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https://www.readbyqxmd.com/read/27923219/nonoperative-versus-operative-treatment-of-displaced-ankle-fractures-in-diabetics
#1
Andrew J Lovy, James Dowdell, Aakash Keswani, Steven Koehler, Jaehon Kim, Steven Weinfeld, David Joseph
BACKGROUND: Diabetes is a risk factor for complications related to displaced ankle fractures. Limited literature exists comparing complication rates in nonoperative versus operative treatment of displaced ankle fractures in diabetics. No study has highlighted the natural history of nonoperative treatment of displaced ankle fractures in diabetics. METHODS: We retrospectively reviewed all adult ankle fractures from September 2011 through December 2014. Inclusion was limited to ambulatory adults (>18 years) with closed, displaced (widened mortise) ankle fractures with diabetes mellitus...
November 14, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27923214/relationships-between-radiographic-pre-and-postoperative-alignment-and-patient-perceived-outcomes-following-weber-b-and-c-ankle-fractures
#2
Erik Hohmann, Frith Foottit, Kevin Tetsworth
BACKGROUND: Anatomic reduction of ankle fractures may influence outcomes but the relationships between these 2 variables are still unknown and require further investigation. The purpose of this study was to investigate the relationships between radiologic alignment of surgically treated ankle fractures and functional outcomes. METHODS: This retrospective study included patients who were surgically treated for Weber B and C ankle fractures. The outcome measures consisted of the Olerud and Molander Ankle Score (OMAS) and the foot and ankle disability measure...
October 23, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27922573/vertebroplasty-and-return-to-work-for-thoracolumbar-fractures-within-the-workers-compensation-population
#3
Jay M Levin, Joshua T Anderson, Arnold R Haas, Rick Percy, Stephen T Woods, Uri M Ahn, Nicholas U Ahn
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: Analyze efficacy of vertebroplasty and its affect on return to work (RTW) in a workers' compensation (WC) population SUMMARY OF BACKGROUND DATA.: Vertebroplasty remains a controversial treatment modality for vertebral compression fractures (VCFs). No studies have analyzed use of vertebroplasty in the clinically distinct WC population. METHODS: A total of 371 Ohio WC subjects were identified who sustained VCFs and were treated with either vertebroplasty or conservative medical therapy between 1993 and 2013 using Current Procedural Terminology procedural and International Classification of Diseases, Ninth Revision diagnosis codes...
December 2, 2016: Spine
https://www.readbyqxmd.com/read/27921146/bone-loss-at-the-distal-femur-and-proximal-tibia-in-persons-with-spinal-cord-injury-imaging-approaches-risk-of-fracture-and-potential-treatment-options
#4
REVIEW
C M Cirnigliaro, M J Myslinski, M F La Fountaine, S C Kirshblum, G F Forrest, W A Bauman
Persons with spinal cord injury (SCI) undergo immediate unloading of the skeleton and, as a result, have severe bone loss below the level of lesion associated with increased risk of long-bone fractures. The pattern of bone loss in individuals with SCI differs from other forms of secondary osteoporosis because the skeleton above the level of lesion remains unaffected, while marked bone loss occurs in the regions of neurological impairment. Striking demineralization of the trabecular epiphyses of the distal femur (supracondylar) and proximal tibia occurs, with the knee region being highly vulnerable to fracture because many accidents occur while sitting in a wheelchair, making the knee region the first point of contact to any applied force...
December 5, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27921129/-shoulder-endoprosthesis-in-the-elderly-hemiarthroplasty-or-total-shoulder-arthroplasty-anatomic-or-reverse
#5
J Kircher
Implantation of reverse shoulder endoprostheses is becoming more popular for elderly patients besides the well-established standard anatomic endoprostheses. The reasons for this are the increased life expectancy, age-dependent degeneration of the rotator cuff leading to cuff tear arthropathy, posttraumatic disability after failed osteosynthesis and primary reverse fracture arthroplasty. Stemless implants are more frequently used for primary osteoarthritis with the bone quality being the limiting factor. Modern implant systems allow the stepwise extension from bone preserving primary implants to modular and convertible revision implants that allow a partial exchange of components...
December 5, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27920870/pyle-disease-metaphyseal-dysplasia-presenting-in-two-adult-sisters
#6
Diego Ximenes Soares, Amália Mapurunga Almeida, André Rodrigues Façanha Barreto, Ilze Jucá Alencar E Silva, José Daniel Vieira de Castro, Francisco José Magalhães Pinto, Daniel Aguiar Dias, Lindenberg Barbosa Aguiar
Pyle's disease is an extremely rare skeletal disorder characterized by a benign course and an autosomal recessive genetic pattern of inheritance. Its causal mutation is still unknown. In the medical literature, fewer than 30 cases have been described to date. We report the case of two female siblings, daughters of consanguineous parents, referred to the radiology department complaining of genu valgum. Laboratory tests showed no other relevant findings. Conventional radiography plain films revealed Erlenmeyer flask deformity in bilateral femorotibial metaphyses, metaphyseal flaring of long bones, and mild sclerosis of the skull base...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27920809/rates-and-reasons-for-lack-of-persistence-with-anti-osteoporotic-drugs-analysis-of-the-campania-region-database
#7
Giovanni Iolascon, Francesca Gimigliano, Antimo Moretti, Ilaria Riccio, Massimo Di Gennaro, Maddalena Illario, Valeria Marina Monetti, Valentina Orlando, Enrica Menditto
Subjects with chronic diseases are more likely to be nonpersistent to pharmacological treatment. Lack of persistence is common among subjects using oral anti-osteoporotic drugs, and leads to increased risk of fragility fracture. The aim of our retrospective study is to analyze the rates and reasons for discontinuation of anti-osteoporotic drugs in the Campania Region. Subjects aged over 40 years were included if they had received at least one prescription for any anti-osteoporotic drugs. Data were obtained from an administrative database of regional data on outpatient drug prescriptions reimbursed by the National Health Service...
May 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/27920805/abaloparatide
#8
REVIEW
Stefano Gonnelli, Carla Caffarelli
Abaloparatide is an investigational analog of human PTHrP (1-34) being developed for the treatment of osteoporosis. The amino-acid sequence of abaloparatide is identical to that of PTHrP in the first 20 amino-acids, while over half of the remaining amino-acids are different. Some studies in animals and in humans reported that abaloparatide presented a potent anabolic activity with reduced effects on bone resorption as compared to that observed with teriparatide. This may be due to a more transient signaling response of abaloparatide related to differing affinities of the two drugs to the specific conformations of the PTH1 receptor...
May 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/27920803/bone-pain-mechanism-in-osteoporosis-a-narrative-review
#9
REVIEW
Consalvo Mattia, Flaminia Coluzzi, Ludovica Celidonio, Renato Vellucci
Bone pain in elderly people dramatically affects their quality of life, with osteoporosis being the leading cause of skeletal related events. Peripheral and central mechanisms are involved in the pathogenesis of the nervous system sensitization. Osteoporosis in the elderly has been associated with increased density of bone sensory nerve fibers and their pathological modifications, together with an over-expression of nociceptors sensitized by the lowering pH due to the osteoclastic activity. The activation of N-methyl-D-aspartate (NMDA) receptors and the microglia, as a response to a range of pathological conditions, represent the leading cause of central sensitization...
May 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/27920801/implications-of-analgesics-use-in-osteoporotic-related-pain-treatment-focus-on-opioids
#10
REVIEW
Renato Vellucci, Consalvo Mattia, Ludovica Celidonio, Rocco Domenico Mediati
Bone loss is asymptomatic and will progress without pain and other symptoms until the occurrence of a fracture. The occurrence of a breaking bone induce acute pain determined and supported by a mechanical, inflammatory and neuropathic component. Very often the acute component evolves in a chronic musculoskeletal component. Overall objectives of the analgesic therapy can be summarized in pain relief, improving sleep, improve mobility, reduce anxiety, emotional component and depression. Osteoporosis is predominantly a condition of the elderly, more likely to have coexisting cardiovascular disease and age-related decline in renal function, receiving treatment for one or more comorbid conditions, taking multiple medications...
May 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/27920504/gender-and-age-related-treatment-compliance-in-patients-with-osteoporosis-in-germany
#11
Peyman Hadji, Louis Jacob, Karel Kostev
AIM: The purpose of this study was to analyze treatment compliance in osteoporotic patients treated with osteoporosis medications in Germany. METHODS: Patients included in the analysis had been diagnosed with osteoporosis with or without fractures and started anti-osteoporotic therapy (bisphosphonates, denosumab, or strontium ranelate) between 2011 and 2014 in a general (GP) or orthopedic practice (OP) setting in Germany. Data pertaining to 6,221 individuals followed in GP and 4,044 individuals followed in OP were analyzed retrospectively...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27920391/dorsal-intercalated-segmental-instability-associated-with-malunion-of-a-reconstructed-scaphoid
#12
J-H Kim, K-H Lee, B G Lee, C-H Lee, S-J Kim, W-S Choi
: We analysed scaphoid deformity as a result of surgical treatment of scaphoid fracture nonunion and assessed the deformity associated with a dorsal intercalated segmental instability pattern of carpal malalignment. A total of 45 patients who were treated for scaphoid fracture nonunion were included in the study. The height-to-length ratio of the scaphoid was measured on computed tomographic images and used to assess scaphoid deformity. Carpal malalignment was quantified based on the radio-lunate angle...
December 5, 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27920281/systematic-review-and-statistical-analysis-of-the-integrity-of-33-randomized-controlled-trials
#13
Mark J Bolland, Alison Avenell, Greg D Gamble, Andrew Grey
BACKGROUND: Statistical techniques can investigate data integrity in randomized controlled trials (RCTs). We systematically reviewed and analyzed all human RCTs undertaken by a group of researchers, about which concerns have been raised. METHODS: We compared observed distributions of p values for between-groups differences in baseline variables, for standardized sample means for continuous baseline variables, and for differences in treatment group participant numbers with the expected distributions...
December 6, 2016: Neurology
https://www.readbyqxmd.com/read/27919768/proximal-femoral-fractures-in-centenarians-a-retrospective-analysis-of-39-patients
#14
A Morice, N Reina, G Gracia, P Bonnevialle, J-M Laffosse, K Wytrykowski, E Cavaignac, N Bonnevialle
BACKGROUND: A corollary of the current population ageing in France is an increase in proximal femoral fractures (PFFs), particularly among centenarians. The outcomes of PFF in centenarians in France are unknown. We therefore conducted a retrospective study of centenarians with PFFs both to assess: 1) assess clinical outcomes according to geriatric and trauma scores, 2) and to determine whether routine surgery is warranted. HYPOTHESIS: Morbidity and mortality in a single-centre cohort of centenarians with surgically treated PFFs are consistent with previous reports...
December 2, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27919767/internal-fixation-of-intra-capsular-proximal-femoral-fractures-in-patients-older-than-80-years-still-relevant-multivariate-analysis-of-a-prospective-multicentre-cohort
#15
Nicolas Reina, Paul Bonnevialle, Brice Rubens Duval, Philippe Adam, François Loubignac, Thierry Favier, Philippe Massin
BACKGROUND: Arthroplasty is now widely used to treat intra-capsular proximal femoral fractures (PFFs) in older patients, even when there is little or no displacement. However, whether arthroplasty is associated with lower mortality and complication rates in non-displaced or mildly displaced PFFs is unknown. The objectives of this prospective study were: 1) to evaluate early mortality rates with the two treatment methods, 2) to identify risk factors for complications, 3) and to identify predictors of functional decline...
December 2, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27919511/metaphyseal-locking-plate-as-an-external-fixator-for-open-tibial-fracture-clinical-outcomes-and-biomechanical-assessment
#16
Ching-Hou Ma, Chin-Hsien Wu, Jiun-Ru Jiang, Yuan-Kun Tu, Ting-Sheng Lin
OBJECTIVE: This study aimed to evaluate the outcome of using a metaphyseal locking plate as a definitive external fixator for treating open tibial fractures based on biomechanical experiments and analysis of clinical results. METHODS: A metaphyseal locking plate was used as an external fixator in 54 open tibial fractures in 52 patients. The mean follow-up was 38 months (range, 20-52 months). Moreover, static axial compression and torsional tests were performed to evaluate the strength of the fixation techniques...
November 29, 2016: Injury
https://www.readbyqxmd.com/read/27919096/should-we-screen-for-vitamin-d-deficiency-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#17
Howard Libman, Alan O Malabanan, Gordon J Strewler, Eileen E Reynolds
The U.S. Preventive Services Task Force (USPSTF) recently issued guidelines on screening for vitamin D deficiency. The guidelines were based on randomized trials of vitamin D deficiency screening and treatment, as well as on case-control studies nested within the Women's Health Initiative. The USPSTF concluded that current evidence is insufficient to assess the benefits and harms of screening for vitamin D deficiency in asymptomatic adults. Compared with placebo or no treatment, vitamin D was associated with decreased mortality; however, benefits were no longer seen after trials of institutionalized persons were excluded...
December 6, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27918446/metabolomics-and-its-application-in-the-development-of-discovering-biomarkers-for-osteoporosis-research
#18
REVIEW
Huanhuan Lv, Feng Jiang, Daogang Guan, Cheng Lu, Baosheng Guo, Chileung Chan, Songlin Peng, Baoqin Liu, Wenwei Guo, Hailong Zhu, Xuegong Xu, Aiping Lu, Ge Zhang
Osteoporosis is a progressive skeletal disorder characterized by low bone mass and increased risk of fracture in later life. The incidence and costs associated with treating osteoporosis cause heavy socio-economic burden. Currently, the diagnosis of osteoporosis mainly depends on bone mineral density and bone turnover markers. However, these indexes are not sensitive and accurate enough to reflect the osteoporosis progression. Metabolomics offers the potential for a holistic approach for clinical diagnoses and treatment, as well as understanding of the pathological mechanism of osteoporosis...
December 2, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27917700/posterior-reversible-encephalopathy-syndrome-following-elevated-mean-arterial-pressures-for-cervical-spinal-cord-injury
#19
Jeffrey H Zimering, Addisu Mesfin
BACKGROUND: Increasing the mean arterial pressure (MAP) is an accepted treatment modality to minimize the risk for irreversible neurologic damage secondary to spinal cord ischemia. Posterior reversible encephalopathy syndrome (PRES) is a rare complication occurring after transplantation surgery, in persons having an autoimmune disorder or after abrupt increases in blood pressure of various etiologies. STUDY DESIGN: Case report. METHODS: Retrospective evaluation of medical records...
December 5, 2016: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/27917349/effect-of-acute-salinity-stress-on-ion-homeostasis-na-k-atpase-and-histological-structure-in-sea-cucumber-apostichopus-japonicus
#20
Chenfan Geng, Yi Tian, Yanpeng Shang, Liqiang Wang, Yanan Jiang, Yaqing Chang
BACKGROUND: Sea cucumbers (Apostichopus japonicus) are an imperiled fauna exposed to a variety of environmental condition such as salinity and studies are urgently needed to assess their effects to guide aquaculture efforts. The effects of acute salinity stress on coelomic fluid osmotic pressure, ion concentrations, the activity of Na(+)/K(+)-ATPase in respiratory trees and the histological variations were measured to evaluate the salinity tolerance of sea cucumbers. RESULTS: Significant correlations in osmotic pressure were observed between coelomic fluid and ambient environmental salinity...
2016: SpringerPlus
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