• Title/Summary/Keyword: osteoporotic fracture

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Therapeutic effects of 1α,25 dihydroxycholecalciferol on osteoporotic fracture in a rat model (랫드에서 1α,25 dihydroxycholecalciferol의 골다공증성 골절 치유효과)

  • Bae, Chun-sik
    • Korean Journal of Veterinary Research
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    • v.39 no.5
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    • pp.974-985
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    • 1999
  • Osteoporosis is defined as a decrease in bone mass that leads to an increased risk of fracture. The therapeutic effect of $1{\alpha}$,25 dihydroxycholecalciferol, the hormonal form of vitamin $D_3$ that mediates calcium translation in intestine and bone, on the healing process of fracture has still been controversial. These studies were designed to understand the healing process of normal fibular fracture, the osteoporotic changes after ovariectomy, and the therapeutic effects of $1{\alpha}$,25 dihydroxycholecalciferol on the osteoporotic fracture in rats. The simple transverse fractures of rat fibulae were produced with a rotating diamond saw. The changes of the biochemical and mechanical indices of rats were investigated. The mechanical study based on bending test revealed the healing of the fibular fracture in the 5th week after simple transverse fracture. The osteoporosis impaired more the healing of osteoporotic fibular fracture than normal non-osteoporotic fibular fracture. The healing process of osteoporotic fracture was facilitated by the treatment with $1{\alpha}$,25 dihydroxycholecalciferol, however, was delayed more than the healing process of normal fracture. The bone strength based on the bending test also confirmed this tendency. The bone strengths in the 5th week after fracture of normal bone, osteoporotic bone, and $1{\alpha}$,25 dihydroxycholecalciferol-treated osteoporotic bone were 75%, 41%, and 67%, respectively, in comparison with those of intact bone. In conclusion, $1{\alpha}$,25 dihydroxycholecalciferol was effective in promoting the osteoporotic fracture healing.

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Risk Factors Associated with the First Osteoporotic Fracture (첫 번째 골다공성 골절에 영향을 미치는 요인)

  • Kim, Young-Sun;Choi, Ja-Yun
    • Korean Journal of Adult Nursing
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    • v.23 no.6
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    • pp.564-573
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    • 2011
  • Purpose: The purposes of this study were to identify the factors associated with the first reported fracture in osteoporotic patients. Methods: One hundred and sixty-four patients who presented with osteoporosis at K hospital in G city, South Korea between July and September 2010 were participated in study. Modified Korea National Health and Nutrition Examination Survey tool were used to measure participants' living habits. Computer aided nutritional analysis program (CAN-PRO) designed by Nutrition Information Center in the Korean Nutrition Society (2002) was used to analyze foods intake and to calculate the individual nutrients intake. Results: The risk of developing the first osteoporotic fracture was ten times higher in the patients between 65 to 74 years (OR=10.06, p=.010), and 28.41 times greater in those with increasing falls (OR=28.41, p<.001). Patients with higher bone marrow density (BMD) and higher consumption of animal protein diet had lower risks of developing the first osteoporotic fracture (OR=0.37, p=.011; OR=0.88, p=.040, respectively). Conclusion: Risk factors for osteoporotic fracture included the age from 65 to 74 years, an increase in falls, low animal protein consumption, and reduced BMD. Systematic educational program is needed to prevent fracture in osteoporotic patients.

Effects of $1\alpha$, 25 Dihydroxycholecalciferol on Osteoporotic Fracture : Light Microscopic and Scanning Electron Microscopic Observation ($1\alpha$, Dihydroxycholecalciferol의 골다공증성 골절 치유효과 : 광학현미경 및 주사전자현미경적 관찰)

  • Bae, Chun-Sik
    • Applied Microscopy
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    • v.29 no.3
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    • pp.315-321
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    • 1999
  • Vitamin D is one of important factors involved in the regulation of bone metabolism. In osteoporosis, the therapeutic effect of vitamin D on the healing process of fracture has still been controversial. These studies were designed to understand the healing process of normal fibular fracture and the therapeutic effects of $1\alpha$, 25 dihydroxycholecalciferol on the osteoporotic fracture in rats. The simple transverse fractures of rat fibulae were produced with a rotating diamond saw. The histological and ultrastructural changes of rats were observed. The histological and ultrastructural studies revealed the healing of the fibular fracture in the 5th week after simple transverse fracture. The osteoporosis impaired more the healing of osteoporotic fibular fracture than normal non-osteoporotic fibular fracture. The healing process of osteoporotic fracture was facilitated by the treatment with $1\alpha$, 25 dihydroxycholecalciferol, however, was delayed more than the healing process of normal fracture. These results suggest that $1\alpha$, 25 dihydroxycholecalciferol was effective for reducing the deleterious effects of osteoporosis in fracture healing.

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Bone Cement Dislodgement : One of Complications Following Bone Cement Augmentation Procedures for Osteoporotic Spinal Fracture

  • Ha, Kee-Yong;Kim, Young-Hoon;Yoo, Sung-Rim;Molon, Jan Noel
    • Journal of Korean Neurosurgical Society
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    • v.57 no.5
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    • pp.367-370
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    • 2015
  • Bone cement augmentation procedures have been getting more position as a minimally invasive surgical option for osteoporotic spinal fractures. However, complications related to these procedures have been increasingly reported. We describe a case of bone cement dislodgement following cement augmentation procedure for osteoporotic spinal fracture by reviewing the patient's medical records, imaging results and related literatures. A 73-year-old woman suffering back and buttock pain following a fall from level ground was diagnosed as an osteoporotic fracture of the 11th thoracic spine. Percutaneous kyphoplasty was performed for this lesion. Six weeks later, the patient complained of a recurrence of back and buttock pain. Radiologic images revealed superior dislodgement of bone cement through the 11th thoracic superior endplate with destruction of the lower part of the 10th thoracic spine. Staged anterior and posterior fusion was performed. Two years postoperatively, the patient carries on with her daily living without any significant disability. Delayed bone cement dislodgement can occur as one of complications following bone cement augmentation procedure for osteoporotic spinal fracture. It might be related to the presence of intravertebral cleft, lack of interdigitation of bone cement with the surrounding trabeculae, and possible damage of endplate during ballooning procedure.

Feasibility of Serum Pentosidine Level as a Potential Risk Factor for Osteoporotic Vertebral Compression Fracture

  • Choi, Dong-Hyuk;Lee, Sang-Min;Lim, Sung-An;Choi, Yong-Soo
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.992-997
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    • 2018
  • Study Design: Feasibility study. Purpose: To evaluate the feasibility of using serum pentosidine level as a potential marker for osteoporotic vertebral compression fracture (OVCF). Overview of Literature: A review of previous studies suggests a negative correlation between serum pentosidine concentration and bone strength. However, it is unclear whether serum pentosidine level might be a potential marker of OVCF in Koreans. Methods: Forty patients who underwent bone mineral density examination were included in this study, and their serum pentosidine levels were prospectively analyzed. Serum pentosidine level was evaluated using enzyme-linked immunosorbent assay. Among all the patients, 11 with OVCF were assigned to the vertebral fracture group and 29 who did not have vertebral fracture were included in the non-fracture group. In addition, we used the Fracture Risk Assessment (FRAX) tool Korean version for assessing the 10-year probability of fracture. Results: There was a statistically significant difference in the mean serum pentosidine level (p=0.04) of the vertebral fracture group (110.8 ng/mL) and the non-fracture group (64.3 ng/mL). Logistic regression analyses showed that serum pentosidine was significantly associated with OVCF. The vertebral fracture group had significantly higher 10-year probability of major osteoporotic fracture as per FRAX than the non-fracture group. There was a positive correlation between pentosidine level and FRAX results (r=0.35, p=0.02). Conclusions: These results suggest that increased serum pentosidine level could be a potential marker for OVCF.

Diagnostic Performance of Diffusion-Weighted Steady-State Free Precession in Differential Diagnosis of Neoplastic and Benign Osteoporotic Vertebral Compression Fractures: Comparison to Diffusion-Weighted Echo-Planar Imaging

  • Shin, Jae Ho;Jeong, Soh Yong;Lim, Jung Hyun;Park, Jeongmi
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.3
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    • pp.154-161
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    • 2017
  • Purpose: To evaluate the diagnostic performance of diffusion-weighted steady-state free precession (DW-SSFP) in comparison to diffusion-weighted echo-planar imaging (DW-EPI) for differentiating the neoplastic and benign osteoporotic vertebral compression fractures. Materials and Methods: The subjects were 40 patients with recent vertebral compression fractures but no history of vertebroplasty, spine operation, or chemotherapy. They had received 3-Tesla (T) spine magnetic resonance imaging (MRI), including both DW-SSFP and DW-EPI sequences. The 40 patients included 20 with neoplastic vertebral fracture and 20 with benign osteoporotic vertebral fracture. In each fracture lesion, we obtained the signal intensity normalized by the signal intensity of normal bone marrow (SI norm) on DW-SSFP and the apparent diffusion coefficient (ADC) on DW-EPI. The correlation between the SI norm and the ADC in each lesion was analyzed using linear regression. The optimal cut-off values for the diagnosis of neoplastic fracture were determined in each sequence using Youden's J statistics and receiver operating characteristic curve analyses. Results: In the neoplastic fracture, the median SI norm on DW-SSFP was higher and the median ADC on DW-EPI was lower than the benign osteoporotic fracture (5.24 vs. 1.30, P = 0.032, and 0.86 vs. 1.48, P = 0.041, respectively). Inverse linear correlations were evident between SI norm and ADC in both neoplastic and benign osteoporotic fractures (r = -0.45 and -0.61, respectively). The optimal cut-off values for diagnosis of neoplastic fracture were SI norm of 3.0 in DW-SSFP with the sensitivity and specificity of 90.4% (95% confidence interval [CI]: 81.0-99.0) and 95.3% (95% CI: 90.0-100.0), respectively, and ADC of 1.3 in DW-EPI with the sensitivity and specificity of 90.5% (95% CI: 80.0-100.0) and 70.4% (95% CI: 60.0-80.0), respectively. Conclusion: In 3-T MRI, DW-SSFP has comparable sensitivity and specificity to DW-EPI in differentiating the neoplastic vertebral fracture from the benign osteoporotic vertebral fracture.

The Case Report about Osteoporotic Compression Fracture Treated with Band Training (밴드트레이닝으로 호전된 골다공증성 압박골절 환자 1례 보고)

  • Jang, Gun;Cho, Tae-Young;Cho, Hyun-Chol;Song, Yun-Kyung;Lim, Hyung-Ho
    • The Journal of Korea CHUNA Manual Medicine
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    • v.6 no.1
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    • pp.147-156
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    • 2005
  • Objective : The objective of this study is to evaluate the treatment effect of Band training in Osteoporotic Compression Fracture. Methods : Band training, Herb medicine and Acupuncture were performed for 56days admission in a patient who had Osteoporotic Compression Fracture. Result : ROM of Lumbar, Milgram test and Dorsiflexion has improved. VAS and ODI score were also decreased.

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PHILOS plate fixation with polymethyl methacrylate cement augmentation of an osteoporotic proximal humerus fracture

  • Kim, Do-Young;Kim, Tae-Yeong;Hwang, Jung-Taek
    • Clinics in Shoulder and Elbow
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    • v.23 no.3
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    • pp.156-158
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    • 2020
  • PHILOS plate fixation in osteoporotic proximal humerus fracture of old age is well-known for high complication rate, especially metal failure, providing various augmentation techniques, such as calcium phosphate cement, allogenous or autologous bone graft. We report a case of polymethyl methacrylate augmentation to provide appropriate reduction with a significant mechanical support. This can be a treatment option for displaced unstable osteoporotic proximal humerus fracture with marked bony defect.

Radiofrequency Neurotomy of the Gray Ramus Communicans for Lumbar Osteoporotic Compression Fracture

  • Kim, Seok-Won;Ju, Chang-Il;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.41 no.1
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    • pp.7-10
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    • 2007
  • Objective : The aim of this study was to determine the efficacy of percutaneous radiofrequency neurotomy[RFN] of ramus communicans nerve in patients suffering from severe low back pain due to osteoporotic compression fracture. Methods : Twenty two patients with lumbar osteoporotic compression fracture who had intractable back pain for less than two weeks and were performed with RFN at L1-L4 from May 2004 to December 2005 were retrospectively analyzed. Clinical outcome using visual analogue scale[VAS] pain scores and modified MacNab's grade was tabulated. Complications related to the procedure were assessed. Results : Twenty-two female patients [age from 63 to 81 years old] were included in this study. The mean VAS score prior to RFN was 7.8, it improved to 2.6 within postoperative time of 48 hours, and the mean VAS score after 3 months was 2.8, which was significantly decreased. Eighteen of 22 patients were graded as excellent and good according to modified MacNab's criteria at final follow up. All patients recovered uneventfully, and the neurologic examination revealed no deficits. Two patients showing poor results worsened in symptom. Percutaneous was performed eventually resulting in symptom improvement. There were no significant complications related to the procedure such as sensory dysesthesia, numbness or permanent motor weakness. Conclusion : RFN is safe and effective in treating the painful osteoporotic compression fracture. in patients with intractable back pain due to lumbar osteoporotic compression fracture, RFN of gray ramus communicans nerve should be considered as a treatment option prior to vertebroplasty.

Clinical Analysis of Acute Radiculopathy after Osteoporotic Lumbar Compression Fracture

  • Kim, Do Eon;Kim, Hyeun Sung;Kim, Seok Won;Kim, Hyun Sook
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.32-35
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    • 2015
  • Objective : The purpose of this study was to analyze the relationship between fracture pattern and the development of acute radiculopathy after osteoporotic lumbar compression fracture. Methods : This study included 59 patients who underwent bone cement augmentation for osteoporotic compression fracture below the L2 level, which can lead to radiculopathic radiating pain. The patients were divided into two groups according to the presence of radiculopathy (group A : back pain only; group B : back pain with newly developed radiating pain). We categorized compression fractures into three types by the position of the fracture line. The incidence of newly developed radiculopathy was examined retrospectively for each compression fracture type. Results : The overall incidence of newly developed leg pain (group B) was 25%, and the frequency increased with descending spinal levels (L2 : 0%, L3 : 22%, L4 : 43%, and L5 : 63%). The back pain-only group (group A) had mostly superior-type fractures. On the other hand, the back pain with radiculopathy group (group B) had mostly inferior-type fractures. Most patients in group B showed significant relief of leg pain as well as back pain after bone cement augmentation. Conclusion : The incidence of a newly developed, radiating pain after osteoporotic compression fractures increased gradually from the L3 to L5 levels. Most of these fractures were of the inferior type, and the bone cement augmentation procedures seemed to be sufficient for relief of both back and radiating pain.