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Sharafi A, Ghaderi A, Shahbazi P, Ghaseminejad‐Raeini A, Ramezani A, Soleimani M, Talebiyan P, Shafiei SH. Illicit drug abuse and complexity of tibial shaft fracture based on AO/OTA classification: Is there any connection? J Exp Orthop 2024; 11:e12003. [PMID: 38455452 PMCID: PMC10903434 DOI: 10.1002/jeo2.12003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 12/25/2023] [Indexed: 03/09/2024] Open
Abstract
Purpose Illicit drug abuse is a global epidemic afflicting millions worldwide. Several studies have investigated the contribution of this dependence as a risk factor for fracture, but its impacts on fracture severity have been rarely studied. The present study primarily aims to determine the relationship between illicit drug abuse and the severity of tibial shaft fractures. Methods This retrospective study consecutively included patients aged ≥18 years with tibial shaft fracture who attended Sina Tertiary Hospital, Tehran, Iran, between 2016 and 2021. The fracture patterns were assessed according to the Arbeitsgemeinschaft für Osteosynthesefragen Foundation/Orthopaedic Trauma Association classification. Participants were divided into three individual specialists into groups: simple (A), wedge (B) and multifragmentary (C) fractures. The association of illicit drug abuse and other recorded variables, including age, sex, body mass index (BMI), comorbidities, physical activity, smoking habits and mechanism of injury, was also examined and assessed in multivariate logistic regression. Results Of 219 patients, 26 were drug abusers, and 193 had no history of use. A total of 20 out of 26 drug abusers experienced a complex fracture, yielding a rate of 76.9%, while this rate for nonusers was 50.3% (97 out of 193), indicating a statistically significant difference between the two subgroups (p = 0.011). The smoking history also influenced the fracture pattern (p = 0.027) based on univariate analysis; however, using adjusted multivariate analysis yielded only illicit drug abuse (odds ratio = 3.495; confidence interval = 1.144-10.680) as a risk factor for more complex fractures. Conclusion The evidence from this study suggests that complexity and fracture patterns can depend on illicit drug abuse history. Level of Evidence Level III.
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Affiliation(s)
- Amirmohammad Sharafi
- Orthopedic Department, Orthopedic Surgery Research Center (OSRC), Sina University HospitalTehran University of Medical SciencesTehranIran
| | - Ali Ghaderi
- Orthopedic Department, Orthopedic Surgery Research Center (OSRC), Sina University HospitalTehran University of Medical SciencesTehranIran
| | - Parmida Shahbazi
- Orthopedic Department, Orthopedic Surgery Research Center (OSRC), Sina University HospitalTehran University of Medical SciencesTehranIran
| | - Amirhossein Ghaseminejad‐Raeini
- Orthopedic Department, Orthopedic Surgery Research Center (OSRC), Sina University HospitalTehran University of Medical SciencesTehranIran
| | - Akam Ramezani
- Orthopedic Department, Orthopedic Surgery Research Center (OSRC), Sina University HospitalTehran University of Medical SciencesTehranIran
| | - Mohammad Soleimani
- Orthopedic Department, Orthopedic Surgery Research Center (OSRC), Sina University HospitalTehran University of Medical SciencesTehranIran
| | - Parham Talebiyan
- Orthopedic Department, Orthopedic Surgery Research Center (OSRC), Sina University HospitalTehran University of Medical SciencesTehranIran
| | - Seyyed Hossein Shafiei
- Orthopedic Department, Orthopedic Surgery Research Center (OSRC), Sina University HospitalTehran University of Medical SciencesTehranIran
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Schlickewei C, Schweizer C, Püschel K, Ondruschka B, Kleinertz H, Barg A, Rolvien T, Stürznickel J. Age-, sex-, and subregion-specific properties of distal fibular microarchitecture and strength: An ex vivo HR-pQCT study. J Orthop Res 2023; 41:355-363. [PMID: 35502758 DOI: 10.1002/jor.25351] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/31/2022] [Accepted: 04/28/2022] [Indexed: 02/04/2023]
Abstract
Despite its clinical relevance in the context of ankle fractures, little is known about the bone microarchitecture and strength of the distal fibula, especially regarding age-, sex-, and subregion-specific effects. To address this gap of knowledge, we obtained fibulae from 30 skeletally intact donors at autopsy (each 15 male and female), which were analyzed by high-resolution peripheral quantitative computed tomography including micro-finite element analysis. Scans were performed in a 7-cm volume of interest and evaluated in three subregions according to the Danis-Weber fracture classification. Group comparisons and linear regression analyses were applied to evaluate the effects of age, sex, and subregion. From distal to proximal, we observed an increase of cortical parameters and a decrease of trabecular parameters. Age was primarily associated with a cortical decrease in all subregions (Danis-Weber type A, B, and C) in women. While women showed a greater magnitude of decline, men also exhibited an age-associated decrease for some parameters, including cortical area and cortical thickness in the type C subregion. Stiffness and failure load were highest in the type C subregion in both women and men. A critical age-related decline in bone strength parameters in the type B subregion was observed in women, providing an explanation for the increased incidence of low-traumatic type B fractures in the elderly. Together, these findings extend the current understanding of distal fibular microarchitecture, likely explaining the epidemiologic features of distal fibula fractures and emphasizing the need for age-adapted treatment algorithms.
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Affiliation(s)
- Carsten Schlickewei
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Conradin Schweizer
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Klaus Püschel
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Kleinertz
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexej Barg
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Hospital Hamburg, Hamburg, Germany.,Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA
| | - Tim Rolvien
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julian Stürznickel
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Wu C, Liu T, Shi Z, Fang L, Jin H, Tong P. Novel nomograms for predicting the risk of low distal bone strength: development and validation in a Chinese population-based observational study. J Orthop Surg Res 2023; 18:70. [PMID: 36717927 PMCID: PMC9885689 DOI: 10.1186/s13018-023-03546-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 01/15/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND This study aims to develop nomogram models based on the speed of sound (SOS) measurements results along with demographic information to predict the risk of low bone strength (LBS) of radius appropriate to the Chinese population of a broad age spectrum. METHODS A population-based cross-sectional study was conducted in 5 outpatient clinics located in Zhejiang, the southern part of China. A total of 38,699 participants from 2013 to 2017 were included. Baseline measurements included SOS of the distal radius and clinical risk factor evaluation. Logistic regression models were used to evaluate prognosis and identify independent predictive factors, which were then utilized to establish nomograms for predicting the low bone strength of radius. The discrimination and calibration of nomograms were validated using the calibration plots, the decision curve analysis (DCA), and the receiver operating characteristics curve (ROC). RESULTS A total of 19,845 of the 38,904 participants ranged in age from 10 to 88 years were selected in this process. LBP nomogram model 1 was constructed based on age, weight, height, BMI, and gender. LBP nomogram model 2 was constructed based on age, height, BMI, and gender. The AUCs for model 1 and model 2 were 0.838 (95% CI: 0.832-0.844) and 0.837 (95% CI: 0.831-0.843), respectively. High-quality calibration plots and DCA in nomogram models were noticed, indicated that the constructed nomogram models were clinically useful. CONCLUSIONS Our study demonstrates that the nomograms established in this study could effectively evaluate the high-risk population groups of distal radius fracture in China.
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Affiliation(s)
- Congzi Wu
- grid.417400.60000 0004 1799 0055Institute of Orthopaedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053 Zhejiang Province People’s Republic of China ,grid.268505.c0000 0000 8744 8924The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053 Zhejiang Province People’s Republic of China
| | - Ting Liu
- grid.268505.c0000 0000 8744 8924School of Nursing, Zhejiang Chinese Medical University, Hangzhou, 310053 China
| | - Zhenyu Shi
- grid.417400.60000 0004 1799 0055Institute of Orthopaedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053 Zhejiang Province People’s Republic of China ,grid.417400.60000 0004 1799 0055Department of Orthopaedic Surgery, The First Affiliated Hospital of Zhejiang, Chinese Medical University, Hangzhou, 310003 Zhejiang Province People’s Republic of China
| | - Liang Fang
- grid.417400.60000 0004 1799 0055Institute of Orthopaedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053 Zhejiang Province People’s Republic of China ,grid.268505.c0000 0000 8744 8924The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053 Zhejiang Province People’s Republic of China
| | - Hongting Jin
- grid.417400.60000 0004 1799 0055Institute of Orthopaedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053 Zhejiang Province People’s Republic of China ,grid.417400.60000 0004 1799 0055Department of Orthopaedic Surgery, The First Affiliated Hospital of Zhejiang, Chinese Medical University, Hangzhou, 310003 Zhejiang Province People’s Republic of China
| | - Peijian Tong
- grid.417400.60000 0004 1799 0055Institute of Orthopaedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053 Zhejiang Province People’s Republic of China ,grid.417400.60000 0004 1799 0055Department of Orthopaedic Surgery, The First Affiliated Hospital of Zhejiang, Chinese Medical University, Hangzhou, 310003 Zhejiang Province People’s Republic of China
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Yan Y, Xu R, Fang Y. Do Better Postoperative Radiological Findings Predict Better Long-Term Functional Outcomes in Adults with a Displaced Distal Radius Fracture? JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: The purpose of this study was to analyze the relationship of early radiological outcomes and longterm function in postoperative distal radius fracture patients. Methods: This was prospective cohort research, with information including sex, age, patient satisfaction,
Gartland and Werley Score, and radiographic score. The statistics, including correlation analysis, ROC Curve, and multivariable binary Logistic Regression, were analyzed in SPSS. Results: In the entire 135 patients, 48 were male, 87 were female. ROC curve showed longterm Gartland and
Werley Score, and early radiographic scores have an association to a certain extent with a Spearman correlation coefficient of 0.196 (p = 0.023) and an AUC of 0.639 (ROC Curve, p = 0.017). Patient satisfaction was mainly determined by the statistical modeling of 4.096×(palmar
flexion−dorsiflexion)−4.378× (pronation−supination)−5.754 (Multivariable Binary Logistic Regression). Conclusion: Long-terms functional outcomes of postoperative distal radius fracture patients are not only influenced by radiographic score. Patient satisfaction
is mainly concerning palmar flexion and pronation–supination of the wrist.
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Affiliation(s)
- Yongqing Yan
- Orthopedics Center, HwaMei Hospital, University of Chinese Academy of Science, Ningbo City, Zhejiang Province, 315010, China
| | - Renjie Xu
- Department of Orthopaedics, Suzhou Municipal Hospital/The Affiliated Hospital of Nanjing Medical University, Suzhou, 215000, Jiangsu, People’s Republic of China
| | - Yufei Fang
- Orthopedics Center, HwaMei Hospital, University of Chinese Academy of Science, Ningbo City, Zhejiang Province, 315010, China
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