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osteoporotic fractures

Ludwig Oberkircher, Steffen Ruchholtz, Pol Maria Rommens, Alexander Hofmann, Benjamin Bücking, Antonio Krüger
BACKGROUND: The estimated incidence of osteoporotic pelvic fractures among persons over age 60 in Germany is 224 per 100 000 persons per year, and rising. A number of surgical treatment options are available, but clinical long-term data are lacking. METHODS: This review is based on pertinent publications and guidelines retrieved by a selective literature search, and on the authors' clinical experience. RESULTS: Patients often report one or more relatively trivial traumatic incidents leading up to the fracture...
February 2, 2018: Deutsches Ärzteblatt International
Tobias Schmidt, Katharina Ebert, Tim Rolvien, Nicola Oehler, Jens Lohmann, Luca Papavero, Ralph Kothe, Michael Amling, Florian Barvencik, Haider Mussawy
BACKGROUND: Impaired bone quality is associated with poor outcome of spinal surgery. The aim of the study was to assess the bone mineral status of patients scheduled to undergo spinal surgery and to report frequencies of bone mineral disorders. METHODS: We retrospectively analyzed the bone mineral status of 144 patients requiring spinal surgery including bone mineral density by dual-energy X-ray absorptiometry (DXA) as well as laboratory data with serum levels of 25-hydroxyvitamin D (25-OH-D), parathyroid hormone, calcium, bone specific alkaline phosphate, osteocalcin, and gastrin...
February 13, 2018: BMC Musculoskeletal Disorders
Ho Joong Kim, Saejong Park, Soo Hyun Park, Jiwon Park, Bong Soon Chang, Choon Ki Lee, Jin S Yeom
PURPOSE: To assess the association between frailty and osteoporotic vertebral compression fracture (OVCF) and to evaluate the relationship between numbers of OVCFs and frailty. MATERIALS AND METHODS: We enrolled 760 subjects, including 59 patients (with OVCF) and 701 controls (without OVCF). Successful matching provided 56 patient-control pairs. We analyzed principal clinical and demographic information, which included sex, age, height, weight, body mass index (BMI), variable frailty phenotypes, and Oswestry Disability Index (ODI) and EuroQol 5-dimension questionnaire (EQ-5D) scores...
March 2018: Yonsei Medical Journal
Kazuyoshi Kobayashi, Kei Ando, Yoshihiro Nishida, Naoki Ishiguro, Shiro Imagama
PURPOSE: There are few epidemiological studies of spinal surgery in Asia and none in Japan. The goal of this study was to review spine surgeries performed in our group between 2004 and 2015 in a cross-sectional study, with a focus on the effects of the superaging society on the characteristics and trends of spinal surgeries. METHODS: A retrospective review was performed for all 45,831 spinal surgeries conducted between 2004 and 2015 and recorded in our prospective multicenter database...
February 12, 2018: European Spine Journal
Ashok S Gavaskar, Naveen C Tummala, Parthasarathy Srinivasan, Hitesh Gopalan, Bhupesh Karthik, S Santhosh
OBJECTIVES: To compare the radiological and clinical results with PFNA - II and InterTan in the treatment of unstable trochanteric fractures in the elderly DESIGN:: Retrospective, multi-center, matched pair SETTING:: 3 tertiary level trauma centres PATIENTS:: 100 elderly patients who underwent intramedullary stabilisation with either the PFNA - II or the InterTan for osteoporotic unstable trochanteric fractures. INTERVENTIONS: 50 matched pairs consisting of AO - A2 and A3 fractures were created from a cohort of 290 patients who underwent internal fixation for unstable trochanteric fractures with the PFNA - II or InterTan nails...
February 9, 2018: Journal of Orthopaedic Trauma
Nicola Napoli, Nicola Pannacciulli, Eric Vittinghoff, Daria Crittenden, Jang Yun, Andrea Wang, Rachel Wagman, Ann V Schwartz
BACKGROUND: RANKL is a key regulator of bone resorption that may also modulate glucose metabolism. Denosumab (DMAb) is a fully human monoclonal antibody that binds RANKL and was associated with fracture risk reduction in the FREEDOM trial. We hypothesized that DMAb treatment decreased fasting serum glucose (FSG) relative to placebo in women with diabetes or prediabetes enrolled in FREEDOM. METHODS: Post-hoc analysis of FREEDOM, in which 7,808 postmenopausal osteoporotic women were randomized to receive DMAb or placebo every 6 months for 36 months...
February 11, 2018: Diabetes/metabolism Research and Reviews
Hsi-Hsien Lin, Ming-Chau Chang, Shih-Tien Wang, Chien-Lin Liu, Po-Hsin Chou
PURPOSE: Polymethylmethacrylate (PMMA) augmentation is a common method to increase pullout strength fixed for osteoporotic spines. However, few papers evaluated whether these pedicle screws migrated with time and functional outcome in these geriatrics following PMMA-augmented pedicle screw fixation. METHODS: From March 2006 to September 2008, consecutive 64 patients were retrospectively enrolled. VAS and ODI were used to evaluate functional outcomes. Kyphotic angle at instrumented levels and horizontal and vertical distances (HD and VD) between screw tip and anterior and upper cortexes were evaluated...
February 11, 2018: International Orthopaedics
S L Greenspan, A Singer, K Vujevich, B Marchand, D A Thompson, Y-J Hsu, D Vaidya, L S Stern, D Zeldow, D B Lee, S Karp, R Recker
PURPOSE: Although half of women and one-quarter of men aged 50 and older will sustain an acute low-trauma fracture, less than a quarter receive appropriate secondary fracture prevention. The goal of this quality improvement demonstration project was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in three open health care systems aided by a cloud-based tool. METHODS: The pre-post study design examined the proportion of men and women over age 50 who received appropriate assessment (bone mineral density, vitamin D levels) and treatment (calcium/vitamin D, pharmacologic therapy) in the six months following a recently diagnosed fracture...
February 10, 2018: Osteoporosis International
Elsa Denoix, Flore Viry, Agnes Ostertag, Caroline Parlier-Cuau, Jean-Denis Laredo, Martine Cohen-Solal, Valérie Bousson, Thomas Funck-Brentano
OBJECTIVES: Osteoporotic vertebral fractures are responsible for acute pain and disability that may persist for more than 2 months. We wanted to identify predicting factors for mid-term outcome after vertebroplasty. METHODS: We included consecutive patients who underwent vertebroplasty for fragility fractures with persistent and intense pain between January 2014-June 2016. Outcome was assessed by an independent clinician after 1 month using a standardized questionnaire...
February 9, 2018: European Radiology
Sundeep Khosla, Joshua N Farr, James L Kirkland
Context: With the aging of the population and projected increase in osteoporotic fractures, coupled with the declining use of osteoporosis medications, there is a compelling need for new approaches to treat osteoporosis. Given that age-related osteoporosis generally co-exists with multiple other co-morbidities (e.g., atherosclerosis, diabetes, frailty), all sharing aging itself as the leading risk factor, there is growing interest in the "Geroscience Hypothesis", which posits that manipulation of fundamental aging mechanisms will delay the appearance or severity of multiple chronic diseases because these diseases share the same underlying risk factor - age...
February 7, 2018: Journal of Clinical Endocrinology and Metabolism
Asem Mansour, Nayef Abdel-Razeq, Hussein Abuali, Mohammad Makoseh, Nouran Shaikh-Salem, Kamelah Abushalha, Samer Salah
BACKGROUND: Vertebroplasty is a minimally invasive procedure commonly performed for vertebral compression fractures secondary to osteoporosis or malignancy. Leakage of bone cement into the paravertebral venous system and cement pulmonary embolism (cPE) are well described, mostly in patients with osteoporosis. Little is known about the clinical sequelae and outcomes in cancer patients. In this study, we report our experience with cPE following vertebroplasty performed in cancer patients...
February 8, 2018: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
Wen-Tao Zhao, Da-Ping Qin, Xiao-Gang Zhang, Zhi-Peng Wang, Zun Tong
BACKGROUND: Clinical results have shown that different vertebral heights have been restored post-augmentation of osteoporotic vertebral compression fractures (OVCFs) and the treatment results are consistent. However, no significant results regarding biomechanical effects post-augmentation have been found with different types of vertebral deformity or vertebral heights by biomechanical analysis. Therefore, the present study aimed to investigate the biomechanical effects between different vertebral heights of OVCFs before and after augmentation using three-dimensional finite element analysis...
February 8, 2018: Journal of Orthopaedic Surgery and Research
Katrin C Reber, Hans-Helmut König, Clemens Becker, Kilian Rapp, Gisela Büchele, Sarah Mächler, Ivonne Lindlbauer
BACKGROUND: In aging societies osteoporotic fractures are a major health problem with high economic costs. Targeting prevention at individuals at high risk is important to reduce the future burden of fractures. Available risk assessment tools (e.g., FRAX®, QFracture, the algorithm provided by the German Osteology Society (DVO-Tool)) rely on self-reported patient information to predict fracture risk. Time and resource constraints, limited access to clinical data, and (un)willingness to participate may hamper the use of these tools...
February 5, 2018: Bone
Dimitrios Ntourantonis, Vasileios Tsekouras, Panagiotis Korovessis
STUDY DESIGN: A case report. OBJECTIVE: To outline the potential risks of late bleeding from the segmental vessels following less invasively dorsolateral approaches to the thoracolumbar spine. SUMMARY OF BACKGROUND DATA: A low risk of major intraoperative bleeding, associated traditional dorsolateral approach to the lumbar spine is reported , but segmental arteries and great vessels may be rarely damaged. Spine surgeons who are involved with these approaches should be aware of these rare but potential dangerous vascular complication because they could be life threatening, particularly in elderly patients with increased morbidity, and/or metastatic disease to the spine...
February 6, 2018: Spine
Yong-Sheng Zhao, Qiang Li, Qiang Li, Yan-Ping Zheng
OBJECTIVE: To observe different bone cement dispersion types of PVP, PKP and manipulative reduction PVP and their effects in the treatment of senile osteoporotic vertebral compression fractures and the bone cement leakage rate. METHODS: The clinical data of patients with osteoporotic vertebral compression fractures who underwent unilateral vertebroplasty from January 2012 to January 2015 was retrospectively analyzed. Of them, 56 cases including 22 males and 34 females aged from 60 to 78 years old were treated by PVP operation; Fouty-eight cases including 17 males and 31 females aged from 61 to 79 years old were treated by PKP operation; Forty-three cases including 15 males and 28 females aged from 60 to 76 years old were treated by manipulative reduction PVP operation...
May 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Sabri Batin, Firat Ozan, Kaan Gurbuz, Semmi Koyuncu, Fatih Vatansever, Erdal Uzun
Background: Hip fracture is a worldwide public health problem that primarily affects osteoporotic individuals and the elderly. A second hip fracture can occur in elderly patients who have already suffered an initial hip fracture. The aim of this study was to investigate possible risk factors for second hip fractures in elderly patients with hip fractures. Methods: Between 2010 and 2014, 230 patients who underwent uncemented bipolar hemiarthroplasty for hip fractures were retrospectively analyzed...
March 2018: Journal of Clinical Medicine Research
Sloan A Kulper, K Y Sze, Christian X Fang, Xiaodan Ren, Margaret Guo, Kerstin Schneider, Frankie Leung, William Lu, Alfonso Ngan
Many features of orthopaedic implants have been previously examined regarding their influence on migration in trabecular bone under axial loading, with screw thread design being one of the most prominent examples. There has been comparatively little investigation, however, of the influence that implant tip design has on migration under axial loads. We present a novel fracture mechanics model that explains how differences in tip design affect the force required for axial penetration of porous, compressible solids similar to trabecular bone...
February 3, 2018: Journal of the Mechanical Behavior of Biomedical Materials
T H Lui
BACKGROUND: To review the efficacy of lag screw fixation in management of avulsion fracture of the posterosuperior tuberosity of the calcaneus. METHODS: Since 2002, thirteen patients with displaced fracture of the posterior tuberosity of the calcaneus were treated with emergency reduction of the fracture and lag screw fixation. The medical records and radiographs of the patients were reviewed and the patients were assessed according to the Kerr calcaneal fracture scoring system during the latest follow up...
February 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Panagiotis Anagnostis, Stavroula A Paschou, Nifon N Gkekas, Aikaterini-Maria Artzouchaltzi, Konstantinos Christou, Dimitrios Stogiannou, Andromachi Vryonidou, Michael Potoupnis, Dimitrios G Goulis
PURPOSE: Both type 1 (T1DM) and type 2 diabetes mellitus (T2DM) have been associated with bone fragility and increased fracture risk. However, little is known regarding the effect of anti-osteoporotic treatment on bone mineral density (BMD) and/or fracture risk in these patients. We aimed to systematically investigate the efficacy of anti-osteoporotic medications in patients with diabetes in comparison with non-diabetic subjects. METHODS: MEDLINE and Scopus databases were searched (up to 31st October 2017)...
February 6, 2018: Endocrine
Karl Philipp Kutzner, Tobias Freitag, Ralf Bieger, Heiko Reichel, Joachim Pfeil, Anita Ignatius, Lutz Dürselen
BACKGROUND: Short-stem total hip arthroplasty (THA) potentially offers advantages compared to conventional THA, including sparing bone and soft tissue and being a facilitated and less traumatic implantation. However, the indication is limited to patients with sufficient bone quality. Cemented short-stem THA might provide an alternative to conventional cemented THA. To date, no cemented short stem is available on the market. METHODS: In the present in vitro study, primary stability of a new cemented short stem was evaluated, comparing standard (undersized stem) versus line-to-line (same-sized stem) cementing techniques, using six pairs of human cadaver femurs...
January 24, 2018: Clinical Biomechanics
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