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Dissertations / Theses on the topic 'Neck of femur fracture'

Author: Grafiati

Published: 11 December 2022

Last updated: 26 January 2023

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1

O'Gorman, Patricia M. "Economic evaluation of arthroplasty choice for femoral neck fractures." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/98419/1/Patricia_O%27Gorman_Thesis.pdf.

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This thesis examined the cost-effectiveness of different types of arthroplasty and fixation methods used to treat femoral neck fractures in the Australian health system. Using a decision analytic model, the study measured the costs and health outcomes associated with different treatment options to determine which prostheses led to cost-effective care. Cemented fixation of prostheses was found to be more cost-effective than uncemented fixation. The cost-effectiveness of different arthroplasties varied with age and whether QALYs or revision surgeries were the health outcome assessed. The results support recommendations that cemented prostheses be used for femoral neck fractures. Further research into defining population groups, collecting preference based values of health states and costs would be beneficial to inform further research into this area.

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2

Shituleni, Sibasthiaan Gometomab. "Displaced intracapsular neck of femur fractures: dislocation rate after total hip arthroplasty." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16788.

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Background: Dislocation is one of the most common orthopaedic complications after primary total hip arthroplasty (THA). The reported dislocation rate in elective THR is 5 - 8%. This number increases up to 22% for THA done for neck of femur fractures. Larger femoral head sizes increase the head-neck ratio and range of motion before impingement, therefore reducing the dislocation rate. Due to the reported increase in dislocation for trauma, some surgeons prefer to do a hemi-arthroplasty or open reduction and internal fixation (ORIF). Methods: A retrospective review of all THA done for neck of femur fractures during 2006 - 2012 was undertaken at a large referral hospital. Records were reviewed for patient related and surgical risk factors. We excluded all pathological fractures, extra-capsular fractures and failed ORIF. Results: A total of 96 cases were identified as suitable for analysis. Average age at surgery was 73.2 years (range 30 - 81). Delay to surgery was 5.3 days (range 1 - 63). Average follow up period was 18.3 months (range 3 months - 4.3years). Four patients (4.3%) had a confirmed dislocation. The four patients who had confirmed dislocation had the following characteristics, 28 mm femoral head size, age over 60 years, 2 posterior approaches and 3 females, although not statistically significant. Conclusion: The outcomes of THR in patients with neck of femur fractures can be favourable and provide good long-term prosthesis survival. We report on low dislocation rate post total hip replacement for intra-capsular neck of femur fractures.

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3

Turner, Jim. "Randomised controlled trial of a high dependency unit in the post-operative care of patients with fractured neck of femur : a cautionary tale." Thesis, University of York, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.247145.

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4

Rohrbach, Daniel. "Quantitative ultrasound in transverse transmission for bone quality assessment and monitoring fracture healing." Doctoral thesis, Humboldt-Universität zu Berlin, Mathematisch-Naturwissenschaftliche Fakultät I, 2013. http://dx.doi.org/10.18452/16813.

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Osteoporose und gestörte Heilungsverläufe von Knochenbrüchen verursachen immer noch beachtliche klinische Komplikationen. Ein vielversprechender Ansatz für die nichtinvasive und nichtionisierende Abschätzung des Frakturrisikos und der Bildgebung von Frakturheilung ist quantitativer Ultraschall (QUS). Dennoch liegt die derzeitige Akzeptanz für die Knochenqualitätsabschätzung noch weit hinter herkömmlichen röntgenbasierten Anwendungen. Es wurden akustische Mikroskopie und Synchrotronstrahlen-Mikrotomographie für die Anatomie und altersabhängige Erfassung von strukturellen und elastischen Variationen auf der mikroskopischen Ebene von humanen Femora verwendet. Die gewonnenen Daten dienten als Grundlage für die Erstellung mikromechanischer Modelle von Knochen für numerische Simulationen der Schallausbreitung im humanen Femurhals. Dabei wurde der Aufbau eines US-basierten Femur-Scanners in transversaler Transmission (TT) nachempfunden. Im letzten Abschnitt der Arbeit wurde QUS in TT in in vitro Experimenten am Rattenfrakturmodell auf eine Anwendung für die Bildgebung der Frakturheilung getestet. Die Studien konnten zeigen, dass ein Großteil der adaptiven Fähigkeiten von Knochen auf mikroskopischer Ebene auf eine Kombination von extrazellulärer Matrixelastizität und Gewebeporosität zurückzuführen ist. Die Simulationen des zweiten Teils konnten die Existenz von geführten Wellen im humanen Femurhals bestätigen. Die sensitive Abhängigkeit von US-parametern von frakturrelevanten Knocheneigenschaften zeigt das hohe Potential von QUS für die Frakturrisikoabschätzung. Der zweite Teil der Arbeit konnte erfolgreich die Möglichkeit von QUS in TT zur Diskriminierung von zeitigen Heilungsstadien demonstrieren. Zusammenfassend bestätigt die Studie das hohe Potential von QUS für die Frakturrisikoabschätzung und die Bildgebung der Frakturheilung.
Osteoporosis and impaired bone healing are of high relevance. A promising non-invasive, non-ionizing candidate for fracture risk prediction and monitoring fracture healing is quantitative ultrasound (QUS). However, the acceptance of QUS for bone quality assessment is still not comparable to X-ray based methods. Scanning acoustic microscopy (SAM) and Synchrotron Radiation micro-computer tomography (SRµCT) has been used to investigate anatomical and age dependent variations of micro elastic, structural and mineralization parameters at the tissue level of human femoral bone. Femoral neck models were created based on these data for numerical sound propagation simulations emulating a transverse transmission (TT) setup of an in vivo QUS prototype. In the last part of the project the TT approach has been tested in ex vivo experiments in a rat healing model. The power of QUS, to discriminate two early healing stages has been compared to µCT measurements at the same specimens. It was found that the major contributor to bone adaptation is related to a combination of extracellular matrix elasticity and tissue porosity. It is hypothesized that these parameters are likely to have a considerable impact on the reliability of in silico models. The simulations of the second part confirmed the existence of guided wave propagation in the cortical shell and a high dependency of US parameters on fracture relevant bone properties. The results demonstrate the high potential for bone fracture risk prediction at the femoral neck using QUS. Finally, it was successfully demonstrated that early healing stage discrimination of QUS in TT was superior compared to µCT. In summary these investigations not only show the importance for a precise estimation of micro mechanical properties for numerical modelling but also demonstrate the feasibility and high potential of QUS for bone quality assessment and monitoring of fracture healing.

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5

Torres, Geórgea Hermógenes Fernandes. "Associação de fraturas vertebrais moderadas e graves com menor densidade volumétrica trabecular na tíbia em mulheres idosas e menor densidade mineral óssea areal em fêmur em homens idosos da comunidade: São Paulo Ageing & Health study (SPAH)." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/5/5166/tde-13022019-143204/.

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Introdução: A tomografia computadorizada periférica quantitativa de alta resolução (HR-pQCT) é um método diagnóstico que avalia microarquitetura óssea e estima resistência óssea por análise de elemento finito, facilitando a compreensão da fisiopatologia das fraturas. Objetivo: Avaliar associação de fraturas vertebrais moderadas e graves com parâmetros obtidos na HR-pQCT, escore trabecular ósseo (TBS) e densidade mineral óssea areal em idosos da comunidade. Métodos: Foram recrutados 276 idosos da coorte SPAH. Dados clínicos foram obtidos a partir de um questionário específico. A fratura vertebral (FV) foi avaliada por DXA-VFA utilizando-se o método semiquantitativo de Genant. HR-pQCT e DXA foram realizados no mesmo dia da coleta de sangue. O modelo de regressão logística foi realizado para verificar quais fatores foram associados de forma independente com a fratura vertebral moderada e grave. Resultados: Na tíbia, mulheres com FV moderada/grave apresentaram menor densidade mineral óssea volumétrica, menor número de trabéculas, menores valores dos parâmetros de resistência óssea e maior separação trabecular; e os homens apresentaram menor número de trabéculas, menor parâmetro de resistência óssea e maior separação trabecular. No rádio, as mulheres com FV moderada/grave tinham menor densidade mineral óssea volumétrica, espessura trabecular e cortical e menor valor do parâmetro de análise do elemento finito; e os homens tinham menor densidade mineral óssea volumétrica trabecular e menor valor de parâmetro de análise do elemento finito. Não foram observadas diferenças no TBS em ambos os sexos. A análise de regressão logística revelou que uma menor densidade mineral óssea volumétrica trabecular na tíbia em mulheres (OR: 0,980, 95% CI: 0,963-0,997, p = 0,022) e uma menor densidade mineral óssea areal do colo femoral e fêmur total em homens (OR: 0,002, IC 95%: 0-0,607, p = 0,033 e OR: 0,003, IC 95%: 0-0,623, p = 0,033) foram independentemente associados com FV moderada/grave. Conclusão: As imagens da HR-pQCT detectaram diferenças na microarquitetura óssea em mulheres idosas com FV moderada/grave independente de densidade mineral óssea areal e TBS por DXA; e HRpQCT pode ser uma ferramenta útil para avaliar o risco de fratura. Diferentemente, nos homens, a densidade mineral óssea areal do fêmur foi associada à FV moderada/grave; e a DXA continua sendo uma ferramenta importante para predizer a FV
Background: Many vertebral fractures (VF) occur in individuals classified by DXA as low risk for fragility fractures. Thus, the aim of this study was to verify the association between VF and peripheral bone microarchitecture and strength parameters using also high-resolution peripheral quantitative computed tomography (HR-pQCT) and axial bone microarchitecture by trabecular bone score (TBS). Study design: Cross-sectional study of 276 subjects aged >=65 years from SPAH cohort. Methods: Lateral scans of spine obtained from Vertebral Fracture Assessment by DXA were analyzed to assess VF. HR-pQCT was performed at radius and tibia. TBS was performed using DXA. Results: At tibia, women with Moderate/severe VF had lower volumetric bone density (vBMD), trabecular number (Tb.N), strength parameters and higher trabecular separation (Tb.Sp); and men had lower Tb.N, strength parameters and higher Tb.Sp. At radius, women with moderate/severe VF had lower v.BMD, trabecular and cortical thickness and strength parameters; and men had lower trabecular v.BMD and strength parameters. No differences were observed in TBS in both genders. Logistic regression analysis revealed that lower trabecular vBMD at tibia in women (OR: 0.980, 95%CI: 0.963-0.997, p = 0.022) and lower femoral neck aBMD and total hip in men (OR: 0.002, 95%CI: 0-0.607, p = 0.033 and OR: 0,003, IC 95%: 0-0,623, p = 0,033) were independently associated with VF. Conclusion: HR-pQCT images detected differences on bone microstructure in older women with moderate/severe VF independent of aBMD and TBS by DXA and HR-pQCT could be useful tool to assess fracture risk. Differently, in men femoral aBMD was associated with moderate/severe VF and DXA continue an important tool for predicting VF

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6

Billard, Rémi. "Développement d'un implant à géométrie variable pour le traitement des fractures du fémur proximal chez les personnes âgées." Phd thesis, Université de Grenoble, 2014. http://tel.archives-ouvertes.fr/tel-00987969.

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Les fractures du fémur proximal de la personne âgée sont généralement fixées par des dispositifs d'ostéosynthèse. Pour les fractures particulières dites inter-trochantériennes, il est possible de fixer la fracture de manière intra-médullaire (à l'intérieur de l'os) ou de manière extra-médullaire (en dehors de l'os). Pour chaque type de traitement, les hôpitaux sont équipés des deux systèmes de fixation. Les différences de morphologie des individus impliquent l'existence de multiples références d'implants et donc de surcoûts en termes d'équipement. Dans ce travail de thèse, un implant original adaptable à la plupart des morphologies a été développé. Cet implant permettra non seulement d'offrir aux chirurgiens une souplesse au cours des interventions chirurgicales mais aussi de réduire de manière significative les stocks d'implants dans les hôpitaux. Le comportement mécanique de l'implant est étudié dans différents cas de fractures par deux approches complémentaires, une méthode numérique par Éléments Finis et une approche expérimentale mettant en oeuvre des techniques de stéréo-corrélation à partir d'images de caméras rapides. Les résultats des calculs numériques sont confrontés à ceux issus d'essais réalisés sur des fémurs synthétiques, puis cadavériques en laboratoire d'anatomie. Les comparaisons avec des implants existants montrent que ce nouveau concept d'implant permet une fixation plus stable des fragments osseux et une bonne compression du foyer de fracture.

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7

Boyce, William Jonathan. "Fracture of the proximal femur." Thesis, University of Oxford, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.235988.

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8

Chen, Yupei. "Classification of Atypical Femur Fracture with Deep Neural Networks." Thesis, KTH, Skolan för kemi, bioteknologi och hälsa (CBH), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-255677.

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Atypical Femur Fracture(AFF) is a type of stress fracture that occurs in conjunction with prolonged bisphosphonate treatment. In practice, AFF is very rarely identiﬁed from Normal Femur Fracture(NFF) correctly on the ﬁrst diagnostic X-ray examination. This project aims at developing an algorithm based on deep neural networks to assist clinicians with the diagnosis of atypical femurfracture. Two diagnostic pipelines were constructed using the Convolutional Neural Network (CNN) as the core classiﬁer. One is a fully automatic pipeline, where the X-rays image is directly input into the network with only standardized pre-processing steps. Another interactive pipeline requires the user to re-orient the femur bones above the fractures to a vertical position and move the fracture line to the image center, before the repositioned image is sent to the CNNs. Three most popular CNNs architectures, namely VGG19, InceptionV3 and ResNet50,were tested for classifying the images to either AFF or NFF. Transfer learning technique was used to pre-train these networks using images form ImageNet. The diagnosis accuracy was evaluated using 5-fold cross-validation. With the fully automatic diagnosis pipeline, we achieved diagnosis accuracy of 82.7%, 89.4%, 90.5%, with VGG19, InceptionV3 and ResNet50, respectively. With the interactive diagnostic pipeline, the diagnosis accuracy was improved to 92.2%, 93.4% and 94.4%, respectively. To further validate the results, class activation mapping is used for indicating the discriminative image regions that the neural networks learn to identify a certain class.

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9

Ye, Ruihua, and 叶锐华. "Development of a hybrid robotic system for femur fracture reduction." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B4714807X.

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10

Pappas, Christos A. "Redesigning of a fracture fixation device : the Mennen femur plate." Thesis, University of Exeter, 2004. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.531674.

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11

MANCZAK, JOEL. "Les fractures cervicales vraies du col du femur osteosynthesees." Toulouse 3, 1989. http://www.theses.fr/1989TOU31156.

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12

CHAVANE, HERVE. "Fractures de la tete femorale (chez l'adulte et chez l'enfant) : travail du service orthopedique et traumatologique du pr l.p. fischer et pr j. bejui, pavillon t, hopital e. herriot." Lyon 1, 1993. http://www.theses.fr/1993LYO1M129.

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13

Wang, Song, and 王松. "Motion planning and control simulation for robot assisted femur fracture reduction." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45161380.

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14

PODGLAJEN, JULIEN. "Les fractures unicondyliennes du femur : a propos de 69 cas." Lille 2, 1993. http://www.theses.fr/1993LIL2M124.

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15

BAUDAT, PHILIPPE. "Les fractures du col du femur chez l'enfant : a propos de cinq cas." Clermont-Ferrand 1, 1990. http://www.theses.fr/1990CLF13036.

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16

LECLAIR, OLIVIER. "L'enclouage verrouille du femur et du tibia : a partir du materiel standard ao : notre experience a partir de 80 cas." Toulouse 3, 1988. http://www.theses.fr/1988TOU31277.

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17

BONNEFOND, MAIMOUNA. "Etude analytique des fractures du col du femur dans un service de gerontologie clinique : hopital de cimiez - chru de nice." Nice, 1993. http://www.theses.fr/1993NICE6530.

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18

Angelini, Alessandro Janson. "Tratamento das fraturas com traço simples da diafise do femur, com tecnica minimamente invasiva e placa em onda." [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312286.

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Orientador: William Dias Belangero
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-08T02:22:20Z (GMT). No. of bitstreams: 1 Angelini_AlessandroJanson_D.pdf: 8473233 bytes, checksum: 3996290e908ef6f361b3a4bf25baf1d9 (MD5) Previous issue date: 2006
Resumo: A partir de resultados de estudos mecânicos com a placa em onda, demonstrando sua maior rigidez em montagens com algum tipo de contato cortical, surge este estudo com o objetivo de analisar o desempenho desse tipo de placa no tratamento das fraturas de traço simples da diáfise do fêmur. Foram incluídos, retrospectivamente, 57 pacientes, consecutivos, tratados com a placa em onda com técnica de osteossíntese biológica, com seguimento mínimo de um ano de pós-operatório. Obteve-se índice de consolidação de 94,74% (54 em 57 pacientes) em tempo médio de 12,88 semanas. Conclui-se que o método pode ser considerado uma alternativa às hastes intramedulares, com índices de consolidação semelhantes
Abstract: Mechanical studies with wave plates, were a higher rigidity was shown in models with cortical contact, suggested a study to analyze the use of wave plate in femoral simple shaft fractures. A consecutive series of 57 patients treated with wave plates and biological internal fixation, and a minimal follow up of 1 year after surgery. Healing occurred in 94,74% (54 of 57 patients) with an average of 12 weeks. In conclusion, this method could be considered an alternative to intramedullary nailing, with similar success rates
Doutorado
Cirurgia
Doutor em Cirurgia

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19

RAOUX, FRANCOIS-XAVIER. "Fracture de la hanche chez la personne agee : evaluation du devenir a un an : a propos de 100 cas." Toulouse 3, 1990. http://www.theses.fr/1990TOU31073.

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20

Wang, Chang Jiang. "Structural behaviour of femoral intramedullary fracture stabilising devices." Thesis, Brunel University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299098.

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21

Newman, Kyle D. "3D Modeling and Finite Element Analysis of Femur After Removing Surgical Screws." OpenSIUC, 2016. https://opensiuc.lib.siu.edu/theses/2025.

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Often bone fractures are joined by inserting metal plates and screws to hold the fragmented bone under compression. However, after the fractured bone is healed removing the screws leaves holes in the bone which takes months to fill up and heal completely. The goal of this research is to investigate those voids specifically in a finite element model of a femur. The holes were found to experience high stress that can easily lead to crack propagations during everyday activities. Finite element models of femurs were modeled after two common fracture fixation systems, specifically just after the plates, rods and screws are removed. To observe the stress levels bones are likely to experience, common mechanical tests that are relevant to or associated with common daily activities were performed. While the 3-point bending tests did not yield significant results, the compression and torsion tests produced high stress areas near the screw holes. In certain cases, the von Mises’ stress reached 3.66 x 106 N/mm2. Our finite element modeling seeks to establish groundwork for future explorations on the holes created by fracture fixation hardware. In the future, this work will lead to redesigning of fixation systems with reduced stress concentration around the holes. Therefore, the initiation of new cracks around these holes will be limited during everyday activity.

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Radi, Nico <1984&gt. "Diversity of the proximal femur in humans: morphological variations of the head-neck junction." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2014. http://amsdottorato.unibo.it/6327/.

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The proximal femur is a high-diversity region of the human skeleton, especially at the anterior junction between head and neck, where various bony morphologies have been recognized since mid nineteenth century. Classical literature on this topic is chaotic and contradictory, making almost impossible the comparison of data from different researches. Starting from an extensive bibliographic review, the first standardized method to score these traits has been created. This method allows representing both the anatomical diversity of the region already described in literature and a part of variability not considered before, giving few and univocal definitions and allowing to collect comparable data. The method has been applied to three identified and five archaeological European skeletal collections, with the aim of investigating the distribution of these features by sex, age and side, in different places and time periods. It has also been applied to 3D digital reconstructions of femurs from CT scan files of coxo-femoral joints from fresh cadavers. In addition to the osseous traits described in the standardized method, the presence and frequency of some features known as herniation pits have been scored both on bones and on CT scans. The various osseous traits of the proximal femur are present at similar frequencies in skeletal samples from different countries and different historical periods, even if with clear local differentiation. Some of the features examined show significant trends related to their distribution by gender and age. Some hypotheses are proposed about the etiology of these morphologies and their possible implication with the acquisition of bipedalism in Humans. It is therefore highlighted the possible relation of some of these traits with the development of disorders of the hip joint. Moreover, it is not recommended the use of any of these features as a specific activity-related marker.

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23

Watson, Hilary Joy. "Longitudinal study of recovery following diaphyseal fracture of the tibia or femur." Thesis, University of Edinburgh, 1988. http://hdl.handle.net/1842/19399.

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VAN, BUTSELE HEC FABIENNE. "Devenir fonctionnel des fractures de l'extremite superieure du femur a 2 ans." Amiens, 1992. http://www.theses.fr/1992AMIEM026.

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PAJOT, PARINGAUX CHRISTINE. "Seconde hanche fracturee : a propos de 48 cas." Angers, 1993. http://www.theses.fr/1993ANGE1074.

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26

Ferly, Michel. "Fractures de la tete femorale : a propos de 15 cas revus." Toulouse 3, 1993. http://www.theses.fr/1993TOU31007.

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27

Bonnet, Nathalie. "Utilisation du fixateur externe orthofix dans les fractures complexes de la diaphyse fémorale : à propos de 10 cas." Bordeaux 2, 1988. http://www.theses.fr/1988BOR25421.

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28

LACOUR, ROUVIER CATHERINE. "La prothese totale de hanche dans le cas de fracture du col du femur : a propos de 28 cas." Toulouse 3, 1989. http://www.theses.fr/1989TOU31178.

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29

DEMOL, FRANCK. "Les fractures du col du femur dans le cadre de l'osteoporose chez le sujet age." Lille 2, 1994. http://www.theses.fr/1994LIL2M244.

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30

Pietrzak, Frédéric. "Incidence sociale des fractures du col du femur : a propos de 626 cas ; prevention." Lille 2, 1991. http://www.theses.fr/1991LIL2M318.

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31

DELOBELLE, VENDEVILLE NATHALIE, and JEAN-MICHEL DELOBELLE. "Les fractures de l'extremite inferieure du femur traitees par vis-plaque de judet : a propos de 135 observations." Lille 2, 1990. http://www.theses.fr/1990LIL2M011.

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32

FASSANARO, GERARD. "Polypathologie dans les suites des fractures du col du femur chez le sujet age." Aix-Marseille 2, 1990. http://www.theses.fr/1990AIX20306.

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33

Vierling, Catherine-Françoise. "Place de l'osteosynthese dans le traitement des fractures cervicales vraies du femur apres 70 ans : etude multicentrique de 204 cas." Université Louis Pasteur (Strasbourg) (1971-2008), 1989. http://www.theses.fr/1989STR1M251.

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Leloir, Lionel. "Osteolyse post-fracturaire du col femoral." Université Louis Pasteur (Strasbourg) (1971-2008), 1991. http://www.theses.fr/1991STR1M179.

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35

Ward, Gillian E. "Functional outcomes following displaced intracapsular fracture of the proximal femur in elderly people." Thesis, University of Leicester, 1998. http://hdl.handle.net/2381/29579.

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Background The United Kingdom's elderly population and incidence of hip fracture are rising, yet outcome evidence to support optimum surgical intervention is lacking. Functional outcome is described by independence in activities of daily living (ADL), however the ideal measure to assess these activities following hip fracture is not known. The role of occupational therapy (OT) in regaining independence for patients with a hip fracture in the Leicestershire trauma unit was unclear. Therefore, the aim of this research was threefold:;To determine the optimum standardised ADL and Instrumental ADL (IADL) measures to assess outcome post hip fracture. To observe the role of OT within the orthopaedic trauma unit in regaining independence following hip fracture. To measure the pattern of independence and determine the effect of type of surgery on functional outcome, contributing to an evidence base. Methods Three studies were conducted to determine the best ADL outcome measure. Firstly a study using content analysis aimed to identify a suitable IADL index. The second compared a new individualised assessment, the Canadian Occupational Performance Measure (COPM), with a traditional OT approach and the third study compared the Barthel index with a new community assessment, the Community Dependency Index (CDI). An observational study of OT intervention was completed. The impact on functional outcome of three types of surgery in two age groups was examined in the context of a randomised controlled trial. 902 functional assessments performed in patients' homes were analysed. Main Results and Conclusion No suitable IADL measure was identified therefore a new index was developed. The Barthel Index was considered insensitive, the CDI being preferred for use whilst the COPM highlighted areas of occupational performance not included in the other assessments. The main analysis of the 902 assessments found these elderly people more dependant in IADL than ADL, but type of surgery did not significantly affect their functional outcomes. This has several implications for patients, purchasers and providers including the justification of choice of surgical intervention by orthopaedic surgeons.

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Artières, Xavier. "Les osteotomies de valgisation de l'extremite superieure du femur : indications en traumatologie." Université Louis Pasteur (Strasbourg) (1971-2008), 1989. http://www.theses.fr/1989STR1M210.

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Smith, Richard A. "Structural analysis and optimization of the support device used for a proximal fracture of the femur." Thesis, Monterey, Calif. : Naval Postgraduate School, 2008. http://edocs.nps.edu/npspubs/scholarly/theses/2008/Dec/08Dec%5FSmithR.pdf.

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Thesis (M.S. in Mechanical Engineering)--Naval Postgraduate School, December 2008.
Thesis Advisor(s): Kwon, Young W. "December 2008." Description based on title screen as viewed on January 30, 2009. Includes bibliographical references (p. 67-68). Also available in print.

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Permeswaran, Palani Taver. "Validation of computational methods for fracture assessment of metastatic disease to the proximal femur." Thesis, University of Iowa, 2018. https://ir.uiowa.edu/etd/6247.

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Stage IV cancer is characterized by a cancer’s ability to metastasize, or spread throughout the body. Metastatic disease in bone is a devastating condition affecting hundreds of thousands of people each year. Stage IV cancer patients suffering from metastatic disease in the proximal femur are at high risk of catastrophic pathologic fracture, an event which severely impacts patient health. Although metrics have been created to assess the risk of impending fracture, they lack specificity in the proximal femoral region. Shortcomings of these metrics further complicate clinical decision making related to prophylactic fixation in these medically compromised individuals. Fortunately, by using computational modeling to study this at-risk patient population, the likelihood of fracture due to metastatic lesions in the proximal femur can be more accurately assessed to improve clinical decision making. Finite element analysis (FEA) is a computational modeling technique that can non-invasively provide mechanics information to better assess true fracture risk of a given metastatic lesion. Although FEA has previously been utilized to study metastatic disease, lesions were always modeled as spheres or ellipsoids, while true lesion shapes are far more amorphous. It was the focus of this study to validate FEA’s ability to predict fracture location in cadaveric femora with realistically shaped experimental metastatic lesions. Off-set torsion, or load applied off-set from the fixed long bone axis, was applied to cadaveric specimens with mechanically induced metastatic lesions, and the resultant fracture location was compared to specimen-specific FEA models replicating the mechanical test. FEA was able to correctly predict fracture locations in five models. Determining fracture risk based on objective mechanical data may more accurate and effective in this patient population.

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Arsiwala, Ali, and Vatsal Shukla. "FE Modelling Of Two Femur Fixation Implants." Thesis, Linköpings universitet, Mekanik och hållfasthetslära, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-180127.

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In the pool of women over the age of 50, the likeliness of an atypical fracture increase drastically, partly due to osteoporosis. With a pre-existing implant in the femur bone, inserted due to a prior atypical fracture, treating a later femoral neck fracture is complex and risky. Currently, a fractured femoral diaphysis is treated using an intermedullary nail which is fixed to the femur bone either through the femoral neck (Recon locking method)or through the lesser trochanter (Antegrade locking method). In a study conducted by Bögl et.al. JBJS102.17 (2020), pp. 1486-1494, it is found that the fixation of the intermedullary nail through the femoral neck reduces the risk of future femoral neck fractures. The study also states that more than 50% of the patients with atypical femoral fractures related to bisphosphonate treatment for osteoporosis (within the study sub population) were treated with the Antegrade locking implant. There does not exist much literature that reasons as to how one locking method is showing lesser risk of re-operation as compared to the other. The purpose of this study is to look into the effects these two implants have on the femur bone using the Finite Element Analysis (FEA). The study presented is aimed at comparing the results of the finite element analysis for the Recon implant model (Recon model) and Antegrade implant model (Antegrade model). The femur model without the implants (native bone model) is used to verify material behavior, while the other two are used for the comparison to study the stress-strain distribution, primarily in the neck region. This is a patient specific study, hence the femur bone model is generated using patient Computed Tomography (CT) scans. The bone model was assigned a heterogeneous isotropic material property derived from patient CT data. The finite element (FE) model of the bone was meshed using Hypermesh. The peak loading condition including the muscle forces were applied on the native bone model along with the Recon and the Antegrademodel. While the loading conditions during normal walking cycle were only applied to theRecon and the Antegrade model to compare the impacts of the two implant types. Both loading conditions were simulated by fixing the distal condyle region of the bone. The analysis results show that the Antegrade implant experiences much higher stresses and strains in the neck region as compared to Recon implant. Also, the presence of the intermedullary nail through the femur diaphysis helps to distribute the stresses and strains in the anterior distal diaphysis region of the bone. For the case of no implants, the model showed strains and stresses in the lateral distal region of femoral diaphysis.

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CARCENAC, YVES. "Interet de l'enclouage centro-medullaire verrouille dans les fractures comminutives du femur : etude d'une serie continue de 39 cas." Toulouse 3, 1993. http://www.theses.fr/1993TOU31109.

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Megy, Bernard. "Les fractures de l'extrémité inférieure du fémur : à propos de 139 observations : résultat fonctionnel et séquelles." Montpellier 1, 1988. http://www.theses.fr/1988MON11093.

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Martin, Bruno. "Les fractures de l'extrémité inférieure du fémur : à propos de 139 cas : étude générale et proposition d'une stratégie thérapeutique." Montpellier 1, 1988. http://www.theses.fr/1988MON11092.

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Astier, Claude. "Essai d'appreciation d'un critere de gravite dans les fractures du col du femur recues en urgence a l'hopital sainte marguerite : a propos de 382 cas." Aix-Marseille 2, 1988. http://www.theses.fr/1988AIX20129.

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Issa, Alexandra. "Les fractures du col fémoral de l'enfant et de l'adolescent : à propos de 7 cas." Université Louis Pasteur (Strasbourg) (1971-2008), 1991. http://www.theses.fr/1991STR1M119.

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Lai, Wang-to Derek. "Prediction of pathological fracture risk due to metastatic bone defect using finite element method." Click to view the E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B37060831.

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46

Spangler, Leslie. "Biomechanical factors and failure of transcervical hip fracture repair /." Thesis, Connect to this title online; UW restricted, 1999. http://hdl.handle.net/1773/10858.

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Anjos, Ana Alexandra da Cunha Pereira. "" Objective Assessment of Acupuncture Effects By Microcirculation-Related Parameters in Patients With Proximal Femur Fracture "." Master's thesis, Instituto de Ciências Biomédicas Abel Salazar, 2011. http://hdl.handle.net/10216/57085.

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Anjos, Ana Alexandra da Cunha Pereira. "" Objective Assessment of Acupuncture Effects By Microcirculation-Related Parameters in Patients With Proximal Femur Fracture "." Dissertação, Instituto de Ciências Biomédicas Abel Salazar, 2011. http://hdl.handle.net/10216/57085.

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DENOT, REGIS. "Analgesie par bloc du nerf crural au cours de la fracture de la diaphyse femorale." Aix-Marseille 2, 1990. http://www.theses.fr/1990AIX20232.

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Kennedy, Eric Allen. "Lateral and Posterior Dynamic Bending of the Mid-Shaft Femur: Fracture Risk Curves for the Adult Population." Thesis, Virginia Tech, 2004. http://hdl.handle.net/10919/32216.

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The purpose of this study was to develop injury risk functions for dynamic bending of the human femur in the lateral-to-medial and posterior-to-anterior loading directions. A total of 45 experiments were performed on human cadaver femurs using a dynamic three-point drop test setup. All 45 tests resulted in mid-shaft femur fractures with comminuted wedge and oblique fractures as the most common fracture patterns. The reaction loads were used to develop the injury criteria given that they represent the inertially compensated bending strength of the femur that is more appropriate for dummy load cell application. In the lateral-to-medial bending tests the peak reaction bending moments were 352 ± 83 Nm. In the posterior-to-anterior bending tests the peak reaction bending moments were 348 ± 96 Nm. Regression analysis was used to identify significant parameters, and parametric survival analysis was used to estimate risk functions. Femur cross-sectional area, area moment of inertia (I), maximum distance to the neutral axis (c), I/c, occupant gender, and occupant mass are shown to be significant predictors of fracture tolerance, while no significant difference is shown for loading direction, bone mineral density, leg aspect and age. Risk functions are presented for femur cross-sectional area, I/c, and a combined occupant gender and mass. The risk function that utilizes the most highly correlated (R2 = 0.77) and significant (p = 0.0001) variable, cross-sectional area, predicts a 50 percent risk of femur fracture of 240 Nm, 395 Nm, and 562 Nm for equivalent cross-sectional area of the 5th percentile female, 50th percentile male, and 95th percentile male respectively.
Master of Science

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