Calcaneal Fractures in Diabetic Patients

Hedlund, Laura J; Maki, Daniel D.; Griffiths, Harry J.

doi:10.1016/s1056-8727(97)00052-4

Cited by 63 publications

(48 citation statements)

References 11 publications

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“…In a comprehensive review of the literature from 1982 to 1997, including 94 cohort and 72 case-controlled studies of risk factors associated with increased fracture rates, T1DM was among the top 10 factors associated with the highest risk of fracture (23). An increased incidence of calcaneal fracture has also been reported (44). To date, only a few studies dispute this association (78).…”

Section: Fracture Riskmentioning

confidence: 99%

Is insulin an anabolic agent in bone? Dissecting the diabetic bone for clues

Thrailkill

Lumpkin

Bunn

et al. 2005

American Journal of Physiology-Endocrinology and Metabolism

436

322

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Diabetic osteoporosis is increasingly recognized as a significant comorbidity of type 1 diabetes mellitus. In contrast, type 2 diabetes mellitus is more commonly associated with modest increases in bone mineral density for age. Despite this dichotomy, clinical, in vivo, and in vitro data uniformly support the concept that new bone formation as well as bone microarchitectural integrity are altered in the diabetic state, leading to an increased risk for fragility fracture and inadequate bone regeneration following injury. In this review, we examine the contribution that insulin, as a potential anabolic agent in bone, may make to the pathophysiology of diabetic bone disease. Specifically, we have assimilated human and animal data examining the effects of endogenous insulin production, exogenous insulin administration, insulin sensitivity, and insulin signaling on bone. In so doing, we present evidence that insulin, acting as an anabolic agent in bone, can preserve and increase bone density and bone strength, presumably through direct and/or indirect effects on bone formation.

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Section: Fracture Riskmentioning

confidence: 99%

Is insulin an anabolic agent in bone? Dissecting the diabetic bone for clues

Thrailkill

Lumpkin

Bunn

et al. 2005

American Journal of Physiology-Endocrinology and Metabolism

436

322

View full text Add to dashboard Cite

show abstract

“…Although an increased fracture risk has not been found in this patient group, increased calcaneal fractures have been reported in patients with long-term vascular complications and in those receiving steroid treatment (80,81). Osteopenia appears to be minimally progressive in adulthood (77,82), suggesting that the low bone density seen in adult patients may result from a reduction in peak bone mass.…”

Section: Other Endocrine Disordersmentioning

confidence: 64%

Hormonal Determinants and Disorders of Peak Bone Mass in Children¹

Soyka

Fairfield

Klibanski

2000

The Journal of Clinical Endocrinology & Metabolism

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“…Two additional distinct avulsion fracture types of the tuberosity exist, namely the neuropathic Charcot-like fractures in diabetics and avulsion fractures of the apophysis of the calcaneus [2,6,35,43,50,52]. The type 1 "Iowa fracture" according to Hedlund et al [35] is an extra-articular tuberosity avulsion fracture near the insertion of the Achilles-tendon, occurring in patients with a history of diabetes.…”

Section: Calcaneal Tuberosity Fracturesmentioning

confidence: 99%

“…The type 1 "Iowa fracture" according to Hedlund et al [35] is an extra-articular tuberosity avulsion fracture near the insertion of the Achilles-tendon, occurring in patients with a history of diabetes.…”

Section: Calcaneal Tuberosity Fracturesmentioning

confidence: 99%

Demographics of extra-articular calcaneal fractures: including a review of the literature on treatment and outcome

Schepers

Ginai

Lieshout

et al. 2007

Arch Orthop Trauma Surg

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Introduction Extra-articular calcaneal fractures represent 25-40% of all calcaneal fractures and an even higher percentage of up to 60% is seen in children. A disproportionately small part of the literature on calcaneal fractures involves the extra-articular type. The aim of this study was to investigate the incidence of extra-articular calcaneal fractures in a Level 1 trauma centre, deWne the distribution of the various types of fractures and compare patient demographics between extra-and intra-articular calcaneal fractures. In addition the literature was reviewed for the most common types of extra-articular calcaneal fractures with regard to incidence, treatment and clinical outcome. Methods The radiological records between 2003 and 2005 were reviewed for intra-and extra-articular calcaneal fractures. Patient gender-distribution and age were compared. A literature search was conducted for the treatment of extra-articular calcaneal fractures. Results In this 3-year study period a total of 49 patients with 50 extra-articular calcaneal fractures and 91 patients with 101 intra-articular fractures were identiWed. The median age for the Wrst group was 32.7 years, and for the second group 40.3 years; P = 0.04. Male predominance was signiWcantly less pronounced for extra-articular (63%) compared with intra-articular fractures (79%; P = 0.04). ConclusionOne-third of all calcaneal fractures are extra-articular. SigniWcant diVerences exist between the intra-and extra-articular groups, in terms of lower age and male-female ratio. The literature study shows inconsistencies in treatment options, but most extra-articular fractures are well manageable conservatively.

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Calcaneal Fractures in Diabetic Patients

Cited by 63 publications

References 11 publications

Is insulin an anabolic agent in bone? Dissecting the diabetic bone for clues

Is insulin an anabolic agent in bone? Dissecting the diabetic bone for clues

Hormonal Determinants and Disorders of Peak Bone Mass in Children¹

Demographics of extra-articular calcaneal fractures: including a review of the literature on treatment and outcome

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Calcaneal Fractures in Diabetic Patients

Cited by 63 publications

References 11 publications

Is insulin an anabolic agent in bone? Dissecting the diabetic bone for clues

Is insulin an anabolic agent in bone? Dissecting the diabetic bone for clues

Hormonal Determinants and Disorders of Peak Bone Mass in Children1

Demographics of extra-articular calcaneal fractures: including a review of the literature on treatment and outcome

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Hormonal Determinants and Disorders of Peak Bone Mass in Children¹