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https://www.readbyqxmd.com/read/29667007/failure-in-diagnosis-and-under-treatment-of-osteoporosis-in-elderly-patients-with-fragility-fractures
#1
Sofia Bougioukli, Panagoula Κollia, Theodora Koromila, Sokratis Varitimidis, Michael Hantes, Theofilos Karachalios, Κonstantinos Ν Malizos, Zoe H Dailiana
We evaluated whether osteoporosis is adequately managed and treated in patients suffering from fragility fractures. Factors that influenced osteoporosis diagnosis and treatment rates were also assessed. To this end, patients with the principal diagnosis of low-energy hip, vertebral, or distal radius fractures were recruited for the study. Collected data included risk factors for osteoporosis, history of previous fractures, known history of osteoporosis, and osteoporosis treatment at the time of admission. The patients' prefracture risk profile was also assessed to determine whether osteoporosis could have been identified prior to the index fracture...
April 17, 2018: Journal of Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/29663104/treatment-goals-for-distal-radius-fractures-in-2018-recommendations-and-practical-advice
#2
REVIEW
F Loisel, M Bourgeois, T Rondot, J Nallet, M Boeckstins, S Rochet, G Leclerc, L Obert, D Lepage
The goals of distal radius fracture treatment in patients above 65 years of age would not change over time if the fracture were the only factor to consider. However, people change, and fixation methods also change. Since this fracture heals in nearly every case and volar plates have eliminated the worry of malunion, we are left with two main goals. In active patients with weakened bones, the aim is to help them regain their quality of life as quickly as possible while avoiding iatrogenic conditions. This compromise is possible because of new tools-but at what price?...
April 16, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29661687/impact-of-weight-loss-with-intragastric-balloon-on-bone-density-and-microstructure-in-obese-adults
#3
Eduardo Madeira, Miguel Madeira, Erika Paniago Guedes, Thiago Thomaz Mafort, Rodrigo Oliveira Moreira, Laura Maria Carvalho de Mendonça, Inayá Correa Barbosa Lima, Leonardo Vieira Neto, Paulo Roberto Alves de Pinho, Agnaldo José Lopes, Maria Lucia Fleiuss Farias
The historical concept that obesity protects against bone fractures has been questioned. Weight loss appears to reduce bone mineral density (BMD); however, the results in young adults are inconsistent, and data on the effects of weight loss on bone microstructure are limited. This study aimed to evaluate the impact of weight loss using an intragastric balloon (IGB) on bone density and microstructure. Forty obese patients with metabolic syndrome (mean age 35.1 ± 7.3 yr) used an IGB continuously for 6 mo...
March 21, 2018: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/29661068/correlation-between-radiological-parameters-and-functional-outcomes-in-patients-older-than-60-years-of-age-with-distal-radius-fracture
#4
Rodrigo Gutiérrez-Monclus, Héctor Gutiérrez-Espinoza, Jonathan Zavala-González, Cristian Olguín-Huerta, David Rubio-Oyarzún, Felipe Araya-Quintanilla
BACKGROUND: The relationship between radiographic and functional outcomes is controversial in the elderly. The objective of this study is to determine whether there is a correlation between functional outcome and acceptable distal radius fracture (DRF) alignment in patients older than 60 years of age. METHODS: This correlation study was carried out at the Central Metropolitan Health Service of Chile. A total of 180 patients diagnosed with extra-articular DRF, according to the AO classification, were prospectively recruited...
April 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29659886/bone-parameters-in-anorexia-nervosa-and-athletic-amenorrhea-comparison-of-two-hypothalamic-amenorrhea-states
#5
Nurgun Kandemir, Meghan Slattery, Kathryn E Ackerman, Shreya Tulsiani, Amita Bose, Vibha Singhal, Charumathi Baskaran, Seda Ebrahimi, Mark Goldstein, Kamryn Eddy, Anne Klibanski, Madhusmita Misra
Purpose: We have reported low bone mineral density (BMD), impaired bone structure, and increased fracture risk in anorexia nervosa (AN) and normal-weight, oligo-amenorrheic athletes (OA). However, data directly comparing compartment-specific bone parameters in AN, OA and controls are lacking. Methods: 426 females 14-21.9 years old were included; 231 AN, 94 OA and 101 normal-weight eumenorrheic controls. Dual energy x-ray absorptiometry was used to assess areal BMD (aBMD) of the whole body less head (WBLH), spine, and hip...
April 5, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29657475/incidence-of-tendon-rupture-following-volar-plate-fixation-of-distal-radius-fractures-a-survey-of-2787-cases
#6
Kotaro Sato, Kenya Murakami, Yoshikuni Mimata, Minoru Doita
This study assessed the comprehensive incidence of tendon rupture following volar locking plate (VLP) surgery for a large number of patients with distal radius fractures (DRFs) at multiple facilities in one prefecture, Japan. During the 4-year period, 2787 patients with DRFs underwent fixation using VLP. The overall incidence rates of rupture of the FPL, the extensor pollicis longus, the flexor digitorum profundus of the index finger, and the extensor digitorum communis were 0.35% (10 patients), 0.29% (8 patients), 0...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29657444/radial-axial-interosseous-load-rail-test-for-essex-lopresti-type-injuries
#7
REVIEW
Zachary C Lum, Eric G Huish, Marc A Trzeciak
Background: When approaching radial head and neck fractures, the decision for ORIF, resection, or arthroplasty is often performed intraoperatively. Factors that contribute include ligamentous and bony stability, cartilage injury, mechanical alignment as well as patient factors. Recent data has suggested conventional methods may not be sufficiently sensitive in detecting Essex Lopresti injuries. Here we describe an intraoperative technique that could objectively assess proximal radio-ulnar stability with subsequent disruption of the ligamentous structures...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29657441/percutaneous-upper-extremity-fracture-fixation-using-a-novel-glass-based-adhesive
#8
Paul Zalzal, Oleg Safir, Adel Alhalawani, Marcello Papini, Mark Towler
Objective: To develop a surgical technique for percutaneous upper extremity fracture fixation using a novel glass-based adhesive. Methods: Three intact upper extremity cadaveric specimens with undisturbed soft tissues were obtained. Two were used to model a wrist fracture, and the third to model a proximal humerus fracture. Fractures were produced using a small osteotome in a percutaneous fashion. Banna Bone Adhesive (BBA) was delivered to the fracture site percutaneously using a 16 gauge needle under bi-planar fluoroscopic guidance...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29644283/plating-of-an-isolated-fracture-of-shaft-of-ulna-under-local-anaesthesia-and-periosteal-nerve-block
#9
Amir Adham Ahmad, Mohammad Arshad Ikram
Isolated fractures of shaft of ulna are common. Plate fixation with anatomic reduction is thought to produce the best functional results in closed or open fractures. Surgery can be done under general and various types of regional anaesthesia. We report a case of fracture shaft of ulna treated by plating under a combination of WALANT (wide awake, local anaesthesia, no tourniquet) using tumescent anaesthesia and periosteal nerve block as a day care procedure.
December 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29643907/fixation-of-unstable-distal-radius-fractures-by-using-expandable-intramedullary-nailing-system-in-adult-patients
#10
Murat Calbiyik
Objective: To present our experience on intramedullary nailing device Sonoma Wrx (Sonoma Orthopedic Products Inc., Santa Rosa, CA, USA) used for internal fixation of extra-articular or simple intra-articular distal radius fractures in adult population. Methods: This study was conducted from February 2011 to October 2016. A total of 48 patients (mean age 47.3±5.6 years, 35.4% females) with distal radius fracture, who underwent intramedullary distal radius fixation by using Sonoma Wrx were included in this retrospective study...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29642947/absence-of-flexor-carpi-radialis-identified-during-volar-approach-for-fixation-of-distal-radius-fracture-a-case-report
#11
Tomoyo Irie, Makoto Motomiya, Norimasa Iwasaki
BACKGROUND: Volar locking plate fixation of distal radius fractures is commonly performed because of its good clinical outcomes. The flexor carpi radialis (FCR) approach is one of the most popular approaches to dissecting the volar side of the distal radius because of its simplicity and safety. We describe an extremely rare case of an absent FCR identified during a volar approach for fixation of a distal radius fracture. CASE PRESENTATION: A 59-year-old woman with distal radius fracture underwent surgery using the usual FCR approach and volar locking plate...
April 11, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29642719/impact-of-pharmacist-physician-collaboration-on-osteoporosis-treatment-rates
#12
Brandi L Bowers, Amy M Drew, Christian Verry
BACKGROUND: The vast majority of women at high risk for osteoporotic fractures are not treated, despite known significant clinical and economic consequences of this prevalent condition. To date, this is the first study of this size and duration to examine the role of pharmacists in management of osteoporosis in a family medicine clinic. OBJECTIVE: To compare the initiation or continuation of prescription antifracture therapy in high-risk patients with collaborative pharmacist-physician to physician-only management; secondarily, to evaluate recommendation rates for antifracture therapy and calcium and vitamin D...
April 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29628706/does-operative-fixation-of-isolated-fractures-of-ulna-shaft-results-in-different-outcomes-than-non-operative-management-by-long-arm-cast
#13
Altaf Hussain, Sandeep Kumar Nema, Deep Sharma, Sujiv Akkilagunta, Gopisankar Balaji
Objective: The optimal treatment for isolated fractures of ulnar shaft is debatable. The purpose of this study was to compare functional outcomes and radiological union in patients treated for isolated fractures of the ulnar shaft by open reduction and internal fixation and a long arm cast. Methods: This prospective study was conducted at level I trauma center from November 2014 to March 2016. 30 patients with isolated fractures of ulnar shaft were randomized to two groups to receive treatment by open reduction and internal fixation by plates and screws and a long arm cast...
March 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29626236/prospective-study-of-comminuted-articular-distal-radius-fractures-stabilized-by-volar-plating-in-the-elderly
#14
Daniel Martinez-Mendez, Alejandro Lizaur-Utrilla, Joaquin de Juan-Herrero
PURPOSE: The objective was to assess the ability of the volar locking plate to maintain the radiographic parameters over the time in elderly patients with complex intra-articular distal radius fractures. METHODS: Prospective cohort of 66 consecutive patients with mean age of 68 (range 60-81) years and AO type C fractures treated with volar locking plate. Radiographic measurements were performed pre and post-operatively at each follow-up. Clinical assessment was made by Patient-Rated Wrist Evaluation scores, Disabilities of the Arm, Shoulder and Hand score, range of motion, and grip strength...
April 7, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29624722/volumetric-bone-mineral-density-and-failure-load-of-distal-limbs-predict-incident-clinical-fracture-independent-of-frax-and-clinical-risk-factors-among-older-men
#15
Lisa Langsetmo, Katherine W Peters, Andrew J Burghardt, Kristine E Ensrud, Howard A Fink, Peggy M Cawthon, Jane A Cauley, John T Schousboe, Elizabeth Barrett-Connor, Eric S Orwoll
Our objective was to determine the associations of peripheral bone strength and microarchitecture with incident clinical and major osteoporotic fracture among older men after adjusting for major clinical risk factors. We used a prospective cohort study design with data from 1794 men (mean age 84.4 years) in the Osteoporotic Fractures in Men (MrOS) study. Eligible men attended the Year 14 visit, had high resolution peripheral quantitative computed tomography (HR-pQCT) scans of the distal radius and distal or diaphyseal tibia, DXA measured BMD, and were followed for mean 1...
April 6, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29621979/nordic-innovative-trial-to-evaluate-osteoporotic-fractures-nitep-group-non-operative-treatment-versus-surgery-with-volar-locking-plate-in-the-treatment-of-distal-radius-fracture-in-patients-aged-65-and-over-a-study-protocol-for-a-prospective-randomized-controlled
#16
Teemu P Hevonkorpi, Antti P Launonen, Lauri Raittio, Toni Luokkala, Juha Kukkonen, Aleksi Reito, Bakir O Sumrein, Minna K Laitinen, Ville M Mattila
BACKGROUND: In the literature, there are numerous studies that compare different surgical procedures in the treatment of distal radius fractures (DRF). It is, however, unknown whether operative treatment and better restoration of anatomy with volar locking plate yields a better functional outcome in the elderly population when compared with non-operative treatment. METHODS AND DESIGN: This study is a prospective, randomized, controlled, multi-center trial. The purpose will be to compare the non-operative and operative treatment of initially or early malaligned distal radius fractures in patients aged 65 and older...
April 5, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29619932/mortality-and-morbidity-in-patients-with-osteogenesis-imperfecta-in-denmark
#17
Lars Folkestad
Ostegenesis imperfecta (OI) is a hereditary disease of the connective tissue caused by mutations to, mainly, the genes that are involved in the biosynthesis of collagen type 1. Patients are grouped according to clinical severity and mode of inheritance according to Sillence's classification (originally 1979, updated 2014). According to our data, the population prevalence of OI in Denmark was 10.3 per 100,000, with 575 patients registered with an OI diagnosis in the National Patient Register and alive at the end of 2012 out of a total population of 5,602,628 persons...
April 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29618418/the-retinaculum-flap-for-dorsal-fixation-of-distal-radius-fractures
#18
REVIEW
Noémie Devaux, Julia Henning, Mathias Haefeli, Philipp Honigmann
In spite of the more popular volar approach for plating of distal radius fractures (DRFs), there are still indications for dorsal plating and even combined dorsovolar plating in complex DRFs. Dorsal plating carries a concern for complications such as tenosynovitis, extensor tendon adhesions, and delayed extensor tendon ruptures. These risks can be minimized by use of modern low-profile plates and the use of an extensor retinaculum flap to cover the distal plate and screws. We describe the technique of the dorsal retinaculum flap for dorsal plating of DRFs...
April 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29615100/ultrasonography-or-direct-radiography-a-comparison-of-two-techniques-to-detect-dorsal-screw-penetration-after-volar-plate-fixation
#19
Yunus Oc, Bekir Eray Kilinc, Anıl Gulcu, Ali Varol, Rodi Ertugrul, Adnan Kara
BACKGROUND: Complications related to extensor tendons have begun to increase with the use of volar plates in the treatment of distal radius fractures. In this study, we aimed to compare four-plane radiography and ultrasonography in the evaluation of dorsal cortex screw penetration following volar plate fixation. METHODS: We recruited 47 patients (33 males, 14 females, mean age 37.4 years; range 18-58 years). To evaluate dorsal screw penetration in all patients, we performed radiographs at 45° pronation, 45° supination and obtained dorsal tangential graphs at maximum palmar flexion, and a wrist lateral radiograph...
April 3, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29615032/the-impact-of-varus-angulation-on-proximal-fractures-of-the-ulna
#20
Xuchao Shi, Tianlong Pan, Dengying Wu, Rong Chen, Zeng Lin, Jun Pan
BACKGROUND: We studied anteromedial varus angulation (VA) in the proximal third of the ulna. The importance of restoration of the anatomical orientation of the ulnar after a proximal fracture is unclear. The purpose of this study was to evaluate the impact of minimal proximal ulna malunion on elbow function after a proximal ulna fracture. METHODS: We reviewed the follow-up of 60 patients who had undergone open reduction with internal fixation (ORIF) of a proximal fracture of the ulna...
April 4, 2018: BMC Musculoskeletal Disorders
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