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European Journal of Trauma and... Oct 2019This study examined a single center's experience with regards to etiology and distribution of fractures treated from July 2015 to August 2016 in Shanghai, China.
PURPOSE
This study examined a single center's experience with regards to etiology and distribution of fractures treated from July 2015 to August 2016 in Shanghai, China.
METHODS
The medical records of 621 patients with craniomaxillofacial fractures were reviewed. Patient notes and radiographic images were analyzed for detailed injury data. Age, gender, etiology, and site of fracture were examined. Chi-square test was used to analyze the causes of single and multiple fractures. p < 0.05 was considered statistically significant.
RESULTS
This study included 426 male and 195 female with a male-to-female ratio of 2.18:1, among which 28.3% were between 19 and 29 years (n = 176). In all the fracture sites, orbit was most commonly involved (n = 319, 51.4%). Traffic accidents (n = 304, 49%) were the most common cause of injury in this study, while ground-level falls were the most common cause of injury in children (n = 19, 41.3%). The probability of multiple fractures due to falling from height (88.6%, p < 0.05) and traffic accidents (73.3%, p < 0.05) were significantly higher than that of other injuries. Orbital fractures have the highest surgical rate (n = 288, 90.3%).
CONCLUSION
Craniomaxillofacial fractures predominantly occur in young men, due to traffic accidents. Orbit was involved in most cases. Falling from height and traffic accidents is more likely to cause multiple fractures.
Topics: Accidental Falls; Accidents, Traffic; Adolescent; Adult; Chi-Square Distribution; China; Female; Humans; Male; Mandibular Fractures; Middle Aged; Orbital Fractures; Retrospective Studies; Skull Fractures; Young Adult; Zygomatic Fractures
PubMed: 29651506
DOI: 10.1007/s00068-018-0950-7 -
Sensors (Basel, Switzerland) Dec 2022Ultrasonic imaging logging can visually identify the location, shape, dip angle and orientation of fractures and holes. The method has not been effectively applied in...
Ultrasonic imaging logging can visually identify the location, shape, dip angle and orientation of fractures and holes. The method has not been effectively applied in the field; one of the prime reasons is that the results of physical simulation experiments are insufficient. The physical simulation of fracture and hole response in the laboratory can provide a reference for the identification and evaluation of the underground geological structure. In this work, ultrasonic scanning experiments are conducted on a grooved sandstone plate and a simulated borehole and the influence of different fractures and holes on ultrasonic pulse echo is studied. Experimental results show that the combination of ultrasonic echo amplitude imaging and arrival time imaging can be used to identify the fracture location, width, depth and orientation, along with accurately calculating the fracture dip angle. The evaluated fracture parameters are similar to those in the physical simulation model. The identification accuracy of the ultrasonic measurement is related to the diameter of the radiation beam of the ultrasonic transducer. A single fracture with width larger than or equal to the radiation beam diameter of the ultrasonic transducer and multiple fractures with spacing longer than or equal to the radiation beam diameter can be effectively identified.
Topics: Humans; Ultrasonography; Computer Simulation; Transducers; Ultrasonics; Bone Plates; Fractures, Bone
PubMed: 36502123
DOI: 10.3390/s22239422 -
Cureus Apr 2024Artificial intelligence (AI) simulates intelligent behavior using computers with minimum human intervention. Recent advances in AI, especially deep learning, have made... (Review)
Review
Artificial intelligence (AI) simulates intelligent behavior using computers with minimum human intervention. Recent advances in AI, especially deep learning, have made significant progress in perceptual operations, enabling computers to convey and comprehend complicated input more accurately. Worldwide, fractures affect people of all ages and in all regions of the planet. One of the most prevalent causes of inaccurate diagnosis and medical lawsuits is overlooked fractures on radiographs taken in the emergency room, which can range from 2% to 9%. The workforce will soon be under a great deal of strain due to the growing demand for fracture detection on multiple imaging modalities. A dearth of radiologists worsens this rise in demand as a result of a delay in hiring and a significant percentage of radiologists close to retirement. Additionally, the process of interpreting diagnostic images can sometimes be challenging and tedious. Integrating orthopedic radio-diagnosis with AI presents a promising solution to these problems. There has recently been a noticeable rise in the application of deep learning techniques, namely convolutional neural networks (CNNs), in medical imaging. In the field of orthopedic trauma, CNNs are being documented to operate at the proficiency of expert orthopedic surgeons and radiologists in the identification and categorization of fractures. CNNs can analyze vast amounts of data at a rate that surpasses that of human observations. In this review, we discuss the use of deep learning methods in fracture detection and classification, the integration of AI with various imaging modalities, and the benefits and disadvantages of integrating AI with radio-diagnostics.
PubMed: 38756254
DOI: 10.7759/cureus.58364 -
Archives of Osteoporosis Nov 2020A retrospective cohort study determined the high incidence of recurrent fractures in osteoporotic patients with high fracture risk during the observation. The strategy...
UNLABELLED
A retrospective cohort study determined the high incidence of recurrent fractures in osteoporotic patients with high fracture risk during the observation. The strategy of starting treatment with more potent regimens (zoledronic acid, denosumab and/or teriparatide) seems to have the best secondary fracture prevention efficacy.
OBJECTIVE
This paper describes the various medical therapy regimens prescribed to osteoporotic patients with high fracture risk and the result of treatment.
METHODS
We carried out a retrospective cohort study in selected Osteoporosis Centers. Patients were considered to have high fracture risk in case of a history of a low-energy hip fracture or two or more vertebral or other site fractures. A total of 812 subjects (768 women and 44 men) aged 36-95 years were included. The observation period was 2285.1 patient-years. Demographic data, clinical findings, and BMD data obtained by DXA, as well as a history of fractures that had occurred during the follow-up, were included in the analysis.
RESULTS
Overall, at baseline, there were 637 non-vertebral fractures including 104 hip fractures. A total of 590 patients had vertebral fractures; of these, 69% suffered multiple fractures. Being on treatment, 119 (14.7%) patients developed new vertebral and non-vertebral fractures. The incidence of new non-vertebral fractures and hip fractures was 39.4 and 13.1 per 1000 patient-years. The total number of vertebral fractures increased by 24.8% from 1353 to 1689. The best results of the treatment were achieved in patients who were started on zoledronic acid, denosumab, or teriparatide and had an adequate duration of treatment. Although these patients had significantly lower BMD values at the time of diagnosis compared with other patients, they showed a lower incidence of new vertebral and hip fractures, during the follow-up.
CONCLUSION
Therapy of patients at high risk of fractures started with more potent treatment regimens (zoledronic acid, denosumab and/or teriparatide) of adequate duration was more effective in terms of prevention of new vertebral and hip fractures as compared with other treatment options. However, treatment appears to be challenging given the number of recurrent fractures in patients on treatment and the frequency of drug withdrawal or replacement.
Topics: Adult; Aged; Aged, 80 and over; Bone Density; Bone Density Conservation Agents; Female; Humans; Male; Middle Aged; Osteoporosis, Postmenopausal; Osteoporotic Fractures; Retrospective Studies; Spinal Fractures; Teriparatide
PubMed: 33219455
DOI: 10.1007/s11657-020-00851-z -
Journal of Orthopaedic Surgery and... Apr 2022Posterior pilon fracture is a relatively common clinical fracture involving the posterior articular surface of the distal tibia. Currently, this form of fracture is...
BACKGROUND
Posterior pilon fracture is a relatively common clinical fracture involving the posterior articular surface of the distal tibia. Currently, this form of fracture is receiving increasing attention. The surgical approach and technique for the treatment of posterior pilon fractures are still controversial. The purpose of this retrospective study was to compare the clinical and imaging outcomes of pilon fractures after treatment with the open fibula fracture line (OFFL) surgical technique versus the traditional posterolateral approach (TPL).
METHODS
A retrospective analysis of patients with posterior pilon fractures treated using the open fibula fracture line technique and the traditional posterolateral approach between January 2015 and March 2020. Thirty-one cases were included in the open fibula fracture line technique group and twenty-eight cases were included in the traditional posterolateral approach group. We used the Burwell-Charnley scale to assess the effectiveness of surgical repositioning. The clinical outcomes were evaluated using American Orthopaedic Foot & Ankle Society ankle-hind foot score (AOFAS) and visual analog score (VAS).
RESULTS
The overall anatomic reduction rate was slightly better in the open fibula fracture line group than in the conventional posterolateral group (81% vs. 71%, p = 0.406), but there was no statistically significant difference between the two groups. There were no statistically significant differences between the two groups in terms of fracture healing time and time to full weight bearing (p > 0.05). At the final follow-up, the AOFAS functional score of the open fibula fracture line group was statistically superior to that of the conventional posterolateral group (p < 0.05). However, there was no statistical difference between the two groups in VAS pain scores at rest, during activity, and under weight bearing (p > 0.05).
CONCLUSION
The trans-fibular fracture approach provides a better surgical option for specific types of posterior pilon fractures with a high rate of anatomic repositioning and a good near-term outcome.
TRIAL REGISTRATION
Retrospective registration.
Topics: Ankle Fractures; Fibula; Fracture Fixation, Internal; Fractures, Multiple; Fractures, Open; Humans; Retrospective Studies; Tibial Fractures; Treatment Outcome
PubMed: 35392983
DOI: 10.1186/s13018-022-03106-4 -
Journal of Pediatric Genetics Mar 2022Several genes are implicated in the etiology of early onset osteogenesis imperfecta (OI). The various genes causing severe OI include , , , , and , although glycine...
Several genes are implicated in the etiology of early onset osteogenesis imperfecta (OI). The various genes causing severe OI include , , , , and , although glycine substitutions in COL1A1chains have also been predicted to cause perinatal lethal OI . Patients with early onset OI present decreased mobility, recurrent rib fractures, bony deformities, and chest infections that lead to an early death. We reported our experience in children with OI in Asian Indian families, which includes two patients with pathogenic variants; and another two patients with severe OI and antenatal fractures caused by pathogenic variants in the gene, identified by next generation sequencing (NGS). For one affected fetus, medical termination of pregnancy was done. The other baby was started on zoledronate therapy just after birth and is now 3 years old. Prenatal diagnosis was subsequently done on chorionic villus sample in the latter family.
PubMed: 35186396
DOI: 10.1055/s-0040-1716830 -
Journal of Pediatric Orthopedics Aug 2019The purpose of this study was to evaluate pediatric scapula fractures occurring in high-energy motorized vehicle accidents and their associated injury patterns in a...
OBJECTIVES
The purpose of this study was to evaluate pediatric scapula fractures occurring in high-energy motorized vehicle accidents and their associated injury patterns in a pediatric patient population.
METHODS
One thousand nine hundred sixty-eight pediatric patients who presented after either on-road or off-road motorized vehicle accidents between 1996 and 2015 were retrospectively reviewed. Thirty-eight patients were found to have scapula fractures and the remaining 1930 were identified as controls.
RESULTS
A total of 39 scapula fractures occurred in 38 patients. The most common pattern was the AO/OTA 14-A3 (n=32), followed by 14-A2 (n=5), 14-B1 (n=1), and 14-C2 (n=1). Scapula fracture patients experienced higher rate of spine fractures (42% vs. 18%, P=0.001), skull fractures (26% vs. 12%, P=0.02), rib fractures (40% vs. 7.6%, P<0.0001), clavicle fractures (34% vs. 6%, P<0.0001), and upper extremity fractures (58% vs. 21%, P<0.0001) compared with controls. Scapula fracture patients had higher Injury Severity Scores (22.1 vs. 10.8, P<0.0001), thoracic injury (79% vs. 31%, P<0.0001), intracranial hemorrhage (32% vs. 15%, P=0.012), pneumothorax (55% vs. 8%, P<0.0001), and lung contusion (63% vs. 12%, P<0.0001). No difference in mortality was observed for scapula and control patients (5% vs. 2%, P=0.302).
CONCLUSIONS
Pediatric scapula fractures were not associated with higher mortality rates in this series but were associated with significant morbidity as demonstrated by high rates of associated intracranial hemorrhage, skull fractures, thoracic injury, upper extremity fractures, and spine fractures compared with control patients. Surgeons who care for pediatric trauma patients should view scapula fractures as an indicator for more significant injuries.
LEVEL OF EVIDENCE
Level III.
Topics: Accidents, Traffic; Adolescent; Clavicle; Female; Fractures, Multiple; Humans; Injury Severity Score; Male; Minnesota; Multiple Trauma; Retrospective Studies; Scapula; Spinal Fractures
PubMed: 31305382
DOI: 10.1097/BPO.0000000000000969 -
Osteoporosis International : a Journal... Nov 2023This study describes the characteristics of 337 patients seen by the fracture liaison service of the Amiens University Hospital for at least two osteoporotic fractures...
UNLABELLED
This study describes the characteristics of 337 patients seen by the fracture liaison service of the Amiens University Hospital for at least two osteoporotic fractures between 2009 and 2019. Results showed that recurrent fracture occurs rapidly after the index fracture. Rheumatological and therapeutic managements are not sufficient, mainly because of cognitive disorders or patients' refusal.
PURPOSE
The aim of this study was to describe the characteristics of patients taken in charge by a fracture liaison service and sustaining a recurrent osteoporotic fracture.
METHODS
This was a retrospective and monocentric study based on the dataset of patients included in the FLS of the Department of Rheumatology of the Amiens University Hospital. To be included in the study cohort, patients must have had at least two consecutive osteoporotic fractures between January 2009 and December 2019.
RESULTS
Three hundred thirty-seven patients were included. The mean age at index fracture was 77.3 ± 12.5 years. Eighty-four percent of the patients were women. 89.3% of the patients had a Charlson comorbidity index between 1 and 4. Nearly half of the patients had cognitive disorders. Femoral neck was the most frequent site for both index and recurrent fractures. Thirty-seven percent of patients benefited from a consultation in Rheumatology after their index fracture. The main reasons for the lack of follow-up were cognitive disorders and patient rejection.
CONCLUSION
Our study showed that recurrent fracture occurs rapidly after the index fracture and that rheumatological and therapeutic managements are not sufficient, mainly because of cognitive disorders or patients' refusal impairing the patients to benefit from specialized management.
Topics: Humans; Female; Osteoporotic Fractures; Male; Aged; Retrospective Studies; Recurrence; Aged, 80 and over; Middle Aged; Femoral Neck Fractures; Referral and Consultation
PubMed: 37552293
DOI: 10.1007/s00198-023-06868-7 -
Reumatologia Clinica Sep 2020Frida Kahlo's medical history shows sequelae of polio, a severe traumatic event that caused multiple fractures and a penetrating pelvic injury, as well as a history of...
Frida Kahlo's medical history shows sequelae of polio, a severe traumatic event that caused multiple fractures and a penetrating pelvic injury, as well as a history of countless surgeries. In her biographical accounts and her works, chronic disabling pain always appears for long periods. Besides, a chronic foot ulcer, gangrene that required amputation of the right leg, a history of abortions, and a positive Wasserman reaction suggest that the artist could have suffered from antiphospholipid antibody syndrome (APS).
PubMed: 32891542
DOI: 10.1016/j.reuma.2020.07.012 -
Craniomaxillofacial Trauma &... Dec 2022Retrospective cohort review.
STUDY DESIGN
Retrospective cohort review.
OBJECTIVE
To investigate the relationship between falls from height and facial injuries.
METHODS
This is a retrospective cohort study, conducted over a 7-year period, of the medical records of all patients who presented to hospital for a maxillofacial injury following a fall from height. Fall heights were classified as low falls (1-3 m), high falls (3-10 m) and very high falls (≥10 m).
RESULTS
A total of 111 patients with 218 facial bone fractures were identified (78 men, 33 women and mean age 50.3 years). High falls were the most common (n = 58, 52.3%). Multiple fractures were identified in 51 (46.0%) patients. Orbital and middle third fractures were the most prevalent. Nasal, mandible, bilateral and fractures involving more than one facial third, increased as fall height increased, as did the requirement for operative fixation. The majority of patients had an associated injury (n = 100, 90.1%) and overall mortality was 6.3%.
CONCLUSIONS
Falls from height are prevalent and there is a trend towards increased severity of facial injury, surgical intervention and associated morbidity as fall height increases. Falls from height are a significant public health concern and an important facet of maxillofacial trauma to recognise, as is the requirement for an interdisciplinary approach as they present to hospital.
PubMed: 36387311
DOI: 10.1177/19433875211055356