Rate of Bone Mineral Density Testing and Subsequent Fracture-Free Interval After Distal Forearm Fracture in the Medicare Population

Parikh, Kisan; Reinhardt, Daniel; Templeton, Kimberly; Toby, Bruce; Brubacher, Jacob

doi:10.1016/j.jhsa.2020.11.020

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…A few recent studies helped to inform our care of the patient with a distal radial fracture. The rate of routine bone mineral density testing in patients with a distal radial fracture remains unacceptably low despite its value 34 . Patients who underwent testing after a fracture had a longer fracture-free interval (819 days) compared with those who did not have testing (579 days), once again highlighting the importance of early intervention.…”

Section: Wrist Traumamentioning

confidence: 99%

What’s New in Hand and Wrist Surgery

Bohn

Wise

2022

Journal of Bone and Joint Surgery

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The intent is to serve as an update of the hand surgery literature for the practicing general orthopaedic surgeon. Carpal Tunnel SyndromeCarpal tunnel syndrome is one of the most common disorders in hand surgery. Nevertheless, the optimum method for diagnosis remains controversial. A growing body of evidence suggests that electrodiagnostic studies [1][2][3][4] are not more sensitive and specific than diagnosis by ultrasound or clinical history and examination. D'Auria et al. 5 examined the role of electrodiagnostic studies compared with clinical judgment and found that the utility of electrodiagnostic studies may be greatest in patients for whom a diagnosis of carpal tunnel syndrome is questionable. Even so, electrodiagnostic studies are performed in many patients with carpal tunnel syndrome 6 . Less expensive, office-based diagnostic tools such as the Carpal Tunnel Syndrome 6 (CTS-6), a 26-point scale that incorporates aspects of the history and clinical examination to predict the probability of carpal tunnel syndrome, and ultrasound will likely supplant the routine use of electrodiagnostic studies for carpal tunnel syndrome.Strong evidence exists for the use of night splints and corticosteroid injections for early treatment of carpal tunnel syndrome. In a comparison of the 2 treatments, 100 patients with a diagnosis of carpal tunnel syndrome were randomized to a night splint or a corticosteroid injection 7 . In the 95 patients who completed follow-up, corticosteroid injections were superior in terms of nocturnal paresthesias, pain, and Boston Carpal Tunnel Questionnaire (BCTQ) function and symptom domains at 1, 3, and 6 months.A novel study on hand function with decreased sensation showed that a digital nerve block to the thumb had the greatest negative impact on dexterity and a loss of sensation in the index and long fingers caused decreased grip and chuck pinch strength, thus explaining the common symptoms of decreased dexterity and strength in patients with carpal tunnel syndrome 8 .Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/G899).

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Section: Wrist Traumamentioning

confidence: 99%

What’s New in Hand and Wrist Surgery

Bohn

Wise

2022

Journal of Bone and Joint Surgery

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“…Data from a Medicare cohort showed only 7% of patients with wrist fractures have DXA testing within 6 months of such injuries, yet 20% later develop fractures of the hip or spine. 39 The American Association of Clinical Endocrinologists and the American College of Endocrinology point out that errors in DXA scan acquisition and analysis can affect interpretation, and they encourage clinicians to review actual scan images and data rather than rely solely on a report, especially when it is discordant with the clinical picture. 40 Assuming this patient's DXA report was of good quality, there are other reasons to question whether it refl ects actual bone risk.…”

Section: ■ Case 2 Revisitedmentioning

confidence: 99%

DXA and clinical challenges of fracture risk assessment in primary care

Williams

Khan

Licata

2021

CCJM

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“…Previous research indicates that out of 46,992 subjects, only 20% had undergone DXA osteoporosis screening within two years before distal radius fracture, with males constituting only 5%. Ultimately, only 7% of patients received DXA osteoporosis testing within six months after the fracture [12]. These findings suggest significant underdiagnosis of osteoporosis currently, or an increase in fracture risk factors due to low examination frequency.…”

Section: Introductionmentioning

confidence: 97%

An Automated Assessment Method for Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD) Utilizing Metacarpal Cortical Percentage

Wu,

Tseng,

Gau

et al. 2024

Electronics

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Chronic kidney disease–mineral and bone disorder (CKD-MBD) frequently occurs in hemodialysis patients and is a common cause of osteoporosis. Regular dual-energy X-ray absorptiometry (DXA) scans are used to monitor these patients, but frequent, cost-effective, and low-dose alternatives are needed. This study proposes an automatic CKD-MBD assessment model using histogram equalization and a squeeze-and-excitation block-based residual U-Net (SER-U-Net) with hand diagnostic radiography for preliminary classification. The process involves enhancing image contrast with histogram equalization, extracting features with the SE-ResNet model, and segmenting metacarpal bones using U-Net. Ultimately, a correlation analysis is carried out between the calculated dual metacarpal cortical percentage (dMCP) and DXA T-scores. The model’s performance was validated by analyzing clinical data from 30 individuals, achieving a 93.33% accuracy in classifying bone density compared to DXA results. This automated method provides a rapid, effective tool for CKD-MBD assessment in clinical settings.

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Rate of Bone Mineral Density Testing and Subsequent Fracture-Free Interval After Distal Forearm Fracture in the Medicare Population

Cited by 7 publications

References 22 publications

What’s New in Hand and Wrist Surgery

What’s New in Hand and Wrist Surgery

DXA and clinical challenges of fracture risk assessment in primary care

An Automated Assessment Method for Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD) Utilizing Metacarpal Cortical Percentage

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