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Gãy xương do loãng xương

Giảm Bởi vì sức mạnh tổ chức các tấm-và-vít cố định trong gãy xương do loãng xương, cố định nội bộ có thể có tỷ lệ thất bại cao, từ 10% đến 25%. Vít Được đặt vào xương vỏ não có khả năng kháng tốt hơn rút quân làm hơn Những Được đặt vào xương trabecular liền kề. | Internal Fracture Fixation in Patients With Osteoporosis Charles N. Cornell MD Abstract Because of the decreased holding power of plate-and-screw fixation in osteoporotic bone fractures internal fixation can have a high failure rate ranging from 10 to 25 . Screws placed into cortical bone have better resistance to pullout than do those placed into adjacent trabecular bone. Plates should not be used to bridge unstable regions of bony comminution in osteoporotic patients. Fixation stability is optimized by securing stable bone contact across the fracture site and by placing screws both as close to and as far from the fracture as possible. Intentional shortening can improve stability and load sharing of the fracture construct. Structural bone graft or other types of fillers can be used to fill voids when comminution prevents stable contact. Load-sharing fixation devices such as the sliding hip screw intramedullary nail antiglide plate and tension band constructs are better alternatives for osteoporotic metaphyseal locations. Proper planning is essential for improved fracture fixation in this high-risk patient group. J Am Acad Orthop Surg 2003 11 109-119 Osteoporosis is a systemic disease characterized by decreased bone mass and deteriorated bone microarchitecture. In the elderly 65 years it is a contributing factor in 75 of fractures caused by low-energy falls.1 Fractures resulting from osteoporosis generally involve the metaphyseal regions of the skeleton. These regions are affected earlier and more profoundly during the development of osteoporosis because they are composed mostly of cancellous bone which has a greater surface area for bone turnover compared with the compact cortical bone of the diaphysis. In the United States 1.5 million fractures are reported annually most from low-energy falls including 300 000 proximal femur fractures 250 000 distal radius fractures and 300 000 fractures in other bones affected by osteoporosis. Of the 28 million Americans with .