Incidence Of Low-energy Fractures Research Articles

Clinical features of osteoporosis among indigenous women of Russian and Buryat ethnicity in Trans-Baikal region

Introduction Osteoporosis (OP) is a major social and medical problem for society.The aim of research was to identify risk factors for OP and the incidence of low-energy fractures in women with OP of Russian and Buryat ethnicity in Trans-Baikal region.Materials and methods We examined 98 women with OP (50 of Russian and 48 of Buryat nationality) and 100 women without objective signs of OP, comparable by age and nationality with the main group. All women underwent a questionnaire to identify risk factors for osteoporosis and osteoporotic fractures, determination of bone mineral density (BMD) using dual-energy X-ray absorptiometry, and determination of the absolute 10-year risk of major osteoporotic fractures using the online FRAX® calculator.Results The mean age of women with OP of Russian ethnicity was 65.5 [57.0;71.0] years, of Buryat nationality – 65.3 [56.0;69.0] years. Among risk factors in female members of Russian nationality, age older than 65 years, tendency to fall and decreased creatinine clearance were found more frequently. There was an inverse association between proximal femoral BMD and risk of falls (R = -0.31, p = 0.04) and a direct correlation between family history of ОP and spinal BMD (R = 0.65, p = 0.02).Discussion Age over 65 is a significant risk factor for osteoporosis and is included in the FRAX (Fracture Risk Assessment Tool) model. Reduces creatinine clearance and a tendency to fall have been associated with the development of OP and fractures in some studies. Our findings are consistent with previous studies.Conclusion Russian women were more likely than Buryat women to have risk factors for OP, such as falls and decreased creatinine clearance. Associations were found between proximal femoral BMD and falls, spinal BMD with a family history of OP and smoking among Russian women.

The Quality of Life, Patient Satisfaction and Rehabilitation in Patients With a Low Energy Fracture-Part III of an Observational Study.

IntroductionDue to the aging population the incidence of Low Energy Fractures (LEF) increases. LEF have high mortality and morbidity rates and often cause elderly to lose independence. Patient-reported outcomes, such as Quality of Life (QoL) and patient satisfaction (PS) are needed to evaluate treatment, estimate cost-benefit analyses, and to improve clinical decision-making and patient-centered care.ObjectiveThe primary goal was to evaluate QoL and PS in patients with LEF, and to compare QoL scores to the community dwelling population. Second, we observed the amount and type of physiotherapy (PT) sessions the patients conducted.MethodsA single-center cohort study was conducted in Switzerland. Patients between 50 and 85 years, who were treated in the hospital for LEF, were followed 1 year after initial fracture. Data on QoL were obtained through the Euroqol-5-Dimension questionnaire-3-Level (EQ-5D-3L) and the EQ VAS (visual analog scale). PS was measured by a VAS on satisfaction with treatment outcome. Data on PT sessions, mobility and use of analgesics were collected by telephone interviews and written surveys. Results were compared between the different fracture locations and subgroup analyses were performed for age categories.Results411 patients were included for analysis. The median scores of the EQ-5D-3L index—VAS and PS were 0.90 (0.75–1.0), 90 (71.3–95) and 100 (90–100). Significant differences in all scores were found between fracture location (P < .05), with hip fracture patients and patients with a malleolar fracture scoring lowest in all measures. QoL index in hip fracture patients was 0.76 (0.70–1.00), QoL VAS 80 (70–90), and PS 95 (80–100). Median amount of PT sessions in all patients was 18 (9–27) and a significant difference was found between fracture locations. Patients with a fracture of the humerus received the highest amount of PT sessions 27 (18–36), hip fracture patients had a median of 18 (9–27) sessions.ConclusionAt follow-up, QoL throughout all patients with a LEF was comparable to a normal population. Remarkably, though hip fracture patients seem to suffer from a clinically relevant loss of QoL, they received fewer PT sessions and performed fewer long-lasting home training than patients with a humerus fracture. Intensive, progressive rehabilitation with a high frequency of supervised training is recommended after hip fracture. The low frequency of PT sessions found in this study is unsatisfying. In hip fracture patients and in patients with a malleolar fracture, especially when aged over 75 years, more efforts are required to improve rehabilitation and subsequently QoL.

Beyond Hip Fracture: Orthopaedic Trauma in an Aging America

Trauma related death and disability is common among working-age Americans, however the impact on older adults is consequential and increasing. Fractures are the most common traumatic injury diagnosis among Medicare beneficiaries, and though fragility fractures continue to be an important health problem, recent data indicate an increase in high-energy fractures. The purpose of this study was to produce national incidence estimates among US men and women ≥ 65 years using data from the 2003-2014 National Inpatient Sample (NIS). The study cohort included hospitalizations involving upper and/or lower extremity fractures which were further classified by mechanism as high or low energy using external cause of injury codes. Incidence was computed using survey weights provided by NIS, and population estimates from the Census Bureau. The incidence of high-energy fractures increased from 744.1/100,000 persons (95%CI: 681.1–807.1) in 2003 to 821.4/100,000 (95%CI: 795.0 – 874.8) in 2014 in women, and from 359.1/100,000 (95%CI: 331.4–386.8) to 408.2/100,000 (95%CI: 394.–809.2) in men. Over 80% were motor vehicle related. The greatest increase was among those ≥ 85 (1,856.4/100,000 to 2,126.3/100,000 in women; 1,069.1/100,000 to 1,215.1/100,000 in men). Simultaneously, the incidence of low-energy fractures declined: 748.4/100,000 (95%CI: 687.5–809.2) to 443.8/100,000 (95%CI: 423.5 -464.1) in women, and 310.6/100,000 (95%CI: 285 – 336.2) to 206.3/100,000 (95%CI: 196.5 - 216) in men. Results suggest that fractures commonly seen in younger adults will be seen more frequently in older age. It is therefore essential to establish treatment pathways to optimize outcomes for the growing number of injured older adults.

Childhood Exposure to Passive Smoking and Bone Health in Adulthood: The Cardiovascular Risk in Young Finns Study.

Passive smoke exposure has been linked to the risk of osteoporosis in adults. We examined the independent effects of childhood passive smoke exposure on adult bone health. Longitudinal, the Cardiovascular Risk in Young Finns Study. The study cohort included 1422 individuals followed for 28 years since baseline in 1980 (age 3 to 18 years). Exposure to passive smoking was determined in childhood. In adulthood, peripheral bone traits were assessed with peripheral quantitative CT (pQCT) at the tibia and radius, and calcaneal mineral density was estimated with quantitative ultrasound. Fracture data were gathered by questionnaires. Parental smoking in childhood was associated with lower pQCT-derived bone sum index in adulthood (β± SE, -0.064 ± 0.023 per smoking parent; P = 0.004) in multivariate models adjusted for age, sex, active smoking, body mass index, serum 25-OH vitamin D concentration, physical activity, and parental socioeconomic position. Similarly, parental smoking was associated with lower heel ultrasound estimated bone mineral density in adulthood (β± SE, -0.097 ± 0.041 per smoking parent; P = 0.02). Parental smoking was also associated with the incidence of low-energy fractures (OR, 1.28; 95% CI, 1.01 to 1.62). Individuals with elevated cotinine levels (3 to 20 ng/mL) in childhood had lower bone sum index with pQCT (β± SE, -0.206 ± 0.057; P = 0.0003). Children whose parents smoked and had high cotinine levels (3 to 20 ng/mL) had significantly lower pQCT-derived bone sum index compared with those with smoking parents but had low cotinine levels (<3 ng/mL) (β± SE, -0.192 ± 0.072; P = 0.008). Children of parents who smoke have evidence of impaired bone health in adulthood.

Vitamin D levels and fracture risk among Hispanic children

There is a lack of knowledge about whether low vitamin D levels increase the risk of pediatric low-energy fractures among Hispanic population. The objective of this study is to determine whether there is a direct relationship between low vitamin D levels and the incidence of low-energy fractures in Hispanic children. Cases included all consecutive patients evaluated with low-energy fractures in the pediatric orthopedic clinic. The control group consisted of all pediatric patients evaluated, without fractures, who had bone and joint pain complaints in the general pediatric clinic. The main focus was to compare cases and controls in relation to their vitamin D levels. Cases and controls were compared using t tests for means of quantitative variables and Chi-square tests. A total of 201 subjects, distributed as cases (n = 107) and controls (n = 94), were included in this study. One hundred twelve (55.7%) of the total study population were males. The mean age for the study population was 8.6years old ranging from 1year to 18years, and standard deviation = 4.0years. The median age for the study population was 9years. The mean vitamin D level for the cases was 32.6ng/dl (SD = 10.9); the mean vitamin D level for controls was 32.3ng/dl (SD = 13.4). This difference was not statistically significant (t = 0.18, 95% CI - 3.2 to 3.9; p = 0.854). A direct relationship between low vitamin D levels and fracture risk in a Hispanic pediatric population was not established. III.

EPIDEMIOLOGICAL STUDY OF LOW ENERGY FRACTURES IN REPUBLIC OF ARMENIA

Until present no data was available inArmeniain respect of incidence of low energy fractures that are typical of osteoporotic locations which consequently did not allow to evaluate the scope of this problem across the country.Purpose of the study – to identify the incidence of low energy fractures in proximal femur, in distal forearm, in proximal humerus and in distal tibia across population ofArmenia aged 50 years and older.Materials and methods. An observing population study was performed in two regions of Armenia during 2011-2013 where the frequency of selected locations in cases of moderate trauma was identified. During 2011-2012 the information was collected based on traumatology service records adding in 2013 other sources including primary level of healthcare due to observed infrequent applications for medical help in cases of trauma. Results. In 2013 the incidence of proximal femur fractures in men was reported as 136 cases per 100 000 of population aged 50 years and older, in women – 201 cases per 100 000. At the same time only 57.7% of patients with proximal femur fractures were admitted to hospital. Distal forearm fractures incidence in men and women was observed correspondingly 56/100 000 and 176/100 000 cases, proximal humerus fractures – 39/100 000 and 86/100 000 cases and distal tibia fractures – 39/100 000 and 86/100 000 cases. The predicted annual number of proximal femur fracture in Armenia amounts to 2067 cases, distal forearm fractures – 1205, proximal humerus fractures – 640.Conclusion. Epidemiological data that was collected for the first time on low energy fractures incidence confirmed the acute osteoporosis issue inArmenia and revealed the problems in organization of medical care for the group of senior patients with injuries.

Trauma type, age, and gender as determinants of hip fracture.

We determined the trauma type of femoral neck and trochanteric fractures in men and women aged greater than or equal to 20 years in 19, 128 fractures reported to a computerized medical information register during 1972-1981. We found that the earlier known exponential increase of fracture incidence by age started in early adulthood rather than during middle age. An age-related increase was found for each type of injury as well, although the incidence of fractures resulting from severe trauma increased less than that of fractures associated with moderate trauma. The incidence of low-energy fractures in men as well as in women displayed a constant increase rate with age from young adulthood on, impugning the widely held belief that the menopause is a significant risk factor for fractures. The dominating risk factor for proximal femoral fracture in adults appears to be age, irrespective of the cause of injury, with a chronological decline in bone strength as the most likely cause of the exponential increase in the fracture incidence during adult life.