scholarly journals Variations in situational risk factors for fractures of the distal forearm, hip, and vertebrae in older women

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wen-Yu Yu ◽  
Hei-Fen Hwang ◽  
Mau-Roung Lin
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Older Women ◽  
Individual Characteristics ◽  
Situational Factors ◽  
Control Group ◽  
Distal Forearm ◽  
Forearm Fractures ◽  
Protective Response ◽  
Distal Forearm Fractures

Abstract Background Situational factors during a fall among three common types of fractures of the distal forearm, hip, and vertebrae among older women in Taiwan were investigated. Methods In 2016 ~ 2017, study participants were identified from those aged ≥65 years who visited emergency departments due to a fall in two university-affiliated hospitals in Taipei. In addition to individual characteristics, situational factors during the fall (location, activity, change of center of mass, fall mode, fall direction, initiating a protective response, and being hit) were collected. A sample of 203 distal-forearm fractures, 189 vertebral fractures, and 375 hip fractures was recruited, while 717 women with a soft-tissue injury were used as a control group. The identification of situational risk factors for each type of fracture was validated by using those who sustained one of the other two types of fracture as a control group. Results After adjusting for age and other individual characteristics, compared to soft-tissue injuries, distal-forearm fractures were significantly more likely to occur with slips (odds ratio [OR] = 11.0; 95% confidence interval [CI] = 4.76 ~ 25.4), trips (OR = 3.40; 95% CI = 1.42 ~ 8.17), step-downs (OR = 4.95; 95% CI = 2.15 ~ 11.4), and from sideways falls (OR = 1.73; 95% CI = 1.12 ~ 2.67) and significantly less likely to occur indoors (OR = 0.62; 95% CI = 0.42 ~ 0.90) or from backwards falls (OR = 0.62; 95% CI = 0.41 ~ 0.95). Hip fractures were significantly more likely to occur with step-downs (OR = 1.76; 95% CI = 1.13 ~ 2.75) and from backwards (OR = 3.16; 95% CI = 2.15 ~ 4.64) or sideways falls (OR = 5.56; 95% CI = 3.67 ~ 8.41) and significantly less likely when hitting an object (OR = 0.26; 95% CI = 0.13 ~ 0.52) or initiating a protective response (OR = 0.58; 95% CI = 0.36 ~ 0.93). Vertebral fractures were significantly more likely to occur with slips (OR = 2.42; 95% CI = 1.30 ~ 4.50), step-downs (OR = 2.53; 95% CI = 1.43 ~ 4.48), and backwards falls (OR = 2.15; 95% CI = 1.39 ~ 3.32). Similar results were found in the validation analyses. Conclusions Large variations in situational risk factors for the three types of fracture in older women existed. A combination of individual and situational risk factors may display a more-comprehensive risk profile for the three types of fracture, and an intervention that adds training programs on safe landing strategies and effective compensatory reactions may be valuable in preventing serious injuries due to a fall.

scholarly journals How long does treated supracondylar humerus fracture in children take to recover elbow range?

2019 ◽  
Vol 5 (5) ◽  
pp. 860
Author(s):  
Abhinav D. D. Jogani ◽  
Tushar N. Rathod ◽  
Chetan V. Shende ◽  
Nandan Marathe
Keyword(s):  
Recovery Period ◽  
Control Group ◽  
Distal Forearm ◽  
Forearm Fractures ◽  
Supracondylar Fractures ◽  
Fracture Group ◽  
Fractures In Children ◽  
Management Protocol ◽  
Supracondylar Humerus Fractures ◽  
Distal Forearm Fractures

<p class="abstract"><strong>Background:</strong> Our goal was to address requirement of physiotherapy after treatment of supracondylar humerus fractures in children and evaluate result of casting on elbow without injury using control group of distal forearm fractures.</p><p class="abstract"><strong>Methods:</strong> 57 cases of supracondylar fractures were included in this retrospective study and compared with group of 54 children with distal forearm fractures treated with long arm casting for 28 days. Passive elbow ROM was checked with goniometer on day of cast removal, 2 weeks later, and then every month until the elbow ROM returned to 95% ROM (ROM-95) of uninjured side. No physiotherapy was given.</p><p class="abstract"><strong>Results:</strong> Average time in cast for supracondylar fracture group was 31.8 days and distal forearm fracture group was 32.4 days. The elbow total flexion angle reached a plateau of 139 degrees at 1month after cast removal whereas forearm group required less than 2 weeks. Total rotation ROM required half the time to reach 139 degrees in forearm group. From the paired t test it took more time for pronation to recover than supination in supracondylar fractures. In supracondylar group there was positive correlation between casting period and recovery period of ROM-95 elbow extension (p=0.021) and days of casting (p=0.021) and ROM-95 flexion recovery period. There was no statistically significant impact between casting and recovery period in other directions and recovery of ROM-95 &amp; F-ROM and the subclassification and type of treatment of individual fractures.</p><p class="abstract"><strong>Conclusions:</strong> Lessons learned: thorough assessment of elbow function post cast removal, lack of need of physiotherapy in management protocol and elbow stiffness is related to initial injury and associated treatment not merely immobilisation.</p>

Risk factors of osteoporotic distal forearm fractures in postmenopausal women in Novosibirsk

2018 ◽  
Vol 16 (9) ◽  
pp. 174-179
Author(s):  
E. S. Mazurenko ◽  
◽  
S. K. Malyutina ◽  
L. V. Shcherbakova ◽  
Yu. I. Ragino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postmenopausal Women ◽  
Distal Forearm ◽  
Forearm Fractures ◽  
Distal Forearm Fractures

X-ray Follow-up after Open Reduction Internal Fixation of Distal Forearm Fracture

2020 ◽  
Author(s):  
Henrik Johan Sjølander ◽  
Sune Jauffred ◽  
Michael Brix ◽  
Per H. Gundtoft
Keyword(s):  
Diagnostic Imaging ◽  
Forearm Fracture ◽  
Minimal Risk ◽  
Distal Forearm ◽  
Forearm Fractures ◽  
Distal Forearm Fracture ◽  
Standard Regimen ◽  
Prolonged Immobilization ◽  
Distal Forearm Fractures

Abstract Background Following surgery, the standard regimen for fractures of the distal forearm includes radiographs taken 2-weeks postoperatively. However, it is unclear whether these radiographs have any therapeutic risks or benefits for patients. Objective The purpose of this study is to determine the importance of radiographs taken 2-weeks after surgery on distal forearm fractures, especially if it leads to further operations, and to establish whether this practice should be continued. Materials and Methods This is a retrospective cohort study of patients with a distal forearm fracture treated surgically with a volar locking plate at two university hospitals in Denmark. Standard aftercare at both departments is 2 weeks in a cast. Patients attend a 2-week follow-up, at which the cast is replaced with a removable orthosis and radiographs are taken. It was recorded whether these radiographs had resulted in any change of treatment in terms of further operations, prolonged immobilization, additional clinical follow-up, or additional diagnostic imaging. Results A total of 613 patients were included in the study. The radiographs led to a change of standard treatment for 3.1% of the patients. A second operation was required by 1.0%; 0.5% were treated with prolonged immobilization, and 1.6% had additional outpatient follow-up due to the findings on the radiographs. Additional diagnostic imaging was performed on 1.9% of the patients. Conclusion The radiographs taken at the 2-weeks follow-up resulted in a change of treatment in 3.1% of the cases. Given the low cost and minimal risk of radiographs of an extremity, we concluded that the benefits outweigh the costs of routine radiographs taken 2 weeks after surgical treatment of distal forearm fractures.

scholarly journals Short and long-arm fiberglass cast immobilization for displaced distal forearm fractures in children: a randomized controlled trial

2020 ◽  
Author(s):  
Michelle Seiler ◽  
Peter Heinz ◽  
Alessia Callegari ◽  
Thomas Dreher ◽  
Georg Staubli ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Range Of Motion ◽  
Daily Life ◽  
Controlled Trial ◽  
Distal Forearm ◽  
Forearm Fractures ◽  
Normal Range ◽  
Randomized Controlled ◽  
Loss Of Reduction ◽  
Distal Forearm Fractures

Abstract Purpose The aim of this study was to investigate whether short-arm fiberglass cast (SAC) immobilization provides fracture stabilization comparable to that of long-arm cast (LAC) treatment of displaced distal forearm fractures after closed reduction in paediatric patients. Methods A prospective, randomized, controlled trial of children aged four to 16 years (mean 9.9 years) was designed with a sample of 120 children, whose size was set a priori, with 60 treated with SAC and 60 with LAC. The primary outcome was fracture stability and rate of loss of reduction. The secondary outcome analysis evaluated duration of analgesic therapy, restriction in activities of daily life, and the duration until patients regained normal range of motion in the elbow. Results No statistically significant differences were found between the two groups in loss of reduction or duration of analgesic therapy. In contrast, the duration until normal range of motion in the elbow was regained was significantly longer in the LAC group (median 4.5 days, P < 0.001). Restriction in activities of daily life did not differ significantly between the two groups except for the item “help needed with showering in the first days after trauma” (SAC 60%, LAC 87%, P = 0.001). Conclusion Fracture immobilization with short-arm fiberglass cast in reduced distal forearm fractures is not inferior to long-arm casts in children four years and older, excluding completely displaced fractures. Furthermore, short-arm casting reduces the need for assistance during showering. Trial registration NCT03297047, September 29, 2017

Plaster cast treatment for distal forearm fractures in children

2020 ◽  
Vol 29 (2) ◽  
pp. 179-186
Author(s):  
Domenico Ravier ◽  
Ilaria Morelli ◽  
Valentina Buscarino ◽  
Chiara Mattiuz ◽  
Luca M. Sconfienza ◽  
...  
Keyword(s):  
Plaster Cast ◽  
Distal Forearm ◽  
Forearm Fractures ◽  
Fractures In Children ◽  
Distal Forearm Fractures
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