The Phenotype of Bone Turnover in Patients with Fragility Hip Fracture: Experience in a Fracture Liaison Service Population

Abstract

Background: Hip fragility fractures are becoming one of the main health care problems in countries with an aging population. This study aimed to evaluate the clinical characteristics and the usefulness of bone turnover markers in patients with a hip fracture. Methods: In a cohort of 363 patients (84.1 ± 9.2 years) with hip fractures we measured 25-hydroxyvitamin D (25OHD), bone alkaline phosphatase, type I collagen β carboxy telopeptide (βCTX), and parathyroid hormone (PTH). We recorded patients’ Charlson Comorbidity Index (CCI) and previous history of fragility fractures. Results: Vitamin D and PTH levels were inversely correlated (r = −024; p < 0.001). The prevalence of 25OHD deficiency was 57.8%, the PTH levels greater than 65 pg/mL was in 47.0 %, and in those who had βCTX values the upper limit was 61.8%. Moreover, 62% of patients with a fragility hip fracture had a history of a previous fracture. The 25OHD serum levels were inversely associated with CCI and a previous fragility fracture. On the contrary, PTH and βCTX serum levels showed a positive significant correlation with CCI and previous fragility fractures. Conclusion: This study confirmed the usefulness of a bone turnover markers assessment, along with the comorbidities and history of previous fragility fractures in order to better identify the risk of hip fracture.

Impact of COVID-19 Pandemic on Treatment and Outcome of Fragility Hip Fractures In Non-COVID Patients: Comparison Between the Lockdown Period, a Historical Series and the “Pandemic Normality” in a Single Institution

“…Also, post-hospital care was redirected to manage COVID-patients, and post-operative care for operated patients was slowed and somewhat suspended in the lockdown period, as for our Fracture Liaison Service, for example. 14 The aim of this study was to evaluate if this forced unexpected and abrupt re-organization of the healthcare system influenced the management and the recovery of non-COVID patients who underwent surgery for FHFs.…”

Functional Outcomes of Anterior-Based Muscle Sparing Approach Compared to Direct Lateral Approach for Total HIP Arthroplasty Following Acute Femoral Neck Fractures

“…We retrospectively reviewed the data prospectively collected as a part of the "Hip Fracture Unit" project that prospectively documents the treatment and outcomes of all patients with a fragility hip fracture admitted to our "Hip Fracture Unit", that annually treats more than 600 patients with proximal femur fracture and is a multidisciplinary project designed to improve the care for these patients at our hospital. [18][19][20] All patients who had undergone THA for acute displaced FNFs (Garden type III and IV) between January 2016 and January 2019 were considered for inclusion in this study. The other inclusion criterium was the use of either the ABMS or the DL approach to perform the procedure.…”

A novel “7 sutures and 8 knots” surgical technique in reverse shoulder arthroplasty for proximal humeral fractures: tuberosity healing improves short-term clinical results

“…The choice of the most effective treatment option for PHFs should take into account the fracture morphology, patient co-morbidities and functional expectations, and it should aim to achieve a pain-free functional shoulder [ 2 , 5 ]. Also, since PHFs in the elderly are fragility fractures, regardless of the treatment option, a multidisciplinary approach such as a fracture liaison service is fundamental in order to reduce the risk of further fractures [ 6 ]. A variety of surgical options can be employed, including closed reduction and percutaneous fixation, closed or open reduction and internal fixation [ 7 ], and arthroplasty [ 3 ].…”