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At least 469 records · Page 26Linked to original sources
PubMed1998

In vitro study of fracture incidence and compressive fracture load of all-ceramic crowns cemented with resin-modified glass ionomer and other luting agents.

STATEMENT OF PROBLEM: Anecdotal reports based on clinical observation have recently linked resin-modified glass ionomer luting agents with postcementation fracture of all-ceramic crowns. PURPOSE: This study evaluated the fracture incidence of In-Ceram and VitaDur Alpha porcelain jacket all-ceramic crowns cemented with 5 luting agents (Fuji I, Fuji Plus, Vitremer, Advance, and Panavia 21) during 2 months storage in 0.8% NaCl solution. MATERIAL AND METHODS: Fifty human maxillary premolar teeth were prepared for each ceramic system and divided into 5 subgroups of 10 teeth to be cemented with 5 luting cements. Specimens were observed for fracture lines and crack initiation at storage times up to 2 months. Incidence of fracture was analyzed with Fisher's Exact test. Specimens that did not fracture during storage were loaded in compression to failure. Failure loads were analyzed by analysis of variance and multiple pairwise comparisons. RESULTS: Only all-ceramic crowns cemented with Advance cement fractured during the 2-month observation period, and porcelain jacket crowns were found to fracture earlier and more frequently than In-Ceram crowns. Cracks initiated at the crown margin, and multiple crack lines were found as the time of storage increased. In-Ceram crowns were significantly stronger (140 +/- 21.5 kg) than porcelain jacket crowns (98.6 +/- 17.8 kg) at P <.05. For In-Ceram crowns, cement type did not influence failure load while for porcelain jacket crowns, Fuji I (110.5 kg) was significantly higher than Vitremer (86.6 kg) at P <.05. CONCLUSIONS: For the cements studied, only crowns cemented with Advance cement demonstrated fracture during 2-month storage. Results for the true resin-modified glass ionomer cements do not support anecdotal reports of fracture of all-ceramic crowns cemented with these materials.

Cementation↗
PubMed2001

[Clinical application of metabolic bone markers for fracture - effects of fracture on metabolic bone markers -].

The process of fracture healing can be divided into three distinct stages - inflammatory, reparative and remodeling stages. The changes of bone formation and bone resorption in the process of fracture healing are expected to be more dynamic than those changes which occur in the remodeling cycle alone because of aging. Bone formation and bone resorption markers increased 1 or 2 weeks after fracture. Bone resorption markers returned to the baseline level at 24 weeks after fracture, while values of bone formation marker were still higher compared to the baseline level at 24 weeks after fracture. It is suggested that bone metabolism is still activated at 24 weeks after fracture. In the acute phase after fracture, many factors such as bed rest, skin incision, intramedullay reaming during operation, could modify the values of bone resorption and bone formation markers. Therefore, clinical application of metabolic bone markers for fracture might be useful in the remodeling stage after fracture.

English Abstract↗
PubMed2005

Marked initial displacement predicts complications in physeal fractures of the distal radius: an analysis of fracture characteristics, primary treatment and complications in 109 patients.

BACKGROUND: Factors predicting redisplacement in the cast and early complications in distal radial physeal injuries have not been analyzed before. PATIENTS AND METHODS: We analyzed 109 consecutive children with displaced physeal fractures of the distal radius treated by manipulation under anesthesia RESULTS: Acute carpal tunnel syndrome developed in 2 patients. Posttraumatic swelling necessitating trimming, splitting or removal of the primary circular cast occurred in one-sixth of the patients. Half of the fractures healed in malunion despite an anatomic primary reduction in 85% of the cases. According to logistic regression models, marked initial malposition of the fracture (< 50% displacement or < 20% angulation) was an independent risk factor for complications and redisplacement. Non-anatomic reduction of the fracture was an additional independent risk factor for redisplacement. INTERPRETATION: The risk of an acute carpal tunnel syndrome should be remembered in patients with marked primary displacement of the fracture. To avoid redislocation, pin fixation of the fracture in patients close to skeletal maturity should be considered if there is a marked initial malposition of the fracture, or if fully anatomic reduction cannot be achieved.

Adolescent↗
PubMed1993

[Indications and incidence of spongiosa transplantation in open fractures: analysis of 470 open fractures].

From a prospective series of 651 open fractures, treated at the institution of the authors in the years 1984-1989, 124 cancellous bone grafts in 470 open long bone fractures--651 open fractures excluding amputation after Type III open fractures, excluding traumatic amputations and open fractures of the ankle joint and foot--were analyzed using approximately 155 variables per individual fracture to deduct the influencing factors for indication and frequency of bone grafts. As a result of this analysis it could be shown that bone grafting depends significantly on variables describing the bone injury as well as the type of fixation used. The frequency of bone grafts in this series was much higher than stated in the literature. The time of surgery for bone grafting depends on the type of fixation used, the concomitant soft tissue injury and the amount of primary bone loss. In contrast to the literature the analysis revealed that for good indications the use of allogeneous bone grafts in open fractures is possible.

Adult↗
PubMed1999

Larger increases in bone mineral density during alendronate therapy are associated with a lower risk of new vertebral fractures in women with postmenopausal osteoporosis. Fracture Intervention Trial Research Group.

OBJECTIVE: To investigate whether the incidence of vertebral fractures is related to the magnitude of change in bone mineral density (BMD) during alendronate treatment. METHODS: Women in this study were age 55-81 years (n = 2,984). While participating in the Fracture Intervention Trial, they received 5 mg/day of alendronate for 2 years followed by 10 mg/day for the remaining 12-30 months of the study. Their BMD was measured at baseline and at 12 and 24 months, and spine radiographs were obtained at baseline and again at 36 or 48 months to identify new vertebral fractures. RESULTS: After 12 months of alendronate treatment, 35% of participants had increases of > or =3% in total hip BMD, and 21% had either decreased total hip BMD or no change. Women who had larger increases in total hip BMD during the first 12 months had a lower incidence of new vertebral fractures during the entire followup period. Only 3.2% of women with increases of > or =3% in total hip BMD experienced new vertebral fractures, whereas twice as many women (6.3%) whose BMD declined or stayed the same experienced new fractures (adjusted odds ratio 0.45, 95% confidence interval 0.27-0.72). Similar patterns were observed for spine BMD at 12 months, and for both sites using change in BMD at 24 months. CONCLUSION: Women with increases of > or =3% in BMD during the first 1 or 2 years of alendronate treatment had the lowest incidence of new vertebral fractures. These findings suggest that, among women taking antiresorptive agents, greater increases in BMD are associated with lower risk of new vertebral fractures.

Aged↗
PubMed1997

Evaluation of bone turnover in postmenopause, vertebral fracture, and hip fracture using biochemical markers for bone formation and resorption.

The purpose of this study is to evaluate bone turnover in postmenopausal status and established osteoporosis with vertebral fracture and hip fracture by assessing bone biochemical markers. Subjects were 50 healthy premenopausal subjects, 44 healthy postmenopausal subjects, 30 osteoporotic patients with vertebral fracture, and 31 osteoporotic patients with hip fracture. Alkaline phosphatase, osteocalcin, PICP, ICTP, NTx, free deoxypyridinoline, total pyridinoline and deoxypyridinoline were measured. In postmenopause, both Z-scores of bone formation markers and resorption markers were around 1-2. In osteoporosis, although Z-scores of bone formation markers were 0.4-2.8, resorption markers were 2.3-9.5. Moreover, Z-scores of resorption markers were higher in hip fracture than in vertebral fracture. These results indicate that bone formation and resorption increased and balanced in postmenopausal status. However, bone resorption increased more than bone formation and did not balance at all in osteoporosis. This imbalance is greater in hip fractures than in vertebral fractures.

Adult↗
PubMed2006

Incidence of hip fracture in southeastern Norway: a study of 1,730 cervical and trochanteric fractures.

The incidence of hip fracture has been studied extensively, but there is still some doubt whether the age-specific incidence is increasing. The proportion of trochanteric fractures has varied and has also been said to be increasing. We studied data on 1,730 prospectively registered cases from 1998-2003 and computed age- and gender-specific incidence rates for intracapsular and trochanteric fractures. The incidence of hip fracture for women over 50 years was 1,263 and for men 452 per 100,000. The proportion of trochanteric fractures was 38% for women and 41% for men. There was no significant difference in the proportion of trochanteric fractures either between or within the genders, and the proportion did not exceed 50% in any age group. These findings confirm the high incidence of hip fracture in Norway but do not indicate any increase. The proportion of trochanteric fractures also seems to be stable.

Adult↗
PubMed1995

Being overweight and multiple fractures are indications for operative treatment of humeral shaft fractures.

Excellent clinical results can be obtained with non-operative treatment of humeral shaft fractures. In certain patients, operative stabilization is the treatment of choice. This study was initiated to determine the results of non-operative treatment in relation to multiple fractures and being overweight. From 1985 to 1992 we treated 35 humeral shaft fractures in 34 patients by non-operative methods. The median age was 51 (18-84) years. There were 12 women and 22 men. Nine were in overweight patients and 11 were in patients with multiple fractures. Fractures in overweight patients were followed for 158 (60-597) days and the Neer score was 61 (50-72) points. Patients with multiple fractures were followed for 178 (52-970) days and the Neer score was 72 (38-96) points. Single fractures in non-overweight patients were followed for 70 (35-412) days and the Neer score was 94 (65-100) points. These results show that humeral shaft fractures in certain patients may best be treated by operative stabilization.

Adolescent↗
PubMed2005

Asymmetrical fracture fixation: stability of oblique fractures is influenced by orientation.

BACKGROUND: Although clear differences in fracture site displacement have previously been demonstrated between transverse and oblique fracture models stabilised by an asymmetrical method, the direction of the obliquity has not been examined biomechanically. METHODS: Eight Sawbones tibiae were cut to represent oblique fractures: four ran from antero-inferior to postero-superior and four from antero-superior to postero-inferior. These were fixed with a Sheffield Ring Fixator and cyclically loaded in axial and off-axis compression. Direct measurements were taken of inter-fragmentary displacement. RESULTS: Significant differences were detected between the fracture directions (P < 0.01) and inter-fragmentary displacements were generally reduced in antero-superior to postero-inferior fractures compared with antero-inferio to postero-superior fractures. INTERPRETATION: Fixation asymmetries need to be tailored to specific fracture orientation to improve fracture site mechanics.

Anisotropy↗