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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A consecutive series of 131 comminuted fractures of the femur in 123 patients has been reviewed. All fractures were stabilized by means of rigid ASIF-plate fixation (mostly DCP). About 60% of the patients were polyfractured or polytraumatized (including brain, chest and abdominal injuries). In 85% of the cases the fracture was stabilized within 24 h after the accident and usually the patients remained on a ventilator with PEEP for 1 to 2 days postoperatively. Of the 4 postoperative deaths only two patients died of a pulmonary complication. All patients could be reexamined 1-3 years postoperatively. Although a number of them had suffered from complications (osteitis, fatigue fractures of the plate, delayed union) and had to be reoperated,92% of the cases displayed an excellent or good functionl result. The factors to reduce the complication rate(i.e. primary cancellous bonegraft) are being discussed.
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PMID:[Experiences with plate fixation in 131 femoral shaft fractures]. 65 44

We present the case of a woman with classical osteitis fibrosa cystica generalisata von Recklinghausen, caused by a single adenoma of the left inferior parathyroid gland. After six months with increasing bone pain, pathological fractures and cystic lesions radiologically, hyperparathyroidism was diagnosed by persistent elevated levels of serum calcium, and elevated levels of PTH. Surgical extirpation of the parathyroid adenoma caused a period with severe hypocalcemia followed by complete clinical restitution. The diagnosis should be considered in any case of persistent bone pain and uncharacteristic fatigue.
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PMID:[Osteitis fibrosa cystica von Recklinghausen]. 232 Dec 26

Both in open and in closed elbow fractures, anatomical joint reconstruction and rigid internal fixation, which permit early initiation of motion, are essential for good joint function. However, in open distal intraarticular humerus fractures this is more difficult to achieve, owing to the high rate of comminuted types C 2 and C 3 fractures. In addition, the extensive soft tissue lesions often mean that physiotherapy cannot be started until later than would otherwise be desirable. This retrospective study shows that the functional results in 60 patients operated on for correction of open distal intraarticular humerus fractures were worse (1/3 "excellent/good", 2/3 "moderate/poor") than those in patients treated for closed fractures. Complications included superficial infection in 7 patients, osteitis in 11, late instability in 10, fatigue failure of the implants in 5, and non-union in 10 patients.
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PMID:[Open fractures of the elbow joint]. 340 2

The "gracilis syndrome," a fatigue fracture of traumatic etiology involving the bony origin of the gracilis muscle at the pubic symphysis, is akin to traumatic osteitis pubis and injuries of the adductor longus muscle origin. It is a well-recognized and reported injury in European athletes, but has received less attention in North America. This paper describes a case of this syndrome in a 23-year-old male athlete with a 2-year history of groin, perineal and medial thigh pain, of gradual onset, associated with his participation in rather violent contact sports. The only positive finding on examination was the belated appearance of local tenderness over the symphysis pubis. Radiographically, a bony fragment, including the inferior corner of his left pubis at the symphysis, could be identified. This lesion was surgically excised, and the patient was relieved of his symptoms. The histopathological features of the fragment revealed both viable and nonviable bony trabeculae embedded in fibrous tissue, suggesting that the lesion is an avulsion type of fatigue fracture with the avulsion related to the directional pull of the gracilis muscle.
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PMID:Traumatic osteitis pubis: the gracilis syndrome. 663 54

Ankylosing spondylitis (AS) is the prototypical form of the spondyloarthropathies, which at a prevalence of 2 % is among the most frequent rheumatic diseases. Spondyloarthropathy comprises the following five disorders: AS, reactive arthritis, psoriatic arthritis, enteropathic arthritis in Crohn's disease, and ulcerosing colitis as well as undifferentiated spondyloarthropathy. In 99 % of the patients with AS initial abnormal findings affect the sacroiliac joints. The radiographic changes required for diagnosing AS occur as late as 5 - 9 years after the onset of clinical symptoms. MRI of the sacroiliac joints reliably demonstrates both chronic inflammatory changes (erosions, sclerotic changes, bone bridges) and acute inflammatory changes (synovitis, capsulitis, osteitis) and allows for grading the chronicity and acuity of such changes. Enthesitis of the interosseous ligaments of the retroarticular space is a manifestation of AS. Spondylodiscitis (Andersson 1937) may occur as an inflammatory or non-inflammatory process (transdiscal fatigue fracture). Inflammations of the facet and costospinal joints developing into ankylosis are typical of AS. Changes of the vertebral bodies occur as anterior (Romanus 1952), posterior, and marginal spondylitis. All forms of spondyloarthropathies are furthermore characterized by asymmetrical synovitis of the large joints, particularly of the legs (gonarthritis, coxitis, tarsitis, peripheral oligoarthritis), rheumatic fibroosteitis (pelvic enthesitis, rheumatic calcaneopathy), and peri- and synchondritis of the pubic symphisis and sternal synchondrosis. Since early inflammatory changes of the spinal column and of the extravertebral localizations in AS are demonstrated by MRI before they become apparent on radiographs, and thereby the diagnostic gap could be closed, the early use of MRI for diagnostic and follow-up is commendable, when new therapeutical options like the so-called "biologicals" are employed.
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PMID:[Magnetic resonance imaging in ankylosing spondylitis (Marie-Struempell-Bechterew disease)]. 1247 19

In the present paper, we report a female patient with multiple cystic lesions of bone arising from the primary hyperparathyroidism and pathological femur and contralateral tibia fractures at the level of these cystic lesions (osteitis fibrosa cystica). The patient's history revealed that she was admitted to a medical center with vague symptoms such as sudden onset of dyspepsia, loss of appetite, myalgia, arthralgia, fatigue, and weight loss six years ago but no disease was diagnosed. Loss of appetite and loss of weight continued. She had been walking only by assisted ambulation for the last year. However, primary hyperparathyroidism was overlooked until our examination. The fractures were managed by interlocking nailing and grafting after confirming with biopsy that the fractures were due to osteitis fibrosa cystica. The fractures healed uneventfully. In conclusion, it is essential to evaluate patients with these vague symptoms with full biochemical screening and radiological examination for the early detection of the disease.
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PMID:[Overlooked primary hyperparathyroidism presented with fractures: case report]. 2115 54

Approximately 100,000 new cases of primary hyperparathyroidism are diagnosed in the United States each year. Thus a disorder that was once considered to be rare is now known to be relatively common. Many patients with primary hyperparathyroidism are diagnosed today with only minimal hypercalcemia (serum calcium less than 1mg/dl above the upper limit of normal) and many have few or no classic symptoms or clinical manifestations of hyperparathyroidism, such as kidney stones or osteitis fibrosa cystica. Many patients with hyperparathyroidism today have fatigue or increased lethargy, muscular weakness, bone or joint pain and depression. It is difficult preoperatively to know whether these clinical manifestations are related to the primary hyperparathyroidism or not. Our own studies suggest that in about 80 per cent of patients with hyperparathyroidism the preoperative symptoms either improve or disappear after parathyroidectomy.
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PMID:Hyperparathyroidism. 2858 74

Not only laymen but also dentists generally believe that extraction of acutely infected teeth should be avoided until the infection subdues by using systemic antibiotics. The aim of this study was to compare perioperative complications in routine extractions of acutely infected teeth with extractions of asymptomatic teeth. This prospective study was performed with 82 patients. Severe pain on percussion of the relevant tooth was considered as basic criteria for acute infection. The acutely infected teeth were labeled as the study group (n = 35) and the asymptomatic teeth as the control group (n = 47). The extractions were done using standard procedures. The amount of anesthetic solution used and duration of extractions were recorded. Postoperative severe pain and exposed bone with no granulation tissue in the extraction socket were indications of alveolar osteitis (AO). The level of statistical significance was accepted as 0.05. Symptoms that could indicate systemic response, including fever, fatigue, and shivering were not found. There was no statistically significant difference between groups in terms of AO, amount of anesthetic solution used, and duration of extraction. The presence of an acute infection characterized by severe percussion pain is not a contraindication for tooth extraction. Infected teeth should be extracted as soon as possible and the procedure should not be postponed by giving antibiotics.
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PMID:Acutely infected teeth: to extract or not to extract? 3054 Jan 2