20-year trends of distal femoral, patellar, and proximal tibial fractures: a Danish nationwide cohort study of 60,823 patients

Vestergaard, Veronique; Pedersen, Alma B; Tengberg, Peter Toft; Troelsen, Anders; Schrøder, Henrik Morville

doi:10.1080/17453674.2019.1698148

Cited by 25 publications

(30 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Court-Brown et al also recorded an increase in proximal tibial fractures for women with increasing age [ 2 ], and a Swedish registry study from 2018 demonstrated an increasing incidence of such fractures for women with increasing age [ 18 ]. Vestergaard et al showed similar results in their cohort study of over 60,000 patients [ 19 ]. A direct comparison of incidence rates in this work with those reported from other countries is not possible due to differences in study designs, data sources, time periods, and statistical methods.…”

Section: Discussionsupporting

confidence: 55%

Changing epidemiology of lower extremity fractures in adults over a 15-year period – a National Hospital Discharge Registry study

Hemmann¹,

Friederich

Körner³

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Demographic changes led to an increasingly ageing population in Germany and thus to possible changes in the frequency of fractures. The primary aim of this study was to report changes in fracture rates of the lower extremities in Germany in 2002 compared to 2017 and to evaluate those changes. Methods Inpatient data from the German National Hospital Discharge Registry (ICD10) for 2002 and 2017 were evaluated. Changes in total counts and incidence rates were analysed for fractures in the following locations: femoral neck, pertrochanteric, subtrochanteric, distal femur, femoral shaft, proximal and distal tibia, tibial shaft, medial and lateral malleolus, and other parts of the lower leg (including bi- and trimalleolar fractures), calcaneus, talus, other tarsal bones, metatarsal bones, greater toe, lesser toe, other fractures of foot or unspecific fractures of foot and toe. Patients were classed into age groups by sex: 15–24, 25–34,35–44, 45–54, 55–64, 65–74, 75–84, 85–90 and > 90 years. Results The total count for lower extremity fractures in men and women increased slightly by 4.5% from 305,764 in 2002 to 319,422 in 2017. Hip and femur fractures increased by 23.5% from 150,565 in 2002 to 185,979 in 2017. The number of these fractures among men increased by 46% and among women by 15.3%. The total count of lower leg fractures decreased by 15.4% from 131,162 in 2002 to 110,924 in 2017. Especially, younger age groups showed a decline for all tibial segments and ankle fractures. For both sexes, the number of lower leg fractures in those 75 years or older increased in all lower leg fracture locations. Most femur and lower leg fractures occurred in women. The incidence of fractures rose sharply from 2002 to 2017, especially for older cohorts. Conclusion The total numbers of lower extremity fractures increased slightly in 2017 compared to 2002 – especially hip and femur fractures among men. The incidence of almost all lower extremity fracture types among older people increased during this time. Women were particularly affected. Therefore, focused prevention programmes should be considered including an extended fracture spectrum in the elderly.

show abstract

Section: Discussionsupporting

confidence: 55%

Changing epidemiology of lower extremity fractures in adults over a 15-year period – a National Hospital Discharge Registry study

Hemmann¹,

Friederich

Körner³

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…The American Academy of Orthopedic Surgeons and the Pediatric Orthopedic Society of North America [ 4 , 5 ] suggest that treatment for femoral shaft fractures in children under the age of 5 years should involve a Pavlik harness, a spica cast, or skeletal traction. For school-aged children or even younger patients, elastic intramedullary nail (EIN) fixation is the first choice and becoming increasingly accepted by most surgeons [ 6 – 8 ]. However, external fixation (EF) may still be used when EIN is not a suitable option, such as with open fixation, multiple fractures, femoral fractures with severe skins lesions, patient weight over 50 kg, proximal or distal humeral fractures that EIN fixation cannot fix [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for refracture of the femoral shaft in children after removal of external fixation

Guo

2021

J Orthop Traumatol

View full text Add to dashboard Cite

Background External fixation is the primary treatment option in children for femoral shaft fractures, such as open femoral or multiple fractures. One complication is refracture, which is the biggest limitation of fixation devices. This study aims to investigate the risk factors associated with refracture after the removal of external fixation devices and decrease the frequency of refracture. Materials and methods Retrospectively reviewed clinical data of 165 patients treated at our hospital for fresh femoral shaft fractures with external fixation between May 2009 and February 2018 were included in this study. Patients with pathological fractures, fractures of the femoral neck, fractures that were fixed using plates or elastic stable intramedullary nailing, and old fractures, as well as those who underwent postoperative femoral surgery were excluded. Potential risk factors included: patient age, gender, and weight, fracture sides, open or closed fracture, fracture sites, reduction methods, operation time, perioperative bleeding, number and diameter of the screws, and immobilization time. These factors were identified by univariate and logistic regression analyses. Results Femoral shaft refracture developed in 24 patients. Univariate analysis revealed that refracture was not statistically significantly associated with any of the above factors, except AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF) classification type 32-D/4.2 and L2/L3 ratio (L2, length of femur fixed by the two screws farthest from the fracture line; L3, the total length from the greater trochanter to the distal end of femur; P < 0.001 and P = 0.0141, respectively). Multivariate analysis showed that PCCF classification type 32-D/4.2 and L2/L3 ratio were also independent risk factors for femoral refracture. Conclusions Femoral shaft refracture is relatively common in children treated with external fixation. Because of the limited number of cases in this study, we cautiously concluded that the PCCF classification type 32-D/4.2 and L2/L3 ratio were independent risk factors for femoral shaft refracture in these patients. Level of evidence IV

show abstract

“…Kang et al have reported that early postnatal exposure to isoflurane causes cognitive deficits [ 22 ]. Second, although most of the patients opted for the minimally-invasive ESIN, they had to be prepared for an open reduction in case closed reduction by ESIN insertion failed [ 1 , 2 ]. Most physicians agree that conservative treatment achieves lower non-union rates compared to surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment for FSF depends on the age of the patient. The Pavlik harness is the first choice of treatment for patients under the age of 6 months [ 1 , 2 ]. For patients over 6 months and younger than 6 years of age (preschool children), closed reduction and casting are widely accepted by most surgeons and patients due to their good outcomes.…”

Section: Introductionmentioning

confidence: 99%

Surveillance ultrasonography for conservative treatment of femoral shaft fractures in young children

Gao

Wang

2020

J Orthop Surg Res

View full text Add to dashboard Cite

Background The treatment for femoral shaft fracture (FSF) depends on the age of the patient. While the Pavlik harness is the first choice for patients under 6 months of age, spica casting is preferred for patients over 6 months and under preschool age. Minimally-invasive surgery using elastic stable intramedullary nails is also used in some cases. Skin traction is another treatment choice for some patients who are not candidates for the above methods. This study aimed to evaluate the feasibility of surveillance ultrasonography (US) for the conservative treatment of FSFs in young children. Materials and methods This retrospective study included 92 children who were diagnosed with FSF in our hospital from April 2017 to May 2019. After applying the inclusion and exclusion criteria, they were divided into US surveillance (A) and control (B) groups. All patients received conservative treatment by skin traction. For group A, US was used to assess the femur fractures and adjust its reduction on days 1, 3, 5, 7, 10, and 14 until the fracture stabilized. For group B, the fractures were checked by radiographs on days 1, 3, 5, 7, 10, and 14 until the callus appeared. The FSF angle was measured using anteroposterior and lateral radiographs. Results All patients were followed up for 18 months. The radiographic evaluation of both groups at the final follow-up showed a significant difference in the FSF angle. The radiograph times and accumulated radiation also showed significant differences between the two groups. However, there was no significant difference in the incidence of complications. Conclusions For FSF closed reduction, surveillance US is a better option compared to radiographs in children treated by skin traction. This approach can significantly decrease exposure to X-ray radiation and improve the reduction. Level of evidence III

show abstract

20-year trends of distal femoral, patellar, and proximal tibial fractures: a Danish nationwide cohort study of 60,823 patients

Cited by 25 publications

References 18 publications

Changing epidemiology of lower extremity fractures in adults over a 15-year period – a National Hospital Discharge Registry study

Changing epidemiology of lower extremity fractures in adults over a 15-year period – a National Hospital Discharge Registry study

Risk factors for refracture of the femoral shaft in children after removal of external fixation

Surveillance ultrasonography for conservative treatment of femoral shaft fractures in young children

Contact Info

Product

Resources

About