No abstract available.
Diagnosis* ; Female ; Humans ; Osteoporosis, Postmenopausal*

PURPOSE: The purpose of this study was to investigate the radiologic and serologic factors related to postoperative union using intramedullary (IM) internal fixation in atypical femoral fractures (AFF), which are closely related to bisphosphonates (BPs) for osteoporosis. MATERIALS AND METHODS: From February 2008 to December 2016, 65 patients (71 cases) who had undergone IM nail fixation after diagnosis of AFF were enrolled in this study. Patients were divided into group A, who experienced union within 6 months and group B, who did not experience union within 6 months. They were evaluated for duration of BPs use, radiologic factors and serological factors. RESULTS: The mean duration of BPs use was 6.17 years in group A and 8.24 years in group B (p=0.039). In the subtrochanteric area, there were 14 cases (27.5%) in group A and 14 cases (70.0%) in group B. In the femoral shaft, there were 37 cases (72.5%) in group A and 6 cases (30.0%) in group B (p=0.001). On the preoperative, the flexion in the coronal plane was 5.9° (2.1°–9.2°) in group A and 8.0° (3.1°–12.1°) in group B (p=0.041). On the postoperative, conversion to valgus was 15 cases (29.4%), 8 cases (40.0%); conversion to neutral was 34 cases (66.7%) and 8 cases (40.0%); conversion to varus was 2 cases (3.9%) and 4 cases (20.0%), each (p=0.037). The fracture site gap was 1.5 mm (0–2.9 mm) on the front side and 1.2 mm (0–2.2 mm) on lateral side and 2.2 mm (0.9–4.7 mm) and 1.9 mm (0.5–3.5 mm), each (p=0.042, p=0.049). Among serological factors, there was no significant difference between the two groups. CONCLUSION: Factors adversely affecting the union should be recognized before surgery, such as longterm BPs use or a severe degree of bending of the femur in the coronal plane. During surgery, proper reduction and spacing of the fracture site on the coronal plane should allow adequate reduction of the anterior and posterior surfaces. Obtaining anatomic reduction would be most beneficial for union, but if that is not possible, obtaining congenital valgus rather than varus on the coronal plane may be helpful for union.
Diagnosis ; Diphosphonates ; Femoral Fractures ; Femur ; Humans ; Osteoporosis

Primary Intestinal lymphangiectasia (PIL) is a common cause of protein losing enteropathy (PLE). It will affect enter-hepatic circulation of lipid-soluble vitamin, and absorption of electrolytes, cause malnutrition related osteomalacia or osteoporosis. While seldom health care workers noted to assess and treat osteomalacia or osteoporosis in PIL. Here we report a related case. We found increased parathyroid hormone, decreased 25(OH)D3, low bone mineral density, which indicated that the PIL patient had osteomalacia and/or osteoporosis. Adequate calcium and vitamin D supply can relieve the condition efficaciously. We should pay attention to osteomalacia and osteoporosis in PIL patients.
Adolescent ; Female ; Humans ; Lymphangiectasis, Intestinal ; diagnosis ; Osteomalacia ; diagnosis ; Osteoporosis ; diagnosis

We have analyzed 27 cases(38.8%) of scapho-lunate(SL) dissociation which were the most com- mon type of total 72 cases of post-traumatic wrist instabilities since 1985. As a result, SL dissociations associated with wrist fracture were 23 cases, more common than simple dynamic SL dissociation(4 cases). Early diagnosis and treatment influenced on their prognosis, and both wrist PA roentgenograms were useful for the confirmative diagnosis of SL dissociation. In 16 cases with early diagnosis, closed reduction, 2 or 3 K-wires fixation under C-arm image and short arm cast for 8 weeks were effective. But in 11 cases with neglected diagnosis and with wrist fractures showed poor results. Excessive wrist ligamentous reconstruction in chronic cases should be avoided because of osteoporosis and wrist stiffness. Conclusively, clinical wrist symptoms are more important than radiological changes in wrist insta- bilites. So if the symptoms are not so severe, we must consider the patient's age, occupation and their social activities etc. to decide the proper way of treatment.
Arm ; Diagnosis ; Early Diagnosis ; Ligaments ; Occupations ; Osteoporosis ; Prognosis ; Wrist

STUDY DESIGN: A Retrospective study OBJECTIVE: To evaluate the results after an anterior decompression and fusion, with anterior instrumentation, using a Z-plate in osteoporotic vertebral fractures. SUMMARY OF LITERATURE REVIEW: Despite conservative treatment, continuous severe pain, progressive neurological impairments and deformity may need surgical treatment in osteoporotic vertebral fractures accompanied with neurological deficit. MATERIALS AND METHODS: Fourteen patients that had undergone anterior decompression and an autogenous iliac bone graft, with anterior internal fixation, between 1997 and 2001, under the diagnosis of an osteoporotic vertebral fracture, were reviewed. The chief complaints, severity of pain measured, using the Denis pain scale, fracture patterns, fracture level, changes of kyphotic angle (revised with sagittal index) and complications were analyzed. RESULTS: Symptoms subsided completely in 5 patients, one case showed no definite improvement and 8 showed improved symptoms. The fracture levels included: 1 and 2 cases at the 11th and 12th thoracic spine, and 8, 1 and 2 in the 1st, 2nd and 3rd lumbar spine, respectively. 10 patients showed wedge type fractures, three a compression type and one a biconcave type. The average kyphotic deformity decreased 49.0% (50.9% when revised with sagittal index) after surgery, but the average loss of correction angle was 28.8% (26.0% when revised with sagittal index), compared with the immediate postoperative correction angle. THE COMPLICATIONS INCLUDED: screw loosening and adjacent vertebral fractures in 3 and 4 patients, respectively. Two patients had the combined problem of screw loosening and an adjacent vertebral fracture. CONCLUSION: In anterior decompression and fusion, with instrumentation, for osteoporotic vertebral fracture treatment, the complications were primarily related, directly or indirectly, to the underlying osteoporosis. Complete neurological recovery occurred 9 of the 11 patients, but residual pain was common.
Congenital Abnormalities ; Decompression* ; Diagnosis ; Humans ; Osteoporosis ; Retrospective Studies ; Spine ; Transplants

PURPOSE: The goal of this study was to develop a new index as an objective reference for evaluating current and newly developed indices used for osteoporosis screening based on dental images. Its name; IDIOS, stands for Index of Dental-imaging Indices of Osteoporosis Screening. MATERIALS AND METHODS: A comprehensive PubMed search was conducted to retrieve studies on dental imaging-based indices for osteoporosis screening. The results of the eligible studies, along with other relevant criteria, were used to develop IDIOS, which has scores ranging from 0 (0%) to 15 (100%). The indices presented in the studies we included were then evaluated using IDIOS. RESULTS: The 104 studies that were included utilized 24, 4, and 9 indices derived from panoramic, periapical, and computed tomographic/cone-beam computed tomographic techniques, respectively. The IDIOS scores for these indices ranged from 0 (0%) to 11.75 (78.32%). CONCLUSION: IDIOS is a valuable reference index that facilitates the evaluation of other dental imaging-based osteoporosis screening indices. Furthermore, IDIOS can be utilized to evaluate the accuracy of newly developed indices.
Absorptiometry, Photon ; Diagnosis ; Mass Screening* ; Osteoporosis* ; Radiography, Dental

Transient osteoporosis of the hip is a self-limited condition of uncertain etiology and pathogenesis that affects young and middle aged adults. Even its clinical features are similar to the features of osteonecrosis the prognosis and clinical end result are quite different. So differential diagnosis between the two is very important. We present a case of transient osteoporosis of the hip in middle aged man, which was completely reeovered after conservative treatment.
Adult ; Diagnosis, Differential ; Hip ; Humans ; Middle Aged ; Osteonecrosis ; Osteoporosis ; Prognosis

Dual-energy X-ray absorptiometry (DXA) is a widely used technology used to diagnosis osteoporosis and monitor changes in bone mineral density (BMD). The present paper reviews the clinical application of DXA in evaluating osteoporosis, including indications for BMD testing, interpretation of DXA results, diagnosis of osteoporosis, and serial BMD follow up. As the clinical utility of DXA depends on the quality of the scan acquisition, the precision assessment of DXA is also discussed.
Absorptiometry, Photon ; Bone Density ; Diagnosis ; Follow-Up Studies ; Osteoporosis

Insufficiency fracture is a type of stress fracture, which is the result of normal stresses on abnormal bone. Postmenopausal osteoporosis is the most common cause of insufficiency fractures. An early diagnosis is best made with a bone scan or magnetic resonance imaging, as radiographs may initially appear normal. Insufficiency fractures of the lower leg and ankle are less common. Furthermore, reports of medial malleolar insufficiency fracture without any history of trauma in elderly patients are extremely rare. Thus, we report a case with a medial malleolar insufficiency fracture of the ankle in an elderly patient with osteoporosis. This case shows that we should be aware of the possibility of encountering an uncommon medial malleolar insufficiency fracture as a cause of pain in the ankle region of an elderly patient with osteoporosis.
Ankle* ; Early Diagnosis ; Female ; Fractures, Stress* ; History ; Humans ; Leg ; Magnetic Resonance Imaging ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Wounds and Injuries

PURPOSE: We studied the improvement of back pain in vertebral fracture and fracture healing in non-vertebral fracture after treatment with zoledronate in postmenopausal patients. MATERIALS AND METHODS: Postmenopausal women with bone mineral density (BMD) T-score of -2.5 or less and existing vertebral fractures or non-vertebral fractures between January 2011 and June 2012 were included. Patients received a single intravenous infusion of zoledronate within 3 days after diagnosis of fractures. The primary outcome was BMD and secondary outcomes were visual analogue scale (VAS) for back pain, fracture healing, and new clinical fracture. RESULTS: T-score increased significantly in the vertebral fracture group (n=97) and non-vertebral fracture group (n=31) at 1 year (p<0.05). The average VAS for back pain decreased significantly in the vertebral fracture group (p<0.05) and there was no delayed union, nonunion in the non-vertebral fracture group. There was no re-fracture and 3 new clinical fractures (2.34%) occurred during the follow-up period. CONCLUSION: Zoledronate, as treatment in postmenopausal osteoporosis patients can improve BMD, reduce back pain in vertebral fracture, and has no negative effect on bone healing after fracture in non-vertebral fracture.
Back Pain ; Bone Density ; Diagnosis ; Female ; Follow-Up Studies ; Fracture Healing ; Humans ; Infusions, Intravenous ; Osteoporosis ; Osteoporosis, Postmenopausal ; Spine* ; Treatment Outcome*