children and adolescents.
CONCLUSION
The main requirements for the proper treatment of fractures in children and adolescents are the immediate alleviation of pain and the provision of effective treatment (either in the hospital or on an outpatient basis) to ensure the best possible outcome, while the associated costs and effort is kept to a minimum. Further important goals are a rapid recovery of mobility and the avoidance of late complications, such as restriction of the range of motion or growth disorders of the fractured bone. To achieve these goals, the treating physician should have the necessary expertise in all of the applicable conservative and surgical treatment methods and should be able to apply them for the proper indications.
Topics: Adolescent; Arm Injuries; Casts, Surgical; Child; Diagnostic Imaging; Fracture Fixation; Fractures, Bone; Humans
PubMed: 21249137
DOI: 10.3238/arztebl.2010.0903 -
Medicine Jun 2023Fracture is a global public health disease. Bone health and fracture risk have become the focus of public and scientific attention. Observational studies have reported...
Fracture is a global public health disease. Bone health and fracture risk have become the focus of public and scientific attention. Observational studies have reported that tea consumption is associated with fracture risk, but the results are inconsistent. The present study used 2-sample Mendelian randomization (MR) analysis. The inverse variance weighted method, employing genetic data from UK Biobank (447,485 cases) of tea intake and UK Biobank (Genome-wide association study Round 2) project (361,194 cases) of fractures, was performed to estimate the causal relationship between tea intake and multiple types of fractures. The inverse variance weighted indicated no causal effects of tea consumption on fractures of the skull and face, shoulder and upper arm, hand and wrist, femur, calf, and ankle (odds ratio = 1.000, 1.000, 1.002, 0.997, 0.998; P = .881, 0.857, 0.339, 0.054, 0.569, respectively). Consistent results were also found in MR-Egger, weighted median, and weighted mode. Our research provided evidence that tea consumption is unlikely to affect the incidence of fractures.
Topics: Humans; Genome-Wide Association Study; Mendelian Randomization Analysis; Upper Extremity; Wrist; Fractures, Bone; Tea; Polymorphism, Single Nucleotide
PubMed: 37266651
DOI: 10.1097/MD.0000000000033542