We report here on a new technique using polymethylmethacrylate to manage vertebral osteoporotic compression fractures in three patients. These patients presented with acute back pain that manifested itself after minor trauma. Osteoporotic compression fractures were diagnosed via plain X-ray and magnetic resonance imaging studies. The patients were treated with absolute bed rest and non-steroidal anti-inflammatory drugs. Despite of the conservative treatment, the patients experienced severe, recalcitrant and progressive pain. The vertebrae were collapsed over 50% or kyphotic deformity was seen on the radiologic materials. We performed a new technique called lordoplasty, which is derived from percutaneous vertebroplasty. The patients experienced a reduction in pain after the procedure. The wedge and kyphotic angles of the fractured vertebrae were significantly restored.
Aged ; Female ; Fractures, Compression/radiography/*surgery ; Humans ; Magnetic Resonance Imaging ; Orthopedic Procedures/*methods ; Osteoporotic Fractures/radiography/*surgery ; Spinal Fractures/radiography/*surgery ; Thoracic Vertebrae/*injuries/radiography/surgery

BACKGROUND: The incidence of distal femur fracture in the elderly has been increasing recently, and commonly occurs with osteoporosis. Retrograde intramedullary nailing has been considered a good surgical option for distal femur fracture. The purpose of the present study was to present our surgical results with retrograde intramedullary nailing for distal femur fractures with osteoporosis. METHODS: Thirteen patients diagnosed with extra-articular distal femur fracture and osteoporosis and managed with retrograde intramedullary nailing were retrospectively reviewed. Cement augmentation was used in four patients, shape memory alloy was used in eight patients and both were used in one patient. All patients were followed up for more than 2 years. Radiologic alignments. were scored and Tegner and the Lysholm activity score was used for a functional assessment. RESULTS: The average time to clinical union was 13 weeks (range, 10 to 15 weeks). In 12 of our cases, the total alignment scores were excellent. At the last follow-up, the mean range of motion was 116degrees (range, 110degrees to 125degrees). The average functional score at postoperative 1 year was 2.6 (range, 1 to 5). CONCLUSIONS: Retrograde intramedullary nailing is a good surgical option for distal femur fracture with osteoporosis. Cement augmentation and shape memory alloy can also be used for added mechanical stability. This surgical technique is very useful for distal femur fracture with osteoporosis as it promotes fracture healing and early rehabilitation.
Aged ; Aged, 80 and over ; Alloys ; Bone Cements ; Female ; Femoral Fractures/pathology/radiography/*surgery ; Femur/pathology/radiography ; Fracture Fixation, Intramedullary/instrumentation/*methods ; Humans ; Male ; Osteoporosis, Postmenopausal/*pathology ; Osteoporotic Fractures/pathology/radiography/*surgery ; Range of Motion, Articular ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo explore the clinical outcomes of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral compression fracture (OVCF).

METHODSFrom January 2007 to February 2010, the data of 40 patients with osteoporotic vertebral compression fracture underwent treatment were retrospectively analyzed. Of them,20 patients were treated with PVP (PVP group), there were 8 males and 12 females with an average age of (66.37 +/- 2.34) years old (54 to 81); 20 patients were treated with PKP (PKP group), there were 11 males and 9 females with an average of (65.12 +/- 3.21) years old (56 to 79). Postoperative at 1 week, 12 weeks, 1 year, pain and daily life function were respectively assessed by visual analogue scale (VAS) and Barthel index (BI); and anterior height of responsibility vertebra, Cobb angle were measured by X-rays.

RESULTSIn PVP group, 1 case complicated with bone cement leakage without clinical symptoms and no operation to treat. No postoperative infection and deep vein thrombosis were found between two groups. All patients were followed up more than 1 year, pain and daily life function has obviously improved than preoperative (P < 0.01); and there was no significant difference on 1 week, 12 weeks, 1 year after operation (P > 0.05); there was no significant difference between two groups (P > 0.05). In PVP group, there was no significant difference in anterior height of responsibility vertebra, Cobb angle before and after operation;and in PKP group, postoperative data has obviously improved than preoperative (P < 0.01), but there was no significant difference postoperative at 1 week, 12 weeks, 1 year (P > 0.05); there was no significant difference between two groups at 1 week, 12 weeks, 1 year after operation.

CONCLUSIONBoth the methods can obviously relieve pain and completely or partly recover daily life function in treating OVCF. But PKP has advantages of recovery of anterior height of responsibility vertebra and correction of Cobb angle, especially for serious compression.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Kyphoplasty ; Male ; Middle Aged ; Osteoporotic Fractures ; diagnostic imaging ; physiopathology ; surgery ; Radiography ; Recovery of Function ; Retrospective Studies ; Spinal Fractures ; diagnostic imaging ; physiopathology ; surgery ; Spine ; surgery ; Treatment Outcome