The statistical analysis results go with the overwhelming evidence concerning FLS importance in promoting bone health assessment and osteoporosis treatment in fracture patients. It also confirms the clinical value and the patient-oriented benefit of an implementation of such a system.

Objectives Hip fragility fractures were regarded as one of the most severe, but recent papers report on the underestimated burden of vertebral compression fractures. This study aims to compare morbidity and mortality of hip and vertebral fragility fractures in patients treated in the same setting. Methods Patients aged ≥50 years with hip fracture, and those with vertebral fracture presenting to our hospital between January 2014 and January 2017 were included. Patients were evaluated 1 year after their index fracture. SF-36 scores, mortality, and institutionalization are then recorded. Patients were divided into 2 groups: hip fractures and vertebral fractures. Results There were 106 and 90 patients respectively evaluated in hip and vertebral fracture groups at 1 year. Patients in both groups were comparable for age, sex, comorbidities and neuropsychiatric condition (P > 0.05). At 1 year follow-up, SF-36 showed better averages in all 8 scales in hip fracture group compared to vertebral fracture group. Mortality in the hip fracture group reached 32.1% compared to 10% for the vertebral fracture group (P < 0.01). Fifteen patients were institutionalized in the hip fracture group compared to 18 patients in the vertebral fracture group (P > 0.05). Conclusions When comparing patients treated in the same setting, hip fracture is associated with significantly increased mortality than vertebral fracture; however, the latter is associated with more morbidity.

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Thoracolumbar vertebral fracture incidents usually occur secondary to a high velocity trauma in young patients and to minor trauma or spontaneously in older people.Osteoporotic vertebral fractures are the most common osteoporotic fractures and affect one-fifth of the osteoporotic population.Percutaneous fixation by ‘vertebroplasty’ is a tempting alternative for open surgical management of these fractures.Despite discouraging initial results of early trials for vertebroplasty, cement augmentation proved its superiority for the treatment of symptomatic osteoporotic vertebral fracture when compared with optimal medical treatment.Early intervention is also gaining ground recently.Kyphoplasty has the advantage over vertebroplasty of reducing kyphosis and cement leak.Stentoplasty, a new variant of cement augmentation, is also showing promising outcomes.In this review, we describe the additional techniques of cement augmentation, stressing the important aspects for success, and recommend a thorough evaluation of thoracolumbar fractures in osteoporotic patients to select eligible patients that will benefit the most from percutaneous augmentation. A detailed treatment algorithm is then proposed.Cite this article: EFORT Open Rev 2017;2:293–299. DOI: 10.1302/2058-5241.2.160057

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Level IV. Epidemiological study.

Surgical treatment of patients with thoracolumbar vertebral fracture without neurological deficit is still controversial.Management of vertebral fracture with percutaneous fixation was first reported in 2004.Advantages of percutaneous fixation are: less tissue dissection; decreased post-operative pain; decreased bleeding and operative time (depending on the steep learning curve); better screw positioning with fluoroscopy compared with an open freehand technique; and a decreased infection rate.The limitations of percutaneous fixation of vertebral fractures include increased radiation exposure to the patient and the surgeon, together with the steep learning curve for this technique.Adding a screw at the level of the fractured vertebra has the advantages of incorporating fewer motion segments with less operative time and bleeding. This also increases the axial, sagittal and torsional stiffness of the construct.Percutaneous fixation alone without grafting is sufficient for treating type A and B1 (AO classification) thoracolumbar fractures with satisfactory results concerning kyphosis reduction when compared with open instrumentation and fusion and with open fixation.Type C and B2 fractures (ligamentous injuries) should undergo fusion since the ligamentous healing is mechanically weak, increasing the risk of instability.This review offers a detailed description of percutaneous screw insertion and discusses the advantages and disadvantages.Cite this article: EFORT Open Rev 2018;3:604-613. DOI: 10.1302/2058-5241.3.170026.

The aim of this study was to investigate the influence of the weight-status (obese, overweight and normal-weight) on bone mineral density of the forearm in Lebanese women. 3,989 Lebanese women (1,138 obese, 1,570 overweight and 1,281 normal weight) aged from 19 to 92 years old participated in this study. Weight and height were measured, and body mass index (BMI) was calculated. BMD of the ultra-distal (UD) radius, the 1/3 radius and the total radius was measured by DXA (GE Healthcare Lunar Prodigy). In the whole population, body weight was positively correlated to UD Radius BMD (r = 0.41; P < 0.001), 1/3 radius BMD (r = 0.35; P < 0.001) and total radius BMD (r = 0.48; P < 0.001) while age was negatively correlated to UD BMD (r = -0.42; P < 0.001), 1/3 Radius BMD (r = -0.52; P < 0.001) and total radius BMD (r = -0.42; P < 0.001). Using multiple linear regression analysis models, age and weight explained 36 %, 41 % and 42 of the UD radius BMD, 1/3 radius BMD and total radius BMD variances respectively. UD radius BMD, 1/3 radius BMD and total radius BMD values were significantly different among the three groups (P < 0.001). UD Radius BMD, 1/3 radius BMD and total radius BMD values were higher in obese and overweight women compared to normal-weight women (P < 0.001) and in obese women compared to overweight women (P < 0.001). These differences among the three groups remained significant after adjusting for age and height (P < 0.001). This study suggests that obesity is associated with higher UD radius, 1/3 radius and total radius BMD values in Lebanese women. Thus, obesity seems to be protective against forearm osteopenia in Lebanese women.