Cause Of Pathological Fracture Research Articles

Epidemiology of humerus shaft fractures in children-observational study of 50 patients

Background: Objective was to study the epidemiology of humerus shaft fracture in children. Methods: This was an observational study of 50 cases of humeral diaphyseal fractures in children aged between 5 to 15 years reporting to tertiary care center over a period of 18 months. Each patient was categorized with respect to age, sex, mode of trauma, side injured, type of fracture, associated injuries, modality of treatment given. Results: Most patients belonged to upper lower class (66 %), and 80% patient belonged to rural population. Boys (60%) were more prone to have humerus shaft fracture than girls. Mean age of the patient were 10.12 years (±2.6 SD). Most common mode of trauma was accidental fall on arm (68%). Traumatic fracture was noted in 94% of cases while 6 % cases were having pathological fracture. Most patients were having middle third shaft fracture (40%), followed by distal third (30%) and lastly proximal third (22%), and left side involvement (58%) was more. Out of the 50 patients, poly trauma was observed in 4 cases, multiple bone fracture was noted in 2 cases, while 2 patients were having fibrous dysplasia and 1 with bony cyst as an associated cause of pathological fracture and 1 patient had radial nerve injury pre-operatively. Conclusions: The findings of this study provide valuable insights into the epidemiology of humerus shaft fractures in children in respect to age, sex, socio-economic status, mode of trauma. These data can help understand the risk factors and help in preventing the incidence. Most of these fracture can be managed successfully with retrograde titanium elastic nailing system (TENS) nailing with minimal complications.

Pathologic Fracture in a Young Basketball Athlete

Bone fractures are commonly due to a high-velocity injury, especially in younger individuals. Fractures resulting from a low-impact mechanism should raise suspicion of an underlining pathological process. This case explores non-ossifying fibroma as an underlining cause of pathological fracture in a young basketball athlete.

Primary hyperparathyroidism as a cause of pathological fracture in a 16-year-old teenager

This article presents a rare clinical observation of a bone form of primary hyperparathyroidism in a 16-year-old adolescent complicated by a pathological fracture of the right femur. The features of the given case are: late diagnosis of primary hyperparathyroidism in an adolescent with clinical manifestations; complication of the disease with a pathological fracture, which required two-stage treatment, open repositioning and metal plate osteosynthesis; difficulties in the organization of the examination and treatment of the patient, related to the detection of covid-19 and his stay in an infectious department; the need for tactical decision on the sequence of surgical treatment of the fracture and its cause - primary hyperparathyroidism.

Percutaneous vertebroplasty in metastatic vertebral fracture: A retrospective cross-sectional study

Introduction: Metastatic vertebral fractures (VF) commonly cause severe disabling pain in cancer patients. VFs are common among elderly patients and account for approximately 1.5 million per year in the general population. Objective: Bone metastasis, which is a second major cause of pathologic fracture, may lead to severe intolerable pain, life-threatening hypercalcemia, spinal cord compression, and immobility. The purpose of this study was to evaluate pain relief and improvement in quality of life (QOL) in patients with metastatic VF undergoing percutaneous vertebroplasty (PVP). Methods: Ten cancer patients having metastatic VF underwent PVP from July 2018 to August 2020. All demographic data, procedures, improvement in pain, and analgesic requirements of patients were taken from a computer data system and telephonic follow-up. Results: Majority of patients were suffering from carcinoma lung followed by carcinoma pancreas. The mean ± standard deviation of Visual Analog Scale preoperatively was 8.8 ± 1.35, reduced to 2.14 ± 2.11 at 6 months postoperatively, suggesting significant pain reduction. Eight patients had reduction in analgesic requirements and two did not require any analgesics postoperatively. During the entire follow-up, there was no delayed complication. Conclusion: PVP is an effective, safe, and minimally invasive procedure for treating painful metastatic vertebral compression fracture refractory to conservative treatments. It provides a marked reduction of pain, maintains mechanical stability of the vertebrae, and improves QOL.

Rare cause of pathological fracture in adults as hypophosphatemic rickets

Hypophosphatemic rickets is a disorder of defective bone minerlization due to defect in renal phosphate handling process. It is characterised by increased phosphate excretion accompanied by increased phosphatonins like fibroblast growth factor 23. It can be hereditary form of X linked, autosomal dominant, autosomal recessive type of hypophosphatemic rickets. It is associated with low serum phosphorus, normal serum calcium, inappropriately low to normal vitamin D level. Correct identification of these disorders is important for determining therapy. Early diagnosis and management prevent subsequent complication of the disease.

Pathological Fracture of the Proximal Tibia from an Intraosseous Gouty Tophus: A Rare Presentation of Gout: 骨內痛風石導致病理性脛骨折的案例 – 一個罕見痛風症的例子

Intraosseous gouty tophus as the cause of pathological fracture is a seldom encountered condition. Not only does the tophus lesion affect the bone, but recent literature has also demonstrated a correlation between bone health in relation to gout as a disease entity, and showed the importance of medical treatment to improve the bone quality in patients with gout. We present a rare case of a pathological fracture due to an intraosseous gouty tophus as the presentation of gout, which imposed a diagnostic challenge, and illustrates the importance of multidisciplinary management in such conditions.

Fibrous dysplasia of the humerus: An uncommon cause of pathological fracture in a 56-year-old

Fibrous dysplasia is a bone disease that manifests usually before the end of the third decade. Fracture occurring after a minor impact is usually on a background of diseased bone. This case illustrates an asymptomatic bone disease that was diagnosed incidentally when there was failure of union of a humeral fracture after 10 weeks of adequate conservative treatment.

Новая концепция в профилактической ортопедии. Предупреждение патологических переломов проксимального отдела бедра путем хирургического армирования кости

The paper is dedicated to the pilot study of the surgical ways of preventing fractures of the hip
 among elderly patients suffering from various diseases that cause destructive‐dystrophic changes of the
 bony tissue (osteoporosis, cancer, cartilage and fibrous dysplasia, etc.) and are the cause of pathological fractures.
 The research involves the identification of people at risk, the development of preventive techniques
 and original reinforcement implant designs, the definition of a methodology for mathematical modeling and
 bench tests to determine the strength of the original implant reinforced hip. Studies have shown that the index
 of strain in the bone is considerably lower than on its surface (closer to longer‐term cortical layer), and when the load increases, it results in the development of a fracture. As a result of the reinforcement of the
 bone with different implants the index of strain at critical points is increases up to 11.6% ‐12.1. The bench
 tests proved that the preventive reinforcement to prevent fractures in low‐energy trauma can increase the
 strength of bone‐implant, depending on the type, design, quality, implant and method of its introduction up
 to 23‐93%.

Nasu-Hakola Syndrome: An Unusual Cause of Pathological Fractures

Nasu-Hakola syndrome is a hereditary cause of pathological fractures. Uniquely, patients also develop neuropsychiatric symptoms and signs. The disease is ultimately fatal. We propose a management strategy for pathological fractures in sufferers based on the stage of the disease.

A cause of pathological fracture

A 62 year old woman presented to the emergency department after having a fall at home. She had left hip pain but was not clinically dehydrated or disorientated. On further examination, her left leg was shortened and externally rotated, indicative of a fracture. Her history included type 2 diabetes, depression, hypercholesterolaemia, hypertension, and recurrent chest infections over the previous six months. Routine blood tests on admission were normal apart from an alkaline phosphatase of 245 IU/l and a corrected calcium of 2.60 mmol/l. Radiographs were taken on admission (figs 1 and 2), and further investigations were performed (figs 3 and 4).⇓⇓⇓⇓ Fig 1 Radiograph of left femur Fig 2 Radiograph of distal femur Fig 3 Radiograph of skull Fig 4 Isotope bone scan …

Symptomatic pathological fracture of odontoid as the primary presentation of multiple myeloma: Evaluation by 3D CT, conventional MR imaging, and in-phase and opposed-phase MR technique

Odontoid fractures commonly occur as a result of traumatic cervical spine injuries; pathological fractures being distinctly uncommon. Malignant tumors involving atlanto-axial spine are uncommon, metastases remain a common cause of pathological fractures at this site. Although, myeloma deposits in the cervical spine often occur, primary presentation of multiple myeloma with pathological fracture of odontoid consequent to such deposits is extremely rare. The above feature and its occurrence at an unusual site are the highlights of this report. A short review of the available literature has also been done. We further describe the utility of in-phase and opposed-phase imaging in differentiation of benign from malignant vertebral fracture in context to the present case.

Bone Formation Using Human Demineralised Bone Matrix (Grafton®) for the Treatment of Bone Cysts in Children

Bone cysts, in particular solitary bone cysts, are the most frequent cause of pathological fractures in children. However, there is still a great variety of regimens used to treat these lesions. Since demineralised bone matrix (DBM) is commercially available, we aimed to use this material for the consolidation of bones diagnosed as fragile because of cyst formation. Each of the 7 bone cysts as well as one enchondroma filled with DBM showed a continuous decrease in bone transparency over a period of two years (mean 8 months). A significant decrease in bone transparency and simultaneous cortical remodelling was radiographically detected in these cases as the specific hallmark of an initiated graft incorporation after 3 to 4 months. It was demonstrated that it is possible to heal children within an acceptable period of time using DBM to fill the cystic lesion. DBM appears to be a reasonable and beneficial alternative for the treatment of bone cysts offering both osteoinduction and osteoconductive features.

Treatment and prevention of neonatal osteopenia

Summary Osteopenia is a recognised cause of pathological fracture in preterm infants. The commonest etiology for osteopenia is mineral deficiency resulting in suboptimal bone formation. Various risk factors affecting bone growth have been implicated. Preterm infants who depend on prolonged total parenteral nutrition and have chronic co-morbidities, such as chronic lung disease and short-gut syndrome, are particularly vulnerable to this complication. Early detection by vigorous monitoring of bone homeostasis and prompt treatment of osteopenia are warranted in these high-risk infants. The aims of this article are to (1) identify infants who are prone to develop osteopenia, and (2) minimise its occurrence and complications.

Pathologic Fracture of the Humerus

Review of patients with pathologic fracture of the humerus disclosed that closed treatment resulted in a high incidence of pain, disability, and failure to heal. The most common cause of pathologic fracture of the humerus is breast cancer. A review of records of 103 patients with persistent disease after initial treatment for breast cancer revealed that 19 had humeral metastases (18.5%); of those with humeral metastases, two patients (10%) had pathologic fractures. Prophylactic internal fixation of humeral metastases is not routinely recommended, but operative treatment for pathologic fracture of the humerus is generally superior to nonoperative methods of fracture management.

Hydatid Cyst—a rare cause of pathological fracture: a case report

Observation chez un enfant de 14 ans qui s'etait fait une fracture du bras gauche en jouant au football

Osseous Gaucher's Disease in Early Childhood

A seldom considered cause of pathological fractures in children is Gaucher's disease. In our investigation of a patient with this disease, it was found that the occurrence of extensive bone erosion without splenomegaly has not been previously reported in the very young. Although there is no specific test for the abnormal cerebroside, thorough histological studies corroborated the diagnosis. The elevation of acid phosphatase demonstrated in this case is particularly significant since it is almost invariably associated with this disease and represents a simple confirmatory test. The course of this patient has been unpredictable as might be expected since there is little correlation between the clinical manifestations and the degree of histological infiltration by the abnormal cells.

PATHOLOGIC FRACTURE DUE TO SYPHILIS

Dermatologists are increasingly appreciative of visceral This report demonstrates some unusual manifestations in syphilis of the bones and viscera. Syphilis has long been recognized as a cause of pathologic fracture. Such fractures, however, are becoming increasingly less common. The older writers emphasized syphilis, and the more recent ones have mentioned it in considering the causes of pathologic fracture. Thus Hazen 1 stated: Fractures as a result of bone destruction are frequently seen and are so frequent as to arouse always in such cases the suspicion of syphilis. Fragenheim 2 devoted considerable discussion to syphilitic fracture and Boyd 3 admitted the possibility of such phenomena. Eliason, 4 in reviewing pathologic fractures of various causes, cited Speed as stating that large numbers of spontaneous fractures due to syphilis are seen each year at the Cook County Hospital. From what follows this citation, however, it seems probable that most of these fractures