Concept: Bone fractures
Hip fractures are associated with diminished quality of life and survival especially amongst the elderly.
To study whether antidepressant use is associated with an increased risk of hip fracture among community-dwelling persons with and without Alzheimer’s disease (AD), and to compare the risk according to duration of use and between antidepressant groups.
Osteoporotic hip fractures present a significant global challenge to patients, clinicians and healthcare systems. It is estimated that hip fracture accounts for 1.4% of total social and healthcare costs in the established market economies.
- The Journal of clinical endocrinology and metabolism
- Published over 6 years ago
Context: Celiac disease (CD) is associated with an increased fracture risk, an increase that persists after diagnosis. A significant proportion of patients with CD have persistent villous atrophy (VA) on follow-up biopsy. Objective: The objective of the study was to determine whether persistent VA impacts long-term fracture risk. Design: This was a cohort study. Setting and Patients: We identified all patients in Sweden with histological evidence of CD who underwent a follow-up biopsy and compared patients with persistent VA with those with mucosal healing. Main Outcome Measures: The following were measured: 1) any fracture; 2) likely osteoporotic fracture (defined as fractures of the hip, distal forearm, thoracic and lumbar spine, or proximal humerus); and 3) hip fracture. Results: Of 7146 patients, VA was present on follow-up biopsy in 43%. There was no significant association between persistent VA and overall fractures [hazard ratio (HR) of persistent VA compared with those with healing 0.93, 95% confidence interval (CI) 0.82-1.06] or with likely osteoporotic fractures (HR 1.11, 95% CI 0.84-1.46). Persistent VA was associated with an increased risk of hip fracture (HR 1.67, 95% CI 1.05-2.66). Hip fracture risk increased, depending on the degree of VA (HR for partial VA compared with those with healing 1.70, 95% CI 0.82-3.49, HR for subtotal/total VA compared with those with healing 2.16, 95% CI 1.06-4.41). Conclusions: Persistent VA on follow-up biopsy is predictive of hip fracture risk. The association between persistent VA and hip fractures, but not fractures overall, implies that thinner sc tissue and fall or trauma may be mechanisms by which persistent VA confers an increased fracture risk.
Effects of Teriparatide Compared with Risedronate on Recovery After Pertrochanteric Hip Fracture: Results of a Randomized, Active-Controlled, Double-Blind Clinical Trial at 26 Weeks
- The Journal of bone and joint surgery. American volume
- Published over 3 years ago
Osteoporosis drugs might affect fracture-healing. We therefore studied the effects of teriparatide in comparison with risedronate on recovery after pertrochanteric hip fractures.
Flexor tendon injuries following plate fixation of distal radius fractures: a systematic review of the literature
- Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology
- Published about 7 years ago
BACKGROUND: Flexor tendon rupture is a rare but major complication associated with volar plate fixation of distal radius fractures. MATERIALS AND METHODS: We performed a systematic review to evaluate the demographics, clinical profile, treatment and outcome of flexor tendon rupture following volar plate fixation of distal radius fracture. Electronic searches of the MEDLINE, EMBASE, and Cochrane databases for systematic reviews and conference proceedings were performed. Studies were included if they reported flexor tendon rupture (partial or complete) as a complication of distal radius fracture plating (all levels of evidence). RESULT: Our search yielded 21 studies. There were 12 case reports and 9 clinical studies. A total of 47 cases were reported. There were 11 males and 23 females (n = 16 studies). The mean age was 61 years old (range 30-85). The median interval between the surgery and flexor tendon rupture was 9 months (interquartile range, 6-26 months). Twenty-nine plates were locking and 15 were nonlocking (n = 20 studies). FPL was the most commonly ruptured tendon (n = 27 cases, 57 %), with FDP to index finger being the second most common (n = 7 cases, 15 %). Palmaris longus tendon graft and primary end-to-end repair were the most common surgical methods used in cases of FPL tendon rupture. CONCLUSION: Flexor tendon rupture is a recognised complication of volar plating of distal radius fracture. Positioning of the plate proximal to the “watershed” line and early removal of the plate in cases with plate prominence or warning symptoms can reduce the risk of this complication.
This review focuses on the use of peripheral nerve blocks as preoperative analgesia, as postoperative analgesia, or as a supplement to general anesthesia for hip fracture surgery and tries to determine if they offer any benefit in terms of pain on movement at 30 minutes after block placement, acute confusional state, myocardial infarction/ischemia, pneumonia, mortality, time to first mobilization, and cost of analgesic.
Many surgeons currently use long cephomedullary nails for the treatment of intertrochanteric fractures. The optimal indications for deploying distal interlocks are still debatable. This study examined the torsional biomechanical properties of 3-part intertrochanteric femur fractures in a cadaveric bone model using two different distal fixation strategies, an unlocked long cephalomedullary nail versus a dynamically locked nail. Our hypothesis is that a long cephalomedullary nail does not require distal locking fixation when used for treatment of a 3-part intertrochanteric fracture.
Although a number of studies showed a lower risk of hip fractures with high-quality diets, few of them were conducted in the United States.
With an ageing population, the burden of hip fractures is expected to increase in the coming decades. Older individuals with hip fracture are more than 3.5 times more likely to die within 12 months compared to non-injured individuals. The main priority for reducing mortality should be prevention of hip fracture.