Articles: femoral-fractures-complications.
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: Distal femoral epiphyseal fractures are uncommon but have a high incidence rate of complications. It is not clear whether there are any reliable predictor factors and whether the type of fracture, displacement (degree and direction), and treatment method alter the outcome. ⋯ : Both SH classification and displacement of the fracture are significant predictors of the final outcome. The degree and the direction of displacement do not statistically correlate with outcome. The treatment method may influence the final outcome.
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Randomized Controlled Trial
Emergency department use of a continuous femoral nerve block for pain relief for fractured femur in children.
This study examined whether an effective continuous femoral nerve block could be inserted by emergency department staff for pain relief in children presenting with a fractured femur.
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To examine the effects of locked distal screws in retrograde nails used in unstable osteopenic distal femur fractures. ⋯ Although most differences in fixation stability were not significant, the locked distal screw nails exhibited less fracture collapse and anterior and medial translation of the nail at the fracture site than the unlocked distal screw nails. The degree of varus angulation after cyclic loading was also less for the locked distal screw nails. The length of the nail chosen should avoid having proximal locking screws distal to the lesser trochanter, thus averting proximal femur stress risers and fractures.
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An 18-year-old male patient sustained right-sided femoral and 2nd degree open tibial shaft fractures following a motorcycle accident. Further injuries, and thoracic injury in particular, were excluded clinically and radiologically. ⋯ Subsequently, the patient's gas exchange parameters improved allowing extubation 1 week after the accident. Secondary tibia nailing and further recovery of the patient were uneventful.
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Comparative Study
Cerebral fat embolism: pulmonary contusion is a more important etiology than long bone fractures.
Lipid embolism is a serious and life-threatening problem and usually arises as a complication of severe trauma associated with long bone or pelvic fractures. It is generally thought that fat droplets enter the circulation at the site of fracture. In the systemic circulation, they become emboli to brain, kidney and other areas. ⋯ Cerebral fat embolism was detected in seven animals exposed to pulmonary contusion and only in one animal exposed to femur fracture. The mean number of branches of middle cerebral artery at midparietal level occluded with fat particles were higher in the pulmonary contusion group than in the long bone fracture group. In conclusion, we found that pulmonary contusion had more deleterious effects than long bone fracture in the formation of cerebral fat embolism.