| 1. |
- Obrant, Karl
(författare)
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Orthopedic treatment of hip fracture
- 1996
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Ingår i: Bone. - : Elsevier BV. - 1873-2763 .- 8756-3282. ; 18:3 Suppl, s. 145-148
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Tidskriftsartikel (refereegranskat)abstract
- There are those who advocate nonoperative treatment of impacted femoral neck fractures, but in general there is consensus that surgery is the treatment of choice for both trochanteric hip fracture and femoral neck fracture. As for trochanteric fractures, modern results after internal fixation are characterized by only a low percentage of secondary operations, even for unstable fractures and when full weight bearing is permitted immediately after operation. The high rates of complication after internal fixation of femoral neck fractures and the insignificant improvement of these results over the decades have made prosthetic replacement an alternative method of treatment, at least for dislocated femoral neck fractures. Until a quantifiable prognostic method to judge whether a given femoral neck fracture will heal is available, and until sufficiently large, prospective techniques have been undertaken, diverging opinions about the operative treatment of choice will persist.
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| 2. |
- Löfman, Owe, et al.
(författare)
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Bone mineral density in normal Swedish women
- 1997
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Ingår i: Bone. - 8756-3282 .- 1873-2763. ; 20:2, s. 167-174
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Tidskriftsartikel (refereegranskat)abstract
- We examined 429 women, aged 20–80 years, randomly selected from the population register to establish normal values for bone mineral density (BMD) in Swedish women. BMD of the spine and hip was measured by dual-energy X-ray absorptiometry (DEXA; Hologic QDR 1000) and in the forearm by single photon absorptiometry (SPA; Molsgaard ND-1100). The recalled age of menarche was negatively correlated to BMD at all ages. There was no significant change in BMD from 20–49 years at any site except a slight decline at Ward's triangle. Bone loss was rapid at all sites during the first decade after menopause. Thereafter, BMD declined slowly in the trochanter and total hip but more rapidly in the forearm, femoral neck, and Ward's triangle. BMD in the spine even increased in the eighth decade probably due to osteoarthritis. The average change in forearm BMD during the 15 perimenopausal years comprising mean age for menopause ± 2 SD (43–57 years) was −0.4% per year in premenopausal females and −1.6% per year in postmenopausal females. The corresponding annual percental change was, for the spine, +0.2 and −1.7; neck, −0.7 and −1.7; trochanter, +0.5 and −1.5; and Ward's triangle, −0.1% and −2.2%, respectively. Our normal values for lumbar spine BMD prior to menopause did not differ from published values or the manufacturer's normal values; however, our spine BMD values for the first decade after menopause were significantly lower (≈10%) than in other studies. Our femoral neck BMD values for younger women were, like those of several other groups, significantly lower than the manufacturer's normal values, but our sample of young women in this study was small. The prevalence of osteoporosis, if defined as t score < −2.5 is highly dependent on the sampling of the reference population of young adult women, and also on the choice of skeletal site. Further studies on bone mineral density in healthy young adult women are needed.
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| 3. |
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| 4. |
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| 5. |
- Karlsson, K M, et al.
(författare)
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Femoral neck geometry and radiographic signs of osteoporosis as predictors of hip fracture
- 1996
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Ingår i: Bone. - 1873-2763. ; 18:4, s. 327-330
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Tidskriftsartikel (refereegranskat)abstract
- A total of 125 consecutive hip fracture patients were investigated regarding hip geometry. There were 33 men of mean age 76 +/- 10 years, and 92 women of mean age 78 +/- 9 years. Patients with previous hip surgery were excluded. Hip geometry (hip-axis length, width of collum femoris, and femoral shaft and neck-shaft angle) were registered on both plain radiographs and DEXA scans performed within 2 weeks after fracture. On the radiographs, the calcar femorale, the Singh index, and the femoral neck index (FNI) were also calculated and compared with earlier published values of bone mineral density hip in the hip fracture patients. The fracture cases were compared with controls, 192 DEXA scans and 163 radiographs, in patients without hip surgery or known hip disease. As measured on the DEXA scans we found a wider collum femoris and a wider femoral shaft in both the male and female fracture cases, compared to controls. Also, the fracture cases showed signs of osteoporosis as measured by the calcar femorale, the Singh index, and the femoral neck index. These measurements showed good correlation with bone mineral density of the hip as measured by the DEXA scans.
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| 6. |
- Karlsson, Magnus, et al.
(författare)
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Changes of bone mineral mass and soft tissue composition after hip fracture
- 1996
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Ingår i: Bone. - 1873-2763. ; 18:1, s. 19-22
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this prospective longitudinal study was to measure prospectively the bone mineral density (BMD) and anthropometric variables after a hip fracture. In particular, we studied changes in the BMD in both the injured and uninjured hips, and examined if the postoperative mortality rate and complications, including pseudarthrosis of the fracture and late segmental collapse of the head of the femur, could be predicted by early bone mass measurements. The bone mineral density and the body composition were measured with dual energy X-ray absorptiometry in 102 consecutive hip fracture patients, 31 men and 71 women, with a mean age of 74 and 79 years, respectively. All cases were operated on within 3 days. The measurements were undertaken within 10 days after the fracture, after 4 and after 12 months. The BMD of the hip fracture cases decreased, especially in the lower extremities where the patients lost 7%, during the first year after the fracture. The patients also lost lean body mass (5%) but gained fat (11%) during the same period. They lost significantly more bone mass in the fractured hip than in the uninjured hip (p < 0.05). No difference was found between those patients who survived and those who died within 2 years after their hip fracture in neither the initial measurement nor in the follow-up measurements. Also, we found no difference between those patients whose hip fracture healed and those who developed late segmental collapse or pseudarthrosis. In conclusion, osteoporotic hip fracture cases lose bone mass at an increased rate, especially in the fractured hip. Also, their soft tissue composition changes, gaining fat while losing muscle mass. Furthermore, it seems that early bone mineral measurements cannot predict postoperative failures or postoperative mortality.
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| 7. |
- Nyquist, Fredrik, et al.
(författare)
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Biochemical markers of bone metabolism after short and long time ethanol withdrawal in alcoholics
- 1996
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Ingår i: Bone. - 1873-2763. ; 19:1, s. 51-54
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Tidskriftsartikel (refereegranskat)abstract
- The etiology of ethanol-associated osteopenia is not fully understood. A direct inhibitory effect of ethanol on osteoblast function has been suggested by in vitro and in vivo studies. In this study, we measured biochemical markers for bone formation (osteocalcin, bone specific alkaline phosphatase, procollagen-1-c-terminal peptide) and resorption (c-terminal telopeptide and urine deoxypyridinoline) in 18 otherwise healthy, but severely alcoholic men during a 10-day period of alcohol withdrawal. The same tests were performed in a group of 18 male abstainers, with more than 5 years of proven alcohol withdrawal. The results were compared with 29 male controls, randomly selected. In the group of alcoholics, osteocalcin (Oc) was significantly decreased at day 1 (p > 0.001; compared with controls). The low serum Oc levels normalized during the observation period and no significant difference was seen after 10 days. After a 5-year withdrawal, the bone-specific alkaline phosphatase was increased (p = 0.040) and there was a tendency, but not significant, of a persistent high level of Oc when compared with controls. A significant increase in fasting urinary secretion of deoxypyrodinoline was seen among the alcoholics (p = 0.001 compared with controls). The increase did not normalize during the 10-day observation period. Also, the abstainers had a significantly higher fasting urinary secretion of deoxypyridinoline after a 5-year alcohol withdrawal (p = 0.022 compared with controls). The present study suggests that there is an imbalance between bone formation and bone resorption among alcoholics that could result in rapid bone loss. Although most directions tended to normalize shortly after alcohol withdrawal, biochemical data suggest that there may still be a persistent high bone turnover after more than 5 years.
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| 8. |
- Åkesson, Kristina, et al.
(författare)
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Serum osteocalcin increases during fracture healing in elderly women with hip fracture
- 1995
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Ingår i: Bone. - : Elsevier BV. - 1873-2763. ; 16:4, s. 427-430
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to define the bone metabolic properties during the postfracture period in elderly women with hip fracture. Osteocalcin (Oc), a marker of bone formation, was measured in 58 women with hip fracture (77 +/- 7 years) admitted to the hospital from their own homes. Serum samples were taken on average 5 h (range 1-21) from fracture and at follow-up, on average 4.6 months later. Comparison was made with 58 age-matched (79 +/- 5 years) women. Women with hip fracture had initially 30% lower Oc levels compared to the controls (p = 0.0001). The Oc level was independent of time elapsed from trauma, within 18 h, after which the level further decreased. At follow-up, Oc showed a 44% increase (p = 0.0001) and had reached the level of the controls, but not beyond it. A concomitant, but less marked increase was noted for alkaline phosphatase (ALP) (p = 0.0001). We conclude that although the bone formation, as assessed by Oc, is apparently lower in elderly women who sustain a hip fracture, the ability to induce a fracture response, with an increased bone turnover during fracture healing is intact. Subsequently, it is essential that a time perspective is applied, as the bone metabolic changes in patients having sustained a fracture are related to the time elapsed from fracture.
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| 9. |
- Luo, Y., et al.
(författare)
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Molecular length dependence of optical properties of hydrocarbon oligomers
- 1998
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Ingår i: Chemical Physics Letters. - : Elsevier BV. - 0009-2614 .- 1873-4448. ; 285:3-4, s. 160-163
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Tidskriftsartikel (refereegranskat)abstract
- It is demonstrated that common power law dependencies for the energy gap, the polarizability, and the hyperpolarizability can be obtained for shorter hydrocarbon oligomers if the molecular length is used as the basic structural parameter.
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