There is a transverse pathologic fracture through the lesion. There is a permeative, lytic, and destructive lesion in the proximal femur with endosteal scalloping. There is a transverse pathologic fracture (white arrows) through the lesion. There is a permeative, lytic, and destructive lesion (black arrows) in the midshaft of the humerus with endosteal scalloping. Cement or bone graft may be used to fill a significant defect.While radiation may help pain, it may also delay osseous healing.If the bone is weight-bearing, such as the femur, intramedullary rodding is frequently used.Fatigue fractures occur with repetitive stress in normal underlying bone.Insufficiency fractures are seen with osteoporosis, not associated with a visible focal abnormality.On MRI, non-pathologic fracture-related hematoma.Soft tissue mass and infiltration of the muscle.Frequently associated with a soft tissue mass.Fracture line extending through a destructive lesion in the bone.Most common primary sites are breast, prostate and lung Preoperative screening in hip fracture patients is vital to minimize perioperative complications.Soft tissue swelling or mass which may pre-date fracture.May occur in osteoblastic as well as osteolytic metastases.Suspect when there is an avulsion fracture in an unusual location, spontaneous avulsion of lesser trochanter in adult.May also involve enchondroma, unicameral bone cysts.Most frequent through a metastatic lesion or multiple myeloma X-ray shows a suspected mildly compressed hip fracture, as incongruity of the cortex.By definition, a fracture that occurs through bone which was previously abnormal. Vertical shear fractures of the femoral neck. Vertically oriented femoral neck fractures: mechanical analysis of four fixation techniques. finding tenderness over the pubic bone may make diagnosis apparent in this age group its important to make important distinction between frx of pelvis & undisplaced or impacted frx of neck of femur single ramus fracture is commonly seen in elderly age groups, in whom falls are common when treating fractures with a large amount of posterior comminution, surgeon should place the superior & posterior screws along calcar femorale to resist posterior collapse degree of posterior comminution is most evident lateral radiograph frxs w/ posterior comminution have higher prevalence of non-union Definition (CSP) breaks or rupture in bones or cartilages of the hip for fractures of the femoral shaft below the subtrochanteric region use LIMB FRACTURE. hence, the outline of the femoral neck is never tangent to the outline of the femoral head in a reduced femoral neck fracture A finding of traumatic injury to the hip in which the continuity of either the femoral head, femoral neck, intertrochanteric or subtrochanteric regions is broken. this outline produces the image of an S or a reversed S curve normal radiographic anatomy of the femoral head and neck reveal a convex outline of femoral head joining the concave outline of femoral neck Non-displaced Frx: - if plain radiographs are negative, consider MRI for immediate interpretation or bone scan after three days Biomechanical analysis of a novel femoral neck locking plate for treatment of vertical shear Pauwel's type C femoral neck fractures. The Pauwels classification for intracapsular hip fractures: Is it reliable? Nonunion of Subcapital Femoral Neck Fractures. 2/5 Garden IV frx w/ vertical frx line had non union 6/14 Garden III frx w/ vertical frx line had non-union 2/5 Garden II frx w/ vertical frx line had non-union 11/11 Garden II frx w/ horizontal frx line had non-union modified Pauwel's method classifies frx as horizontal, transverse, or vertical, according to direction of frx on femoral head Assessment of Risk of Non-union: (using modified Pauwel's method) do not order frog leg pts suspected of having a hip frx Lateral x-ray: of affected limb on the stretcher while good limb is flexed upto obtain the proper angle AP & Lateral of Ipsilateral Femur + Internal Rotation View
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