Wrist Fractures and Osteoporosis

Wu, John; Strickland, Carson D.; Chambers, Jonathan

doi:10.1016/j.ocl.2018.10.004

Cited by 23 publications

(14 citation statements)

References 74 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Distal radial fracture (DRF) is the most common fracture in the elderly, causing both suffering and substantial health care costs. A recent epidemiological study showed increasing incidences of DRF [ 1 ], with osteoporosis being a contributing factor [ 2 ]. Data from the Swedish fracture register shows that approximately 26% of all DRF’s are surgically treated and over the recent decade surgery has become increasingly common [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Supraclavicular block with Mepivacaine vs Ropivacaine, their impact on postoperative pain: a prospective randomised study

et al. 2021

View full text Add to dashboard Cite

Background Supraclavicular block (SCB) with long-acting local anaesthetic is commonly used for surgical repair of distal radial fractures (DRF). Studies have shown a risk for rebound pain when the block fades. This randomised single-centre study aimed to compare pain and opioid consumption the first three days post-surgery between SCB-mepivacaine vs. SCB-ropivacaine, with general anaesthesia (GA) as control. Methods Patients (n = 90) with ASA physical status 1–3 were prospectively randomised to receive; SCB with mepivacine 1%, 25–30 ml (n = 30), SCB with ropivacaine 0.5%, 25–30 ml (n = 30) or GA (n = 30) with propofol/fentanyl/sevoflurane. Study objectives compared postoperative pain with Numeric Rating Scale (NRS) and sum postoperative Opioid Equivalent Consumption (OEC) during the first 3 days post-surgery between study-groups. Results The three groups showed significant differences in postoperative pain-profile. Mean NRS at 24 h was significantly lower for the SCB-mepivacaine group (p = 0.018). Further both median NRS and median OEC day 0 to 3 were significanly lower in the SCB-mepivacaine group as compared to the SCB-ropivacaine group during the first three days after surgery; pain NRS 1 (IQR 0.3–3.3) and 2.7 (IQR 1.3–4.2) (p = 0.017) and OEC 30 mg (IQR 10–80) and 85 mg (IQR 45–125) (p = 0.004), respectively. The GA-group was in between both in pain NRS and median sum OEC. Unplanned healthcare contacts were highest among SCB-ropivacaine patients (39.3%) vs. SCB-mepivacaine patients (0%) and GA-patients (3.4%). Conclusions The potential benefit of longer duration of analgesia, associated to a long-acting local anaesthetic agent, during the early postoperative course must be put in perspective of potential worse pain progression following block resolution. Trial registration NCT03749174 (clinicaltrials.gov, Nov 21, 2018, retrospectively registered).

show abstract

Section: Introductionmentioning

confidence: 99%

Supraclavicular block with Mepivacaine vs Ropivacaine, their impact on postoperative pain: a prospective randomised study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Several strategies for the treatment of distal radius fractures have been described in the literature including closed reduction and splinting or casting, external fixation, and open reduction and internal fixation. Although both conservative and surgical management have been reported to be successful, current evidence and the most recent American Academy of Orthopaedic Surgeons (AAOS) clinical guidelines comparing conservative and surgical treatment of distal radius fragility fractures are inconclusive [ 33 ]. Although cast immobilization alone avoids the potential complications of surgery, it may fail in maintaining the correct reduction, and it is also associated with a certain risk of late fracture collapse and malunion; therefore, most physicians advise surgical fixation because it improves stability and enhances earlier recovery of ROM [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Bone Loss in Distal Radial Fractures Treated with A Composite Xenohybrid Bone Substitute: A Two Years Follow-Up Retrospective Study

et al. 2020

View full text Add to dashboard Cite

(1) Background: Recently, surgical treatment of distal radius fractures has increased exponentially. Many locking plates’ fixation systems have been developed allowing a more stable reduction and early mobilization. Sometimes, open reduction and fixation of distal radius fractures may leave a residual bone loss requiring grafting. This retrospective study reports clinical and radiologic outcomes of distal radius fractures treated with xenohybrid bone grafting in order to assess (i) the safety of the investigated bone graft; (ii) its radiological integration and biomechanical performances, and (iii) clinical outcomes of the patients; (2) Methods: We performed a retrospective study on a cohort of 19 patients. Preoperative X-ray and CT scan were performed. The mean clinical and radiographical follow-up was two years. Safety of the xenohybrid bone graft was constantly evaluated. Clinical results were assessed through the DASH score and Mayo wrist score; (3) Results: No adverse reactions, infections, and local or general complication were related to the use of xenohybrid bone graft. The radiolucency of the xenografts suggested progressive osteointegration. No evidence of bone graft resorption was detected. All the patients reached consolidation with good to excellent clinical results; and (4) Conclusions: Clinical and radiological data demonstrated that xenohybrid bone grafting promotes new bone formation and healing in osteopenic areas caused by fracture reduction.

show abstract

“…The accurate segmentation of the ulna and radius, for BMD measurement to diagnose osteoporosis, could be helpful for the early diagnosis and treatment of distal radius fracture, which may be the initial presentation of osteoporosis [ 17 ]. For ulna and radius segmentation, many researchers have used image processing technology to solve the segmentation problem.…”

Section: Introductionmentioning

confidence: 99%

Deep learning approach for automatic segmentation of ulna and radius in dual-energy X-ray imaging

et al. 2021

View full text Add to dashboard Cite

Background Segmentation of the ulna and radius is a crucial step for the measurement of bone mineral density (BMD) in dual-energy X-ray imaging in patients suspected of having osteoporosis. Purpose This work aimed to propose a deep learning approach for the accurate automatic segmentation of the ulna and radius in dual-energy X-ray imaging. Methods and materials We developed a deep learning model with residual block (Resblock) for the segmentation of the ulna and radius. Three hundred and sixty subjects were included in the study, and five-fold cross-validation was used to evaluate the performance of the proposed network. The Dice coefficient and Jaccard index were calculated to evaluate the results of segmentation in this study. Results The proposed network model had a better segmentation performance than the previous deep learning-based methods with respect to the automatic segmentation of the ulna and radius. The evaluation results suggested that the average Dice coefficients of the ulna and radius were 0.9835 and 0.9874, with average Jaccard indexes of 0.9680 and 0.9751, respectively. Conclusion The deep learning-based method developed in this study improved the segmentation performance of the ulna and radius in dual-energy X-ray imaging.

show abstract

Wrist Fractures and Osteoporosis

Cited by 23 publications

References 74 publications

Supraclavicular block with Mepivacaine vs Ropivacaine, their impact on postoperative pain: a prospective randomised study

Supraclavicular block with Mepivacaine vs Ropivacaine, their impact on postoperative pain: a prospective randomised study

Bone Loss in Distal Radial Fractures Treated with A Composite Xenohybrid Bone Substitute: A Two Years Follow-Up Retrospective Study

Deep learning approach for automatic segmentation of ulna and radius in dual-energy X-ray imaging

Contact Info

Product

Resources

About