Fractures in myelomeningocele.
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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.
Analysis of Variance
Femoral Neck Fractures
Fracture Fixation, Internal
Injury Severity Score
Published Version (Please cite this version)10.1007/s10195-010-0102-2
Publication InfoAbel, R; Akbar, M; Bresch, B; Bruckner, T; Carstens, C; Fürstenberg, CH; ... Seyler, Thorsten M (2010). Fractures in myelomeningocele. J Orthop Traumatol, 11(3). pp. 175-182. 10.1007/s10195-010-0102-2. Retrieved from https://hdl.handle.net/10161/10374.
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Assistant Professor in Orthopaedic Surgery
Based on a recent market research survey, the U.S. demand for implantable medical devices is forecast to increase 7.7% annually to $52 billion in 2015. While orthopedic implants remain the largest segment, implantable devices are frequently used in urology, cardiovascular specialties, neurology, gynecology, and otolaryngology. With the increased usage of implantable devices, the number of biofilm-associated infections has emerged as a significant clinical problem because biofilms are oft
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