Pub Date : 2024-11-01DOI: 10.1016/j.recot.2024.08.007
G. Martínez-Díaz-Guerra, F. Hawkins Carranza, S. Librizzi
Low socioeconomic status (SES) is associated with a higher risk of fragility fractures, as well as higher mortality in the first-year post-fracture. The SES variables that have the greatest impact are educational level, income level, and cohabitation status. Significant disparities exist among racial and ethnic minorities in access to osteoporosis screening and treatment.
In Spain, a higher risk of fractures has been described in people with a low-income level, residence in rural areas during childhood and low educational level. The civil war cohort effect is a significant risk factor for hip fracture. There is significant geographic variability in hip fracture care, although the possible impact of socioeconomic factors has not been analyzed. It would be desirable to act on socioeconomic inequalities to improve the prevention and treatment of osteoporotic fractures.
{"title":"[Translated article] Socioeconomic status, osteoporosis and fragility fractures","authors":"G. Martínez-Díaz-Guerra, F. Hawkins Carranza, S. Librizzi","doi":"10.1016/j.recot.2024.08.007","DOIUrl":"10.1016/j.recot.2024.08.007","url":null,"abstract":"<div><div>Low socioeconomic status (SES) is associated with a higher risk of fragility fractures, as well as higher mortality in the first-year post-fracture. The SES variables that have the greatest impact are educational level, income level, and cohabitation status. Significant disparities exist among racial and ethnic minorities in access to osteoporosis screening and treatment.</div><div>In Spain, a higher risk of fractures has been described in people with a low-income level, residence in rural areas during childhood and low educational level. The civil war cohort effect is a significant risk factor for hip fracture. There is significant geographic variability in hip fracture care, although the possible impact of socioeconomic factors has not been analyzed. It would be desirable to act on socioeconomic inequalities to improve the prevention and treatment of osteoporotic fractures.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages T539-T546"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.recot.2024.10.001
C. Mengis , N. Plais , F. Moreno , G. Cózar , F. Tomé-Bermejo , L. Álvarez-Galovich
Osteoporosis and fragility play a significant role in the treatment and planning of patients with deformity secondary to osteoporotic vertebral fracture (OVF). The resulting deformity can present significant challenges for its management, both from a medical and surgical perspective. The need for a specific classification for these deformities, including the potential for the development of artificial intelligence and machine learning in predictive analysis, is emerging as a key point in the coming years. Relevant aspects in preoperative optimisation and management of these patients are addressed. A classification with therapeutic guidance for the management of spinal deformity secondary to OVF is developed, emphasising the importance of personalised treatment. Flexibility and sagittal balance are considered key aspects. On the other hand, we recommend, especially with these fragile patients, management with minimally invasive techniques to promote rapid recovery and reduce the number of complications.
{"title":"[Translated article] Management of spinal deformities caused by osteoporotic vertebral fractures","authors":"C. Mengis , N. Plais , F. Moreno , G. Cózar , F. Tomé-Bermejo , L. Álvarez-Galovich","doi":"10.1016/j.recot.2024.10.001","DOIUrl":"10.1016/j.recot.2024.10.001","url":null,"abstract":"<div><div>Osteoporosis and fragility play a significant role in the treatment and planning of patients with deformity secondary to osteoporotic vertebral fracture (OVF). The resulting deformity can present significant challenges for its management, both from a medical and surgical perspective. The need for a specific classification for these deformities, including the potential for the development of artificial intelligence and machine learning in predictive analysis, is emerging as a key point in the coming years. Relevant aspects in preoperative optimisation and management of these patients are addressed. A classification with therapeutic guidance for the management of spinal deformity secondary to OVF is developed, emphasising the importance of personalised treatment. Flexibility and sagittal balance are considered key aspects. On the other hand, we recommend, especially with these fragile patients, management with minimally invasive techniques to promote rapid recovery and reduce the number of complications.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages T615-T623"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.recot.2024.03.011
A.I. Hormigo-Sánchez , M. Neira-Álvarez , T. Pareja-Sierra
Osteoporosis is a metabolic and systemic disease characterized by alterations at the level of bone tissue with loss of bone mineral density, changes in microarchitecture, mineralization and remodeling that determine greater bone fragility and risk of fracture.
Falls in the elderly are a risk factor closely related to fragility fractures and numerous studies demonstrate this relationship.
Vertebral fractures are a major cause of morbidity and mortality. The epidemiology differs from osteoporotic fractures at other skeletal sites, as only one-third are clinically recognized. In the elderly, the approach to osteoporotic vertebral fracture involves comprehensive evaluation of the patient, since it is both a cause and a consequence of multiple geriatric syndromes. This fracture, in its acute phase and subsequently, can lead to destabilization of other organs and systems of the elderly, medical complications at different levels, functional deterioration, dependence, and even the need for institutionalization.
Therefore, it is important to carry out a multiple assessment of patients with vertebral fractures, addressing not only the history and risk factors of osteoporosis, but also those factors that lead to falls, as well as a comprehensive geriatric assessment and the complications closely associated with it.
In this chapter we address each of these aspects that are necessary in the individual and multidimensional approach to the elderly patient with vertebral fracture due to bone fragility.
{"title":"Abordaje del adulto mayor con fractura vertebral por fragilidad ósea","authors":"A.I. Hormigo-Sánchez , M. Neira-Álvarez , T. Pareja-Sierra","doi":"10.1016/j.recot.2024.03.011","DOIUrl":"10.1016/j.recot.2024.03.011","url":null,"abstract":"<div><div>Osteoporosis is a metabolic and systemic disease characterized by alterations at the level of bone tissue with loss of bone mineral density, changes in microarchitecture, mineralization and remodeling that determine greater bone fragility and risk of fracture.</div><div>Falls in the elderly are a risk factor closely related to fragility fractures and numerous studies demonstrate this relationship.</div><div>Vertebral fractures are a major cause of morbidity and mortality. The epidemiology differs from osteoporotic fractures at other skeletal sites, as only one-third are clinically recognized. In the elderly, the approach to osteoporotic vertebral fracture involves comprehensive evaluation of the patient, since it is both a cause and a consequence of multiple geriatric syndromes. This fracture, in its acute phase and subsequently, can lead to destabilization of other organs and systems of the elderly, medical complications at different levels, functional deterioration, dependence, and even the need for institutionalization.</div><div>Therefore, it is important to carry out a multiple assessment of patients with vertebral fractures, addressing not only the history and risk factors of osteoporosis, but also those factors that lead to falls, as well as a comprehensive geriatric assessment and the complications closely associated with it.</div><div>In this chapter we address each of these aspects that are necessary in the individual and multidimensional approach to the elderly patient with vertebral fracture due to bone fragility.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages 572-581"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140795861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.recot.2024.03.004
P. Checa-Betegón, R. Luque-Pérez, D. Oñate-Martínez-Olascoaga, J.L. Pérez-González, I. Domínguez-Esteban
Osteoporosis, and the consequences derived from it, such as fragility fractures, constitute a growing public health problem. Suffering from a fracture of this nature is the main risk factor for suffering a new fracture.
It is documented that vertebral compression fractures lead to significant morbidity and mortality, in the short and long term, as well as other complications, such as sagittal imbalance and hyperkyphosis of the segment. However, we have not found documentation that analyzes the medium and long-term consequences of these injuries, assessing the type of treatment used, and the economic impact they represent.
The purpose of this review is to analyze the main recent literature on the subject and make a breakdown of the consequences of these fractures in various spheres, such as economic, quality of life, sagittal balance and radiographic parameters, pain or mortality; as well as a brief analysis of epidemiology and natural history.
Conclusion
Osteoporotic fractures constitute an emerging problem, both in the medical and economic fields. The consequences and sequelae on the patient are multiple and although surgical options offer good long-term results, it is necessary to properly select the patient, through multidisciplinary teams, to try to minimize potential complications.
{"title":"Fracturas vertebrales osteoporóticas: historia natural e impacto","authors":"P. Checa-Betegón, R. Luque-Pérez, D. Oñate-Martínez-Olascoaga, J.L. Pérez-González, I. Domínguez-Esteban","doi":"10.1016/j.recot.2024.03.004","DOIUrl":"10.1016/j.recot.2024.03.004","url":null,"abstract":"<div><div>Osteoporosis, and the consequences derived from it, such as fragility fractures, constitute a growing public health problem. Suffering from a fracture of this nature is the main risk factor for suffering a new fracture.</div><div>It is documented that vertebral compression fractures lead to significant morbidity and mortality, in the short and long term, as well as other complications, such as sagittal imbalance and hyperkyphosis of the segment. However, we have not found documentation that analyzes the medium and long-term consequences of these injuries, assessing the type of treatment used, and the economic impact they represent.</div><div>The purpose of this review is to analyze the main recent literature on the subject and make a breakdown of the consequences of these fractures in various spheres, such as economic, quality of life, sagittal balance and radiographic parameters, pain or mortality; as well as a brief analysis of epidemiology and natural history.</div></div><div><h3>Conclusion</h3><div>Osteoporotic fractures constitute an emerging problem, both in the medical and economic fields. The consequences and sequelae on the patient are multiple and although surgical options offer good long-term results, it is necessary to properly select the patient, through multidisciplinary teams, to try to minimize potential complications.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages 587-596"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140783215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.recot.2024.06.012
F. Tomé-Bermejo , J.F Bartolomé Gómez
Osteoporosis weakens the structural strength of bone to such an extent that normal daily activity may exceed the capacity of the vertebra to bear this load. Vertebral fracture and deformity is a hallmark of osteoporosis. The detriment of trabecular bone properties alone cannot explain the occurrence of osteoporotic vertebral fracture. The ability of the spine to bear and resist loads depends on the structural capacity of the vertebrae, but also on loading conditions arising from activities of daily living or low-energy trauma. This review describes the mechanical properties of the vertebral bone, the structural load-bearing capacity of the various elements forming the spine, the neuromuscular control of the trunk, as well as the biomechanics of the loads to which the spine is subjected in relation to the presence of osteoporosis and the risk of vertebral fracture. A better understanding of biomechanical factors may help to explain both the high incidence of osteoporotic vertebral fractures and their mechanism of production. Consideration of these issues may be important in the development of prevention and management strategies.
{"title":"Factores anatómicos y biomecánicos de la fractura vertebral osteoporótica y la aparición de las fracturas en cascada","authors":"F. Tomé-Bermejo , J.F Bartolomé Gómez","doi":"10.1016/j.recot.2024.06.012","DOIUrl":"10.1016/j.recot.2024.06.012","url":null,"abstract":"<div><div>Osteoporosis weakens the structural strength of bone to such an extent that normal daily activity may exceed the capacity of the vertebra to bear this load. Vertebral fracture and deformity is a hallmark of osteoporosis. The detriment of trabecular bone properties alone cannot explain the occurrence of osteoporotic vertebral fracture. The ability of the spine to bear and resist loads depends on the structural capacity of the vertebrae, but also on loading conditions arising from activities of daily living or low-energy trauma. This review describes the mechanical properties of the vertebral bone, the structural load-bearing capacity of the various elements forming the spine, the neuromuscular control of the trunk, as well as the biomechanics of the loads to which the spine is subjected in relation to the presence of osteoporosis and the risk of vertebral fracture. A better understanding of biomechanical factors may help to explain both the high incidence of osteoporotic vertebral fractures and their mechanism of production. Consideration of these issues may be important in the development of prevention and management strategies.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages 562-571"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.recot.2024.08.004
A.I. Hormigo-Sánchez , M. Neira-Álvarez , T. Pareja-Sierra
Osteoporosis is a metabolic and systemic disease characterised by alterations at the level of bone tissue with loss of bone mineral density, changes in microarchitecture, mineralisation and remodelling that determine greater bone fragility and risk of fracture.
Falls in the elderly are a risk factor closely related to fragility fractures and numerous studies demonstrate this relationship.
Vertebral fractures are a major cause of morbidity and mortality. The epidemiology differs from osteoporotic fractures at other skeletal sites, as only one-third are clinically recognised. In the elderly, the approach to osteoporotic vertebral fracture involves comprehensive evaluation of the patient, since it is both a cause and a consequence of multiple geriatric syndromes. This fracture, in its acute phase and subsequently, can lead to destabilisation of other organs and systems of the elderly, medical complications at different levels, functional deterioration, dependence, and even the need for institutionalisation.
Therefore, it is important to carry out a multiple assessment of patients with vertebral fractures, addressing not only the history and risk factors of osteoporosis, but also those factors that lead to falls, as well as a comprehensive geriatric assessment and the complications closely associated with it.
In this chapter we address each of these aspects that are necessary in the individual and multidimensional approach to the elderly patient with vertebral fracture due to bone fragility.
{"title":"[Translated article] Approach to the elderly patient with vertebral fracture due to bone fragility","authors":"A.I. Hormigo-Sánchez , M. Neira-Álvarez , T. Pareja-Sierra","doi":"10.1016/j.recot.2024.08.004","DOIUrl":"10.1016/j.recot.2024.08.004","url":null,"abstract":"<div><div>Osteoporosis is a metabolic and systemic disease characterised by alterations at the level of bone tissue with loss of bone mineral density, changes in microarchitecture, mineralisation and remodelling that determine greater bone fragility and risk of fracture.</div><div>Falls in the elderly are a risk factor closely related to fragility fractures and numerous studies demonstrate this relationship.</div><div>Vertebral fractures are a major cause of morbidity and mortality. The epidemiology differs from osteoporotic fractures at other skeletal sites, as only one-third are clinically recognised. In the elderly, the approach to osteoporotic vertebral fracture involves comprehensive evaluation of the patient, since it is both a cause and a consequence of multiple geriatric syndromes. This fracture, in its acute phase and subsequently, can lead to destabilisation of other organs and systems of the elderly, medical complications at different levels, functional deterioration, dependence, and even the need for institutionalisation.</div><div>Therefore, it is important to carry out a multiple assessment of patients with vertebral fractures, addressing not only the history and risk factors of osteoporosis, but also those factors that lead to falls, as well as a comprehensive geriatric assessment and the complications closely associated with it.</div><div>In this chapter we address each of these aspects that are necessary in the individual and multidimensional approach to the elderly patient with vertebral fracture due to bone fragility.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages T572-T581"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.recot.2024.06.011
M. Nikitsina , P. Quiroga-Colina , S. Castañeda
Osteoporosis is a highly prevalent and multifactorial disease whose main manifestation is the appearance of fragility or low-impact fractures. The most frequent locations of osteoporotic fractures occur at the vertebrae, femoral, distal end of the radius and humerus. Osteoporotic vertebral fracture deserves special mention among them due to its prevalence, importance as it often goes unnoticed and medium-long term consequences are: pain, deformity, disability and deterioration in quality of life. In this review we will focus on the classification and initial evaluation of the patient with osteoporosis, estimation of risk factors, laboratory and imaging studies for an adequate assessment using simple radiography, dual densitometry and magnetic resonance imaging. We will also address the main aspects of the differential diagnosis, treatment and prevention of vertebral fragility fracture, briefly reviewing the main therapeutic agents currently used for its prevention and treatment.
{"title":"Evaluación, diagnóstico diferencial y tratamiento de la osteoporosis vertebral: cómo evitar la aparición de nuevas fracturas","authors":"M. Nikitsina , P. Quiroga-Colina , S. Castañeda","doi":"10.1016/j.recot.2024.06.011","DOIUrl":"10.1016/j.recot.2024.06.011","url":null,"abstract":"<div><div>Osteoporosis is a highly prevalent and multifactorial disease whose main manifestation is the appearance of fragility or low-impact fractures. The most frequent locations of osteoporotic fractures occur at the vertebrae, femoral, distal end of the radius and humerus. Osteoporotic vertebral fracture deserves special mention among them due to its prevalence, importance as it often goes unnoticed and medium-long term consequences are: pain, deformity, disability and deterioration in quality of life. In this review we will focus on the classification and initial evaluation of the patient with osteoporosis, estimation of risk factors, laboratory and imaging studies for an adequate assessment using simple radiography, dual densitometry and magnetic resonance imaging. We will also address the main aspects of the differential diagnosis, treatment and prevention of vertebral fragility fracture, briefly reviewing the main therapeutic agents currently used for its prevention and treatment.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages 547-561"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-29DOI: 10.1016/j.recot.2024.10.013
R Luque, D Garríguez, P Checa Betegon, M Sanchez, M Olvera, J L Perez Gonzalez, I Dominguez Esteban
Introduction: Stiffness is increased in vertebrae after kyphoplasty with bone cement is performed, which cause an increase in subsequent fractures in adjacent levels. This has led to increased interest in alternative filling materials such as bioactive calcium phosphate ceramics or silicon-based polymers. This study's objective is to compare the results between kyphoplasty with bone cement and with the VK100 silicone.
Materials and methods: This is a comparative, prospective study involving 64 patients, 23 treated using VK100 and 41 with PMMA. Clinical, radiological and functional results (Oswestry) and quality of life and (EQ-5D) were analyzed and compared between both groups, focusing on differences in subsequent fractures in adjacent levels.
Results: There are no differences between the two treatments in terms of epidemiological factors (age and sex) or hospital management. A significant difference is observed in the gain of vertebral body height, with greater improvement in those treated with PMMA. There is also a higher fracture rate in the PMMA group, the difference is not significant. Finally, both treatments show similar outcomes in pain relief and quality of life.
Conclusion: Both VK100 Elastoplasty and PMMA Kyphoplasty are effective treatments for vertebral fractures. VK100 has a lower rate of complications and adjacent fractures. However, long-term results in terms of pain relief and quality of life are similar, making both treatments equally valid.
{"title":"Silicone kyphoplasty (elastoplasty) versus traditional cement kyphoplasty for osteoporotic vertebral fractures. Does this new technique reduce the complications?","authors":"R Luque, D Garríguez, P Checa Betegon, M Sanchez, M Olvera, J L Perez Gonzalez, I Dominguez Esteban","doi":"10.1016/j.recot.2024.10.013","DOIUrl":"10.1016/j.recot.2024.10.013","url":null,"abstract":"<p><strong>Introduction: </strong>Stiffness is increased in vertebrae after kyphoplasty with bone cement is performed, which cause an increase in subsequent fractures in adjacent levels. This has led to increased interest in alternative filling materials such as bioactive calcium phosphate ceramics or silicon-based polymers. This study's objective is to compare the results between kyphoplasty with bone cement and with the VK100 silicone.</p><p><strong>Materials and methods: </strong>This is a comparative, prospective study involving 64 patients, 23 treated using VK100 and 41 with PMMA. Clinical, radiological and functional results (Oswestry) and quality of life and (EQ-5D) were analyzed and compared between both groups, focusing on differences in subsequent fractures in adjacent levels.</p><p><strong>Results: </strong>There are no differences between the two treatments in terms of epidemiological factors (age and sex) or hospital management. A significant difference is observed in the gain of vertebral body height, with greater improvement in those treated with PMMA. There is also a higher fracture rate in the PMMA group, the difference is not significant. Finally, both treatments show similar outcomes in pain relief and quality of life.</p><p><strong>Conclusion: </strong>Both VK100 Elastoplasty and PMMA Kyphoplasty are effective treatments for vertebral fractures. VK100 has a lower rate of complications and adjacent fractures. However, long-term results in terms of pain relief and quality of life are similar, making both treatments equally valid.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-28DOI: 10.1016/j.recot.2024.10.011
J V Andrés-Peiró, M M Reverté-Vinaixa, O Pujol-Alarcón, M Altayó-Carulla, S Castellanos-Alonso, J Teixidor-Serra, J Tomàs-Hernández, J Selga-Marsà, C A Piedra-Calle, F Blasco-Casado, Y García-Sánchez, N Joshi-Jubert, J Minguell-Monyart
Introduction: Ankle fractures are increasingly common in frail patients, with hospitalization being the principal cost driver, particularly for the elderly who often need referral to nursing facilities. This study aims to identify factors affecting resource utilization per admission (hospital and nursing) in the fixation of low-energy ankle fractures.
Materials and methods: This retrospective cohort study examined patients undergoing fixation for low-energy ankle fractures. The primary outcome was the length of hospitalization. Secondary outcomes included delays in fixation and the need for referral to a nursing institution. Multiple linear and logistic regression models were used to determine predictors related to patient demographics, injury characteristics, and treatment.
Results: We analyzed 651 patients with a median age of 58years. The median hospitalization duration was 9days, primarily before surgery. Extended hospitalization was associated with antithrombotic treatment (b=4.08), fracture-dislocation (2.26), skin compromise (7.56), complications (9.90), and discharge to a nursing center (5.56). Referral to a nursing facility occurred in 17.2%, associated with older age (OR=1.10) and an ASA score ≥III (6.96).
Conclusions: Prolonged hospitalization was mainly due to surgical delays and was related to fracture-dislocations, skin compromise, and complications. Older and comorbid patients were more likely to need nursing facilities, and delays in these facilities' availability contributed to extended hospital stays.
{"title":"Predictive factors of hospital and nursing facility admission in the fixation of low-energy ankle fractures.","authors":"J V Andrés-Peiró, M M Reverté-Vinaixa, O Pujol-Alarcón, M Altayó-Carulla, S Castellanos-Alonso, J Teixidor-Serra, J Tomàs-Hernández, J Selga-Marsà, C A Piedra-Calle, F Blasco-Casado, Y García-Sánchez, N Joshi-Jubert, J Minguell-Monyart","doi":"10.1016/j.recot.2024.10.011","DOIUrl":"10.1016/j.recot.2024.10.011","url":null,"abstract":"<p><strong>Introduction: </strong>Ankle fractures are increasingly common in frail patients, with hospitalization being the principal cost driver, particularly for the elderly who often need referral to nursing facilities. This study aims to identify factors affecting resource utilization per admission (hospital and nursing) in the fixation of low-energy ankle fractures.</p><p><strong>Materials and methods: </strong>This retrospective cohort study examined patients undergoing fixation for low-energy ankle fractures. The primary outcome was the length of hospitalization. Secondary outcomes included delays in fixation and the need for referral to a nursing institution. Multiple linear and logistic regression models were used to determine predictors related to patient demographics, injury characteristics, and treatment.</p><p><strong>Results: </strong>We analyzed 651 patients with a median age of 58years. The median hospitalization duration was 9days, primarily before surgery. Extended hospitalization was associated with antithrombotic treatment (b=4.08), fracture-dislocation (2.26), skin compromise (7.56), complications (9.90), and discharge to a nursing center (5.56). Referral to a nursing facility occurred in 17.2%, associated with older age (OR=1.10) and an ASA score ≥III (6.96).</p><p><strong>Conclusions: </strong>Prolonged hospitalization was mainly due to surgical delays and was related to fracture-dislocations, skin compromise, and complications. Older and comorbid patients were more likely to need nursing facilities, and delays in these facilities' availability contributed to extended hospital stays.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-28DOI: 10.1016/j.recot.2024.10.012
I Iriberri-Etxabeguren, I Rey-Urdiain, I Larrañaga-Imendji, J Revuelta-González
Background: Prosthetic Joint Infections (PJI) are associated with significant morbidity and mortality, underscoring the importance of identifying the related risk factors. The objective of the present study was to evaluate whether environmental factors were correlated with an increase in PJI.
Material and method: Retrospective cohort study of 1847 consecutive hip and knee prosthesis surgeries performed at a single center over a 10-year period. All patients who underwent surgery during this period were included, with a minimum follow-up of 2 years. The association between infection cases and environmental temperature and humidity was analyzed for both the day of surgical intervention and the week following the procedure.
Results: Sixty-three cases of infection (3.4%) were identified. No statistically significant differences were observed in the infection rate according to the month (p=0.13) or season (p=0.42) in which the surgery was performed. Furthermore, no significant association was found between the incidence of PJI and the average temperature or humidity on the day or week following the prosthesis implantation.
Conclusions: Environmental temperature and humidity do not influence the incidence of PJI in regions with an oceanic climate. The increase in PJI according to environmental conditions is primarily observed in large-scale studies based on national registries.
{"title":"Influence of environmental temperature and humidity on the incidence of prosthetic joint infections.","authors":"I Iriberri-Etxabeguren, I Rey-Urdiain, I Larrañaga-Imendji, J Revuelta-González","doi":"10.1016/j.recot.2024.10.012","DOIUrl":"10.1016/j.recot.2024.10.012","url":null,"abstract":"<p><strong>Background: </strong>Prosthetic Joint Infections (PJI) are associated with significant morbidity and mortality, underscoring the importance of identifying the related risk factors. The objective of the present study was to evaluate whether environmental factors were correlated with an increase in PJI.</p><p><strong>Material and method: </strong>Retrospective cohort study of 1847 consecutive hip and knee prosthesis surgeries performed at a single center over a 10-year period. All patients who underwent surgery during this period were included, with a minimum follow-up of 2 years. The association between infection cases and environmental temperature and humidity was analyzed for both the day of surgical intervention and the week following the procedure.</p><p><strong>Results: </strong>Sixty-three cases of infection (3.4%) were identified. No statistically significant differences were observed in the infection rate according to the month (p=0.13) or season (p=0.42) in which the surgery was performed. Furthermore, no significant association was found between the incidence of PJI and the average temperature or humidity on the day or week following the prosthesis implantation.</p><p><strong>Conclusions: </strong>Environmental temperature and humidity do not influence the incidence of PJI in regions with an oceanic climate. The increase in PJI according to environmental conditions is primarily observed in large-scale studies based on national registries.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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