Epidemiology of adult fractures: A review

Court-Brown, Charles M.; Caesar, Ben

doi:10.1016/j.injury.2006.04.130

Cited by 2,829 publications

(1,895 citation statements)

References 12 publications

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“…Thus, our study may not be able to resolve small differences in ROM between patient subgroups. Bone mineral density would have been useful [7,26,47], but was not available at the time of followup.…”

Section: Discussionmentioning

confidence: 99%

Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

Synn

Makhni

et al. 2008

Clin Orthop Relat Res

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The relationship between radiographic and functional outcomes in older patients with distal radius fractures is controversial. We explored this relationship by assessing the influence of radiographic displacement and fracture comminution on the functional outcomes of these fractures. We also asked whether operative intervention and demographic factors (age, gender, duration of followup) influenced outcome. We examined 53 patients older than 55 years with distal radius fractures with various functional assessments: range of motion (ROM) and strength measurements, three subjective surveys (Disabilities of the Arm, Shoulder, and Hand; Patient-rated Wrist Evaluation; Modernized Activity Subjective Survey of 2007), a Gartland and Werley score, and an objective, standardized hand performance test (Jebsen-Taylor). We measured angulation, articular gap/stepoff, and radial shortening on final radiographs and fracture comminution of preoperative radiographs. We observed no effect of radiographic displacement on subjective or objective outcome assessments, including standardized hand performance timed testing. Surgically treated fractures were less likely to display residual dorsal angulation and radial shortening, but surgical intervention did not independently predict functional outcome. Fracture comminution, patient gender, and months of followup similarly had no effect on outcome. We found no relationship between anatomic reduction as evidenced by radiographic outcomes and subjective or objective functional outcomes in this older patient cohort.

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Section: Discussionmentioning

confidence: 99%

Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

Synn

Makhni

et al. 2008

Clin Orthop Relat Res

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“…Ankle fractures represent approximately 10 % of all fractures and are among the most frequently encountered surgically treated fractures [10]. The incidence of ankle fractures has increased up to 300 % in the last 30 years, especially in the elderly population [3,16].…”

Section: Introductionmentioning

confidence: 99%

The timing of ankle fracture surgery and the effect on infectious complications; A case series and systematic review of the literature

Schepers

Vries

Lieshout

et al. 2013

International Orthopaedics (SICOT)

145

105

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Purpose Information about the influence of delayed surgery on infectious wound complications is ambiguous. A clinical audit was performed to test the hypothesis that early surgery lowers the rate of infectious wound complications. Secondly we looked at the influence of surgical delay and complications on patient reported functional outcome. Methods All consecutive, closed distal fibular fractures treated surgically with a plate were included and retrospectively analysed for the delay in operation and wound complications. In a second cohort of patients with a AO-Weber Btype ankle fracture outcome was measured using the OlerudMolander ankle score (OMAS), the American Orthopaedic Foot and Ankle Society score (AOFAS) and a visual analog score (VAS) for overall satisfaction. Results Patients treated within one day experienced no wound complications (zero out of 60), whereas in the delayed group 11 % (16/145) did (p=0.004). A similar significant difference was found for the patients treated within one week (2/98) versus after one week (14/107). A systematic review of the literature showed a difference in wound complications of 3.6 % (early) versus 12.9 % (late) (p<0.0001). After 43 months, the median AOFAS was 11.5 points lower in the complication group, the OMAS 10 points, and the VAS 0.5 points, with all differences being statistically significant. Conclusions Every effort should be made to operate on closed ankle fractures as soon as reasonably possible. A delay in surgery is associated with a significant rise in infectious wound complications, which significantly lowers outcome and patient satisfaction. These fractures should preferably be treated within the first day.

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“…Fractures of the proximal humerus are among the most common fractures encountered in clinical practice, particularly in patients with osteoporosis [3,2,9]. Classic teaching mandates that these injuries undergo a thorough and appropriate plain radiographic evaluation by means of the shoulder trauma series.…”

Section: Introductionmentioning

confidence: 99%

The Axillary View Typically Does Not Contribute to Decision Making in Care for Proximal Humeral Fractures

Berkes

Dines

Birnbaum

et al. 2015

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Convention dictates that an axillary view be obtained when evaluating proximal humerus fractures (PHF). However, the axillary view is frequently omitted because of pain and technical considerations. Furthermore, its diagnostic utility is unclear in this setting. Questions/Purposes: The purpose of this study was to (1) determine the rate of obtaining an adequate axillary X-ray and complete shoulder series at a level I trauma center, (2) understand the cost of ordering and attempting an axillary radiograph, and (3) determine if axillary radiographs influence the management of PHF. Patients and Methods: PHF treated between 2009 and 2011 that were ordered for an AP, scapular Y, and axillary view was identified. The types of radiographs actually obtained were recorded. The cost of obtaining three views and a single view of the shoulder with X-ray was determined. Lastly, three surgeons reviewed 42 PHF, both with and without an axillary view (AV), and treatment recommendations were compared. Results: 30% of PHF in this series had an adequate axillary view, and 14% received a complete trauma series. No factors could be identified that were associated with successfully obtaining an axillary view. Reviewers demonstrated substantial intraobserver reliability (κ=0.759-0.808) regarding treatment recommendations for PHF with and without the axillary view. The addition of the AV had minimal influence on treatment recommendations. Conclusion: Considering that the axillary view for PHF is painful, labor-intensive, costly, and does not appear to provide additional diagnostic value, orthopedic surgeons can consider foregoing the use of the axillary view when evaluating and treating PHF, particularly if other advanced imaging is utilized.

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Epidemiology of adult fractures: A review

Cited by 2,829 publications

References 12 publications

Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

The timing of ankle fracture surgery and the effect on infectious complications; A case series and systematic review of the literature

The Axillary View Typically Does Not Contribute to Decision Making in Care for Proximal Humeral Fractures

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