M Bethel1, L Bailey2, F Weaver3, B Le1, S P Burns4, J N Svircev4, M H Heggeness5, L D Carbone1. 1. 1] Charlie Norwood Veterans Affairs Medical Center, Augusta, GA, USA [2] Department of Medicine, Georgia Regents University, Augusta, GA, USA. 2. 1] Center of Innovation for Complex Chronic Healthcare, Edward J. Hines, Jr. VA Hospital, Hines, IL, USA [2] Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA. 3. 1] Center of Innovation for Complex Chronic Healthcare, Edward J. Hines, Jr. VA Hospital, Hines, IL, USA [2] Stritch School of Medicine, Loyola University, Maywood, IL, USA. 4. 1] VA Puget Sound Health Care System-Seattle Division, Seattle, WA, USA [2] Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA. 5. 1] Robert J. Dole Veterans Affairs Medical Center, Wichita, KS, USA [2] Department of Orthopaedic Surgery, University of Kansas School of Medicine, Wichita, KS, USA.
Abstract
STUDY DESIGN: Retrospective review of a clinical database. OBJECTIVES: To examine treatment modalities of incident appendicular fractures in men with chronic SCI and mortality outcomes by treatment modality. SETTING: United States Veterans Health Administration Healthcare System. METHODS: This was an observational study of 1979 incident fractures that occurred over 6 years among 12 162 male veterans with traumatic SCI of at least 2 years duration from the Veterans Health Administration (VA) Spinal Cord Dysfunction Registry. Treatment modalities were classified as surgical or nonsurgical treatment. Mortality outcomes at 1 year following the incident fracture were determined by treatment modality. RESULTS: A total of 1281 male veterans with 1979 incident fractures met inclusion criteria for the study. These fractures included 345 (17.4%) upper-extremity fractures and 1634 (82.6%) lower-extremity fractures. A minority of patients (9.4%) were treated with surgery. Amputations and disarticulations accounted for 19.7% of all surgeries (1.3% of all fractures), and the majority of these were done more than 6 weeks following the incident fracture. There were no significant differences in mortality among men with fractures treated surgically compared with those treated nonsurgically. CONCLUSIONS: Currently, the majority of appendicular fractures in male patients with chronic SCI are managed nonsurgically within the VA health-care system. There is no difference in mortality by type of treatment.
STUDY DESIGN: Retrospective review of a clinical database. OBJECTIVES: To examine treatment modalities of incident appendicular fractures in men with chronic SCI and mortality outcomes by treatment modality. SETTING: United States Veterans Health Administration Healthcare System. METHODS: This was an observational study of 1979 incident fractures that occurred over 6 years among 12 162 male veterans with traumatic SCI of at least 2 years duration from the Veterans Health Administration (VA) Spinal Cord Dysfunction Registry. Treatment modalities were classified as surgical or nonsurgical treatment. Mortality outcomes at 1 year following the incident fracture were determined by treatment modality. RESULTS: A total of 1281 male veterans with 1979 incident fractures met inclusion criteria for the study. These fractures included 345 (17.4%) upper-extremity fractures and 1634 (82.6%) lower-extremity fractures. A minority of patients (9.4%) were treated with surgery. Amputations and disarticulations accounted for 19.7% of all surgeries (1.3% of all fractures), and the majority of these were done more than 6 weeks following the incident fracture. There were no significant differences in mortality among men with fractures treated surgically compared with those treated nonsurgically. CONCLUSIONS: Currently, the majority of appendicular fractures in male patients with chronic SCI are managed nonsurgically within the VA health-care system. There is no difference in mortality by type of treatment.
Authors: L Abderhalden; F M Weaver; M Bethel; H Demirtas; S Burns; J Svircev; H Hoenig; K Lyles; S Miskevics; L D Carbone Journal: Osteoporos Int Date: 2016-12-06 Impact factor: 4.507
Authors: Alban Fouasson-Chailloux; Raphael Gross; Marc Dauty; Guillaume Gadbled; Sophie Touchais; Marc Le Fort; Brigitte Perrouin-Verbe Journal: J Spinal Cord Med Date: 2017-05-10 Impact factor: 1.985
Authors: M Bethel; F M Weaver; L Bailey; S Miskevics; J N Svircev; S P Burns; H Hoenig; K Lyles; L D Carbone Journal: Osteoporos Int Date: 2016-05-26 Impact factor: 4.507
Authors: Monique Bethel; Lauren Bailey; Frances Weaver; Robert L Harmon; Michael M Priebe; Brian Le; Hammad Aslam; Zachary Fausel; Helen Hoenig; Laura D Carbone Journal: J Spinal Cord Med Date: 2016-02-29 Impact factor: 1.985
Authors: Nour Zleik; Frances Weaver; Robert L Harmon; Brian Le; Reshmitha Radhakrishnan; Wanda D Jirau-Rosaly; B Catharine Craven; Mattie Raiford; Jennifer N Hill; Bella Etingen; Marylou Guihan; Michael H Heggeness; Cara Ray; Laura Carbone Journal: J Spinal Cord Med Date: 2018-05-10 Impact factor: 1.985
Authors: Bridget Sinnott; Cara Ray; Frances Weaver; Beverly Gonzalez; Elizabeth Chu; Sarah Premji; Mattie Raiford; Rachel Elam; Scott Miskevics; Stephen Parada; Laura Carbone Journal: JBMR Plus Date: 2022-01-05