tetracycline and Femoral-Fractures

Topics: Adolescent; Age Factors; Animals; Bone Development; Cartilage; Child; Child, Preschool; Epiphyses; Femoral Fractures; Femur; Growth Disorders; Humans; Humeral Fractures; Humerus; Infant; Joint Dislocations; Osteogenesis; Osteotomy; Rabbits; Radius; Tetracycline; Tibia

Since their introduction into clinical medicine, bisphosphonates have revolutionized clinical osteoporosis care. Ironically, in rare circumstances, long-term, combined anti-remodeling therapy may be associated with skeletal harm.. We report atypical skeletal fragility in three subjects after long-term, combined anti-remodeling therapy.. Three subjects experienced spontaneous or minimal-trauma chalk-stick type metadiaphyseal femoral fractures while on long-term bisphosphonate therapy. The fracture location, type, bilaterality, prodromal pain, and delayed healing were atypical for uncomplicated postmenopausal osteoporosis. All three subjects had concomitant circumstances (endogenous estrogen) or medications (glucocorticoids, hormone replacement therapy, and raloxifene) that likely suppressed bone remodeling beyond the effect of the bisphosphonate alone. Biochemical markers of bone turnover were very low or in the low premenopausal range. Double tetracycline-labeled bone biopsy showed very low activation frequency in one subject and limited single tetracycline label in a second consistent with severely suppressed bone turnover (SSBT). These three cases resemble previous descriptions of SSBT.. Atypical skeletal fragility may signify SSBT in the setting of long-term, combined anti-remodeling therapy. We speculate that osteoclast tolerance for pharmacological suppression may vary among individual patients and that in some cases combined anti-remodeling therapy may result in skeletal harm.

Topics: Aged; Alendronate; Bone Density; Bone Density Conservation Agents; Bone Remodeling; Female; Femoral Fractures; Humans; Middle Aged; Tetracycline

Our aim was to estimate the rate of osteogenesis by using tetracycline double labeling and to correlate it with the radiological grading of osteoporosis in patients of intertrochanteric fracture of the femur in different age groups. Thirty-two cases of intertrochanteric fracture of the femur of either sex, without any associated osteopenic conditions, who were admitted for surgery constituted the clinical material. The cases were divided into three age groups: group I, <45 years; group II, 45-60 years; and group III, >60 years. Osteoporosis was graded in all groups on plain X-rays by Singh's index (SI) and metacarpal index (MI). The patients were labeled with a single large dose (1.5 g) of tetracycline orally on day 1 and day 8. An iliac crest bone biopsy specimen was obtained from each of the patients during surgical intervention. Thin undecalcified sections were made by the hand grinding technique. The sections were studied under UV light for presence of fluorescence, and rate of osteogenesis (mineral appositional rate, MAR) was calculated for each of the groups. Only 7 patients were found to have radiological osteoporosis (by Singh's index). The average MI and MAR were found to be 46.5% and 1.48 microm/day, respectively. The single-dose labeling schedule has shown good fluorescent bands, comparable to the conventional dose schedule. No correlation was found between Singh's index and metacarpal index in group I and III, whereas in group II it was significant. There is no significant correlation between the rate of new bone formation and the radiological grading of osteoporosis.

Topics: Adult; Aged; Bone and Bones; Female; Femoral Fractures; Humans; Male; Middle Aged; Osteogenesis; Osteoporosis; Radiography; Staining and Labeling; Tetracycline

A 19-year-old man incurred a closed femoral fracture complicated by hematogenous dissemination of Brucella osteomyelitis. Repeated limited incision and drainage were ineffective in eradicating infection. Wide debridement, delayed wound closure, and vigorous antimicrobial therapy with streptomycin and tetracycline, along with cephalosporin for secondary staphylococcal infection, were necessary measures before the infection was eradicated. A constant awareness of brucella musculoskeletal infection is advisable when caring for patients frequently exposed to all kinds of livestock, including domesticated and wild animals.

Topics: Adult; Brucella abortus; Brucellosis; Cephalosporins; Combined Modality Therapy; Debridement; Drainage; Femoral Fractures; Fractures, Closed; Humans; Male; Osteomyelitis; Staphylococcal Infections; Streptomycin; Tetracycline; Time Factors; Wound Infection

Topics: Bone and Bones; Bone Nails; Femoral Fractures; Fracture Fixation, Internal; Humans; Iodine Radioisotopes; Radionuclide Imaging; Tetracycline; Tetracyclines; Time Factors; Tissue Distribution; Wound Healing

Topics: Femoral Fractures; Femur; Humans; Phlebography; Tetracycline

Topics: Adolescent; Adult; Cephalosporins; Chloramphenicol; Chronic Disease; Culture Media; Enterococcus faecalis; Erythromycin; Female; Femoral Fractures; Femur Head; Humans; Hypertonic Solutions; Kanamycin; L Forms; Male; Microbial Sensitivity Tests; Middle Aged; Necrosis; Osteomyelitis; Penicillins; Polymyxins; Proteus; Radiography; Staphylococcal Infections; Staphylococcus; Tetracycline; Vancomycin

Topics: Animals; Bone Resorption; Femoral Fractures; Fluorescence; Fracture Fixation; Hematoporphyrins; Osteogenesis; Periosteum; Radiography; Rats; Tetracycline; Tibial Fractures; Wound Healing

Topics: Adult; Age Factors; Anemia, Sickle Cell; Bone Diseases; Female; Femoral Fractures; Femur Head; Fluorescence; Follow-Up Studies; Humans; Male; Microscopy, Polarization; Middle Aged; Necrosis; Osteogenesis; Radiography; Sex Factors; Synovial Fluid; Synovitis; Tetracycline; Uric Acid; X-Ray Diffraction

Topics: Angiography; Animals; Bone and Bones; Epiphyses; Female; Femoral Fractures; Femur; Fluorescence; Fractures, Bone; Osteotomy; Rabbits; Tetracycline

Topics: Animals; Bone and Bones; Bone Regeneration; Femoral Fractures; Fracture Fixation; Guinea Pigs; Haversian System; Microscopy, Fluorescence; Tetracycline; Wound Healing

Topics: Apnea; Colistin; Dexamethasone; Escherichia coli Infections; Femoral Fractures; Fractures, Spontaneous; Hydrocortisone; Injections; Injections, Intramuscular; Osteomyelitis; Spinal Injuries; Tetracycline; Toxicology