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Inoue H, Oyama R, Nakamura K, Inokuchi A, Hamada T, Izumi T, Imamura R, Ebihara T, Inoue T, Arizono T. Bisphosphonates Prescription for Patients With Hip Fractures Based on Evaluation by a Dentist. Cureus 2023; 15:e35407. [PMID: 36987487 PMCID: PMC10040204 DOI: 10.7759/cureus.35407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2023] [Indexed: 03/30/2023] Open
Abstract
Background The purpose of this study is to clarify the current status of the prescription of postoperative bisphosphonates for patients with hip fractures and to explore the factors that prevent the postoperative prescription of bisphosphonates. Methods Of 180 patients with hip fractures treated surgically at our hospital between August 2019 and April 2020, 149 patients (46 men and 103 women; mean age: 83.9 ± 9.0 years), excluding 31 patients already prescribed bisphosphonates or denosumab, were included in the study. All patients were treated based on our clinical pathway, and their risk of jaw osteonecrosis was evaluated prior to the initiation of bisphosphonates by a dentist in our hospital. We collected data from the medical records on osteoporosis treatment interventions at admission and discharge, the reasons why postoperative bisphosphonates could not be prescribed at discharge, the proportion of patients who had follow-ups at our hospital, and patients' osteoporosis treatment status. Results Eighteen (12.8%) and 95 (63.8%) patients were prescribed anti-osteoporosis drugs at admission and discharge, respectively. One hundred and twenty-one patients (86.8%) could not be prescribed postoperative bisphosphonates at discharge - 71 (58.7%) because of oral hygiene problems, 34 (28.1%) because they did not have regular dental consultations, seven (5.8%) because of renal dysfunction, eight (6.6%) because of poor cognitive and swallowing function, and one (0.8%) because of medication side effects. Forty-nine patients (32.9%) went to our hospital for follow-up and 11 were introduced to bisphosphonates or denosumab at follow-up. Conclusions The number of patients with hip fractures who were prescribed postoperative bisphosphonates was low in our study. The oral hygiene problems identified by dentists accounted for responsible for the low prescription rate of postoperative bisphosphonates. Therefore, coordination with dentists may be important to increase the postoperative bisphosphonate prescription.
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Affiliation(s)
- Hayato Inoue
- Department of Orthopedic Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, JPN
| | - Ryunosuke Oyama
- Department of Orthopedic Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, JPN
| | - Kimitaka Nakamura
- Department of Orthopedic Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, JPN
| | - Akihiko Inokuchi
- Department of Orthopedic Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, JPN
| | - Takahiro Hamada
- Department of Orthopedic Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, JPN
| | - Teiyu Izumi
- Department of Orthopedic Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, JPN
| | - Ryuta Imamura
- Department of Orthopedic Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, JPN
| | - Toshihiro Ebihara
- Department of Orthopedic Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, JPN
| | - Takahiro Inoue
- Department of Orthopedic Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, JPN
| | - Takeshi Arizono
- Department of Orthopedic Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, JPN
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Yu S, Li C, Zhong Y, Zang J, Zhou Z, Wang S, Zhang Y. Risk factors for contralateral hip refractures in patients aged over 80 years with intertrochanteric femoral fractures. Front Surg 2022; 9:924585. [PMID: 36176341 PMCID: PMC9513157 DOI: 10.3389/fsurg.2022.924585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose The purpose of this study was to identify which of the risk factors would contribute to the contralateral fracture in very elderly patients after intramedullary nail fixation. Methods Clinical data of 227 intertrochanteric fracture patients aged 80 years or older were retrospectively reviewed. Intramedullary nails (IMNs) were used on all of the patients. Potential risk factors for contralateral hip refractures were determined using univariate and logistic regression analyses. Results Contralateral hip refractures occurred in 11 patients (4.84%). Univariate analysis revealed that age, gender, body mass index, fracture classification, hematocrit, D-dimer, and CRP level were not associated with contralateral fractures (P > 0.05). However, neurological diseases, cardiovascular disease, and visual impairments were significantly associated with contralateral fractures (P < 0.05). Multivariate analysis further revealed that neurological diseases (OR 4.25, P = 0.044) and visual impairments (OR 5.42, P = 0.015) were independent risk factors associated with contralateral refractures. Conclusion To prevent contralateral refractures, more attention should be paid to elderly intertrochanteric fracture patients with underlying neurological disease and visual impairments.
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Affiliation(s)
- Shujun Yu
- The First Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
| | - Chen Li
- The First Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
| | - Yuqiao Zhong
- Department of Radiology, Tianjin Hospital, Tianjin, China
| | - Jiacheng Zang
- The First Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
| | - Zhanzhe Zhou
- Department of Orthopedics, Tianjin Xiqing Hospital, Tianjin, China
| | - Song Wang
- The First Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
- Correspondence: Song Wang Yinguang Zhang
| | - Yinguang Zhang
- The First Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
- Correspondence: Song Wang Yinguang Zhang
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Umehara T, Kaneguchi A, Watanabe K, Inukai A, Kuwahara D, Kaneyashiki R, Mizuno N, Iwamoto Y, Kito N, Kakehashi M. Association between movement control during one-leg standing and femoral BMD in patients with hip fractures. J Bone Miner Metab 2021; 39:474-483. [PMID: 33389195 DOI: 10.1007/s00774-020-01185-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/17/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Prior studies have focused only on the temporal component of one-leg standing, no reports have examined the relationship between the qualitative components of one-leg standing and femoral BMD. Thus, this study investigated whether quality (i.e., movement control) of one-leg standing also associated femoral BMD. MATERIALS AND METHODS A total of 80 patients with unilateral hip fracture were included in a cross-sectional study. Basic and medical information and physical functions including movement control during one-leg standing were assessed at admission and 2 weeks after surgery, respectively. Hierarchical multiple regression analysis was performed to identify predictors of femoral BMDs on the non-fractured side. Dependent variables included femoral neck and total hip BMDs in models 1 and 2, respectively. RESULTS Hierarchical multiple regression analysis (standardized partial regression coefficients) in model 1 identified age (- 0.18), sex (0.38), body mass index (BMI) (0.41), movement control during one-leg standing on the non-fractured side (0.19), and life-space assessment (0.17) as factors associating femoral neck BMD. Meanwhile, hierarchical multiple regression analysis (standardized partial regression coefficients) in model 2 identified age (- 0.12), sex (0.36), BMI (0.37), and movement control during one-leg standing on the non-fractured side (0.25) as factors associating total hip BMD. The coefficients of determination adjusted for degrees of freedom (R2) were 0.529 and 0.470 for models 1 and 2, respectively. CONCLUSION Our results suggest that improving movement control during one-leg standing may be important for maintaining and improving femoral BMD on the non-fractured side.
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Affiliation(s)
- Takuya Umehara
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Kurose-Gakuendai 555-36, Higashi-Hiroshima, Hiroshima, Japan.
- Department of Rehabilitation, Saiseikai Kure Hospital, Sanjo 2-1-13, Kure, Hiroshima, 737-0821, Japan.
| | - Akinori Kaneguchi
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Kurose-Gakuendai 555-36, Higashi-Hiroshima, Hiroshima, Japan
| | - Keita Watanabe
- Department of Rehabilitation, Kure Kyosai Hospital, Nishichuo 2-3-28, Kure, Hiroshima, Japan
| | - Ayaka Inukai
- Department of Rehabilitation, Saiseikai Kure Hospital, Sanjo 2-1-13, Kure, Hiroshima, 737-0821, Japan
| | - Daisuke Kuwahara
- Department of Rehabilitation, Saiseikai Kure Hospital, Sanjo 2-1-13, Kure, Hiroshima, 737-0821, Japan
| | - Ryo Kaneyashiki
- Department of Rehabilitation, Saiseikai Kure Hospital, Sanjo 2-1-13, Kure, Hiroshima, 737-0821, Japan
| | - Naoyuki Mizuno
- Department of Orthopedics, Saiseikai Kure Hospital, Sanjo 2-1-13, Kure, Hiroshima, Japan
| | - Yoshitaka Iwamoto
- Department of Neuromechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Hiroshima Minami-ku, Hiroshima, Japan
| | - Nobuhiro Kito
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Kurose-Gakuendai 555-36, Higashi-Hiroshima, Hiroshima, Japan
| | - Masayuki Kakehashi
- Department of Health Informatics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Hiroshima Minami-ku, Hiroshima, Japan
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