Zeitschrift für Orthopädie und Unfallchirurgie
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Osteoporosis is a widespread disease characterised by low bone mass and structural deterioration of bone resulting in an increased susceptibility to fractures. Osteoporosis affects women more frequently than men; every second woman older than 50 years suffers from an osteoporotic fracture, frequently a vertebral fracture. The aim of this study was to induce osteoporosis in rats to establish an osteoporotic small-animal model that simulates the human pathology particularly in the spine. Therefore, bone density parameters, which are routinely determined in the spine of osteoporotic patients, were investigated by Dual-Energy X-ray Absorptiometry (DEXA). ⋯ A reproducible vertebral osteoporosis can be generated in a rat model by combination of ovariectomy with administration of a calcium/vitamin D3 deficient diet. T- and Z-values of this experimental group mimicked values obtained from osteoporotic patients, reflecting a simulation of their pathology. Interestingly, the increase in bone area over time with the steady BMC results in lower mineral density (BMD) of the OVX + diet group. Therefore, this rat model presents a reliable experimental set-up that may serve as a tool to better understand and treat osteoporosis.
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A 36-year-old motorcyclist sustained multiple severe injuries in a motorcycle accident. The leading injury was a type B open-book pelvic fracture, resulting in a relevant haemodynamic instability. ⋯ After repositioning of the pelvic binder in the emergency room, the pelvis was adequately stabilised, leading to a transient stabilisation of the haemorrhagic shock. This example illustrates the benefit of a simple and effective tool for the initial stabilisation of pelvic fractures in haemodynamically compromised patients and in particular the importance of the correct placement of the pelvic binder.
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As a further alternative to previously used vertebral augmentation methods, the Kiva VCF Treatment System® was clinically investigated. ⋯ On the basis of these results, the new augmentation can be described as being effective in the treatment of painful vertebral fractures.
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To offer a correct treatment strategy for osteoporotic vertebral body fractures remains a huge challenge in modern spine surgery. ⋯ After 5 years the therapy concept seems to be of low risk and not being associated with major complications. The PCS and MCS scores are comparable to a norm group of the same age. The correction loss exceeded the operative reduction marginally but turned out to be slightly lower compared to that of an isolated kyphoplasty.