Essay on The Three Most Common Pathologic Fractures

Essay on The Three Most Common Pathologic Fractures

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Wheeless, 2013 described pathologic fractures as occurring as a result of low energy impact through an area of weak bone with a pre-existing abnormality. An example of pathologic fractures would be fragility fractures, a common clinical manifestation of osteoporosis. The three most common fragility fractures are hip fractures, vertebral fractures and Colles’ fracture. A study published recently found that the single largest cause of fractures in the elderly population was fall from standing height (Amin, Achenbach, Atkinson, Khosla, & Melton, 2013) which is a definition of fragilty fractures according to the National Osteoporosis Foundation.
About 81% of all fractures in women aged 50 and above are fragility fractures. A history of fragility fracture after the age of 40 increases the risk of future fractures. Depending on the age and the number and site of fracture, the associated increase in risk is 1.5 to 9.5 fold. It has been estimated that by 2050, the incidence of hip fractures alone will reach 6.3 million worldwide due to the aging population. A quarter of these patients will die within a year of sustaining the fracture (Giangregorio, Papaioannou, Cranney, Zytaruk, & Adachi, 2006). Fragility fractures are also associated with an increase in healthcare costs. In 2007 alone, there were approximately 84,000 osteoporotic fractures in New Zealand. A total of NZD212mil was used to treat the fractures, and an additional 85mil NZD for after-fracture care with the figures expected to increase in the future (Brown, McNeill, Leung, Radwan, & Willingale, 2011).
Fracture union is the endpoint of successful bone healing, but this does not always occur as fractures can progress to delayed or non-unions. According to Harwood et al., 2010, t...


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... with tibial shaft fractures developed non-unions. These patients were found to have an increased risk of future fractures in a 2-year follow up, longer opioid use and were more likely to need physical therapy (Antonova, Le, Burge, & Mershon, 2013). This causes significant financial strain on the healthcare system.
The aim of management in fractures is to provide adequate stability and support to the poor biological environment surrounding the delayed or non-union. The technique used is dependent on the type of non-union and the alignment of fracture fragments (Panagiotis, 2005). For large bone defects, the current gold standard treatment is autografting, where donor bone is harvested, usually from the iliac crest, and transplanted into the defect site. This is, however, impeded by limited harvest site. An alternative strategy is therefore desirable (Stevens, 2008).

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