Injury
-
Tibial plateau fractures account for approximately 1% of all fractures. They usually occur after a direct high-energy trauma. Despite adequate treatment, these fractures can result in malalignment and secondary osteoarthritis (OA). Research concerning long-term functional outcome is limited. The primary aim of this study was to evaluate mid- to long-term functional outcome of surgically treated tibial plateau fractures. The secondary aim was to investigate whether radiological characteristics of OA one year after surgery are predictive of functional outcome at follow-up. ⋯ This is the first study to describe mid- to long-term functional outcome after ORIF for all types of tibial plateau fractures, with the use of the KOOS. Patients should be informed about the likelihood of lower functional outcome in the long-term. This study shows that radiological characteristics of osteoarthritis are not related with lower functional outcomes in the mid- to long-term.
-
Review
Enhancement of hip fracture healing in the elderly: Evidence deriving from a pilot randomized trial.
Enhancement of healing of osteoporotic fractures remains a significant objective of contemporary clinical care. Aiming to produce preliminary clinical evidence on the effect of antiosteoporotic drugs on the process of fragility fracture healing, a pilot prospective randomized assessor-blinded trial was performed. ⋯ However, significant difficulties of recruitment and completion of follow up did not allow the researchers to produce the preliminary evidence testing the study hypothesis, highlighting the challenges that contemporary clinical investigators face when conducting studies focusing on elderly patients, with high proportion of coinciding factors affecting patients' eligibility, compliance, and overall outcome. Nevertheless, the significance of enhancing bone healing in this specific patient population, dictates further clinical efforts and future well designed and funded trials of adequate power and level of evidence are desirable to allow the effective and safer management of the consequences of the modern epidemic of osteoporosis.
-
Osteogenesis imperfecta (OI) is a group of genetic disorders, of which Type III is the most severe among survivors. The disease is characterised in particular by bone fragility, decreased bone mass and increased incidence of fractures. Other usual findings are muscle hypotonia, joint hypermobility and short stature. ⋯ Bisphosphonates have revolutionised the treatment of newborn children with severe OI type III. Surgery is still needed in most patients due to high frequency of the fractures. In this systematic review we describe the present state-of-art in treating the most severe type of OI in newborn and preschool children with their bone fractures.