The Assessment of Fracture Risk

Unnanuntana, Aasis; Gladnick, Brian P.; Donnelly, Eve; Lane, Joseph M.

doi:10.2106/jbjs.i.00919

Cited by 315 publications

(225 citation statements)

References 96 publications

(101 reference statements)

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“…The American College of Rheumatology has recommended that patients receive prophylactic bisphosphonate therapy when they undergo treatment with ≥5 mg/day of prednisolone for three months or more and their T-score is less than −1.0 42 . Thus, in this circumstance, treatment should be considered even if the ten-year fracture probability calculated with FRAX is <3% for a hip fracture or <20% for a major osteoporosisrelated fracture [13] .…”

Section: Resultsmentioning

confidence: 99%

FRAX predictior with and without BMD for assessment of osteoporotic fracture risk in the Himalayan state of India: A comparative study

Sharma¹,

Nagar²,

Shukla³

et al. 2017

Int. J. Orthop. Sci.

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Objective: BMD (bone mineral density) testing facilities are not available in every places in India. We compare the predictive ability of FRAX with BMD and FRAX without BMD for major osteoporotic and hip fracture in Himalayan population. Materials and methods: a hospital based cross sectional study was conducted on patients attending the outpatient Department of orthopaedics of SGRRIMHS, and others for a period of 2 years from Aug 2015 to July 2017. A total no. of 125 patients (104 F+ 21M) in the age group 40 -90 years were selected randomly for study. Exclusion criteria were age less than 40 and more than 90 years, confirmed cases of osteoporosis, patients on antiresorptive treatment, cases of surgically removed ovary and uterus, bone metastasis. Dual Energy X-ray Absorptiometry (DXA) scans were obtained to assess presence of low BMD. FRAX calculations with and without addition of femoral neck BMD were done in all patients. Statistical Package for Social Sciences (SPSS) version 20 was used for statistical analysis. Results: Hip fracture probabilities (6.00±10.47% ̴ 5.03±10.26%) and MO fracture probabilities (11.34±12.85% ̴ 11.89±12.87%) were similar with or without inclusion of BMD in FRAX tool respectively. Conclusion: FRAX may be used to assess for 10 year hip and major osteoporotic fracture probabilities status in the absence of DXA facilities or avoiding unnecessary DXA scanning.

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Section: Resultsmentioning

confidence: 99%

FRAX predictior with and without BMD for assessment of osteoporotic fracture risk in the Himalayan state of India: A comparative study

Sharma¹,

Nagar²,

Shukla³

et al. 2017

Int. J. Orthop. Sci.

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“…Recognition of the poor bone quality by the surgeon is essential [97]. With aging, several changes occur to the bone that change its biomechanical properties, making it more prone to fracture and more difficult to repair using standard techniques.…”

Section: Operative Fixation Of Fragility Fracturesmentioning

confidence: 99%

Short-term and Long-term Orthopaedic Issues in Patients With Fragility Fractures

Bukata

Kates

O’Keefe

2011

Clinical Orthopaedics &Amp; Related Research

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Background Patients with impaired bone quality who suffer a fragility fracture face substantial challenges in both their short-and long-term care. In addition to poor bone quality, many of these patients have multiple medical comorbidities that alter their surgical risk and affect their ultimate functional recovery. Some medical issues can contribute to the altered bone quality and must be addressed to prevent future fractures. Questions/purposes This review summarizes the modifications in perioperative management and fracture fixation in patients with common fragility fractures who have impaired bone quality. It also summarizes the postoperative diagnosis and treatment of secondary causes of impaired bone quality in these patients. Methods We performed a PubMed search, and literature published after 2000 was prioritized, with the exception of benchmark clinical trial studies published before 2000. Results Patients with altered bone quality require rapid perioperative management of multiple medical comorbidities. Implant selection in patients with poor quality bone should permit early weightbearing, and constructs should maximize surface area contact with the remaining bone. Long-term diagnosis and treatment of other disease states contributing to poor bone quality (vitamin D deficiency/ insufficiency, hypothyroidism, hyperthyroidism, hyperparathyroidism, Cushing's disease, and hypogonadism) must occur to minimize the chances of future fractures. Conclusions Recognition of patients with impaired bone quality and proper treatment of their special needs in both the short and long term are essential for their best opportunity for maximal functional recovery and prevention of future fractures.

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“…FRAX provides a 10-year fracture risk and can be used with or without femoral neck bone mineral density. 24 However, current guidelines require that the patient has osteopenia demonstrated by DXA scan combined with FRAX results before pharmacologic treatment is indicated. Future studies should investigate the initiation of osteoporosis treatment using FRAX analysis with and without DXA scan results.…”

Section: Discussionmentioning

confidence: 99%

Improving the Pharmacologic Management of Patients after Osteoporotic Hip Fractures

Klaus¹,

Modarresi²,

Aguilar³

et al. 2017

mjm

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The Assessment of Fracture Risk

Cited by 315 publications

References 96 publications

FRAX predictior with and without BMD for assessment of osteoporotic fracture risk in the Himalayan state of India: A comparative study

FRAX predictior with and without BMD for assessment of osteoporotic fracture risk in the Himalayan state of India: A comparative study

Short-term and Long-term Orthopaedic Issues in Patients With Fragility Fractures

Improving the Pharmacologic Management of Patients after Osteoporotic Hip Fractures

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