Awareness of Osteoporosis among Postmenopausal Women in Najran Region, Saudi Arabia: A Cross-Sectional Study
Rashed Salem Alqudhaya1, Saleh Yousef Alyami2*, Salem Mohammed AlHashel2, Hidar Salem Alqudhaya2, Eibraheim Ahmad AlMardef2, Nemer Nasser AlMardef2, Mohammed Nasser AlMutlaq2, Ali Salem AlShaiban2, Ashjan Saeed AlMansour2, Yunus Salem Alyami3
1King Khalid Hospital, Najran city, Saudi Arabia
2College of Medicine, Najran University, Najran City, Saudi Arabia
3Medical Laboratory, Najran University, Najran city, Saudi Arabia
Introduction: Osteoporosis is characterized by a decrease in bone mass. Fractures due to osteoporosis are associated with chronic pain, limited mobility, increased mortality, and financial burdens. While osteoporosis is common in both genders, postmenopausal women are at increased risk. This study aims to evaluate the awareness of osteoporosis among postmenopausal women in the Najran region, Saudi Arabia, and to identify its associated factors.
Methods: This cross-sectional study was conducted from April to June 2024. It evaluated osteoporosis awareness among 313 postmenopausal women in Najran, Saudi Arabia, excluding postmenopausal women who work as healthcare providers on hormone replacement therapy and with mental limitations. An online questionnaire assessed demographic and osteoporosis-related characteristics using the Osteoporosis Knowledge Assessment Tool (OKAT), an Arabic valid and reliable tool, had 20 questions rated on a three-point Likert scale (true, false, and I don’t know).
Results: Out of 701 women, only 313 postmenopausal women were included. The median age was 53 years. Seventy-five percent (236) were married,145 (46%) had a university education or higher and 162 (52%) were housewives. Thirty-six percent (114) and 98 (31%) had a personal and family history of osteoporosis, respectively. The median age at puberty was 13 years, and 226 (72%) reported a history of regular menses previously. The mean knowledge score was 8.965±3.406. Among the participants, 43.5% had good knowledge of osteoporosis. Higher education levels were significantly associated with better knowledge (p=0.030), with those with a university education scoring higher than those with lower education levels.
Conclusion: Although 43.5% of participants demonstrated good knowledge of osteoporosis, the majority had poor knowledge, highlighting a significant gap in awareness that needs to be addressed through targeted educational interventions
DOI: 10.29245/2767-5130/2024/3.1206 View / Download PdfPrevalence and Associated Factors of Nonunion in Open Tibial Shaft Fracture among Patients Treated with External Fixation in Tibebe Ghion Specialized Hospital
Abiy Misganaw1, Worku Belay2, Getachew Hailu3, Tadesse Misganaw4*
1Department of Surgery, Dessie Comprehensive Specialized Hospital, Ethiopia
2Department of Orthopedics & Trauma Surgery, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia
3Department of Epidemiology, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia
4Department of Medical Laboratory Sciences, College of Health Sciences, Woldia University, Ethiopia
Background: The definitive treatment of open tibial shaft fractures remains challenging and nonunion after treatment of open tibial shaft fractures with external fixation complicates a significant proportion of cases. There are varying rates of occurrence of nonunion and the prevalence is not well known in Ethiopia. The objective of the study is to assess the prevalence and associated factors of nonunion in open tibial shaft fractures treated with EX FIX in TGSH.
Methods: The study was conducted using a cross-sectional study in patients with open tibial shaft fractures who were admitted and treated with external fixation in the Tibebe Ghion Specialized Hospital orthopedics department from January 1, 2019, to January 29, 2021. The study involved 75 patients, which was the total number of cases in the study period and fulfilled the inclusion criteria. Bivariate and multiple variable logistic regression analyses were used to analyze the association between variables. The degree of association between variables was determined at the p-value of <0.05.
Results: The overall prevalence of nonunion in open tibial shaft fractures treated with external fixation in TGSH was 21.3%. The severity of the injury, presence of wound infection, and treatment factors affect the occurrence of nonunion. It occurs in 9 of 19 (47.4%) Gustilo-Anderson grade IIIB fractures and 6 of 48 (12.5%) Gustilo-Anderson grade IIIA fractures. A delay in soft tissue covering of Gustilo-Anderson grade IIIB fracture of 15 days or more increases the nonunion rate to 72.7%. Nonunion occurred in 41.7% of cases with SSI and 11.8% of cases without SSI. Gustilo-Anderson grade (AOR=4.85, CI 95%: 1.31-18.01), surgical site infection (AOR=4.12, CI 95%: 1.11-15.26), and time until coverage of bone of Gustilo-Anderson grade IIIB fracture (AOR=18.23, CI 95%: 1.17-284.8) have statistically significant association with nonunion.
Conclusion and Recommendation: External fixation use for definitive treatment of open tibial fractures should be disfavored as the prevalence of nonunion in open tibial shaft fractures treated with EX FIX is higher than other previous studies done in European and Asian countries. Gustilo-Anderson grade of injury, surgical site infection, and time from injury to bone coverage of Gustilo-Anderson grade IIIB fractures were found to be statistically significantly associated with the occurrence of nonunion. Therefore, attention should be given to early soft tissue reconstruction of exposed bones to establish a favorable environment for bone healing and to make treatment with internal fixations possible. Better management of wounds to minimize surgical site infections is required for better healing of open tibial shaft fractures. Prospective studies are also recommended on the issue.
DOI: 10.29245/2767-5130/2024/2.1200 View / Download PdfMobilization after Fixation with Endobutton Device versus Transfixation Screw for Syndesmotic Disruption
Henry Kuechly*, Sarah Kurkowski, John Bonamer, Brian Johnson, Richard Smith, Nihar Shah, Augusto Roca, Jacob Meyer, Richard Laughlin
Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA
Background: Fitness trackers have been used to measure postoperative mobility following arthroplasty procedures, but there is no published research using fitness tracker data to compare mobilization following screw fixation versus dynamic fixation for syndesmotic ankle injuries. The objective of this study was to measure steps and activity levels following syndesmotic fixation with either endobutton fixation or screw fixation using a wearable fitness tracker.
Methods: Patients that underwent operative management of ankle fractures with syndesmotic disruption using either a transfixation screw or endobutton were provided a Fitbit Inspire to electronically track their steps and activity level.
Results: Patients treated with endobutton fixation device had statistically significantly more mean daily steps and more mean daily very active minutes than patients treated with screw fixation at the 3, 4, 5, and 6-month time points and 4, 5, and 6 month time points respectively (p<0.05).
Conclusion: Patients with ankle fractures treated with endobutton device for syndesmotic fixation have earlier and higher levels of mobilization during the first 6 postoperative months than those treated with transfixation screw as measured by a fitness tracker. Fitness trackers are increasing in popularity and the data gathered from these devices contains significant potential for creating patient specific rehabilitation guidelines that may ultimately improve patient functional outcomes postoperatively.
DOI: 10.29245/2767-5130/2024/2.1201 View / Download PdfWeight Changes after Ankle Fracture Surgery: A Retrospective Cohort Study
Cameron G Thomson1,2, Henry A Kuechly1*, Garrett Gordon1, Jorge Figueras1,3, Tristian Epley4, Richard Laughlin1
1Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
2Department of Orthopaedics, Warren Alpert Medical School at Brown University, Providence, RI, USA
3Department of Orthopaedic Surgery, Keck School of Medicine at University of Southern California, Los Angeles, CA, USA
4Ohio University College of Osteopathic Medicine, Cleveland, OH, USA
Background: Recovery from open reduction internal fixation of the ankle frequently involves a decrease in activity level and some limitations in weightbearing. The purpose of this study was to evaluate weight changes during the postoperative period following ankle fracture surgery.
Methods: Hospital billing records were retrospectively reviewed to identify all patients who underwent open reduction internal fixation of bimalleolar and trimalleolar ankle fractures at our hospital system between January 1, 2018 and June 30, 2021. Weight data from outpatient encounters coinciding with the 3-month, 6-month, and 1-year postoperative time points were recorded and analyzed.
Results: 56 patients had complete weight data. The mean age at surgery was 44.6±16.2 years. There were 27 women and 29 men. At time of surgery, the mean weight was 197.2.3±53.9 lbs and BMI was 30.3±7.1 kg/m2. At 1 year postoperative, the mean weight was 219.2±51.6 lbs and BMI was 33.8±7.0 kg/m2, representing statistically significant increases of 22.0 lbs and 3.4 BMI points compared to preoperative (p=0.0491 and 0.0330, respectively). On subgroup analysis of different preoperative BMI groups (<25, 25-29, 30-34, and ≥35), only those patients with a pre-operative BMI of <25 experienced statistically significant increases in weight and BMI, 27.9 lbs and 4.8 kg/m2 respectively (p=0.029 and p=0.001).
Conclusion: This is the first study to evaluate weight changes following ankle fracture. This study showed that at 1 year patients recovering from ankle open reduction internal fixation gain an average of 22 lbs and 3.4 BMI points. Patients with a pre-operative BMI of <25 are subject to statistically significant increases in weight. We recommend monitoring patients’ weight and counseling them on the risks of weight gain. Further research is necessary to better characterize the risk of weight gain following orthopedic surgery.
Level of Evidence: 4 (retrospective cohort)
DOI: 10.29245/2767-5130/2024/2.1202 View / Download PdfThe Prevena Restor Bella.FormTM in the management of lower limb traumatic wounds
Oliver Miles1*, Eugenia Koulaeva2, Sally Ng1,2
1Department of Plastic and Reconstructive Surgery, Austin Health, Heidelberg, Australia
2Department of Plastic and Reconstructive Surgery, Eastern Health, Box Hill, Australia
Objectives: The Prevena Restor Bella.FormTM is a novel closed incisional negative pressure wound therapy with a 14 day lifespan and a large contact area. This study aims to demonstrate the utility of the Prevena Restor Bella.FormTM in high risk lower limb traumatic wounds.
Methods: 4 consecutive patients with complex traumatic lower limb wounds were included. The Prevena Restor Bella.FormTM was applied as a primary therapy or an adjunct to soft tissue reconstruction. Wounds were monitored fortnightly, limb circumference measured and patient satisfaction assessed by a questionnaire. All 4 patients healed within 6 weeks of Prevena application.
Results: No cases developed wound complications. Limb oedema, assessed by circumference, decreased in all patients within 2 weeks. All patients were satisfied with the Prevena Restor Bella.FormTM with regards to comfort and mobility.
Conclusions: Prevena Restor Bella.FormTM demonstrated clinical effectiveness in all patients, and was universally well tolerated.
Level of Evidence: IV
DOI: 10.29245/2767-5130/2024/2.1199 View / Download PdfAdipose Derived Stem Cells in Orthopaedics: History and Current Applications
Brian Johnson, Rajul Gupta, Bret Betz, Henry Kuechly*, Sarah Kurkowski, Brian Grawe
Department of Orthopaedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati, Ohio, USA
Context: Some studies have shown promising results with adipose-derived stem cell treatments for orthopaedic problems as a nonsurgical treatment option or an augmentation of surgical treatment.
Purpose: Review of the history and background, preparation methods, and current applications of adipose-derived stem cells in orthopedics. Provide critical appraisal of the available evidence for the use of Adipose Derived Stem Cells.
Results: Most of the studies utilizing adipose-derived stem cells are case series or meta-analyses with a small number of studies, therefore presenting a risk of selection bias. In cases of femoral head avascular necrosis and meniscal repair, no systematic review or meta-analysis has been published and available evidence is derived from smaller studies. Almost every review article concluded that large, multicenter, randomized control trials are needed to establish the value of adipose-derived stem cells in orthopaedics.
Conclusion: There is a need in orthopaedics for treatment modalities that increase biological healing potential for some pathologies and adipose derived stem cells represent a potential modality for such a purpose. However, there is a lack of high quality and robust evidence regarding the efficacy and safety of this treatment modality in orthopaedic applications. The use of adipose derived stem cells in orthopaedics requires additional studies of higher quality before they can be considered an appropriate treatment option.
Strength of Recommendation: Level C for use of Adipose-derived stem cells in orthopaedics.
DOI: 10.29245/2767-5130/2024/2.1197 View / Download Pdf