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Surgical treatment of patients with displaced femoral neck fractures : aspects on outcome and selection criteria /Blomfeldt, Richard, January 2006 (has links)
Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.
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Bone and aluminium /Hellström, Hans-Olov, January 2007 (has links)
Diss. (sammanfattning) Uppsala : Uppsala universitet, 2007. / Härtill 5 uppsatser.
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Maxillofacial and dental injuries in contact team sportsSane, Juha. January 1988 (has links)
Thesis--University of Helsinki, 1988. / Also published in : Proceedings of the Finnish Dental Society, 1988, vol. 84, Suppl. VI. Includes bibliographical references.
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Use of the 15-second lateral step-up for comparison of hip function between two surgical approaches for intramedullary nailing of femur fracturesFutch, Lydia A. January 2007 (has links) (PDF)
Thesis (D. Sc. P.T.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed Oct. 30, 2007). Includes bibliographical references (p. 18-20).
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Συγκριτική βιο-μηχανική μελέτη οστεοσύνθεσης καταγμάτων γωνίας κάτω γνάθου με χρήση εύκαμπτων τριών διαστάσεων (3D) πλακών οστεοσύνθεσης με αντίστοιχες κλασικές / Comparative biomechanical evaluation of three diamensional (3D) miniplates with classic osteosynthesis systems in mandibular angle fractures.Καλφαρέντζος, Ευάγγελος 13 July 2010 (has links)
H θεραπεία των καταγμάτων της γωνίας της κάτω γνάθου είναι αμφιλεγόμενη και παραμένει ένα θέμα διαρκούς αντιπαράθεσης στη διεθνή βιβλιογραφία. Οι τρισδιάστατες μίνι πλάκες (3D) είναι σχετικά καινούργιες και υποστηρίζεται ότι εμφανίζουν βελτιωμένη μηχανική συμπεριφορά, χωρίς όμως να υπάρχουν βιβλιογραφικά δεδομένα ή κλινικές έρευνες που να υποστηρίζουν τη χρήση τους. Σκοπός της μελέτης αυτής είναι να αξιολογηθούν δύο τρισδιάστατα μίνι συστήματα οστεοσύνθεσης και να συγκριθούν με αντίστοιχα κλασικά συστήματα μίνι πλακών που χρησιμοποιόυνται ευρέως στην κλινική πράξη.
Υλικό-Μέθοδος: Συνθετικές κάτω γνάθοι χρησιμοποιήθηκαν για την αξιολόγηση των τρισδιάστατων συστημάτων οστεοσύνθεσης, σε σύγκριση με τέσσερα ακόμα συστήματα. Οι ομάδες μελέτης ήταν οι εξής:
Ομάδα 1 Mία 3D μίνι πλάκα2x2 οπές, τετράγωνη 2.0mm
Ομάδα 2 Mία 3D μίνι πλάκα4x2 οπές, ορθογώνια, 2.0mm
Ομάδα 3 Σύστημα δύο πλακών, 4 οπές, ευθείες, 2.0mm & 1.6mm
Ομάδα 4 Mια μίνι πλάκα, 4 οπές, ευθεία με διάστημα, 2.0mm
Ομάδα 5 Σύστημα δύο πλακών, 4 οπές, ευθείες, 2.0mm & 1.6mm
Ομάδα 6 Μια πλάκα κατάγματος (fracture plate) 6 οπές, γωνία 140ο, 2.0mm
Κάθε ομάδα υποβλήθηκε σε φόρτιση στην πρόσθια τομική περιοχή και στην σύστοιχη με το κάταγμα γομφιακή περιοχή, μέσω ενός μηχανήματος εφαρμογής τάσης (Monsanto Tensometer 20). Έγινε μέτρηση και καταγραφή του κενού στο άνω όριο του κατάγματος καθώς επίσης και μετρήσεις τιμών ακαμψίας (stiffness) για κάθε τύπο φόρτισης ξεχωριστά. Υπολογίστικαν οι μέσες τιμές και οι σταθερές αποκλίσεις των παραπάνω τιμών και ακολούθως έγινε στατιστική ανάλυση των αποτελεσμάτων με χρήση του απλού t-test. Στατιστικά σημαντικά θεωρήθηκαν αποτελέσματα με p< 0,05 %.
Αποτελέσματα: Κατά τη φόρτιση της ομόπλευρης προς το κάταγμα γομφιακής περιοχής η στατιστική ανάλυση ανέδειξε στατιστικά σημαντικές διαφορές μεταξύ των ομάδων. Κατά τη φόρτιση της πρόσθιας τομικής περιοχής δεν αναδείχθηκαν στατιστικά σημαντικές διαφορές. Το κενό στο άνω χείλος του κατάγματος ήταν οριακό σε τέσσερα από τα συστήματα που εξετάστηκαν.
Συμπεράσματα: Με βάση το πειραματικό μοντέλο που χρησιμοποιήθηκε η ομάδα 1 (τετράγωνη 3D) εμφάνισε την καλύτερη εμβιομηχανική συμπεριφορά. / Therapy of mandibular angle fractures is controversial and is still a subject of continuous interest in international literature. Three dimensional (3D) mini plates are relatively new, with no biomechanical or clinical studies to support their use. The aim of this study is to comparatively evaluate the use of two 3D mini plating systems for the treatment of mandibular angle fractures, with mini plates used in ordinary clinical practice.
Materials and Methods: Synthetic mandible replicas were used to evaluate the effectiveness of the 3D plates along with four other mandibular angle plating techniques. The plating techniques consisted of:
1. A 3D miniplate (2x2 holes, square, 2mm)
2. A 3D miniplate (6x2 holes, curved, 2mm)
3. Two plate system (four hole, straight, 2mm,placed at the lateral oblique ridge and 1,6mm)
4. One single miniplate (four hole, straight, 2mm)
5. Two plate system (four hole, straight, 2mm,placed in the buccal aspect of the lateral oblique ridge and 1,6mm)
6. A fracture plate (six hole, curved).
Each group was subjected to incisal and homolateral molar region loading by a tensile materials testing machine (Monsanto Tensometer 20). Load stiffness values and peak measurements of the fracture gap distraction at the superior aspect of the mandible were measured. The mean values (± standard deviation) were derived and compared using students t-test, with statistical significance set at p<0.05.
Results: For homolateral molar loading, statistically significant differences existed within groups (P<0, 05). For incisal edge loading, no statistically significant differences were found for stiffness among the fixation methods tested. Gap distraction at the superior aspect of the mandible was limited for four of the groups tested.
Conclusion: Under the conditions tested the 3D square plate system provided the most favourable mechanical behaviour.
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Προσομοίωση κατάγματος πτέρνας και εσωτερικής οστεοσύνθεσης πτέρνας με πλάκα και βίδεςΜαρώση, Τρισεύγενη 15 June 2010 (has links)
- / -
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Computational study of wave propagation in materials with microstructure effect : bone applicationΠαπαχαραλαμπόπουλος, Αλέξιος 04 December 2012 (has links)
Fractures are common at human bones. So, a callus is formed and the procedure
of osteogenesis is initiated. Medical doctors need to have a tool that allows
them to evaluate the healing procedure without taking X-ray photos every week.
Such a variety of tools can be provided by non-destructive inspection techniques.
But rst, one has to create a model for predicting phenomena such as size-e ects
and in particular dispersive acoustic waves propagation.
Before this thesis, there has been made an attempt by (Vavva, 2009), to
predict modal wave propagation with Mindlin's Form-II. Herein, for the rst
time there are presented dynamic solutions of this theory.
To begin with, the bone is considered to be a dampless homogeneous (ortho)
isotropic composite material, with interstitial tissue being the matrix and
the osteons being the bres. So, Mindlin's theory can be applied in this case.
Next, a fundamental solution is obtained for Mindlin's Form-II of his gradient
elasticity theory. In conjunction to an existing integral representation, there can
be obtained solutions using the Boundary Element Method. With the help of a
considered Representative Volume Element, simulations have been conducted and
results are presented for the cases of P, S and Rayleigh waves, as well as guided
waves in plates. The dispersion diagrams as given by Wigner-Ville representations
are compared to the theoretical ones. What is more, the validity and accuracy of
the BEM code have been checked using analytical solutions of one-dimensional
problems.
Furthermore, relaxation functions from viscoelastic theories are considered
and are taken into account using the correspondence principle. So, both viscoelastic
and gradient-visco-elastic models have been considered and the results
of various cases (P, S, Rayleigh and Lamb waves) have been compared to the
above.
Finally, since the present thesis has to do with information extracted from
dispersive wave propagation, some studies have been made and measures have
been proposed for velocities and dispersion.
All in all, this has been a work dealing with the fact that micro-structure
a ects the macro-behavior of a material concerning waves propagation and, in
the framework of Mindlin's Form-II, there have been extracted several conclusions
concerning bone-like materials. / Τα κατάγματα δεν είναι σπάνια στα οστά. Έτσι, μετά την δημιουργία του πώρου, κατά τη διαδικασία της οστεογένεσης, οι γιατροί χρειάζονται ένα εργαλείο για την αξιολόγησή της, εκτός φυσικά της έκθεσης σε ακτινοβολία. Μια πληθώρα τέτοιων εργαλείων μπορεί να ανακύψει από τις τεχνικές των μη-καταστροφικών ελέγχων. Πρωτύτερα όμως πρέπει να γίνει η μελέτη των φαινομένων κλίμακας και πιο συγκεκριμένα της διάδοσης ακουστικών κυμάτων με διασκόρπιση. Να σημειωθεί εδώ πως έχει προηγηθεί η διδακτορική διατριβή (αα, 2009), η οποία προβλέπει διάφορα φαινόμενα για την περίπτωση της οδηγούμενης διάδοσης κυμάτων στο πλαίσιο της δεύτερης φόρμας του Μϊντλιν. Εδώ όμως για πρώτη φορά παρουσιάζονται δυναμικές λύσεις γι'αυτή τη θεωρία.
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Estudo clínico e molecular em indivíduos com osteogênese imperfeita e análise do tratamento com bifosfonadosBrizola, Evelise Silva January 2015 (has links)
A Osteogênese Imperfeita (OI) é uma doença genética do tecido conjuntivo caracterizada por fragilidade óssea e susceptibilidade à fratura sob mínimo ou nenhum trauma. O objetivo deste trabalho foi estudar características clínicas e moleculares de crianças e adultos com Osteogênese Imperfeita e analisar o efeito do tratamento medicamentoso com bifosfonados em relação aos biomarcadores metabólicos e ósseos em pacientes adultos. Esta tese se dividiu em dois capítulos onde 1) foi realizado um estudo retrospectivo sobre as características clínicas no momento do diagnóstico de OI, com ênfase nas características clínicas, especialmente em relação às fraturas ósseas; 2) avaliação clínica e análise da mutação c.-14C>T no gene IFITM5 foi estuda em uma população com características sugestivas de OI tipo V; e 3) estudo retrospectivo em adultos com OI divididos em 2 grupos tratados com bifosfonados e não tratados. Em relação ao tratamento com bifosfonados foram avaliados os seguintes parâmetros: tipo de droga e duração do tratamento, valores de biomarcadores metabólicos e ósseos por um período de 5 anos, incidência de fraturas num de período de 5 ou 10 anos e densidade mineral óssea da coluna lombar, quadril total e colo femural no início e no final do tratamento. Nossos resultados mostraram que 1) no momento do diagnósico de OI características como escleras azuladas, dentinogênese imperfeita, ossos wormianos e fraturas de membros inferiores e superiores podem ser observadas. Pacientes com formas mais graves de OI foram diagnosticados mais precocemente quando comparados com pacientes com formas leves. Nenhuma criança com OI apresentou fraturas posteromediais das costelas, fratura de escápula ou lesões metafisárias. Essas informações associadas a história da saúde da criança são relevantes para a realização do diagnóstico diferencial. 2) OI tipo V correspondeu a 4% dos casos de OI atendidos no Centro de Referência para OI do HCPA. Indivíduos com OI V associada a mutação c.-14C> T no gene IFITM5 apresentaram características clínicas distintas como formação de calo hiperplásico, calcificação das membranas interósseas, deslocamento da cabeça radial e deformidade de coluna, porém a expressão da doença é variável. 3) Observamos que o tratamento de adultos com OI a longo prazo não foi associado com redução na incidência das fraturas e não se refletiu de forma significativa nos níveis de biomarcadores metabólicos e ósseos, porém houve uma melhora significativa na densidade mineral óssea da coluna lombar associada à terapia. Por ser uma doença rara com prevalência variável e ampla variabilidade fenotípica e genotípica, estudos clínicos e moleculares bem como estudos sobre o efeito do tratamento medicamentoso são imprescindíveis, contribuindo no melhor entendimento da doença, aconselhamento genético acurado e propiciando melhores estratégias de prevenção e tratamento para esta população. / Osteogenesis Imperfecta (OI) is a genetic connective tissue disease characterized by bone fragility and susceptibility to fracture under minimal or no trauma. The aim of this study was to evaluate clinical and molecular features of children and adults with OI and analyze the effect of the drug treatment with bisphosphonates in regarding to metabolic and bone biomarkers in adult patients. This thesis was divided by two chapters: 1) a retrospective study was performed where the clinical characteristic at the moment of diagnosis of OI, the clinical characteristics specially related to bone fractures was evaluated; 2) clinical evaluation and mutation analysis of c.-14C>T in the IFITM5gene was studied in a population with clinical charcteristics suggestive of OI type V; and 3) retrospective study in adults with OI divided in two groups treated with biphosphonates and not treated. Bisphosphonate treatment was evaluated according to the parameters: type of drug and duration of treatment, metabolic and bone biomarkers values for a period of 5 years, incidence of fractures in a period of 5 or 10 years and bone mineral density of the lumbar spine, total hip and femoral neck at baseline and at the end of treatment. Our results showed that 1) at the time of OI diagnosis features such as bluish slerae, dentinogenis imperfecta, wormian bones, and fractures of upper and lower limbs can be observed. Patients with more severe forms of OI were diagnosed earlier when compared with patients with mild forms. No OI children presented posteromedial fractures of the ribs, scapula fracture or metaphyseal lesions. This information associated with the child's health history are relevant for carrying out the differential diagnosis. This information is relevant for carrying out the differential diagnosis. 2) OI type V corresponds to 4% of OI cases at the Reference Center for OI at HCPA. Subjects with OI V associated to the mutation c.-14C> T in the IFITM5 gene presented distinctives clinical features as hyperplastic callus formation, calcification of interosseous membranes, dislocation of the radial head and spinal deformity, but the expression of the disease is variable. 3) We observed that long-term treatment with bisphosphonates (BP) for adults with OI was not associated with reduced incidence of fractures and was not reflected significantly in the levels of metabolic and bone biomarkers, but there was a significant improvement in bone mineral density of the lumbar spine associated to the therapy. Because it is a rare disease with a prevalence variable and wide phenotypic and genotypic variability, clinical and molecular studies and studies of the effect of drug treatment are essential, contributing to the better understanding of the disease, accurate genetic counseling and providing better strategies for prevention and treatment for this population.
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Impact of organized sports on risk of bone fracture among adolescents: ABCD – growth study / Impacto dos esportes organizados no risco de fratura óssea entre adolescentes: ABCD – growth studyLynch, Kyle Robinson 21 June 2018 (has links)
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Previous issue date: 2018-06-21 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Objetivo: Analisar o risco de fraturas traumáticas de acordo com o engajamento em esportes com diferentes níveis de impacto, assim como identificar o potencial impacto da participação esportiva nos gastos entre adolescentes. Métodos: Estudo longitudinal com 24 meses de seguimento. A amostra foi composta por 285 adolescentes de ambos os sexos (202 meninos e 83 meninas) que foram contatados pelos pesquisadores em escolas (n= 104) e clubes esportivos (n= 181) localizados na região metropolitana de Presidente Prudente, SP, Brasil. Todos os adolescentes foram convidados considerando os seguintes critérios de inclusão: a) idade entre 10-19 anos, 2) assinatura dos pais no termo de consentimento, 3) se contatados em clubes esportivos, pelo menos um ano de treino; se contatados na escola, pelo menos um ano sem prática esportiva ou exercícios. Os grupos foram classificados em: Controle (n= 104), Natação (n= 34), e Esportes de Impacto (n= 147). A ocorrência de fraturas e gastos em saúde foram avaliadas mensalmente durante 12 meses antes da linha de base e 12 meses após linha de base. Sexo, idade, composição corporal, participação esportiva, maturação biológica e proteína CReativa (PCR) foram avaliados durante os 12 meses após a linha de base. Análise estatística foi composta por teste Mann-Whitney, qui-quadrado, Regressão de Cox, Kruskal-Wallis, Analise de Covariância e medidas de tamanho de efeito. A significância estatística foi fixada em p<0.05 e todas as análises foram realizadas no software BioEstat (versão 5,2 [BioEstat, Teffe, Brasil]). Resultados: A incidência de novas fraturas foi de 2,1% (n= 6). A ocorrência de fraturas traumáticas durante o período de 24 meses (12 meses de seguimento + 12 meses prévios) foi de 6,0% ([IC95%: 3,2% a 8,7%]; n= 17). Os gastos totais acumulados durante o período de 12 meses de seguimento foram de U$ 2.991,96. Quando comparados os adolescentes de acordo com a incidência de novas fraturas, não houveram diferenças por sexo, idade, densidade óssea, gordura corporal, esportes, maturação biológica e PCR. Gastos totais também não apresentaram diferença de acordo com a ocorrência de qualquer fratura durante o período de 24 meses. Participação esportiva não mostrou qualquer associação ou risco para a ocorrência de fraturas traumáticas. Quando desmembrados os grupos por esportes, atletismo [US$ 4,13 (27,67)], ginástica [US$ 10,77 (23,90)], judô [US$ 4,24 (6,96)] e natação [US$ 24,67 (46,50)] apresentaram maiores gastos quando comparados ao grupo controle. Caratê, kung-Fu, tênis, basquete e baseball não apresentaram diferenças significativas quando comparados ao grupo controle. Nadadores apresentaram maiores gastos com medicação (p-valor= 0,001), consultas (p-valor= 0,001) e exames (p-valor= 0,005) quando comparados ao grupo controle e esportes de impacto. Mesmo após ajustes por fatores de confusão, nadadores (Média: US$ log10 1,172 [IC95%: 0.925 a 1.420]) tiveram maiores gastos do que o grupo controle (Média: US$ log10 0,280 [IC95%: 0,101 a 0,459]) e esportes de impacto (Média: US$ log10 0,404 [IC95%: 0,290 a 0,519]) (p-valor = 0,001). Participação esportiva explicou 13,2% de toda variância em gastos com saúde, enquanto sexo (2,6% da variância) e fraturas (3,5% da variância) também foram covariáveis relacionadas aos gastos nesse modelo. Conclusão: Os achados desse estudo indicaram que participação esportiva (incluindo esportes de impacto) não aumentou o risco de fraturas entre adolescentes, enquanto fraturas traumáticas foram o principal determinante de gastos com saúde entre adolescentes. Além disso, alguns esportes pareceram estar mais relacionados a maiores gastos com saúde entre adolescentes, independente do impacto econômico de fraturas e sexo. / Objective: To analyze the risk of traumatic fractures according to the engagement in sports with different levels of physical impact, as well as to identify the potential impact of sports participation on health care costs among adolescents. Methods: Longitudinal study with 24 months of follow-up. The sample was composed of 285 adolescents of both sexes (202 boys and 83 girls) who were contacted by the researchers in schools (n= 104) and sports clubs (n= 181) located in the metropolitan region of Presidente Prudente, Sao Paulo, Brazil. All adolescents were invited, considering the inclusion criteria: 1) 10-19 years-old, 2) parents' consent form signed, 3) if contacted in any sports club, at least one year of training experience; if contacted in any school unit, at least one year without regular practice of sport or exercise. The groups were classified as: Control (n= 104), Swimming (n= 34), and Impact Sports (n= 147). The occurrence of fractures and health care costs were assessed monthly during the 12 months before baseline, as well as 12 months after baseline. Sex, age, body composition, sports participation, peak height velocity (PHV) and C-reactive protein (CRP) were assessed during the 12 months of follow-up. Statistical analyses were composed of Mann-Whitney test, chisquare test, Cox Regression, Kruskal-Wallis test, Analysis of Covariance and measures of effect size. Statistical significance was set at p<0.05 and all analyzes were performed using BioEstat software (version 5.2 [BioEstat, Teffe, Brazil]). Results: The incidence of new fractures was 2.1% (n= 6). The occurrence of traumatic fractures during the 24-month period (12-month follow-up plus previous 12 months) was 6.0% ([95%CI: 3.2% to 8.7%]; n= 17). The overall costs accounted during the 12-month follow-up were U$ 2,991.96. When comparing the adolescents according to the incidence of new fractures, there were no differences regarding age, BMD, BF, sports, PHV, and CRP. Overall health care costs were also not different according to subjects with any fracture during the 24-month period. Sports participation did not show any significant association or risk with the occurrence of traumatic fractures. When breaking the groups down by sport, track and field [US$ 4.13 (27.67)], gymnastics [US$ 10.77 (23.90)], judo [US$ 4.24 (6.96)], and swimming [US$ 24.67 (46.50)] presented higher costs when compared to the control group. Karate, kung-Fu, tennis, basketball and baseball did not show significant differences when compared to the control group. Concerning health care costs, swimmers presented higher costs with medicine (p-value= 0.001), appointments (p-value= 0.001), and tests (p-value= 0.005) when compared to control and impact sports groups. Even after adjustment by confounders, swimmers (Mean: US$ log10 1.172 [95%CI: 0.925 to 1.420]) had higher health care costs than control (Mean: US$ log10 0.280 [95%CI: 0.101 to 0.459]) and impact sports (Mean: US$ log10 0.404 [95%CI: 0.290 to 0.519]) (p-value = 0.001). Sports participation explained 13.2% of all variance in health care costs, while sex (2.6% of the variance) and fractures (3.5% of the variance) were also covariates related to health care costs in this model. Conclusion: The findings from this study indicate that sports participation (including impact sports) did not increase the risk of fracture among adolescents, while traumatic fracture was the main determinant of health care costs among these adolescents. Moreover, some sports seem to be related to higher health care costs among adolescents, independently of the significant economic burden of fractures and sex. / 2016/20377-0
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Estudo de fatores associados à incidência de fraturas por fragilidade óssea em mulheres na menopausaCosta, Adriana de Mattos V. da January 2012 (has links)
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Previous issue date: 2012 / Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Departamento de Ensino. Programa de Pós-Graduação em Saúde da Criança e da Mulher. Rio de Janeiro, RJ, Brasil / Introdução: O aumento na ocorrência de fraturas secundárias à fragilidade óssea
representa um significativo problema de Saúde Pública, já que corresponde a um importante
aumento na morbidade, mortalidade e nos custos de mulheres na pós menopausa. Objetivos:
Avaliar os fatores relacionados à ocorrência de fraturas em mulheres pós-menopausa
acompanhadas em uma unidade básica de saúde. Metodologia: Foi realizado um estudo de
coorte prospectivo, na ilha de Paquetá/RJ no ano de 2011. Através do banco de dados já
existente, as mulheres foram localizadas por telefonemas e comparecimento no hospital local.
As pacientes selecionadas foram submetidas a um questionário estruturado de avaliação de
fatores relacionados à fragilidade óssea. Resultados: A incidência de fratura por fragilidade
óssea encontrada foi de 21%, tendo como sitio principal o antebraço com 13%. A idade
média da população foi de 72 anos com DP ± 9,0. No grupo de pacientes fraturadas 50%
tinham entre 65 e 79 anos sugerindo ser essa faixa etária mais susceptível as fraturas por
fragilidade óssea. Das pacientes que tiveram a Ultrassonometria óssea de calcâneo alterado,
22 % tiveram fraturas nesse período. Foi calculado o RR= 1,13 (IC95%: 0,48 - 2,63). As
pacientes que tiveram fraturas se mostraram com maior sobrepeso ou obesas (72,2%), com
maior historia familiar de fratura de quadril (13,3%) e com maior diagnostico de osteoporose
(47,1%) do que as pacientes sem fraturas (p valor>0,05). E 23,5% das pacientes acamadas
por mais de dois meses sofreram alguma fratura, com p valor <0,05. Na correlação entre as
variáveis idade, tempo de menopausa e IMC, foi evidenciada uma associação positiva entre a
idade e o tempo de menopausa nos grupos de pacientes com e sem fraturas. Conclusão: Os
fatores de risco para fraturas por fragilidade óssea encontrados ajudam a conhecermos o
perfil da nossa população e termos subsídios para combater esse agravo. / Introduction: The increased occurrence of secondary fractures associated with bone
fragility represents a significant Public Health problem since it leads to a considerable
increase in morbidity, mortality and in health care costs for postmenopausal women.
Objectives: To evaluate the factors related to the occurrence of fractures in postmenopausal
women attended at a public health center. Methodology: A prospective cohort study was
conducted in Paquetá Island, Rio de Janeiro, in 2011. Using an existing database, these
women were identified, contacted by phone and asked to come to the local hospital. The
selected patients were submitted to a structured questionnaire assessing factors related to
bone fragility. Results: The incidence of fracture due to bone fragility was of 21%, and the
main site was the forearm, accounting for 13%. The average age of the population was 72
with a SD ± 9.0. In the group of fractured patients, 50% were between 65 and 79 years old,
which suggest this is the age group that is most susceptible to fractures associated with bone
fragility. Twenty two percent of the patients who had an altered quantitative ultrasonometry
of the calcaneus had fractures in that period of their lives. The RR was calculated: RR = 1.13
(CI 95%: 0.48 – 2.63). The patients who had fractures were more overweight or obese
(72.2%), had a longer family history of hip fracture (13.3%) and more diagnoses of
osteoporosis (47.1%) than patients without fractures (p-value > 0.05). And 23.5% of the
patients who were bedridden for more than two months suffered some type of fracture, with a
p-value < 0.05. In the correlation between the different ages, time of menopause and BMI, a
positive association between age and time of menopause became clear in the groups of
patients with and without fractures. Conclusion: The risk factors for fractures associated with
bone fragility help us to define the profile of our population and provide us with means to
fight this problem.
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