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  1. Preliminary survey of aetiological factors in femoral shaft fractures
    Iqbal QM
    Med J Malaya, 1970 Sep;25(1):25-8.
    PMID: 4249490
    Matched MeSH terms: Femoral Fractures/etiology*
  2. Primary hyperparathyroidism presenting with pathological fracture
    Deshmukh RG, Alsagoff SA, Krishnan S, Dhillon KS, Khir AS
    J R Coll Surg Edinb, 1998 Dec;43(6):424-7.
    PMID: 9990797
    Primary hyperparathyroidism (PHPT) is an intriguing condition. Routine automated biochemical screening has made the diagnosis commonplace in developed countries and the disease is diagnosed early in its course when it is often asymptomatic. In developing countries or in recent immigrants from these countries, PHPT is often seen in an advanced stage with bone involvement. Associated dietary deficiencies may alter the biochemical profile and cause a diagnostic dilemma. It is important to include it in the differential diagnosis of pathological fractures. We report three cases of PHPT presenting with pathological fractures and discuss their diagnosis and management.
    Matched MeSH terms: Femoral Fractures/etiology*
  3. Expression of TGF-β1 in the blood during fracture repair in an estrogen-deficient rat model
    Estai MA, Suhaimi F, Das S, Shuid AN, Mohamed Z, Soelaiman IN
    Clinics (Sao Paulo), 2011;66(12):2113-9.
    PMID: 22189738
    OBJECTIVES: Previous studies have reported that osteoporosis due to estrogen deficiency influences fracture healing. Transforming growth factor (TGF-b) has been found to be involved in fracture healing via the regulation of the differentiation and activation of osteoblasts and osteoclasts. The current study aimed to determine the effects of estrogen on the expression of TGF-β1 during fracture healing in ovariectomized rats.

    METHODS: Thirty female Sprague-Dawley rats weighing 200-250 g were assigned to: (i) a sham-operated group that was given a normal saline; (ii) an ovariectomized control group that was given a normal saline; or (iii) an ovariectomized + estrogen (100 mg/kg/day) group that was treated with conjugated equine estrogen. The right femur of all rats was fractured, and a Kirschner wire was inserted six weeks post-ovariectomy. Treatment with estrogen was given for another six weeks post-fracture. At the end of the study, blood samples were taken, and the right femur was harvested and subjected to biomechanical strength testing.

    RESULTS: The percentage change in the plasma TGF-β1 level before treatment was significantly lower in the ovariectomized control and estrogen groups when compared with the sham group (p<0.001). After six weeks of treatment, the percentage change in the plasma TGF-β1 level in the estrogen group was significantly higher compared with the level in the ovariectomized control group (p = 0.001). The mean ultimate force was significantly increased in the ovariectomized rats treated with estrogen when compared with the ovariectomized control group (p = 0.02).

    CONCLUSION: These data suggest that treatment with conjugated equine estrogen enhanced the strength of the healed bone in estrogen-deficient rats by most likely inducing the expression of TGF-β1.

    Matched MeSH terms: Femoral Fractures/etiology
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