Popa Mihnea, Cursaru Adrian, Cretu Bogdan, Iordache Sergiu, Iacobescu Georgian L, Spiridonica Razvan, Serban Bogdan, Cirstoiu Catalin
Orthopedics and Traumatology Department, University Emergency Hospital, Bucharest, ROU.
Orthopaedics and Trauma, University of Medicine and Pharmacy Carol Davila, Bucharest, ROU.
Cureus. 2024 May 5;16(5):e59681. doi: 10.7759/cureus.59681. eCollection 2024 May.
Managing osteoporotic fractures in older individuals is a difficult task in orthopedic surgery. It requires a careful approach that combines advanced diagnostic methods, customized surgical treatments, and comprehensive rehabilitation strategies. This article presents the results of an analysis carried out at the University Emergency Hospital, Bucharest. The analysis specifically examines the treatment of osteoporotic fractures using different osteosynthesis techniques. Although diagnostic tools like dual-energy X-ray absorptiometry (DXA) and Fracture Risk Assessment Tool (FRAX) have improved, a considerable number of fractures still happen in people who do not have obvious osteoporosis. This emphasizes the importance of using additional diagnostic measures such as high-resolution peripheral quantitative computed tomography (HR-pQCT) and quantitative computed tomography (QCT) to improve the accuracy of predictions. The study demonstrates the intricate nature of surgical decision-making and the significance of adjusting techniques to meet the specific needs of each patient. An instance of osteosynthesis failure resulting from the inappropriate choice of method highlighted the crucial significance of a thorough preoperative assessment. The discussion highlights the importance of early mobilization and rehabilitation in reducing the risks associated with prolonged immobilization and improving patient recovery. This paper strongly supports the use of evidence-based and patient-centered methods in the management of osteoporotic fractures. It emphasizes the importance of utilizing the most recent advancements in diagnostic and surgical technologies. Promising advancements in orthopedic medicine lie in the future, particularly in the integration of interdisciplinary research and personalized medicine. These advancements have the potential to enhance patient outcomes in this population that is at high risk.
在老年个体中处理骨质疏松性骨折是骨科手术中的一项艰巨任务。这需要一种谨慎的方法,将先进的诊断方法、定制的手术治疗和全面的康复策略结合起来。本文介绍了在布加勒斯特大学急诊医院进行的一项分析结果。该分析具体研究了使用不同骨固定技术治疗骨质疏松性骨折的情况。尽管双能X线吸收法(DXA)和骨折风险评估工具(FRAX)等诊断工具有所改进,但在没有明显骨质疏松的人群中仍有相当数量的骨折发生。这强调了使用高分辨率外周定量计算机断层扫描(HR-pQCT)和定量计算机断层扫描(QCT)等额外诊断措施以提高预测准确性的重要性。该研究证明了手术决策的复杂性以及根据每个患者的具体需求调整技术的重要性。因方法选择不当导致骨固定失败的一个实例突出了全面术前评估的关键意义。讨论强调了早期活动和康复在降低与长期固定相关的风险以及改善患者恢复方面的重要性。本文强烈支持在骨质疏松性骨折管理中使用基于证据和以患者为中心的方法。它强调了利用诊断和手术技术最新进展的重要性。骨科医学未来有充满希望的进展,特别是在跨学科研究和个性化医学的整合方面。这些进展有可能改善这一高危人群的患者预后。