Hip fracture after hemiplegia

Mulley, Graham; Espley, Arthur

doi:10.1136/pgmj.55.642.264

Cited by 81 publications

(28 citation statements)

References 2 publications

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“…1 These fractures usually occur relatively late after stroke onset and affect the paretic side of the body. [2][3][4][5] Hip fractures are associated with more deaths, disabilities, and medical costs than all other osteoporosis-related fractures combined. 6 We previously measured the bone mineral density (BMD) in patients with stroke in the second metacarpal bone and demonstrated a decrease in the bone mass in the hemiplegic limb that corresponded to the degree of palsy and vitamin D deficiency, 7 which may explain why hip fractures in patients poststroke occur almost exclusively on the hemiplegic side of the body.…”

Section: T He Risk Of a Hip Fracture Inmentioning

confidence: 99%

Effect of Folate and Mecobalamin on Hip Fractures in Patients With Stroke

Satō¹,

Honda²,

Iwamoto³

et al. 2005

JAMA

264

174

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Section: T He Risk Of a Hip Fracture Inmentioning

confidence: 99%

Effect of Folate and Mecobalamin on Hip Fractures in Patients With Stroke

Satō¹,

Honda²,

Iwamoto³

et al. 2005

JAMA

264

174

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“…4 On the other hand, from 4% to 15% of hip fractures occur as a late complication of stroke, with Ն79% occurring on the hemiplegic side. [7][8][9][10] To prevent hip fracture, the goal of this study was to determine the bone turnover and bone mass in hemiplegic patients at different phases of recovery from stroke. We examined the differences in biochemical indices of bone metabolism and turnover and the changes in bone density between patients in an earlier recovery period (Ͻ1 year, early group) and those in a later recovery stage (illness duration between 1 and 2 years, long-term group).…”

mentioning

confidence: 99%

Increased Bone Resorption During the First Year After Stroke

Satō

Kuno

Kaji

et al. 1998

Stroke

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Background and Purpose-Significant bone mineral density (BMD) reduction occurs in stroke patients on the hemiplegic side compared with the intact side. To elucidate the pathogenesis of hip fractures in this population, we measured serum markers of bone metabolism and BMD in the stroke patients within 1 year (early group) and between 1 and 2 years after onset of hemiplegia (long-term group). Methods-Sera were collected from 51 patients from the early group and 93 patients from the long-term group. All patients had hemiplegia. Sera were assayed for pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen (ICTP; a bone resorption marker) and bone Gla protein (a bone formation marker). The z score of BMD was determined in both second metacarpals. Results-Serum ICTP concentrations (ng/mL) were higher in the early group (15.4Ϯ4.1) than in the long-term group (6.7Ϯ4.4). Bone Gla protein was normal or low in both groups. Multiple regression analysis identified Barthel Index, degree of hemiplegia, and illness duration as independent determinants of ICTP in the early group, whereas Barthel Index, degree of hemiplegia, and serum calcium were determinants of ICTP in the long-term group. There were statistically significant correlations between the z score of the hemiplegic side and age, Barthel Index, degree of hemiplegia, illness duration, 25-hydroxyvitamin D (25-OHD), and ICTP in the early group and between the z score and degree of hemiplegia and 25-OHD level in the long-term group. Conclusions-The pathogenesis of reduced BMD differed between the early and long-term stroke groups. These results suggest that in the early group, increased bone resorption caused by immobilization was responsible for osteopenia on the hemiplegic side, whereas the degree of hemiplegia and 25-OHD level were the determinants of osteopenia in the long-term group. (Stroke. 1998;29:1373-1377.)

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“…Researchers have long recognized that stroke survivors experience excess bone loss (i.e., in addition to that associated with normal aging) in the paretic upper limbs and in the lower limbs [2][3][4]. Bone loss in the lower limb is a particularly serious concern, because stroke survivors have a hip fracture risk two to four times higher than that of age-and sex-matched healthy individuals [5][6].…”

Section: Introductionmentioning

confidence: 99%

Key characteristics of walking correlate with bone density in individuals with chronic stroke

Worthen¹,

Kim²,

Kautz³

et al. 2005

JRRD

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Abstract-Several recent studies of ambulatory stroke survivors have shown decreased bone mineral density (BMD) in the lower limbs and an elevated risk of hip fracture. Because bone mass is linked to skeletal loading, weight-bearing activities of daily living such as walking are considered critically important for maintenance of femoral BMD in ambulatory individuals. Little is known about the relationships between walking characteristics, skeletal loading, and bone maintenance in individuals who have experienced a stroke. This study determined whether certain gait-related parameters correlate with proximal femoral BMD in ambulatory individuals with poststroke walking deficits. We analyzed data from 33 individuals with chronic stroke and found that a recently introduced metric, the Bone Density Index, which incorporates body weight, number of steps per day, and ground reaction force magnitude, predicted proximal femoral BMD better than other commonly measured demographic and gait-related parameters that we examined.

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Hip fracture after hemiplegia

Cited by 81 publications

References 2 publications

Effect of Folate and Mecobalamin on Hip Fractures in Patients With Stroke

Effect of Folate and Mecobalamin on Hip Fractures in Patients With Stroke

Increased Bone Resorption During the First Year After Stroke

Key characteristics of walking correlate with bone density in individuals with chronic stroke

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