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Search Results: 1 - 10 of 2431 matches for " pathologic-fractures spontaneous "
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Diabetic osteopathy
Ili? Jana,Kova?ev Branka
Medicinski Pregled , 2005, DOI: 10.2298/mpns0504147i
Abstract: Introduction. The aim of this study was to point out some dilemmas about the existence and pathogenesis of primary diabetic osteopathy as a separate entity, based on currently available studies. Expert disagreements are present not only about the occurrence of generalized osteopathy with diabetic disease, but also about direct relationship between metabolic diabetes control and bone metabolism and influence of disease duration and sex on bone changes. Pathogenesis of diabetic osteopathy Decreased bone formation is the basic mechanism leading to decreased bone mass. Biochemical markers showed no clear connection with bone density measurement. Insulin and insulin-like growth factor (IGF) affect bone metabolism. Osteopathy in patients with diabetic disease-type 1 Some clinical studies have shown that patients with diabetic disease-type 1 have a mild decrease in bone mass, while others have not presented such results. Osteopathy in patients with diabetic disease-type2 In patients with diabetic disease-type 2 the risk for osteopathy is even less defined. Patients treated with oral hypoglycemics present with higher decrease of bone mass has than patients treated with insulin therapy. This could partly be explained by anabolic effects of insulin on bones. Bone fractures in patients with diabetic disease Literature data are contradictory concerning the occurrence of bone fractures in diabetic patients. A survey of bone fracture occurrence in diabetic patients was performed in "Veljko Vlahovi Medical Center" in Vrbas and it included a group of 100 patients with diabetic disease. The results show that 12 patients had some fractures: mostly females in postmenopause, aged and with secondary insulin-dependent diabetes and most frequently arm fractures. Considering contradictory literature data, further longitudinal studies are necessary. .
Compromiso esquelético en el hiperparatiroidismo primario
Iatreia , 2006,
Abstract: symptomatic bone disease is not usual in primary hyperparathyroidism (phpt). increased awareness of the various manifestations of the disease may lead to earlier diagnosis before devastating and irreparable effects have occurred. our aim was to review skeletal manifestations of phpt as an important presentation of the disease. material and methods: we reviewed archives at our institution (2000-2006) searching for cases of phpt with bone disease being the initial or main clinical manifestation. clinical and laboratory data, radiological features and outcome were registered. based on this information, we carried out a review. results: we found three cases with these inclusion criteria. in all of them, the initial bone manifestation was a fracture; however, every one had suffered from unspecific systemic manifestations for several months or years. other bone alterations were: multiple osteoblastic lesions, spine deviation, finger deformity, bone pain, decreased bone mineral density, and brown tumor. extra-skeletal manifestations in our cases included: gastrointestinal alterations, neurological symptoms, weight loss and depressed mood. in all cases a parathyroid adenoma was detected. conclusions: although infrequent, bone disease in phpt involves multiple sites and usually is associated with unspecific extra-skeletal manifestations that permit to suspect the diagnosis. serum calcium determination may lead to the correct diagnosis.
Avalia??o clínica da vertebroplastia percutanea transpedicular
Hubner, André Rafael;Carneiro, Marlon Ferreira;Nunes, Marcos Ceita;Azevedo, Vinicius Gon?alves de;Suárez, Alvaro Diego Heredia;Ribeiro, Marcelo;Spinelli, Leandro de Freitas;
Coluna/Columna , 2011, DOI: 10.1590/S1808-18512011000200007
Abstract: objective: this paper evaluates the analgesic effect and obtained vertebral stability of percutaneous vertebroplasty with polymethylmethacrylate (pmma) in patients with vertebral pathological fractures, and performs a detailed revision of this technique. methods: a retrospective analysis of 64 percutaneous vertebroplasty procedures in 46 patients was performed. patients were evaluated by medical records, pre and post-operative radiographs, and by pain status (visual analog pain scale). results: 37 (80.4%) patients were female and 9 (19.6%) male, with mean age of 71 years (standard deviation + / - 9.2), ranging from 50 to 90 years. sixty-four levels were treated, with a predominance of thoracic-lumbar segment, the majority 17 (26.6%) of vertebroplaties at t12 pedicle. thirty-one patients (67.4%) presented only one fractured level, 12 patients (26.1%) presented 02 levels and three (6.5%) presented 03 or more treated levels. osteoporosis was the most common diagnosis (33 cases, 71.7%). a high satisfaction rate of 90 to 100% was observed to the majority of patients when considering relief of pain postoperatively. conclusions: vertebroplasty has proven to be an effective procedure to treat pain caused by pathological fracture, and it is also used for diagnostic investigation (bone biopsy). the technique is secure and has provided low complications rates.
Surgery of skeletal metastases
Alexander Katzer,Norbert M. Meenen,Frederike Grabbe,G tz von Foerster
Journal of Orthopaedics and Traumatology , 2001, DOI: 10.1007/PL00012206
Abstract: During a period of 5 years, 74 women and 27 men with an average age of 63.3 years underwent a total of 117 operations for management of impending (n=41) or already existing (n=76) pathologic fractures due to osseous metastases. The average stay in hospital was 17.8 days and the average postoperative survival was 15.8 months. The patients whose limbs were stabilized as a preventive measure were discharged 1.5 days earlier and survived surgery 5.9 months longer than the patients with pathologic fractures. The large percentage of female patients is due to the predominant role of mammary cancer (50%) and the comparatively long survival of patients after primary diagnosis of this type of carcinoma. The other diagnoses involved were: bronchial carcinoma (11%), hypernephroma (8%), and non-Hodgkin's lymphoma (8%). The metastases were mainly located at the proximal end or shaft of the femur (59.8%) and in the humerus (18.8%) so that in the majority of cases it was possible to implant weight-bearing prostheses or at least achieve-enough stability to allow non-weight-bearing physiotherapy and thus early remobilization. The rate of systemic complications (excluding fatalities) was 14.5%. Local complications in the operated area occurred in 24.8% of cases. As a result, revision surgery was necessary in 10 cases (8.5%) and the fatality rate in hospital (6 weeks) was 7.9%. In view of the advanced stage of the disease in most of the patients, some of them with polypathia, we see these results as a basis for the generous indication for preventive stabilization of osseous metastases. Except in some cases, the primary intention of this therapy is not to cure the disease or prolong life, but to improve the quality of life remaining for these patients while keeping their stay in hospital as short as possible and the rate of complications at an acceptable level.
Complica??es precoces no tratamento ortopédico das metástases ósseas
Teixeira, Luiz Eduardo Moreira;Miranda, Ricardo Horta;Ghedini, Daniel Ferreira;Aguilar, Rafael Bazílio;Novais, Eduardo Nilo Vasconcelos;Silva, Guilherme Moreira de Abreu e;Araújo, Ivana Duval;Andrade, Marco Ant?nio Percope de;
Revista Brasileira de Ortopedia , 2009, DOI: 10.1590/S0102-36162009000600011
Abstract: objective: to assess the early complications in the orthopedic treatment of metastatic bone lesions and the factors associated with these complications. method: there were assessed, retrospectively, 64 patients that underwent surgical treatment for bone metastases, analyzing the complications that occurred in the pre-operative and early post- operative period and associating them with the tumor origin, type of procedure done, the need of blood reposition before the surgery, the need of new surgical procedures and the mortality due to the complications. results: early complications in the treatment were observed in 17 (26.6%) patients, of which six (35.2%) ended up dying due to these complications. regarding the type, 15 (23.8%) cases were due to surgical complications, four (6.3%) clinical and three (4.7%) patients showed clinical and surgical complications. there was no significant difference in the frequency of complications or mortality when assessed the type of reconstruction or affected region. the tumors with a renal origin needed more blood reposition and showed a bigger frequency of complications. conclusion: the complications occurred in 26.6%. the complications are not related to the kind of treatment performed or to the region affected. the renal origin tumors showed a higher risk of hemorrhage.
Reconsidera??es sobre o tempo de consolida??o das fraturas na picnodisostose
Rabelo, Flávio Dorcilo;Prado, Carlos Henrique Ribeiro do;Rabelo, Flávio Le?o;Martins, Letícia;
Revista Brasileira de Ortopedia , 2010, DOI: 10.1590/S0102-36162010000600017
Abstract: objective: to discuss what has been described so far in the literature regarding the time of consolidation of fractures in pycnodysostosis. materials and methods: thirteen new cases were studied, as a matter of the availability of medical records and radiographic examinations, totaling 44 patients in the period from november 1970 to august 2004 in the hospital ortopédico de goiania. field research and simultaneous clinical monitoring for new fractures in two patients, and the retrospective evaluation of medical records were made on the basis of determining the total number of fractures for each patient to determine which of these were viable for this study. the group of patients is composed of three women and two men aged 51.4 years. the tibia was the bone most affected, followed by the femur. fractures the follow-up for which had been done in another facility were excluded. results: of the 12 fractures fully considered for the study, nine occurred in femurs (six in the femur e and three in the femur d; one in the tibia (d); one in the clavicle (d); and one in the ulna (e)). among the 12 fractures, eight developed pseudoarthrosis at an average of 29.25 months, three consolidated well in an average of 5.83 months, and one patient progressed with delayed consolidation in just 2 months. conclusion: in combination with genetic and micromorphological studies, we await further studies to reconfirm the diagnosis of such a rare clinical entity.
índice quístico: Valor pronóstico y terapéutico
Marrero Riverón,Luis Oscar; Cárdenas Centeno,Orlando M. de; Fernández Carpio,Adrián A.; Castro Soto del Valle,Antonio; Rey Valdivia,Ninel;
Revista Cubana de Ortopedia y Traumatolog?-a , 1999,
Abstract: a retrospective study of 47 patients who underwent surgery at the international scientific orthopedic complex between january, 1990, and december, 1994, due to solitary bone cyst confirmed by means of the anatomopathological study was carried out. the cystic index was obtained in all patients by using kaelin and macewen’s formula. 31 patients were males and 95.75% were under 20. relapses after the curettage and bone filling were frequent. when the cystic index was over 3.5 in the femur and over 4 in the humerus, the number of pathological fractures and relapses was also high.
Compromiso esquelético en el hiperparatiroidismo primario Bone involvement in primary hyperparathyroidism
Jorge Eduardo López Valencia,Juan Manuel Romero,Luis Fernando Arias Restrepo
Iatreia , 2006,
Abstract: La enfermedad ósea sintomática es infrecuente en el hiperparatiroidismo primario (HPTP), y cuando se presenta puede transcurrir mucho tiempo antes del diagnóstico. Con el objetivo de revisar y actualizar conceptos acerca del compromiso esquelético en el HPTP buscamos en nuestros archivos casos de pacientes en quienes las manifestaciones iniciales o principales de la enfermedad hubieran sido las alteraciones óseas. Materiales y métodos: revisamos los archivos de la Sección de Ortopedia y del Departamento de Patología de la Facultad de Medicina, Universidad de Antioquia (2000-2006) en busca de casos de hiperparatiroidismo con presentación clínica inicial o principal en los huesos. De cada caso resumimos los hallazgos clínicos, paraclínicos y de seguimiento más relevantes. Basados en estos casos hicimos una revisión del tema. Resultados: encontramos tres casos que cumplían estas características. En los tres la atención inicial fue motivada por una fractura; sin embargo, los tres habían tenido síntomas sistémicos inespecíficos de varios meses o a os de evolución. Otras alteraciones óseas detectadas fueron: lesiones osteoblásticas múltiples, desviación de la columna, deformidades en los dedos, osteopenia, dolores óseos y tumor pardo. Los síntomas extraesqueléticos incluían alteraciones gastrointestinales, neurológicas, adinamia y disminución de peso. En los tres casos se detectó adenoma paratiroideo. Conclusiones: aunque infrecuentes, las alteraciones esqueléticas en el HPTP comprometen múltiples huesos y suelen asociarse con síntomas extraesqueléticos inespecíficos. Si se tiene en mente esta enfermedad, se debe medir el calcio sérico como prueba inicial que ayudará al diagnóstico. Symptomatic bone disease is not usual in primary hyperparathyroidism (PHPT). Increased awareness of the various manifestations of the disease may lead to earlier diagnosis before devastating and irreparable effects have occurred. Our aim was to review skeletal manifestations of PHPT as an important presentation of the disease. Material and methods: We reviewed archives at our institution (2000-2006) searching for cases of PHPT with bone disease being the initial or main clinical manifestation. Clinical and laboratory data, radiological features and outcome were registered. Based on this information, we carried out a review. Results: We found three cases with these inclusion criteria. In all of them, the initial bone manifestation was a fracture; however, every one had suffered from unspecific systemic manifestations for several months or years. Other bone alterations were: multipl
Importancia do diagnóstico da fratura subcondral da cabe?a do fêmur, suas diferen?as com a necrose avascular e seu tratamento
Polesello, Giancarlo;Sakai, Denis Seguchi;Ono, Nelson K.;Honda, Emerson K.;Guimar?es, Rodrigo Pereira;Ricioli Júnior, Walter;
Revista Brasileira de Ortopedia , 2009, DOI: 10.1590/S0102-36162009000200003
Abstract: subchondral fracture of the femoral head is an uncommon and underdiagnosed affection. the abrupt or gradual onset of groin pain with functional disability on weight-bearing that improves with a resting period should alert the orthopedic surgeon to the possibility of this diagnosis. the differential diagnosis from osteonecrosis of the femoral head can be provided by assessing the different patterns of bone edema on mri studies of the hip, thus avoiding unnecessary invasive operations on the hip.
Diagnostic dilemma in a case of early spinal tumour fracture (Plasmacytoma) : a case report.
Kamat A,Velho V
Neurology India , 2000,
Abstract: MRI findings of D12 fracture were suspicious of a pathological fracture. However, biopsy did not show any evidence of tumour. This resulted in the patient following up after one and half years with an epidural mass lesion and neurological deterioration. This paper highlights some of the MRI features of fractures associated with underlying pathology over traumatic or osteoporotic fracture.
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