Journal of the Korean Medical Association (대한의사협회지)

Korean Medical Association (대한의사협회)
권호 표지
DOI QR코드

DOI QR Code

Surgical or nonsurgical treatment of osteoporotic fractures

골다공증성 골절의 수술적, 비수술적 치료

  • Park, Si Young (Department of Orthopaedic Surgery, Korea University College of Medicine) ;
  • Lee, Soon Hyuck (Department of Orthopaedic Surgery, Korea University College of Medicine) ;
  • Jeong, Woong Kyo (Department of Orthopaedic Surgery, Korea University College of Medicine) ;
  • Kang, Chun Hyung (Department of Orthopaedic Surgery, Korea University College of Medicine)
  • 박시영 (고려대학교 의과대학 정형외과학교실) ;
  • 이순혁 (고려대학교 의과대학 정형외과학교실) ;
  • 정웅교 (고려대학교 의과대학 정형외과학교실) ;
  • 강전형 (고려대학교 의과대학 정형외과학교실)
  • Received : 2016.10.03
  • Accepted : 2016.10.17
  • Published : 2016.11.01
⟨ Previous Next ⟩

Abstract

The worldwide population of the elderly is steadily increasing, and even more so in Korea, thus causing an increase in the osteoporotic fracture prevalence. Osteoporotic fracture is a serious injury that can decrease quality of life, and can also produce major social problems when it causes mortality. Preventing such fractures from happening in the first place is of utmost importance but once a fracture does occur, it is important to select appropriate treatment modalities to prevent secondary fractures. Recently, with the increase of life expectancy, it has become favorable to perform surgical fixation for significantly displaced osteoporotic fractures and use early rehabilitation programs to return the patient to normal body performance as soon as possible. To do so, it is important to accurately assess the location and the degree of the fractures in order to select appropriate treatment modalities. Furthermore, it is important to prevent secondary fractures from happening once the previous fractures heal.

Keywords

References

  1. NIH Consensus Development Panel on Osteoporosis Preven-tion, Diagnosis, and Therapy. Osteoporosis prevention, diag-nosis, and therapy. JAMA 2001;285:785-795. https://doi.org/10.1001/jama.285.6.785
  2. Eisman JA, Bogoch ER, Dell R, Harrington JT, McKinney RE Jr, McLellan A, Mitchell PJ, Silverman S, Singleton R, Siris E; ASBMR Task Force on Secondary Fracture Prevention. Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention. J Bone Miner Res 2012;27:2039-2046. https://doi.org/10.1002/jbmr.1698
  3. Dell R, Greene D, Schelkun SR, Williams K. Osteoporosis dis-ease management: the role of the orthopaedic surgeon. J Bone Joint Surg Am 2008;90 Suppl 4:188-194. https://doi.org/10.2106/JBJS.H.00628
  4. Yoo JH, Moon SH, Ha YC, Lee DY, Gong HS, Park SY, Yang KH. Osteoporotic fracture: 2015 position statement of the Ko- rean Society for Bone and Mineral Research. J Bone Metab 2015;22:175-181. https://doi.org/10.11005/jbm.2015.22.4.175
  5. Haentjens P, Autier P, Collins J, Velkeniers B, Vanderschueren D, Boonen S. Colles fracture, spine fracture, and subsequent risk of hip fracture in men and women: a meta-analysis. J Bone Joint Surg Am 2003;85:1936-1943. https://doi.org/10.2106/00004623-200310000-00011
  6. Lee YK, Jang S, Jang S, Lee HJ, Park C, Ha YC, Kim DY. Mor-tality after vertebral fracture in Korea: analysis of the National Claim Registry. Osteoporos Int 2012;23:1859-1865. https://doi.org/10.1007/s00198-011-1833-5
  7. Park C, Ha YC, Jang S, Jang S, Yoon HK, Lee YK. The inci-dence and residual lifetime risk of osteoporosis-related frac-tures in Korea. J Bone Miner Metab 2011;29:744-751. https://doi.org/10.1007/s00774-011-0279-3
  8. Ha YC, Park YG, Nam KW, Kim SR. Trend in hip fracture incidence and mortality in Korea: a prospective cohort study from 2002 to 2011. J Korean Med Sci 2015;30:483-488. https://doi.org/10.3346/jkms.2015.30.4.483
  9. Matin P. The appearance of bone scans following fractures, including immediate and long-term studies. J Nucl Med 1979;20:1227-1231.
  10. Park SY, Lee SH, Suh SW, Park JH, Kim TG. Usefulness of MRI in determining the appropriate level of cement augmen-tation for acute osteoporotic vertebral compression fractures. J Spinal Disord Tech 2013;26:E80-E85. https://doi.org/10.1097/BSD.0b013e318261f438
  11. Takahashi S, Hoshino M, Takayama K, Iseki K, Sasaoka R, Tsujio T, Yasuda H, Sasaki T, Kanematsu F, Kono H, Toyoda H, Nakamura H. Time course of osteoporotic vertebral fractures by magnetic resonance imaging using a simple classification: a multicenter prospective cohort study. Osteoporos Int 2016 Aug 30 [Epub]. http://dx.doi.org/10.1007/s00198-016-3737-x.
  12. Hasserius R, Karlsson MK, Nilsson BE, Redlund-Johnell I, Johnell O; European Vertebral Osteoporosis Study. Prevalent vertebral deformities predict increased mortality and increased fracture rate in both men and women: a 10-year population-based study of 598 individuals from the Swedish cohort in the European Vertebral Osteoporosis Study. Osteoporos Int 2003;14:61-68. https://doi.org/10.1007/s00198-002-1316-9
  13. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteopo-ros Int 2006;17:1726-1733. https://doi.org/10.1007/s00198-006-0172-4
  14. Yoon SP, Lee SH, Ki CH, Lee YT, Hong SH, Lee HM, Moon Study (EFOS). Osteoporos Int 2011;22:2709-2719. https://doi.org/10.1007/s00198-010-1498-5
  15. Papaioannou A, Watts NB, Kendler DL, Yuen CK, Adachi JD, Ferko N. Diagnosis and management of vertebral fractures in elderly adults. Am J Med 2002;113:220-228. https://doi.org/10.1016/S0002-9343(02)01190-7
  16. Fahrleitner-Pammer A, Langdahl BL, Marin F, Jakob F, Karras D, Barrett A, Ljunggren O, Walsh JB, Rajzbaum G, Barker C, Lems WF. Fracture rate and back pain during and after discontinuation of teriparatide: 36-month data from the European Forsteo Observational Study (EFOS). Osteoporos Int 2011;22:2709-2719. https://doi.org/10.1007/s00198-010-1498-5
  17. Tsuchie H, Miyakoshi N, Kasukawa Y, Nishi T, Abe H, Segawa T, Shimada Y. The effect of teriparatide to alleviate pain and to prevent vertebral collapse after fresh osteoporotic vertebral fracture. J Bone Miner Metab 2016;34:86-91. https://doi.org/10.1007/s00774-014-0646-y
  18. Fujita T, Ohue M, Fujii Y, Miyauchi A, Takagi Y. Comparison of the analgesic effects of bisphosphonates: etidronate, alen-dronate and risedronate by electroalgometry utilizing the fall of skin impedance. J Bone Miner Metab 2009;27:234-239. https://doi.org/10.1007/s00774-009-0035-0
  19. Kim HJ, Yi JM, Cho HG, Chang BS, Lee CK, Kim JH, Yeom JS. Comparative study of the treatment outcomes of osteopo-rotic compression fractures without neurologic injury using a rigid brace, a soft brace, and no brace: a prospective random-ized controlled non-inferiority trial. J Bone Joint Surg Am 2014;96:1959-1966. https://doi.org/10.2106/JBJS.N.00187
  20. Gnanenthiran SR, Adie S, Harris IA. Nonoperative versus operative treatment for thoracolumbar burst fractures without neurologic deficit: a meta-analysis. Clin Orthop Relat Res 2012;470:567-577. https://doi.org/10.1007/s11999-011-2157-7
  21. Lee HM, Park SY, Lee SH, Suh SW, Hong JY. Comparative analysis of clinical outcomes in patients with osteoporotic vertebral compression fractures (OVCFs): conservative treat-ment versus balloon kyphoplasty. Spine J 2012;12:998-1005. https://doi.org/10.1016/j.spinee.2012.08.024
  22. Buchbinder R, Osborne RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, Graves S, Staples MP, Murphy B. A randomized trial of vertebroplasty for painful osteoporotic vertebral frac-tures. N Engl J Med 2009;361:557-568. https://doi.org/10.1056/NEJMoa0900429
  23. Kallmes DF, Comstock BA, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH, Edwards R, Gray LA, Stout L, Owen S, Hollingworth W, Ghdoke B, Annesley-Williams DJ, Ralston SH, Jarvik JG. A randomized trial of vertebroplasty for oste-oporotic spinal fractures. N Engl J Med 2009;361:569-579. https://doi.org/10.1056/NEJMoa0900563
  24. Itshayek E, Miller P, Barzilay Y, Hasharoni A, Kaplan L, Fraifeld S, Cohen JE. Vertebral augmentation in the treatment of vertebral compression fractures: review and new insights from recent studies. J Clin Neurosci 2012;19:786-791. https://doi.org/10.1016/j.jocn.2011.12.015
  25. Healy WL, Iorio R. Total hip arthroplasty: optimal treatment for displaced femoral neck fractures in elderly patients. Clin Orthop Relat Res 2004;(429):43-48.
  26. Kain MS, Marcantonio AJ, Iorio R. Revision surgery occurs frequently after percutaneous fixation of stable femoral neck fractures in elderly patients. Clin Orthop Relat Res 2014;472:4010-4014. https://doi.org/10.1007/s11999-014-3957-3
  27. Park SY, Yang KH, Yoo JH, Yoon HK, Park HW. The treat-ment of reverse obliquity intertrochanteric fractures with the intramedullary hip nail. J Trauma 2008;65:852-857. https://doi.org/10.1097/TA.0b013e31802b9559
  28. Parker MJ, Handoll HH. Gamma and other cephalocondylic intramedullary nails versus extramedullary implants for extra-capsular hip fractures in adults. Cochrane Database Syst Rev 2005;(4):CD000093.
  29. Shane E, Burr D, Abrahamsen B, Adler RA, Brown TD, Cheung AM, Cosman F, Curtis JR, Dell R, Dempster DW, Ebeling PR, Einhorn TA, Genant HK, Geusens P, Klaushofer K, Lane JM, McKiernan F, McKinney R, Ng A, Nieves J, O'Keefe R, Papapoulos S, Howe TS, van der Meulen MC, Weinstein RS, Whyte MP. Atypical subtrochanteric and dia-physeal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 2014;29:1-23. https://doi.org/10.1002/jbmr.1998
  30. Girgis CM, Sher D, Seibel MJ. Atypical femoral fractures and bisphosphonate use. N Engl J Med 2010;362:1848-1849. https://doi.org/10.1056/NEJMc0910389
  31. Odvina CV, Zerwekh JE, Rao DS, Maalouf N, Gottschalk FA, Pak CY. Severely suppressed bone turnover: a potential complication of alendronate therapy. J Clin Endocrinol Metab 2005;90:1294-1301. https://doi.org/10.1210/jc.2004-0952
  32. Kim S, Yang KH, Lim H, Lee YK, Yoon HK, Oh CW, Park KK, Min BW, Ryu JA, Kwack KS, Lee YH. Detection of prefracture hip lesions in atypical subtrochanteric fracture with dual-energy X-ray absorptiometry images. Radiology 2014;270:487-495. https://doi.org/10.1148/radiol.13122691
  33. Yang KH, Min BW, Ha YC. Atypical femoral fracture: 2015 position statement of the Korean Society for Bone and Mine-ral Research. J Bone Metab 2015;22:87-91. https://doi.org/10.11005/jbm.2015.22.3.87
  34. Lee YK, Ha YC, Kang BJ, Chang JS, Koo KH. Predicting need for fixation of atypical femoral fracture. J Clin Endocrinol Metab 2013;98:2742-2745. https://doi.org/10.1210/jc.2012-4322
  35. Gong HS, Oh WS, Chung MS, Oh JH, Lee YH, Baek GH. Patients with wrist fractures are less likely to be evaluated and managed for osteoporosis. J Bone Joint Surg Am 2009;91:2376-2380. https://doi.org/10.2106/JBJS.H.01871
  36. Handoll HH, Vaghela MV, Madhok R. Percutaneous pinning for treating distal radial fractures in adults. Cochrane Data-base Syst Rev 2007;(3):CD006080.
  37. Taras JS, Ladd AL, Kalainov DM, Ruch DS, Ring DC. New concepts in the treatment of distal radius fractures. Instr Cou-rse Lect 2010;59:313-332.
  38. Murray IR, Amin AK, White TO, Robinson CM. Proximal humeral fractures: current concepts in classification, treat-ment and outcomes. J Bone Joint Surg Br 2011;93:1-11.
  39. Xue Q, Li H, Zou X, Bunger M, Egund N, Lind M, Christen-sen FB, Bunger C. The influence of alendronate treatment and bone graft volume on posterior lateral spine fusion in a porcine model. Spine (Phila Pa 1976) 2005;30:1116-1121. https://doi.org/10.1097/01.brs.0000162929.19985.d2
  40. Gong HS, Song CH, Lee YH, Rhee SH, Lee HJ, Baek GH. Early initiation of bisphosphonate does not affect healing and outcomes of volar plate fixation of osteoporotic distal radial fractures. J Bone Joint Surg Am 2012;94:1729-1736. https://doi.org/10.2106/JBJS.K.01434
  41. Ohtori S, Inoue G, Orita S, Yamauchi K, Eguchi Y, Ochiai N, Kishida S, Kuniyoshi K, Aoki Y, Nakamura J, Ishikawa T, Miyagi M, Kamoda H, Suzuki M, Kubota G, Sakuma Y, Oikawa Y, Inage K, Sainoh T, Takaso M, Ozawa T, Taka-hashi K, Toyone T. Teriparatide accelerates lumbar postero- lateral fusion in women with postmenopausal osteoporosis: prospective study. Spine (Phila Pa 1976) 2012;37:E1464-E1468. https://doi.org/10.1097/BRS.0b013e31826ca2a8
  42. Hirsch BP, Unnanuntana A, Cunningham ME, Lane JM. The effect of therapies for osteoporosis on spine fusion: a systema-tic review. Spine J 2013;13:190-199. https://doi.org/10.1016/j.spinee.2012.03.035

Cited by

  1. Ageing society and osteoporosis vol.59, pp.11, 2016, https://doi.org/10.5124/jkma.2016.59.11.833
  2. 고관절 골절 수술 이후 광선치료를 포함한 한방치료 3예 보고 vol.28, pp.4, 2016, https://doi.org/10.18325/jkmr.2018.28.4.113
  3. Safety and Effectiveness of the Anchor Augmentation with Bone Cement on Osteoporotic Femoral Fracture: A Systematic Reviews vol.32, pp.2, 2016, https://doi.org/10.12671/jkfs.2019.32.2.89