Abstract:
INTRODUCTION:Osteoporosis and decreased bone density are known to increase fracture incidence and severity. Although much is known regarding the effects of bone density on fracture risk and the treatment options for prevention of fragility fractures, whether bone quality alters clinical outcomes after fracture fixation is unknown. The purpose of this study was to determine whether bone quality correlates with clinical outcomes after fracture fixation. MATERIALS AND METHODS:A prospective database of all operatively treated ankle fractures by a single surgeon from 2003 to 2013 was used to identify patients. All patients included in the study had preoperative computed tomography (CT) imaging of the injured ankle and postoperative CT imaging of the contralateral ankle. Hounsfield unit (HU) measurement values were determined by placing an elliptical region of interest confined to the cancellous metaphyseal region of the distal tibia and fibula. The primary and secondary clinical outcomes included Foot and Ankle Outcome Scores (FAOS) and ankle range of motion (ROM). Included patients had at least 12 months of clinical outcome data. RESULTS:Sixty-four patients met the inclusion criteria. Comparison of HU values from the injured and contralateral side demonstrated almost perfect agreement (ICC(2,1) = 0.938), suggesting that HU values can be accurately measured in the setting of a fracture. Increased HU values of the injured distal tibia and fibula significantly correlated with improved outcomes in four of five FAOS domains, including pain, activities of daily living, sports, and quality of life (beta = 0.285-0.344; P ≤ 0.05 for all). Range of motion outcomes did not significantly correlate with HU values. CONCLUSIONS:Our results suggest that decreased bone quality, as measured using preoperative CT, significantly correlates with inferior short-term clinical outcomes. These results have significant implications for integrating bone quality into treatment algorithms for fracture patients.
journal_name
Arch Orthop Trauma Surgjournal_title
Archives of orthopaedic and trauma surgeryauthors
Warner SJ,Garner MR,Fabricant PD,Lorich DGdoi
10.1007/s00402-018-3017-7subject
Has Abstractpub_date
2018-12-01 00:00:00pages
1653-1657issue
12eissn
0936-8051issn
1434-3916pii
10.1007/s00402-018-3017-7journal_volume
138pub_type
杂志文章abstract::In this paper, a case of closed medial subtalar dislocation and accompanying talar head fracture in a 22-year-old man which occurred while walking on a downhill road is reported. Closed reduction under general anesthesia was unsuccessful. The obstacle for closed reduction was determined at surgery for open reduction a...
journal_title:Archives of orthopaedic and trauma surgery
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journal_title:Archives of orthopaedic and trauma surgery
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doi:10.1007/s00402-016-2450-8
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journal_title:Archives of orthopaedic and trauma surgery
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00453143
更新日期:1990-01-01 00:00:00
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journal_title:Archives of orthopaedic and trauma surgery
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doi:10.1007/s004020100342
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journal_title:Archives of orthopaedic and trauma surgery
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doi:10.1007/s004020050011
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journal_title:Archives of orthopaedic and trauma surgery
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journal_title:Archives of orthopaedic and trauma surgery
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journal_title:Archives of orthopaedic and trauma surgery
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-014-2098-1
更新日期:2014-12-01 00:00:00
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journal_title:Archives of orthopaedic and trauma surgery
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journal_title:Archives of orthopaedic and trauma surgery
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-010-1144-x
更新日期:2011-04-01 00:00:00
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-010-1195-z
更新日期:2011-04-01 00:00:00
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020000227
更新日期:2001-06-01 00:00:00
abstract:INTRODUCTION:Preoperative femoral templating for total hip arthroplasty (THA) has been performed by antero-posterior radiographs of both hips which should be taken with the femur rotated internally to reduce the effect of femoral anteversion. However, there is no criterion to evaluate the optimal rotated radiograph. He...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0349-0
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
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更新日期:2010-08-01 00:00:00
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0557-7
更新日期:2008-12-01 00:00:00
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-011-1316-3
更新日期:2011-10-01 00:00:00
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-009-0834-8
更新日期:2009-12-01 00:00:00
abstract:INTRODUCTION:Approximately 10-15% of all fractures of long bones heal with delay, prolonged immobilization and repetitive operative interventions. Despite intense investigations, the pathomechanism of impaired healing of skeletal tissue remains unclear. An important role in the pathomechanism of mal-union of close frac...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
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更新日期:2011-02-01 00:00:00
abstract::Fractures of the posterior wall of the acetabulum form a special group in acetabular fractures. This study aims to evaluate the results in the management of such fractures. Thirty-two patients with fractures of posterior wall of acetabulum were reviewed retrospectively. The follow-up period was 7 (range 3-10) years. T...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00439052
更新日期:1996-01-01 00:00:00
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journal_title:Archives of orthopaedic and trauma surgery
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更新日期:2018-06-01 00:00:00
abstract:PURPOSE:The physical examination of the shoulder is usually not reliable for the true diagnosis of superior glenoid labrum anterior to posterior (SLAP) lesions. Magnetic resonance imaging (MRI) has been routinely used for the diagnosis. This prospective study investigates the radiological diagnosis of the SLAP lesions ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-016-2605-7
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:At present, the best treatment for primary patellar dislocation (PPD) has not been unified. Moreover, meta-analyses comparing the non-surgical and surgical treatments of PPD are lacking. Thus, we aimed to compare the clinical efficacy of surgical or non-surgical treatment of PPD. METHODS:Randomized controll...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,meta分析
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