1/12. Femoral neck stress fracture presenting as gluteal pain in a marathon runner: case report.A case is described of a 50-year-old man with a femoral neck stress fracture presenting as gluteal pain. An operative pinning procedure of the femoral neck was performed for stabilization. Femoral neck stress fractures are often misdiagnosed early in their presentation. The signs and symptoms can mimic those of more commonly seen disorders. Appropriate physiatric history and physical examination, along with indicated studies, will help prevent misdiagnosis and potentially serious complications associated with musculoskeletal pathology.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/12. Hip pain related to femoral neck stress fracture in a 12-year-old boy performing intensive soccer playing activities--a case report.We describe the rare case of a 12-year-old boy complaining of repetitive severe pain in the left thigh, during physical activity related to a femoral neck stress fracture. Even though stress fractures are common in the adult athletic population, they occur rarely in children, with the epiphyseal growth plates still open. Diagnosis is delayed as only unspecific changes are found when conventional radiography is performed. For adequate treatment, early diagnosis by MRT or bone scintigraphy is essential. Conservative treatment will be effective through prevention of overuse.- - - - - - - - - - ranking = 0.25675759339285keywords = physical (Clic here for more details about this article) |
3/12. Case study of hip fracture in an older person.PURPOSE: To discuss proximal femoral (hip) fractures as the leading cause of hospitalization for injuries among older persons, using a case example that illustrates not only the orthopedic injury but also how an older person's chronic problems complicate the acute event. DATA SOURCES: Extensive review of scientific literature on the conditions discussed, supplemented by the case study. CONCLUSIONS: hip fractures in older adults can present multiple challenges to care when complicated by preexisting or coexisting conditions. This case of an older man with a hip fracture emphasizes the resuscitation priorities for the patient found after a "long lie" and the impact of chronic alcoholism and malnutrition, which lead to serious complications. IMPLICATIONS FOR PRACTICE: Careful physical and psychosocial assessment is important for determining the presenting problem and comorbid conditions. Priorities for postoperative management of hip fracture and its complications guide the nurse practitioner through the successful return of the patient to the community.- - - - - - - - - - ranking = 0.25675759339285keywords = physical (Clic here for more details about this article) |
4/12. Central fracture-dislocation of the hip with ipsilateral femoral neck fracture: case report.Central fracture dislocation of the hip with associated fracture of the femoral neck is rare. Treatment of choice consists of open reduction of the displacement and internal fixation of both fractures. Nevertheless, inadequate reduction of the burst fracture of the acetabulum may lead to hip arthritis, and the surgical approach to the femoral neck jeopardizes its vitality. In elderly patients early full motion and prompt physical rehabilitation can be achieved by total hip arthroplasty after fusion of the displaced femoral head to the acetabular wall.- - - - - - - - - - ranking = 0.25675759339285keywords = physical (Clic here for more details about this article) |
5/12. Stress fractures of the femoral neck following strenuous activity.Stress fractures of the femoral neck following sustained strenuous physical activity are uncommon. In 194 military recruits in elite basic training who had sustained 257 stress fractures, most of them in long bone diaphyses, nine such fractures were located in the femoral neck. Seven of these fractures were transverse and undisplaced, and were treated successfully by bed rest and non-weight bearing for 6-8 weeks. The other two fractures displaced into a varus position. One of them was treated successfully by manipulation and plaster of paris spica immobilization. Solid union of the fracture followed within 3 months. The second displaced fracture was treated by two successive procedures of internal fixation because it did not unite after the first intervention and slipped again into varus position. It is therefore suggested that unstable stress fractures of the femoral neck should be initially operated on and stabilized by rigid internal fixation, in order to avoid displacement and severe disability.- - - - - - - - - - ranking = 0.25675759339285keywords = physical (Clic here for more details about this article) |
6/12. Pathologic fractures associated with idiopathic amyloidosis of bone in chronic hemodialysis patients.Amyloid bone lesions were found in 2 chronic hemodialysis patients presenting with pathologic hip fractures. These amyloid deposits were noted as lytic defects on plain skeletal radiographs. No evidence for disseminated amyloidosis was discovered on physical examination, skin biopsy, or bone marrow biopsy. Myeloma, other plasma cell dyscrasia, and preceding chronic inflammatory states were not found in either patient. The amyloid deposits had staining characteristics suggestive of secondary amyloid based on the potassium permanganate reaction. Isolated amyloid bone deposits should be included in the differential diagnosis of lytic bone lesions or pathologic fractures in chronic dialysis patients.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
7/12. Stress fractures of the femur in runners.early diagnosis, followed by conservative management, permitted five of six long-distance runners to return to running after they had suffered stress fractures of the femur. The sixth patient developed a displaced fracture of the femoral neck which was openly reduced and internally fixated at surgery: this athlete returned to marathoning one year later. In the series there were two fractures of the femoral neck and four of the proximal medical shaft of the femur. Although early diagnosis depends upon a complete history, physical examination and x-ray film results, bone scanning is a further aid when x-ray films still do not confirm the presumptive diagnosis.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
8/12. Bilateral nonunited femoral neck fracture in a child with osteopetrosis.We report a case of osteopetrosis with bilateral nonunited femoral neck and coxa vara in a 7-year-old boy. There was a history of traumatic transcervical left femoral neck fracture unsuccessfully treated by internal fixation. We performed a bilateral subtrochanteric valgus osteotomy. K-Wire fixation failed on the right side due to hardness of the bone. Finally, internal fixation with an angular plate after predrilling of the femoral neck offered stability. Bone union was achieved on both sides, resulting in full recovery of normal physical activity.- - - - - - - - - - ranking = 0.25675759339285keywords = physical (Clic here for more details about this article) |
9/12. Stress fracture of the femoral neck in a long distance runner: biomechanical aspects.With the rising public interest in physical fitness, emergency physicians are seeing an increasing number of stress fractures. early diagnosis, followed by conservative management, allowed a long-distance runner with a compression type stress fracture of the femoral neck to return to running. The biomechanical cause of this injury may be related to erosion of the sole of the running shoe that reduced its shock absorption and increased the potential for injury.- - - - - - - - - - ranking = 0.25675759339285keywords = physical (Clic here for more details about this article) |
10/12. False negative bone scan in a female runner.Stress fractures are more prevalent in today's fitness cognizant society. Stress fractures of the femoral neck are common and present with specific symptoms and findings. The diagnosis is based on clinical history, physical exam, radiography, bone scintigraphy, and computed tomography (C.T.) scans. The triple-phase bone scan is the most sensitive test for the diagnosis of stress fractures and is considered the gold standard for the diagnosis of the occult stress fracture. This case presents a 42-yr-old female marathon runner who presented with hip pain and clinical symptoms indicating a stress fracture of the femoral neck. Initial radiographs and a triple-phase bone scan were negative. When symptoms persisted, a repeat x-ray revealed a femoral neck fracture of the superior surface. In spite of a false negative bone scan, clinical suspicion allowed appropriate treatment of this femoral neck stress fracture. Nondiagnosed stress fractures of the femoral neck may lead to severe disability, including avascular necrosis of the femoral head. Therefore, clinical index of suspicion is very important even if ancillary tests are nondiagnostic.- - - - - - - - - - ranking = 0.25675759339285keywords = physical (Clic here for more details about this article) |
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