Subjective and novel objective radiographic evaluation of inflatable bone tamp treatment of articular calcaneus, tibial plateau, tibial pilon and distal radius fractures.
ABSTRACT There is a growing need to develop tools that allow for better reductions of difficult to treat fractures in minimally disruptive ways. One such technique has been developed using the inflatable bone tamp and a fast setting calcium phosphate. KYPHON(®) XPANDER Inflatable Bone Tamp and the KYPHON(®) Osteo Introducer(®) System were used to reduce the articular fractures and a fast-setting calcium phosphate was introduced into those voids and metal hardware was applied as deemed necessary. Subjects were skeletally mature patients treated for articular fractures of the calcaneus, tibial plateau, tibial pilon, or distal radius. Post-operative day zero and week 12 radiographs were objectively and subjectively evaluated by three independent orthopaedic surgeons. Their objective scores were then translated into subjective categories based on the Heiney-Redfern scaled scoring (H-R score) system established herein. Overall, the thorough radiographic analysis by independent reviewers indicates that the technique is capable of obtaining and maintaining articular reductions in a good or adequate manner at 12-weeks post-operatively. Introduced is a potential novel evaluation scale scoring system for these articular fractures that evaluates the important anatomic considerations reproducibly in fracture reductions. There are many potential benefits that remain speculative to this type of tool within a procedure, and therefore this tool and technique warrants further research.
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Article: Morbidity at bone graft donor sites.[Show abstract] [Hide abstract]
ABSTRACT: A review of the medical records of 239 patients with 243 autogenous bone grafts was undertaken to document the morbidity at the donor sites. The overall major complication rate was 8.6%. Major complications included infection (2.5%), prolonged wound drainage (0.8%), large hematomas (3.3%), reoperation (3.8%), pain greater than 6 months (2.5%), sensory loss (1.2%), and unsightly scars. Minor complications (20.6%) included superficial infection, minor wound problems, temporary sensory loss, and mild or resolving pain. There was a much higher complication rate (17.9% major) if the incision used for the surgery was also the same incision used to harvest the bone graft.Journal of Orthopaedic Trauma 02/1989; 3(3):192-5. · 1.54 Impact Factor
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ABSTRACT: This case-control study sought to assess the effects of diabetes and its complications on the risk of fractures. There were 124,655 fracture cases and 373,962 age- and sex-matched controls. The main exposure was diabetes and its complications, and the main confounders were use of insulin and oral antidiabetic agents, presence of cardiovascular disease, and use of drugs for cardiovascular disease, along with a number of other confounders. In the crude analysis, diabetes and all complications was associated with a statistically significantly increased overall risk of fractures. The increase in risk of fractures was higher in type 1 diabetes (T1D) than in type 2 diabetes (T2D). However, after adjustment for confounders, the difference between T1D and T2D disappeared, and only diabetic kidney disease in T1D retained a significantly increased risk of fractures. There was a time dependency in the risk of fractures with an early increase at <2.5 years after diagnosis. followed by a decrease to the level of the background population from 2.5 to 5 years after diagnosis, and a limited increase in T1D but not T2D at >5 years after diagnosis. We conclude that diabetes, whether T1D or T2D, seems to carry an increased risk of fractures, and complications to diabetes except for diabetic kidney disease add little to the overall risk of fracture, perhaps pointing at a common risk factor linked to the high blood glucose levels, which may weaken bone strength.Calcified Tissue International 01/2009; 84(1):45-55. · 2.75 Impact Factor
Article: Deaths: final data for 2006.[Show abstract] [Hide abstract]
ABSTRACT: This report presents final 2006 data on U.S. deaths, death rates, life expectancy, infant and maternal mortality, and trends by selected characteristics such as age, sex, Hispanic origin, race, marital status, educational attainment, injury at work, state of residence, and cause of death. It also presents more detailed information than previously presented about the mortality experience of the American Indian or Alaska Native and the Asian or Pacific Islander populations. Information reported on death certificates, which are completed by funeral directors, attending physicians, medical examiners, and coroners, is presented in descriptive tabulations. The original records are filed in state registration offices. Statistical information is compiled in a national database through the Vital Statistics Cooperative Program of the Centers for Disease Control and Prevention's National Center for Health Statistics. Causes of death are processed in accordance with the International Classification of Diseases, Tenth Revision (ICD-10). In 2006, a total of 2,426,264 deaths were reported in the United States. The age-adjusted death rate was 776.5 deaths per 100,000 standard population, a decrease of 2.8 percent from the 2005 rate and a record low historical figure. Life expectancy at birth rose 0.3 years, from a revised 2005 value of 77.4 years to a record 77.7 years in 2006. Age-specific death rates increased for those aged 25-34 years but decreased for most other age groups: 5-14 years, 35-44 years, 45-54 years, 55-64 years, 65-74 years, 75-84 years, and 85 years and over. The 15 leading causes of death in 2006 remained the same as in 2005. Heart disease and cancer continued to be the leading and second-leading causes of death, together accounting for almost half of all deaths. The infant mortality rate in 2006 was 6.69 deaths per 1,000 live births. Mortality patterns in 2006, such as the decline in the age-adjusted death rate to a record historical low, were generally consistent with long-term trends. Life expectancy increased in 2006 from 2005.National vital statistics reports: from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System 04/2009; 57(14):1-134.