Context: Contemporary patients with primary hyperparathyroidism are diagnosed with milder disease than previously. Clinical and biochemical factors predictors with an impact on fracture incidence and bone mineral density after surgery have not been firmly established.
Objective: To investigate predictors of fracture incidence and bone mineral density preoperatively and after surgery for primary hyperparathyroidism (pHPT).
Design: Prospectively collected surgical cohort with matched population controls. Data were cross-linked with the Swedish National Patient Register, the Prescribed Drug Register, and the Cause of Death Register.
Setting: Tertiary referral center.
Patients Or Other Participants: Seven hundred nine patients with successful parathyroidectomy for pHPT and 2112 controls matched on sex, age, and municipality were included in the study.
Main Outcome Measures: Fracture incidence, absolute change, and ≥2.77% increase in bone mineral density of femoral neck, L2-L4, and distal third of radius at 1-year follow-up.
Results: Patients with pHPT had an increased fracture incidence before surgery but not after pHPT surgery. Fracture incidence after surgery was inversely related to preoperative 24-hour urine calcium (incidence rate ratio for the highest tertile 220- mg/d 0.29, 95% confidence interval 0.11-0.73). Serum and 24-hour urine calcium, parathyroid hormone, osteocalcin, and adenoma weight were all associated with bone mineral density recovery after surgery.
Conclusion: Twenty-four-hour urine calcium is the most important biochemical variable to predict a decreased fracture incidence and improved bone mineral density after surgery for pHPT.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570390 | PMC |
http://dx.doi.org/10.1210/clinem/dgae106 | DOI Listing |
Background Fragility fractures, often caused by osteoporosis, are a major public health concern among the growing population of the United Kingdom (UK). In addition to being a major source of illness and mortality, the rising incidence of osteoporosis places a heavy strain on healthcare systems if it is not adequately managed. In order to lower the risk of additional fractures, current guidelines place a strong emphasis on the timely evaluation and treatment of fragility fractures.
View Article and Find Full Text PDFRev Bras Ortop (Sao Paulo)
December 2024
Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, Paquistão.
Surgical procedures of curettage and surgical resection are used to treat giant cell tumor (GCT) of the distal radius, but it is still controversial whether one provides better functional outcomes than the other. The present study aims to determine and compare both procedures regarding complications, local recurrence, and mobility. A complete search of the applicable literature was done and independently assessed by three authors.
View Article and Find Full Text PDFArthritis Care Res (Hoboken)
December 2024
Taoyuan Psychiatric Center, Taoyuan City, Taiwan.
J Orthop Surg Res
December 2024
Department of Orthopedic Surgery, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.
Background: An open fracture of the tibia is one of the most common and dangerous type of open fractures. In the management of these injuries, the primary focus is on reducing the infection rate, as this is crucial for achieving the best clinical outcomes. This study aims to explore how provisional external fixation duration influences the rates of infection and union in open tibial shaft fractures.
View Article and Find Full Text PDFBMC Surg
December 2024
Department of Orthopedics, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou, Xiamen, 363000, China.
Purpose: This study aims to investigate the risk factors for postoperative complications following Femoral Neck System (FNS) fixation in young patients with femoral neck fractures (FNFs).
Methods: We retrospective analyzed 133 patients with FNFs who underwent FNS fixation between May 2021 and October 2023. Potential risk factors that may affect the results included age, gender, body mass index (BMI), Pauwels classification, Garden classification, fracture anatomical classification, reduction method, reduction quality, coronal plane position of the FNS bolt.
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