So birling is a game where lumberjacks try to balance on a floating log. What might happen? One could fall and break a bone.

There is a researcher whose surname is almost the same. Bierling and the subject is fractures.   

J Arthroplasty. 2014 Feb;29(2):443-7. doi: 10.1016/j.arth.2013.06.018. Epub 2013 Jul 26.

Age-dependent fracture risk in hip revisions with radial impaction grafting technique: a 5-10 year medium-term follow-up study.

 Chomrikh L1, Gebuhr P2, Bierling R3, Lind U4, Zwart HJ1.

  

1Department of Orthopaedics, Annatommie, Rijswijk, Netherlands.

2Department of Orthopaedics, Hvidovre Hospital, Hvidovre, Denmark.

3Department of Orthopaedics, Haukeland University Hospital, Kysthospitalet i Hagevik, Hagevik, Norway.

4Department of Orthopaedics, Södersjukhuset, Stockholm, Sweden.

Abstract

Radial impaction grafting (RIG) potentially improves the durability and reliability of cementing the femoral components in revision total hip arthroplasty (THA). In this multicenter, prospective study, 88 revision THAs (87 patients) with RIG technique were performed. The average follow-up time was 7.0 years (range, 5.0-10.2). There were 14 femur fractures: 2 intraoperative, 5 within 3 months after surgery, and 7 later in the postoperative stage (range, 5-84 months). Sixteen patients were lost to follow-up and 20 died without stem re-revision. None of the patients have been re-revised for any reason during follow-up. Age was observed to be a significant factor for determining fracture risk. In conclusion, RIG can be considered a reliable surgical technique, especially for younger patients.