Orthopedics Commons^™

Comparison Of Osteoporosis Pharmacotherapy Fracture Rates: Analysis Of A Marketscan® Claims Database Cohort, Alan W. Reynolds, Guodong Liu, Paul T. Kocis, Jenna N. Skowronski, Douglas L. Leslie, Edward J. Fox

Student Papers, Posters & Projects

Background: Several different classes of medications have been shown to be efficacious at preventing fractures in patients with osteoporosis. No study has compared real world efficacy at preventing fractures between all currently approved medications.

Objectives: To directly compare the efficacy of all currently available osteoporosis medications by using a large population claims database.

Methods: The Truven Health Analytics MarketScan® database from 2008 - 2012 was used to identify all patients who started a new osteoporosis medication. Patients who experienced a fracture after at least 12 months of treatment were identified and risk factors for fracture for all patients were recorded. …

Do Non-Steroidal Anti-Inflammatory Drugs Increase The Risk For Non- Or Mal-Union Following Acute Fracture? A Literature Review, Bryan Moritz

Theses and Graduate Projects

NSAID medications are among the most commonly used analgesic medications world wide, and it was estimated in 2010 (updated 2015 data is expected to be published next year) that about 29 million adults in the United States regularly used NSAID medications at least three times per week for more than three months. Fracture healing has been shown to be dependent on the inflammatory cascade. NSAID medication use appears to have a mechanistic in-vivo and in-vitro animal risk for the development of non- and mal-union following fracture. However, human data is lacking to support total avoidance of this analgesic option for …

Lateral Versus Dorsal Plating For Treating Metacarpal And Phalanx Fractures: A Retrospective Cohort Study, Joshua W. Hustedt, Collin C. Barber, Michael Bonnelli, Lloyd P. Champagne

UNM Orthopaedic Research Journal

Background: The purpose of this study was to investigate the differences between the dorsal and lateral plate position for metacarpal and phalanx fractures.

Methods: We conducted a retrospective review of prospectively collected patient data for 186 fractures treated by a single surgeon between 2009 and 2011. Rates of plate removal, total arc of postoperative motion (TAM), and patient and injury demographics were tested for association with plating position.

Results: Increasing age, larger plates, and dorsal plating were found in univariate analysis to be associated with decreased TAM and increased plate removal in phalanx but not in metacarpal fractures.

Conclusions: These …

Determining Frequency And Defining The Patient Profile Of Sacral Insufficiency Fractures, Blake Obrock, Jeremy Wearn, Matthew L. Dehart, Paxton Gehling, Amer M. Mirza

UNM Orthopaedic Research Journal

Background: Insufficiency fractures at the sacrum represent a considerable cause of low back pain and disability within the geriatric population. However, there has never been a large-scale study examining the epidemiologic trends associated with the disease, and thus this condition has been largely under recognized.

Methods: This study analyzed a Nationwide Inpatient Sample (NIS) database to trend frequency and burden of sacral insufficiency fractures (SIF). All inpatient stays from 1998 to 2010 noted on the NIS were included if the case maintained at least one or more diagnostic code. A total of 257,697 unique admissions (63% women, 37% men) met …

Sciatic Nerve Palsy After Operative Treatment Of Subtrochanteric Femur Fracture Resulting From Postoperative Hematoma: A Case Report, Tony G. Pedri, Gehron P. Treme

UNM Orthopaedic Research Journal

Treatment of subtrochanteric femur fractures can be difficult owing to high risk of complications. No cases of sciatic nerve palsy after hematoma following open reduction and intramedullary nailing of a subtrochanteric femur fracture have been reported. We describe a 28-yearold man who presented with a subtrochanteric fracture in the left femur after a motor-vehicle collision, in whom open reduction and intramedullary nailing led to an immediate postoperative hematoma and sciatic nerve palsy. Prompt diagnosis and early wound exploration resulted in complete resolution of the palsy at 1 month postoperatively. Our findings reinforce the importance of prompt diagnosis and treatment in …

Vitamin D Supplementation: Preventing Fractures, Courtney L. Carn, Michael S. Doherty

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the ability of vitamin D supplementation in preventing musculoskeletal fractures. Methods: Systematic literature review using Google Scholar search terms “vitamin D supplementation” and “preventing hip fractures” from 2006-2015. Only RCTs, meta-analysis, and clinical guidelines were included. Results: Our search resulted in one meta-analysis and two randomized controlled trials. Conclusion: The summation of our investigation into vitamin D deficiency and the presence of musculoskeletal fractures has proven to be relatively inconclusive. The resulting data from our three studies did not provide any definitive proof that improved vitamin D levels correlates with better bone health.

Fracture Burden And Risk Factors In Childhood Ckd: Results From The Ckid Cohort Study., Michelle R. Denburg, Juhi Kumar, Thomas Jemielita, Ellen R. Brooks, Amy Skversky, Anthony A. Portale, Isidro B. Salusky, Bradley A. Warady, Susan L. Furth, Mary B. Leonard

Manuscripts, Articles, Book Chapters and Other Papers

Childhood chronic kidney disease (CHD) poses multiple threats to bone accrual; however, the associated fracture risk is not well characterized. This prospective cohort study included 537 CKD in Children (CKiD) participants. Fracture histories were obtained at baseline, at years 1, 3, and 5 through November 1, 2009, and annually thereafter. We used Cox regression analysis of first incident fracture to evaluate potential correlates of fracture risk. At enrollment, median age was 11 years, and 16% of patients reported a prior fracture. Over a median of 3.9 years, 43 males and 24 females sustained incident fractures, corresponding to 395 (95% confidence …

Periprosthetic Fractures Of The Femur After Total Hip Arthroplasty And Hemiarthroplasty: A Review, Reilly R. Kuehn

UNM Orthopaedic Research Journal

Periprosthetic fractures of the femur after total hip arthroplasty (THA) and hemiarthroplasty represent relatively uncommon but challenging complications. The incidence of these types of fractures has been rising, owing to an increasing number of hip arthroplasties performed, aging population, and prevalent use of uncemented stems, which may have unsuccessful long-term results compared with use of cemented stems. Method of treatment has been generally based on the Vancouver classification system that describes radiographic characteristics of fractures and stability of the femoral stems in respect to placement in the bone. In particular, the presence of loose stems has often indicated the need …

Treatment Of Injuries And Conditions Of The Distal Clavicle: A Review, Heather M. Menzer

UNM Orthopaedic Research Journal

Several trauma-related injuries and degenerative conditions affect the distal end of the clavicle. Fractures of the distal clavicle and separations of the acromioclavicular (AC) joint are common, resulting from direct impact onto the shoulder region. Osteolysis and osteoarthritis of degenerative processes of the AC joint are caused by repetitive activity and overuse of the shoulder. To help identify options for treating the distal end of the clavicle, this review highlighted notable anatomical locations and biomechanics; findings of physical examinations; classification systems of injuries; and standard operative and nonoperative methods used for treatment. Although distal clavicle fractures, AC joint separations, osteolysis, …

Prophylaxis Against Heterotopic Ossification After Elbow And Acetabular Fractures — Do We Really Need It, Rizwan Haroon Rashid, Irfan Qadir, Waseem Ahmed, Masood Umer

Department of Surgery Docs

Abstract

OBJECTIVE:

To compare the efficacy and safety of prophylactic modalities for heterotopic ossification prevention after elbow and acetabular surgeries.

METHODS:

The retrospective chart review was conducted at the Aga Khan University Hospital and comprised record of patients who underwent open reduction and internal fixation for elbow and acetabular fractures between 2010 and 2013. Data was classified into three groups: Group A patients had received single dose of radiotherapy; Group B patients had received indomethacin, and Group C patients had not received any prophylaxis. Outcome variables included time-to-fracture healing, heterotopic ossification, non-union and wound infection.

RESULTS:

Of the 104patients 70(67.3%) …

Open Reduction And Internal Fixation For Treatment Of Proximal Humerus Fractures: A Review, Heather K. Woodin

UNM Orthopaedic Research Journal

Fractures of the proximal humerus are common in older patients, and the incidence of these fractures in the United States is expected to notably increase with the aging population. Nonoperative procedures have been preferred in elderly patients with stable fracture patterns to avoid complications associated with osteoporotic bone. However, more complex and unstable fracture patterns often necessitate operative techniques to allow for more anatomical healing. Although proximal humerus fractures have been thoroughly examined, systemized, and studied, no clear method to choosing an appropriate surgical treatment or candidate has been accepted. I reviewed the role of the following factors on successful …