Bilateral femoral neck fractures after an epileptic attack: A case report

WOS: 000397094300031PubMed ID: 25528038INTRODUCTION: Bilateral femoral neck fractures can occur due to high-or low-energy trauma, in the presence of various predisposing factors, such as osteoporosis, renal osteodystrophy, hypocalcemic seizures, primary or metastatic tumors, electroconvulsive therapy, epileptic seizures, and hormonal disorders. PRESENTATION OF CASE: This report presents a case of bilateral femoral neck fractures that occurred during an epileptic attack in a 24-year-old male with mental retardation. His complaints had started after a grand mal epileptic attack 10 days earlier. Bilateral displaced femoral neck fractures (Garden type 4) were seen in lateral radiographs of both hips. The patient was operated on urgently, with closed reduction, three stainless steel cannulated screws, and internal fixation applied to both hips. At postoperative week 12, solid joining was achieved and active walking with complete loading was started. DISCUSSION: Bilateral femoral neck fractures can occur following a grand mal epilepsy attack in young patients. The use of antiepileptic drugs can also lead to the development of pathological fractures by reducing bone mineral density. CONCLUSION: Femoral neck fractures should be suspected in patients with epilepsy who present with severe pain in both hips and an inability to walk. Stainless steel implants can be used for treatment. The viability of the femoral head should be evaluated by scintigraphy. Bone mineral density should be monitored in patients who use anti-epileptic drugs, and internal fixation is preferred in the treatment of femoral neck fractures

A case report of osteoblastoma on the distal phalanx of the ring finger successfully treated with curettage and polymethylmethacrylate filling

WOS: 000361072200035PubMed ID: 26072004BACKGROUND: Osteoblastoma is an aggressive benign tumor whose presentation varies with location and size. This rare bone tumor is thus difficult to diagnose particularly when it occurs outside its most common location - the vertebral column and long bones. CASE: We report a case of osteoblastoma of the fourth distal phalanx of the left hand in an 18-year-old male, presented with pain and swelling and treated with curettage and polymethylmethacrylate filling followed by immobilization by a cast, which was opened 10 days later to start physical therapy. Patient was pain-free, recovered full function of his finger, and remained without pain at one month post-surgery. The finger was monitored closely for two years; sequential films showed a radiopaque interface and no evidence of local recurrence. CONCLUSION: This is the first report of osteoblastoma on the distal phalanx. The possibility of osteoblastoma should be considered in cases of pain and swelling of phalanx, and if diagnosed, curettage and polymethylmethacrylate filling may be the treatment of choice

Effect of increase in birth weight in a newborn on hip ultrasonography

WOS: 000362112100003PubMed ID: 26196367Exposure to the pressure experienced by higher birth weight babies during the intrauterine period might cause hip dysplasia. The aim of this study is to determine the effect of birth weight in newborns on hip ultrasonography when the paternal and maternal risk factors are excluded. A total of 701 babies born at 38-42 gestational weeks were included in the study. Hip ultrasonography was performed within 7 days following birth using the Graf technique in the babies without risk factors for developmental dysplasia of the hip. Images obtained were controlled with respect to conformity to the Graf method and angular measurements were performed. According to the and angle values obtained, type 1A and 1B hips were categorized as mature; type 2A hips were categorized as immature; and type 2C, D, 3A, 3B, and 4 hips were categorized as pathological hips. The results obtained were analyzed for the effect of birth weight on the angular values and hip typing. The birth weight of the babies was 338488 +/- 48241g (2030-6124g). It was determined that the birth weight had no effect on the values of and angles in the male babies (P=0.21, 0.76). It was determined that increasing birth weight decreased the angle value (P=0.001) and caused no difference in the angle value (P=0.057) in the female babies. It was found that birth weight had no effect on hip typing in both female and male babies (P=0.060, 0.22). Increases in birth weights caused decreases in ultrasonographic angles only in female babies

Effect of bone mineral density on functional and radiological results in conservatively treated distal radius fractures

WOS: 000409955700002Amaç: Bu çalışma, kapalı redüksiyon ve alçılama ile tedavi edilen distal radius kırıklarının, fonksiyonel ve radyografik sonuçları üzerine kemik mineral yoğunluğunun etkisini değerlendirmek üzere tasarlanmıştır. Gereç ve Yöntem: Distal radius kırığı nedeniyle kapalı redüksiyon ve kısa kol alçı ile tedavi edilen 52 hasta (21 erkek, 31 kadın, 31 sağ, 21 sol el bileği, ortalama yaş 63,4 (50-84)) çalışmaya alındı. Hastalar kemik mineral yoğunluğu ölçüm sonuçlarına göre düşük (grup 1, n=31) ve normal (grup 2, n=21) şeklinde gruplara ayrıldı. Gruplar iyileşme zamanı, son kontrollerin radyografik parametreleri ve Gartland-Werley fonksiyonel skorlarına göre karşılaştırıldı. Bulgular: Her iki grup kırık tipi, baskın taraf, cinsiyet dağılımı ve ortalama yaş bakımından homojendi (p=0,18; p=0,96, p=0,38 ve p=0,42). İki grup arasında radyal eğim kaybı (p=0,17), volar tilt kaybı (p=0,24) ve radyal kısalma miktarı (p=0,14) bakımından anlamlı farklılık yoktu. Aynı zamanda kaynama zamanı açısından gruplar arasında anlamlı farklılık yoktu (p=0,87). Düşük kemik mineral yoğunluğu olanlarda fonksiyonel skorlar anlamlı düzeyde daha düşüktü (p=0,03) ve kemik mineral yoğunluğu ve fonksiyonel sonuçlar arasında anlamlı pozitif bir ilişki bulundu (r=0,29, p=0,04). Fonksiyonel skorlar ile radyal kısalma miktarı, radyal inklinasyon ve volar tilt kaybı arasında anlamlı ilişki yoktu (p=0,53, p=0,38, p=0,57). Sonuç: Bu çalışma konservatif olarak tedavi edilen distal radius kırıklarında daha düşük kemik mineral yoğunluğu değerlerinin kaynama zamanı ve redüksiyon kaybı gelişimi üzerine anlamlı etkisi olmadığını ancak fonksiyonel sonuçları olumsuz etkilediğini göstermiştir.Objective: This study was designed to evaluate the effect of bone mineral density on functional and radiographic results of distal radius fractures, which were treated with closed reduction and casting. Materials and Methods: Fifty-two patients [21 males, 31 females, 31 right, 21 left-wrist mean age: 63.4 years (range, 50-84)] who were treated with closed reduction and short arm casting due to fracture of distal radius were included in this study. Patients were divided into groups according to bone mineral density (BMD) measurement results as low (group 1, n=31) and normal (group 2, n=21). Groups were compared according to healing times, radiographic parameters of the last controls and Gartland-Werley functional scores. Results: The fracture type, dominant side, gender distribution and mean age were homogeneous in both group (p=0.18; p=0.96, p=0.38 and p=0.42). There were no significant differences in terms of loss of radial inclination (p=0.17), the volar tilt loss (p=0.24) and the amount of radial shortening (p=0.14) between two groups. There was also no significant difference between the groups in terms of time to union (p=0.87). Functional scores were significantly lower in group with low BMD (p=0.03) and a significant positive correlation was found between BMD and functional results (r=0.29, p=0.04). There was no significant correlation between functional scores and amount of shortening, loss of radial inclination and volar tilt (p=0.53, p=0.38 and p=0.57). Conclusion: This study showed that, lower BMD scores have no significant effect on healing time and loss of reduction of conservatively treated distal radius fractures, however affect adversely the functional results