Prediction of a new fracture after a wrist fracture – a five year follow up

2020 ◽  
Author(s):  
Eva Ekvall Hansson ◽  
Leif E Dahlberg ◽  
Måns Magnusson ◽  
Anders Beckman
Keyword(s):  
Fracture Risk ◽  
Assessment Tool ◽  
Postural Sway ◽  
Force Plate ◽  
Wrist Fracture ◽  
Local Health ◽  
Ageing Population ◽  
Self Rated Health ◽  
Future Fracture

Abstract Background Falls and ensuing fractures are major challenges in our ageing population. The aim of this study was to study if clinical balance measures, function of the inner ear, self-rated health or fracture risk assessed by FRAX ® could predict future admission to hospital because of a fracture among a group of older persons with previous wrist fracture. Methods This was a longitudinal study with a 5-year follow-up. Searches in the local health authority’s patient administrative system (PAS) were performed 5 years after inclusion and baseline measurements were taken. Information was extracted about whether participants had been treated for a fracture or hospitalized other reasons during the 5-year period. Persons, 50 years and above, with previous wrist fracture (n=83). Five different clinical balance measures was assessed, postural sway was assessed by means of a force plate, vestibular asymmetry was assessed with the head- shake test, self-rated health by EuroQol 5 Dimension visual analogue scale and risk of future fracture by the Fracture Risk Assessment Tool (FRAX ® ). Age and body mass index was also used in the risk analysis. Results Age was associated with risk of future fracture, OR 1,06 (95% CI 1,01-1,12). The ability to stand on one leg with eyes open correlated significantly with future fracture (p=0.011) and so did FRAXosteo, however on the limits of significance (p=0.052). Conclusion This follow-up study showed that the one-leg standing time-test was a stronger predictor for future facture within five-years after a wrist fracture than FRAX not including a measure of balance.

scholarly journals The influence of snuff and smoking on bone accretion in late adolescence. The Tromsø study, Fit Futures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ole Andreas Nilsen ◽  
Nina Emaus ◽  
Tore Christoffersen ◽  
Anne Winther ◽  
Elin Evensen ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Late Adolescence ◽  
Areal Bone Mineral Density ◽  
Childhood And Adolescence ◽  
Preventive Strategy ◽  
Mineral Density ◽  
Future Fracture

Abstract Summary Areal bone mineral density (aBMD) predicts future fracture risk. This study explores associations between use of tobacco and bone accretion in Norwegian adolescents. Our results indicate that use of snuff is negatively associated with accretion of aBMD in adolescence and may be a signal of increased future fracture risk. Purpose Bone mineral accrual in childhood and adolescence is a long-term primary preventive strategy of osteoporosis. Areal bone mineral density (aBMD) is a surrogate measure of bone strength and a predictor of fracture risk. The aim of this population-based 2-year follow-up cohort study was to explore associations between use of snuff and smoking and changes (∆) in aBMD in Norwegian girls and boys aged 15–17 years at baseline. Methods The first wave of the Tromsø study, Fit Futures was conducted from 2010 to 2011. Femoral neck (FN), total hip (TH), and total body (TB) bone mineral content (BMC) and aBMD were measured by dual-energy X-ray absorptiometry. Information on use of snuff, smoking habits, and other lifestyle related variables were collected through self-administered questionnaires. Two years later, during 2012–2013, the measurements were repeated in the second wave. The present study included 349 girls and 281 boys and compared “non-users” (n = 243 girls, 184 boys) with “users” (n = 105 girls, 96 boys) of snuff and “non-smokers” (n = 327 girls, 249 boys) with “smokers” (n = 21 girls, 31 boys) using linear regression adjusted for age, baseline height and weight, change in height and weight, pubertal maturation, physical activity, ethnicity, alcohol consumption, diagnosis known to affect bone, and medication known to affect bone. The influence of “double use” on bone accretion was also explored. Results In girls, no associations between use of snuff and ∆aBMD were found. In boys, use of snuff was associated with reduced bone accretion in all ∆aBMD models. Sensitivity analysis with exclusion of “sometimes” users of snuff strengthened associations at femoral sites in girls and attenuated all associations in boys. In girls, no associations between smoking and ∆aBMD were found. In boys, only the association with TB ∆aBMD was significant in the fully adjusted models. In girls, “double users” analyses showed similar association to smoking. In boys, nearly all models showed statistically significant associations with a difference of ~ 1–2% in ∆aBMD between “non-users” and “double users” during 2 years of follow-up. Conclusions Our results indicate that tobacco use in late adolescence could be detrimental to bone accretion and may be a signal of increased fracture risk in adult life.

scholarly journals A - 27 The Clinical Utilization of SWAY and mBESS for Post-Trauma and Follow-up Concussion Evaluations

2021 ◽  
Vol 36 (4) ◽  
pp. 667-667
Author(s):  
Sohoni R ◽  
Gorres K ◽  
Sibol M ◽  
Yousif M ◽  
LoGalbo A
Keyword(s):  
Reaction Time ◽  
Assessment Tool ◽  
Postural Sway ◽  
Cognitive Testing ◽  
Sports Concussion ◽  
Clinical Utilization ◽  
Paired Samples ◽  
Significant Difference ◽  
Before And After

Abstract Objective SWAY is a mobile software system using an accelerometer designed to measure postural sway and reaction time in the context of concussion. This study examined the efficacy of SWAY in detecting changes in balance and reaction time before and after concussion. Methods College athletes (N = 30, 10 females) underwent baseline, post-trauma, and follow-up evaluations following a concussion including SWAY, mBESS, Sports Concussion Assessment Tool 5th Edition (SCAT-5), and Immediate Post Concussion Assessment and Cognitive Testing (ImPACT). Results Paired-samples t-tests revealed a decline in SWAY balance from baseline (M = 82.65, SD = 14.48) to post-trauma (M = 74.61, SD = 17.41), t(29) = 2.99, p = 0.006, but no significant difference was observed in reaction time (M = 5.07, SD = 13.61), t(29) = 2.04, p = 0.050. Meanwhile, balance improved at follow-up (M = 78.93, SD = 15.32), and was no longer discrepant from baseline (M = 81.97, SD = 14.51), t(21) = 1.03, p = 0.316. Similarly, there was a significant decline in mBESS scores from baseline (M = 2.88, SD = 3.62) to post-trauma (M = 5.68, SD = 5.32), t(24) = −3.51, p = 0.002, followed by a return to baseline at follow up (M = 4.22, SD = 4.95), t(22) = −1.60, p = 0.124. Conclusions Although challenges were apparent in obtaining an optimal baseline, current results appear to support the clinical utility of SWAY for assessing balance in the context of concussion evaluations. Further research appears warranted to support SWAY as a method of diagnosing concussion and monitoring return to baseline.

scholarly journals 2016 American Association of Clinical Endocrinologists/American College of Endocrinology Clinical Practice Guidelines on Postmenopausal Osteoporosis

2016 ◽  
Vol 12 (02) ◽  
pp. 74 ◽  
Author(s):  
Pauline M Camacho ◽  
Keyword(s):  
Risk Assessment ◽  
Fracture Risk ◽  
Postmenopausal Osteoporosis ◽  
Assessment Tool ◽  
American Association ◽  
Bisphosphonate Therapy ◽  
High Fracture ◽  
Fracture Risk Assessment Tool ◽  
Diagnostic Criterion

The 2016 American Association of Clinical Endocrinologists/American College of Endocrinology Guidelines for postmenopausal osteoporosis provides comprehensive guidance on the diagnosis, evaluation and treatment of postmenopausal osteoporosis. A new diagnostic criterion which expands the diagnosis to patients with osteopenia and a high Fracture Risk Assessment Tool score has been added to the old diagnostic criteria. Recommendations on duration of bisphosphonate therapy are clearly outlined and are based on fracture risk stratification. The accompanying algorithm, which goes through all the steps from diagnosis to treatment and follow up is a handy guide for clinicians.

The ankle fracture as an index of future fracture risk: A 25–40 year follow-up of 1063 cases

1993 ◽  
Vol 64 (4) ◽  
pp. 482-484 ◽  
Author(s):  
Magnus K Karlsson ◽  
Ralph Hasserius ◽  
Karl J Obrant
Keyword(s):  
Fracture Risk ◽  
Ankle Fracture ◽  
Future Fracture

Accuracy of a fracture risk assessment tool in Iranian osteopenic and osteoporotic women

2016 ◽  
Vol 1 (1) ◽  
pp. 15-19 ◽  
Author(s):  
Arman Ahmadzadeh ◽  
Tahere Sabaghian ◽  
Mina Ebrahimi-Rad ◽  
Mohammad Moslemizadeh ◽  
Mohammad Mehdi Emam ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Fracture Risk ◽  
Assessment Tool ◽  
Fracture Risk Assessment ◽  
Risk Assessment Tool ◽  
Fracture Risk Assessment Tool

scholarly journals 71 Ultrasound directed reduction of Colles’ type distal radial fractures in ED (UDiReCT): a feasibility randomized controlled trial

2020 ◽  
Vol 37 (12) ◽  
pp. 835.3-836
Author(s):  
Hamza Malik ◽  
Andrew Appelboam ◽  
Gordon Taylor ◽  
Daryl Wood ◽  
Karen Knapp
Keyword(s):  
Data Collection ◽  
Controlled Trial ◽  
Wrist Fracture ◽  
Recruitment Rate ◽  
Feasibility Trial ◽  
Point Of Care Ultrasound ◽  
Distal Radial Fractures ◽  
Definitive Trial ◽  
Randomised Controlled

Aims/Objectives/BackgroundWrist fractures are among the commonest injuries seen in the emergency department (ED). Around 25% of these injuries have Colles’ type fracture displacement and undergo manipulation in the ED. In the UK, these manipulations are typically done ‘blind’ without real time imaging and recent observational studies show that over 40% of the injuries go on to require surgical fixation (due to inadequate initial reduction or re-displacement). Point of care ultrasound has been used to guide and improve wrist fracture reductions but it’s effect on subsequent outcome is not established. We set up and ran the UK’s first randomised controlled feasibility trial comparing standard and ultrasound guided ED wrist fracture manipulations to test a definitive trial protocol, data collection and estimate recruitment rate towards a future definitive trial.Methods/DesignWe conducted a 1:1, single blind, parallel group, randomised controlled feasibility trial in two UK hospitals. Adults with Colles’ type distal radial fractures requiring manipulation in the ED were recruited by supervising emergency physicians supported by network research nurses. Participants were randomised to ultrasound directed fracture manipulation (intervention) or standard care with sham ultrasound (controls). The trial was run through Exeter Clinical Trials Unit and consent, randomisation and data collection conducted electronically in REDCap cloud. All participants were followed up at 6 weeks to record any surgical intervention and also underwent baseline and 3 month quality of life (EQ-5D-5L) and wrist function (Patient Rated Wrist Evaluation (PRWE) assessments.Results/ConclusionsWe recruited 47 patients in total, with 23 randomised to the interventional arm and 24 randomised to the control arm. We were able to follow up 100% of the patients for the 6 week follow up. Data analysis and results will be presented at the time of the conference.

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