دورية أكاديمية
أعرض في EDS

Analysis of Postoperative Distal Radius Fracture Outcomes in the Setting of Osteopenia and Osteoporosis for Patients with Comorbid Conditions.

التفاصيل البيبلوغرافية
العنوان: Analysis of Postoperative Distal Radius Fracture Outcomes in the Setting of Osteopenia and Osteoporosis for Patients with Comorbid Conditions.
المؤلفون: Tuaño KR; Division of Plastic and Reconstructive Surgery, University of Colorado Hospital, Denver, CO., Fisher MH; Medical Scientist Training Program, University of Colorado Anschutz Medical Campus, Aurora, CO., Lee N; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO., Khatter NJ; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO., Le E; Division of Plastic and Reconstructive Surgery, University of Colorado Hospital, Denver, CO., Washington KM; Division of Plastic and Reconstructive Surgery, University of Colorado Hospital, Denver, CO., Iorio ML; Division of Plastic and Reconstructive Surgery, University of Colorado Hospital, Denver, CO.
المصدر: Journal of hand surgery global online [J Hand Surg Glob Online] 2023 May 20; Vol. 5 (5), pp. 601-605. Date of Electronic Publication: 2023 May 20 (Print Publication: 2023).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101759126 Publication Model: eCollection Cited Medium: Internet ISSN: 2589-5141 (Electronic) Linking ISSN: 25895141 NLM ISO Abbreviation: J Hand Surg Glob Online Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [New York] : Elsevier Inc., [2019]-
مستخلص: Purpose: Distal radius fractures (DRFs) are among the most common orthopedic injuries, especially in the elderly. A wide variety of approaches have been advocated as successful treatment modalities; yet, there remains variability in practice patterns of DRF in patients with osteoporosis and osteopenia. Using large data set analysis, we sought to determine the risk profile of operative fixation of DRF in patients with low bone mineral density.
Methods: A commercially available health care database, PearlDiver, was queried for all patients who underwent open reduction internal fixation of DRFs between 2010 and 2020. The study population was divided into groups based on the presence or absence of osteopenia or osteoporosis and was further classified by patients who were receiving bisphosphonate therapy. Complication rates were calculated, including rates of malunion, surgical site infection, osteomyelitis, hardware failure, and hardware removal. Five-year future fragility fractures were defined in hip, vertebrae, humerus, and wrist fractures. Chi-square analysis and logistic regression were performed to determine an association between these comorbidities and various postoperative complications.
Results: A total of 152,926 patients underwent open reduction internal fixation of a DRF during the study period. Chi-square analysis of major complications at 3 months showed a statistically significant increase in malunion in patients with osteopenia ( P  = .05) and patients with osteoporosis ( P  = .05) who underwent open reduction internal fixation. Logistic regression analysis at 12 months after surgery demonstrated that osteopenia was associated with an increased risk of hardware failure ( P < .0001), hardware removal ( P < .0001), surgical site infection ( P < .0001), and malunion ( P  = .004). Osteoporosis was associated with a significantly increased risk of hardware failure ( P  = .01), surgical site infection ( P < .0001), and malunion ( P < .0001).
Conclusions: We demonstrated, using large data set analysis, that DRF patients with osteopenia and osteoporosis are predicted to be at increased risk of multiple postoperative complications, and thus, bone density should be strongly considered in treatment planning for these patients.
Type of Study/level of Evidence: Prognostic III.
(© 2023 The Authors.)
References: J Bone Joint Surg Am. 2009 Sep;91(9):2086-93. (PMID: 19723984)
Clin Orthop Relat Res. 2009 Jun;467(6):1612-20. (PMID: 19082864)
Clin Orthop Surg. 2020 Mar;12(1):9-21. (PMID: 32117533)
J Bone Joint Surg Am. 2009 Aug;91(8):1837-46. (PMID: 19651939)
Hand Clin. 2012 May;28(2):113-25. (PMID: 22554654)
Microorganisms. 2022 Sep 26;10(10):. (PMID: 36296182)
J Hand Surg Am. 2012 Oct;37(10):2027-34. (PMID: 22938805)
Acta Orthop. 2007 Apr;78(2):271-7. (PMID: 17464618)
Arch Bone Jt Surg. 2017 Nov;5(6):380-383. (PMID: 29299492)
J Hand Surg Am. 2018 Aug;43(8):720-730. (PMID: 29908931)
J Arthroplasty. 2019 Jan;34(1):116-122. (PMID: 30337254)
J Hand Surg Am. 2011 Aug;36(8):1282-7. (PMID: 21705154)
J Hand Surg Am. 2011 Dec;36(12):1912-8.e1-3. (PMID: 22123045)
PM R. 2010 Sep;2(9):799-805. (PMID: 20869677)
J Hand Surg Am. 2012 Aug;37(8):1718-25. (PMID: 22763062)
Curr Rev Musculoskelet Med. 2019 Mar;12(1):50-56. (PMID: 30706284)
J Bone Joint Surg Am. 2007 Sep;89 Suppl 2 Pt.2:256-66. (PMID: 17768220)
J Bone Joint Surg Am. 2009 Mar 1;91(3):613-9. (PMID: 19255221)
Osteoporos Int. 2021 Jul;32(7):1395-1404. (PMID: 33479844)
Osteoporos Int. 2005 Mar;16 Suppl 2:S80-4. (PMID: 15614440)
Clin Orthop Relat Res. 2005 Jun;(435):219-25. (PMID: 15930942)
Injury. 2006 Aug;37(8):691-7. (PMID: 16814787)
J Orthop Surg Res. 2017 Jul 19;12(1):116. (PMID: 28724387)
Osteoporos Int. 1999;9(6):469-75. (PMID: 10624452)
Cureus. 2019 Aug 6;11(8):e5328. (PMID: 31598435)
Eur J Trauma Emerg Surg. 2009 Jun;35(3):281-6. (PMID: 26814905)
Front Endocrinol (Lausanne). 2021 Aug 30;12:688269. (PMID: 34526966)
Osteoporos Int. 2002 Oct;13(10):824-8. (PMID: 12378372)
J Orthop Trauma. 2008 Sep;22(8 Suppl):S126-30. (PMID: 18753889)
JAMA Netw Open. 2020 Jan 3;3(1):e1919433. (PMID: 31951273)
Orthopade. 2017 May;46(5):447-450. (PMID: 28258366)
J Hand Surg Am. 2001 Sep;26(5):908-15. (PMID: 11561245)
J Hand Surg Am. 2008 Mar;33(3):421-9. (PMID: 18343302)
Bone Rep. 2021 Aug 16;15:101117. (PMID: 34458509)
Epidemiology. 1996 Nov;7(6):612-8. (PMID: 8899387)
Orthopedics. 2014 Oct;37(10):e866-78. (PMID: 25275973)
J Bone Joint Surg Am. 2006 Dec;88(12):2687-94. (PMID: 17142419)
J Orthop Trauma. 2015 Aug;29(8):e242-4. (PMID: 25714441)
فهرسة مساهمة: Keywords: Distal radius; Fragility fracture; ORIF; Osteopenia; Osteoporosis
تواريخ الأحداث: Date Created: 20231004 Latest Revision: 20231005
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10543796
DOI: 10.1016/j.jhsg.2023.04.005
PMID: 37790836
قاعدة البيانات: MEDLINE
الوصف
تدمد:2589-5141
DOI:10.1016/j.jhsg.2023.04.005