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Fractures in myelomeningocele
BACKGROUND: In patients with myelomeningocele (MMC), a high number of fractures occur in the paralyzed extremities, affecting mobility and independence. The aims of this retrospective cross-sectional study are to determine the frequency of fractures in our patient cohort and to identify trends and r...
Autores principales: | , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948122/ https://www.ncbi.nlm.nih.gov/pubmed/20721596 http://dx.doi.org/10.1007/s10195-010-0102-2 |
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author | Akbar, Michael Bresch, Bjoern Raiss, Patric Fürstenberg, Carl Hans Bruckner, Thomas Seyler, Thorsten Carstens, Claus Abel, Rainer |
author_facet | Akbar, Michael Bresch, Bjoern Raiss, Patric Fürstenberg, Carl Hans Bruckner, Thomas Seyler, Thorsten Carstens, Claus Abel, Rainer |
author_sort | Akbar, Michael |
collection | PubMed |
description | BACKGROUND: In patients with myelomeningocele (MMC), a high number of fractures occur in the paralyzed extremities, affecting mobility and independence. The aims of this retrospective cross-sectional study are to determine the frequency of fractures in our patient cohort and to identify trends and risk factors relevant for such fractures. MATERIALS AND METHODS: Between March 1988 and June 2005, 862 patients with MMC were treated at our hospital. The medical records, surgery reports, and X-rays from these patients were evaluated. RESULTS: During the study period, 11% of the patients (n = 92) suffered one or more fractures. Risk analysis showed that patients with MMC and thoracic-level paralysis had a sixfold higher risk of fracture compared with those with sacral-level paralysis. Femoral-neck z-scores measured by dual-energy X-ray absorptiometry (DEXA) differed significantly according to the level of neurological impairment, with lower z-scores in children with a higher level of lesion. Furthermore, the rate of epiphyseal separation increased noticeably after cast immobilization. Mainly patients who could walk relatively well were affected. CONCLUSIONS: Patients with thoracic-level paralysis represent a group with high fracture risk. According to these results, fracture and epiphyseal injury in patients with MMC should be treated by plaster immobilization. The duration of immobilization should be kept to a minimum (<4 weeks) because of increased risk of secondary fractures. Alternatively, patients with refractures can be treated by surgery, when nonoperative treatment has failed. |
format | Text |
id | pubmed-2948122 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-29481222010-10-20 Fractures in myelomeningocele Akbar, Michael Bresch, Bjoern Raiss, Patric Fürstenberg, Carl Hans Bruckner, Thomas Seyler, Thorsten Carstens, Claus Abel, Rainer J Orthop Traumatol Original Article BACKGROUND: In patients with myelomeningocele (MMC), a high number of fractures occur in the paralyzed extremities, affecting mobility and independence. The aims of this retrospective cross-sectional study are to determine the frequency of fractures in our patient cohort and to identify trends and risk factors relevant for such fractures. MATERIALS AND METHODS: Between March 1988 and June 2005, 862 patients with MMC were treated at our hospital. The medical records, surgery reports, and X-rays from these patients were evaluated. RESULTS: During the study period, 11% of the patients (n = 92) suffered one or more fractures. Risk analysis showed that patients with MMC and thoracic-level paralysis had a sixfold higher risk of fracture compared with those with sacral-level paralysis. Femoral-neck z-scores measured by dual-energy X-ray absorptiometry (DEXA) differed significantly according to the level of neurological impairment, with lower z-scores in children with a higher level of lesion. Furthermore, the rate of epiphyseal separation increased noticeably after cast immobilization. Mainly patients who could walk relatively well were affected. CONCLUSIONS: Patients with thoracic-level paralysis represent a group with high fracture risk. According to these results, fracture and epiphyseal injury in patients with MMC should be treated by plaster immobilization. The duration of immobilization should be kept to a minimum (<4 weeks) because of increased risk of secondary fractures. Alternatively, patients with refractures can be treated by surgery, when nonoperative treatment has failed. Springer International Publishing 2010-08-19 2010-09 /pmc/articles/PMC2948122/ /pubmed/20721596 http://dx.doi.org/10.1007/s10195-010-0102-2 Text en © The Author(s) 2010 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. |
spellingShingle | Original Article Akbar, Michael Bresch, Bjoern Raiss, Patric Fürstenberg, Carl Hans Bruckner, Thomas Seyler, Thorsten Carstens, Claus Abel, Rainer Fractures in myelomeningocele |
title | Fractures in myelomeningocele |
title_full | Fractures in myelomeningocele |
title_fullStr | Fractures in myelomeningocele |
title_full_unstemmed | Fractures in myelomeningocele |
title_short | Fractures in myelomeningocele |
title_sort | fractures in myelomeningocele |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948122/ https://www.ncbi.nlm.nih.gov/pubmed/20721596 http://dx.doi.org/10.1007/s10195-010-0102-2 |
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