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Osteoporosis and trauma

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https://www.readbyqxmd.com/read/28740526/evaluation-of-bone-microstructure-in-crps-affected-upper-limbs-by-hr-pqct
#1
Haider Mussawy, Tobias Schmidt, Tim Rolvien, Wolfgang Rüther, Michael Amling
INTRODUCTION: Complex regional pain syndrome (CRPS) is a major complication after trauma, surgery, and/or immobilization of an extremity. The disease often starts with clinical signs of local inflammation and develops into a prolonged phase that is characterized by trophic changes and local osteoporosis and sometimes results in functional impairment of the affected limb. While the pathophysiology of CRPS remains poorly understood, increased local bone resorption plays an undisputed pivotal role...
January 2017: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/28737630/first-in-the-nation-one-unit-s-journey-to-achieving-fragility-fracture-certification
#2
Audry McDonald, Samantha Church, Laura Hixon, Linda Vo, Martha Sleutel
Osteoporosis is related to more than 2 million fractures and $19 billion in healthcare costs each year (). A fragility fracture (FF) is a low-energy fracture of the distal radius, proximal humerus, ankle, or proximal femur (hip) from minimal trauma such as a fall from a standing height. In addition to cost, FFs often result in the loss of independence and productivity (). In 2015, our orthopaedic unit received the first certification ever awarded for FFs. Fragility fracture certification is a new certification demonstrating that a healthcare facility complies with national patient care standards and uses evidence-based practice guidelines to deliver quality outcomes...
July 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28734187/proximal-femoral-nail-antirotation-versus-hemiarthroplasty-in-the-treatment-of-senile-intertrochanteric-fractures-case-report
#3
Xiangping Luo, Shengmao He, Dingshi Zeng, Lijun Lin, Qi Li
BACKGROUND: Primary hemiarthroplasty was recommended by some surgeons as the preferred choice in treating unstable senile intertrochanteric fractures with osteoporosis. However, many studies reported that proximal femoral nail antirotation (PFNA) currently was as an optimal implant for the treatment of different type of intertrochanteric fractures. Which method is better for treating senile intertrochanteric fractures remains controversial due to the insufficient clinical evidences. METHODS: We reviewed all consecutive senile intertrochanteric fractures treated with PFNA or cemented hemiarthroplasty at our institution between July 2010 and March 2015...
July 11, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28695555/adherence-to-osteoporosis-pharmacotherapy-one-year-after-osteoporotic-fracture-a-swiss-trauma-center-secondary-prevention-project
#4
Sabrina Morell, Christoph Hemmeler, Felix Amsler, Thomas Gross
AIMS OF THE STUDY: According to current evidence, one out of ten fracture patients with osteoporosis does not sustain another fracture if he or she is on adequate medication. However, epidemiological surveys show that only about 15 to 30% of affected patients avail themselves of the treatments. This cohort study investigated how many fracture patients with a recommendation for antiosteoporotic therapy effectively received treatment and the possible reasons why the treatment was not implemented...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28689879/nonstandard-lumbar-region-in-predicting-fracture-risk
#5
Dima Alajlouni, Dana Bliuc, Thach Tran, Nicholas Pocock, Tuan V Nguyen, John A Eisman, Jacqueline R Center
Femoral neck (FN) bone mineral density (BMD) is the most commonly used skeletal site to estimate fracture risk. The role of lumbar spine (LS) BMD in fracture risk prediction is less clear due to osteophytes that spuriously increase LS BMD, particularly at lower levels. The aim of this study was to compare fracture predictive ability of upper L1-L2 BMD with standard L2-L4 BMD and assess whether the addition of either LS site could improve fracture prediction over FN BMD. This study comprised a prospective cohort of 3016 women and men over 60 yr from the Dubbo Osteoporosis Epidemiology Study followed up for occurrence of minimal trauma fractures from 1989 to 2014...
July 6, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28685278/does-regional-loss-of-bone-density-explain-low-trauma-distal-forearm-fractures-in-men-the-mr-f-study
#6
B C Hanusch, S P Tuck, R J Q McNally, J J Wu, M Prediger, J Walker, J Tang, I Piec, W D Fraser, H K Datta, R M Francis
The pathogenesis of low trauma wrist fractures in men is not fully understood. This study found that these men have lower bone mineral density at the forearm itself, as well as the hip and spine, and has shown that forearm bone mineral density is the best predictor of wrist fracture. INTRODUCTION: Men with distal forearm fractures have reduced bone density at the lumbar spine and hip sites, an increased risk of osteoporosis and a higher incidence of further fractures. The aim of this case-control study was to investigate whether or not there is a regional loss of bone mineral density (BMD) at the forearm between men with and without distal forearm fractures...
July 6, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28677081/the-role-of-impairment-of-mesenchymal-stem-cell-function-in-osteoporotic-bone-fracture-healing
#7
Lihai Zhang, Saeed Miramini, Martin Richardson, Priyan Mendis, Peter Ebeling
With demographic change and increasing life expectancy, osteoporotic fractures have become one of the most prevalent trauma conditions seen in daily clinical practice. A variety of factors are known to affect the rate of healing in osteoporotic conditions (e.g. both biochemical and biomechanical environment of callus cells). However, the influence of impairment of mesenchymal stem cell function in the osteoporotic condition on bone fracture healing has not been fully understood. In the present study, we develop a mathematical model that quantifies the change in biological processes within the fracture callus as a result of osteoporosis...
July 4, 2017: Australasian Physical & Engineering Sciences in Medicine
https://www.readbyqxmd.com/read/28667524/low-evaluation-rate-for-osteoporosis-among-patients-presenting-with-a-rib-fracture
#8
Whang Kim, Hyun Sik Gong, Seung Hoo Lee, Jin Woo Park, Kahyun Kim, Goo Hyun Baek
This study in a regional hospital setting found a low evaluation rate for osteoporosis among patients presenting with a rib fracture. Increased emphasis or education for osteoporosis evaluation may be necessary in case of rib fractures. INTRODUCTION: Rib fractures from a low-energy trauma are common in the elderly, and a history of rib fracture has been reported to increase the risk for a subsequent osteoporotic fracture. The purpose of this study was to evaluate how many of the patients presenting with an isolated rib fracture were being evaluated for osteoporosis and the risk for a subsequent fracture...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28664275/barriers-to-secondary-fracture-prevention-in-primary-care
#9
A S Mendis, K Ganda, M J Seibel
This study of current osteoporosis management patterns in general practice found that the majority of patients presenting to their local health practitioner with a recent low-trauma fracture was not managed appropriately. The analysis demonstrated that failure to investigate was highly predictive of failure to treat and that one of the major barriers to effective osteoporosis management is a lack of specific knowledge about who to investigate and treat. INTRODUCTION: Osteoporotic fractures are associated with significant morbidity and mortality...
June 29, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28630761/partial-proximal-tibia-fractures
#10
Michael J Raschke, Christoph Kittl, Christoph Domnick
Partial tibial plateau fractures may occur as a consequence of either valgus or varus trauma combined with a rotational and axial compression component.High-energy trauma may result in a more complex and multi-fragmented fracture pattern, which occurs predominantly in young people. Conversely, a low-energy mechanism may lead to a pure depression fracture in the older population with weaker bone density.Pre-operative classification of these fractures, by Müller AO, Schatzker or novel CT-based methods, helps to understand the fracture pattern and choose the surgical approach and treatment strategy in accordance with estimated bone mineral density and the individual history of each patient...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28620868/osteoporosis-in-children-with-chronic-illnesses-diagnosis-monitoring-and-treatment
#11
REVIEW
Monica Grover, Laura K Bachrach
PURPOSE OF REVIEW: Osteoporosis is an under-recognized complication of chronic illness in childhood. This review will summarize recent literature addressing the risk factors, evaluation, and treatment for early bone fragility. RECENT FINDINGS: Criteria for the diagnosis of pediatric osteoporosis include the presence of low trauma vertebral fractures alone or the combination of low bone mineral density and several long bone fractures. Monitoring for bone health may include screening for vertebral fractures that are common but often asymptomatic...
June 15, 2017: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/28618161/prevention-of-osteoporotic-refractures-in-regional-australia
#12
Emily Davidson, Alexa Seal, Zelda Doyle, Kerin Fielding, Joe McGirr
OBJECTIVE: Clinical guidelines recommend that patients who sustain a minimal trauma fracture (MTF) should receive a bone mineral density (BMD) scan and bisphosphonate (or equivalent) therapy if diagnosed with osteoporosis. A pilot fracture liaison service (FLS) was implemented in regional NSW to improve adherence to the guidelines. DESIGN: Prospective cohort study with an historical control. SETTING: Primary care. PARTICIPANTS: Control (n = 47) and cohort (n = 93) groups comprised patients consenting to interview who presented with a MTF to the major referral hospital 4 months before and 12 months after FLS implementation respectively...
June 15, 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/28611963/pelvic-insufficiency-fracture-in-severe-osteoporosis-patient
#13
Woong Chae Na, Sang Hong Lee, Sung Jung, Hyun Woong Jang, Suenghwan Jo
PURPOSE: To evaluate clinical features and the effect of parathyroid hormone (PTH) on treatment outcomes of patients with pelvic insufficiency fractures. MATERIALS AND METHODS: Fifteen patients diagnosed with pelvic insufficiency fractures were evaluated retrospectively. All patients had osteoporosis with mean lumbar T score of -3.9 (range, -3.1 to -6.4) and the mean age was 76.5 years. In all cases, simple radiography and computed tomography was used for final diagnosis; additional magnetic resonance imaging and technetium bone scans were used to confirm the diagnosis in 2 and 6 patients, respectively...
June 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28595648/investigation-and-management-of-osteoporosis-in-aged-trauma-patients-a-treatment-algorithm-adapted-to-the-german-guidelines-for-osteoporosis
#14
Carl Neuerburg, Lena Mittlmeier, Ralf Schmidmaier, Christian Kammerlander, Wolfgang Böcker, Wolf Mutschler, Ulla Stumpf
BACKGROUND: Osteoporosis-associated fractures are of increasing importance in trauma surgery. Systematic diagnostics and treatment of osteoporosis during a hospital stay, however, remain inadequate. Therefore, a specific algorithm for diagnosing and treating osteoporosis in trauma surgery patients was developed based on the DVO (German Osteology Society) guideline for osteoporosis from 2014. METHODS: In a first step, the individuals' age and risk profile for osteoporosis is identified considering specific fractures indicating osteoporosis and risk factors assessed by a specific questionnaire...
June 8, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28580386/hospitalizations-for-osteoporosis-related-fractures-economic-costs-and-clinical-outcomes
#15
Derek Weycker, Xiaoyan Li, Rich Barron, Rebecca Bornheimer, David Chandler
BACKGROUND: Osteoporotic fractures frequently require inpatient care, and are associated with elevated risks of morbidity, mortality, and re-hospitalization. A comprehensive evaluation of healthcare costs, resource utilization, and outcomes associated with osteoporosis (OP)-related fractures treated in US hospitals was undertaken. METHODS: A retrospective analysis using the Premier Perspective Database (2010 - 2013) was conducted. Study population comprised patients aged ≥ 50 years hospitalized with a principal diagnosis of a closed or pathologic fracture commonly associated with OP; the first qualifying hospitalization was designated the "index admission"...
December 2016: Bone Reports
https://www.readbyqxmd.com/read/28578439/long-term-use-of-bisphosphonates-in-osteoporosis
#16
Basmah K Alwahhabi, Basil A Alsuwaine
To report and describe the management and response to treatment of patients referred to the osteoporosis clinic after prolonged use of bisphosphonate BPs) (4 years and more) with and without new fracture (any site) or any other new skeletal symptoms.  Methods: This is a single center observational retrospective cohort study conducted from January 2009 to May 2016 in a tertiary center. We describe cause of referral, X-rays findings, management, and response to treatment. Results: Thirty-four patients, aged 46-89 years, were collected...
June 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28574525/severe-right-hip-pain
#17
Anthony P Trace, Kimberly Hoang, Joseph S McMonagle
While this patient had osteoporosis, she hadn't experienced any recent trauma or falls that would explain her pain.
June 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28556236/osteoporosis-in-crisis-it-s-time-to-focus-on-fracture
#18
Neil Binkley, Robert D Blank, William D Leslie, E Michael Lewiecki, John A Eisman, John P Bilezikian
A crisis in osteoporosis treatment exists; the majority of those who sustain fracture do not receive treatment to reduce future fracture risk. This crisis presents an opportunity to focus the field from osteoporosis to fracture, the outcome of consequence. Proposed here is a change in focus suggesting that 1) attempts to define the level of trauma leading to fracture are counterproductive and that all fractures in older adults merit consideration of evaluation and 2) bone loss is not the entire problem but rather part of a broader syndrome including osteoporosis, sarcopenia, and other factors leading to fracture...
July 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28545316/lower-extremity-fractures-in-patients-with-spinal-cord-injury-characteristics-outcome-and-risk-factors-for-non-unions
#19
Lukas Grassner, Barbara Klein, Doris Maier, Volker Bühren, Matthias Vogel
CONTEXT: Sublesional osteoporosis is an important sequel after spinal cord injury (SCI) resulting in a high incidence of fractures and impaired osseous healing due to altered bone metabolism. The following study aims to identify demographic characteristics and outcome of patients with SCI with lower extremity fractures. DESIGN: Retrospective observational study. SETTING: Level-I cross-regional trauma center. PARTICIPANTS: All patients with SCI suffering from osteoporotic/pathologic fractures during an 11-year-period (01/2003-12/2013) at the Center for Spinal Cord Injuries (Trauma Center Murnau) were analyzed via a chart review...
May 25, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28543781/fracture-prospectively-recorded-from-prepuberty-to-young-adulthood-are-they-markers-of-peak-bone-mass-and-strength-in-males
#20
Thierry Chevalley, Jean-Philippe Bonjour, Marie-Claude Audet, Fanny Merminod, Bert van Rietbergen, Rene Rizzoli, Serge Ferrari
Fractures are common in otherwise healthy children and adolescents. They result from trauma of varying severity. Some reflect a greater skeletal fragility. A long-term implication of these fractures is their potentiality to predict adult bone fragility and increased risk of osteoporosis in later life. Using dual-energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT), and micro-finite element analysis (μFEA) measurements, we previously found in 124 healthy females, followed from the age of 7...
May 24, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
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