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Fragility Fracture

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https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#1
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27908492/fragility-fractures-of-the-ankle-in-the-elderly-open-reduction-and-internal-fixation-versus-tibio-talo-calcaneal-nailing-short-term-results-of-a-prospective-randomized-controlled-study
#2
D Georgiannos, V Lampridis, I Bisbinas
INTRODUCTION: The management of ankle fractures in the elderly remains unpredictable, secondary to their various co-morbidities. Although tibiotalocalcaneal (TTC) nailing has been an effective option for ankle arthrodesis due to ankle arthritis or Charcot arthropathy there are few reports regarding the use of TTC nail for the treatment of ankle fractures. PURPOSE: Aim of this study was to compare the results of ORIF versus TTC nailing for the treatment of unstable ankle fractures in the elderly...
November 17, 2016: Injury
https://www.readbyqxmd.com/read/27908253/assessment-of-bone-quality-in-osteoporosis-treatment-with-bone-anabolic-agents-really-something-new
#3
Fabio Massimo Ulivieri, Renata Caudarella, Marzia Camisasca, Daniela Maria Cabrini, Ilaria Merli, Carmelo Messina, Luca Petruccio Piodi
Osteoporosis is a chronic pathologic condition, particularly of the elderly, in which a reduction of bone mineral density (BMD) weakens bone, leading to the so-called fragility fractures, most often of spine and femur. The gold standard exam for the quantitative measurement of BMD is the dual X-ray photon absorptiometry (DXA), a radiological method. However, a relevant number of fragility fractures occurs in the range of normal BMD values, meaning that also qualitative aspects of bone play a role, namely bone architecture and bone geometry...
December 1, 2016: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/27900532/mir-148a-the-epigenetic-regulator-of-bone-homeostasis-is-increased-in-plasma-of-osteoporotic-postmenopausal-women
#4
Ajda Bedene, Simona Mencej Bedrač, Lea Ješe, Janja Marc, Peter Vrtačnik, Janez Preželj, Tomaž Kocjan, Tilen Kranjc, Barbara Ostanek
BACKGROUND: Osteoporosis is a prevalent skeletal disorder characterized by reduced bone mineral density and microarchitectural deterioration of bone tissue, resulting in bone fragility and low-trauma fractures. Imaging techniques are routinely used to detect low bone mass; however, they are unable to identify deterioration of bone quality. Recently, microRNAs have emerged as regulators of bone remodelling and potentially also as a new class of sensitive biomarkers of bone health to aid in diagnosis and treatment monitoring of osteoporosis...
November 29, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27896467/audit-of-geriatric-hip-fracture-care-a%C3%A2-slovenian-trauma-center-analysis
#5
Dejan Krušič, Drago Brilej, Colin Currie, Radko Komadina
BACKGROUND: The aim was to describe an audit of hip fracture patient care and outcomes in a Slovenian healthcare setting prior to the implementation of the Geriatric Fracture Center (GFC) model of care. METHODS: The Fragility Fracture Network (FFN) hip fracture audit database was used to collect data on hip fracture care in elderly patients. Epidemiological data were submitted as well as fracture type, prefracture residence and mobility prior to the fracture. The timeline of events and acute care data were also collected...
November 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27895472/safety-and-effectiveness-of-daily-teriparatide-for-osteoporosis-in-patients-with-severe-stages-of-chronic-kidney-disease-post-hoc-analysis-of-a-postmarketing-observational-study
#6
Atsushi Nishikawa, Fumito Yoshiki, Masanori Taketsuna, Kenta Kajimoto, Hiroyuki Enomoto
Teriparatide (recombinant 1-34 N-terminal sequence of human parathyroid hormone) for the treatment of osteoporosis should be prescribed with caution in patients with severe stages of chronic kidney disease (CKD). However, in clinical settings, physicians and surgeons who treat such patients have few available options. We sought to further explore the safety and effectiveness of teriparatide for the treatment of osteoporosis in Japanese patients with severe stages of CKD. This was a post hoc analysis of a postmarketing surveillance study that included patients with osteoporosis at high risk of fracture and stage 4 or 5 CKD...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27886945/implementation-of-models-of-care-for-secondary-osteoporotic-fracture-prevention-and-orthogeriatric-models-of-care-for-osteoporotic-hip-fracture
#7
REVIEW
Paul Mitchell, Kristina Åkesson, Manju Chandran, Cyrus Cooper, Kirtan Ganda, Muriel Schneider
As the world's population ages, the prevalence of osteoporosis and its resultant fragility fractures is set to increase dramatically. This chapter focuses on current frameworks and major initiatives related to the implementation of fracture liaison services (FLS) and orthogeriatrics services (OGS), Models of Care designed to reliably implement secondary fracture prevention measures for individuals presenting to health services with fragility fractures. The current evidence base regarding the impact and effectiveness of FLS and OGS is also considered...
June 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27885708/oldest-medical-description-of-osteogenesis-imperfecta-17th-century-france
#8
Philippe Charlier, Antonio Perciaccante, Raffaella Bianucci
Osteogenesis imperfecta (OI), also known as Lobstein's syndrome or Vrolik's syndrome, comprises a heterogeneous group of rare genetic connective tissue disorders. It is characterized by increased bone fragility, low bone mass, and susceptibility to bone fractures of variable severity. Originally named "osteomalacia congenita," the condition was first medically described in a family by Ekman in 1778. Here, we report a 17th century medical account from France, which predates Eckman's doctoral dissertation by about a century...
November 7, 2016: Clinical Anatomy
https://www.readbyqxmd.com/read/27872956/hip-fracture-registries-utility-description-and-comparison
#9
P Sáez-López, F Brañas, N Sánchez-Hernández, N Alonso-García, J I González-Montalvo
: Hip fractures (HF) are prevalent and involve high morbidity and mortality so improving their management is important. HF registries are a good way to improve knowledge about this condition and its quality of care, while at the same time reducing clinical variability, optimizing efficiency, improving outcomes, and reducing costs. INTRODUCTION: Hip fractures (HF) are a prevalent fragility fracture secondary to osteoporosis that involves high morbidity and mortality...
November 21, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27867811/dramatic-mitigation-of-bone-pain-after-phosphorus-replacement-therapy-in-a-subject-with-fgf23-related-hypophosphatemic-osteomalacia
#10
Fuminori Tatsumi, Megumi Horiya, Akihito Tanabe, Momoyo Nishioka, Yoshiro Fushimi, Junpei Sanada, Yurie Hirata, Shintaro Irie, Tomoe Kinoshita, Shinji Kamei, Masashi Shimoda, Tomoatsu Mune, Kohei Kaku, Hideaki Kaneto
INTRODUCTION: Fibroblast growth factor 23 (FGF23) is secreted from bone and suppresses the absorption of phosphorus in renal proximal tubule and in intestinal tract. Therefore, the increase of serum FGF23 levels leads to hypophosphatemic situations. Tumor-induced osteomalacia is often induced by various tumors, but it is often difficult to identify the localization of tumor, because most of the FGF23-producing tumors are small and could be observed in any part of the body. CASE DESCRIPTION: Here we report a case of elderly female subject with FGF23-related hypophosphatemic osteomalacia who repeatedly experienced severe bone pain and fragility fracture in various parts of the body...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27866309/osteoporosis-in-patients-with-diabetes-after-kidney-transplantation
#11
REVIEW
Elvira O Gosmanova, Aidar R Gosmanov
Preexisting diabetes increases risk of fractures after kidney transplantation (KT). However, little is known about mechanisms and prevention of increased fragility in these patients. Pathophysiology of osteoporosis after KT is complex and characterized by high prevalence of adynamic bone disease. Despite high prevalence of preexisting diabetes in KT recipients, diabetes patients were underrepresented in the studies that explored mechanisms and treatments of osteoporosis after KT. Therefore, caution should be exercised before considering conventional fracture prevention strategies in this unique group of patients...
November 19, 2016: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/27858179/outcome-parameters-in-orthogeriatric-co%C3%A2-management%C3%A2-a%C3%A2-mini-review
#12
REVIEW
Radko Komadina, Klaus W Wendt, Gerold Holzer, Tomaž Kocjan
Recognizing hip and other fragility fractures as an adverse event of chronic geriatric conditions led to the concept of orthogeriatric co-management (OGC). OGC today represents various forms of structural cooperation between orthopedic trauma surgeons and multiprofessional geriatric teams taking care of frail elderly patients. The models are country specific. Despite several published models there are still no clear recommendations on how this service should be best organized. The 12 outcome parameters published by the Experts' Roundtable in 2013 were recommended to be used for the further assessment of different OCG models...
November 17, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27857238/implementation-of-fracture-liaison-service-in-a-new-zealand-public-hospital-waitemata-district-health-board-experience
#13
David Kim, Denise Mackenzie, Rick Cutfield
AIM: To analyse the performance of a Fracture Liaison Service (FLS) at Waitemata District Health Board (WDHB), and to detail how systematic secondary fracture prevention can be delivered in a secondary healthcare setting in New Zealand. METHOD: Clinical details of patients supervised by the WDHB FLS during the calendar year 2014 were reviewed and analysed. Additional information including treatment compliance and re-fracture rates were sought a year after initial intervention...
November 18, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27856519/transcriptional-landscape-analysis-identifies-differently-expressed-genes-involved-in-follicle-stimulating-hormone-induced-postmenopausal-osteoporosis
#14
Katre Maasalu, Ott Laius, Lidiia Zhytnik, Sulev Kõks, Ele Prans, Ene Reimann, Aare Märtson
Osteoporosis is a disorder associated with bone tissue reorganization, bone mass, and mineral density. Osteoporosis can severely affect postmenopausal women, causing bone fragility and osteoporotic fractures. The aim of the current study was to compare blood mRNA profiles of postmenopausal women with and without osteoporosis, with the aim of finding different gene expressions and thus targets for future osteoporosis biomarker studies. Our study consisted of transcriptome analysis of whole blood serum from 12 elderly female osteoporotic patients and 12 non-osteoporotic elderly female controls...
November 17, 2016: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/27852598/frailty-and-bone-health-in-european-men
#15
Michael J Cook, Alexander Oldroyd, Stephen R Pye, Kate A Ward, Evelien Gielen, Rathi Ravindrarajah, Judith E Adams, David M Lee, Gyorgy Bartfai, Steven Boonen, Felipe Casanueva, Gianni Forti, Aleksander Giwercman, Thang S Han, Ilpo T Huhtaniemi, Krzysztof Kula, Michael E Lean, Neil Pendleton, Margus Punab, Dirk Vanderschueren, Frederick C Wu, Terence W O'Neill
BACKGROUND: frailty is associated with an increased risk of fragility fractures. Less is known, however, about the association between frailty and bone health. METHODS: men aged 40-79 years were recruited from population registers in eight European centres for participation in the European Male Aging Study. Subjects completed a comprehensive assessment which included quantitative ultrasound (QUS) scan of the heel (Hologic-SAHARA) and in two centres, dual-energy bone densitometry (dual-energy x-ray absorptiometry, DXA)...
November 16, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27849385/fracture-liaison-services-multidisciplinary-approaches-to-secondary-fracture-prevention
#16
Patricia Mejia Osuna, Mary D Ruppe, Laila S Tabatabai
CONTEXT: A well-recognized gap exists between evidence-based recommendations for post-fracture care and actual clinical practice, demonstrated by the high percentage of fragility fracture patients who are neither diagnosed nor treated for osteoporosis. Our purpose is to review fracture liaison service (FLS) models and to evaluate national and international experiences in secondary fracture prevention. EVIDENCE ACQUISITION: We performed a systematic search of publication databases (MEDLINE, SCOPUS) and included randomized controlled trials, meta-analyses and review articles using the following keywords: Fracture liaison services, Secondary prevention of fracture, Post-fracture health care gap and Fragility fractures...
November 16, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27832795/bone-histomorphometric-changes-in-children-with-rheumatic-disorders-on-chronic-glucocorticoids
#17
Jennifer Harrington, Douglas Holmyard, Earl Silverman, Etienne Sochett, Marc Grynpas
BACKGROUND: Rheumatic diseases are associated with an increased fracture risk. The tissue level characteristics of the bone involvement in children have not been well elucidated. Our objectives were to describe the bone micro-architectural characteristics in children with rheumatic diseases on chronic glucocorticoids, and to determine associations between micro-architectural findings with clinical and radiological variables. METHODS: Children on chronic glucocorticoids for an underlying rheumatic disease were referred for evaluation of bone fragility given the presence of vertebral compression fractures...
November 10, 2016: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/27832315/bazedoxifene-ameliorates-homocysteine-induced-apoptosis-and-accumulation-of-advanced-glycation-end-products-by-reducing-oxidative-stress-in-mc3t3-e1-cells
#18
Ippei Kanazawa, Tsutomu Tomita, Shun Miyazaki, Eiji Ozawa, Luis A Yamamoto, Toshitsugu Sugimoto
Elevated plasma homocysteine (Hcy) level increases the risk of osteoporotic fracture by deteriorating bone quality. However, little is known about the effects of Hcy on osteoblast and collagen cross-links. This study aimed to investigate whether Hcy induces apoptosis of osteoblastic MC3T3-E1 cells as well as affects enzymatic and nonenzymatic collagen cross-links and to determine the effects of bazedoxifene, a selective estrogen receptor modulator, on the Hcy-induced apoptosis and deterioration of collagen cross-links in the cells...
November 10, 2016: Calcified Tissue International
https://www.readbyqxmd.com/read/27831978/management-of-blowout-fracture-with-support-of-video-endoscopy-in-a-pediatric-patient
#19
Thiago Henrique Martins, João Paulo Bonardi, Glaykon Alex Vitti Stabile, Eduardo Dallazen, Eduardo Hochuli-Vieira, Cecilia Luiz Pereira-Stabile
Pure orbital fractures have the tendency to occur on medial wall and orbital floor; because these points are more fragile, the endoscopy can be utilized for accomplishing the task of repositioning the herniated content, as well as serving as an additional tool, helping to view the orbital defects through a transantral approach. The presented case is a female patient, 12 years old, who was diagnosed as having a pure blowout fracture, on right orbital floor, type trapdoor, with orbital content herniated toward the maxillary sinus...
November 9, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27821102/the-osteoporotic-fracture-prevention-program-in-rural-areas-ofra-a-protocol-for-a-cluster-randomized-health-care-fund-driven-intervention-in-a-routine-health-care-setting
#20
Kilian Rapp, Karin Kampe, Patrick Roigk, Hella Kircheisen, Clemens Becker, Ivonne Lindlbauer, Hans-Helmut König, Dietrich Rothenbacher, Gisela Büchele
BACKGROUND: Fragility fractures are one of the leading causes for disability in old people. The main underlying mechanisms are osteoporosis and falls. Evidence-based measures to prevent either falls or fractures are available. However, coordinated preventive approaches combining bone health and fall prevention are rare. The objective of the study is to evaluate a health care fund driven program, which encourages insured persons to adhere to national guidelines regarding bone health and physical activity and falls prevention...
November 8, 2016: BMC Musculoskeletal Disorders
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