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Fracture management

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https://www.readbyqxmd.com/read/28734710/use-of-trabecular-bone-score-tbs-as-a-complementary-approach-to-dual-energy-x-ray-absorptiometry-dxa-for-fracture-risk-assessment-in-clinical-practice
#1
Enisa Shevroja, Olivier Lamy, Lynn Kohlmeier, Fjorda Koromani, Fernando Rivadeneira, Didier Hans
Osteoporosis is a common bone disease characterized by low bone mass and altered bone microarchitecture, resulting in decreased bone strength with an increased risk of fractures. In clinical practice, physicians can assess the risk of fracture for a patient based on several risk factors. Some such as age, weight, and history of fractures after 50 years of age, parental fracture, smoking status, and alcohol intake are incorporated into FRAX, an assessment tool that estimates the 10-year probability of hip fracture and major osteoporotic fractures based on the individual's risk factors profile...
July 19, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28734709/worldwide-fracture-prediction
#2
Ghada El-Hajj Fuleihan, Marlene Chakhtoura, Jane A Cauley, Nariman Chamoun
The substantial increase in the burden of non-communicable diseases in general and osteoporosis in particular, necessitates the establishment of efficient and targeted diagnosis and treatment strategies. This chapter reviews and compares different tools for osteoporosis screening and diagnosis; it also provides an overview of different treatment guidelines adopted by countries worldwide. While access to dual-energy X-ray absorptiometry to measure bone mineral density (BMD) is limited in most areas in the world, the introduction of risk calculators that combine risk factors, with or without BMD, have resulted in a paradigm shift in osteoporosis screening and management...
July 19, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28734536/evaluation-of-functional-outcome-after-nonsurgical-management-of-terrible-triad-injuries-of-the-elbow
#3
Farid Najd Mazhar, Davod Jafari, Alireza Mirzaei
BACKGROUND: Terrible triad (TT) is one of the severe injuries of the elbow that generally requires surgery. Nonsurgical treatment has recently been applied in selected cases of TT injury. Evaluation of the results of this treatment was the main aim of this study. METHODS: In a prospective cohort study, 10 patients with a mean follow-up of 30.6 months were evaluated. The inclusion criteria included a congruent joint after closed reduction, no indication for surgery of the coronoid and radial head fractures, no block in supination and pronation up to 60°, no intra-articular fragments, and a free and stable joint with ulnohumeral extension up to a minimum of 45°...
August 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28733846/implementation-of-a-standardized-protocol-to-manage-elderly-patients-with-low-energy-pelvic-fractures-can-service-improvement-be-expected
#4
Nikolaos K Kanakaris, Tess Greven, Robert M West, Arie B Van Vugt, Peter V Giannoudis
PURPOSE: The incidence of low energy pelvic fractures (FPFs) in the elderly is increasing. Comorbidities, decreased bone-quality, problematic fracture fixation and poor compliance represent some of their specific difficulties. In the absence of uniform management, a standard operating procedure (SOP) was introduced to our unit, aiming to improve the quality of services provided to these patients. METHODS: A cohort study was contacted to test the impact of (1) using a specific clinical algorithm and (2) using different antiosteoporotic drugs...
July 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28733716/osteosarcopenia-where-bone-muscle-and-fat-collide
#5
REVIEW
H P Hirschfeld, R Kinsella, G Duque
As the world's population ages, the prevalence of chronic diseases increases. Sarcopenia and osteoporosis are two conditions that are associated with aging, with similar risk factors that include genetics, endocrine function, and mechanical factors. Additionally, bone and muscle closely interact with each other not only anatomically, but also chemically and metabolically. Fat infiltration, a phenomenon observed in age-related bone and muscle loss, is highly prevalent and more severe in sarcopenic and osteoporotic subjects...
July 22, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28733108/first-line-management-of-distal-humerus-fracture-by-total-elbow-arthroplasty-in-geriatric-traumatology-results-in-a-21-patient-series-at-a-minimum-2-years-follow-up
#6
D Lami, M Chivot, A Caubere, A Galland, J N Argenson
INTRODUCTION: Total elbow arthroplasty (TEA) is one option in distal humerus fracture in elderly osteoporotic patients. HYPOTHESIS: The study hypothesis was that, in patients aged 70 years or more,TEA provides functional results and ranges of motion compatible with everyday activity, with a complications rate equal to or lower than with internal fixation, and no loss of autonomy or cognitive impairment. MATERIALAND METHODS: In this retrospective study, 21 patients receiving TEA for distal humerus fracture were included...
July 18, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28733098/obesity-and-failure-of-nonsurgical-management-of-pediatric-both-bone-forearm-fractures
#7
Ugochi C Okoroafor, Lisa K Cannada, Jasmin L McGinty
PURPOSE: In pediatric extremity fractures treated nonsurgically, maintaining reduction can be difficult in obese children owing to the larger soft tissue envelope. The purpose of this study was to investigate the relationship between obesity and failure of nonsurgical management of pediatric both-bone forearm fractures. METHODS: We conducted a retrospective review of 129 skeletally immature patients older than 2 years who received nonsurgical treatment for closed radius and ulna shaft fractures at a level I pediatric trauma center between 2011 and 2014...
July 18, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28733044/management-of-displaced-inferior-patellar-pole-fractures-with-modified-tension-band-technique-combined-with-cable-cerclage-using-cable-grip-system
#8
Xu Yang, Qinfen Wu, Chin-Hui Lai, Xin Wang
INTRODUCTION: We present a modified tension band technique combined with cable cerclage using Cable Grip System for the treatment of displaced inferior patellar pole fractures and report the knee functional outcome. PATIENTS AND METHODS: The patients who had had operative treatment of a displaced inferior patellar pole fracture (AO/OTA 34-A1) between December 2013 and December 2015 were studied retrospectively. Eleven consecutive patients had had open reduction and internal fixation with the modified technique using Cable Grip System, of whom, five males and six females with an average age of 60...
July 13, 2017: Injury
https://www.readbyqxmd.com/read/28733042/complications-and-unplanned-outcomes-following-operative-treatment-of-tibial-plateau-fractures
#9
David Kugelman, Abdullah Qatu, Jack Haglin, Phillip Leucht, Sanjit Konda, Kenneth Egol
INTRODUCTION: The operative management of tibial plateau fractures is challenging and post-operative complications do occur. The purpose of this study was three-fold. 1). To report complications and unplanned outcomes in patients who had sustained tibial plateau fractures and were operatively managed 2). To report predictors of these post-operative events 3). To report if differences in clinical outcomes exist in patients who sustained a post-operative event. METHODS: Over 11 years, all tibial plateau fractures were prospectively followed...
July 12, 2017: Injury
https://www.readbyqxmd.com/read/28732221/atrophic-mandible-fractures-are-bone-grafts-necessary-an-update
#10
Jaime Castro-Núñez, Larry L Cunningham, Joseph E Van Sickels
PURPOSE: The management of atrophic mandibular fractures poses a challenge because of anatomic variations and medical comorbidities associated with elderly patients. The purpose of this article is to review and update the literature regarding the management of atrophic mandible fractures using load-bearing reconstruction plates placed without bone grafts. MATERIALS AND METHODS: We performed a review of the English-language literature looking for atrophic mandibular fractures with or without continuity defects and reconstruction without bone grafts...
June 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28730696/cd34-cells-seeded-in-collagen-scaffolds-promote-bone-formation-in-a-mouse-calvarial-defect-model
#11
Jens Hertweck, Ulrike Ritz, Hermann Götz, Patrick C Schottel, Pol Maria Rommens, Alexander Hofmann
Bone tissue engineering (BTE) holds promise for managing the clinical problem of large bone defects. However, clinical adoption of BTE is limited due to limited vascularization of constructs, which could be circumvented by pre-cultivation of osteogenic and endothelial derived cells in natural-based polymer scaffolds. However, until now not many studies compared the effect of mono- and cocultures pre-seeded in collagen before implantation. We utilized a mouse calvarial defect model and compared five groups of collagen scaffolds: a negative control of a collagen scaffold alone, a positive control treated with BMP-7, monocultures of either human osteoblasts (hOBs) or CD34+ cells, and a coculture of hOB and CD34(+) cells...
July 21, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28730322/orthopaedic-surgeons-opinions-surrounding-the-management-of-proximal-humerus-fractures-an-international-survey
#12
Lauren L Nowak, Milena R Vicente, Michael D McKee, Jeremy A Hall, Aaron Nauth, Emil H Schemitsch
PURPOSE: The purpose of this study was to survey surgeons' preferences surrounding the management and evaluation of proximal humerus fractures internationally. METHODS: A questionnaire was developed using previous literature and input from practicing orthopaedic surgeon opinion leaders. Between November 13, 2014 and December 31, 2014, the questionnaire was posted on the membership section of three major orthopaedic and shoulder surgery association websites. Survey responses were anonymous...
July 20, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28729799/evaluation-of-knowledge-among-general-dentists-in-treatment-of-traumatic-injuries-in-primary-teeth-a-cross-sectional-questionnaire-study
#13
Dhanalakshmi Ravikumar, Ganesh Jeevanandan, E M G Subramanian
OBJECTIVE: The purpose of the present study was to assess the knowledge of General dentist regarding the management of dental traumatic injuries of primary teeth. MATERIALS AND METHODS: A total of 100 general dentists were selected and a validated questionnaire was distributed among the dentist to assess their knowledge on treatment strategies regarding traumatized primary teeth. STATISTICAL ANALYSIS: Data were entered into SPSS version 20...
April 2017: European Journal of Dentistry
https://www.readbyqxmd.com/read/28729006/a-representative-assessment-of-the-management-of-open-fractures-of-the-lower-limb-within-uk-orthoplastic-centres-a-two-centre-audit-of-compliance-with-national-standards
#14
B Rymer, E O F Dimovska, D T S Chou, R Choa, B Davis, S Huq
BACKGROUND: Open fractures of the lower limb represent a complex and varied array of injuries. The BOAST 4 document produced by BAPRAS and the BOA provides standards on how to manage these patients, and NICE have recently produced additional guidance. We aimed to assess concordance with these standards in a large cohort representative of UK orthoplastic centres. METHODS: Patients admitted to the orthoplastic units at Norfolk and Norwich University Hospital and Royal Stoke University Hospital with open lower limb fractures between 2009 and 2014 were included...
July 11, 2017: Injury
https://www.readbyqxmd.com/read/28728260/-clinical-analysis-of-pacing-therapy-and-treatment-of-complications-during-follow-up-in-children
#15
P J Zhao, Y W Chen, F Li, Y Li, J P Yang, J J Wu
Objective: To analyze characteristics of permanent pacemaker implantation in children as well as treatment and prognosis of complications. Method: Clinical data of children who underwent endocardial or epicardial permanent pacemaker implantation between April 2000 and June 2016 in Shanghai Xinhua Hospital and Shanghai Children's Medical Center were analyzed retrospectively. These patients were discharged 5 days after implantation. Electrocardiogram, chest X ray, echocardiography and pacemaker programming were performed during follow-up...
July 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28722005/a-conservative-management-of-iatrogenically-damaged-distal-root-of-the-mandibular-second-molar
#16
Rashmi Bansal, Sonali Roy, Praveen Chandra, Anuraag Gurtu, Rahul Pandey
Trauma to the adjacent hard and soft tissue is the most common iatrogenic injury during extraction of the mandibular third molar. As every functional component of the dental arch is of prime importance in contemporary dental practice, the major concern must be in conserving the tooth and its structure as much as possible. The present case discusses the application of this conservative approach for management of iatrogenically damaged distal root of the mandibular second molar during extraction of impacted third molar, in which excessive guttering of alveolar bone and fractured apical third of distal root of 37 was observed radiographically...
May 2017: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
https://www.readbyqxmd.com/read/28721996/open-reduction-and-internal-fixation-screw-injury-retrospective-study
#17
Preetha Balaji, S M Balaji
BACKGROUND/AIMS: Open reduction and internal fixation (ORIF) is a standard surgical procedure in jaw trauma and in orthognathic surgery. Insertion of screws is a significant risk for accidental tooth root injury with varying outcomes. Contrary evidences are found in literature due to a variety of study designs. This study was undertaken to address the lacunae and possibly estimate the difference in occurrence of tooth damage during or after ORIF between trauma and planned osteotomies...
May 2017: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
https://www.readbyqxmd.com/read/28720988/non-surgical-management-of-acute-osteoporotic-vertebral-compression-fracture-a-review
#18
REVIEW
Bhavuk Garg, Vivek Dixit, Sahil Batra, Rajesh Malhotra, Alok Sharan
Osteoporosis is a major public health problem. Last decade has seen rise in osteoporotic vertebral fractures. Pragmatic management of osteoporotic VCF is challenging to the surgeons. In clinical settings, the situation becomes more complex when it comes to managing painful osteoporotic vertebral compression fractures (VCFs) due to various co-morbid factors that may limit aggressive interventions. Patients with Osteoporotic vertebral fractures are often characterized by general/relative immobility and physical frailty...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720985/conservative-management-of-odontoid-peg-fractures-long-term-follow-up
#19
REVIEW
Aheed Osman, Nabil A Alageli, D J Short, W S El Masri
OBJECTIVE: The aim of the study was to look at the long-term effects of conservative management of odontoid peg fractures. METHODS: We reviewed 48 consecutive patients with type II (32) and 16 type III, odontoid peg fractures. The clinical & radiological outcomes were assessed over an average period of follow up of 8 years. Union rate was determined and we discussed several factors that may affect it. Patients were treated conservatively with an average period of bed rest of 4 weeks followed by bracing for an average of 9 weeks...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720693/catastrophic-cervical-spinal-injury-in-an-amateur-college-wrestler
#20
Jayakrishnan Kelamangalathu Narayana Kurup, Ravitheja Jampani, Simanchal P Mohanty
A young amateur wrestler presented with a burst fracture of the seventh cervical vertebra with complete paraplegia. He was treated with surgery for spine stabilisation and was actively rehabilitated. Adolescents and teenagers are indulging in high-contact sports like wrestling, without proper training and technical know-how, which can lead to severe injuries and possibly, permanent handicap or death. Trainers, assistants and institutions should be well equipped to diagnose and provide initial care of people with a spinal injury to prevent a partial injury from progressing to complete injury...
July 18, 2017: BMJ Case Reports
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