P Y Ho1, N Tang, S W Law, H F Tsui, T P Lam, K S Leung. 1. Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. pyho@ort.cuhk.edu.hk
Abstract
OBJECTIVES: To compare bone mineral density of women with postmenopausal ankle fractures with controls and review patient characteristics, injury mechanisms, and outcomes. DESIGN: Prospective case-control study. SETTING: University teaching hospital, Hong Kong. PARTICIPANTS: Women older than 60 years, admitted with ankle fractures between 2002 and 2003 and controls (age-matched women with femoral neck fractures). MAIN OUTCOME MEASURES: Demographic data, bone mineral density, mechanism of injury, fracture pattern, treatment, and the functional outcome. RESULTS: The mean age of the study group (18 ankle fracture patients) was 74 years. The fractures usually resulted from a low-energy trauma; isolated lateral malleolar fracture was the most common (8/18), whilst six had bimalleolar fractures. Their mean T-score bone mineral density values at the spine and hip were -1.67 and -1.70, respectively; corresponding Z-scores were +0.73 and +0.99. The bone mineral density of the study group was significantly higher than in patients with fractured neck of femur (controls) and the general population (P<0.05). Nine of the study group had diabetes and one had impaired glucose tolerance. Treatment comprised casting in 10 patients and operative fixation in seven. Good functional recovery was achieved; most patients were able to resume their premorbid level of independent daily activities with a good motor functional independence score (85.18/91) 1 year post-injury. CONCLUSION: In this case-control study, postmenopausal ankle fractures were not associated with osteoporosis. Diabetic neuropathy may have been a risk factor for such injury. The functional outcome of such patients was generally satisfactory, provided appropriate treatment was given.
OBJECTIVES: To compare bone mineral density of women with postmenopausal ankle fractures with controls and review patient characteristics, injury mechanisms, and outcomes. DESIGN: Prospective case-control study. SETTING: University teaching hospital, Hong Kong. PARTICIPANTS: Women older than 60 years, admitted with ankle fractures between 2002 and 2003 and controls (age-matched women with femoral neck fractures). MAIN OUTCOME MEASURES: Demographic data, bone mineral density, mechanism of injury, fracture pattern, treatment, and the functional outcome. RESULTS: The mean age of the study group (18 ankle fracturepatients) was 74 years. The fractures usually resulted from a low-energy trauma; isolated lateral malleolar fracture was the most common (8/18), whilst six had bimalleolar fractures. Their mean T-score bone mineral density values at the spine and hip were -1.67 and -1.70, respectively; corresponding Z-scores were +0.73 and +0.99. The bone mineral density of the study group was significantly higher than in patients with fractured neck of femur (controls) and the general population (P<0.05). Nine of the study group had diabetes and one had impaired glucose tolerance. Treatment comprised casting in 10 patients and operative fixation in seven. Good functional recovery was achieved; most patients were able to resume their premorbid level of independent daily activities with a good motor functional independence score (85.18/91) 1 year post-injury. CONCLUSION: In this case-control study, postmenopausal ankle fractures were not associated with osteoporosis. Diabetic neuropathy may have been a risk factor for such injury. The functional outcome of such patients was generally satisfactory, provided appropriate treatment was given.
Authors: J M Pritchard; L M Giangregorio; G Ioannidis; A Papaioannou; J D Adachi; W D Leslie Journal: Osteoporos Int Date: 2011-05-12 Impact factor: 4.507
Authors: Titilola Akhigbe; Amy S Chin; Jelena N Svircev; Helen Hoenig; Stephen P Burns; Frances M Weaver; Lauren Bailey; Laura Carbone Journal: J Spinal Cord Med Date: 2013-11-07 Impact factor: 1.985