SEARCH · PubMed Health

Results for “Fractures, Compression”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 847 records · Page 47Linked to original sources

PubMed1989

Fracture behavior of urinary stones under compression.

The fracture behavior of two types of urinary stones, namely struvite and calcium oxalate, during compression testing was studied. Scanning electron microscopy (SEM) was used to characterize the fracture surfaces. Both types of stone showed pseudo-plastic behavior as indicated by their load-displacement curve. The onset of nonlinear behavior was found to correspond to development of microcracks in the specimens. The compressive strength was defined as the stress calculated at the maximum load. In struvite samples, the maximum load corresponded with the development of large cracks parallel to the compressive axis. For oxalate stones a separation of the outer layer (crust) from the inner layer (core) marked the point of maximum load. The compressive strength of the struvite samples was found to depend on the orientation of lamellae relative to the loading axis. Struvite stones, when loaded parallel to the lamination direction showed a higher compressive strength than oxalate stones did. The fracture behavior and compressive strength of a model material (z-brick) were also characterized and compared to those of the urinary stones.

Lithotripsy↗

PubMedDate not supplied

Recurrent fracture after vertebral kyphoplasty.

BACKGROUND CONTEXT: Osteoporotic compression fractures cause great morbidity to the aging population. Various percutaneous methods have been developed to aid in treatment, including vertebral kyphoplasty. Biomechanical studies and recent published data relate concerns about adjacent fracture. PURPOSE: This study investigated the incidence of recurrent fracture after the kyphoplasty procedure. STUDY DESIGN/SETTING: Retrospective review of kyphoplasty procedures preformed by a single surgeon. PATIENT SAMPLE: A total of 109 procedures in 94 patients were reviewed. OUTCOME MEASURES: Patient medical records were reviewed as well as the radiology database at two major regional hospitals. METHODS: Patient records were reviewed for fracture recurrence. RESULTS: Confounding factors of age at procedure, sex, and chronic steroid use were also considered and found to have no statistically significant difference between those with fracture recurrence and those without fracture recurrence (p=.1979, p=.2058, p=.4684, respectively). Eleven kyphoplasty procedures resulted in a recurrent fracture after kyphoplasty within the first 90 days (34+/-19). After the first 90 days, five recurrent fractures occurred (459+/-101). The number of vertebral levels treated was found to be related to incidence of recurrent fracture with a p value of .0005 via chi-square testing. Patients who sustained a recurrent fracture tended to have a higher number of vertebral levels treated. There was no statistically significant difference between the survival time of kyphoplasty procedures that resulted in recurrent adjacent versus distant vertebral body fracture (survival time 112+/-145 vs. 237+/-268, p value .2362). CONCLUSIONS: The incidence of recurrent fracture after kyphoplasty is substantial at 10% within the first 90 days. It is difficult to determine if this fracture rate is the result of surgical intervention or the natural history of the patient's osteoporosis.

Aged↗

PubMed1996

Simultaneous anterior and posterior approaches for correction of late deformity due to thoracolumbar fractures.

Thirty-one patients with an average age of 27 years were included in this study to analyze the short-term results of simultaneous anterior and posterior approaches in the treatment of late complications of thoracolumbar fractures. The complications treated were pseudoarthrosis and malunion resulting in neurologic compromise and pain. There were 20 burst fractures, 2 fracture/dislocations, and 9 compression fractures in this group. Average preoperative Sagittal Index was 35 degrees, which improved to an average of 4 degrees after surgical treatment. The average Motor Index Score improved from 90 to 98 after surgery. Average follow-up was 16 months. Average estimated blood loss was 2000 ml and average operation time was 5 h. It was concluded that the late problems associated with thoracolumbar fractures can be addressed quite adequately with simultaneous anterior and posterior approaches. The simultaneous anterior and posterior approach is associated with decreases in operating time, blood loss, and hospital stay. Technical advantages of the simultaneous technique include elimination of acute instability between the stages, protection against dislodgment of the graft, and application of the posterior instrumentation under complete visualization of the anterior graft.

Adult↗

PubMed1984

The steroid treatment of hereditary motor and sensory neuropathy.

A placebo or methylprednisolone (45-60 mg/M2) was administered in a crossover study as a single morning dose on alternate days to fourteen patients who had a familial progressive polyneuropathy that either began or was maximum in the distribution of the peroneal nerves. Neither the patients nor the examining physician were told whether the patient was taking a placebo or steroid but the steroid side-effects made a double-blind trial impossible. Patients were evaluated at the initiation of the study, the time of crossover, and at the conclusion of the study. Five patients with proven HMSN-I completed the study; eight patients with HMSN-I were placed on a placebo or on steroids for a six-month-period. In neither group was there any evidence of a significant increase in nerve conduction times, a decrease in terminal latencies, an increase in strength or a decrease in sensory loss when evaluated by quantitative methods. These patients were subject to a high incidence of complications from steroids possibly because of root hypertrophy, relative inactivity, and high CSF proteins. These included excessive weight gain, a compression fracture of T-12; cord compression from enlarged nerve roots; myopathy; pseudotumor; and psychiatric disturbances. Considering the lack of benefit of steroids and the high incidence of complications due to the medication further trials of adrenal-corticosteroids in patients who definitely have familial HMSN-I do not seem to be justified.

Adolescent↗

PubMed2002

Feasibility of ultrasound examination in posterior ligament complex injury of thoracolumbar spine fracture.

STUDY DESIGN: A prospective study of 12 patients with thoracolumbar spinal fractures was conducted. OBJECTIVE: To assess the feasibility of ultrasound examination for posterior ligament complex injury in thoracolumbar spinal fractures. SUMMARY OF BACKGROUND DATA: In posterior ligament complex injury of thoracolumbar spine fracture, the reliability of magnetic resonance imaging (MRI) for diagnosis has been reported. Nevertheless the usefulness of ultrasound for diagnosis has not been studied, whereas diagnostic ultrasound has been applied in the musculoskeletal system. METHODS: Two healthy volunteers without a history of spinal trauma were recruited for pilot examination of the ultrasound procedure to access normal findings of the posterior ligament complex. This study investigated 12 thoracolumbar spine fractures. Four were flexion distraction injury; six were stable or unstable burst fractures; and two were simple compression fractures. Osteoporotic spine fractures were excluded from this study. Ultrasound was performed over the injured area by an experienced musculoskeletal radiologist in addition to radiography and MRI. Five patients underwent operative procedures to stabilize the fractured spine. Imaging data and operative findings were correlated with ultrasound examination. RESULTS: In the patients who did not undergo surgery, agreement in diagnosis between MRI and ultrasound was moderate (5 of 7). Difficulty evaluating ligament status was encountered when the region of interest was the lower thoracic level (T10, T11, T12) because of long overlapping spinous processes. In the patients who underwent surgery, correlation between MRI, ultrasound, and operative findings was excellent, especially in diagnosing the status of the supraspinous and interspinous ligaments. Nevertheless, it is impossible to visualize deep-seated structures (i.e., ligamentum flavum, deep muscles of the spine, and facet joint) with ultrasound. CONCLUSIONS: This study demonstrated the excellent diagnostic ability of ultrasound to detect the status of the supraspinous and interspinous ligaments, especially in patients who undergo surgery. Although ultrasound examination appears to be less sensitive than MRI in predicting ligament status, the cost effectiveness of ultrasound and its use as an alternative to MRI in special situations (i.e., patients with pacemaker, ferromagnetic implant, or severe claustrophobia) should be emphasized. More clinical data concerning the sensitivity, specificity, and accuracy of ultrasound examination should be addressed in future studies.

Adult↗

PubMed1991

Role of peak bone mass and bone loss in postmenopausal osteoporosis: 12 year study.

OBJECTIVE: To examine the role of peak bone mass and subsequent postmenopausal bone loss in the development of osteoporosis and the reliability of identifying women at risk from one bone mass measurement and one biochemical assessment of the future bone loss. DESIGN: Population based study. SETTING: Outpatient clinic for research into osteoporosis. SUBJECTS: 178 healthy early postmenopausal women who had participated in a two year study in 1977. 154 of the women underwent follow up examination in 1989, of whom 33 were excluded because of diseases or taking drugs known to affect calcium metabolism. MAIN OUTCOME MEASURES: Bone mineral content of the forearm and values of biochemical markers of bone turnover. RESULTS: The average reduction in bone mineral content during 1977-89 was 20%, but the fast losers had lost 10.0% more than had the slow loser group (mean loss 26.6% in fast losers and 16.6% in slow losers; p less than 0.001). Prediction of future bone mineral content using baseline bone mineral content and estimated rate of loss gave results almost identical with the actual bone mineral content measured in 1989. Seven women had had a Colles' fracture and 20 a spinal compression fracture. The group with Colles' fracture had low baseline bone mineral content (34.7 (95% confidence interval 31.3 to 38.1) units v 39.4 (38.1 to 40.8) units in women with no fracture) whereas the group with spinal fracture had a normal baseline bone mineral content (38.1 (35.0 to 41.1) units) but an increased rate of loss (-2.4 (-3.5 to -1.3)%/year v -1.8 (-2.1 to -1.5)%/year in women with no fracture). CONCLUSIONS: One baseline measurement of bone mass combined with a single estimation of the rate of bone loss can reliably identify the women at menopause who are at highest risk of developing osteoporosis later in life. The rate of loss may have an independent role in likelihood of vertebral fracture.

Age Factors↗

PubMedDate not supplied

Hot-air ballooning injuries.

The sport of hot-air ballooning is generally safe, but does place its participants in certain unique circumstances which may predispose them to injury. Fractures of the ankle and compression fractures of the lumbar spine are among the most common skeletal injuries that require orthopaedic care. Attention to basket design, proper education of the passenger, and careful consideration of terrain and prevailing weather conditions may help make ballooning a safer sport.

Adult↗

PubMed1986

Injuries to the metatarsophalangeal joints in athletes.

Injury to the metatarsophalangeal joints in sports has become an increasing problem with the advent of more flexible shoewear and artificial playing surfaces. These injuries vary from mild sprains to severe tearing of the capsuloligamentous complex including avulsion fractures. This may include a compression fracture of the metatarsal head in the more severe cases. At the extreme, dislocation or fracture-dislocation of the metatarsophalangeal joint occurs. The findings in 62 cases of these injuries in Rice University athletes from 1971 to 1985 are presented. Treatment follows a standard regimen of ice, taping and anti-inflammatory medication with gradual return to sports activity as symptoms allow. Recommendations for preventive therapy include stiffening the forefoot in athletic shoes or the use of an orthotic device. This should reduce the incidence of long-term sequelae.

Adult↗

PubMed1986

The radiographic characterization of burst fractures of the spine.

A retrospective review of 75 burst fractures of the spine was performed to define the radiographic features found on high-resolution CT, polytomography, and plain radiography and thereby allow full characterization of this uncommon spinal injury. Characteristic components of the injury include: centripetally oriented disruption of the vertebral body, unilateral or bilateral laminar fractures that abut the spinous process, marked anterior wedging, vertically oriented vertebral fracture emanating from the basivertebral foramen, increased interpediculate distance, and significant spinal canal narrowing by characteristic retropulsed fragments. Nearly all bursts occurred from T9 to L5; double bursts were present in less than 10% of cases. The usually present neurologic deficit nearly always corresponded to the level of the burst rather than to the frequently found noncontiguous associated spine fracture. Recent literature suggests that these complex fractures, which were initially thought to represent stable injuries, are often unstable. A subcategorization of burst fractures and their variants is proposed to explain this instability. An approach to the radiographic diagnosis of the spinal burst is proposed, and plain film clues to distinguish the burst fracture from the more common compression fracture are discussed. Representative cases are illustrated.

Adolescent↗

PubMed2004

Vertebral deformities in female patients with osteoporosis: influence of trauma and bone mineral density.

Aging societies have an increased incidence of fractures caused by osteoporosis. Vertebral compression fractures occur most frequently in the thoracolumbar vertebrae of elderly individuals. The severe pain caused by this type of fracture causes many patients to become bedridden. However, the initial pain generally diminishes after around 1 month and is replaced by dull pain in the lumbar and lumbosacral regions. We carried out a cross-sectional and longitudinal study of these fractures in 328 female outpatients with osteoporosis. All subjects initially presented at our hospital with back pain and bone mineral density measurements were taken using both dual energy X-ray absorptiometry and quantitative computed tomography. Our main findings were as follows. Decreased BMD appears to be one cause of vertebral body deformities. However, we found it difficult to predict whether deformities will progress or cause additional deformities of adjacent vertebral bodies, because the key contributing factors include not only BMD and age but also lifestyle and activity patterns. In addition, none of the drug administration methods investigated here resulted in a notable increase in BMD.

Age Factors↗

PubMed1992

[Ventral stabilization of thoracic and lumbar spinal injuries].

An isolated ventral approach to the thoracal or lumbar spine seems sufficient in special burst fractures (type A2/3) or older compression fractures. The most effective ventral decompression of the spinal cord is followed by the fusion of the ventral body. Ventral plate instrumentation avoid dislocations of the interposed bone transplants. Our own clinical results are demonstrated.

Bone Plates↗

PubMed2004

Imaging diagnosis of thoracolumbar burst fractures.

OBJECTIVE: To review imaging use in the diagnosis of thoracolumbar burst fractures and to determine the diagnostic value of different imaging methods. METHODS: One hundred and fourteen patients with 120 thoracolumbar burst fractures were retrospectively reviewed. Plain radiographs were available in all cases; CT scans and MRI were obtained in 96 and 74 cases, respectively. RESULTS: A total of 27 burst fractures were misdiagnosed as other types of fractures on radiographs alone, and accounted for 22.5% of all fractures. The results indicated that plain radiographs often fail to delineate the pathological features of thoracolumbar burst fractures, leading to delay in diagnosis. CONCLUSION: In regard to thoracolumbar injury diagnosis, burst fractures should be differentiated from compression fractures. CT should be routinely indicated and MRI examination, when necessary, may be simultaneously considered.

Adolescent↗

PubMed2005

[Evaluation of vertebral fractures and associated injuries in adults].

OBJECTIVES: We evaluated vertebra fractures and associated injuries in adults to determine the profile of patients presenting with a trauma etiology. METHODS: The study included 372 patients (264 men, 108 women; mean age 30.4 years; range 18 to 65 years) who were treated for vertebra fractures from 1988 to 2003. Evaluations included demographic features of patients, trauma mechanisms, fracture levels and types, treatment modalities, and associated injuries. The types of fractures were assessed according to the Denis classification. RESULTS: The types of fractures were classified as follows: compression fractures (n=212, 57.0%), burst fractures (n=146, 39.3%), seat belt-induced fractures (n=8, 2.2%), and fracture-dislocations (n=6, 1.6%). Involvement was at one level in 290 patients (77.9%), two levels in 61 patients (16.4%), three levels in 15 patients (4.0%), and four levels in six patients (1.6%). The most common localization was the thoracolumbar spine (transition zone) with 275 fractures (57.2%). The causes of fractures were fall from height in 211 patients (56.7%), traffic accidents in 145 patients (39.0%), and direct trauma in 16 patients (4.3%). Associated fractures were detected in 110 patients (29.6%), the most common being calcaneus fractures in 35 patients (9.4%). Apart from orthopedic problems, 38 patients (10.2%) had other organ injuries and/or head trauma. Treatment was conservative in 302 patients (81.2%) and surgical in 70 patients (18.8%). CONCLUSION: Every patient presenting after a high-energy trauma should be regarded as having a vertebra fracture until proven otherwise. When a vertebra fracture is detected, investigation should be extended for involvement at other levels and associated injuries.

Adolescent↗

PubMed1997

Vertebral fracture after aircraft ejection during Operation Desert Storm.

During Operation Desert Storm, 21 United States and 2 Italian military personnel were held in Iraq as prisoners of war. Of these, 18 had ejected from fixed-wing, ejection seat-equipped, combat aircraft prior to their capture. Of the 18, 6 (33%) had sustained vertebral fractures; 4 of these were compression fractures. This fracture rate is comparable to that of previously studied groups. Fractures were noted to be at several different vertebral sites and after ejecting from a variety of aircraft. Apart from contusions and abrasions, vertebral fractures were the most common injuries discovered in this repatriated population. None of the vertebral fractures produced recognizable neurological disability. The development of vertebral fractures was neither associated with the use of any particular ejection system or aircraft nor did the development of vertebral fractures appear dependent on the age, height or length of service of the affected personnel. Ejected aircrew with low altitude mission profiles seemed more predisposed to vertebral fracture than those at high altitudes, but with a small sample population, this relationship was not statistically significant (p > 0.25). Reliable data were unavailable on aircrew positioning and preparation time for ejection.

Adult↗

PubMed2006

Pain outcome and vertebral body height restoration in patients undergoing kyphoplasty.

INTRODUCTION: Kyphoplasty, a minimally invasive technique, has recently been developed to provide immediate pain relief, biomechanical stabilization, prevention of fracture progression, vertebral height restoration, and prevention or reversal of kyphosis to patients with osteoporotic vertebral compression fractures (VCF). MATERIALS AND METHODS: We retrospectively reviewed 24 patients treated with kyphoplasty. A total of 37 vertebral levels were augmented. Visual analog scale (VAS) scores were documented in the immediate pre- and postoperative period, as well as 4, 12, and 72 weeks after the procedure. Vertebral body height restoration was assessed on postoperative x-rays. RESULTS: Mean preoperative VAS score was 9.3 and improved to 5.4 in the immediate postoperative period. At 4, 12 and 72 weeks post-operatively, mean VAS scores were 5.1, 5.9, and 6.1 respectively. All patients returned to their daily activities within 24 hours. No significant restoration of vertebral body height was observed. CONCLUSION: In regards to pain relief and postoperative functional outcome, kyphoplasty is a safe and effective treatment modality for osteoporotic VCFs, even when no significant restoration of vertebral body height is achieved.

Aged↗

PubMed2005

The effect on anterior column loading due to different vertebral augmentation techniques.

BACKGROUND: Vertebral compression fractures are a significant cause of morbidity amongst the elderly, resulting in pain, kyphosis, decreased mobility, and often depression. The two most popular operative treatments of compression wedge fractures are vertebroplasty and kyphoplasty, however, which method leads to restoration of normal spinal loading is unknown. METHODS: A cadaveric thoracolumbar spine model was fractured and then treated using one of two techniques: vertebroplasty or kyphoplasty. Three non-destructive loading regimes were applied to the intact, fractured and treated cases. Sub-adjacent nuclear pressure, used as a measure of anterior column loading, was determined for each experimental variant and loading case. FINDINGS: The data indicate that nuclear pressure was substantially reduced after the spine was fractured. These pressures were minimally increased after treatment, however, not to the level of the pre-fractured condition. In all loading cases, there were no significant differences between the two treatment types. INTERPRETATION: While our data show that both vertebroplasty and kyphoplasty allow the disc to generate higher nuclear pressures, neither treatment increased nucleus pulposus pressure above the level of the intact state. This directly relates to the clinical condition in that adjacent segment fractures sustained subsequent to either treatment is likely the result of overall disease progression, and not a direct result of the intervention.

Adult↗

PubMed1988

Determinants of atraumatic vertebral fracture rates in menopausal women: biologic v mechanical factors.

In menopausal women, the susceptibility to atraumatic vertebral fractures is thought to be governed by both mechanical factors (as represented by bone density) and by biologic factors such as age, body size, and dietary calcium. Whether these biologic factors independently influence fracture rates beyond the effect of bone density is a matter of controversy. To compare the relative importance of mechanical and biologic factors on vertebral fractures, we elucidated the determinants of atraumatic compression fractures in 63 menopausal women who had no chronic diseases other than osteopenia. Trabecular bone density was determined by quantitative computerized tomography of the spine. Fracture frequency was expressed as the number of compressed vertebrae per person between T5 and L4. The analysis showed that fracture frequency, bone density, and the biologic factors were closely interrelated. Fracture frequency was inversely correlated to bone density [R2 (spline model) = .40, P less than .0001], body size (r = -.26, P = .05), and dietary calcium (r = -.28, P = .04), and directly correlated with age (r = .46, P = .0002). Bone density decreased with age (r = -.65, P less than .0001), increased with body size (r = .37, P = .004), and tended to increase with dietary calcium (r = .24, P = .08). After controlling for bone density, there was no perceptible residual relationship between fracture frequency and any of these biologic factors. We conclude that mechanical factors overshadow age, body size, and dietary calcium as determinants of vertebral fracture frequency. The apparent influence of these biologic factors on fracture frequency is explained by their surrogate effects on bone density.

Aged↗

PubMed1983

[Osteosynthesis of unstable pertrochanteric femoral fractures with the compression hip screw].

Injuries of unstable pertrochanteric fractures of the upper femur represent a contingent with high multi-morbidity at highest average age. The only successful procedures within biologically set boundaries, would be those of an early and weight-bearing resistive osteo-synthesis. Starting in 1979 till the middle of 1982, we treated 70 unstable pertrochanteric fractures out of 350 proximal femur fractures, with this compression hip screw. Because of its underlying bio-mechanical principle, its advantageous operative handling, as well as high durability of the material used, this version of an osteosynthesis showed few complications. We found neither head penetration and pseudoarthrosis, nor did we find any implant bending and breaking so far. Although averaging almost 80 years, 63% of our patients could be released after hospitalization for an average of 39 days, leaving at full mobility. The set goal of an early weight-bearing with elderly patients was fully achieved by means of this version of osteo-synthesis, since dynamic compression of even comminuted fracture zones permitted a statically sound and unhindered possibility at weight-bearing.

Aged↗