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Femoral Neck Fractures

Femoral Neck Fractures are serious injuries that occur at the junction of the femur and the hip joint.
These fractures can be challenging to treat and often require specialized surgical intervention.
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By easily locating and comparing protocols from literature, preprints, and patents, researchers can find the best approach for their work and take their femoral neck fracture research to the next level.
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Most cited protocols related to «Femoral Neck Fractures»

Table 1 lists the 35 administrative data case definitions that were selected for investigation. These were selected based on a review of published studies [3 (link),12 (link),30 (link)], recommendations from clinical co-investigators with expertise in fracture ascertainment in administrative databases (WDL, SM), and the authors’ previous experience ascertaining other chronic diseases, include osteoporosis, in administrative data [31 (link)-33 (link)]. The case definitions were differentiated by: (a) source of data, (b) number of records with the relevant diagnosis code(s), (c) type of diagnosis in hospital data, (d) presence of service codes in physician billing claims, and (e) duration of the fracture-free period. With the exception of one hip fracture case definition, all site-specific definitions used the same ICD-9-CM and ICD-10-CA diagnosis code(s). For hip fracture, we considered ICD-9-CM 820 (fracture of neck of the femur) and 821 (fracture and other unspecified parts of the femur) because some hip fractures may be assigned a less precise diagnosis code [34 (link)]. Case definitions were based on hospital data only (hip) or hospital and physician claims data, in keeping with previous research [3 (link),15 (link)]. For the latter, case definitions requiring one or at least two records with the specified diagnosis code(s) were considered. Service codes capture radiologic and magnetic resonance imaging services for incident clinical vertebral fracture, immobilization or fixation services for wrist fracture, and surgical repair and fixation procedures for hip fracture. Service codes have also been used in previous studies to improve fracture ascertainment [35 (link)]. Fracture-free periods of zero, six or twelve months were considered, using the site-specific fracture index date to establish the end-point of the fracture-free period.
To illustrate the interpretation of the case definitions, H1 identifies hip fractures using hospital records with ICD-9-CM 820 or 821 (ICD-10-CA S72.0, S72.1, or S72.2) as the most responsible (i.e., primary) diagnosis; it does not use physician service codes nor does it require a fracture-free period. In contrast, case definition H13 identifies hip fractures from hospital records with ICD-9-CM 820 (ICD-10-CA S72.0, S72.1, or S72.2) in any diagnosis field. A physician service code was present within the hospitalization period and a 12-month fracture-free period was adopted. For wrist fracture, case definition W1 identifies fractures using hospital or physician billing records with ICD-9-CM 813 (ICD-10-CA S52) in any diagnosis field. This case definition requires a physician service code to accompany the diagnosis code and does not adopt a fracture-free period.
The fracture index date was the date of the first diagnosis or service code for a fracture event. Pathologic fractures were included because they represent a small proportion of all fractures and their exclusion can lead to underestimation of the fracture burden due to osteoporosis [36 (link)]. For each case definition, the number of incident fractures was generated for the Manitoba population 50years of age and older for fiscal years 1997/98 to 2006/07. Age, which was defined using the fracture index date, was obtained from health insurance registration files. For hip fracture, counts of incident fractures were generated both including and excluding residents of long-term care (i.e., nursing home) facilities [37 (link)]; the CaMos data excludes residents of these facilities and this may affect comparability of estimates. Residence in a facility was determined from nursing home files containing admission and separation dates.
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Publication 2012
Age Groups Clinical Investigators Diagnosis Disease, Chronic Femoral Neck Fractures Femur Fracture, Bone Fracture, Wrist Fracture Fixation Galloway Mowat syndrome Health Insurance Hip Fractures Hospitalization Immobilization Long-Term Care Operative Surgical Procedures Osteoporosis Pathological Fracture Physicians Spinal Fractures
The statistical package SAS was used for the analyses in this study. SAS was used to select the study and comparison groups (SAS Institute Inc., Cary, NC, USA). Descriptive analyses of the independent variables (patient characteristics, demographics, personal history at baseline, surgical interventions, the amount of time between fracture and the onset of depression and other comorbidities) are reported as percentages or the mean ± standard deviation (SD). The X2 test was used to make between-groups comparisons of patient demographics, including economic status (monthly income: USD$>1000, USD$601∼1000, USD$<600), urbanization of their home city (level 1 to 4), the geographic location of patients’ residence (northern, central, southern, and eastern Taiwan), personal history at baseline (diabetes mellitus, hypertension, renal failure, liver cirrhosis, stroke and osteoporosis) and mortality rate between patients with fracture and non-fracture. The urbanization of patients’ home city was defined by population and certain indicators of the city’s level of development. Level 1 urbanization was defined as having a population greater than 1,250,000 people and a specific status of political, economic, cultural and metropolitan development. Level 2 urbanization was defined as having a population between 500,000 and 1,250,000 and an important role in the Taiwanese political system, economy and culture. Urbanization levels 3 and 4 were defined as having a population between 150,000 and 500,000 and less than 150,000, respectively. Furthermore, a crude hazard ratio (HR) was calculated using Cox’s stratified proportional hazards model (stratified with age, sex and the number of years since index hospitalization) to analyze the risk of new-onset major depression between the study and comparison groups. The covariate-adjusted HR was analyzed after adjusting for diabetes mellitus, hypertension, renal failure, liver cirrhosis, stroke, osteoporosis, geographic regions, post-fracture co-morbidities, monthly income and urbanization of patients’ home cities. In addition, we used SAS to analyze the eight most common post-fracture comorbidities during the study period. The relationship between post-fracture comorbidities and major depression was also analyzed. We used the Kaplan-Meier method and Log-rank test to estimate survival curves and compare the 3-year major depression-free survival rate between patients with femoral neck fracture and those without. Among the femoral neck fracture patients, the amount of time before the onset of major depression was recorded and divided into 6 periods (<200, 201–400, 401–600, 601–800, 801–1000 and >1000 days). Additionally, the relationship between surgical interventions (including hip replacement and open reduction of internal fixation of the hip) and the chance of suffering new-onset major depression was analyzed for this group (X2 test). Hip replacement included hip arthroplasty in this study. A p-value <0.05 was considered to be statistically significant.
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Publication 2014
Arthroplasty Cerebrovascular Accident Diabetes Mellitus Femoral Neck Fractures Fracture, Bone Fracture Fixation, Internal High Blood Pressures Hospitalization Kidney Failure Liver Cirrhosis Major Depressive Disorder Open Fracture Reductions Operative Surgical Procedures Osteoporosis Patients Replacement Arthroplasties, Hip Urbanization
Human MSC of non-osteoporotic donors were obtained from bone marrow of femoral heads according to the described protocol [53] (link) after total hip arthroplasty due to osteoarthritis and/or hip dysplasia. MSC of patients suffering from osteoporosis were isolated from femoral heads after low-energy fracture of the femoral neck. Additional criteria for confirming primary osteoporosis in these donors were vertebrae fractures and advanced age.
Cell culture medium, fetal calf serum (FCS), trypsin-EDTA and antibiotics were obtained from PAA Laboratories GmbH, Linz, Austria. Human MSC were selected by surface adherence and expanded in DMEM/Ham's F-12 (1∶1) medium supplemented with 10% heat-inactivated FCS, 1 U/ml penicillin, 100 µg/ml streptomycin and 50 µg/ml L-ascorbic acid 2-phosphate (Sigma Aldrich GmbH, Schnelldorf, Germany).
For long term cultivation, cells were expanded at 70–90% confluence by trypsinization with 1× trypsin-EDTA and reseeding in a ratio of 1∶3. This procedure was repeated for up to x passages when the hMSC did not become confluent within 3 weeks due to replicative senescence.
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Publication 2012
Antibiotics ascorbate-2-phosphate Bone Marrow Cell Aging Cell Culture Techniques Cells Degenerative Arthritides Donors Edetic Acid Femoral Neck Fractures Femur Heads Fetal Bovine Serum Hip Dysplasia Homo sapiens Osteoporosis Patients Penicillins PRSS1 protein, human Spinal Fractures Streptomycin Total Hip Arthroplasty Trypsin
The study sample included three level one to three trauma hospitals in Finland: Tampere University Hospital (level I), Hatanpää City Hospital of Tampere (level III), and the Central Hospital of Kanta-Häme (level II). Patients 18 years or older were included. In Finland, register-based studies do not require the approval of ethics committee by legislation. However, all register studies that utilize any confidential medical information such as patient charts and radiographs, require an approval of the corresponding institution or hospital. These permissions were obtained from all hospitals that participated our study.
The sample was obtained by selecting from the NHDR all patients with a diagnosis of pertrochanteric hip fracture admitted alive to any of the three study hospitals between 1st of January 2008 and 31st of December 2010. All re-hospitalizations due to either rehabilitation, medical or surgical complications were excluded based on the original medical records and thus only primary hospitalizations after the initial injury were included into the study. We used the International Classification of Diseases 10th edition (ICD-10) code S72.1
[11 ]. After 1996 all procedural coding in Finland has been done according to a Finnish version of Nomesco procedure classification and so Nomesco procedural coding was used in this study. The main outcome variable in the study was assessed by comparison of data from the NHDR to the original patient charts and x-ray archives.
As noted above, the Finnish NHDR is a mandatory national register for all of our hospitals encompassing private, public, and other institutions. The NHDR is collected and maintained by the National Institute for Health and Welfare, Helsinki, Finland.
After the sample was collected, all selected cases were evaluated by going through the patient chart, and x-rays taken both pre- and post-operatively. Accuracy of the diagnosis was assessed by examining pre-operative x-rays and determining the type of the hip fracture (fracture of the femoral neck, pertrochanteric fracture or subtrochanteric fracture) and then comparing the result to the type of the fracture (diagnosis) recorded in the hospital register. Coverage of the procedure coding was determined by reading through the medical records and radiographs to find the patients who had undergone surgery. It was then determined how many of these procedures were recorded into the NHDR. Accuracy (dichotomy right/wrong) of the procedural coding was assessed by examining the post-operative x-rays and determining the type of fixation used and then comparing to the type of fixation (procedure code) in the NHDR.
Coverage of the external cause for injury was examined by comparing the number of patients who were injured (and had a diagnosis of a pertrochanteric fracture) to the number of patients who had an external cause for injury recorded on the hospital discharge register. Accuracy of the external cause for injury was assessed by going through the medical records and determining the mechanism of injury (for example a fall) and then comparing it to the external cause for injury recorded on the hospital register.
All of the results were expressed as a percentage with 95% confidence interval (CI).
Two experienced physicians (T.T.H. and V.M.M.) examined the patient charts and radiological findings separately. In case of a disagreement, consensus was reached. If there was an unresolved radiological finding, the result was resolved by the expert opinion of the radiologist who had originally evaluated the radiological images.
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Publication 2014
Diagnosis Ethics Committees Femoral Neck Fractures Fracture, Bone Hip Fractures Hospitalization Injuries Operative Surgical Procedures Patient Discharge Patients Physicians Radiography Radiologist Rehabilitation Subtrochanteric Fractures Wounds and Injuries X-Rays, Diagnostic
Records from the Korean NHI claims database from 2002 and 2004 were used to identify patients with hip fractures and to monitor their 1-year mortality. The incidence of hip fractures was defined as patients having a claim record with a diagnosis of hip fracture and a hip fracture-related operation. Since identifying hip fracture cases solely based on diagnosis is likely to cause misclassification problems due to potential miscoding, we combined the information from both diagnosis and surgical records. This conservative approach underestimates the real incidence rate of hip fractures in Korea, but improves the validity of the incidence cases identified from insurance claims data.
All claims records of outpatient visits or hospital admissions of patients aged 50 or older containing a diagnosis of femur fracture (fracture of femur [International Classification of Diseases (ICD)-10 diagnostic code: S72], fracture of the neck of the femur [S72.0, S72.00], pertrochanteric fracture [S72.1, S72.10]) and hip fracture-related operation (open reduction & internal fixation [ICD-10 procedure code: N0601], closed reduction and percutaneous fixation [N0991], total hip replacement [N0711], or hip hemiarthroplasty [N0715]) from January 1 to December 31, 2003 were identified from the NHI claims database. The diagnosis and operation code for hip fracture was selected based on previous epidemiologic studies [1 (link),14 (link)] and was confirmed by a panel of four orthopedic clinicians working in four different general hospitals in Korea. The cases having more than one claim record that satisfied the inclusion criteria during 2003 were counted only once.
In general, not all operations are carried out during the first fracture visit or admission. However, most of the operations are performed within a month following the first visit, according to a consultation of orthopedic clinicians in Korea. Thus, we additionally defined the incidence cases as patients who did not have a record of a hip fracture-related operation in the claim record of the initial visit or admission, but had it within a month after the initial visit.
The 6-month period prior to 2003 (i.e., July - December, 2002) was set as a 'window period,' such that patients were defined as incident cases only if their first record of a fracture visit or admission was observed after this 6-month period. Since most of the follow-up treatments for hip fracture are completed within 6 months after the initial fracture, we assumed that the absence of any claims record with a diagnosis of hip fracture and hip-fracture-related operation in the previous 6 months assured that the fracture was a new case.
NHI claims data were merged with national mortality data provided by the National Statistical Office to determine the survival status of individual patients at the 12 months following the incidence.
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Publication 2010
Diagnosis Femoral Fractures Femoral Neck Fractures Fracture, Bone Fracture Fixation, Internal Hemiarthroplasty Hip Fractures Koreans Open Fracture Reductions Outpatients Patient Admission Patients Total Hip Arthroplasty

Most recents protocols related to «Femoral Neck Fractures»

Data used in this secondary analysis of 404 patients with acute HFs were from two randomized controlled trials (RCT1 and RCT2). Both RCT were performed in the orthopedic- and the geriatric departments of Umeå University Hospital, Sweden. RCT1 included 199 patients with femoral-neck fractures enrolled in May 2000-December 2002 [20 (link)]; RCT2 included 205 patients with femoral-neck and trochanteric-region fractures enrolled in May 2008-June 2011 [21 (link)]. Inclusion criteria for both studies were age ≥ 70 years and Umeå municipality residence. Exclusion criteria for RCT1 were severe rheumatoid arthritis/hip osteoarthritis, pathological/hospital-acquired HF, renal failure, and bedridden before the fracture occurred. Those for RCT2 were hospital-acquired/pathological HF. Both RCTs included patients with cognitive impairment or dementia.
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Publication 2023
Dementia Disorders, Cognitive Femoral Neck Fractures Fracture, Bone Kidney Failure Neck, Femur Osteoarthritis Of Hip Patients Rheumatoid Arthritis Trochanteric Fractures
The clinical bone tissue samples of the experimental group used in this paper are from 15 patients with steroid induced avascular necrosis of the femoral head, including nine male patients and six female patients. Another 15 femoral head tissue samples from patients undergoing total hip replacement (The artificial prosthesis, including the femur and acetabulum, is fixed on the normal bone by bone cement and screws to replace the diseased joint) due to femoral neck fracture are used as the control group in this article, including eight male and seven female patients with femoral neck fracture. All patients participating in the study signs the informed consent form, and obtains detailed clinical pathology and prognosis data of all patients in the experimental group and the control group. The study covering relevant patient screening, clinical examination, clinical data acquisition and subsequent experimental analysis. The collected femoral head bone tissue samples are frozen in the prepared liquid nitrogen immediately after the operation for subsequent experimental analysis of total RNA and protein sample extraction.
Cell line: The product classification numbers of hFOB1.19 and human renal epithelial cell line 293 T are CRL-11372 and CRL-3216 respectively.
Main reagents and antibodies: conventional chemical reagents: disodium hydrogen phosphate, methanol, anhydrous ethanol, glacial acetic acid, isopropanol and other conventional reagents used in this paper are analytical pure. Total RNA extraction reagent (Trizol solution) is purchased from Bioengineering Co., Ltd. (Shanghai), and the product number is B511311. Diethyl pyrocarbonate is purchased from Sigma Aldrich (China) Co., Ltd. (Shanghai, China), and the product number is 472565. Agarose is purchased from Yisheng Biotechnology Co., Ltd. (Shanghai, China), and the product number is 10208ES60.
DNA marker is purchased from Beyotime Biotechnology Company (Nantong, China), and the product number is D0107. Nucleotide fluorescent dye (SYBR GreenI) is purchased from Thermo Fisher Scientific (China) Co., Ltd. (Shanghai, China), and the product number is S7563. Taq DNA polymerase is purchased from Fullgold Biotechnology Co., Ltd. (Beijing, China), and the product number is AP101-12. The basic idea of clinical experiment is shown in Figure 2.
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Publication 2023
Absolute Alcohol Acetabulum Acetic Acid Antibodies Avascular Necrosis of Femur Head Bone Cements Bones Bone Tissue Cell Lines Diethyl Pyrocarbonate Epithelial Cells Femoral Neck Fractures Femur Femur Heads Fluorescent Dyes Freezing Homo sapiens Isopropyl Alcohol Joints Kidney Males Markers, DNA Methanol Nitrogen Nucleotides Patients Physical Examination Prognosis Prosthesis Proteins Sepharose sodium phosphate, dibasic Specimen Collection Steroids Taq Polymerase Tissues Total Hip Arthroplasty trizol Woman
Cell Counting Kit-8 (CCK8) method is used to detect the cell viability of cultured human hFOB1. 19 osteoblasts. The experimental operation process is carried out according to the technical methods provided in the manual. The simple experimental process is as follows. After transfection, hFOBl. 19 osteoblasts are cultured for 24–27 h and used for CCK-8 analysis of cell activity. Cells in each group are collected at three different time points, namely, 24, 48 and 72 h. First, pipettes are used to gently remove old media. Then, according to the ratio of 100:1, the fresh complete culture medium is diluted with CCK-8 reagent. Finally, the cell culture plate nj is put back into the incubator to continue to culture for about 1 h, and then detected by the microplate reader for statistical analysis of the difference cy in cell activity among groups. At least three biological repeats shall be set for the above analysis (Wang et al., 2019 (link)). kg=gFSg
nj=lz*n
aas=1dλ
cy=h+gPmaxt0
During the miR-206 expression level difference experiment, the femoral head tissue samples of 15 patients with femoral neck fracture who underwent total hip arthroplasty were collected as the control group.
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Publication 2023
Biopharmaceuticals Cell Culture Techniques Cells Cell Survival Cultured Cells Culture Media Femoral Neck Fractures Femur Heads Homo sapiens Osteoblasts Patients Sincalide Tissues Total Hip Arthroplasty Transfection
The ethics committee of the Xi’an Hong Hui hospital approved this study (No.202202002). We recruited a 26-year-old healthy male volunteer with no history of hip joint or systemic diseases. The participant provided written informed consent to participate in this study. Computed tomography (CT) data images were collected to reconstruct 3D model of cancellous and cortical bones of femur via Mimics software (Materialise, Leuven, Belgium). CT examination uses X-ray to scan the body structure of the examiner, which will cause minimal radiation damage to healthy individuals, but usually will not cause serious damage. The CT (SOMATOM Definition AS1; Siemens, thickness, 0.6 mm; resolution, 512 × 512 pixels) scanning voltage and current were set in the range of 70–140 kV and 30–800 mA, respectively, until clear images were gotten. Then, CT images with the axial slice thickness of 1.5 mm were captured. We used Hounsfield Unit (HU) value (representing bone density threshold value) to distinguish cortical bones. The HU values for cancellous bones were defined as of less than 700, while that of cortical bones was more than 700 (Abdul Wahab et al., 2020 (link)). After that, a femoral neck fracture model with Pauwels angle of 70° was established. Computer-aided design (CAD) software (SolidWorks software, Dassault Systemes SolidWorks Corp., USA) was used to build five configurations of implants for UFNFs. The above fixation models were converted into the stereolithography (STL) format and exported to the 3-Matic software (Materialise, Leuven, Belgium), whereby the implants were inserted into the femur bone. Five different constructions were included: three CSs in an inverted triangle configuration (Model 1), DHS + AS (Model 2), FNS (Model 3), the modified IFNS (Model 4), and the modified IIS (Model 5). Figure 1A shows the five fixation models constructed in our study. Figures 1B, C show the two modified intramedullary devices. The dimensions of the implant designs were provided by the relevant manufacturer. For Model 4 and 5, the diameter and length of the main intramedullary nail is 10 mm × 170 mm. The diameter and length of two neck screws and one sleeve are 10 mm × 65 mm, 6.4 mm × 70 mm, and 14 mm × 35 mm for Model 4 while the diameter and length of two neck screws are 10 mm × 95 mm, 6.4 mm × 80 mm for Model 5, respectively. In Model 4, the included angle of the thick neck screw and the main nail is 130° while the included angle of the two neck screws is 7.5°, respectively. In Model 5, the included angle of the thick neck screw and the main nail is also 130° while the included angle of the two neck screws is 60°, respectively.
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Publication 2023
Bone Density Bones Cancellous Bone Compact Bone Ethics Committees Femoral Neck Fractures Femur Healthy Volunteers Hip Joint Human Body Males Medical Devices Nails Neck Radiation Radiography Stereolithography X-Ray Computed Tomography
A 26-year-old male volunteer was recruited, and the femur was scanned using a Siemens 64-row CT scanner with a thickness of 0.6 mm, and a resolution of 512 × 512 pixels. The femoral CT data were extracted and imported into MIMICS 21.0 (MATERIALISE, Leuven, Belgium). A three-dimensional model of the upper femur was established based on the gray value of the tissue using the region segmentation command and then exported in stereolithography (STL) format. These STL formats were imported into the Geomagic Wrap 2017 software (Geomagic Wrap 2017, USA) for smoothing, meshing, noise reduction, and surface adaptation and then into the SolidWorks 2017 software (Dassault, France). The three-dimensional models of cortical and cancellous bone were established by Boolean operation, and the femoral neck fracture models with Pauwels angles of 55°, 65°, and 75° were established. According to the fixed clinical procedure and engineering geometry data, the models of CCS and FNS were generated by Solidworks software (Fig. 4). In the ANSYS Workbench software (ANSYS, American), each component was meshed by solid tetrahedral elements, and the grid convergence calculation was tested by different sizes. Regarding material parameters, cortical bone, cancellous bone, femoral neck plate, and locking screw were assumed to be continuous, isotropic, and uniform linear elastic materials. The parameters of each component used in the calculation and the number of nodes and units of the two assembly units are shown in Tables 3 and 4 [27 (link), 28 (link)]. According to the contact method described in the reference, the fracture surface was set to friction (coefficient of friction = 0.46). The titanium plate and bone surface were contacted by friction (friction coefficient = 0.3); the Friction coefficient between the screw and sleeve = 0.23. The threaded screw area was used for bonding with the bone, and the nonthreaded area was kept in contact with the bone. The screws were used to contact the titanium plate [27 (link), 29 (link)]. For calculation purposes, the distal femur was fixed entirely. To simulate the single-leg standing posture, each calculated assembly model extended 10° outward, tilted 9° backward, and was statically loaded to the center of the femoral head with a downward vertical force of 2100N [30 (link)].

Models of femoral neck fractures with virtual fixation using FNS and CCS with Pauwels angles of 55°, 65°, and 75°, respectively

Material properties information consisting of finite elements models

Titanium alloyCortical boneCancellous bone
E (GPa)10516.80.84
Poisson’s ratio0.350.30.2

Element information consisting of finite elements models

ModelPauwels angle of 55°Pauwels angle of 65°Pauwels angle of 75°
FNS
 Node363,521428,723498,219
 Unit278,243288,519314,218
CCS
 Node270,069289,414301,942
 Unit184,177192,584220,142
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Publication 2023
Acclimatization Bones Cancellous Bone CAT SCANNERS X RAY Compact Bone Cortex, Cerebral Femoral Neck Fractures Femur Femur Heads Fracture, Bone Friction Males Neck, Femur Stereolithography Tissues Titanium Voluntary Workers

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More about "Femoral Neck Fractures"

Femoral neck fractures, also known as hip fractures, are serious injuries that occur at the junction of the femur and the hip joint.
These traumatic events can be challenging to treat and often require specialized surgical intervention, such as open reduction and internal fixation (ORIF) or total hip arthroplasty (THA).
Researchers studying femoral neck fractures can leverage the power of AI-driven platforms like PubCompare.ai to optimize their research protocols and enhance the reproducibility of their studies.
PubCompare.ai's intuitive platform allows researchers to easily locate and compare protocols from the literature, preprints, and patents related to femoral neck fracture research.
By accessing this comprehensive database of protocols, researchers can find the best approach for their work, whether it involves using techniques like Lunar Prodigy for bone density assessment, QIAamp DNA Mini Kit for genetic analysis, or DMEM/Nutrient Mixture F-12 for cell culture experiments.
Experiance the benefits of AI-driven comparisons and discover how PubCompare.ai can elevate your femoral neck fracture research.
Optimize your study design, enhance reproducibility, and take your research to new heights by leveraging the power of this innovative platform.
Explore the latest advancements in femoral neck fracture management, from surgical interventions to rehabilitation protocols, and stay ahead of the curve in this critical area of orthopedic research.