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Clinical Orthopaedics and Related Research®

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01-08-2011 | Symposium: Bone Quality: From Bench to Bedside

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

Authors: Susan V. Bukata, MD, Stephen L. Kates, MD, Regis J. O’Keefe, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 8/2011

Abstract

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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Title: Short-term and Long-term Orthopaedic Issues in Patients With Fragility Fractures
Authors: Susan V. Bukata, MD
Stephen L. Kates, MD
Regis J. O’Keefe, MD, PhD
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 8/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-011-1779-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

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